1,721,086 research outputs found

    Generating psychotropic drug exposure data from computer-based medical records

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    Purpose: To develop a methodology for extracting psychotropic drug exposure data from computer-based medical records and for generating drug exposure variables suitable for secondary use. Methods: In South-Verona, Italy, a registry including every patient receiving psychotropic medications is operating since 2004. The basic structure of the registry is the medication record. Each record stores data on a specific prescription, and patients with more than one prescription have more than one record. Results: The longitudinal history of drug use was described identifying consecutive prescriptions of a specific drug, concomitant prescriptions of a specific drug and distinct prescriptions of a specific drug. Consecutive prescriptions implies that the beginning of the second prescription coincides with the end of the first prescription, concomitant prescriptions implies that the beginning of the second prescription precedes the end of the first prescription, distinct prescriptions implies that a gap of at least 1 day exists between prescriptions. Using this framework of drug representation, we identified episodes of drug therapy, where each episode is constituted of consecutive and/or concomitant prescriptions. Within each episode, prescriptions were categorised into theoretical phases, where the beginning of the new phase always coincides with the end of the previous phase. On the basis of this data representation, a module operating in Access and using Visual Basic for Applications was developed for creating episodes and phases on a routine basis (available from authors). A graphical representation of this conceptual model is presented. Conclusion: The development of a simple methodology for extracting and generating drug exposure data suitable for secondary use will allow a better understanding of the beneficial and adverse consequences of psychotropic drug use in ordinary practice. © 2006 Elsevier Ireland Ltd. All rights reserved

    Using the GHQ-12 to screen for mental health problems among primary care patients: psychometrics and practical considerations

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    Abstract: Background: This study explores the factor structure of the Indonesian version of the GHQ-12 based on several theoretical perspectives and determines the threshold for optimum sensitivity and specificity. Through a focus group discussion, we evaluate the practicality of the GHQ-12 as a screening tool for mental health problems among adult primary care patients in Indonesia. Methods: This is a prospective study exploring the construct validity, criterion validity and reliability of the GHQ-12, conducted with 676 primary care patients attending 28 primary care clinics randomised for participation in the study. Participants’ GHQ-12 scores were compared with their psychiatric diagnosis based on face-to-face clinical interviews with GPs using the CIS-R. Exploratory and Confirmatory Factor Analyses determined the construct validity of the GHQ-12 in this population. The appropriate threshold score of the GHQ-12 as a screening tool in primary care was determined using the receiver operating curve. Prior to data collection, a focus group discussion was held with research assistants who piloted the screening procedure, GPs, and a psychiatrist, to evaluate the practicality of embedding screening within the routine clinic procedures. Results: Of all primary care patients attending the clinics during the recruitment period, 26.7% agreed to participate (676/2532 consecutive patients approached). Their median age was 46 (range 18–82 years); 67% were women. The median GHQ-12 score for our primary care sample was 2, with an interquartile range of 4. The internal consistency of the GHQ-12 was good (Cronbach’s α = 0.76). Four factor structures were fitted on the data. The GHQ-12 was found to best fit a one-dimensional model, when response bias is taken into consideration. Results from the ROC curve indicated that the GHQ-12 is ‘fairly accurate’ when discriminating primary care patients with indication of mental disorders from those without, with average AUC of 0.78. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the intended utility, with a Positive Predictive Value of 0.68 to 0.73 respectively. The screening procedure was successfully embedded into routine patient flow in the 28 clinics. Conclusions: The Indonesian version of the GHQ-12 could be used to screen primary care patients at high risk of mental disorders although with significant false positives if reasonable sensitivity is to be achieved. While it involves additional administrative burden, screening may help identify future users of mental health services in primary care that the country is currently expanding

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Early Intervention Programme for Young Adults in Northern Italy: A 10-Year Analysis of Socio-Demographic and Clinical Characteristics

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    Introduction: Early intervention represents an opportunity to contain psychological distress and intervene promptly on conditions that, otherwise, could assume a chronic course. Based on these observations, an early intervention programme for people 18-25 years old, the 'Progetto Giovani' (Youth Project), was implemented in two adult mental health services (AMHSs) in the northwest of Italy. Methods: This study aims to describe the socio-demographic and clinical characteristics of the patients included in the Youth Project from 1 January 2013 to 31 December 2022. A retrospective observational design was used. Results: In 10 years, 323 patients were taken into care. More than half (56.3%) were females; the mean age was 20.7 years (SD 2.3). The most frequent diagnosis was anxiety disorder (38%). Seventy per cent of subjects benefitted from psychological treatment, and 60.8% had a pharmacological prescription. In 87.8% of cases, the care pathway was ≤ 24 months, and more than two-thirds of the subjects did not go to another AMHS after discharge. More than 90% of subjects did not require hospitalisation in the psychiatric diagnostic and treatment service. Conclusions: These findings suggest that early intervention programmes may be a valuable tool for AMHSs to improve patient outcomes and reduce the burden on the healthcare system

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods
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