1,721,007 research outputs found
Informed consent in elderly people: assessing the patient’s decision-making capacity = Consenso informato al trattamento medico: valutazione della capacità decisionale del paziente anziano
Full text linkLa capacità di un paziente anziano di prendere delle decisioni mediche deve essere considerata sempre valida, indipendentemente dall’età. Quando il paziente, però, non è in grado di accettare o rifiutare un trattamento, non può comprendere e ricordare le informazioni ricevute e/o non può utilizzare tali informazioni quando deve esprimere la propria decisione, è necessario valutare la sua capacità decisionale mediante strumenti clinici obiettivi, poiché il consenso ottenuto da un paziente privo di capacità decisionale non è legalmente valido. Lo strumento per la valutazione della capacità decisionale dovrebbe essere semplice e di facile uso, obiettivo e replicabile; dovrebbe poter essere somministrato in breve tempo e, possibilmente, non richiedere alcun addestramento formale. MATERIALI E METODI Nel presente lavoro sono stati presi in considerazione i metodi di screening più frequentemente utilizzati per valutare la capacità decisionale del paziente: il MacArthur Competence Assessment Tool for Treatment (MacCAT-T), l’Aid to Capacity Evaluation (ACE) e il Mini Mental State Examination (MMSE). RISULTATI Il MMSE è uno strumento clinico di semplice utilizzo, non richiede una formazione specifica, può essere somministrato in meno di 10 minuti, è un test obiettivo e, anche se non è stato creato specificamente per valutare l’incapacità, utilizza punteggi facilmente fruibili dal medico. Il punteggio va da 0 a 30: un punteggio MMSE da 0 a 17 si associa a elevata probabilità di incapacità decisionale; un punteggio da 18 a 23 indica un lieve deficit cognitivo, mentre il punteggio da 24 a 30 riduce significativamente la probabilità di perdita dell’autonomia decisionale. CONCLUSIONI Il Mini Mental State Examination può essere considerato lo strumento clinico più adatto per il medico nella pratica quotidiana. Nei pazienti con un basso punteggio MMSE, che suggerisce la probabilità di mancanza di capacità decisionale, sarà necessario che il consenso alle procedure mediche sia concesso da un tutore legale o dall’amministratore di sostegno, secondo le leggi e la giurisdizione del paese coinvolto.OBJECTIVE Elderly patients are legally assumed to be competent to give consent to medical treatment. When patients are unable to make a decision on assenting or refusing treatment; if they cannot understand and remember the information provided, andor cannot use that information when considering their decision, the decision-making capacity of the patient should be evaluated with specific clinical tools, since consent obtained from an incompetent patient is invalid. The clinical tool should be simple and easy to use, be replicable, and should require a short administration time and, possibly, no formal training. MATERIALS AND METHODS We have considered frequently used clinical screening methods for cognitive impairment, such as the MacArthur Competence Assessment Tool for Treatment (Mac-CAT-T), the Aid to Capacity Evaluation (ACE) and the Mini Mental State Examination (MMSE), to evaluate the decision-making capacity of the patient. RESULTS The MMSE is a very simple bedside clinical tool, does not require specific training, takes less than 10 minutes to complete, is objective and uses scores indicating decreasing cognitive function. The scores range from 0 to 30: a MMSE score of 0 to 17 increases the likelihood of lack of capacity, a score of 18 to 23 indicates mild cognitive impairment, while a score of 24 to 30 significantly reduces the likelihood of incapacity. CONCLUSIONS The Mini Mental State Examination can be considered the clinical tool more suitable for the physician in the daily practice. In patients with a low MMSE score, suggesting likelihood of lack of capacity, it will be necessary that the consent to medical procedures be granted by a surrogate decision maker, according to the laws and jurisdiction of the country involved
Anaesthesiology and ethics : can the anaesthesiologist ameliorate simply and rapidly the assessment of decision-making capacity in the elderly?
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Variations on the Author
Full text link“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
Full text linkWe 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
Full text linkWe 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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Building indicators of innovation at sub-regional level. A comparative exercise on INNODEC provinces
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