1,721,014 research outputs found
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
End-of-Career Practice Patterns of Primary Care Physicians in Ontario
No full textIncomplete understanding of attrition from the physician workforce has hampered policy-makers’ efforts to achieve optimal alignment of the supply of physicians with population demand for medical services. This longitudinal study of Ontario primary care physicians uses health administrative data to characterize changes in physicians’ practice patterns over time. We examined the workload and scopes of practice of 21,240 physicians between 1992 and 2013. We found that physicians reduce their workloads gradually as they age, retiring from clinical practice at an average age of 70.5. Furthermore, we found that 60% of family physicians who stop providing comprehensive primary care continue to provide clinical services for an average of three years, with reduced workloads, before retiring fully. Our findings clarify the process of physician attrition from the workforce and will help to improve estimates of attrition and make physician workforce planning more accurate and effective
Chronic Disease Development and Multimorbidity Among Immigrants and Refugees in Ontario
No full textChronic diseases such as cancer, diabetes, cardiovascular and respiratory diseases are a global concern. In recent decades, Canada has also experienced a major increase in immigration. Yet, a detailed profile of chronic disease and multimorbidity risk patterns across different immigrant populations has been lacking in Canada. The purpose of this dissertation is to identify knowledge gaps in the scientific literature on the development of chronic conditions and multimorbidity across immigrant populations in Ontario, using population-based immigrant and health data housed at ICES.
The principal findings of this dissertation indicate that:
1. The risk of developing a chronic condition and multimorbidity was complex and varied by immigrants’ visa category and world region origin since:
a. Refugees had the highest risk of developing a chronic condition and multimorbidity (two or more co-occurring chronic conditions) compared to long-term Ontario residents.
b. There were differences in the risk of developing a chronic condition and multimorbidity by world regions of origin, when examined across different immigrant categories.
2. Hypertension and diabetes, and in combination with Chronic Obstructive Pulmonary Disease were the leading multimorbidity dyad and triad groups for all immigrant categories and long-term residents of Ontario.
3. The risk of developing a chronic condition increased among immigrants in more recent landing cohorts. The risk was highest among more recent refugees, and lower for family and economic class immigrants, when compared to long-term Ontario residents.
These findings provide evidence to inform public health policy and planning by highlighting the complexity and heterogeneity of health outcomes across immigrant populations. Knowledge generated from this work will inform policies and evidence-based decision-making aimed to address the threat of chronic diseases and reduce health disparities
Variations on the Author
Get PDF“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
Get PDFWe 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
Evaluation of the Equity of Primary Care Service Delivery Models in Ontario
No full textBackground: In health care services, equity is the delivery of similar care for similar needs (horizontal equity), and the delivery of more care for higher needs (vertical equity). This study assessed the extent to which primary care provision is equitable across gender, age and socioeconomic groups, and whether any observed disparity is associated with the type of primary care remuneration model to which a family practice belongs. Remuneration models include Fee For Service in which the physician is paid for each encounter, Salary where payment is fixed for the number of hours worked, and Capitation where payment is tied to the number of patients under the care of the provider, and very little or no additional compensation is provided for each patient encounter. // Methods: This thesis used data from a cross sectional study of 5,361 patients receiving care from practices (n) in which primary care providers were remunerated by Fee For Service (35), Salary (35), or Capitation (68). Multi-level linear or logistic regressions were used to assess the impact of gender, age and socioeconomic strata on quality of care. The quality of health service delivery and health promotion were assessed through surveys based on the Primary Care Assessment Tool (n=5,111). The quality of preventive care (n=4,108) and chronic disease management (n-514) were evaluated through chart abstraction using the Canadian recommendations for care as the standard. The analyses were conducted stratified by remuneration model to allow the impact of the model on the extent of disparity in quality of care between social strata to be assessed. // Results: Men and women reported similar quality of health service delivery. Women were significantly more likely to be up to date on their preventive care, but adherence to recommended guidelines for chronic disease management was better for men in the Fee For Service practices. Older individuals reported better health service delivery than younger ones. The quality of chronic disease management was also age dependent with better care delivered to individuals ages 60-69. Individuals of low income and education had better accessibility than those not disadvantaged in the Salaried model and Fee For Service, but not Capitation model. Despite their higher health risks, these individuals were not more likely to receive healthy lifestyle counseling. // Conclusions: Significant inequalities in the care of patients were found across social strata. In some cases, these inequalities are deemed appropriate; a justifiable response to differing health care needs. In other cases, they are deemed inappropriate and representing inequities in the delivery of care. Some of the observed disparities were present in one remuneration model but not others, suggesting that the payment approach may be contributing to these differences. The results raise the concern that the capitation remuneration structure may compromise accessibility
Evaluation of the Equity of Primary Care Service Delivery Models in Ontario
No full textBackground: In health care services, equity is the delivery of similar care for similar needs (horizontal equity), and the delivery of more care for higher needs (vertical equity). This study assessed the extent to which primary care provision is equitable across gender, age and socioeconomic groups, and whether any observed disparity is associated with the type of primary care remuneration model to which a family practice belongs. Remuneration models include Fee For Service in which the physician is paid for each encounter, Salary where payment is fixed for the number of hours worked, and Capitation where payment is tied to the number of patients under the care of the provider, and very little or no additional compensation is provided for each patient encounter. // Methods: This thesis used data from a cross sectional study of 5,361 patients receiving care from practices (n) in which primary care providers were remunerated by Fee For Service (35), Salary (35), or Capitation (68). Multi-level linear or logistic regressions were used to assess the impact of gender, age and socioeconomic strata on quality of care. The quality of health service delivery and health promotion were assessed through surveys based on the Primary Care Assessment Tool (n=5,111). The quality of preventive care (n=4,108) and chronic disease management (n-514) were evaluated through chart abstraction using the Canadian recommendations for care as the standard. The analyses were conducted stratified by remuneration model to allow the impact of the model on the extent of disparity in quality of care between social strata to be assessed. // Results: Men and women reported similar quality of health service delivery. Women were significantly more likely to be up to date on their preventive care, but adherence to recommended guidelines for chronic disease management was better for men in the Fee For Service practices. Older individuals reported better health service delivery than younger ones. The quality of chronic disease management was also age dependent with better care delivered to individuals ages 60-69. Individuals of low income and education had better accessibility than those not disadvantaged in the Salaried model and Fee For Service, but not Capitation model. Despite their higher health risks, these individuals were not more likely to receive healthy lifestyle counseling. // Conclusions: Significant inequalities in the care of patients were found across social strata. In some cases, these inequalities are deemed appropriate; a justifiable response to differing health care needs. In other cases, they are deemed inappropriate and representing inequities in the delivery of care. Some of the observed disparities were present in one remuneration model but not others, suggesting that the payment approach may be contributing to these differences. The results raise the concern that the capitation remuneration structure may compromise accessibility
Prediction of recurrence in prostate cancer following radiotherapy: Value of biomarkers microvessel density, MIB-1, P-53, BCL2, and Bax
No full textBackground. Standard traditional parameters relied on for estimating the risk of disease recurrence after curative radiotherapy in prostate cancer are stage, Gleason score and PSA.
Objectives. To elucidate the prognostic role of biomarkers: P-53, MIB-1, MVD, Bax and BCL2 in prostate cancer.
Method. Cox proportional hazard model was used to estimate the risk of disease progression associated with these biomarkers and develop models based on traditional parameters only or incorporating biomarkers. Models were compared for their predictive potential using Akaike information criteria and concordance index.
Results. Statistically significant associations were found between all biomarkers and risk of progression. MVD, Bax and Bax/BCL2 were independent predictors of outcome. Models incorporating biomarkers were superior to the traditional one in identifying patients at risk of local progression.
Conclusions. Biomarkers may be useful in forecasting the risk of local recurrence following radiotherapy in prostate cancer patients. The results require validation in a separate cohort
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