1,720,976 research outputs found
Expanding the Reach of Critical Care Pharmacists Globally*
No full textDrug therapy plays a key role in treating critical illness; the average ICU patient receives more than 30 different medications (1). Critical care clinicians are faced with numerous decisions each day regarding drug selection, dosing, administration, availability, cost, and monitoring. A failure to appropriately manage these complex issues increases the risk for patient harm. The intensivist-led, multidisciplinary team (MDT) has been embraced as a model of care for the critically ill by clinicians, hospitals, and outside stakeholders (2)
Comparing opioid exposure and associated risk factors in adult patients admitted to ICU or HDU following right hemicolectomy
No full textIntroduction: following right hemicolectomy, patients at University Hospital Southampton (UHS) NHS Foundation Trust are often admitted to the intensive care unit (ICU) or high dependency unit (HDU). This decision is based on patients’ underlying co-morbidities and surgical complexity. Pain management here consistently features strong opioids (fentanyl, morphine, oxycodone) and adjuvant agents (paracetamol, regional anaesthesia) [1]. Postoperative opioid exposure and its associated risk factors are important to establish given opioids’ safety profile. There is a potential risk of relative overdose in intensive care where mechanical ventilation precludes titration to effect, though this has not yet been examined rigorously.Objectives: to compare patients’ opioid consumption within 24 hours of admission to an ICU or HDU following right hemicolectomy and identify clinically relevant factors associated with this opioid use.Methods: this retrospective cohort study was registered and approved by the University of Southampton’s ethics service (ERGO reference 88350.A1). It included adult patients admitted to the ICU or HDU at UHS (between 2017 and 2024) following right hemicolectomy that received opioids within 24 hours of admission. Clinical data was manually extracted from a local clinical information system (MetaVision) and opioid doses were converted into IV morphine milligram equivalents (MMEs) [2]. Multiple linear regression (MLR) analysis was then conducted. The dependent variable was log-transformed opioid consumption in IV MMEs within 24 hours of admission and the independent variables were demographic characteristics (gender, age, weight), history of substance dependence (alcohol, smoking, pre-hospital opioids), unit admitted to (ICU or HDU), mechanical ventilation and sequential organ failure assessment (SOFA) score.Results: a total of 254 patients were included: 57 were admitted to the ICU and 197 to the HDU. Median (IQR) opioid consumption in IV MMEs within 24 hours of admission was 68 (32-124) in ICU and 39 (20-70) in HDU patients (p=0.002). The MLR model explained 24% of the variance in opioid consumption (adjusted R2=0.24) and was statistically significant (p=<0.001). Age (B=0.97, p=<0.001) and history of alcohol dependence (B=1.98, p=0.038) were significant predictors of opioid consumption, while pre-hospital opioid exposure (B=1.50, p=0.054) was marginally significant. In contrast, gender, weight, history of smoking, unit admitted to, mechanical ventilation and SOFA score did not reach statistical significance. Conclusions: oioid consumption was significantly greater in patients admitted to the ICU compared to the HDU following right hemicolectomy. Younger age and history of alcohol dependence (>14 units per week) both positively predicted opioid consumption. Adequately powered research is needed to confirm these findings and should assess the clinical impact of greater opioid consumption in ICU patients.Reference(s): 1.Devlin JW, Skrobik Y, Gélinas C, Needham DM, Slooter AJ, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical care medicine. 2018;46(9):e825-73.<br/
Impact of continuous intravenous opioids in mechanically ventilated adults: a systematic review and meta-analysis
No full textMarriage record of Laturn, Thomas and Devlin, Anna
No full textMarriage license for Thomas Laturn and Anna Devlin. J.W. Harris was the officiant
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
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