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Medikamentenadhärenz und psychosoziale Charakteristika von Patienten mit einer hypertensiven Entgleisung an der Notaufnahme
Full text linkDeutsche Zusammenfassung
Hintergrund:
Hypertensive Entgleisungen sind ein häufiger Grund für Vorstellungen an Notaufnahmen und können mit einer unzureichenden Medikamentenadhärenz assoziiert sein. Das Ziel der vorliegenden Arbeit ist die Identifikation medizinischer und psychosozialer Charakteristika von Patienten, die sich aufgrund einer hypertensiven Entgleisung an einer Notaufnahme vorstellen.
Methoden:
In diese prospektive klinische Studie wurden Patienten eingeschlossen, die aufgrund einer arteriellen Hypertonie mit einer blutdrucksenkenden Therapie behandelt wurden und sich mit einer hypertensiven Entgleisung, definiert als plötzlicher Anstieg des Blutdrucks von systolisch ≥180 mmHg und/oder diastolisch ≥110 mmHg, zwischen Mai 2018 und April 2019 an der Internistischen Notaufnahme des Universitätsklinikums des Saarlandes vorstellten. Demographische und psychosoziale Daten wurden im Rahmen eines Patientengespräches und mit Hilfe eines Fragebogens erfasst. Die Gesundheitskompetenz wurde mit dem Newest Vital Sign Test erhoben. Um Symptome von Depression und Angst zu erkennen, wurde die Hospital Anxiety and Depression Scale (HADS) verwendet. Zur Überprüfung der Adhärenz wurden das Blutplasma und der Urin der Patienten mittels Hochleistungs-Flüssigkeitschromatographie mit Massenspektrometrie-Kopplung (LC-HRMS/MS) auf das Vorhandensein blutdrucksenkender Wirkstoffe und deren Metaboliten untersucht.
Ergebnisse:
Insgesamt wurden 104 Patienten (62% weiblich) mit einem medianen systolischen Blutdruck von 200 mmHg (Interquartilbereich [IQR]: 190-212) und einem medianen diastolischen Blutdruck von 97,5 mmHg (IQR: 87-104) in die Studie eingeschlossen. 25 Patienten (24%) waren nicht-adhärent (Nachweis von <80% der verschriebenen Wirkstoffe). Nicht-adhärente Patienten waren häufiger männlich als adhärente Patienten (64% vs. 30%; p=0,003), sie erhielten mehr antihypertensive Medikamente (Median 3, IQR: 3-4 vs. 2, IQR: 1-3; p<0,001) und wurden häufiger mit Kalziumkanalblockern (80% vs. 24%; p<0,001), Diuretika (64% vs. 39%; p=0,030) sowie Vasodilatatoren (12% vs. 1%; p=0,042) behandelt.
Es bestanden keine signifikanten Unterschiede hinsichtlich der Gesundheitskompetenz (p=0,904) oder der HADS-Summenwerte der Subskalen für Depression (p=0,319) und Angst (p=0,529) zwischen adhärenten und nicht-adhärenten Patienten.
Schlussfolgerung:
Eine höhere Anzahl antihypertensiver Wirkstoffe, insbesondere eine Therapie mit Kalziumkanalblockern, Diuretika und Vasodilatatoren, waren mit Nicht-Adhärenz assoziiert. Männer waren häufiger nicht-adhärent als Frauen. Es wurden keine spezifischen psychosozialen Charakteristika identifiziert, die mit Nicht-Adhärenz assoziiert waren.
Abstract
Background:
Hypertensive urgencies are common reasons for presentations to emergency departments and may be associated with non-adherence. The present study aims to identify medical and psychosocial characteristics of patients presenting to an emergency department because of hypertensive urgency.
Methods:
This prospective clinical study included patients treated with antihypertensive drugs who presented at the Internal Medicine Emergency Department of Saarland University Hospital with a hypertensive urgency, defined as an acute increase in blood pressure of systolic ≥180 mmHg and/or diastolic ≥110 mmHg. Patients were included between May 2018 and April 2019. Demographic and psychosocial data were collected during patient interviews and using dedicated questionnaires. Health literacy was assessed utilizing the Newest Vital Sign Test. The Hospital Anxiety and Depression Scale (HADS) was used to detect symptoms of depression and anxiety. Drug adherence was assessed using liquid chromatography-high-resolution mass spectrometry (LC-HRMS/MS) in urine and plasma.
Results:
A total of 104 patients (62% female) with a median systolic blood pressure of 200 mmHg (interquartile range [IQR]: 190-212) and a median diastolic blood pressure of 97.5 mmHg (IQR: 87-104) were included in this study. A total of 25 patients (24%) were non-adherent (<80% of prescribed agents were detectable). Non-adherent patients were more often male than adherent patients (64% vs. 30%; p=0.003), prescribed more antihypertensive drugs (median 3, IQR: 3-4 vs. 2, IQR: 1-3; p<0.001) and more often treated with calcium channel blockers (80% vs. 24%; p<0.001), diuretics (64% vs. 39%; p=0.030) and vasodilators (12% vs. 1%; p=0.042). There was no difference in health literacy (p=0.904) or the scores on the HADS subscales for depression (p=0.319) and anxiety (p=0.529) between adherent and non-adherent patients.
Conclusion:
Higher number of antihypertensive drugs, particularly treatment with calcium channel blockers, diuretics and vasodilators were associated with non-adherence in patients presenting with hypertensive urgencies. Men were more likely to be non-adherent than women. No specific psychosocial characteristics were identified that were associated with non-adherence.
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
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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