1,721,067 research outputs found
Caesarean Sections in Sierra Leone An Evaluation in the Light of the Lancet Global Surgery Indicators
No full textBackground: Two third of the world’s population does not have adequate access to timely safe and affordable surgical services. The Lancet Commission on Global Surgery has defined a framework with six indicators and targets to evaluate preparedness, service delivery and financial impact of surgical services. In Sierra Leone, insufficient access to emergency obstetric and surgical services has led to poor maternal and perinatal outcomes. To improve access to caesarean sections, the Free Health Care Initiative was implemented to abolish user fees for obstetric and paediatric care. In addition, a task-sharing training programme for associate clinicians has been introduced to increase the surgical workforce.
Aims: The aim of thesis was to evaluate caesarean sections in Sierra Leone performed by associate clinicians and medical doctors using the framework of the Lancet Commissions on Global Surgery indicators. The thesis specifically aimed to: I. compare the outcome of caesarean sections performed by associate clinicians and medical doctors, II. analyse factors associated with perinatal death, III. evaluate catastrophic expenditure, impoverishment and the impact of the Free Health Care Initiative, and IV. assess patient reported and geospatial modelled travel time.
Methods: A prospective observational multicentre non-inferiority study was applied in all hospitals where both associate clinicians and medical doctors performed caesarean sections in 2016. Women undergoing caesarean section, either performed by associate clinicians or medical doctors, were included in the study and were followed with home visits after 30 days. Data on obstetric history, indication, travel time, household characteristics, health expenditure, and maternal and neonatal outcomes were collected. Individual income was estimated based on household characteristics and further used to determine impoverishing and catastrophic expenditure. The impact of the Free Health Care Initiative was assessed using a counterfactual scenario. Geospatial modelled travel times were generated based on two models and compared with patient reported travel time.
Findings: Between October 2016 and May 2017, 1,728 caesarean sections were done by either associate clinicians or medical doctors in the nine study hospitals. Of those, 1,274 women and 1,376 babies were included in the study and 1,161 women (91.1%) were successfully followed up with a home visit. Medical doctors performed a higher proportion of caesarean sections outside office hours, while associate clinicians did more surgeries for twin pregnancies. The 30-day perioperative maternal mortality was 0.2% (1 of 443) in the associate clinician group and 1.8% (15 of 831) in the medical doctor group (crude odds ratio 0.12, 90% confidence interval 0.01 to 0.67). Of the 1,376 babies, 261 (19.0%) were perinatal deaths. Indications with the highest perinatal mortality were uterine rupture, abruptio placentae, and antepartum haemorrhage. The median expenditure was 23 international dollars, with travel and food being the largest expenses. Patients in the poorest quintile had significantly higher healthcare related expenses compared to patients in the richest quintile. Catastrophic expenditure was encountered by 12.0% and 4.0% (10% and 25% threshold, respectively) of the women and without the Free Health Care Initiative, 66.1% and 28.8% of the women would have encountered catastrophic expenditure. The median reported travel time was 60 minutes, compared with 13 and 34 minutes estimated by the two models, respectively. Longer travel times were associated with poverty, low or no education, transport by ambulance or boat, and visiting one or two health facilities before reaching the final hospital where the caesarean section war performed. Higher perinatal mortality was identified in the group with a reported and modelled travel time of 2 hours or more.
Significance.: Caesarean sections in Sierra Leone - an evaluation in the light of the Lancet Global Surgery Indicators has provided more insight in the preparedness, service delivery and financial impact of caesarean sections in Sierra Leone. This thesis has documented noninferiority of caesarean sections performed by associate clinicians compared to medical doctors based on prospective data collection. It has also provided new insights in the associated factors of the high perinatal mortality related to caesarean sections. In addition, it has expanded the understanding of modelled travel time compared to patient-reported travel time. Finally, it has shown the effect of the Free Health Care Initiative on catastrophic expenditure and impoverishmen
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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