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Immigrants with heart failure- A descriptive comparative study of symptoms, self care, social support, care and treatment
No full textBackground: The current demographic profile in Sweden demonstrates blended ethnicities and cultures evolving through mass migration and resettlement. While it is acknowledged that cultural background affects, illness experience, participation in the care or self-management of illness, little is presently known about the treatment patterns, symptoms, health care seeking and health outcomes among immigrants with heart failure (HF) in Sweden or other Scandinavian countries – despite the fact that worsening of chronic heart failure is the most common cause of hospitalisation in patients over 65 years of age. Aim: This comparative, explorative thesis describes immigrants with HF regarding symptoms, self-care, social support, care and treatment, physical limitation and emotional state, as well as health outcomes, e.g., readmissions and mortality, in comparison to Swedes. Method: The thesis has a descriptive and comparative design. The first study is an interview study exploring symptom recognition and health care strategies related to worsening of HF. The second and third studies of the thesis are retrospective record audits of patient records describing care and treatment of immigrant and Swedish patients with HF in a medical ward and at a nurse-led HF clinic. The fourth study is a descriptive study with group comparisons of changes from baseline to four month follow up, in symptoms, functional limitations, emotional status, social support and self-care measures over a four month period, from baseline to four-month follow-up. The study setting was a university hospital serving a large and diverse immigrant population. Results: A majority of the immigrant and Swedish patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. In addition, equal numbers of patients in both groups were aware of their reluctance to seek care when symptoms and signs occurred, and gave diverse explanations for delays. However, twice as many immigrants as Swedes were unaware of the underlying reason for their illness and its connection with HF (I). Reviewed patient records revealed no significant differences between the groups regarding symptoms, diagnostic investigations, medical treatment, hospital stay and health outcomes, such as readmissions and mortality. Furthermore, records from both patient groups showed that functional status using the New York Heart Association classification was infrequently assessed and that documentation of provided HF information was lacking. The only significant between-group differences were that more immigrants were referred to the nurse-led HF clinic for a follow-up visit at discharge (II); fewer routine clinical parameters were assessed in immigrants; and fewer immigrants were scheduled for follow-up visits (III). No differences were seen between immigrants and Swedes regarding 4-month changes in symptoms and signs, physical functioning, social support, emotional status, or in health care seeking in response to certain symptoms. However, adherence to prescribed medications was significantly higher among immigrants, whereas significantly fewer immigrants reported that they had access to emotional support if needed (IV). Conclusion and implication: Although immigrant and Swedish patients with chronic heart failure were provided largely the same care and treatment, fewer immigrants were able to relate their symptoms to their condition when seeking acute care. Immigrants also reported higher adherence to prescribed medication and were more often referred to the nurse-led HF clinic by physicians at discharge from hospital, possibly with the expectation that the patients would receive more individualised care and follow up. Information about how and if patient education and counselling had been carried out was rarely documented in the patient records. More precise and comprehensive notations of the patients’ own perceptions of their care may enhance the quality of this documentation. Patient records should also document performed assessments and interventions, which may improve communication between caregivers in different health care settings and consequently improve the efficiency of future care plans
Immigrants with heart failure- A descriptive comparative study of symptoms, self care, social support, care and treatment
No full textBackground: The current demographic profile in Sweden demonstrates blended ethnicities and cultures evolving through mass migration and resettlement. While it is acknowledged that cultural background affects, illness experience, participation in the care or self-management of illness, little is presently known about the treatment patterns, symptoms, health care seeking and health outcomes among immigrants with heart failure (HF) in Sweden or other Scandinavian countries ? despite the fact that worsening of chronic heart failure is the most common cause of hospitalisation in patients over 65 years of age. Aim: This comparative, explorative thesis describes immigrants with HF regarding symptoms, self-care, social support, care and treatment, physical limitation and emotional state, as well as health outcomes, e.g., readmissions and mortality, in comparison to Swedes. Method: The thesis has a descriptive and comparative design. The first study is an interview study exploring symptom recognition and health care strategies related to worsening of HF. The second and third studies of the thesis are retrospective record audits of patient records describing care and treatment of immigrant and Swedish patients with HF in a medical ward and at a nurse-led HF clinic. The fourth study is a descriptive study with group comparisons of changes from baseline to four month follow up, in symptoms, functional limitations, emotional status, social support and self-care measures over a four month period, from baseline to four-month follow-up. The study setting was a university hospital serving a large and diverse immigrant population. Results: A majority of the immigrant and Swedish patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. In addition, equal numbers of patients in both groups were aware of their reluctance to seek care when symptoms and signs occurred, and gave diverse explanations for delays. However, twice as many immigrants as Swedes were unaware of the underlying reason for their illness and its connection with HF (I). Reviewed patient records revealed no significant differences between the groups regarding symptoms, diagnostic investigations, medical treatment, hospital stay and health outcomes, such as readmissions and mortality. Furthermore, records from both patient groups showed that functional status using the New York Heart Association classification was infrequently assessed and that documentation of provided HF information was lacking. The only significant between-group differences were that more immigrants were referred to the nurse-led HF clinic for a follow-up visit at discharge (II); fewer routine clinical parameters were assessed in immigrants; and fewer immigrants were scheduled for follow-up visits (III). No differences were seen between immigrants and Swedes regarding 4-month changes in symptoms and signs, physical functioning, social support, emotional status, or in health care seeking in response to certain symptoms. However, adherence to prescribed medications was significantly higher among immigrants, whereas significantly fewer immigrants reported that they had access to emotional support if needed (IV). Conclusion and implication: Although immigrant and Swedish patients with chronic heart failure were provided largely the same care and treatment, fewer immigrants were able to relate their symptoms to their condition when seeking acute care. Immigrants also reported higher adherence to prescribed medication and were more often referred to the nurse-led HF clinic by physicians at discharge from hospital, possibly with the expectation that the patients would receive more individualised care and follow up. Information about how and if patient education and counselling had been carried out was rarely documented in the patient records. More precise and comprehensive notations of the patients? own perceptions of their care may enhance the quality of this documentation. Patient records should also document performed assessments and interventions, which may improve communication between caregivers in different health care settings and consequently improve the efficiency of future care plans
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
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
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe 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
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