1,721,015 research outputs found
Trauma radiology in northern Norway
No full textBackground: This thesis focuses on diagnostic imaging in potentially severely injured patients admitted to the University Hospital of North Norway. Imaging is important for timely initiation of treatment and survival after trauma. The use of standardized whole body computer tomography (SWBCT) is increasing. However, the ionizing radiation used may cause a small risk for induction of cancer later in life. The aim of this audit was to characterize the patients, validate the injury coding in the National trauma registry, and describe the diagnostic imaging used and doses delivered, to evaluate the degree of adherence to the International commission of radiological protection’s (ICRP) justification principles for dose optimization.
Methods: We audited all 144 patients admitted with trauma team activation in 2015. Injury codes in the registry were validated against a consensus reference standard. All diagnostic imaging was registered. Dose area product (DAP) (X-ray), dose length product (DLP) (CT) and effective doses are reported. Patients were categorized into trauma admission CT examination strategy groups SWBCT, selective CT or no CT, and factors associated with examination strategy decisions analyzed.
Results and conclusions: The patients were predominantly young men exposed to vehicle accidents. Few were severely injured and pre-hospital transport times were long. Concordance between codes in the registry and the reference standard was moderate, influencing individual patients’ injury code validity, but not aggregated group injury severity score. The majority were examined with CT, predominately SWBCT. DLP for a SWBCT was slightly above national reference levels. There was no difference in injury severity and frequency of interventions between children and adults. The high proportion of patients with minor injuries and the significantly lower use of CT among children, indicate that use of a selective CT examination strategy in a higher proportion of the patients would have approximated the ICRP’s justification principles better
Subarachnoid hemorrhage : incidence, risk factors and sex differences
Get PDFSubarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain. SAH may occur spontaneously, or following traumatic brain injury. Spontaneous SAH is in 85% of cases caused by rupture of an outpouching (aneurysm) of an intracranial artery. This is called an aneurysmal SAH (aSAH). The main findings of the present thesis concerned the incidence of aSAH in Norway, and sex differences in the risk factors for aSAH. The data source was the Norwegian Patient Register, and a combined cohort of the Tromsø study and the Nord-Trøndelag Health Study.
The crude incidence of aSAH in Norway decreased from 11.1 per 100,000 person-years (95% confidence interval, CI: 10.5–11.6) in the period 1999–2001 to 8.9 per 100,000 person-years (95% CI: 8.4–9.4) in the period 2005–2007. Significant regional variations were observed, indicating an increasing gradient from south to north.
Daily cigarette smoking was approximately twice as hazardous in women as in men (Hazard ratio, HR 6.5, 95% CI 3.56-11.9 vs HR 3.5, 95% CI 1.6-7.4). After adjusting for age, hypertension, and alcohol consumption, current cigarette smoking was 3.4 times more hazardous in female than male participants (HR 9.8, 95% CI 5.1-18.7 vs HR 2.9, 95% CI 1.3-6.3)
Er det forskjell i behandlingsresultat mellom pasienter som besvarer spørreskjema om utfall etter nakkekirurgi og pasienter som ikke gjør det?
Get PDFBakgrunn og formål:
Oppgaven er en valideringsstudie basert på data fra Nasjonalt kvalitetsregister for rygg- og nakkekirurgi (NKR). Validiteten til kvalitetsregistre er avhengig av tilstrekkelig høy responsrate for at konklusjonene som trekkes angående effekt av en behandling skal være korrekte. Formålet med studien er å analysere om det er forskjell i behandlingsresultat mellom pasienter som besvarer oppfølgingsskjema per post ett år etter nakkekirurgi, og pasienter som ikke gjør det. Samtidig vil vi identifisere prediktorer for å ikke respondere.
Metode:
Totalt ble 334 pasienter som fortløpende ble operert for degenerative nakkelidelser ved ti norske sykehus inkludert i studien. 238 av disse responderte på standard oppfølging med spørreskjema per post. Vi forsøkte å komme i kontakt med de 96 pasientene som ikke reponderte for å gjennomføre et strukturert telefonintervju. Utfallsmålene var forbedring i armsmerte, nakkesmerte, helserelatert livskvalitet (EQ-5D-3L), samt pasientrapportert nytte av operasjonen.
Resultat:
Vi fant ingen signifikante forskjeller i utfall mellom respondentene (71,3 % av pasientene) og telefonrespondentene (18,9 % av pasientene). 33 pasienter var utilgjengelig for oppfølging (9,9 % av pasientene). En større andel av telefonrespondentene rapporterte om komplikasjoner etter tolv måneder, men tre måneders data viste ingen forskjell i andel komplikasjoner mellom gruppene. Multivariat analyse viste at lavere alder (OR 0,96, 95 % KI 0,93 – 0,98 per år), annet morsmål enn norsk (OR 2,96, 95 % KI 1,37 – 6,41) og tidligere nakkoperasjon (OR 1,91, 95 % KI 1,05-3,50) var assosiert med økt sannsynlighet for å ikke respondere på den ordinære oppfølgingen.
Konklusjon:
Vi fant ingen forskjell i behandlingsresultat mellom respondenter og telefonrespondenter 12 måneder etter nakkekirurgi. En andel på 29% som ikke responderer på oppfølging etter nakkekirurgi fører ikke til at det trekkes feil konklusjoner angående behandlingseffekt
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
Ten-year tenure as a physician CEO at a Nordic university hospital: Five lessons learnt
Get PDFBackground - I was a 42-year-old neurosurgeon with experience as department head when I took chair as chief executive officer (CEO) at the University Hospital of North Norway to lead a comprehensive organisational and financial restructuring. This article aims to develop lessons learnt during my 10-year tenure.
Methods - I restructured the organisation and hired a new executive team. We developed a new strategy and measures to implement it. I describe the results, a strategic disagreement that developed and my resignment, and reflect critically over my actions as a leader.
Results - Measures of safety and quality in clinical processes, cost-effectiveness and financial equity improved. We expedited investments in medical equipment, information technology and hospital facilities. Patient satisfaction was stable, but employees’ job satisfaction decreased. After 9 years, a politicised strategic disagreement with superior authorities developed. I was criticised for attempting to influence inappropriately, and resigned.
Lessons learnt -(1) Data-driven improvement works, but comes at a cost. Healthcare organisations should consider to prioritise resilience over efficiency. (2) It is inherently difficult to recognise when and how an issue changes from a professional to a political logic. I should have used contacts in politics and surveilled local media better. (3) During conflict, role clarity is crucial. (4) CEOs should be prepared to resign when strategically unaligned with superior authorities. (5) A CEO tenure should not last more than 10 years.
Conclusion - My experiences as a physician CEO was intense and immensely interesting, but some of the lessons were painfully learnt
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
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