1,721,034 research outputs found
Can referrals to a pediatric Osteopathic Manipulative Medicine (OMM) clinic be increased through provider education?
Full text linkPurpose:
Many pediatricians in the U.S. have trained in osteopathic medicine and have a Doctor of Osteopathy degree. However, other members of the health care team are often unaware of what osteopathic manipulative medicine (OMM) is or its indication in pediatrics. This quality improvement (QI) project aims to increase the average number of referrals to the University of New Mexico Hospital’s (UNMH) pediatric OMM clinic by 25% by May 2020.
Methods:
The QI project was designed based on the Model for Improvement. As the first Plan-Do-Study-Act (PDSA) cycle, health care provider trainings on pediatric OMM were implemented in November 2019. A post-presentation survey was used to gather feedback. The primary measure will be average monthly referrals to UNMH’s pediatric osteopathic clinic.
Results:
Thirty-one providers responded to the survey – most were physicians (DO [39%] or MD [52%]) with(87%). Twenty-three percent had previously referred to OMM clinic. On average, respondents reported an interest of 8.10 (SD 2.47) in referring to the pediatric OMM clinic, on a scale of 0 (no interest at all) to 10 (extremely interested). The average respondent was still not sure about the indications and evidence-base for use of OMM in pediatrics. Some respondents indicated that they would like additional training in OMM techniques, and that the clinic needs more hours/capacity due to a long wait time (\u3e1 month).
Conclusion:
Health care provider trainings generated interest in referring to the pediatric osteopathic clinic at UNMH. There is a need for additional PDSA cycles related to building provider knowledge and skills and addressing wait time to be seen in OMM clinic. We will monitor referrals as we implement additional PDSAs
Antibiotic Use for Children in the PICU with severe viral bronchiolitis
No full textAntibiotic use for children in the PICU with severe viral bronchiolitis Anjali Subbaswamy, MD; Chelsea Sanchez, MD; Claire Zeorlin, MD; Elizabeth Yakes Jimenez, PhD, RDN, LD
BACKGROUND: Viral bronchiolitis is not treated with antibiotics, but with supportive care. Antibiotics may be used for secondary bacterial pneumonia, which is difficult to diagnose in small children. Children with severe bronchiolitis are admitted to the PICU, and often receive empiric antibiotics.
OBJECTIVES: To examine clinical factors associated with systemic antibiotic use in severe bronchiolitis based on retrospective chart review of PICU patients.
METHODS: We identified children discharged from the UNMH PICU from January 2017-January 2019 diagnosed with severe viral bronchiolitis. Variables extracted included demographics, treatments, lab values and outcomes. Stata/SE 15.1 was used to calculate descriptive statistics and to examine relationships between clinical factors and antibiotic administration using a t-test, Pearson’s chi-square test or Fisher’s exact test.
RESULTS: Children (n=208) were on average 11.3 ± 8.6 (SD) months old with a length of stay of 10.8 ± 6.4 days. Seventy children (34%) received antibiotics. Fifteen children (7%) had a definitive diagnosis of bacterial pneumonia (positive tracheal culture). Children who received antibiotics were slightly younger than those who did not (average age 10.3 vs. 11.9 months; p = 0.09). Fifty-four percent of children on a ventilator (n=26) received antibiotics versus 31% of children who were not ventilated (p=0.02). Forty-one percent of children with elevated temperature (≥38°C; n=115) received antibiotics versus 24% of children with normal temperature (n=89; p=0.009). Seventy-two percent of children with high CRP (\u3e2 mg/L; n=18) received antibiotics versus 56% of children with normal CRP (n=18; p=0.24).
CONCLUSIONS: In the UNMH PICU, a substantial proportion of children with severe viral bronchiolitis receive antibiotics without a definitive diagnosis of bacterial pneumonia. These children were younger and sicker, with fever, elevated CRP and mechanical ventilation. An evidence-based, expert opinion supported, clinical decision-making algorithm is needed to better identify children that require systemic antibiotics in the setting of severe viral bronchiolitis
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
Preventing Chronic Disease (PCD)
Full text linkIntroductionAlthough recent studies indicate that rates of childhood obesity and severe obesity may be declining, few studies have reported prevalence trends in early childhood or differences in trends across sociodemographic groups. The primary aim of this study was to report trends in prevalence of early childhood obesity and severe obesity 2007 through 2014 in a diverse, metropolitan school district in the southwestern United States and determine whether these trends vary by race/ethnicity, socioeconomic status, and disability status.MethodsWe analyzed height, weight and demographic data from 43,113 kindergarteners enrolled in a large, urban school district in the southwestern United States for 7 school years. Adjusted odds of obesity and severe obesity were calculated to assess changes in prevalence for non-Hispanic white, Hispanic, and American Indian students; free or reduced-price lunch participants and nonparticipants; and students with and without disabilities. To test for differences in obesity trends, interaction terms were added to the logistic regressions between school year and sex, race/ethnicity, free or reduced-price lunch participation, and disability status.ResultsThe adjusted prevalence of both obesity (from 13.1% in 2007\u20132008 to 12.0% in 2013\u201320014) and severe obesity (from 2.4% in 2007\u20132008 to 1.2% in 2013\u20132014) declined overall. We found no significant interactions between the adjusted prevalence of obesity over time and any of the sociodemographic subgroups. Obesity prevalence declined more among American Indian students than among Hispanic or non-Hispanic white students.ConclusionIn this district, from 2007 through 2014, severe obesity decreased and obesity did not increase, overall and across all sociodemographic subpopulations for kindergarten students
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
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