1,721,040 research outputs found
Interdisciplinary S2k guidelines on the diagnosis and treatment of endometrial carcinoma
Full text linkTransvaginal Ultrasound for Endometrial Carcinoma Screening - Current Evidence-based Data
No full textThe value of transvaginal ultrasound in gynaecological examinations is beyond dispute. But it is of particular forensic importance that the validity of this type of imaging with regard to the reliable detection of early-stage malignancy is properly understood. Vaginal ultrasound screening in asymptomatic patients for the early detection of endometrial carcinoma is not useful from a medical point of view, nor is it cost-efficient. However, even though the validity of transvaginal ultrasound for screening has currently not been proven, the method should still be an integral part of gynaecological examinations
Optimising therapy management of gynecological cancer and mamma carcinoma via interdisciplinary and cross-sectoral Online tumor conferences
No full textDas Therapiemanagement gynäkologischer Malignome und Mammakarzinome erfordert multimodale Behandlungsstrategien und multidisziplinäre Zusammenarbeit der Behandler, auch über Sektorengrenzen hinweg. Ein redundanzfreies und koordiniertes Therapiemanagement wird zudem vor dem Hintergrund des steigenden Kostendrucks im Gesundheitswesen immer wichtiger. Tumorkonferenzen sind das klassische Verfahren, um interdisziplinäre Empfehlungen zu erarbeiten, bringen jedoch zahlreiche zeitliche und logistische Hürden mit sich. Aus diesem Grund wurde an der Charité (Berlin) und dem Universitätsklinikum Essen eine interdisziplinäre und intersektorale Online-Tumorkonferenz für Patientinnen mit gynäkologischen Malignomen und Mammakarzinomen initiiert. Von Dezember 2004 bis Dezember 2008 fanden über 130 Tumorkonferenzen mit über 2.000 Teilnahmen statt und es wurden mehr als 450 Kasuistiken beraten. Ziel der vorliegenden Arbeit war es, zu evaluieren, inwieweit die Online-Tumorkonferenz die Qualität des Therapiemanagements sichert und erhöht. Der Schwerpunkt der vorliegenden Arbeit lag in der Befragung aller an der Online-Tumorkonferenz teilnehmenden Behandler (N=109 – 2 Subgruppen: 52 Kliniker und 57 Niedergelassene) zu wesentlichen qualitäts-determinierenden Aspekten der Online-Tumorkonferenz. Die Erwartungen der Teilnehmer an die Konferenz wurden evaluiert und die Fähigkeit des Konferenz-Konzeptes, diese Erwartungshaltungen und Beratungsbedarfe zu erfüllen, belegt. Die Evaluationsergebnisse zeigen des Weiteren, dass die Hälfte der Teilnehmer durch die Online-Tumorkonferenz verstärkt Zweitmeinungen einholt, und es konnte belegt werden, dass insbesondere die detaillierte und evidenzbasierte Prüfung der Kasuistiken einen klaren Mehrwert der Online-Tumorkonferenz darstellt. 70% der Teilnehmer bestätigten zudem, dass sich die Zusammenarbeit zwischen dem ambulanten und dem klinischen Versorgungssektor verstärkt. Fast alle Niedergelassenen bestätigten, dass durch die Online-Tumorkonferenz Informationen schneller ausgetauscht werden. Eine überwiegende Mehrheit der Teilnehmer bejahen einen Zuwachs ihres Fachwissens sowie ihrer Therapiesicherheit und alle Teilnehmer gaben an, dass die Therapieempfehlungen, die in der Konferenz getroffen werden, für sie nachvollziehbar sind. Dies gilt als entscheidendes Kriterium für die spätere Translation der Konferenzempfehlungen in die Praxis. 60% sind der Ansicht, dass Redundanzen in der Diagnostik und Therapie durch die Online-Tumorkonferenz vermieden werden können. Es lässt sich somit festhalten, dass das multidisziplinäre und intersektorale Konzept der Online-Tumorkonferenz von vielen Ärzten angenommen wird und eine effektive und evidenzgesicherte Möglichkeit darstellt, Zweitmeinungen in einem multidisziplinären Team zu generieren, die Kooperation der Behandler zu stärken und Redundanzen im Therapiemanagement zu vermeiden.The therapy of gynecological malignancies and mamma-carcinomas require a multimodal therapy approach and interdisciplinary cooperation, also across care-sectors. A non-redundant and coordinated therapy management becomes also more important against the background of rising cost pressure in the health care systems. Tumor boards are a traditional approach in order to develop interdisciplinary recommendations, but they also entail timely and logistical hurdles. Against this background the Departments of Gynecology and Obstetrics at the Charité (Berlin) and at the University Hospital Essen initiated a interdisciplinary and cross-sectoral online tumor conference for patients with gynecological malignancies and breast cancer. From December 2004 to December 2008 over 130 conferences with over 2,000 participations were conducted and more than 450 casuistics were analysed. The aim of this study was to evaluate to what extent the online tumor conference ensures and increases the quality of treatment management. One main focus of this study was an evaluation among all participants of the online tumor conference (N = 109-2 subgroups: 52 clinicians and 57 outpatient specialists) concerning the major quality-determining aspects of the online tumor conference. The expectations of participants in the conference were evaluated and it could be shown that the conference concept meets the expectations and needs of the participants. Evaluation results also proved that half of the participants seek for more second-opinions by the possibility of the online tumor conference and it could be shown that in particular the detailed and evidence-based examination of the casuistics are seen as an added value of the online tumor conference. 70% of participants also confirmed that cooperation between the inpatient and outpatient sector increases by the online tumor conference. Almost all outpatient contributors confirmed that they receive information faster and a vast majority of the participants could state a gain of knowledge and of their therapeutic safety. All participants confirmed that the treatment recommendations developed in the conference are comprehensible. This is a crucial criterion for the subsequent translation of the conference recommendations into clinical practice. 60% believed that redundancies in the therapy management can be avoided by the online tumor conference. It can therefore be summarized that the multidisciplinary and cross-sectoral approach of the online tumor conference meets high acceptance by many doctors and provides an effective and evidence-based possibility to generate second opinions in a multi-disciplinary team, to strengthen the cooperation between the specialists and to avoid redundancies in the therapy management
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
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