1,720,962 research outputs found
Proactive Advance Care Planning in Rural Primary Care
Get PDFRelying on a family member to make medical decisions on behalf of a person who is unable to speak for themselves can cause unnecessary stress, cost, and dissatisfaction for both patients and their family. Making decisions without knowing a person’s preference for care often leads to a poorer quality of life and discordant care. Without an advance directive to guide care, family members are left to assume the patient’s wishes which can cause them to second guess a decision. Lack of knowledge and understanding are among the top reasons for not completing advance directives. As part of routine check-ups or well visits, primary care providers have the responsibility to introduce advance care planning to patients while patients are of sound mind and continue this discussion to include caregivers and/or family members. This quality improvement project helped facilitate a new process for beginning the advance care planning conversation in one rural Midwest primary care clinic. Current practices were identified to develop methods for change followed by an eight- week period where educational materials were offered to patients being seen for wellness visits which allowed the provider an opportunity to introduce advance care planning. Ancillary staff helped identify patients meeting inclusion criteria and facilitate a post-educational handout regarding patient satisfaction that was used to measure outcomes of implementing a standardized process. Keywords: advance care planning, rural communities, primary car
Early Recognition of Sepsis in Outpatient Ambulatory Settings: An Educational Program for Primary Care Providers in Rural, South Central Kansas
Get PDFAbstract Background and Review of Literature: Sepsis is a life-threatening, dysregulated human response to infection. It claims more lives than breast, lung or prostate cancer. Sepsis affects annually, 1.7 million Americans and 10,000 Kansas. The mortality rate can reach 50-80% if treatment is delayed. Early identification, prevention, and intervention, beginning in the community, before emergency room admission, is necessary. It is important to educate primary care providers and community members on early sepsis prevention, early identification, treatment, and recognition of high-risk groups. Purpose: The purpose of this quality improvement project was to increase knowledge about sepsis among community-based, primary care providers such as nurse practitioners, physician assistants, and physicians in ambulatory settings in rural, South-Central Kansas. Methods: A single group, pretest-posttest approach was used for this quality improvement project. An online educational module on sepsis early identification and treatment, created by TMF Health Quality Institute (2018), was synchronously presented to primary care providers employed in a rural, primary care health organization. Knowledge acquisition was measured using a test provided by TMF(2018). Result: Three providers participated. The overall percent increase in test scores from pretest to posttest was 16.6%. Pretest scores were low ranging from 40% -70%. Posttest scores were 70%. Discussion: Low pretest scores indicated a need for this education. The results showed an average 16.6% increase on test scores. Test score improvement demonstrated knowledge attained from the education provided and that this educational method and material was effective. This or similar projects delivered to primary care providers in an outpatient clinic could be beneficial. Keywords: sepsis, early recognition, ambulatory setting, primary car
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
Improving the Reach and Effectiveness of Palliative Care in Low-Resource Countries
Get PDFPurpose: The purpose of this compendium is to identify strategies to extend the reach and effectiveness of palliative care in low resource countries by 1) examining palliative care interventions, outcomes, and outcome measures, 2) evaluating a home-based palliative care program in rural India, and 3) exploring the concept of acceptability of rural medical practitioners in rural India. Problem: Limited access to effective palliative care services remains an urgent global concern for the over 19 million people requiring palliative care, the majority of whom live in low resource countries. An accompanying lack of research into palliative care interventions in resource-poor areas to support the development of feasible, acceptable, and useful context-specific interventions also exists. This dissertation is a compendium of three manuscripts that represent studies designed to offer information about improving the reach and effectiveness of palliative care in low resource countries. Design: The research designs used to carry out these studies included a systematic review of the literature that identified palliative care interventions and patient outcomes in low resource countries and the outcome measures used to evaluate the interventions (manuscript 1); the qualitative evaluation using a grounded theory approach of a pilot palliative care program in a rural area outside Kolkata, India, from the perspective of key stakeholder (manuscript 2) using a grounded theory approach, and dimensional concept analysis of the acceptance of rural medical practitioners (RMPs) as health care providers in rural India (manuscript 3). Findings: Findings from the systematic review characterize the types of palliative care models available in low resource areas while highlighting the need for more rigorous research to help guide the development of effective palliative care programs. It also reports the need for validation of palliative care outcome measures that are designed for and validated in low resource settings. Findings from the qualitative evaluation of the palliative care program indicated the value of the program for stakeholders in terms of the delivery of palliative care to rural cancer patients. The palliative care program incorporating the training of RMPs as CHWs is a model worthy of consideration by other low resource areas of India. The results of the dimensional concept analysis revealed five dimensions and two sub-dimensions for acceptability: accessibility with two subdimensions of availability and proximity; affordable, familiar, satisfactory, and trusted. The findings suggest that using RMPs in health care interventions in rural India may be feasible because of their acceptability across stakeholders. Conclusion: The reach and effectiveness of palliative care in low resource countries may be expanded by additional rigorous research on palliative care interventions to support the development of context-specific programs. The evaluation of home-based palliative care programs from the perspective of key stakeholders will help identify strengths of the program and opportunities for improvement. The concept of acceptability may be used to design interventions that employ RMPs to deliver health care in rural areas of India
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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