1,720,989 research outputs found
Supplemental Material, Lencucha_Appendix_A_FINAL - Examining the intersection of policy and occupational therapy: A scoping review
No full textSupplemental Material, Lencucha_Appendix_A_FINAL for Examining the intersection of policy and occupational therapy: A scoping review by Raphael Lencucha and Keiko Shikako-Thomas in Canadian Journal of Occupational Therapy</p
Supplemental Material, Lencucha_Appendix_B_FINAL - Examining the intersection of policy and occupational therapy: A scoping review
No full textSupplemental Material, Lencucha_Appendix_B_FINAL for Examining the intersection of policy and occupational therapy: A scoping review by Raphael Lencucha and Keiko Shikako-Thomas in Canadian Journal of Occupational Therapy</p
Evaluation of the implementation of stroke units: the case of Korle-Bu teaching hospital, Ghana
No full textOrganised Stroke unit care is the most recommended stroke care policy to improve stroke outcomes. There is sufficient evidence supporting the effectiveness of stroke unit care compared to care on medical or neurological wards. The research on and wide spread implementation of organised stroke unit care has mainly been conducted in high income countries with advanced research environments and well-resourced health care systems. Nevertheless, there is some, although limited evidence that stroke unit care is effective in lower resource setting. In 2014, the Korle-Bu Teaching hospital took steps in restructuring acute stroke care by establishing a stroke unit. The adoption of stroke unit care as a key component of stroke care policy in Ghana must be based on evidence of efficacy, effectiveness, efficiency and applicability. The efficacy and effectiveness of stroke units have been well established. The questions that still remain are, can stroke units implemented in Ghana realize similar outcomes as those implemented elsewhere? Is there evidence over time in Ghana, that restructuring stroke care from care in the general medical wards to a dedicated stroke unit changed outcomes? ObjectivesThe global aim is to contribute evidence towards the effectiveness of stroke units in Ghana. This aim was achieved through five interrelated manuscripts.The objective of the first manuscript was to estimate the extent to which outcomes of mortality and length of stay changed following the implementation of stroke unit care in KBTH. This was a historically controlled study comparing the pre-stroke unit period (2011-2013) to the post stroke unit period (2014-2016). Patients treated at the stroke unit had a 61% lower risk of dying and shorter length of stay compared to the general medical wards. The objective of the second manuscript was to estimate the extent to which resource use at the stroke unit was associated with functional independence amongst patients admitted. This was a study of an admission-to-discharge cohort from the stroke unit. For people surviving the acute care period, resource use was associated with an increase in functional independence from time of admission to discharge. The third manuscript estimated and compared the construct validity of a stroke specific preference measure, the Preference Based Stroke Index (PBSI), to a generic preference measure, the EuroQol Five Dimension (EQ-5D-3L). The PBSI demonstrated significantly higher construct validity compared to the EQ-5D-3L and could discriminate amongst known groups. Its use is recommended in the stroke population as it covers dimensions particularly relevant to the stroke population. The objective of the fourth manuscript was to compare estimates of recovery at 3 months post stroke, among three measures, the Barthel Index (BI) for ADL, the EQ-5D-3L, and the PBSI. This was an observational study of a consecutive series of patients discharged alive from the stroke unit from 2014 to 2016. In summary, the EQ-5D-3L and the PBSI had comparable estimates on recovery. However, the PBSI had a larger effect size. The objective of the last manuscript was to explore the meaning of recovery post stroke from the perspective of a sample of stroke survivors in Ghana. This study was a qualitative analysis based on interpretive description methodology. Results from this study emphasizes the need for clinicians to engage patients to understand what recovery means to them and their expectations of recovery in order to truly meet patients’ needs and desires.This thesis provides evidence on the applicability of stroke unit care in Ghana. It shows that resource-use in providing stroke unit care is associated with an increase in functional independence. Furthermore, it highlights the importance of having a discussion with patients on what recovery means to them in order to meet patients’ needs. Les soins des unités d’Accident Vasculaire Cérébrale (AVC) organisé est la politique de soins d’AVC la plus recommandée pour améliorer les résultats d’AVC. Il existe des preuves suffisantes à l’appui de l’efficacité des soins de l’unité d’AVC par rapport aux soins dispensés dans les services médicaux. La recherche sur la mise en œuvre à grande échelle des unités de soins d'AVC organisées a été principalement menée dans des pays à revenu élevé dotés d'environnements de recherche avancés et de systèmes de soins de santé bien dotés en ressources. Ils existent des preuves limitées sur l’efficacités des soins en unité d’AVC dans les milieux de ressources inférieures. En 2014, l'Hôpital d'Enseignement Korle-Bu (HEKB) a entrepris des démarches de restructuration des soins d’AVC aigu en créant une unité de soin d’AVC. L'adoption des soins des unités d’AVC en matière de soins des AVC au Ghana doit reposer sur des preuves d'efficacité, d'efficience et d'applicabilité. L’efficacité des unités de soins d’AVC ont été bien établies. Les questions qui restent sans réponse sont, les unités d’AVC mises en place au Ghana peuvent-elles obtenir des résultats similaires à ceux mis en place ailleurs? Y a-t-il des preuves, au fil du temps au Ghana, que la restructuration des soins d’AVC parmi les soins de services de médecine générale à une unité spécialisée en AVC, d’avoir changé les résultats ? Objectifs:L’objectif global est de contribuer des données probantes sur l’efficacité des unités d’AVC au Ghana. Cet objectif a été atteint à travers cinq manuscrits interdépendants.L’objectif du premier manuscrit était d’estimer la mesure dans laquelle les résultats en termes de mortalité et de durée de séjour ont changé à la suite de la mise en œuvre des soins d’unité des accidents vasculaires cérébraux en HEKB. Il s'agissait d'une étude historiquement contrôlée comparant la période de l’unité pré-AVC (2011-2013) à la période de l’unité post-AVC (2014-2016). Les patients à l'unité d'AVC avaient 61% moins de risque de décès et une durée de séjour plus courte par rapport aux salles de médecine générale.Le deuxième manuscrit avait pour objectif d’évaluer dans quelle mesure l’utilisation des ressources dans l’unité d’AVC était associée à l’indépendance fonctionnelle des patients admis dans cette unité. Il s'agissait d'une étude d'une cohorte de l'admission jusqu’au congé de l'unité d'AVC. Pour les personnes ayant survécu à la période des soins aigus, l'utilisation des ressources était associée à une augmentation de l'indépendance fonctionnelle.Le troisième manuscrit a estimé et comparé la validité conceptuelle d’une mesure de préférence spécifique à un AVC, l’indice d’AVC basé sur la préférence, à une mesure de préférence générique, l’EuroQol Cinq Dimensions. L’indice d’AVC basé sur la préférence a démontré une validité conceptuelle significativement supérieure à celle du EQ-5D-3L et a pu discriminer les groupes connus.L’objectif du quatrième manuscrit était de comparer les estimations de la récupération trois mois post-AVC, parmi trois mesures, l’indice de Barthel pour les AVQ, l’EQ-5D-3L et l’indice d’AVC basé sur la préférence. Il s'agissait d'une étude d'observation d'une série consécutive de patients ayant eu un congé et étant en vie de l'unité d’AVC de 2014 à 2016. Le EQ-5D-3L et l’indice d’AVC basé sur la préférence avaient des estimations comparables en matière de récupération. Cependant, l’indice d’AVC basé sur la préférence avait un effet très important.L'objectif du dernier manuscrit était d'explorer la signification de récupération de survivants post-AVC au Ghana. C’était une analyse qualitative basée sur la méthodologie de description interprétative. Les résultats de cette étude soulignent la nécessité pour les cliniciens d’engager les patients à comprendre ce que la récupération signifie pour eux et leurs attentes en matière de récupération.
Is It Time to Say Farewell to the ISDS System?; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?”
No full textInvestor-state dispute settlement (ISDS) continues to plague health-oriented government regulation. This is particularly reflected in recent challenges to tobacco control measures through bilateral investment agreements. There are numerous reform proposals circulating within the public health community. However, I suggest that perhaps it is time for the community to explore a stronger position on ISDS. I draw from mounting evidence on the problematic uses of the ISDS to explore the proposition that ISDS is no longer justified. I tackle the normative question of shouldthe ISDS system persist and point out that the ISDS system is not justifiable from a development perspective and because of its nefarious use, is of no added value to a system that could rely on domestic courts
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
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