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End-of-life decision-making of relatives and physicians towards Filipino patients in a persistent vegetative state: a grounded theory
No full textThis study utilized a grounded theory approach to arrive at a substantial level theory of the process of decision-making for Filipino patients in a persistent vegetative state. The main participants of this study derived through purposive snowball and theoretical sampling were 10 relatives and 14 physicians of Filipino patients in a persistent vegetative state. The field sites of this study had been the Department of Neurosciences, the Supportive Palliative and Hospice Care Clinic and Ward 1 of the University of the Philippines-Philippine General Hospital (UP-PGH).
Line-by-line analysis as well as open, axial and selective coding of semi-structured interview transcripts revealed six major themes in the decision-making process of relatives namely: (1) Period of the Precipitating Event; (2) Period of Denial and Shock; (3) Factors Considered in Decision-Making; (4) Decisions Made; (5) Period of Desensitization, Anger, Waiting and =Acceptance‘; and (6) Sustained Processes. Five themes were identified in the decision-making process of physicians: (1) Preparing the Self; (2) Communicating the Diagnosis; (3) Presenting Options; (4) After Presenting Options; and (5) Sustained Processes.
Factors found to influence relatives in decision making included their (1) socioeconomic capacity; (2) their relationship with the patient; (3) their personal, religious and familial values; (4) physicians‘ implicit and explicit suggestions; (5) avoidance of guilt and blame for the death of their patient and "hiya" or fear of being socially-ostracized; (6) Prognosis, benefit and comfort of the patient; (7) family‘s perceived signs of improvement of the patient and (8) the patient‘s physical presence. Factors found to guide physicians in deciding what options to present to relatives included: (1) prognosis of the patient and clinical judgment; (2) Appraisal of family‘s psychosocial, economic and religious background; (3) type of hospital environment; (4) Comparison with past patients; (5) Patient‘s age and Quality of Life; and (6) Physician‘s experiences, personal, moral and ethical principles.
This study found that in the context of the Philippines, relatives are regarded as the ultimate decision-makers for their patients however physicians exerted influence through implicit suggestions of withholding and withdrawing treatment especially when the patient‘s prognosis is poor. The process of meaning-making has been found as a source of hope for relatives. The issue of medical triage due to insufficient hospital resources in UP-PGH has also been examined. The findings of this research suggest that the core Philippine values of hiya, smooth interpersonal relationships (pakikisama), amor proprio and utang na loob underlied most processes in end-of-life decision making.
The study concludes that the concept of "euthanasia" for Filipino relatives means caring for their patients and letting go only until such time that they perceive that God and the patient himself has =decided‘ that it is time to rest, namely when their patient‘s heart stops during the period of waiting and =acceptance.‘ For physicians, "euthanasia" means continually caring for the patient but indirectly suggesting and doing withholding and withdrawing of life-sustaining treatments from the patient so that this will be beneficial not only for the patient himself but also for those whom he leaves behind - euthanasia as humane care
Family Support as Moderator of the relation between Coping Skills and Substance Use Dependence among Filipinos who use drugs
Get PDFFamily Support as Moderator of the relation between Coping Skills and Substance Use Dependence among Filipinos who use drugs
No full textVulnerability to substance use disorders (SUD) vary across individuals; however, there is scant evidence examining how family support is associated with coping skills and substance abuse, especially among adults. This study described how family support moderated the relationship between coping skills and substance abuse among Filipino adults who used drugs. The social influence theory on drug use was used to guide the analysis of data from 340 participants from the Katatagan Kontra Droga sa Komunidad program, a voluntary outpatient substance abuse treatment program held in two cities in the Philippines. Participants answered a survey questionnaire measuring substance use dependence (SUD) symptoms, drug recovery skills, life skills, and perceived family support. Most of the participants were males and mostly used methamphetamine or shabu. Among those with SUD symptoms, moderation analysis showed that life skills were inversely associated with SUD symptoms. Family support moderated the relationship between life skills and SUD symptoms, suggesting that family support is most critical for those with lower life skills. The study concludes that life skills and family support are important factors that contribute to the treatment success among mild-risk persons who use drugs (PWUDs) in the Philippines and therefore need to be prioritized in treatment programs and health promotion initiatives
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
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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