1,721,029 research outputs found
Critical Period, High-acuity Illness, Inequitable Access: Understanding Outcomes following Postpartum Psychiatric Emergency Visits, and the Role of Social Determinants of Health
Get PDFWithin the year following childbirth, approximately 1 in 100 postpartum individuals visit an emergency department (ED) for a psychiatric reason. Postpartum psychiatric ED visits are an indication of acute need for mental health care, and an opportunity to coordinate services. This thesis aimed to fill gaps in knowledge about the outcomes of postpartum individuals following psychiatric ED visits, and specifically understand how individual and intersecting social determinants of health relate (1) to inpatient hospital admission from the ED, and for discharged individuals, (2) to outpatient physician follow-up within 30 days, and (3) to subsequent psychiatric admission within 365 days. The thesis is comprised of three projects, all of which use Ontario health administrative data to examine a cohort of postpartum individuals with psychiatric ED visits (2008 to 2020). In each project, social determinants were examined independently, then in intersection using three distinct methods. In Project 1, 16.0% of individuals were admitted to hospital from the initial ED visit and, of the examined social determinants of health, only Chinese ethnicity was associated with an increased risk of admission after adjusting for clinical and other factors. Additive interaction to evaluate for synergistic or antagonistic effects between social determinants was non-significant. In Project 2, 44.8% of discharged individuals saw a physician for mental health care in the 30 days following the ED visit, with less follow-up in younger individuals, those in low-income and rural areas, and immigrants. Conditional inference trees used to examine social determinants in intersection identified patterns not evident from traditional regression (e.g., neighbourhoods diversity related to follow-up only among those aged ≤25 years). In Project 3, 9.5% of those discharged had a subsequent psychiatric admission, with a lower likelihood of admission among younger and immigrant individuals. Latent class analysis identified 4 socially distinct subgroups, which had differing risk of admission. Taken together, this thesis identified gaps in both inpatient and outpatient mental health care in a high-acuity postpartum population. Complexity in the relationships between social determinants and health service access underscore the need for intersectionality-informed approaches to improve equitable postpartum mental health service delivery.Ph.D.2024-03-13 00:00:0
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
Electroconvulsive Therapy for Hospitalized Patients with Depression
Get PDFElectroconvulsive therapy (ECT), the most effective treatment for depression in psychiatry, is underused due to stigma and lack of information regarding its risks and benefits. The aims of this thesis were to inform evidence-based use of ECT by identifying patient-level factors that influence the use of ECT and determining the association between ECT and rare but clinically important medical and psychiatric outcomes. The thesis included three projects using administrative health data of hospitalized patients with depression in Ontario, Canada between 2007 and 2017. The first project was a comprehensive assessment of patient characteristics associated with receipt of inpatient ECT in Ontario. Both clinically appropriate, and potentially inappropriate factors were associated with receipt of inpatient ECT, suggesting opportunities to increase appropriate utilization. In the second project, the risk of serious medical events associated with ECT compared to no ECT was evaluated using propensity score matching that adjusted for a large set of sociodemographic and clinical variables. There was no clinically significant increased risk of serious medical events – as measured by medical hospitalization or death – with ECT exposure. In the third project, weighting by the odds of the propensity score was used to compare the risk of suicide among individuals receiving ECT vs. similar individuals not receiving ECT in the year following discharge from psychiatric hospitalization. ECT was associated with a significantly reduced risk of suicide and all-cause death. Taken together, these findings provide important data that can be used to support the evidence-based use of ECT in a highly vulnerable clinical population.Ph.D
Twin Pregnancy and Severe Maternal Mental Illness: A Canadian Population-based Cohort Study
Get PDFObjective: To quantity the short- and long-term risks of severe maternal mental illness arising after a twin vs. singleton birth.
Methods: This propensity-score weighted population-based retrospective cohort study comprised primiparous Canadian women aged 15-50 years. We compared 15,024 twin livebirths to 796,804 singletons livebirths, from 2003-2019. The primary composite outcome was a psychiatric emergency department visit, hospitalization, self-harm or suicide event – both in the first year postpartum, and from 1 year postpartum up to 17 years post-delivery.
Results: In the first year postpartum, after weighting, the rate of composite outcome events was 10.5 vs. 8.7 per 1000 person-years among twin and singleton births respectively (HR 1.21, 95% CI 1.07-1.47). Starting from 1 year postpartum, the corresponding rates were 5.9 vs. 6.1 per 1000 person-years (HR 0.96, 95% CI 0.89-1.04).
Conclusions: Women with a twin birth may experience more severe adverse mental health within 1-year postpartum, but not in the long-term.M.Sc
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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