1,720,969 research outputs found
Intestinal parasite infection amongst preschool-age children in the Democratic Republic of Congo: a multilevel analysis
No full textWhat can standardised assessments tell us about the language skills of junior aged children with hearing impairment?
No full textA comparison of rectilinear and truncated exponential biphasic waveforms in elective cardioversion of atrial fibrillation: a prospective randomized controlled trial
No full textBackground: several different biphasic waveforms are used clinically, but few studies have compared their efficacy. The two main waveforms are the biphasic rectilinear (BR) and biphasic truncated exponential (BTE) waveforms, both of which have important differences, particularly at the extremes of transthoracic impedance.Objective: to compare the efficacy of two commonly used defibrillation waveforms in the elective cardioversion of atrial fibrillation.Methods: in a prospective randomized controlled study, sequential adult patients undergoing elective cardioversion for AF were recruited. Patients were randomized to receive synchronized defibrillation using either a BR or BTE waveform, both using a 50 J, 100 J, 150 J, 200 J, 200 J selected energy escalating protocol. Failure to cardiovert after the fifth shock was classed as failed defibrillation. The power of this study was 80% with 5% significance level to detect a difference of 20% or greater between groups. Survival analysis was used to compare the total energy delivered to achieve successful cardioversion between groups.Results: a total of 202 patients were recruited, of which data are complete for 199 (100 BR; 99 BTE). Median number of shocks to achieve cardioversion was 2 for the BR waveform and 3 for the BTE waveform (P = 0.059). In the BR waveform group, 95/100 (95.0%) achieved sinus rhythm. In the BTE waveform group, 90/99 (90.9%) achieved sinus rhythm and this group required on average 117.1 J more energy to achieve the outcome compared to the BR waveform group (P = 0.838).Conclusions: BR and BTE waveforms show similar high efficacy in the elective cardioversion of atrial fibrillatio
Risk-taking in junior doctors working night shifts in intensive care
No full textSleep deprivation impairs executive function, information processing, visual-spatial perception, psychomotor skills and, importantly, affects clinical performance. Alternating day and night shifts causes circadian misalignment, compounding these deficits . Risk taking, although causally linked to sleep deprivation, has not been reported in doctors working night shifts.We studied risk taking in 12 healthy junior doctors (below consultant level) working 3-4 consecutive 13h night shifts in neurological and paediatric ICUs . Participants were tested at lunchtime before the first night shift and between 8:30-10:00 am after the last shift. Randomised testing order controlled for practice effects. Eleven participants (9 male); aged 26-36y, completed two computerised tasks at each time point: the Balloon Analogue Risk Task (BART) and the Attention network task (ANT). Wilcoxon-signed rank tests in SPSS v22 (Armonk, NY: IBM Corp) and 95% confidence intervals (CI) for the difference between medians in Confidence Interval Analysis (CIA) software (version 2.2.0) were used in the analysis. The study was approved by the Faculty of Medicine Ethics Committee, University of Southampton. Participants showed a significant increase in risk taking on the BART (pre-shift median=38.5, post-shift median=45.0; difference between medians with 95% CI=11.4 (3.1 to 20.9); p=0.021). There were no differences in change in BART scores by gender. There was no significant change in ANT scores (see online supplement, below), noteworthy as attention is sensitive to sleep deprivation, indicating that risk taking may be particularly vulnerable to night shift exposure.What are the professional implications of risk taking? Junior doctors are less risk averse than senior peers and confidence levels in decision-making remain intact during sleep deprivation. Higher levels of risk-taking, without compensatory reduction in confidence, increase the likelihood of clinical error, particularly in an ICU where rapid decisions are necessary. What of the personal consequences? Of 1,135 UK doctors surveyed online, 41% of reported falling asleep whilst driving home after a night shift. Junior doctors may suffer double jeopardy on the roads as risk taking behaviours increase vulnerability to road traffic accidents.Risk-taking behaviour in junior doctors after ICU night shifts has potentially serious implications for professional practice and personal wellbeing and deserves further study.<br/
Young persons' access to genitourinary medicine clinics in the UK: a cross-sectional survey
No full textStudy design: this service evaluation of genitourinary medicine (GUM) clinics in the UK was designed to quantify access for young people requesting to be seen and to establish whether they could be seen outside school hours.Methods: in December 2009 postal questionnaires were sent to all lead clinicians in UK GUM clinics asking when they expected a young person would be offered an appointment and whether it could be outside school hours. Between January and March 2010 trained male and female medical students posing as 16 year olds telephoned all GUM clinics listed on the British Association for Sexual Health and HIV website with symptomatic and asymptomatic scenarios and requested an appointment after school hours.Results: 99% of the 152 responding clinicians estimated that an appointment would be offered within 48?h for both male and female contacts and over 90% could be seen outside school hours whether symptomatic or not. Of the 666 clinic telephone contacts, 88% were offered an appointment within two working days, and 66% were offered an after school appointment within 2?days. There was no significant difference whether the ‘patient’ was symptomatic or not (87% vs 86%, respectively, p=0.784) in being offered an appointment within two working days. There was variation between countries, with England performing significantly better; 94% were offered an appointment within 2?days versus 58%, 55% and 67% for Wales, Scotland and Northern Ireland, respectively.Conclusion: the findings would support the impact and value of process targets on service deliver
Neutralising antibody responses in cattle and sheep following booster vaccination with two commercial inactivated bluetongue virus serotype 8 vaccines
No full textCattle and sheep that had received a primary course of vaccination with an inactivated bluetongue virus serotype 8 (BTV-8) vaccine were booster vaccinated 6 or 12 months later with the homologous vaccine or an alternative inactivated BTV-8 vaccine and neutralising antibody responses were determined. Antibody titres to the alternative vaccine were significantly higher than to the homologous vaccine (P = 0.013) in cattle. There was no significant difference between the antibody responses to alternative and homologous vaccines in sheep. These data indicate that cattle and sheep primed with one inactivated BTV-8 vaccine may be effectively boosted with an alternative commercial inactivated BTV-8 vacci
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
- …
