Decision making in medical surgical nursing/ Gorzeman

xx, 427 hal.: ill.; 27 c

Decision making in medical surgical nursing/ Gorzeman

xx, 427 hal.: ill.; 27 c

Decision making in medical surgical nursing/ Gorzeman

xx, 427 hal.: ill.; 27 c

Political topic-communities and their framing practices in the Dutch Twittersphere

In light of the need for political plurality and informed debate this study questions information distribution and curation on Twitter. We contribute to the understanding of ideological homophily by exploring the notion of the ‘echo chamber’. Using a sample of two weeks of Dutch Twitter data, we combine network analysis of retweet networks, with qualitative reading and categorisation of engagement with media content in tweets within political topic communities. We found that media references were predominantly framed in affirmative ways in relation to the referenced medium content. Our findings show that users consciously select media messages that correspond with the general sentiment within their topic community, or frame them accordingly. We see this as a willful ‘echo chamber’, or a ‘repillarisation’

Political topic-communities and their framing practices in the Dutch Twittersphere

In light of the need for political plurality and informed debate this study questions information distribution and curation on Twitter. We contribute to the understanding of ideological homophily by exploring the notion of the ‘echo chamber’. Using a sample of two weeks of Dutch Twitter data, we combine network analysis of retweet networks, with qualitative reading and categorisation of engagement with media content in tweets within political topic communities. We found that media references were predominantly framed in affirmative ways in relation to the referenced medium content. Our findings show that users consciously select media messages that correspond with the general sentiment within their topic community, or frame them accordingly. We see this as a willful ‘echo chamber’, or a ‘repillarisation’

Clinical value of drugs of abuse point of care testing in an emergency department setting

Objective: Toxicology screening tests for drugs-of-abuse and therapeutic drugs in urine (TST-U) are often used to assess whether a patient’s clinical condition can be explained by the use of drugs-of-abuse (DOA) and/or therapeutic drugs. TST-U have clinical value when they support clinical decision making by influencing diagnosis and patient care. We aim to quantify the influence of TST-U results on diagnosis and patient care in an emergency department. Our secondary objective is to identify specific patients for which a TST-U is most warranted or mostly unhelpful. Methods: This prospective observational study was performed at the emergency department of a middle-sized urban teaching hospital. A point of care TST-U has been used in this department for three years. When a TST-U is considered indicated by a physician, the influence of the TST-U result on diagnosis and patient care is quantified before and after the test results are available, by means of a questionnaire. Urgency and complaints upon admission have also been registered. Results: Of 100 TST-U results 37% were reported having a substantial influence on diagnosis and 25% on patient care. TST-U had a substantial influence on diagnosis in 48% of patients with decreased consciousness, 47% of patients with psychiatric symptoms and in 47% of patients with “other” complaints. In this last category patients with neurological symptoms benefited most. In patients who were already suspected to be intoxicated, only 18% of the TST-U results had substantial influence on diagnosis. Conclusions: The use of point of care TST-U in an Emergency Department helps physicians to understand the clinical condition of a patient. They influence the way a patient is treated to a lesser extent. These tests are most helpful in patients with decreased consciousness, psychiatric or neurological symptoms and mostly unhelpful in patients who, upon admission, are already known to be intoxicated. Keywords: Intoxications, Drug tests, Point of care testing, Drugs of abus

The Gab Project: The Methodological, Epistemological, and Legal Challenges of Studying the Platformized Far Right

In this article we describe our five-year research project on the notorious radical free speech service and fringe platform Gab. During these years we scraped an entire platform, prepared it into a dataset for analysis, and opened it up to a broader community of students and researchers. Each of these projects provides us not just with a small slice of platformized far-right culture but also with a larger sphere of a fringe platform. However, the overarching goal of the Gab project was to contribute to a methodology for the study of the contemporary platformized far right. The atypical nature of the project posed many methodological, epistemological, and legal challenges. It therefore kicked off an institutional learning process about the possibilities, legal boundaries, and best practices for research compliant with General Data Protection Regulation (GDPR). In this article we argue that the study of the platformized far right should have a thorough understanding of the medium on which the object is present, as well as the methods with which the object is captured. What is more, scholars that use digital tools and data methods for capture and analysis of web platforms must become literate in operating them. Consequently, data-driven research on the far right is naturally interdisciplinary and therefore cooperative and adherent to the principles of open science

Minder onterechte appendectomie door echografie en CT

To evaluate the effect of the use of ultrasonography (US) and optional computed tomography (CT) or diagnostic laparoscopy on the percentage of unnecessary appendectomies in patients with suspected acute appendicitis. Prospective and comparison with a historical control group. Following the introduction of ultrasound imaging as an initial step, the outcomes in all patients presenting with suspected appendicitis in the emergency department were prospectively collected during a period of 18 months (July 2006-December 2007). Results were compared to retrospectively collected data on all patients who had undergone appendectomy for acute appendicitis in 2001, before the introduction of this imaging investigation. Of the 312 consecutive patients in the emergency department with suspected acute appendicitis, the condition was excluded in 51 patients following clinical and laboratory investigation. The diagnostic algorithm was applied in 239 of the 261 patients (92%). All of them had initial US, followed by additional CT in 75 patients (31%) and diagnostic laparoscopy in 12 patients (5%). Appendectomy was performed in 130 patients, and 8 (6%) of the appendices were shown to be healthy following pathological investigation. Before the implementation of preoperative imaging 36 of the 170 appendices (21%) were healthy. Following the introduction of imaging techniques in accordance with the guideline there was a significant reduction in the percentage of unnecessary appendectomies (21% versus 6%; p <0,001). The complete supplementary diagnostic algorithm had a positive and negative predictive value of respectively 90% and 98% for acute appendicitis. Structural implementation of US with optional CT and diagnostic laparoscopy in patients with suspected acute appendicitis resulted in a lower percentage of unnecessary appendectomie