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Definitions in paediatric palliative care. 儿科姑息治疗的定义。
Health trends Pub Date : 1993-01-01
R Sutherland, J Hearn, D Baum, S Elston
{"title":"Definitions in paediatric palliative care.","authors":"R Sutherland,&nbsp;J Hearn,&nbsp;D Baum,&nbsp;S Elston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Consideration of care provision for children with life-threatening and life-limiting illness may be hampered by the lack of an agreed set of working definitions for such basic terms as: child, life-threatening condition, life-limiting condition, palliative care, respite care and hospice care. We suggest definitions to stimulate debate, and hopefully agreement, about terms that are central to the Department of Health's current programme of pilot initiatives in support of children with life-threatening and life-limiting illnesses, and their families.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 4","pages":"148-50"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21055796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Childhood immunisation and family size. 儿童免疫接种和家庭规模。
Health trends Pub Date : 1993-01-01
J Li, B Taylor
{"title":"Childhood immunisation and family size.","authors":"J Li,&nbsp;B Taylor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper reports an investigation into the associations between the number of children in the family and the vaccination uptake performance of those children. Using data from child health computer system the pertussis vaccination status was studied in 3,694 children aged 12 to 14 months. The findings show a strong association between vaccination uptake and the number of children in the family. The uptake rates reduced steadily from 86% for families with only one child to 58% for families with five children or more. Children from larger families were not only less likely to complete their full course of pertussis vaccination, but were also vaccinated later. Logistic regression analysis, which allowed for other associated factors, estimated that one 'child unit' increase in family size decreases the odds of being vaccinated by a factor of 1.7 in rural and suburban families and 1.3 in inner-city families respectively. Health professionals involved with the immunisation service should use child health computer data to target their problematic populations more effectively to achieve high vaccination uptake rates.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"16-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The inappropriate use of acute hospital beds in an inner London District Health Authority. 内伦敦地区卫生局对急症病床的不当使用。
Health trends Pub Date : 1993-01-01
C Victor, B Nazareth, M Hudson, N Fulop
{"title":"The inappropriate use of acute hospital beds in an inner London District Health Authority.","authors":"C Victor,&nbsp;B Nazareth,&nbsp;M Hudson,&nbsp;N Fulop","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The requirement for District Health Authorities to assess the health care needs of their population implies that they must consider how well acute hospital care meets these identified needs. This study, which was conducted in an inner London health district, identified that 123 (14.6%) patients were perceived by medical and/or nursing staff to be inappropriately located in an acute bed. This group was dominated by patients aged 65 years or above, those in general and geriatric medicine, those with a length of stay of 30 days or more, and those with high levels of physical and mental dependency. The main reasons for patients being labelled as 'inappropriate' were the need for non-acute health services (eg rehabilitation, terminal care etc), a need for nursing home places or because of social or housing problems. Five months after identification, the notes of 100 of the 123 inappropriate patients were traced. Retrospective classification of these notes using the more 'objective' Oxford Bed Study Instrument showed that 97 patients were still defined as inappropriate. Details of the length of inappropriate stay were available for 74 patients who accrued 7,519 inappropriate bed days at a cost of 836,547 pounds. These patients are an illustration of the potential failings of current health and social care systems and highlight the need for imaginative care solutions which bridge this divide.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"94-7"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between a severity of illness indicator and mortality and length-of-stay. 疾病严重程度指标与死亡率和住院时间之间的关系。
Health trends Pub Date : 1993-01-01
N Hicks, R Kammerling
{"title":"The relationship between a severity of illness indicator and mortality and length-of-stay.","authors":"N Hicks,&nbsp;R Kammerling","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One important determinant of the cost and outcome of medical care is the severity of illness; there is no routinely available severity measure used in the United Kingdom. An American clinical information system, Medisgroups, was used to allocate 2,279 general medical patients to one of five admission severity groups in an English teaching hospital. The results showed a highly significant association between increasing severity and both length-of-stay and mortality. However, a further analysis of patients in the ten most common Diagnosis Related Groups showed that diagnostic group alone accounted for about twice the amount of variation explained by severity. The addition of severity to Diagnosis Related Groups only gave a very small rise in the overall explanatory power. These results are broadly consistent with those from larger American studies, which suggest that severity of illness at admission may not be as important as widely supposed in explaining variations in length-of-stay and mortality.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 2","pages":"65-8"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New horizons in post-marketing surveillance. 上市后监控的新视野。
Health trends Pub Date : 1993-01-01
P Waller, S Wood
{"title":"New horizons in post-marketing surveillance.","authors":"P Waller,&nbsp;S Wood","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Post-marketing surveillance is the process of monitoring and evaluating the safety of marketed medicines using a variety of methods. However, many doctors believe that post-marketing surveillance has a more limited meaning, ie an observational study of a new medicine sponsored by a pharmaceutical company. Although such studies were performed extensively in the United Kingdom during the 1980s, few have been published. Their purpose was to study large populations of users in ordinary practice with the aim of identifying hazards that had been missed, because clinical trials were too small, too short or did not always reflect real life. To some extent these studies have now fallen into disrepute, both on scientific grounds and because they have often been thought to be a thinly-disguised promotional exercise. The purpose of this article is to examine some of the previous problems with post-marketing surveillance and to propose new directions for the future.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prophylactic antibiotics at caesarean section do not reduce costs. 剖腹产时预防性使用抗生素并不能降低成本。
Health trends Pub Date : 1993-01-01
D Keane, D James
{"title":"Prophylactic antibiotics at caesarean section do not reduce costs.","authors":"D Keane,&nbsp;D James","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A prospective audit of 200 patients was undertaken to determine the effectiveness of prophylactic antibiotics at caesarean section in reducing the cost of postnatal care. The main outcome measures were the cost-effectiveness of this treatment in reducing the cost of care and incidence of infection. The results show that the routine administration of prophylactic antibiotics had no significant effect on infection rates, the prescribing of puerperal antibiotics or the duration of stay in the postnatal period. The total cost of antibiotics in the prophylaxis group was over four times that in the non-prophylaxis group. The results of this study suggest that routine administration of antibiotics at caesarean section does not reduce the costs of care in the puerperium.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"84-7"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neonatal hypoglycaemia: changing attitudes in the Northern Region. 新生儿低血糖:北方地区态度的改变。
Health trends Pub Date : 1993-01-01
U Wariyar, M W Platt
{"title":"Neonatal hypoglycaemia: changing attitudes in the Northern Region.","authors":"U Wariyar,&nbsp;M W Platt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There has been a recent resurgence of interest in the significance of moderate hypoglycaemia in neonates; although old assumptions have been questioned, there are insufficient data for new and authoritative guidelines to be published. This longitudinal study was designed to test the hypothesis that there have been changes in attitudes among those caring for newborn babies in the 18 maternity units in one health Region. The data were collected by questionnaire in 1986 and 1991, and responses were complete. The results showed a significant shift to higher values in the definition of hypoglycaemia over the five years, in association with a tendency to feed babies earlier--although some units had not altered their policies.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 4","pages":"150-2"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21006818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blood use in spinal operations in children. 儿童脊柱手术中的血液使用。
Health trends Pub Date : 1993-01-01
P Laing, N Lalliotis, J Dorgan, L Ball, J Minnards
{"title":"Blood use in spinal operations in children.","authors":"P Laing,&nbsp;N Lalliotis,&nbsp;J Dorgan,&nbsp;L Ball,&nbsp;J Minnards","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper reports a retrospective analysis of blood use in 27 children undergoing major spinal surgery in Liverpool in 1990. Overall 133 units of blood were cross-matched, but only 60 units (45%) were used. The results of the analysis show a significant difference between the operative techniques used in elective spinal surgery. This hospital has now introduced new guidelines for the cross-matching of blood.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"12-3"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical audit of behaviour therapy training of nurses. 护士行为治疗培训的临床审核。
Health trends Pub Date : 1993-01-01
C Duggan, I Marks, D Richards
{"title":"Clinical audit of behaviour therapy training of nurses.","authors":"C Duggan,&nbsp;I Marks,&nbsp;D Richards","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In health care training, professional examinations of competence test trainees' knowledge rather than their actual contribution to the improvement of patients' health. Clinical training programmes have the ultimate aim of improving patients' health, but rarely measure their success in attaining it. This paper provides an analysis of the results of clinical outcome for 2,032 patients treated during eight consecutive English National Board 650 courses, in which 68 nurse behaviour therapist trainees were trained at the Maudsley Hospital from 1978-91. The outcome of 668 patients treated in three recent courses (1987-91) is compared with that of 1,384 patients treated in five earlier courses (1978-86). Measures and diagnostic categories were similar over the whole study period. The trainees in 1987-91 achieved a similar health gain for most of their patients as did their counterparts in 1979-86, but this was achieved over a shorter time spent with each patient, and with greater effect in patients diagnosed as obsessive ruminators. These efficiency gains seem to reflect the incorporation into recent training of treatment advances in anxiety disorders.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Community leg ulcer clinics: cost-effectiveness. 社区腿部溃疡诊所:成本效益。
Health trends Pub Date : 1993-01-01
N Bosanquet, P Franks, C Moffatt, M Connolly, M Oldroyd, P Brown, R Greenhalgh, C McCollum
{"title":"Community leg ulcer clinics: cost-effectiveness.","authors":"N Bosanquet,&nbsp;P Franks,&nbsp;C Moffatt,&nbsp;M Connolly,&nbsp;M Oldroyd,&nbsp;P Brown,&nbsp;R Greenhalgh,&nbsp;C McCollum","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study investigates the cost-effectiveness and efficacy of a new service provided by community leg ulcer clinics, and compares it with treatment in existing hospital-based venous ulcer care clinics. Data were provided prospectively from district nurses and retrospectively from patients. Success in treatment was assessed as a percentage of ulcers completely healed after 12 weeks of treatment, analysed by the up-table method. Treatment success of 22% at 12 weeks using existing methods compared with 80% in community clinics. Costs were estimated to be 433,600 pounds and 169,000 pounds respectively. These findings indicate that community leg ulcer clinics were more effective and less expensive than the previous system of care.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 4","pages":"146-8"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21006813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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