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At least 1,297 records · Page 72Linked to original sources
PubMed2003

Predicting attendance for breast screening using routinely collected data.

The aim of this paper is to predict attendance if the age range for routine invitation to breast screening were to be extended. The response to the most recent screening invitation is modelled for women eligible for screening if the age range were extended. The independent variables include (i) the woman's characteristics: her screening history; the deprivation score of the area she lives in and (ii) the characteristics of the screening: whether the screening took place in a mobile van or at a static site; and time of the year. The predictive ability of the regression model is tested by goodness of fit measures and by predicting attendance for a holdout sample of the data and for women who participated in a demonstration project. The modelling of attendance is quite successful in that most hypothesised variables have the expected sign. Moreover, the predictive ability of the model is satisfactory in terms of goodness of fit statistics and in terms of accuracy of predictions for a holdout sample. The model predicts less well for the demonstration project possibly because it is less representative of usual screening practice.

Aged↗
PubMed2000

Assessment of dysfunctional working models of self and others in schizophrenic patients: a summary of data collected in nine nations. International Research Group.

OBJECTIVE: To investigate the cross-cultural feasibility of a new scale for assessing dysfunctional working models of self and others, and to evaluate its discriminative power. METHOD: Schizophrenic patients (N=351), non-psychotic patients (N= 86) and non-clinical subjects (N= 511) collected in 10 centres completed the DWM-S. Current psychopathology was assessed by means of the BPRS. RESULTS: Alpha coefficients were high in all samples. Mean scores on the DWM-S appeared to be comparable in all countries, suggesting cross-national generalizability. No significant correlation was found with sex, age, levels of psychopathology and duration of illness. Discriminant analyses showed that more than 70% of the schizophrenic patients are correctly classified. CONCLUSION: The DWM-S is an easily administered self-report instrument which allows to pinpoint internal dysfunctional working models of self and others in various types of patients. It is a useful tool for case conceptualization, especially when psychotherapeutic interventions are part of the treatment programme.

Adult↗
PubMed2006

Adherence to antiretroviral medications in HIV: differences in data collected via self-report and electronic monitoring.

Controversy remains regarding the reliability of methods used to determine adherence to antiretroviral medication in HIV. In this study the authors compared adherence rates of 119 HIV-positive participants during a 6-month study, as estimated via electronic monitoring (EM) and self-report (SR). Adherence for both short (4-day) and long (4-week, or intervisit) periods was examined, as well as factors that underlie discrepancies between EM and SR. Results showed that intervisit EM estimates were consistently lower than those of SR. SR estimates based on shorter periods (4 days) were closer to those of EM. Higher discrepancies between EM and SR estimates were associated with lower cognitive functioning and externalized locus of control. These findings lend support for using both EM and SR methods; however, study design (e.g., length) and other factors (e.g., cognitive status, cost) should be considered.

Adult↗
PubMed2002

A description of an intermediate care service using routinely collected data.

Background Intermediate care is a potentially important means of reducing pressures on acute hospitals. However, intermediate care itself is a heterogeneous concept, so to make appropriate comparisons it is important to be able to describe and to group different types of intermediate care services. The aim of this study was to explore the information available from routine data sources to assess its potential for monitoring performance. Methods A retrospective examination of routine community-based data for a newly established intermediate care nursing service over a 12-month period from April 1998 to March 1999. Results The service provided out-of-hours community nursing care for 903 patients in 1071 episodes of care and 6033 recorded contacts. Although information about patient characteristics and episode start-dates were complete, over half the episode end-dates were missing. The data suggested that this was primarily a domiciliary service for people aged 65 years and over, covering six main care programmes: genito-urinary, neoplasm, wound management, elderly care, gastro-intestinal and locomotor care. Most of the referrals were from primary care clinicians. Conclusion Using routine data can provide a reasonably good description of services, enabling appropriate comparisons of similar services. At present, the way we view and count activity can fragment services and increase the stress on clinicians. We need to shift our service-focused approach to a patient-centred one. This can be done now by consistent use of patient identifiers and by encouraging services to plan data linkage. But a gap still remains with regards to outcomes, limiting our ability to measure effectiveness.

Adolescent↗
PubMed2001

[Quality assurance study of benign and malignant goiter. Prospective multicenter data collection regarding 7,617 patients].

A quality control study was undertaken on 7,265 patients with benign goitre and 352 patients with malignant goitre who were surgically treated between 1.1.98 and 31.12.98. 3 hospital groups were defined according to surgical workload: Group 1: < 50 operations/yr; Group 2: 50-150 operations/yr; Group 3: > 150 operations/yr. The temporary rate of recurrent laryngeal nerve (RLN) palsies for benign goitre was 3.9% and the permanent 1.1%. For malignant goitre the rates were 12.8% and 6.8% respectively. The rate of temporary (p < 0.040) and permanent (0.003) palsies after surgery for benign goitre was lower in group 3 compared to group 1 and 2. There were too few cases for statistical analysis of the malignant goitres. After benign goitre surgery a transient hypocalcaemia rate of 6.3% and a permanent of 1.1% were observed. For malignant goitre the incidence was 23.8% and 7.1%, respectively. A significantly increased rate of permanent hypocalcaemia (p < 0.003) was demonstrated in group 3 after surgery for multinodular goitre. Centres in group 3 made more extended (smaller thyroid remnants) resections (p < 0.01) with the equivalent rate of general complications. The average inpatient stay for malignant goitres was 13.1 days and for benign goitres 8.7 days. On average, patients with bilateral resections for benign goitre stayed 0.4 days longer in hospital than those with unilateral procedures. Prophylactic antibiotics were administered to 2.1% of patients and 94.6% received thrombosis prophylaxis.

Adult↗
PubMed1996

[Emergency service utilization and athletic injuries--data collection from the Fulda district].

Throughout the period of one year all sports accidents, which implied the need of medical services (n = 59), in the district of Fulda with 195,000 inhabitants were analysed. The bulk of the accidents took place during soccer matches (37.3%). The share of women was 25.4%. A repeated trauma was registered in 69.5% of the cases. 16% of the casualties received outpatient treatment. The ambulance was already at the site of the accident in 35.6% of the cases. The greater part of the accidents happened in the afternoon (57.6%). The accident was caused due to another athlete in 44.1% of the accidents. An ambulance with a doctor on board was needed four times, because the injury demanded treatment by an internist. The principle measure of first aid, taken by the ambulance men, was the positioning of the injured limb on a splint (n = 44). The incidence of sports accidents with need for medical service is 30/100,000 inhabitants. The part of sports accidents in relation to all ambulance actions is 2.3% (internal medicine only 0.18% and surgery only 15.3%). The percentage of sports accidents demanding a doctor in relation to all rescues with the need for a doctor is 0.3%.

Adolescent↗
PubMed1999

[Sexual homicide--a data collection from psychiatric records].

After an analysis of the concerning literature we conceptualized a questionnaire with 124 items, which describes the most common characteristics of sexual murderers. The relevance of these characteristics was examined on the basis of psychiatric records. The hypothesis was, that persons who murdered more than once show these characteristics more evidently than single murderers. We compared 20 psychiatric records about single sexual murderers with those about 10 repetitive sexual murderers. Planned offenses, chronic isolation, narcism and tendency to perversity were found more often in persons that murdered more than once. Especially the psychosocial factors were found less often than in the angloamerican literature. More pronounced were the differences between a group of sadistic murderers compared with nonsadistic murderers, using criteria for sadism extracted from Kafft-Ebings first description (1892), Schorsch and Becker (1977), MacCulloch et al. (1983) and Ressler et al. (1988). A case example illustrates the importance of an elaborated concept of sadism and its relation to personality disorder.

Adult↗
PubMed1999

Indication-based use of antimicrobials in Finnish primary health care. Description of a method for data collection and results of its application.

OBJECTIVE: To collect population-based information on treatment of infections with antibiotics in PHC. DESIGN: A questionnaire study for general practitioners (GPs). SETTING: All health centres of Pirkanmaa Hospital District in Finland. PATIENTS: Patients with any infection attending health centre during 1 week in November 1994. MAIN OUTCOME MEASURES: An infection diagnosis by the GP. RESULTS: A total of 4150 questionnaires were received from 223 doctors. Respiratory tract infections comprised 80% of all infections. Of all patients 64% received antimicrobial treatment. Unspecified upper respiratory tract infections and pharyngitis were rarely treated with antimicrobials (10 and 21%, respectively), whereas patients with acute bronchitis received antibiotics as often (83%) as patients with otitis media (93%) or tonsillitis (86%). The most commonly prescribed substances were cephalosporins (19% of all antimicrobials), penicillin V (17%), and amoxycillin (17%). Half of the cephalosporin use could be regarded as overuse. Half of the sulphatrimethoprims were used for otitis media. A quarter of the patients expressed a desire to receive antibiotic treatment. CONCLUSION: The method was practical, inexpensive, and successful in giving such information, which is needed for supervising the rational use of antibiotics in primary health care.

Adolescent↗