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At least 163 records · Page 9Linked to original sources
PubMed1999

[Quality assurance in intensive care: the situation in Switzerland].

The movement for quality in medicine is starting to take on the dimensions of a crusade. Quite logically it has also reached the intensive care community. Due to their complex multidisciplinary functioning and because of the high costs involved, ICUs are model services reflecting the overall situation in our hospitals. The situation of Swiss intensive care is particularly interesting, because for over 25 years standards for design and staffing of Swiss ICUs have been in effect and were enforced via onsite visits by the Swiss Society of Intensive Care without government involvement. Swiss intensive care thus defined its structures long before the word "accreditation" had even been used in this context. While intensive care in Switzerland is practised in clearly defined, well equipped and adequately staffed units, much less is known about process quality and outcomes of these services. Statistics on admissions, length of stay and length of mechanical ventilation, as well as severity data based on a simple classification system, are collected nationwide and allow some limited insight into the overall process of care. Results of intensive care are not systematically assessed. In response to the constant threat of cost containment, Swiss ICUs should increasingly focus on process quality and results, while maintaining their existing good structures.

Critical Care↗
PubMed1992

Analysis of injury and death from burning upholstered furniture.

AIMS: Upholstered furniture is considered by governments in the United Kingdom, United States of America, Canada and New Zealand to be a potentially hazardous product. Use of polyurethane foam in upholstered furniture in the United Kingdom was banned in 1989 so as to reduce the risk of injuries and deaths from fire. This study assessed the situation in New Zealand. METHODS: Burn related deaths (1977-86) and injuries (1986) from the Health Statistics Services hospitalisation records were examined to identify cases in which upholstered furniture and bedding were implicated and analysed to describe the situation. Coroners files where relevant were examined. Detail on all fires and domestic fires for 1987 obtained from the New Zealand Fire Service were also examined. Characteristics of upholstered furniture available in New Zealand during the 1987 production year were identified through responses to a questionnaire sent to manufacturers, wholesalers and importers of this type of furniture. RESULTS: Examination of burn related deaths in which upholstered furniture and bedding were implicated (28.3% of all burn related deaths) showed the average annual death rate was at least 0.16 per 100,000 population and that the change in rate over ten years was not significant. Bedding and mattresses appeared to be the first textile items to ignite in 25.1% of those deaths occurring in the bedroom and furniture in 7.2% of those in the lounge. At risk groups were males (1.9 per 100,000 compared with 1.3 per 100,000 for females), those over 55 years (males 5.3, females 4.8 per 100,000) and those who may live alone (separated 4.5, single 5.4, divorced 11.4, widowed 13.4 per 100,000). The mix of alcohol consumption, smoking, then falling asleep created a situation of risk. Sufficient information was not always available to identify with certainty that upholstered furniture and/or bedding was the item to first ignite those fires which subsequently caused burn related injuries and deaths. Manufacturers, wholesalers and importers of upholstered furniture in New Zealand reported that of the total units, at least 38.5% had covers of wool/wool rich or leather and other materials which generally do not ignite readily. Polyurethane and polyester hollow-fill were commonly used as fillings. CONCLUSIONS: The death rate attributable to burning of upholstered furniture and bedding was not found to be especially high. Bedding, mattresses and bedroom furniture were reported more frequently than upholstered furniture.

Bedding and Linens↗
PubMed1955

Mortality rate from skin cancer.

Cancer of the glabrous skin (exclusive of cancer of the superficial mucous membranes, melanoma, sarcoma and other rare skin tumors) is a highly curable disease. However, the mortality rate based on United States Public Health Service statistics for the State of California and an analysis of 35 fatalities occurring in 2,122 cases as observed over a 20-year period in the Visible Tumor Clinic at the University of California, is approximately 1.65 per cent to 1.75 per cent. Skin cancer could theoretically approach a 100 per cent cure rate with two simple rules: Firstly, the patient should seek proper medical advice early for all suspicious growths, moles or warts. Secondly, after an exact diagnosis is made by biopsy, the first treatment given by the physician, whether surgical, chemosurgical, electrosurgical or x-ray, should be complete and adequate, for the first time is the "golden opportunity" for cure.

Biopsy↗
PubMed1992

The impact of chronic diseases of lifestyle and their major risk factors on mortality in South Africa.

The purpose of this study was to determine the impact of chronic diseases of lifestyle on the mortality pattern of South Africans and to estimate the number of South Africans affected by major risk factors for these diseases. The proportion of deaths due to chronic diseases of lifestyle was calculated from the deaths reported to the Central Statistical Services. This group of diseases was responsible for 24.5% of deaths of all South Africans and 28.5% of those aged 35-64 years whose deaths were reported in 1988. The major causes of death contributing to these figures were cerebrovascular diseases (7.2% of all deaths and 7.9% of deaths of persons aged 35-64 years) and ischaemic heart disease (8.7% of all deaths and 9.6% of deaths of persons aged 35-64 years). The age-standardised prevalence rates for the major risk factors reported in five cross-sectional studies in different areas and groups are compared. Estimates from the reported prevalence rates, based on the size of the South African population recorded in the 1985 census figures, were calculated for the major risk factors. Overall 4.88 million South Africans smoked, the largest group of smokers being black males (2.6 million). for hypertension 5.5 million South Africans had blood pressures above 140/90 mmHg; again the largest groups were blacks (3.0 million). For hypercholesterolaemia and raised low-density lipoprotein cholesterol levels, 4.8 million and 3.1 million South Africans respectively had an increased risk for ischaemic heart disease, blacks having the lowest levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Incidence of cancer among Pacific Island people in New Zealand.

AIM: to describe the epidemiology of new cancer registrations among Pacific Island people in New Zealand with a view to identifying important cancers for preventive activities. METHODS: new cancer cases registered with the New Zealand Cancer Registry of the Health Statistical Services for the decade 1979-88 were analysed. Cancer cases among Pacific Island people were compared with cancer cases among Maori and the remainder of the New Zealand population (other). RESULTS: while the number of cases reported among Pacific Island people was relatively small (1884), age standardised rates for cancer of all sites were much higher than age standardised rates for Maori and other populations. The age standardised rate (per 100,000 person years) for cancer of all sites among males in all age groups was 400 for Pacific Island, 308.8 for Maori and 295.3 for others. The age standardised rate for cancer of all sites among women in all age groups was 373.3 for Pacific Island women, 324.2 for Maori and 313.4 for other women. Liver cancer was more common among Pacific Island men than could be explained by temporary migration from the Pacific Islands for treatment. The age standardised rate for liver cancer was 28.2 for Pacific Island men, 11.4 for Maori and 1.9 for other men. Cancer of the cervix was the leading site among Pacific Island women as in Maori women, compared with breast cancer among women in the rest of the population. The age standardised rate for cervical cancer was 61.8 for Pacific Island, 69.0 for Maori and 59.3 for other women. CONCLUSION: in the decade 1979-88 there was an excess number of new registrations for some cancers described among Pacific Island people compared with Maori and other ethnic groups. Temporary migration from the Pacific Islands for treatment may explain some of the excess cases.

Adolescent↗
PubMed1987

[Characteristics of work-loss in diseases of the peripheral nervous system].

Diseases of the peripheral nervous system (PNS) rank fourth among all causes of temporal loss of working ability and first in the structure of neurological morbidity causing temporal disability. Statistical service based on the principles of the International Classification of Diseases, Injuries and Causes of Death does not provide the neurologic service with data about loss of the working time due to PNS diseases. In the comprehensive work on the improvement of neurologic care of patients with PNS diseases conducted in Byelorussia an important place has been recently given to the systematic monitoring of the temporal disability rate which decreased by 28.3% over a period of 3 years (1983-1985).

Delivery of Health Care↗
PubMed1988

[Morbidity registries of animal diseases: development, examples, trends].

The earliest registries of animal morbidity were established at the end of the nineteenth century and concerned contagious diseases. In the 1970s, the development of modern managerial methods on stock farms implied more systematized collection of statistics on clinical disorders. Since breeders are the principal observers of diseases, and because such sources of information as hospitals do not exist for animals, morbidity analysis must be based on surveys especially constructed and relying upon the participation of volunteers. We have cited here the example of ecopathological surveys based on volunteer stock farms and conducted in France at the level of cattle herds. The future of animal pathology registries should be based upon procedures using randomly selected samples, as in the system recently established in France by the Agronomic Research and Statistical Services of the Ministry of Agriculture.

Animal Diseases↗
PubMed1987

Notifiable malignant lesions in the RSA, 1979-1983--trends and mortality. I. Malignant neoplasms of the bronchus and lung.

Primary malignant tumours of the bronchus, lung and pleura were introduced as notifiable medical conditions in August 1979. The western Cape, Natal and eastern Cape have been the regions with the highest notification rates. Small numbers of cases and deaths were notified from other areas (Orange Free State, southern Transvaal, northern Transvaal and northern Cape). During the period 1979-1983 one-fifth of deaths registered at Central Statistical Services were notified to the Department of National Health and Population Development. Mortality due to lung cancer, as registered, increased by 39.3% in coloured females; from 24.2/100,000 to 33.7/100,000.

Adult↗
PubMed1987

Notifiable malignant lesions in the RSA, 1979-1983--trends and mortality. II. Primary malignant neoplasms of the pleura.

From August 1979 to December 1983, 22 cases of and 17 deaths due to primary malignant neoplasms of the pleura were notified to the Department of National Health and Population Development. Correspondingly, 458 deaths due to mesothelioma and malignant neoplasms of the pleura were registered at Central Statistical Services; 4% of these deaths were notified. Most of the deaths due to mesothelioma and malignant neoplasms of the pleura registered were in white males, who showed a mortality rate of 15.8/1,000,000.

Adult↗
PubMed1980

[Early education of disabled children seen from the angle of regionalization and inter-disciplinary work (author's transl)].

Early education of disabled children is presented as a specific and indispensable yet integrated part of a complex task which can be mastered solely by inter-disciplinary co-operation and interchange between educational, psychological, medical and clinical services. The author submits a concept - developed and put to the test at federal state level - of a regional and closely knit network of educationally-oriented education services. Statistical data obtained from 103 early education facilities in Bavaria give an insight into the work of such institutions.

Child Development↗
PubMedDate not supplied

Analysis of neonatal and infant mortality data for the white population of the Witwatersrand.

Statistics of population size, number of births, and neonatal and infant mortality for the White populations of 10 Witwatersrand municipalities were studied. Sources of data were: (i) national statistics from the Central Statistical Services; and (ii) annual reports from the local authorities. The two sources correlated well for population size and number of births (r = 0,99), less so for infant deaths (r = 0,71), and not at all for neonatal deaths (r = 0,43). Causes of infant mortality were also studied, using national and local reports. Comparison of hospital records with those of the local Department of Health revealed significant coding errors in the recording of causes of death. The mechanisms for reporting births and deaths are discussed and suggestions for improvements in the system are made.

Death Certificates↗
PubMed1984

[Multiple myeloma in South Africa--is the incidence increasing?].

Multiple myeloma was once thought to be extremely rare, with an estimated frequency of less than 0,1% of all malignant tumours. In 1964 Oettlé reported that available mortality statistics showed 171 deaths in the 10-year period 1949-1958 in the RSA for Whites, Coloureds and Asiatics aged 20 years and older. During the 5-year period 1968-1972, however, 222 cases of multiple myeloma appeared in the mortality records of the Central Statistical Service. Since 1964 150 new cases have been diagnosed at Karl Bremer Hospital and later at Tygerberg Hospital, with an average of 15 new cases cases per year from 1978 to 1982. Four examples of familial myelomatosis and one of familial macroglobulinaemia were found at these two hospitals. On 1 January 1983, 48 patients were on record who had attended the Tygerberg Hospital Haematology Clinic and 78 who had attended Groote Schuur Hospital, giving a total of 126 patients under treatment in the Western Cape during 1982. In addition, for the 6-year period from January 1971 to December 1976, 162 patients were reported from the haematology clinics at the Johannesburg General Hospital and Baragwanath Hospital. The true incidence of multiple myeloma in the RSA is problematical because there is no National Cancer Register; establishment of such a register would need the co-operation of all doctors in the country.

Adult↗
PubMed1981

Syphilis and gonorrhea; epidemiology update.

The epidemiologic patterns of venereal diseases (VD) in Greece were studied using data from the National Statistical Service, the University Hospital for VD and the special clinic for VD of the Ministry of Health, where prostitutes and homosexuals are examined. The main findings are as follows. Between 1962 and 1976 the frequency of both syphilis and gonorrhea declined among men as well as among women but the decline was more evident among women and among the older age groups (20+). Among men, the highest incidence is the age group 20-29 years, whereas among women the peak incidence is a little earlier. The rates for both syphilis and gonorrhea are higher in men than in women, higher in the greater Athens area than in the rest of Greece, and higher in single persons than in married one. There was a marked seasonal variation of VD with peak incidence at late summer. The decline of VD was also evident among prostitutes and male homosexuals with the exception of syphilis among uncontrolled prostitutes (increase) and male homosexuals (slight decrease).

Adolescent↗
PubMed1993

Maternal mortality in rural communities of Illubabor, southwestern Ethiopia: as estimated by the "sisterhood method".

In this study, the "sisterhood method", a new indirect technique, utilizing a cross-sectional survey by retrospective recall for deriving population-based estimates of maternal mortality for rural communities, was used in rural Illubabor region, Southwestern Ethiopia, in December 1991. The findings indicate a lifetime risk of maternal mortality of 0.0426, or 1 in 23 women; approximating a maternal mortality ratio of 570 per 100,000 live-births. The communities experience high maternal mortality which is compounded by high fertility as reflected by the total fertility rate of 7.6. The method can readily be applied to our settings to estimate the lifetime risk of maternal mortality and derive the maternal mortality ratio. In order to generate awareness, support planning and intervention strategies, community-based estimates of maternal mortality will remain a priority where vital events registration is non-existent and health service statistics are not reliable.

Adolescent↗
PubMed1995

Training birth attendants in the Sahel.

A small-scale training programme for birth attendants in a remote area of Burkina Faso was evaluated two years after it had been started. The evaluation methods included interviews with trained birth attendants and the analysis of health service statistics and survey data. The findings showed that the programme had been moderately successful in imparting knowledge and overcoming cultural inhibitions about assisted deliveries. However, the effectiveness of the programme was severely curtailed by structural deficits in the health system, especially lack of skilled staff, supervision and transport. In deprived areas such as the Sahel, it is probably the health centre, the hospital and the referral system that should be the first priority for improvement, rather than grass-roots practices.

Adult↗