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Information System Database (information + system_database)
Selected AbstractsCorticosteroids for acute chest syndrome in children with sickle cell disease: Variation in use and association with length of stay and readmission,AMERICAN JOURNAL OF HEMATOLOGY, Issue 1 2010Amy Sobota Acute chest syndrome (ACS) causes significant morbidity and mortality in sickle cell disease. The role of corticosteroids is unclear. The objectives of our study were to examine the variation between hospitals in their use of corticosteroids for ACS, describe characteristics associated with corticosteroids, and investigate the association between corticosteroids, length of stay, and readmission. We performed a retrospective examination of 5,247 hospitalizations for ACS between January 1, 2004, and June 30, 2008, at 32 hospitals in the Pediatric Health Information System database. We used multivariate regression to examine the variability in the use of corticosteroids adjusting for hospital case mix, identify factors associated with corticosteroid use, and evaluate the association of corticosteroids with length of stay and 3-day readmission rates controlling for propensity score. Corticosteroid use varied greatly by hospital (10,86% among all patients, 18,92% in patients with asthma). Treatment with corticosteroids was associated with comorbid asthma (OR 3.9, 95% CI: 3.2,4.8), inhaled steroids (OR 1.4, 95% CI: 1.1,1.7), bronchodilators (OR 3.2, 95% CI: 2.5,4.2), nitric oxide (OR 2.4, 95% CI: 1.2,5.0), oxygen (OR 2.3, 95% CI: 1.8,2.9), ICU (OR 1.7, 95% CI: 1.3,2.3), ventilation (OR 2.0, 95% CI: 1.4,2.8), APR-DRG severity level (OR 1.4, 95% CI: 1.2,1.6), and discharge year (OR 0.86, 95% CI: 0.80,0.92). Corticosteroids were associated with an increased length of stay (25%, 95% CI: 14,38%) and a higher 3-day readmission rate (OR 2.3, 95% CI: 1.6,3.4), adjusted for confounding. Hospitals vary greatly in the use of corticosteroids for ACS, even in patients with asthma. Clear evidence of the efficacy and toxicity of corticosteroid treatment in ACS may reduce variation in care. Am. J. Hematol. 2010. © 2009 Wiley-Liss, Inc. [source] A survey in the park: Methodological and practical problems associated with geophysical investigation in a late Victorian municipal parkARCHAEOLOGICAL PROSPECTION, Issue 3 2010Andrew Parkyn Abstract The survey of Pudsey Park is a geophysical investigation of a late Victorian municipal park. The aim of the survey was to use geophysical techniques to identify the park's changing designs over a 120 year period. An initial design for the park was located during the desk-based assessment, however, it was unclear how much of the original plan had been implemented. It was suspected that Pudsey Park's design has been simplified over time. The project also aimed to identify a suitable sampling strategy for studying park and garden sites by using high-resolution surveys and multiple probe separations for varying depths of detection during earth resistance survey. It was hoped that multiple electrode separations combined with a high density survey could be used to differentiate the signal responses from the modern park designs and earlier design schemes. The choice of strategy is at a significantly higher resolution than guidelines for geophysical investigations for traditional archaeological features. The survey provided highly detailed but complicated data sets; areas of the park have had several redesigns, often where the modern scheme masks previous designs. A number of ,hard' and ,soft' landscaping features were identified including the foundations of the original bandstand (now replaced) and former flower beds. The 0.25,m probe separation surprisingly produced the most defined data with the greatest level of information due to the increased spatial resolution. The geophysical investigation is the first of its kind to investigate a Victorian municipal park in its entirety. The survey validates the importance of high-resolution survey in the study of parks and gardens and also provides a reference data set for future work where poorer documentation hinders interpretation. The geophysics data, together with the accompanying Geographical Information System database produce a unique and detailed picture of a Victorian park from its inception through 120 years of development. Copyright © 2010 John Wiley & Sons, Ltd. [source] Suicide decline in Australia: where did the cases go?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2009Amr Abou Elnour Abstract Objectives: To describe the causes of death codes assigned in Australian Bureau of Statistics (ABS) mortality data to deaths in Australia from 2000 to 2005 that were coded as intentional self-harm (suicide) in the National Coroners Information System (NCIS). Methods: Data for deaths in the period mid-2000 to end-2005 were obtained from the National Coroners Information System database (NCIS). We selected cases recorded in the NCIS as having intent at completion = intentional self-harm. The record linkage was done by the ABS and NCIS and did not form part of this project. Results: During the study period, 12,786 deaths recorded in NCIS were assigned intent at completion = intentional self-harm. Of these, 9,937 (77.7%) had been assigned ICD-10 underlying cause of death codes in the range normally reported as suicide (X60-X84), 1,135 had been assigned other ICD-10 codes and the remaining 1,714 (13.4%) NCIS records did not hold any ICD-10 codes. Conclusions: These findings confirm that routine mortality data have underestimated suicide mortality in Australia in recent years probably due to incomplete coroner data being available to ABS coders. Certain types of unintentional injury deaths have been over-estimated. Incomplete linkage of NCIS and ABS data in the source data used for this project complicates calculations of adjusted estimates and trends. [source] Perinatal services and outcomes in Quang Ninh province, VietnamACTA PAEDIATRICA, Issue 10 2010Nguyen T Nga Abstract Aim:, We report baseline results of a community-based randomized trial for improved neonatal survival in Quang Ninh province, Vietnam (NeoKIP; ISRCTN44599712). The NeoKIP trial seeks to evaluate a method of knowledge implementation called facilitation through group meetings at local health centres with health staff and community key persons. Facilitation is a participatory enabling approach that, if successful, is well suited for scaling up within health systems. The aim of this baseline report is to describe perinatal services provided and neonatal outcomes. Methods:, Survey of all health facility registers of service utilization, maternal deaths, stillbirths and neonatal deaths during 2005 in the province. Systematic group interviews of village health workers from all communes. A Geographic Information System database was also established. Results:, Three quarters of pregnant women had ,3 visits to antenatal care. Two hundred and five health facilities, including 18 hospitals, provided delivery care, ranging from 1 to 3258 deliveries/year. Totally there were 17 519 births and 284 neonatal deaths in the province. Neonatal mortality rate was 16/1000 live births, ranging from 10 to 44/1000 in the different districts, with highest rates in the mountainous parts of the province. Only 8% had home deliveries without skilled attendance, but those deliveries resulted in one-fifth of the neonatal deaths. Conclusion:, A relatively good coverage of perinatal care was found in a Vietnamese province, but neonatal mortality varied markedly with geography and level of care. A remaining small proportion of home deliveries generated a substantial part of mortality. [source] Modelling long-term pan-European population change from 1870 to 2000 by using geographical information systemsJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2010Ian N. Gregory Summary., The paper presents work that creates a geographical information system database of European census data from 1870 to 2000. The database is integrated over space and time. Spatially it consists of regional level data for most of Europe; temporally it covers every decade from 1870 to 2000. Crucially the data have been interpolated onto the administrative units that were available in 2000, thus allowing contemporary population patterns to be understood in the light of the changes that have occurred since the late 19th century. The effect of interpolation error on the resulting estimates is explored. This database will provide a framework for much future analysis on long-term Europewide demographic processes over space and time. [source] | ||||||||||