Home About us Contact | |||
Service Records (service + record)
Selected AbstractsImpact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trialCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2007Richard Reading Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trial . Henderson, M., Wight, D., Raab, G. M., Abraham, C., Parkes, A., Scott, S. & Hart, G. ( 2007 ) British Medical Journal , 334 , 133 , 6 . DOI: 10.1136/bmj.39014.503692.55. Objective To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the National Health Service. Design Follow-up of cluster randomized trial 4.5 years after intervention. Setting National Health Service records of women who had attended 25 secondary schools in east Scotland. Participants A total of 4196 women (99.5% of those eligible). Intervention SHARE programme (intervention group) vs. existing sex education (control group). Main outcome measure National Health Service recorded conceptions and terminations for the achieved sample linked at age 20 years. Results In an ,intention to treat' analysis, there were no significant differences between the groups in registered conceptions per 1000 pupils (300 SHARE vs. 274 control; difference 26, 95% CI ,33 to 86) and terminations per 1000 pupils (127 vs. 112; difference 15, ,13 to 42) between ages 16 and 20 years. Conclusions This specially designed sex education programme did not reduce conceptions or terminations by age 20 years compared with conventional provision. The lack of effect was not due to quality of delivery. Enhancing teacher-led school sex education beyond conventional provision in eastern Scotland is unlikely to reduce terminations in teenagers. [source] Imputation of 10-year osteoporotic fracture rates from hip fractures: A clinical validation studyJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2010William D Leslie Abstract The World Health Organization (WHO) fracture risk assessment system (FRAX) allows for calibration from country-specific fracture data. The objective of this study was to evaluate the method for imputation of osteoporotic fracture rates from hip fractures alone. A total of 38,784 women aged 47.5 years or older at the time of baseline femoral neck bone mineral density (BMD) measurement were identified in a database containing all clinical dual energy X-ray absorptiometry (DXA) results for the Province of Manitoba, Canada. Health service records were assessed for the presence of nontrauma osteoporotic fracture codes after BMD testing (431 hip, 787 forearm, 336 clinical vertebral, and 431 humerus fractures). Ten-year hip and osteoporotic fracture rates were estimated by the Kaplan-Meier method. The population was stratified by age (50 to 90 years, 5-year width strata) and again by femoral neck T -scores (,4.0 to 0.0, 0.5 SD width strata). Within each stratum, the ratio of hip to osteoporotic fractures was calculated and compared with the predicted ratio from FRAX. Increasing age was associated with greater predicted hip-to-osteoporotic ratios (youngest 0.07 versua oldest 0.41) and observed ratios (youngest 0.10 versus oldest 0.48). Lower T -scores were associated with greater predicted (highest 0.04 versus lowest 0.71) and observed ratios (highest 0.06 versus lowest 0.44). There was a strong positive correlation between predicted and observed ratios (Spearman r,=,0.90,0.97, p,<,.001). For 14 of the 18 strata, the predicted ratio was within the observed 95% confidence interval (CI). Since collection of population-based hip fracture data is considerably easier than collection of non,hip fracture data, this study supports the current emphasis on using hip fractures as the preferred site for FRAX model calibration. © 2010 American Society for Bone and Mineral Research [source] Simplified System for Absolute Fracture Risk Assessment: Clinical Validation in Canadian Women,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2009William D Leslie Abstract Absolute 10-yr fracture risk based on multiple factors is the preferred method for risk assessment. A simplified risk assessment system from sex, age, DXA, and two clinical risk factors (CRFs),prior fracture and systemic corticosteroid (CS) use-has been used in Canada since 2005. This study was undertaken to evaluate this system in the Canadian female population. A total of 16,205 women ,50 yr of age at the time of baseline BMD (1998,2002) were identified in a database containing all clinical DXA test results for the Province of Manitoba, Canada. Basal 10-yr fracture risk from age and minimum T-score (lumbar spine, femur neck, trochanter, total hip) was categorized as low (<10%), moderate (10,20%), or high (>20%). Health service records since 1987 were assessed for prior fracture codes (N = 5224), recent major CS use (N = 616), and fracture codes after BMD testing (mean, 3.1 yr of follow-up) for the hip, vertebrae, forearm, or humerus (designated osteoporotic, N = 757). Fracture risk predicted from age and minimum T-score alone showed a significant gradient in observed fracture rates (low 5.1 [95% CI, 4.1,6.4], moderate 11.5 [95% CI, 10.1,13.0], high 25.4 [95% CI, 23.2,27.9] per 1000 person-years; p -for-trend <0.0001). There was an incremental increase in incident fracture rates from a prior fracture (13.9 [95% CI, 11.3,16.4] per 1000 person-years) or major CS use (11.2 [95% CI, 4.1,18.2] per 1000 person-years). This simplified fracture risk assessment system provides an assessment of fracture risk that is consistent with observed fracture rates. [source] Validation study of the Victorian Birth Defects RegisterJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 9-10 2004M Riley Objective: To determine whether there has been an improvement in ascertainment of birth defects cases (,case validity') by the Victorian Birth Defects Register (BDR) since an earlier study (conducted in 1993), to ascertain the accuracy of registered data (,item validity') and to investigate another possible source of notification. Methods: The medical records were reviewed of 500 children born after 1 January 1993 who were consecutively admitted after 1 January 1999 to two paediatric teaching hospitals in Victoria. In addition, records of 200 children referred to a clinical genetics service were reviewed for children born after 1 January 1993 and who were seen in two periods: 2 months after 1 January 2001 and 2 months after 1 January 2002. The records from the hospitals and clinical genetics service were reviewed separately to determine whether children recorded as having a birth defect had previously been notified to the BDR. Results: Twenty percent of the hospital records related to a child with a birth defect, as did 70% of the clinical genetics service records. Overall case validity for birth defect cases from the hospitals was 88%. There was 100% ascertainment for three of five categories. Sixty per cent of birth defects cases from the clinical genetics service had been notified to the BDR. When all diagnoses in matched cases were considered, item validity was 54%, however, if only primary diagnoses were included then 92% of cases had the same diagnosis. Conclusions: Overall case validity from the two paediatric teaching hospitals has significantly improved since our previous study. The addition of an extra data source from a clinical genetics service would identify new cases, particularly genetic disorders and developmental delay, as well as adding new diagnoses to existing ones. This study has highlighted the need to improve item validity, perhaps through routine education for all coders and notifiers on the inclusion and exclusion of specific associated conditions when notifying major birth defects. [source] The Ironies of Helping: Social Interventions and Executable SubjectsLAW & SOCIETY REVIEW, Issue 2 2009Kerry Dunn Law and society scholars have theorized about the link between capital punishment and the hegemony of individualism, but few offer empirical investigations to illustrate how individualism makes capital punishment possible (and vice versa) in the contemporary United States. In order to fill this gap, we analyze the legal and human service records that were compiled in the construction of one executable subject, Daniel Farnsworth. Using a critical discourse approach, we look at what was said and not said about Daniel in the records created by various helping agencies. In our analysis, we demonstrate how the helping agencies involved in Daniel's life repeatedly relied on an individuating psychological paradigm that led them to produce decontextualized catalogs of his actions and characteristics. Next, we illustrate how these pathologizing accounts were, ironically, later invoked in court in the name of preserving his life. Finally, we explain how "helping" discourses, along with the rules that regulate capital defense practice, straightjacket defense attorneys into reinforcing individualism in this context. [source] School,Based Early Intervention and Later Child Maltreatment in the Chicago Longitudinal StudyCHILD DEVELOPMENT, Issue 1 2003Arthur J. Reynolds Investigated were the effects of participation in the Title I Child,Parent Centers (CPC) on substantiated reports of child maltreatment for 1,408 children (93% of whom are African American) in the Chicago Longitudinal Study. The CPCs provide child education and family support services in high,poverty areas. After adjusting for preprogram maltreatment and background factors, 913 preschool participants had significantly lower rates of court petitions of maltreatment by age 17 than 495 children of the same age who participated in alternative kindergarten interventions (5.0% vs. 10.5%, a 52% reduction). Participation for 4 to 6 years was significantly associated with lower rates of maltreatment (3.6% vs. 6.9%, a 33% reduction). Findings based on child protective service records (as well as combined protective service and court records) were similar. Preschool length, family risk, and school poverty were associated with lower rates of maltreatment. Parental involvement in school and school mobility were significant mediators of intervention effects. [source] |