National Trends (national + trend)

Distribution by Scientific Domains


Selected Abstracts


National Trends in Emergency Department Antibiotic Prescribing for Children with Acute Otitis Media, 1996,2005

ACADEMIC EMERGENCY MEDICINE, Issue 12 2007
Thomas Fischer MD
Objectives Withholding antibiotics in nontoxic children with acute otitis media (AOM) is now recommended to reduce bacterial resistance rates. Using the National Hospital Ambulatory Medical Care Survey (NHAMCS), the authors describe the national trends for prescribing antibiotics in children with AOM presenting to emergency departments (EDs) in the United States over the past decade. The authors hypothesized that the rates of prescribing antibiotics would decline over time. Methods This was a retrospective study of NHAMCS databases. A national sampling of ED visits for 1996,2005 was used to identify trends in ED prescription of antibiotics to patients with AOM. The National Drug Code Directory Drug Classes were used to identify type of antibiotic prescribed. Frequency and type of antibiotic prescription patterns over time were evaluated. Results There were 2.6 million and 2.1 million ED visits for AOM during the first and last years of the study. Children ages 2,12 years accounted for about 40% of all ED visits for AOM, with another 40% in the younger than 2 years age group and 20% in the older than 12 years of age group. During the first and last year of the study, 79.2% and 91.3% of the patients with AOM were prescribed antibiotics, respectively. There was a slight increasing trend in the proportion prescribed antibiotics over time (p = 0.02). The rates of use of antibiotics for AOM were similar in all three age groups. Conclusions There was a slight increase in the percentage of children with AOM who were prescribed antibiotics in the ED between 1996 and 2005. There was also no change in the patterns of prescribing antibiotics. [source]


National trend of antidepressant consumption and its impact on suicide rate in Hungary,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008
Réka Viola MSc Pharm
Abstract Purpose The aim of this study was to analyse the changes in the amount and structure of Hungarian antidepressant consumption at national and regional level, furthermore to investigate the possible relationship between antidepressant sales and trends in suicide rates using regional data. Method Retrospective analysis of antidepressant sales data was performed on a 12 years period (1993,2004), applying the ATC/DDD methodology developed by WHO. Linear regression model was set up to investigate the trends in antidepressant utilisation. The association between antidepressant consumption and suicide rates was measured by Pearson correlation. Results The nationwide utilisation of antidepressants revealed more than five-fold increase in the studied 12 year period. The usage of tricyclic antidepressants (N06AA) decreased to one third of the previous value, while the usage of selective serotonin reuptake inhibitors (N06AB) multiplied by 21. The consumption of ,other antidepressants' (N06AX) was found very low (3.66 DDD/1000inhabitants/day in 2004). There was not found any significant correlation between increased antidepressant consumption and decreased suicide rates at regional level by our statistical analysis (rmin,=,,0.160; rmax,=,,0.314). Conclusion Further investigation is required to identify determinants that have contributed to recent decline in suicide rate in Hungary. Copyright © 2008 John Wiley & Sons, Ltd. [source]


A multimethod study of needs for physician assessment: Implications for education and regulation

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2009
Richard Hawkins MD Senior Vice President for Professional, Scientific Affairs
Abstract Introduction: Deficiencies in physician competence play an important role in medical errors and poor-quality health care. National trends toward implementation of continuous assessment of physicians hold potential for significant impact on patient care because minor deficiencies can be identified before patient safety is threatened. However, the availability of assessment methods and the quality of existing tools vary, and a better understanding of the types of deficiencies seen in physicians is required to prioritize the development and enhancement of assessment and remediation methods. Methods: Surveys of physicians and licensing authorities and analysis of the Federation of State Medical Boards (FSMB) Board Action Data Bank were used to collect information describing the nature and types of problems seen in practicing physicians. Focus groups, depth interviews with key professional stakeholders, and state medical board site visits provided additional information about deficiencies in physician competence. Results: Quantitative and qualitative analyses identified (1) communication skills as a priority target for assessment approaches that also should focus on professional behaviors, knowledge, clinical judgment, and health-care quality; and (2) differences between regulatory approaches of licensing and certifying bodies contribute to a culture that limits effective self-assessment and continuous quality improvement. System problems impacting physician performance emerged as an important theme in the qualitative analysis. Discussion: Considering alternative perspectives from the regulatory, education, and practice communities helps to define assessment priorities for physicians, facilitating development of a coherent and defensible approach to assessment and continuing professional development that promises to provide a more comprehensive solution to problems of health-care quality in the United States. [source]


A retrospective study of the diagnostic accuracy of fine-needle aspiration for breast lesions and implications for future use

DIAGNOSTIC CYTOPATHOLOGY, Issue 12 2008
Christina Day M.D.
Abstract In recent years, the use of fine-needle aspiration (FNA) in the diagnosis of breast lesions has declined in many institutions. We sought to evaluate the role of FNA for breast lesions and the annual rate of the procedure at our institution over a 4˝ year period (May 2002,October 2006). A total of 831 FNAs were performed, with 258 (31%) having histologic follow-up. The number of FNAs obtained was 159 from 5/02 to 4/03, 192 from 5/03 to 4/04, 194 from 5/04 to 4/05, 191 from 5/05 to 4/06, and 95 from 5/06 to 10/06. Each case was placed into one of four categories: nondiagnostic (9%), benign (77.5%), atypical/suspicious (5.5%), or malignant (8%). Surgical tissue was available for 37% of nondiagnostic cases, 22% of benign cases, 80% of atypical/suspicious cases, and 72% of malignant cases. The overall sensitivity and specificity for FNA was 83 and 92% respectively. The overall positive and negative predictive values were 83 and 92% respectively. There were no false-positive cases, indicating a positive predictive value of 100% for a Dx of malignancy. For cases with surgical follow-up, the false-negative rate was 5.4%. Although there is a national trend away from FNAs of breast lesion, this has not been the experience at our institution. Although FNA may not be ideal in the initial evaluation of suspicious lesions, we argue that FNA for clinically benign palpable lesions and recurrent carcinomas has significant value. Diagn. Cytopathol. 2008. © 2008 Wiley-Liss, Inc. [source]


Trends in Labor Induction in the United States: Is It True That What Goes Up Must Come Down?

BIRTH, Issue 2 2004
IN THE LITERATURE
Commentary on: Zhang J, Yancey MK, Henderson CE. U.S. national trends in labor induction, 1989,1998. J Reprod Med 2002;47:120,124. MacDorman MF, Mathews TJ, Martin JA, Malloy MH. Trends and characteristics of induced labour in the United States, 1989,98. Paediatr Perinat Epidemiol 2002;16:263,273. Kozak LJ, Weeks JD. U.S. trends in obstetric procedures, 1990,2000. Birth 2002;29:157,161. Abstract:,Three recent studies examined the national trend in labor induction in the United States. All show a doubling in the rate of induction during the 1990s, although vital statistics data show a consistently higher trend than that obtained from national hospital discharge data. Neither data source adequately documents the full range of indications for induction, its timing, hospital staffing considerations, and other factors that may play a role. Although rates of induction of labor may be leveling off, despite a lack of scientific evidence for its widespread use, rates are likely to remain at current levels for the next few years. [source]


Sociodemographic Predictors of Pattern and Volume of Alcohol Consumption Across Hispanics, Blacks, and Whites: 10-Year Trend (1992,2002)

ALCOHOLISM, Issue 10 2010
Raul Caetano
Background:, There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods:, Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results:, Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion:, The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [source]


MPs and web technologies: an untapped opportunity?

JOURNAL OF PUBLIC AFFAIRS, Issue 2 2003
Nigel Jackson
Abstract MPs have not previously been assigned a major role in electoral campaigning, being considered only one element of a political party's ,marketing' tools for winning votes. Evidence now suggests that the relationship between MPs and their constituents is changing. The concept of ,constituency service' implies that individual MPs can have a much greater influence on local voters and so possibly buck national trends. At the same time the concept of the ,permanent campaign' is transforming political campaigning whereby the political elite needs ever-greater control of the tools used to provide messages to voters. The internet is a potential battleground between MPs who want greater control of their own local campaigning and the party elite who want to ensure a consistent, coherent and controlled message. The Internet is a new addition to the campaigning armoury, yet the focus so far has been on e-government, e-democracy and election campaigns. By concentrating on how and why MPs use their websites this paper considers whether MPs have fully understood and utilised this new medium. Key questions include whether their websites are ,sticky', interactive and a means of creating a targeted message. The findings of this detailed study of MPs' websites show that apart from a few pioneers, MPs have not progressed beyond using the Internet as ,shovelware' , the vast majority view their website as an electronic brochure and not a new form of two-way communication. Copyright © 2003 Henry Stewart Publications [source]


Influence of a Rural Primary Care Clerkship on Medical Students' Intentions to Practice in a Rural Community

THE JOURNAL OF RURAL HEALTH, Issue 2 2000
Alma R. Jones M.D., M.P.H.
The Association of American Medical Colleges Medical School Graduation Questionnaire (GQ) for years 1988 through 1997 was examined to compare the career plans of students graduating from Morehouse School of Medicine (MSM) with those of all students graduating from United States medical schools before the period 1988 through 1992 and after the period 1993 through 1997, after the inception of the rural clerkship at MSM. Select GQ data items examined include student demographics, medical school experiences, and career plans. Statistical analyses were used to compare pre- and post-clerkship responses for MSM students and to compare their responses with the national trends. Results indicate that, following a transition period, MSM students showed an increased preference for a future career in a rural community. A smaller upward trend in the national data was observed. There appears to be an association between the rural clerkship experience at MSM and the stated preferred career choices of the students. [source]


Trends in Labor Induction in the United States: Is It True That What Goes Up Must Come Down?

BIRTH, Issue 2 2004
IN THE LITERATURE
Commentary on: Zhang J, Yancey MK, Henderson CE. U.S. national trends in labor induction, 1989,1998. J Reprod Med 2002;47:120,124. MacDorman MF, Mathews TJ, Martin JA, Malloy MH. Trends and characteristics of induced labour in the United States, 1989,98. Paediatr Perinat Epidemiol 2002;16:263,273. Kozak LJ, Weeks JD. U.S. trends in obstetric procedures, 1990,2000. Birth 2002;29:157,161. Abstract:,Three recent studies examined the national trend in labor induction in the United States. All show a doubling in the rate of induction during the 1990s, although vital statistics data show a consistently higher trend than that obtained from national hospital discharge data. Neither data source adequately documents the full range of indications for induction, its timing, hospital staffing considerations, and other factors that may play a role. Although rates of induction of labor may be leveling off, despite a lack of scientific evidence for its widespread use, rates are likely to remain at current levels for the next few years. [source]


National Trends in Emergency Department Antibiotic Prescribing for Children with Acute Otitis Media, 1996,2005

ACADEMIC EMERGENCY MEDICINE, Issue 12 2007
Thomas Fischer MD
Objectives Withholding antibiotics in nontoxic children with acute otitis media (AOM) is now recommended to reduce bacterial resistance rates. Using the National Hospital Ambulatory Medical Care Survey (NHAMCS), the authors describe the national trends for prescribing antibiotics in children with AOM presenting to emergency departments (EDs) in the United States over the past decade. The authors hypothesized that the rates of prescribing antibiotics would decline over time. Methods This was a retrospective study of NHAMCS databases. A national sampling of ED visits for 1996,2005 was used to identify trends in ED prescription of antibiotics to patients with AOM. The National Drug Code Directory Drug Classes were used to identify type of antibiotic prescribed. Frequency and type of antibiotic prescription patterns over time were evaluated. Results There were 2.6 million and 2.1 million ED visits for AOM during the first and last years of the study. Children ages 2,12 years accounted for about 40% of all ED visits for AOM, with another 40% in the younger than 2 years age group and 20% in the older than 12 years of age group. During the first and last year of the study, 79.2% and 91.3% of the patients with AOM were prescribed antibiotics, respectively. There was a slight increasing trend in the proportion prescribed antibiotics over time (p = 0.02). The rates of use of antibiotics for AOM were similar in all three age groups. Conclusions There was a slight increase in the percentage of children with AOM who were prescribed antibiotics in the ED between 1996 and 2005. There was also no change in the patterns of prescribing antibiotics. [source]