Home About us Contact
|
Home About us Contact | ||
|
|
||
National Variations (national + variation)
Selected AbstractsNATIONAL VARIATIONS IN CLASSIFICATIONSADDICTION, Issue 7 2010PIA ROSENQVIST No abstract is available for this article. [source] Explaining the national differences in pressure ulcer prevalence between the Netherlands and Germany , adjusted for personal risk factors and institutional quality indicatorsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2009Antje Tannen RN MA MPH Abstract Background, Pressure ulcers have a known impact on quality of life as well as on morbidity and mortality of the persons affected. Remarkable differences in pressure ulcer prevalence between the Netherlands and Germany have been found during the last 6 years. This study explores to what extent the individual risk of the population and quality indicators of the institutions can explain the variation in national prevalence. Methods, Data of a binational multi-centred cross-sectional study in 103 hospitals (n = 21 378 patients) and 129 nursing homes (n = 15 579 residents) were analysed using random effects regression models to calculate the differences in national prevalences within the nursing homes and hospitals, adjusted for personal risk for pressure ulcer and quality indicators. Results, The prevalence of pressure ulcers among the at-risk group (Bradenscore ,20) in nursing homes was 30.8% in the Netherlands and 8.3% in Germany [OR: 4.9 (CI 95%: 4.2,5.7)]. In hospitals, the prevalence among the at-risk group was 26.1% in the Netherlands and 21.2% in Germany [OR: 1.3 (CI 95%: 1.2,1.5)]. After adjusting for individual risk factors (age, gender, Bradenscore) as well as for quality structures (use of prevention and treatment protocols, experts groups, information leaflets, nurses training, central pressure ulcer statistics and regular updating of protocols), the chance of developing a pressure ulcer was 6.05 times higher (CI 95%: 4.0,9.2) in a Dutch nursing home than in a German nursing home. Within the hospitals, the OR for Dutch patients was 2.03 (CI 95%: 1.4,3.0). Conclusion, A remarkable national variation exists in pressure ulcer prevalence and nursing practice. Neither the populations vulnerability for pressure ulcers nor pressure ulcer management as measured in this study could explain this national variation. Therefore, other risk factors should be taken into consideration. Additionally, it is possible that quality indicators are implemented in differing ways with varying levels of effectiveness. Therefore, further research is needed to examine prospectively and in more detail the reality of care within facilities in both countries. [source] Something about young people or something about elections?EUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 6 2007Electoral participation of young people in Europe: Evidence from a multilevel analysis of the European Social Survey A particular cause for concern is that young people are less likely to participate than older voters. Evidence presented in this article, based on national election results and the 2002,2003 European Social Survey, shows the overall turnout rate for 22 European countries in elections between 1999 and 2002 was 70 per cent compared to 51 per cent for electors aged less than 25. The authors examine national variations in turnout for young people across Europe, and use multilevel logistic regression models to understand these variations, and to test the extent to which they are attributable to the characteristics of young people and the electoral context in each country. Variations in turnout among young people are partially accounted for by the level of turnout of older voters in the country and partly by the characteristics of young voters, including the level of political interest and civic duty. The authors conclude that both individual-level and election-specific information are important in understanding the turnout of young electors. [source] Calman,Hine reassessed: a survey of cancer network development in England, 1999,2000JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2002Beth Kewell BA PhD Abstract Rationale, aims and objectives,The paper assesses preliminary national data on the development of cancer care networks in England. Methods,In January 2000, a national postal survey was sent to lead clinicians at 36 cancer centres and associate centres. Respondents were asked to provide basic numerical data on the design of the network (i.e. its configuration), detailing how many units it encompassed, and whether the centre was a multiple or a single entity. Results,The survey highlighted national variations in the size and configuration of networks. The survey also highlighted tentative signs of shifts in clinical practice. The results showed that consultants at cancer centres and units were engaging in two forms of collaboration across centre,unit boundaries. Type 1 involved routine multidisciplinary team (MDT) outreach from centres to units, incorporating joint planning between clinicians at cancer centres and cancer units. Type 2 collaboration involved joint planning but also promoted joint centre and unit training and continuing professional development (CPD) programmes. Conclusions,In our estimation, both forms of collaboration represented early evidence of qualitative changes in medical working practices. Organizational changes within cancer services have moved swiftly since initial soundings were taken in 2000 and we update our initial commentary in the light of recent empirical data. The findings may be of wider significance to managers and health practitioners who are working towards the implementation of delivery network elsewhere in the UK National Health Service. [source] Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network,ANAESTHESIA, Issue 3 2010S. M. White Summary The aim of this audit was to investigate process, personnel and anaesthetic factors in relation to mortality among patients with proximal femoral fractures. A questionnaire was used to record standardised data about 1195 patients with proximal femoral fracture admitted to 22 hospitals contributing to the Hip Fracture Anaesthesia Network over a 2-month winter period. Patients were demographically similar between hospitals (mean age 81 years, 73% female, median ASA grade 3). However, there was wide variation in time from admission to operation (24,108 h) and 30-day postoperative mortality (2,25%). Fifty percent of hospitals had a mean admission to operation time < 48 h. Forty-two percent of operations were delayed: 51% for organisational; 44% for medical; and 4% for ,anaesthetic' reasons. Regional anaesthesia was administered to 49% of patients (by hospital, range = 0,82%), 51% received general anaesthesia and 19% of patients received peripheral nerve blockade. Consultants administered 61% of anaesthetics (17,100%). Wide national variations in current management of patients sustaining proximal femoral fracture reflect a lack of research evidence on which to base best practice guidance. Collaborative audits such as this provide a robust method of collecting such evidence. [source] | ||||||||||