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Ten-year Period (ten-year + period)
Selected AbstractsNational Study on Emergency Department Visits for Transient Ischemic Attack, 1992,2001ACADEMIC EMERGENCY MEDICINE, Issue 6 2006Jonathan A. Edlow MD Abstract Objectives: To describe the epidemiology of U.S. emergency department (ED) visits for transient ischemic attack (TIA) and to measure rates of antiplatelet medication use, neuroimaging, and hospitalization during a ten-year time period. Methods: The authors obtained data from the 1992,2001 National Hospital Ambulatory Medical Care Survey. TIA cases were identified by having ICD-9 code 435. Results: From 1992 to 2001, there were 769 cases, representing 2,969,000 ED visits for TIA. The population rate of 1.1 ED visits per 1,000 U.S. population (95% CI = 0.92 to 1.30) was stable over time. TIA was diagnosed in 0.3% of all ED visits. Physicians administered aspirin and other antiplatelet agents to a small percentage of patients, and 42% of TIA patients (95% CI = 29% to 55%) received no medications at all in the ED. Too few data points existed to measure a statistically valid trend over time. Physicians performed computed tomography scanning in 56% (95% CI = 45% to 66%) of cases and performed magnetic resonance imaging (MRI) in < 5% of cases, and there was a trend toward increased imaging over time. Admission rates did not increase during the ten-year period, with 54% (95% CI = 42% to 67%) admitted. Regional differences were noted, however, with the highest admission rate found in the Northeast (68%). Conclusions: Between 1992 and 2001, the population rate of ED visits for TIA was stable, as were admission rates (54%). Antiplatelet medications appear to be underutilized and to be discordant with published guidelines. Neuroimaging increased significantly. These findings may reflect the limited evidence base for the guidelines, educational deficits, or other barriers to guideline implementation. [source] Assessing Cost-Effectiveness of Sealant Placement in ChildrenJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2005Rocio B. Quiñonez DMD Abstract Objective: The lack of cost-effectiveness information regarding sealant placement strategies is thought to have influenced reimbursement policies and subsequent sealant utilization in dental practice. This study compared three strategies for managing the occlusal surfaces of first permanent molars: seal all (SA), risk-based (RBS), and seal none (SN). Methods: A decision tree was developed for various possible outcomes following each of the above strategies. Due to the complexity of the decision tree, a Markov model was used to allow for the construction of a chain of events representing the natural history of sealant retention, caries formation, and their associated health states. The outcome measures were the incremental cost per month gained in a cavity-free state over a ten-year period. Results: Our theoretical model showed that RBS strategy improved clinical outcomes, in the form of cavity-free months, and saved money over SN. The strategy of sealing both high and low risk teeth (SA) further improved outcomes but at an additional cost compared to RBS. However, the cost was small, $08 for each additional cavity-free month gained per tooth. Further, minor changes in the baseline assumptions resulted in the SA strategy being the dominant strategy. Conclusion: This study provides evidence that sealing children's first permanent molars can improve outcomes and save money by delaying or avoiding invasive treatment and the destructive cycle of caries. In a time of limited funds for dental services, these results can assist payers in establishing more rational sealant reimbursement policies. [source] Development of a new wind-rose for the British Isles using radiosonde data, and application to an atmospheric transport modelTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 621 2006A. J. Dore Abstract A six-hourly dataset of radiosonde ascents spanning a ten-year period from four stations in the British Isles has been used to generate a set of wind frequency roses and wind speed roses for the pressure level range 950,900 hPa. The wind frequency rose showed close agreement with the long-term series of the Jenkinson classification scheme. Small but significant inter-station and interannual variations were observed. Seasonal analysis of the data revealed the higher incidence of north-easterlies during spring months whilst the stronger wind speeds associated with the winter months were also evident. The use of a harmonic mean was found to be appropriate for calculating a directionally dependent wind speed for use in an atmospheric transport model. A harmonic mean wind speed value of 7.5 m s,1 was generated from the entire dataset, the same as that which has previously been used in other transport models. This is also the same value as the ,optimized wind speed' that was generated by Singles et al. The radiosonde wind frequency rose and wind speed rose were input to the FRAME atmospheric transport model. This resulted in an improved correlation with measurements of SO2 concentrations from a national monitoring network when compared to a model simulation using the earlier dataset of Jones. Copyright © 2006 Royal Meteorological Society [source] The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Nick CALVERT Aims: To review the perinatal outcomes for prenatally diagnosed exomphalos from a single geographical region. Methods: Retrospective review of cases of prenatally identified exomphalos in the state of Western Australia in the ten-year period 1998,2007 using the medical databases of the sole tertiary obstetric and paediatric hospitals. Results: Ninety-four cases of prenatally identified exomphalos comprise this consecutive case series. Culture-proven karyotypic abnormalities occurred in 40 (42.6%) fetuses. No karyotypically abnormal fetus survived the neonatal period, with 33 of 40 (82.5%) pregnancies interrupted, five of 40 (12.5%) resulting in fetal demise and two (5%) neonatal deaths. For the 49 (52.1%) fetuses with a normal karyotype, 26 (53.1%) had associated abnormalities with termination occurring in 22 (84.6%). Prenatally isolated exomphalos was present in 23 cases (24.5%), with live birth in 15 cases (30.6% of euploid fetuses). Fourteen (93.3%) of the liveborn prenatally isolated exomphalos cases survived with no postoperative deaths, although four (28.5%) had significant abnormalities detected postdelivery and most have experienced childhood morbidity. Conclusions: In the the majority of cases of prenatally detected exomphalos the pregnancy was interrupted secondary to chromosomal or structural abnormalities. In only 10.6% of prenatally recognised fetuses with exomphalos was the disorder truly isolated with neonatal survival occurring. [source] Risk factors for and timing of death of extremely preterm infantsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Dawn E. ELDER This study examined risk factors for timing and cause of death for extremely preterm infants , 23 weeks and < 28 weeks. There were 479 liveborn infants and 98 deaths reviewed over a ten-year period. Thirty-two deaths (33%) occurred on the first day of life and 72 (75%) in the first month of life. Lower gestation and intrauterine growth restriction were significant risk factors for death. Most deaths occurred in the first month of life and at the lowest gestation in the first week. [source] The NDP Regime in British Columbia, 1991,2001: A Post-Mortem*CANADIAN REVIEW OF SOCIOLOGY/REVUE CANADIENNE DE SOCIOLOGIE, Issue 2 2005WILLIAM K. CARROLL Cette étude porte sur les relations entre la social-démocratie, les mouvements sociaux et l'État au cours d'une période de dix ans dans la province de Colombie-Britannique, au Canada. À l'aide d'une analyse de textes d'interviews en profondeur de représentants de l'État de six ministères importants et de membres du Nouveau Parti démocratique de l'Assemblée législative, les auteurs examinent de façon approfondie les difficultés rencontrées par le régime social-démocrate. Celui-ci tente de remplir un mandat de réforme sociale en partie inspirée par les programmes de militants de mouvements sociaux, mais il est également limité par les contraintes imposées par la mondialisation économique et par les politiques budgétaires néolibérales. En étudiant les dilemmes et les obstacles structurels, les auteurs tentent de clarifier les profonds défis auxquels sont confrontés les mouvements sociaux à l'époque actuelle. This study focuses on the relationship between social democracy, social movements and the state over a ten-year period in the province of British Columbia, Canada. Through textual analysis of in-depth interviews with state officials from six key ministries and New Democratic Party members of the Legislative Assembly, we probe the difficulties faced by a social democratic regime attempting to carry out a mandate for social reform partly driven by the agendas of social movements supporters but also bounded by the constraints imposed by economic globalization and neo-liberal fiscal policies. In examining the dilemmas and structural obstacles, our study clarifies the profound challenges confronting social movements in the current era. [source] | ||||||||||