Результаты поиска

Emergency paediatric critical care in England: describing trends using routine hospital data.

OBJECTIVE: To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). DESIGN: Birth cohort study created from Hospital Episode Statistics. SETTING: National Health Service funded hospitals in England. PATIENTS: 8 577 680 singleton children born between 1 May 2003 and 31 April 2017. OUTCOME MEASURES: Using procedure and diagnostic codes, we assigned indicators of high dependency care (eg, non-invasive ventilation) or intensive care (eg, invasive ventilation) to emergency admissions. INT…

Educational Inequalities in Hospital Use Among Older Adults in England, 2004-2015.

UNLABELLED: Policy Points US policymakers considering proposals to expand public health care (such as "Medicare for all") as a means of reducing inequalities in health care access and use could learn from the experiences of nations where well-funded universal health care systems are already in place. In England, which has a publicly funded universal health care system, the use of core inpatient services by adults 65 years and older is equal across groups defined by education level, after controlling for health status. However, variation among these groups in the use of outpatient and emergency…

Variation in laparoscopic anti-reflux surgery across England: a 5-year review.

BACKGROUND: Laparoscopic anti-reflux surgery (LARS) remains central to the management of gastro-oesophageal reflux disease but the scale and variation in provision in England is unknown. The aims of this study were firstly to examine the processes and outcomes of anti-reflux surgery in England and compare them to national guidelines and secondly to explore potential variations in practice nationally and establish peer benchmarks. METHODS: All adult patients who underwent LARSin England during the Financial years FY 2011/2012-FY 2016/2017 were identified in the Surgeon's Workload Outcomes and …

Age-related sarcoma patient experience: results from a national survey in England.

BackgroundSarcomas are rare, heterogeneous tumours affecting patients of any age. Previous surveys describe that sarcoma patients report a significantly worse experience than those with common cancers. Consequently, Sarcoma UK conducted a national survey and these data were examined for age- and tumour-related differences in patients' experiences.MethodsPatients were randomly selected from respondents to National Cancer Patient Experience Surveys (n = 900). Differences between patient groups according to age (Adolescents and Young Adults [AYA] 18-39 years, middle-aged 40-64 years, elderly 65 +

Совпадение в полном тексте источника
… The NCPES is an annual survey commissioned by the National Health Service in England. … Public Health England National Cancer Intelligence Network Report. English National Cancer Patient Experience Surveys linked to cancer registration data. …

Giardiasis in North West England: faecal specimen requesting rates by GP practice.

Many cases of giardiasis in the UK are undiagnosed and among other things, diagnosis is dependent upon the readiness of GPs to request a specimen. The aim of this study is to assess the rate of specimens requested per GP practice in Central Lancashire, to examine the differences between GP practices and to estimate the pattern of unexplained spatial variation in the practice rate of specimens after adjustment for deprivation. To achieve this, we fitted a set of binomial and Poisson regression models, with random effects for GP practice. Our analysis suggests that there were differences in the

Existing medications among non-pregnancy-related listeriosis patients in England, 2007-2009.

To identify which medications were most commonly taken by non-pregnancy-related listeriosis patients prior to illness, we compared the medications reported by 512 cases identified via national surveillance in England between 2007 and 2009 with national prescription data, using British National Formulary (BNF) coding. Relative risks and corresponding confidence intervals were calculated, as appropriate, for BNF chapters and sections. Among listeriosis cases, the rates for cytotoxic drugs, drugs affecting the immune response and corticosteroids were significantly higher than for other medication…

Oral fluid testing during 10 years of rubella elimination, England and Wales.

Surveillance of rubella in England and Wales has included immunoglobulin M testing of oral (crevicular) fluid from reported case-patients since 1994. The need for laboratory confirmation to monitor rubella elimination is emphasized by poor sensitivity (51%, 95% confidence interval 48.9%-54.0%) and specificity (55%, 95% confidence interval 53.7%-55.6%) of the clinical case definition. During 1999-2008, oral fluid from 11,709 (84%) of 13,952 reported case-patients was tested; 143 (1.0%) cases were confirmed and 11,566 (99%) were discarded (annual investigation and discard rate of clinically susp…

Health outcomes of youth development programme in England: prospective matched comparison study.

OBJECTIVE: To evaluate the effectiveness of youth development in reducing teenage pregnancy, substance use, and other outcomes. DESIGN: Prospective matched comparison study. SETTING: 54 youth service sites in England. PARTICIPANTS: Young people (n=2724) aged 13-15 years at baseline deemed by professionals as at risk of teenage pregnancy, substance misuse, or school exclusion or to be vulnerable. INTERVENTION: Intensive, multicomponent youth development programme including sex and drugs education (Young People's Development Programme) versus standard youth provision. MAIN OUTCOME MEASURES:…

Parents' views about pre-school immunization: an interview study in southern England.

BACKGROUND: National Health Service immunization statistics for England indicate that uptake of the first plus second dose of measles, mumps and rubella (MMR) vaccine, and pre-school booster against diphtheria, tetanus, polio and pertussis, is lower than for the primary course alone. This qualitative study aimed to explore parents' views about pre-school immunization and to identify possible reasons for lower pre-school uptake compared with the primary course. METHODS: Semi-structured interviews were conducted with 21 parents of children aged 2-5 years from 19 family units. The parents were r…

Appropriateness of coronary artery bypass graft surgery performed in northern New England.

OBJECTIVES: The goal of this study was to assess the concordance between the American College of Cardiology (ACC) and the American Heart Ass … ecutive isolated coronary artery bypass graft procedures performed in 2004 and 2005 in northern New England. Our regional registry data were used to categorize patients into clinical subgroups. Detailed clinical criteria were then used to categorize procedures within these subgroups as class I (useful and effective), class IIa (evidence favors usefulness) …

Increasing hospitalizations and general practice prescriptions for community-onset staphylococcal disease, England.

Rates of hospital-acquired staphylococcal infection increased throughout the 1990s; however, information is limited on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylococcal disease. Hospital admission rates for staphyloccocal septicemia, staphylococcal pneumonia, staphylococcal scalded-skin syndrome, and impetigo increased >5-fold. Admission rates increased 3-f

Adverse pregnancy outcomes near landfill sites in Cumbria, northwest England, 1950--1993.

Although several researchers have addressed the risk of congenital anomaly in relation to proximity to landfill sites, few have considered the risks of stillbirth or neonatal death for mothers who reside near landfills. The authors studied all 4,325 stillbirths, 3,430 neonatal deaths, and 1,569 lethal congenital anomalies that occurred among 287,993 births to mothers residing in Cumbria, northwest England, during the years 1950 to 1993. Logistic regression models, with data stratified by time period and adjusted for subject-specific demographic factors, were used to investigate the risk for ea…

Middle cerebral artery occlusive disease: the New England Medical Center Stroke Registry.

To analyze the clinical features, vascular lesions, and infarct distribution in Asian and white patients with middle cerebral artery (MCA) territory ischemia, we studied age, sex, race, risk factors, angiographic, and neuroimaging findings among patients in the New England Medical Center Stroke Registry. We included patients with well-defined intrinsic occlusive lesions of the MCAs and patients with embolic MCA territory infarcts. Among 695 patients in the stroke registry, 89 (12.8%) qualified. They had 28 MCA intrinsic stenoses, 17 MCA embolic occlusions (cardiogenic or unknown origin), and 4…

Autosomal dominant familial spastic paraplegia: report of a large New England family.

A large New England family with autosomal dominant familial spastic paraplegia is described. In a pedigree of 173 individuals, 71 affected individuals are identified. Seventeen cases examined by the authors are described with regard to the natural history of FSP in this family. A staging system for following progress and planning interventions is proposed. Three illustrative cases are presented. In this family, FSP is found to have a homogeneous clinical course with nearly complete penetrance. Onset occurs at or before 3 years of age with involvement limited to the lower extremities. After the…

Variation in procedure selection for end stage ankle arthritis management in England.

INTRODUCTION: End-stage ankle arthritis is a debilitating condition presenting with pain and functional limitations. Surgical management typically involves ankle arthrodesis (AA) or total ankle replacement (TAR). This study aimed to investigate demographic, socioeconomic, and clinical factors associated with receiving TAR versus AA in England. METHODS: A retrospective cohort analysis was conducted using Hospital Episode Statistics (HES) data for all elective AAs and TARs performed in England between April 2013 and March 2025. Patients aged 17 years and over were included. Multivariable logist…

Smoking and drinking among the Gypsy and Traveller communities: A population study in England.

BACKGROUND AND AIMS: Gypsy and Traveller communities in the United Kingdom (UK) face substantial health challenges. Smoking tobacco and drin … in a series of monthly cross-sectional surveys of representative samples of the adult population in England. PARTICIPANTS: Adults aged 18+, between 2013 and 2025 (total n = 226 339; Gypsy or Traveller n = 213). MEASUREMENTS: Marginal means were derived from regression models and used to estimate the prevalence of current smoking and drinking (both of wh …