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Accelerometer-determined physical activity and self-reported health in a population of older adults (65-85 years): a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature264724
Source
BMC Public Health. 2014;14:284
Publication Type
Article
Date
2014
Author
Hilde Lohne-Seiler
Bjorge H Hansen
Elin Kolle
Sigmund A Anderssen
Source
BMC Public Health. 2014;14:284
Date
2014
Language
English
Publication Type
Article
Keywords
Accelerometry - statistics & numerical data
Activities of Daily Living - classification
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Exercise
Female
Guideline Adherence - statistics & numerical data
Health status
Humans
Life Style
Male
Middle Aged
Norway
Personal Satisfaction
Quality of Life
Questionnaires
Registries
Regression Analysis
Sedentary lifestyle
Self Report
Abstract
The link between physical activity (PA) and prevention of disease, maintenance of independence, and improved quality of life in older adults is supported by strong evidence. However, there is a lack of data on population levels in this regard, where PA level has been measured objectively. The main aims were therefore to assess the level of accelerometer-determined PA and to examine its associations with self-reported health in a population of Norwegian older adults (65-85 years).
This was a part of a national multicenter study. Participants for the initial study were randomly selected from the national population registry, and the current study included those of the initial sample aged 65-85 years. The ActiGraph GT1M accelerometer was used to measure PA for seven consecutive days. A questionnaire was used to register self-reported health. Univariate analysis of variance with Bonferroni adjustments were used for comparisons between multiple groups.
A total of 560 participants had valid activity registrations. Mean age (SD) was 71.8 (5.6) years for women (n=282) and 71.7 (5.2) years for men (n=278). Overall PA level (cpm) differed considerably between the age groups where the oldest (80-85 y) displayed a 50% lower activity level compared to the youngest (65-70 y). No sex differences were observed in overall PA within each age group. Significantly more men spent time being sedentary (65-69 and 70-74 years) and achieved more minutes of moderate to vigorous PA (MVPA) (75-79 years) compared to women. Significantly more women (except for the oldest), spent more minutes of low-intensity PA compared to men. PA differed across levels of self-reported health and a 51% higher overall PA level was registered in those, with "very good health" compared to those with "poor/very poor health".
Norwegian older adults PA levels differed by age. Overall, the elderly spent 66% of their time being sedentary and only 3% in MVPA. Twenty one percent of the participants fulfilled the current Norwegian PA recommendations. Overall PA levels were associated with self-reported health.
Notes
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PubMed ID
24673834 View in PubMed
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Accreditation and improvement in process quality of care: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature274471
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Publication Type
Article
Date
Oct-2015
Author
Søren Bie Bogh
Anne Mette Falstie-Jensen
Paul Bartels
Erik Hollnagel
Søren Paaske Johnsen
Source
Int J Qual Health Care. 2015 Oct;27(5):336-43
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Accreditation - statistics & numerical data
Denmark
Follow-Up Studies
Guideline Adherence - statistics & numerical data
Heart Failure - therapy
Hospital Bed Capacity
Hospitals, Public - statistics & numerical data
Humans
Peptic Ulcer - therapy
Practice Guidelines as Topic
Quality Improvement - statistics & numerical data
Quality Indicators, Health Care - statistics & numerical data
Residence Characteristics
Stroke - therapy
Abstract
To examine whether performance measures improve more in accredited hospitals than in non-accredited hospital.
A historical follow-up study was performed using process of care data from all public Danish hospitals in order to examine the development over time in performance measures according to participation in accreditation programs.
All patients admitted for acute stroke, heart failure or ulcer at Danish hospitals.
Hospital accreditation by either The Joint Commission International or The Health Quality Service.
The primary outcome was a change in opportunity-based composite score and the secondary outcome was a change in all-or-none scores, both measures were based on the individual processes of care. These processes included seven processes related to stroke, six processes to heart failure, four to bleeding ulcer and four to perforated ulcer.
A total of 27 273 patients were included. The overall opportunity-based composite score improved for both non-accredited and accredited hospitals (13.7% [95% CI 10.6; 16.8] and 9.9% [95% 5.4; 14.4], respectively), but the improvements were significantly higher for non-accredited hospitals (absolute difference: 3.8% [95% 0.8; 8.3]). No significant differences were found at disease level. The overall all-or-none score increased significantly for non-accredited hospitals, but not for accredited hospitals. The absolute difference between improvements in the all-or-none score at non-accredited and accredited hospitals was not significant (3.2% [95% -3.6:9.9]).
Participating in accreditation was not associated with larger improvement in performance measures for acute stroke, heart failure or ulcer.
PubMed ID
26239473 View in PubMed
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[Adequacy between prescriptions and CHADS(2) score recommendations in geriatric patients].

https://arctichealth.org/en/permalink/ahliterature101701
Source
Geriatr Psychol Neuropsychiatr Vieil. 2011 Mar;9(1):39-44
Publication Type
Article
Date
Mar-2011
Author
Nolya Haïda
Marion Albouy-Llaty
Céline Baudemont
Fabienne Bellarbre
Marc Paccalin
Author Affiliation
Département de gériatrie-Pôle médecine. m.paccalin@chu-poitiers.fr
Source
Geriatr Psychol Neuropsychiatr Vieil. 2011 Mar;9(1):39-44
Date
Mar-2011
Language
French
Publication Type
Article
Keywords
Aged, 80 and over
Atrial Fibrillation - drug therapy - epidemiology
Cross-Sectional Studies
Female
Fibrinolytic Agents - adverse effects - therapeutic use
France
Guideline Adherence - statistics & numerical data
Health Status Indicators
Hemorrhage - chemically induced - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Retrospective Studies
Risk assessment
Stroke - epidemiology - etiology - prevention & control
Abstract
Atrial fibrillation (AF) is a major risk factor for stroke. Thromboprophylaxis with anticoagulant reduces the incidence of stroke and is warranted by the CHADS(2) recommendations when score =2. But such therapy remains underused particularly among elderly patients. The aim of our study was to evaluate the adequacy between prescriptions and CHADS(2) recommendations in geriatric hospitalised patients with AF. Method: retrospective study set in the Geriatrics Department of the University hospital of Poitiers (France), of patients >75 y with AF, between July and December 2009. The description of the patients taken into the count: epidemiological data, functional daily activities (score GIR), cognitive assessment, antithrombotic treatment, and evaluation of the CHADS(2) and HEMORR(2)HAGES scores. Results: in this study161 hospitalisations were analysed, mean age of the patients was 87.4?±?5.4 years. Antithrombotic treatment was prescribed in 84% of cases. The overall conformity to CHADS(2) recommendations was 44%. Most of hospitalisations (88.9%) included patients with CHADS(2) score =2. Non-conformity rate was up to 60% in this group with 5 significant variables: MMSE score
PubMed ID
21586375 View in PubMed
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Adherence to calcium channel blocker poisoning treatment recommendations in two Canadian cities.

https://arctichealth.org/en/permalink/ahliterature124475
Source
Clin Toxicol (Phila). 2012 Jun;50(5):424-30
Publication Type
Article
Date
Jun-2012
Author
Maude St-Onge
Patrick Archambault
Natalie Lesage
Chantal Guimont
Julien Poitras
René Blais
Author Affiliation
University of Toronto, Toronto, Ontario, Canada. egnomie@hotmail.com
Source
Clin Toxicol (Phila). 2012 Jun;50(5):424-30
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Calcium Channel Blockers - poisoning
Female
Guideline Adherence - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Poison Control Centers - statistics & numerical data
Practice Guidelines as Topic
Quebec
Retrospective Studies
Time Factors
Treatment Outcome
Vasoconstrictor Agents - administration & dosage - therapeutic use
Abstract
No study has documented whether physicians call poison control centres (PCC) for calcium channel blocker (CCB) poisoning or if interventions suggested by the PCC are being applied.
This study evaluated the compliance of physicians with the Quebec Poison Control Center's (QPCC) recommendations for the treatment of CCB poisoning. It also assessed the outcomes of these patients.
This retrospective chart review was conducted with CCB-poisoned adults who were admitted to a hospital in Quebec City or Montreal between January 2004 and November 2007. Using the sequence of interventions, it was determined whether or not the PPC recommendations were adhered to. Level of care provided, morbidity and mortality were reported. The researchers also used the QPCC database to verify if the poison centre was consulted for the care of the patient.
A total of 103 cases were identified. 42% (43/103) were classified as compliant (all PCC recommendations were followed) and 58% (60/103) non-compliant group (some or no PCC recommendations followed). The poison control centre (PCC) was contacted for 74% of the total cases (81% of cases in the compliant group and 68% in the non-compliant group). High-dose insulin euglycemia therapy (HIET) was not started when indicated or started at too low dosage in 20 cases. Glucagon was given, even if not indicated, in 14 cases and decontamination was inappropriate in at least 10 cases. For the entire sample, there was an average of 8 days of hospitalization, 47 h of intensive care, 11 h of vasopressor use, a morbidity of 50% and a mortality of 6%. Acute renal failure (35%), metabolic acidosis (25%), acute pulmonary oedema (15%), aspiration pneumonia (15%), rhabdomyolysis (8%), myocardial ischemia (7%), abnormal liver function tests (AST/ALT) (6%), cerebral anoxia (4%) and ileus (3%) were among the most frequent complications. The outcomes in the non-compliant group versus the compliant group showed a mortality of 10% versus 0% (95%CI 0.00-0.20, p-value
PubMed ID
22578114 View in PubMed
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Adherence to guidelines for surveillance colonoscopy in patients with ulcerative colitis at a Canadian quaternary care hospital.

https://arctichealth.org/en/permalink/ahliterature148080
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Publication Type
Article
Date
Sep-2009
Author
Dan Kottachchi
Derek Yung
John K Marshall
Author Affiliation
Department of Internal Medicine, McMaster University, Hamilton, ON, Canada.
Source
Can J Gastroenterol. 2009 Sep;23(9):613-7
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Biopsy - statistics & numerical data
Canada - epidemiology
Cell Transformation, Neoplastic - pathology
Colitis, Ulcerative - complications - diagnosis
Colon - pathology
Colonic Neoplasms - epidemiology - etiology - prevention & control
Colonic Polyps - epidemiology - etiology - pathology
Colonoscopy - statistics & numerical data
Female
Gastroenterology - standards
Guideline Adherence - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Intestinal Mucosa - pathology
Male
Mass Screening - methods
Middle Aged
Physician's Practice Patterns - standards
Practice Guidelines as Topic
Precancerous Conditions - epidemiology - etiology - pathology
Retrospective Studies
Severity of Illness Index
Abstract
Patients with ulcerative colitis (UC) are at high risk of colonic dysplasia. Therefore, surveillance colonoscopy to detect early dysplasia has been endorsed by many professional organizations.
To determine whether gastroenterologists at Hamilton Health Sciences (Hamilton, Ontario) adhere to recommendations for UC surveillance issued by the Canadian Association of Gastroenterology and to retrospectively assess the incidence and type of dysplasia found and the subsequent outcome of patients with dysplasia (ie, colorectal cancer [CRC], colectomy, dysplasia recurrence).
A retrospective chart review of all patients with UC undergoing colonoscopy screening at Hamilton Health Sciences from January 1980 to January 2005, was performed. Patients were classified by the extent of colonic disease: limited left-sided colitis (LSC), pancolitis and any disease extent with concurrent primary sclerosing cholangitis.
A total of 141 patients fulfilled eligibility criteria. They underwent 921 endoscopies, including 453 for surveillance, which were performed by 20 endoscopists. Overall, screening was performed on 90% of patients, and surveillance at the appropriate time in 74%. There was a statistically significant increase in the mean number of biopsies per colonoscopy after the guidelines were published (P
Notes
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PubMed ID
19816624 View in PubMed
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Adherence to guidelines on antibiotic treatment for respiratory tract infections in various categories of physicians: a retrospective cross-sectional study of data from electronic patient records.

https://arctichealth.org/en/permalink/ahliterature271494
Source
BMJ Open. 2015;5(7):e008096
Publication Type
Article
Date
2015
Author
David Tell
Sven Engström
Sigvard Mölstad
Source
BMJ Open. 2015;5(7):e008096
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Anti-Bacterial Agents - therapeutic use
Child
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Electronic Health Records
Female
General Practice - statistics & numerical data
Guideline Adherence - statistics & numerical data
Humans
Internship and Residency - statistics & numerical data
Male
Middle Aged
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Professional Practice Location
Respiratory Tract Infections - drug therapy
Retrospective Studies
Sex Factors
Sweden
Young Adult
Abstract
To study how prescription patterns concerning respiratory tract infections differ between interns, residents, younger general practitioners (GPs), older GPs and locums.
Retrospective study of structured data from electronic patient records.
Data were obtained from 53 health centres and 3 out-of-hours units in Jönköping County, Sweden, through their common electronic medical record database.
All physicians working in primary care during the 2-year study period (1 November 2010 to 31 October 2012).
Physicians' adherence to current guidelines for respiratory tract infections regarding the use of antibiotics.
We found considerable differences in prescribing patterns between physician categories. The recommended antibiotic, phenoxymethylpenicillin, was more often prescribed by interns, residents and younger GPs, while older GPs and locums to a higher degree prescribed broad-spectrum antibiotics. The greatest differences were seen when the recommendation in guidelines was to refrain from antibiotics, as for acute bronchitis. Interns and residents most often followed guidelines, while compliance in descending order was: young GPs, older GPs and locums. We also noticed that male doctors were somewhat overall more restrictive with antibiotics than female doctors.
In general, primary care doctors followed national guidelines on choice of antibiotics when treating respiratory tract infections in children but to a lesser degree when treating adults. Refraining from antibiotics seems harder. Adherence to national guidelines could be improved, especially for acute bronchitis and pneumonia. This was especially true for older GPs and locums whose prescription patterns were distant from the prevailing guidelines.
Notes
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PubMed ID
26179648 View in PubMed
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Adherence to guidelines on the management of dystocia and cesarean section rates.

https://arctichealth.org/en/permalink/ahliterature163725
Source
Am J Perinatol. 2007 May;24(5):271-5
Publication Type
Article
Date
May-2007
Author
Lawrence W Oppenheimer
Paul Holmes
Qiuying Yang
Tubao Yang
Mark Walker
Shi Wu Wen
Author Affiliation
Division of Maternal-Fetal Medicine, Ottawa Hospital, Ottawa, Ontario, Canada.
Source
Am J Perinatol. 2007 May;24(5):271-5
Date
May-2007
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cesarean Section - standards - utilization
Databases, Factual - statistics & numerical data
Dystocia - prevention & control
Female
Guideline Adherence - statistics & numerical data
Humans
Obstetrics
Practice Guidelines as Topic
Pregnancy
Retrospective Studies
Societies, Medical
Abstract
The purpose of this study was to investigate to what extent the Society of Obstetricians and Gynecologists of Canada (SOGC) guidelines on dystocia are being followed, and whether adherence to the guidelines is related to cesarean section rates. Data were extracted from a maternity database for nulliparous women with singleton, cephalic pregnancies at 37 or more completed weeks of gestation for a 4-year period. Patients delivered by elective cesarean section were excluded. Data were examined to determine whether those who had a cesarean section for dystocia in the first stage of labor fulfilled SOGC guidelines. In addition, the obstetricians were divided into two groups (high or low) according to their cesarean section rate for dystocia to determine whether a higher section rate was associated with an increased guideline violation rate. There were 239 nulliparous women who had a cesarean section for dystocia in the first stage of labor. The guidelines were followed in 47.7% of spontaneous labors and 77.5% of inductions. The mean section rate for dystocia in the first stage of labor was 10.8% in the high group and 6.6% in the low group, and the incidence of guideline violations in these groups was 48.0% and 39.6%, respectively ( P = 0.07). The study had a power of 0.88 to detect a 40% difference in guideline violation rates between the two groups. We conclude that many women have cesarean section for dystocia performed without fulfilling SOGC guidelines.
PubMed ID
17484079 View in PubMed
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[Adherence to international recommendations in the fight against antimicrobial resistance - Substantial difference between outpatient consumption in Spain and Denmark].

https://arctichealth.org/en/permalink/ahliterature278374
Source
Rev Esp Quimioter. 2016 Feb;29(1):40-3
Publication Type
Article
Date
Feb-2016
Author
Sara Malo
María José Rabanaque
Lars Bjerrum
Source
Rev Esp Quimioter. 2016 Feb;29(1):40-3
Date
Feb-2016
Language
Spanish
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy - epidemiology - microbiology
Cephalosporins
Databases, Factual
Denmark - epidemiology
Drug Resistance, Bacterial
Drug Utilization
Fluoroquinolones
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Humans
Macrolides
Outpatients
Spain - epidemiology
Abstract
Increasing antibiotic resistance represents a major public health threat that jeopardises the future treatment of bacterial infections. This study aims to describe the adherence to recommendations proposed by the World Health Organization (WHO) Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR), in Spain and Denmark, and to analyse the relation between the outpatient use of Critically Important Antimicrobials (CIA) and the bacterial resistance rates to these agents.
The Antimicrobial consumption interactive database (ESAC-Net) and Antimicrobial resistance interactive database (EARS-Net) provided data on outpatient use (2010-2013) of CIA (fluoroquinolones, macrolides, and 3rd and 4th generation cephalosporins) and the percentages of isolates of the main pathogens causing serious infections, resistant to these agents.
The use of cephalosporins and fluoroquinolones, as well as the percentage of bacteria resistant, is higher in Spain than in Denmark. Although consumption of macrolides in both countries is similar, the proportion of Streptococcus pneumoniae resistant to macrolides is significantly higher in Spain.
The high outpatient consumption of CIA agents in Spain deviates substantially from the WHO recommendations. Moreover, it has the effect of elevated rates of antimicrobial resistance, that are lower in Denmark.
PubMed ID
26809795 View in PubMed
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Adherence to national guidelines for surveillance after curative resection of nonmetastatic colon and rectum cancer: a survey among Norwegian gastrointestinal surgeons.

https://arctichealth.org/en/permalink/ahliterature133589
Source
Colorectal Dis. 2012 Mar;14(3):320-4
Publication Type
Article
Date
Mar-2012
Author
K. Søreide
J H Træland
P J Stokkeland
T. Glomsaker
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway. ksoreide@mac.com
Source
Colorectal Dis. 2012 Mar;14(3):320-4
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Colonic Neoplasms - diagnosis - surgery
Guideline Adherence - statistics & numerical data
Health Care Surveys
Hospitals - statistics & numerical data
Humans
Neoplasm Metastasis - diagnosis
Neoplasm Recurrence, Local - diagnosis
Norway
Physician's Practice Patterns - statistics & numerical data
Population Surveillance
Practice Guidelines as Topic
Rectal Neoplasms - diagnosis - surgery
Abstract
National guidelines recommend enrollment of patients in surveillance programmes following curative resection of colorectal carcinoma (CRC) in order to detect recurrence or distant metastasis at an asymptomatic/early stage when secondary curative treatment can be offered. Little is known about surgeons' adherence to such guidelines. In this national survey we analyse adherence and attitudes to postoperative follow up among Norwegian gastrointestinal surgeons involved in the care of patients with CRC.
We performed a nationwide survey of all hospitals performing surgery for colon and/or rectum cancer. The presence of a surveillance programme, the type of programme, adherence to national guidelines or report on any deviation thereof, location of follow up at the hospital or with a general practitioner (GPs) and the estimated annual volume of surgery were queried through mail and telephone.
All hospitals (n=41) performing colorectal surgery responded, of which 25 (61%) conducted postoperative follow up by surgeons in the hospital outpatient clinics, four (10%) carried out follow up with a combination of hospital outpatient visits and visits to GPs, and 12 (29%) referred surveillance to the GP alone. For total reported patient numbers, almost two-thirds (60%) received surveillance according to national recommendations through outpatient visits with the surgeon or GP, while one-third (37%) were subject to other alternative routines. A small number (2%) received informal 'ad hoc' surveillance only. More liberal use of imaging outside guideline recommendations was reported for rectal cancer patients, while colon cancer patients treated in larger hospitals were more likely to be referred for GP surveillance.
All hospitals reported having a strategy for surveillance after surgery for colon and rectal cancer, but there was considerable variance in strategy. A scientific audit of the true level of compliance, effectiveness and cost-benefit is warranted at a national level.
PubMed ID
21689321 View in PubMed
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Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients.

https://arctichealth.org/en/permalink/ahliterature163594
Source
Eur J Emerg Med. 2007 Apr;14(2):75-81
Publication Type
Article
Date
Apr-2007
Author
Hetti Kirves
Markus B Skrifvars
Marko Vähäkuopus
Kaj Ekström
Matti Martikainen
Maaret Castren
Author Affiliation
Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, 00029 HUS, Helsinki, Finland. Hetti.Kirves@hus.fi
Source
Eur J Emerg Med. 2007 Apr;14(2):75-81
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Aged
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Finland
Guideline Adherence - statistics & numerical data
Heart Arrest - therapy
Hospitalization
Humans
Logistic Models
Male
Middle Aged
Outcome Assessment (Health Care)
Practice Guidelines as Topic
Prognosis
Resuscitation
Abstract
The impact of prehospital care after the return of spontaneous circulation in out-of-hospital cardiac arrest patients is not known. This study describes adherence to the resuscitation guidelines, factors associated with poor adherence and possible impact of prehospital postresuscitation care on the outcome of out-of-hospital cardiac arrest.
One hundred and fifty-seven Finnish out-of-hospital cardiac arrest patients hospitalized during 1 year, were analyzed retrospectively. Patient and arrest characteristics, prehospital postresuscitation care and survival to hospital discharge were analyzed using multivariate logistic regression.
Forty percent of the patients received care accordant with the guidelines. Male sex (P=0.045), witnessed arrest (P=0.031), initial ventricular fibrillation/ventricular tachycardia rhythm (P=0.007) and the presence of an emergency physician (P=0.017) were associated with care in line with the current guidelines. In multivariate logistic regression analysis, age over median (odds ratio=3.6, 95% confidence interval 1.5-8.6), nonventricular fibrillation/ventricular tachycardia initial rhythm (odds ratio=4.0, 95% confidence interval 1.6-9.8), administration of adrenaline (odds ratio=7.0, 95% confidence interval 2.3-21.4) and unsatisfactory prehospital postresuscitation care (odds ratio=2.5, 95% confidence interval 1.1-6.3) were associated with a failure to survive up to hospital discharge.
Less than 50% of out-of-hospital cardiac arrest patients received prehospital postresuscitation care compatible with the current guidelines. Markers of poor prognosis were associated with unsatisfactory care, which in turn was more frequent among the patients who did not survive to hospital discharge. The importance of the guidelines should be highlighted in the future.
PubMed ID
17496680 View in PubMed
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