To get an overview of Norwegian telemedicine, a questionnaire was sent to the contact persons of telemedicine programmes. There was an 83% response rate from 102 telemedicine programmes; there were 66 active research projects. Several larger networks had recently started operation, probably as a result of the Ministry of Health and Social Affairs' plan of action on information and communication technology in health care. Twenty-one programmes involved primary care or home care. Few programmes were using telemedicine to bridge established divisions of service responsibility or to make connections to institutions abroad. There were three large national research programmes in which telemedicine played an important role. Research projects were evaluating the economic, organizational and sociological aspects of telemedicine, as well as the medical. The oldest telemedicine activities were in northern Norway.
Assessment of the usage of medical library services before and after the implementation of several new services, as well as assessment of the clinical impact of the information provided by the medical library.
A sample of employees, residents and physicians were surveyed using a stratified, random selection process in two surveys 4 years apart. The response rate for the first survey was 52% and the response rate for the second survey was 35.2%.
Differences in usage included increased overall use of the librarians and library services, decreased use of the Internet as a source of information, and direct and indirect impacts upon patient care. Information needs of respondents also increased to where 65% of employees and 94% of physicians require information at least once a week. Patient management was the main reason for needing information. The top two specific uses were to find out about a condition and determine a treatment plan.
These findings parallel some of the findings of other researchers, and contradict the findings of others. Possible explanations for these findings and implications for future research are discussed.
Bariatric surgery is a treatment option for obese patients when weight-reduction strategies such as lifestyle modifications and pharmacotherapy fail. To date, bariatric surgery has resulted in sustained weight loss; the resolution of diabetes for some patients has also been observed. The objective of this study was to explore changes in-patient bariatric surgery delivery in Canada between 2004-2005 and 2008-2009.
The purpose of the study was to assess vaccination coverage of 2-year-olds and estimate immunization practices in Canada using a postal survey with a panel of 862 households. RIM weighting was used to provide national estimates. 95% CIs were calculated using the binomial method. Completed questionnaires were received for 534 children born between February 1991 and January 1992. Thirty nine percent of children had received all/most of their vaccinations at a public health clinic. Overall 5.6% parents indicated they had their child immunized because it was mandatory and 7.4% because of requirements for school, pre-school, nursery or day care attendance. A total of 78.7% of parents remembered receiving information on benefits of immunizations and 97% on the risks/side-effects. By their second birthday, 83.7% (95% CI 80.3-86.7) of 2-year-olds had received complete immunization against poliomyelitis; 97.2% (95% CI 95.4-98.4), at least one dose of a measles containing vaccine; 86.5% (95% CI 83.3-89.3), at least one dose of Haemophilus influenzae type b vaccine; and 81.6% (95% CI 78.1-84.8), at least, four doses of diphtheria, tetanus and pertussis vaccine.
Intraosseous infusion (IOI) is recommended when intravenous access cannot be readily established in both pediatric and adult resuscitation. We evaluated the current use of IOI in Danish emergency departments (EDs).
An online questionnaire was e-mailed to the Heads of Department of the twenty EDs currently established in Denmark. The questionnaire focused on the use of IOI in the EDs and included questions on frequency of use, training, equipment and attitudes towards IOI.
We received a total of 19 responses (response rate of 95%). Of the responding 19 Danish EDs 74% (n = 14) reported having intraosseous devices available. The median number of IOI procedures performed in these departments over the preceding 12 months was 5.0 (range: 0-45). In 47% (n = 9) of the departments, prior training sessions in the use of intraosseous devices had not been provided, and 42% (n = 8) did not have local guidelines on IOI. The indication for IOI use was often not clearly defined and only 11% (n = 2) consistently used IOI on relevant indication. This is surprising as 95% (n = 18) of responders were aware that IOI can be utilized in both pediatric and adult resuscitation.
The study shows considerable variations in IOI usage in Danish EDs despite the fact that IOI devices were available in the majority of EDs. In addition, in many EDs there were no local guidelines on IOI and no training in the procedure. We recommend more extensive training of medical staff in IOI techniques in Danish EDs.
Relatively little is known about the ability of Canadian emergency departments (EDs) and the federal, provincial and territorial governments to quantify ED activity. The objectives of this study were to determine the use of electronic patient data in Canadian EDs, the accessibility of provincial data on ED visits, and to identify the data elements and current methods of ED information system (EDIS) data collection nationally.
Surveys were conducted of the following 3 groups: 1) all ED directors of Canadian hospitals located in communities of >10,000 people, 2) all electronic EDIS vendors, and 3) representatives from the ministries of health from 13 provincial and territorial jurisdictions who had knowledge of ED data collection.
Of the 243 ED directors contacted, 158 completed the survey (65% response rate) and 39% of those reported using an electronic EDIS. All 11 EDIS vendor representatives responded. Most of the vendors provide a similar package of basic EDIS options, with add-on features. All 13 provincial or territorial government representatives completed the survey. Nine (69%) provinces and territories collect ED data, however the source of this information varies. Five provinces and territories collect triage data, and 3 have a comprehensive, jurisdiction-wide, population-based ED database. Thirty-nine percent of EDs in larger Canadian communities track patients using electronic methods. A variety of EDIS vendor options are available and used in Canada.
The wide variation in methods and in data collected presents serious barriers to meaningful comparison of ED services across the country. It is little wonder that the majority of information regarding ED overcrowding in Canada is anecdotal, when the collection of this critical health information is so variable. There is an urgent need to place the collection of ED information on the provincial and national agenda and to ensure that the collection of this information consistent, comprehensive and mandatory.