National clinical audit: lessons from cardiac surgery

2009 ◽  
Vol 91 (9) ◽  
pp. 296-297
Author(s):  
Ben Bridgewater
Keyword(s):  
Cardiac Surgery ◽  
Clinical Audit ◽  
National Database ◽  
Freedom Of Information ◽  
National Data ◽  
History Of Collecting ◽  
Support Programme ◽  
History Of ◽  
The Uk

Cardiac surgery has a long history of collecting and analysing clinical outcomes data. Initial systems for benchmarking mortality against pooled national data started in the 1970s. The initiative was given impetus by the Bristol Pubic Inquiry Report and the introduction of the Freedom of Information Act in 2005. Over recent years national data collection has been supported by funding from the National Clinical Audit Support Programme. All NHS hospitals in the UK now submit data to the national database. The Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) in conjunction with Dendrite Clinical Systems have recently produced a major report, Demonstrating quality, the sixth national database report, which received significant national press coverage because it reported marked improvement in the quality of care for patients undergoing cardiac surgery over the last decade.

scholarly journals CEH-GEAR: 1 km resolution daily and monthly areal rainfall estimates for the UK for hydrological use

2015 ◽  
Vol 8 (1) ◽  
pp. 83-112 ◽  
Author(s):  
V. D. J. Keller ◽  
M. Tanguy ◽  
I. Prosdocimi ◽  
J. A. Terry ◽  
O. Hitt ◽  
...  
Keyword(s):  
Monthly Rainfall ◽  
Annual Rainfall ◽  
National Database ◽  
Maximum Information ◽  
Weather Observations ◽  
The Republic ◽  
Areal Rainfall ◽  
The Uk ◽  
Rainfall Estimates

Abstract. The Centre for Ecology & Hydrology – Gridded Estimates of Areal Rainfall (CEH-GEAR) dataset was developed to provide reliable 1 km gridded estimates of daily and monthly rainfall for Great Britain (GB) and Northern Ireland (NI) (together with approximately 3500 km2 of catchment in the Republic of Ireland) from 1890 onwards. The dataset was primarily required to support hydrological modelling. The rainfall estimates are derived from the Met Office collated historical weather observations for the UK which include a national database of raingauge observations. The natural neighbour interpolation methodology, including a normalisation step based on average annual rainfall, was used to generate the daily and monthly rainfall grids. To derive the monthly estimates, rainfall totals from monthly and daily (when complete month available) read raingauges were used in order to obtain maximum information from the raingauge network. The daily grids were adjusted so that the monthly grids are fully consistent with the daily grids. The CEH-GEAR dataset was developed according to the guidance provided by the British Standards Institution. The CEH-GEAR dataset contains 1 km grids of daily and monthly rainfall estimates for GB and NI for the period 1890–2012. For each day and month, CEH-GEAR includes a secondary grid of distance to the nearest operational raingauge. This may be used as an indicator of the quality of the estimates. When this distance is greater than 100 km, the estimates are not calculated due to high uncertainty. CEH-GEAR is available free of charge for commercial and non-commercial use subject to licensing terms and conditions. doi:10.5285/5dc179dc-f692-49ba-9326-a6893a503f6e

The changing landscape of local authority commissioning

2020 ◽  
pp. 177-196
Author(s):  
Dave Ayre
Keyword(s):  
Academic Research ◽  
The European Union ◽  
Public And Private ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
The Uk ◽  
Relationship Of ◽  
The Relationship

This chapter assesses the history of the relationship between public and private sectors and the extent to which the political and regulatory environment of governments and institutions such as the European Union (EU) can help or hinder the efforts of public bodies in seeking to deliver services that determine the health and quality of life for communities. The relationship of public and private sectors in the United Kingdom (UK) and the commissioning, procurement, and development of public–private partnerships is driven by the prevailing political and economic environment. However, rigorous academic research on the benefits of partnering to organisations, societies and between countries is limited. Evidence is needed to fill the policy vacuum. A bolder approach is necessary to work with public and private sectors to develop and implement successful partnering alternatives to the outsourcing of public services. The growing catalogue of outsourcing failures in construction, probation, rail franchising, health, and social care is creating an appetite for change, and the exit of the UK from the EU provides the opportunity.

Continuing care of Old People—A Medical Viewpoint

1988 ◽  
Vol 8 (2) ◽  
pp. 189-209 ◽  
Author(s):  
Richard Lewis ◽  
John Wattis
Keyword(s):  
Social Services ◽  
Continuing Care ◽  
Present System ◽  
Old People ◽  
The United Kingdom ◽  
Health And Social Care ◽  
History Of ◽  
Informal Carers ◽  
The Uk

ABSTRACTProvision for old people who are in need of continuing care requires close co-operation between informal carers and different agencies and disciplines providing health and social care. In the United Kingdom, the present system of care has evolved from earlier patterns of care centred on the asylums and the poor law with its workhouse institutions. It lacks cohesion. Despite the designation of old people as a priority group, resources are still inadequate to provide a good quality of care. Organisational differences between health and social services can lead to inefficient use of existing resources. More specialised medical, psychiatric and social services for old people enhance the possibilities for co-operation even though they may appear to lead to greater fragmentation. The history of the development of these services in the UK, including the recent expansion of private sector care, is reviewed, with special attention from the medical perspective to the phenomenon of ‘bed blocking’. The recently published Griffiths Report on community care is briefly considered, and some principles for future developments are laid down.

scholarly journals Investigation of clinical characteristics and genome associations in the UK Lipoedema cohort

2021 ◽  
Author(s):  
Dionysios Grigoriadis ◽  
Ege Sackey ◽  
Katie Riches ◽  
Malou van Zanten ◽  
Glen Brice ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Genome Wide Association Study ◽  
Subcutaneous Fat ◽  
Lower Limbs ◽  
Genome Wide ◽  
A Genome ◽  
History Of ◽  
Different Populations ◽  
The Uk

Lipoedema is a chronic adipose tissue disorder mainly affecting women, causing excess subcutaneous fat deposition on the lower limbs with pain and tenderness. There is often a family history of lipoedema, suggesting a genetic origin, but the contribution of genetics is currently unclear. A tightly phenotyped cohort of 200 lipoedema patients was recruited from two UK specialist clinics. Objective clinical characteristics and measures of quality of life data were obtained. In an attempt to understand the genetic architecture of the disease better, genome-wide single nucleotide polymorphism (SNP) genotype data were obtained, and a genome wide association study (GWAS) performed on 130 of the recruits. The analysis revealed genetic loci suggestively associated with the lipoedema phenotype, with further support provided by an independent cohort taken from the 100,000 Genomes Project. Top SNPs included loci associated with lipoma formation, biosynthesis of hormones and lipid hydroxylation. Exactly how these SNPs relate to a lipoedema disease mechanism is not yet understood but the findings are consistent with existing fat and hormone hypotheses. This first GWAS of a UK lipoedema cohort has identified genetic regions of suggestive association with the disease. Further replication of these findings in different populations is warranted.

Quality Processes in Distance Education

2011 ◽  
pp. 1728-1733
Author(s):  
Alistair Inglis
Keyword(s):  
Distance Education ◽  
Course Design ◽  
Teaching Staff ◽  
Failure Rates ◽  
Broadcast Media ◽  
History Of ◽  
New Type ◽  
The Uk ◽  
The University

Practitioners and providers in distance education owe a great debt to the founders of the UK Open University (UKOU). The history of distance education can be broken into two eras, each separated by the successful establishment of the UKOU. The UKOU had as strong an incentive as any institution to improve quality — its very survival is dependent on its success. Prior to the establishment of the UKOU, distance education (or correspondence education, or extramural studies or external studies, as it was then known) was characterized by high attrition and high failure rates (White, 1974). The UKOU planners recognized this fact. They realized that, for the University to succeed, the causes of the high attrition and high failure rates had to be addressed. The fact that the University continues to this day is testament to its success. The way in which the UKOU tackled the issue of quality, carries some lessons for distance education providers today. It did so, not by targeting one key area, but by tackling the range of factors that affect the quality of a student’s experience of studying at a distance: by investing heavily in the presentation quality of materials; by making innovative use of media, (particularly the broadcast media); by putting in place a new type of organisational structure to support teaching staff in the work of course design, teaching, and assessment; and by building up a range of other support functions: establishing local study centres, employing local tutors, and instituting a program of residential schools.

scholarly journals Mortality of babies enrolled in a community-based support programme: CONI PLUS (Care of Next Infant Plus)

2015 ◽  
Vol 100 (7) ◽  
pp. 637-642 ◽  
Author(s):  
Alison J Waite ◽  
Robert C Coombs ◽  
Angela McKenzie ◽  
Charlotte Daman-Willems ◽  
Marta C Cohen ◽  
...  
Keyword(s):  
Extended Family ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Community Based ◽  
Support Programme ◽  
Life Threatening ◽  
History Of ◽  
The Uk ◽  
Age Range

ObjectiveTo report mortality in babies enrolled on a community-based programme, Care of Next Infant Plus (CONI PLUS), which primarily supports parents anxious because of previous sudden unexpected death in infancy (SUDI) in their extended family or following an apparent life threatening event (ALTE) in their baby.DesignProspective observational study from 1996 to 2010 in the UK.ResultsOf 6487 babies enrolled, 37 died (5.7 per 1000). There were 2789 (43.0%) SUDI related babies of whom, six died suddenly and unexpectedly (2.15 per 1000). Four babies were sharing a sofa at night or a bed with parent(s) who smoked or had consumed alcohol. Of the 1882 (29.0%) babies enrolled following an ALTE, five died suddenly and unexpectedly (2.66 per 1000): four unexplained and one due to infection. None occurred while sharing a sleep surface, and at least three died during the day. The remaining 1816 (28%) babies were enrolled for other reasons. Seven died suddenly and unexpectedly (3.85 per 1000), two were unexplained and none associated with bed sharing.ConclusionsThe number of SUDI deaths in babies enrolled on CONI PLUS is higher than expected from UK averages. Deaths in babies enrolled because of family history of SUDI were mostly associated with inappropriate sharing of a sleep surface at night and mostly outside the peak age range for sudden infant death. The opposite is true for those enrolled following an ALTE. The number of deaths is small but findings suggest a different mechanism for death in these two groups.

Unusual presentation of rheumatic fever in a 3-year-old child in the UK

2020 ◽  
Vol 13 (9) ◽  
pp. e232595
Author(s):  
Taryn Miller ◽  
Yee Aung ◽  
David Blundell ◽  
Amal Saleh Eldin Seed Ahmed Kona
Keyword(s):  
Rheumatic Fever ◽  
Young Patients ◽  
District General Hospital ◽  
Left Ventricular ◽  
Tertiary Centre ◽  
Viral Illness ◽  
History Of ◽  
The Uk ◽  
Developed World

In the developed world, acute rheumatic fever (ARF) is rare. When it does arise, symptoms commonly include fever, arthralgia and rash. We describe a presentation of a 3-year-old child with ARF in a UK District General Hospital. The patient had a 6-week history of diarrhoea, rash and intermittent right hip arthralgia. This was initially thought to be a viral illness until she re-presented with shortness of breath and fever with a pan-systolic murmur. A throat-culture was negative, but an anti-streptolysin titre was elevated, with a bedside echocardiogram demonstrating moderate to severe mitral regurgitation. The young child was transferred to the local tertiary centre for further management; however, she went on to develop acute left ventricular failure. This case illustrates the need to be vigilant for the presentation of a rare illness, such as rheumatic fever, as there can be significant impacts on the quality of life of young patients.

scholarly journals Value of Personalized Dementia-Specific Quality of Life Scales: An Explorative Study in 3 European Countries

2021 ◽  
Vol 36 ◽  
pp. 153331752110337
Author(s):  
Iris Hendriks ◽  
Raquel Demetrio ◽  
Franka J. M. Meiland ◽  
Rabih Chattat ◽  
Dorota Szcześniak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Practice ◽  
Support Programme ◽  
People With Dementia ◽  
Individual Character ◽  
Moderate Dementia ◽  
The Uk ◽  
Severity Of Dementia ◽  
The Relationship

Measuring Quality of Life (QOL) can be difficult due to its individual character. To explore the value of personalized QOL measurement for people with dementia, personalized versions of two dementia-specific QOL scales (Dementia quality of Life (DQoL) and Quaility of Life in Alzheimer's Disease (QoL-AD)) were constructed. This study investigated whether the personalized measures are more valid to detect variations in QOL than their standard versions for people with mild to moderate dementia, with sufficient internal consistency. Moreover, the relationship between the personalized QOL measures and severity of dementia was investigated. Finally, the study explored the differences between countries regarding the personalized overall QOL and differences in the importance of QOL domains. This explorative one-group design study used baseline data from the MEETINGDEM study into the implementation of the Meeting Centres Support Programme in Italy, Poland and the UK. The personalized versions of the DQoL and QoL-AD were reliable, but not more valid than their standard versions. No relationship between severity of dementia and personalized QOL was found. While no differences were found between countries for the overall QOL score, some QOL domains were valued differently: people with dementia from the UK rated self-esteem, mood, physical health, energy level and the ability to do chores around the house significantly less important than people from Italy and Poland. The personalized versions of the DQoL and QoL-AD may offer dementia care practice important insights into what domains contribute most to an individual’s QOL.

scholarly journals Auras and the risk of seizures with impaired consciousness following epilepsy surgery: implications for driving

2017 ◽  
Vol 89 (6) ◽  
pp. 599-602 ◽  
Author(s):  
Sam Fairclough ◽  
Aidan G O’Keeffe ◽  
Jane de Tisi ◽  
John S Duncan
Keyword(s):  
Epilepsy Surgery ◽  
Focal Epilepsy ◽  
Prior History ◽  
Surgery Outcome ◽  
History Of ◽  
Impaired Awareness ◽  
The Uk ◽  
International League

ObjectiveTo calculate the chance of a seizure in the next year (COSY) for seizures with impaired awareness in those experiencing auras only, those with no seizures and those with continuing seizures. Epilepsy surgery is an effective treatment for refractory focal epilepsy. Driving is an important factor affecting quality of life. In the UK, driving is not permitted if focal seizures with no impairment of awareness (auras, simple partial seizures) continue, if there is a prior history of seizures with impaired awareness, as will invariably be the case in those having epilepsy surgery. Current UK driving regulations allow driving if COSY is less than 20%.MethodWe calculated COSY in 819 epilepsy surgery patients with up to 25 years follow-up. Each patient year was graded on the The International League against Epilepsy surgery outcome scale.ResultsPatients who were entirely seizure-free for 1, 2 and 3 years had COSY of 4.9%, 3.5% and 2.4% respectively. Patients with only auras within the last 1, 2 or 3 years had a COSY of 11.3%, 9.2% and 7.8% respectively.ConclusionsIndividuals with auras only after epilepsy surgery had a higher COSY than those who were seizure-free. If a COSY of below 20% is regarded as an acceptable risk, it may be suggested that those with auras only in a given year be allowed to drive. The relative risk of these patients causing accidents is lower than population groups such as those aged <25 or >75 years, who are permitted to drive.

scholarly journals Antiquarian attitudes. Changing responses to the past in the museum environment

1970 ◽  
pp. 6
Author(s):  
Arthur MacGregor
Keyword(s):  
Design Quality ◽  
The Past ◽  
History Of Collecting ◽  
History Of ◽  
Museum Environment ◽  
The Many ◽  
The Way ◽  
Common Components

Of the many attributes that may deem an object worthy of inclusion in a museum, that of antiquity is one of the most potent - in a sense the most powerful of all, for other considerations such as beauty of form, originality of design, quality of workmanship or historical association may all be glossed over in the presence of extreme age. While antiquities have formed common components of museums throughout the history of collecting, striking changes have taken place in the significance attributed to them, not merely in the light of better understanding but more fundamentally in the way in which perceptions of antiquity itself have been repeatedly revised and reinterpreted within the museum context. These twin considerations of expanding understanding and changing perceptions of the past within the museum programme will form the basis of my paper. 

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