Five-year trends in induction of labour in a large Australian metropolitan maternity service.

Background: The World Health Organisation recommends that induction of labour (IOL) be performed only with a clear medical indication. Australian rates of IOL appear to be rising, with more than one-third of women having labour induced. This may reflect changing clinician and consumer perceptions of the benefits and potential harms of term IOL.

Electronic palliative care co-ordination system: an electronic record that supports communication for end-of-life care - a pilot in Richmond, UK.

Most people prefer to die at home, however, the majority die in an acute hospital. Supporting a patient in their preferred place of care may be aided by exchange of information across sectors. Richmond piloted an electronic palliative care coordination system (EPaCCS) to enhance interprofessional communication for end-of-life care.

Electronic palliative care co-ordination system: an electronic record that supports communication for end-of-life care - a pilot in Richmond, UK.

Most people prefer to die at home, however, the majority die in an acute hospital. Supporting a patient in their preferred place of care may be aided by exchange of information across sectors. Richmond piloted an electronic palliative care coordination system (EPaCCS) to enhance interprofessional communication for end-of-life care.

A model based on age, sex, and morbidity to explain variation in UK general practice prescribing: cohort study.

Objective: To examine whether patient level morbidity based measure of clinical case mix explains variations in prescribing in general practice.

Design: Retrospective study of a cohort of patients followed for one year.

Setting: UK General Practice Research Database.

Tight glycaemic control: a prospective observational study of a computerised decision-supported intensive insulin therapy protocol.

Introduction: A single centre has reported that implementation of an intensive insulin protocol, aiming for tight glycaemic control (blood glucose 4.4 to 6.1 mmol/l), resulted in significant reduction in mortality in longer stay medical and surgical critically ill patients.

Association of age, sex and deprivation with quality indicators for diabetes: population-based cross sectional survey in primary care.

Objectives: To determine the quality of diabetes management in primary care after the publication of the National Service Framework and examine the impact of age, gender and deprivation on the achievement of established quality indicators.

Design: Population-based cross sectional survey using electronic general practice records carried out between June-October 2003.

Setting: Thirty-four practices in Wandsworth, South-West London, UK.

Case-mix and variation in specialist referrals in general practice.

Background: The potential of a comprehensive measure of patient morbidity to explain variation in referrals to secondary care has not previously been examined in the UK.

Aim: To examine the relative role of age, sex and morbidity as defined by the Johns Hopkins ACG Case-Mix System in explaining variations in specialist referrals in general practice.

Design Of Study: Retrospective study of a cohort of patients followed for 1 year.

Adjusting for case mix and social class in examining variation in home visits between practices.

Objectives: The purpose of this study was to investigate whether adjusting for clinical case mix and social class explains more of the variation in home visits between general practices than adjusting for age and sex alone.

Methods: The setting was 60 general practices in England and Wales taking part in the 1 year Fourth National Morbidity Survey. The participants comprised 349 505 patients who were registered with one of the participating general practices for at least 180 days, and who had at least one consultation during the period.

The effect of heparin on graft thrombosis in pediatric renal allografts.

Graft thrombosis is an important cause of early (<4 weeks) renal graft loss. Reports show that heparin reduces the incidence of early renal allograft thrombosis. Routine peri-operative administration of unfractionated heparin was introduced in our unit in 1994.

Value of sequential monitoring of left ventricular ejection fraction in the management of thalassemia major.

Regular monitoring of left ventricular ejection fraction (LVEF) for thalassemia major is widely practiced, but its informativeness for iron chelation treatment is unclear. Eighty-one patients with thalassemia major but no history of cardiac disease underwent quantitative annual LVEF monitoring by radionuclide ventriculography for a median of 6.0 years (interquartile range, 2-12 years).

Mouth opening: a new angle.

Background: The authors hypothesized that craniocervical extension occurs during normal mouth opening.

Methods: Twenty volunteers were studied. Interdental distance was measured at four different degrees of craniocervical extension.