Transitions across various continuing care settings.

Purpose: to compare cross-nationally the sources and rates of admission and discharge in nursing homes.

Methods: data on admission were used from the Minimum Data Set of the Resident Assessment Instrument as collected in a multi-nation database at the University of Michigan. Additional data containing longitudinal episodes were used from databases in the Netherlands, Switzerland and the USA.

Variation in training programmes for Resident Assessment Instrument implementation.

Background: this paper provides an overview of the Minimum Data Set/Resident Assessment Instrument (MDS/RAI) training programmes in eight countries where the system has been introduced into nursing homes. Formal education and training in the skills of assessment and care planning of nursing home personnel is reputed to be poor. In response to this problem several researchers and clinicians view MDS/RAI implementation as an opportunity to upgrade staff knowledge in care of elderly people.

Efforts to establish the reliability of the Resident Assessment Instrument.

Background: since its original implementation in the USA, the Resident Assessment Instrument (RAI) has been used in many countries in languages other than English. This paper describes the efforts that have been made to test the inter-rater reliability of the core set of items forming the minimum data set items in the USA and in non-English speaking countries (Denmark, Iceland, Italy, Japan, Sweden and Switzerland).

Results: a large proportion (from 70 to 96%) of the items in the RAI achieved an adequate to excellent level of reliability, with no substantial differences across countries.

[Towards a history of prematurity].

The infant's mortality calendar regarding populations in the past, testifies of an unusual concentration in the few days following births. A similar phenomenon can be observed nowadays as far as premature baby is confronted with and particularly hypothermia, the author puts forward the hypothesis that the very high neonatal mortality as well as the rate of stillbirths observed until the end of the XIXth century, would be first and foremost a consequence of early delivery caused by heavy domestic work. Various clues, among which the seasonal curve of neomortality, seem to confirm this hypothesis.