Monitoring of IVF birth outcomes in Finland: a data quality study

BACKGROUND: The collection of information on infertility treatments is important for the surveillance of potential health consequences and to monitor service provision. STUDY DESIGN: We compared the coverage and outcomes of IVF children reported in aggregated IVF statistics, the Medical Birth Register (subsequently: MBR) and research data based on reimbursements for IVF treatments in Finland in 1996–1998. RESULTS: The number of newborns were nearly equal in the three data sources (N = 4331–4384), but the linkage between the MBR and the research data revealed that almost 40% of the reported IVF children were not the same individuals. The perinatal outcomes in the three data sources were similar, excluding the much lower incidence of major congenital anomalies in the IVF statistics (157/10 000 newborns) compared to other sources (409–422/10 000 newborns). CONCLUSION: The differences in perinatal outcomes in the three data sets were in general minor, which suggests that the observed non-recording in the MBR is most likely unbiased

Comparison of high and low molar activity TSPO tracer [18F]F-DPA in a mouse model of Alzheimer’s disease

[18F]F-DPA, a novel translocator protein 18 kDa (TSPO)-specific radioligand for imaging neuroinflammation, has to date been synthesized with low to moderate molar activities (Am’s). In certain cases, low Am can skew the estimation of specific binding. The high proportion of the non-radioactive component can reduce the apparent-specific binding by competitively binding to receptors. We developed a nucleophilic synthesis of [18F]F-DPA resulting in high Am (990 ± 150 GBq/µmol) and performed in vivo comparison with low Am (9.0 ± 2.9 GBq/µmol) [18F]F-DPA in the same APP/PS1-21 and wild-type mice (injected masses: 0.34 ± 0.13 µg/kg and 38 ± 15 µg/kg, respectively). The high level of microgliosis in the APP/PS1-21 mouse model enables good differentiation between diseased and healthy animals and serves better to distinguish the effect of differing Am on specific binding. The differing injected masses affect the washout profile and shape of the time–activity curves. Ratios of standardized uptake values obtained with high and low Am [18F]F-DPA demonstrate that there is a 1.5-fold higher uptake of radioactivity in the brains of APP/PS1-21 animals when imaging is carried out with high Am [18F]F-DPA. The differences between APP/PS1-21 and wild-type animals showed higher significance when high Am was used.</p

A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study

<p>Abstract</p> <p>Background</p> <p>Health care policies in many countries aim to enable people with dementia to live in their own homes as long as possible. However, at some point during the disease the needs of a significant number of people with dementia cannot be appropriately met at home and institutional care is required. Evidence as to best practice strategies enabling people with dementia to live at home as long as possible and also identifying the right time to trigger admission to a long-term nursing care facility is therefore urgently required. The current paper presents the rationale and methods of a study generating primary data for best-practice development in the transition from home towards institutional nursing care for people with dementia and their informal caregivers. The study has two main objectives: 1) investigate country-specific factors influencing institutionalization and 2) investigate the circumstances of people with dementia and their informal caregivers in eight European countries. Additionally, data for economic evaluation purposes are being collected.</p> <p>Methods/design</p> <p>This paper describes a prospective study, conducted in eight European countries (Estonia, Finland, France, Germany, Netherlands, Sweden, Spain, United Kingdom). A baseline assessment and follow-up measurement after 3 months will be performed. Two groups of people with dementia and their informal caregivers will be included: 1) newly admitted to institutional long-term nursing care facilities; and 2) receiving professional long-term home care, and being at risk for institutionalization. Data will be collected on outcomes for people with dementia (e.g. quality of life, quality of care), informal caregivers (e.g. caregiver burden, quality of life) and costs (e.g. resource utilization). Statistical analyses consist of descriptive and multivariate regression techniques and cross-country comparisons.</p> <p>Discussion</p> <p>The current study, which is part of a large European project 'RightTimePlaceCare', generates primary data on outcomes and costs of long-term nursing care for people with dementia and their informal caregivers, specifically focusing on the transition from home towards institutional care. Together with data collected in three other work packages, knowledge gathered in this study will be used to inform and empower patients, professionals, policy and related decision makers to manage and improve health and social dementia care services.</p

Application of new human factors tool in an air traffic management organization

m: An easy-to-use human factors (HF) tool for air traffic control (ATC) operators was applied in an air traffic management (ATM) organization to ensure ATC operators' learning and commitment to HF, which is seen as a critical factor in improving safety. Methods: ATC operators analyzed the positive and negative causal factors of 3163 incident reports in 2008-2010 using the HF tool in 27 ATC units. We studied the active usage of the HF tool and causal factors of incidents. Users' experiences of the HF tool were assessed using questionnaires with open questions. Results: Although the usage of the tool varied from year to year and across units, it helped ATC units analyze both positive and negative HF-related causal factors of incidents. It also enabled ATC operators to learn about the new field of HF. Discussion: The target ATM organization accepted the new HF tool. The benefits of the tool were its visuality, user-friendliness and the congruence of its contents with existing HF tools. The lessons learnt revealed the need for more extensive training, clearer instructions for the users of the HF tool, and publicizing the actions based on the findings. Conclusions: The application of a new HF tool in the target ATM organization was supported by the fact that it could be included as one of the core processes of ATC work (reporting system). Improving HF competence in the organization is recommended, to further improve ATC work and the safety of ATC operations. The HF tool would support this

Impact of patient information booklet on treatment decision - a randomized trial among women with heavy menstruation

Objective  Does a patient information booklet influence treatment for menorrhagia? Design  Randomized trial and a pre‐trial prospective cohort study. Setting  Gynaecology outpatient clinics in 14 Finnish hospitals. Participants  A total of 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia. Intervention  An information booklet about menorrhagia and treatment options, mailed before the first visit to the outpatient clinic. Main outcome measures  Distribution of treatment modalities, knowledge about treatment options, satisfaction with communication with personnel and anxiety. Results  Treatment decision within 3 months was made more often in the intervention group than in the control group (96% and 89% respectively, P = 0.02). Oral medication was more frequently chosen, and newly introduced treatments (minor surgery, hormonal intrauterine system) were less frequently used in the intervention group (at 3‐month follow‐up 21% and 29%, respectively). The differences persisted at the 12‐month follow‐up. In the pre‐trial group, new treatment methods were less frequently chosen and used than in the control group. Additional information did not increase the number of surgical procedures used, improve knowledge, or influence satisfaction or anxiety. Conclusion  Additional information led to an increase in specific treatment decisions and changed the distribution of used treatments without increasing the number of surgical procedures. The study suggests that well‐informed women adopting an active role may counteract physicians’ emphasis on newly introduced treatments