16 research outputs found
Rural High North: A High Rate of Fatal Injury and Prehospital Death
Finnmark County is the northernmost county in Norway. For several decades, the rate of mortality
after injury in this sparsely inhabited region has
remained above the national average. Following documentation of this discrepancy for the period 1991â1995, improvements to the trauma system were implemented. The present study aims to assess whether trauma-related mortality rates have subsequently improved.
All injury-associated fatalities in Finnmark from
1995â2004 were identified retrospectively from the
National Registry of Death and reviewed. Low-energy trauma in elderly individuals and poisonings were excluded.
A total of 453 cases of trauma-related death
occurred during the study period, and 327 of those met the inclusion criteria. Information was retrievable for 266 cases. The majority of deaths (86%) occurred in the prehospital phase. The main causes of death were suicide (33%) and road traffic accidents (21%). Drowning and snowmobile injuries accounted for an unexpectedly high
proportion (12 and 8%, respectively). The time of death did not show trimodal distribution. Compared to the previous study period, there was a significant overall decline in injury-related mortality, yet there was no change in place
of death, mechanism of injury, or time from injury until death.
Changes in injury-related mortality cannot be linked to improvements in the trauma system. There was no change in the epidemiological patterns of injury. The high rate of on-scene mortality indicates that any major improvement in the number of injury-related deaths lies in
targeted prevention
Measuring Sustainment of Multiple Practices Fiscally Mandated in Childrenâs Mental Health Services
Examining sustainment of multiple evidence-based practices is crucial to understanding the processes and outcomes of system-driven implementation efforts that are increasingly common. This study used administrative claims data to characterize volume and penetration of six practices over 19 fiscal quarters following initial implementation within the context of a system-driven, fiscally mandated implementation effort in Los Angeles County Department of Mental Healthâs Prevention and Early Intervention services. Patterns of volume changes over time revealed an overall ramp up of practice claims over time, but variability in patterns of volume and penetration for each practice. Findings varied by the methods used to index and analyze volume and penetration. Furthermore, a number of client case-mix and therapist characteristics were associated with the volume of therapistsâ claims for each practice relative to their claims for the other practices
Providersâ Attitudes Toward Evidence-Based Practices: Is it Just About Providers, or Do Practices Matter, Too?
Evidence-based practice (EBP) attitudes were measured in a sample of Los Angeles County mental health service providers. Three types of data were collected: provider demographic characteristics, attitudes toward EBP in general, and attitudes toward specific EBPs being implemented in the county. Providers could reliably rate characteristics of specific EBPs, and these ratings differed across interventions. Preliminary implementation data indicate that appealing features of an EBP relate to the degree to which providers use it. These findings suggest that assessing EBP-specific attitudes is feasible and may offer implementation-relevant information beyond that gained solely from providers' general attitudes toward EBP