Trends in treated drug misuse in the Midland Health Board Area 1996-2000. Occasional Paper no. 3.

This occasional paper contains information gathered by the National Drug Treatment Reporting System (NDTRS), an epidemiological database on treated drug misuse complied by the Drug Misuse Research Division (DMRD) of the Health Research Board (HRB). The data shows that between 1996 and 1999 the number of drug users presenting for treatment within the Midland Health Board (MHB) had more than doubled, from 63 clients in 1996 to 150 clients in 2000. The socio-demographic data showed that the typical client is male, in his early twenties and living in the family home. Clients were slightly older in 2000 than in 1996,with the mean age for all contacts rising from 22 years in 1996 to 24 years old in 2000. Cannabis is the main drug causing problems (67% in 2000), with opiates the drug causing second most problems (38% in the same year). In 2000 the majority (33 of 56 clients) inject their opiates, with over two thirds of IDUs having shared injecting equipment

Trends in treated problem cannabis use in the seven health board areas outside the Eastern Regional Health Authority, 1998 to 2002. Occasional Paper no. 14.

The data presented in this paper describe trends in treated problem cannabis use in seven health board areas, namely: the Midland, Mid-Western, North Eastern, North Western, Southern, South Eastern and Western Health Boards. The total numbers include 6,164 cases who lived and were treated in the seven health boards between 1998 and 2002. In this paper, treated problem cannabis use is described in relation to person, place and time. This paper will assist policy makers and service planners develop appropriate responses to problem cannabis use. The analysis presented in this paper is based on data reported to the National Drug Treatment Reporting System (NDTRS)

National Drug Treatment Reporting System. statistical bulletin 1997 and 1998.

This Statistical Bulletin provides information regarding treated drug misuse in the Republic of Ireland for 1997 and 1998. Drug misuse which occurs outside the treatment context is not included - its extent is unknown. The Statistical Bulletin is based on data collected through the National Drug Treatment Reporting System [NDTRS]. The NDTRS is an epidemiological database providing information on people who present themselves to the health services throughout the country for help with their drug use problems. These problems may involve the misuse of controlled drugs such as cannabis, ecstasy, heroin etc.; or prescribed drugs such as benzodiazepines or antidepressants. Volatile inhalants such as solvents or glue are also included. Data is provided to the NDTRS through centres or service locations where drug use is treated. The locations cover a range of services and facilities including both medical and non-medical care. Returns were received for 68 service locations in 1997 and 100 locations in 1998. Not all possible centres made returns. Amongst the reasons for services not returning data were - no clients presented for treatment or returns were not forthcoming, due, for example, to lack of resources. In conclusion, it is felt that the centres which have returned data for 1997 and 1998, represent reasonable coverage of treated drug misuse in Ireland

Post-Acute Care Payment Reform Demonstration: Final Report Volume 4 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

Post-Acute Care Payment Reform Demonstration: Final Report Volume 2 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

Post-Acute Care Payment Reform Demonstration: Final Report Volume 1 of 4

This is the Final Report for the Post-Acute Care Payment Reform Demonstration (PAC-PRD), authorized by section 5008 of the Deficit Reduction Act of 2005, Public Law 109-171. The report has 12 sections, which are divided into four volumes: Volume 1: Executive Summary. Volume 2: Sections 1-4 (Section 1: Introduction; Section 2: Underlying Issues of the PAC-PRD Initiating Legislation; Section 3: Developing Standardized Measurement Approaches: The Continuity Assessment Record and Evaluation (CARE); Section 4: Demonstration Methods and Data Collection) Volume 3: Sections 5-6 (Section 5: Framework for Analysis; Section 6: Factors Associated with Hospital Discharge Destination) Volume 4: Sections 7-12; References (Section 7: Outcomes: Hospital Readmissions; Section 8: Outcomes: Functional Status; Section 9: Determinants of Resource Intensity: Methods and Analytic Sample Description; Section 10: Determinants of Resource Intensity: Lessons from the CART Analysis; Section 11: Determinants of Resource Intensity: Multivariate Regression Results; Section 12: Conclusions and Review of Findings; References

The bodily presence of significant others: Intensive care patients' experiences in a situation of critical illness

This study is about intensive care patients and the bodily presence of significant others. The aim of the study is to inquire and understand the patients experience of the body in relation to their significant others during critical illness. Open, unstructured, in-depth interviews with six former intensive care patients provide the data for the study. The phenomenological–hermeneutical analysis points to a theme among ICU patients' experience of conflict between proximity and distance during the bodily presence of their relations. Patients experience different and conflicting forms of responses to the presence of their significant others. Patients experience significant positive confirmation but also negation through this presence. In the ICU situation, the reactions of significant others appear difficult to deal with, yet the physical presence is significant for establishing a sense of affinity. Patients seek to take some responsibility for themselves as well as for their relatives, and are met with a whole spectrum of reactions. Intensive care patients experience the need to be actively, physically present, which often creates sharp opposition between their personal needs and the needs of their significant others for active participation

Project FIT: Rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children

<p>Abstract</p> <p>Background</p> <p>This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA.</p> <p>Methods/design</p> <p>There are four overall components to Project FIT: school, community, social marketing, and school staff wellness - all that focus on: 1) increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2) improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3) improving the knowledge, self-efficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4) impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5) encouraging dialogue among all community partners to leverage existing programs and introduce new ones.</p> <p>Discussion</p> <p>At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day), excessive screen time (75% do not meet recommendation of < 2 hours per day), and low intake of vegetables and whole grains and high intake of sugar-sweetened beverages, French fries and chips and desserts as well as a high prevalence of overweight and obesity (48.5% including 6% with severe obesity) among low income, primarily Hispanic and African American 3^rd-5^thgrade children (n = 403).</p> <p>Trial registration</p> <p><b>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01385046">NCT01385046</a></b></p

Factors predicting hospital length-of-stay and readmission after colorectal resection: a population-based study of elective and emergency admissions

<p>Abstract</p> <p>Background</p> <p>The impact of developments in colorectal cancer surgery on length-of-stay (LOS) and re-admission have not been well described. In a population-based analysis, we investigated predictors of LOS and emergency readmission after the initial surgery episode.</p> <p>Methods</p> <p>Incident colorectal cancers (ICD-O2: C18-C20), diagnosed 2002-2008, were identified from the National Cancer Registry Ireland, and linked to hospital in-patient episodes. For those who underwent colorectal resection, the associated hospital episode was identified. Factors predicting longer LOS (upper-quartile, > 24 days) for elective and emergency admissions separately, and whether LOS predicted emergency readmission within 28 days of discharge, were investigated using logistic regression.</p> <p>Results</p> <p>8197 patients underwent resection, 63% (n = 5133) elective and 37% (n = 3063) emergency admissions. Median LOS was 14 days (inter-quartile range (IQR) = 11-20) for elective and 21 (15-33) for emergency admissions. For both emergency and elective admissions, likelihood of longer LOS was significantly higher in patients who were older, had co-morbidities and were unmarried; it was reduced for private patients. For emergency patients only the likelihood of longer LOS was lower for patients admitted to higher-volume hospitals. Longer LOS was associated with increased risk of emergency readmission.</p> <p>Conclusions</p> <p>One quarter of patients stay in hospital for at least 25 days following colorectal resection. Over one third of resected patients are emergency admissions and these have a significantly longer median LOS. Patient- and health service-related factors were associated with prolonged LOS. Longer LOS was associated with increased risk of emergency readmission. The cost implications of these findings are significant.</p