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F Drever

Publications and source records attributed to F Drever.

8 recordsLinked to original sources
PubMed2005

Adverse events and near miss reporting in the NHS.

OBJECTIVES: To conduct a multicentre study on adverse event and near miss reporting in the NHS and to explore the feasibility of creating a national system for collecting these data. DESIGN: Prospective voluntary reporting by staff with anonymised transfer of data was used by a national system to collect data from 18 NHS trusts. PARTICIPANTS: Staff from 12 acute trusts, three mental health trusts, two ambulance trusts, and one primary care trust. MAIN OUTCOMES MEASURED: Number of incidents, date and time of incident, patient age and sex, clinical speciality, location, outcome, risk rating, type and description of incident. RESULTS: A total of 28 998 incidents were reported including 11 766 (41%) slips, trips and falls, 2514 (9%) medication management incidents, 2429 (8%) resource issues, and 2164 (7%) treatment issues. 138 catastrophic and 260 major adverse outcomes were reported. Slips, trips and falls (n = 11 766) were the most common type of incident. CONCLUSIONS: Voluntary reporting by staff when linked to a multicentre data collecting system can yield information on a large number of incidents. This provides support for the principle of creating a national IT system to collect and analyse incident data.

Accidental Falls↗
PubMed1999

Narrowing social inequalities in health? Analysis of trends in mortality among babies of lone mothers (abridged version 1).

OBJECTIVES: To examine trends in mortality among babies registered solely by their mother (lone mothers) and to compare these with trends in infant mortality for couple registrations overall and couple registrations subdivided by social class of father. DESIGN: Analysis of trends in infant death rates from 1975 to 1996 for the three groups. The data source was the national linked infant mortality file, containing all records of infant death in England and Wales linked to the respective birth records. SETTING: England and Wales. PARTICIPANTS: All live births (n=14.3 million) from 1975 to 1996; all deaths of infants from birth to 12 months of age over the same period (n=135 800). MAIN OUTCOME MEASURES: Death rates in the perinatal, neonatal, and postneonatal periods and for infancy overall. RESULTS: For the babies of lone mothers infant mortality has fallen to less than a third of the 1975 level, with a clear reduction in the gap between the mortality in these babies compared with all couple registrations: the excess mortality in solely registered births was 79% in 1975 reducing to 33% in 1996. Most of the narrowing of the sole-couple differential was associated with the neonatal period, for which there is now no appreciable gap. For couple registrations analysed by social class of father, infant death rates have more than halved in each social class from 1975 to 1996. The reductions in mortality were greater in the late 1970s and early 1990s. Infant death rates in classes IV-V remained between 50% and 65% higher than in classes I-II. Differentials between social classes were largest in the postneonatal period and smallest in the perinatal and neonatal periods. The gap in perinatal and neonatal mortality between the babies of lone mothers and couple parents in social classes IV-V has disappeared. CONCLUSIONS: The differential in infant mortality between social classes still exists, whereas the differential between sole and couple registrations has decreased, showing positive progress in the reduction of inequalities. As the reduction in the differential was confined to the neonatal period these improvements may be more a reflection of healthcare factors than of factors associated with lone mothers' social and economic circumstances.

England↗
PubMed1999

Narrowing social inequalities in health? analysis of trends in mortality among babies of lone mothers (abridged version 2)

Objectives: To examine trends in mortality among babies registered solely by their mother (lone mothers) and to compare these with trends in infant mortality for couple registrations overall and couple registrations subdivided by social class of father. Design: Analysis of trends in infant death rates from 1975 to 1996 for the three groups. The data source was the national linked infant mortality file, containing all records of infant death in England and Wales linked to the respective birth records. Setting: England and Wales. Participants: All live births (n=14.3 million) from 1975 to 1996; all deaths of infants from birth to 12 months of age over the same period (n=135 800). Main outcome measures: Death rates in the perinatal, neonatal, and postneonatal periods and for infancy overall. Results: For the babies of lone mothers infant mortality has fallen to less than a third of the 1975 level, with a clear reduction in the gap between the mortality in these babies compared with all couple registrations: the excess mortality in solely registered births was 79% in 1975 reducing to 33% in 1996. Most of the narrowing of the sole-couple differential was associated with the neonatal period, for which there is now no appreciable gap. For couple registrations analysed by social class of father, infant death rates have more than halved in each social class from 1975 to 1996. The reductions in mortality were greater in the late 1970s and early 1990s. Infant death rates in classes IV-V remained between 50% and 65% higher than in classes I-II. Differentials between social classes were largest in the postneonatal period and smallest in the perinatal and neonatal periods. The gap in perinatal and neonatal mortality between the babies of lone mothers and couple parents in social classes IV-V has disappeared. Conclusions: The differential in infant mortality between social classes still exists, whereas the differential between sole and couple registrations has decreased, showing positive progress in the reduction of inequalities. As the reduction in the differential was confined to the neonatal period these improvements may be more a reflection of healthcare factors than of factors associated with lone mothers' social and economic circumstances.

Journal Article↗
PubMed1996

Increasing mortality from Creutzfeldt-Jakob disease in England and Wales since 1979: ascertainment bias from increase in post-mortems?

Creutzfeldt-Jakob disease (CJD) is a rare and fatal dementing illness. A direct link has been proposed between cattle infected with bovine spongiform encephalopathy (BSE) and a newly-identified variant of CJD. One possible explanation for the emergence of this new variant, together with a general increase in death due to classical CJD, would be ascertainment bias, due to an increase in the frequency of post-mortems in death attributed to dementia. This article uses national mortality records to look at trends in the proportion of deaths due to dementing illnesses for which a post-mortems was carried out. The results show an increase in deaths due to both CJD and other dementing illnesses, but a slight decrease in the proportion of post-mortems. We conclude that an increase in post-mortems is unlikely to explain the increase in deaths certified as due to CJD. Similarly, the appearance of the new variant of CJD since 1994 cannot easily be attributed to this form of ascertainment bias, in line with the conclusion reached by the Spongiform Encephalopathy Advisory Committee in March 1996.

Adult↗
PubMed1996

Current patterns and trends in male mortality by social class (based on occupation).

Every ten years, information from the decennial census is used together with national death registration data to study socio-economic differences in mortality. This article reports the findings of one of the analyses prepared for the latest decennial supplement. This volume is due for publication late in 1997. Over 175,000 deaths of men aged 20-64 in England and Wales were analysed using the Registrar General's Social Class (based on occupation) schema. The social gradient in all-cause mortality observed in earlier decades is still seen in 1991-93. In absolute terms, there has been a fall in mortality rates in England and Wales over the twenty-year period 1970-72 to 1991-93. This is reflected in the falls in mortality rates for each of the social classes I to IV over the two decades. In contrast, the mortality rate of Social Class V rose in the early 1980s. Since then, it has fallen. However, it is still higher than in the early 1970s. Trends in mortality show a relative widening of social differentials developing over this period. This is true for all-cause mortality and for the specific causes investigated in this article. Mortality is almost three times higher in Social Class V (SMR 189) than in Social Class I (SMR 66). Classes IIIM and IV (SMRs 117, 116 respectively) have nearly double the mortality of Class I. Even larger differentials are observed for stroke, lung cancer and suicide.

Adult↗
PubMed1995

Mortality in regions and local authority districts in the 1990s: exploring the relationship with deprivation.

Regional and local authority patterns of mortality in England and Wales for both males and females are presented for the latest available years (1989-93). The familiar geographic pattern of higher mortality in the north and west and lower mortality to the south and east of the country has continued into the 1990s and there has been no significant widening or narrowing in the mortality gap between the worst and the best regions during the 1980s. The local authorities with higher mortality are still predominantly in urban areas. Using a modified form of the Department of Environment's 1991 deprivation index, mortality in more than 350 English local authorities in 1989-93 was analysed to study the interaction between socio-economic and geographic variables. There is a very strong relationship between mortality and deprivation at the local authority level measured by this new index, with a tendency for higher mortality to be associated with greater deprivation. This relationship is most marked for males, but is still strong for females.

Adolescent↗
PubMed1994

Asthma, the changing scene?

This short article looks at the changes in the rate of asthma episodes reported to the Birmingham Research Unit of the Royal College of General Practitioners. The general perception is that the incidence of asthma is on the increase and is worse in summer than previously thought. The data do not support such a view. The reported incidence of asthma is increasing, there is a peak in summer, but that has been so for several years, and the June peak of 1994 was not as high as that of 1992.

Asthma↗