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PubMed2001

European Resuscitation Council Guidelines 2000 for Basic Paediatric Life Support. A statement from the Paediatric Life Support Working Group and approved by the Executive Committee of the European Resuscitation Council.

The European Resuscitation Council (ERC) last issued guidelines for Paediatric Life Support (PLS) in 1998 [1]. These were based on the "Advisory Statements" of the International Liaison Committee on Resuscitation (ILCOR) published in 1997 [2]. Following this, the American Heart Association, together with representatives from ILCOR, undertook a series of evidence-based evaluations of the science of resuscitation which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Paediatric Life Support Working Party of the European Resuscitation Council has considered this document and the supporting scientific literature and has recommended changes to the ERC Basic PLS guidelines. These are presented in this paper. There have been few major changes to the ERC recommended guidelines as some of the changes agreed in "Guidelines 2000" had already been introduced into Europe subsequent to the 1998 ILCOR "Advisory Statements" (Fig. 1).

Adolescent↗

PubMed2001

European Resuscitation Council Guidelines 2000 for Advanced Paediatric Life Support. A statement from Paediatric Life Support Working Group and approved by the Executive Committee of the European Resuscitation Council.

The European Resuscitation Council (ERC) last issued guidelines for Paediatric Life Support (PLS) in 1998 [1]. These were based on the "Advisory Statements" of the International Liaison Committee on Resuscitation (ILCOR) published in 1997 [2]. Following this, the American Heart Association, together with representatives from ILCOR, undertook a series of evidence-based evaluations of the science of resuscitation which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Paediatric Life Support Working Party of the European Resuscitation Council has considered this document and the supporting scientific literature and has recommended changes to the ERC Advanced PLS guidelines. These are presented in this paper. There have been few major changes to the ERC recommended guidelines as some of the changes agreed in "Guidelines 2000" had already been introduced into Europe subsequent to the 1998 ILCOR "Advisory Statements" (Fig. 1).

Advanced Cardiac Life Support↗

PubMed2001

European Resuscitation Council Guidelines 2000 for Newly Born Life Support. A statement from the Paediatric Life Support Working Group and approved by the Executive Committee of the European Resuscitation Council.

The European Resuscitation Council (ERC) last issued guidelines for the resuscitation of the newly born infant in 1999 [1]. This was an "Advisory Statement" of the International Liaison Committee on Resuscitation (ILCOR). Following this, the American Heart Association and the Neonatal Resuscitation Programme Steering Committee of the American Academy of Paediatrics and representatives of the World Health Organisation, together with representatives from ILCOR, undertook a series of evidence-based evaluations of the science of resuscitation which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [2,3]. The Paediatric Life Support Working Party of the European Resuscitation Council has considered this document and the supporting scientific literature and presents the ERC Newly Born Guidelines in this paper. Readers will find few changes to the ILCOR Advisory Statement recommendations as the new evidence that has emerged since its publication in 1999 has been confirmatory of the ILCOR recommendations.

Advanced Cardiac Life Support↗

PubMed1996

A position statement on resuscitation by all levels of nurse. Confederation of Australian Critical Care Nurses Inc.

As part of its brief, the CACCN Inc. Advanced Life Support (ALS) Subcommittee has been reviewing and compiling a national policy for education in ALS for nurses. We believe this is an appropriate pursuit, since critical care nurses are at the forefront of practice in this area and also care for patients receiving life-saving interventions. One of the Subcommittee's concerns is the lack of a uniform approach to the issue of resuscitation across the nursing community, despite the broad applicability of such skills to many of the diverse settings in which nurses practice. The following is a position statement aimed at setting a precedent for both Basic and Advanced Life Support practice and education in the Australian nursing context. We have distributed the statement widely to stimulate debate and, eventually, a broader acceptance of this competency for nurses. We look forward to your comments.

Australia↗

PubMed2000

What drove changes in the use of breast conserving surgery since the early 1980s? The role of the clinical trial, celebrity action and an NIH consensus statement.

BACKGROUND: Three important events in the history of breast cancer treatment occurred between 1983 and 1995: a large clinical trial, first lady Nancy Reagan's choice of mastectomy and the publishing of an NIH consensus statement. OBJECTIVE: To assess the effects of these events on use of breast conserving surgery (BCS). RESEARCH DESIGN: Data from the cohort study of the surveillance, epidemiology and end results (SEER) Program from 1983 to 1995 were divided into four periods: Baseline, Trial, Celebrity, and Consensus. SUBJECTS: Of the women, 169,466 diagnosed with early stage breast cancer in nine SEER areas. MEASURES: Monthly percentages of BCS. RESULTS: A linear regression model generated a separate intercept and slope term for four time periods, adjusting for demographic characteristics of breast cancer patients. For the Baseline, Celebrity and Consensus Periods, slopes indicated an increasing use of BCS which varied between 0.24% and 0.28% per month. Slopes for these three periods were not statistically different (p = 0.120). In contrast, there was no change in use of BCS during the trial period (p = 0.247). We tested the magnitude of discontinuity between periods. At the beginning of the trial, celebrity and consensus periods, there were increases in BCS of 5.54% (p < 0.001), -3.55% (p < 0.001), and 2.37% (p < 0.001), respectively. CONCLUSIONS: The use of BCS was substantially affected by the reports of a clinical trial of BCS and by celebrity action. These effects were abrupt but transient. The NIH consensus statement stimulated a small change in use of BCS and may be an important intervention for maintaining the increasing trend in use of BCS since the 1990s.

Adult↗

PubMed1998

Meanings assigned by undergraduates to frequency statements of condom use.

Studies of condom use must rely upon self-report data which may not be reliable and valid. This investigation examined how 192 undergraduates (17-48 years) interpret response categories (never, rarely, sometimes, most of the time, always) used in some surveys to assess frequency of condom use. Subjects completed a questionnaire that described a scenario of a couple who had engaged in sexual intercourse 20 times during the past 3 months. As part of the survey, there were 21 statements in which the stated number of times condoms were used varied from 0 to 20 (e.g., condoms were used 18 out of the 20 episodes of sexual intercourse). For each statement, subjects were instructed to circle the category they believed best matched the frequency with which condoms had been used: 31% indicated that using condoms 1 out of 20 times was an example of never using condoms; similarly, 23% indicated that using condoms 2 times out of the 20 encounters was an example of never using condoms, 40% indicated that condom use for 19 out of 20 encounters was always using condoms, whereas 23% applied the always label to condom use for 18 out of 20 encounters. These results generally support the validity of this type of condom use measurement, but suggest that caution is needed in interpretation. Implications of these findings are discussed with respect to health messages and research methodology.

Adolescent↗

PubMed1999

Dissociating judgment from response processes in statement verification: the effects of experience on each component.

This research used the stochastic judgment model of statement verification to demonstrate a dissociation between judgment and response processes and investigated hypotheses about the effects of practice on each component. Data from respondents judging statements as true or false under various payoffs supported the dissociation and the following conclusions: Their ability to discriminate true from false depended on knowledge domain but not on payoffs. Experience with the domain did not improve this ability but did decrease the trial-by-trial confidence variability associated with memory search. Practice in a different domain had no such effect. Response criteria depended only on payoffs and experience. Criterion variability decreased with cumulative practice over domains. Most respondents had a bias to say "true" under symmetric payoffs, which did not dissipate with experience. Theoretical implications of the results are discussed.

Attention↗

PubMed2002

Selecting accurate statements from the cognitive interview using confidence ratings.

Participants viewed a videotape of a simulated murder, and their recall (and confidence) was tested 1 week later with the cognitive interview. Results indicated that (a) the subset of statements assigned high confidence was more accurate than the full set of statements; (b) the accuracy benefit was limited to information that forensic experts considered relevant to an investigation, whereas peripheral information showed the opposite pattern; (c) the confidence-accuracy relationship was higher for relevant than for peripheral information; (d) the focused-retrieval phase was associated with a greater proportion of peripheral and a lesser proportion of relevant information than the other phases; and (e) only about 50% of the relevant information was elicited, and most of this was elicited in Phase 1.

Crime↗

PubMedDate not supplied

Position statement on the role of health care assistants who are involved in direct patient care activities within critical care areas.

Intensive care has developed as a speciality since the 1950s, and during this time, there have been major technological advances in health care provision, leading to a rapid expansion of all areas of critical care. The ongoing problem in recruiting qualified nurses in general has affected, and continues to be a problem for, all aspects of critical care areas. During the past decade, nursing practice has evolved, as qualified nurses have expanded their own scope of practice to develop a more responsive approach to the complex care needs of the critically ill patient. The aim of this paper is to present the British Association of Critical Care Nurses (BACCN) position statement on the role of health care assistants involved in direct patient care activities, and to address some of the key work used to inform the development of the position statement.

Clinical Competence↗

PubMed2002

A statement of principles: toward improved care of older patients in surgical and medical specialties.

The statement and recommendations in this report resulted from detailed discussions between geriatricians and specialists of 10 medical and surgical disciplines, including representatives of the American Academy of Physical Medicine and Rehabilitation. These physicians and their parent organizations are participants in a major project supported by the John A. Hartford Foundation and the American Geriatrics Society. The goal of this project is to improve the care of older patients. This position statement reviews demographic forces shaping contemporary health care, states the objectives of project, and lists 10 specific recommendations. The recommendations encompass attitudes, knowledge, medical training, clinical service delivery, and advocacy.

Aged↗

PubMed2001

Income statement management in a turbulent health care environment.

This article considers the role of accounting information embedded in the income statement of health care providers in their increasingly difficult economic environment. This turbulent economic environment has resulted from the dramatic shift in power from the seller to the buyer of health care services, with a consequential shift of risks that will mandate that health care providers obtain access to better cost and utilization information. This article looks at the 2 critical components of the income statement--the revenue function and the cost structure-in terms of their importance in the management of enhanced economic performance in both the fee-for-service and the prepaid provision of health care services.

Accounting↗

PubMed2006

[When is a doctor a good doctor? An analysis of the contents of statements by representatives of the medical profession ].

BACKGROUND: Several professional bodies have developed influential documents which have tried to describe the essential competences of a good doctor. Such an initiative has not been previously conducted in German-speaking countries. Differences between the published statements point towards the significance of differences in the respective sociocultural setting. METHODS: The first step was to take advantage of a series of standardized written interviews [including the item "What makes a doctor a good doctor?"], conducted with leading German physicians and published serially in the Deutsche Medizinische Wochenschrift. Responses were qualitatively analysed by three assessors in accordance with Grounded Theory. Text fragmentation and assignment of categories was built successively: it was based on the actual material and repeatedly revised. RESULTS: 261 statements were extracted from a total of 83 interviews. It was possible to assign 249 of them to one of the following nine categories: "knowledge", "empathy" and "patient orientation" and, less frequently "practical competence", "genuineness", "helper", "awareness of limits", "life-long learning" and "cooperation". Results were similar for older and younger physicians, or when comparing representatives of clinical and theoretical disciplines. CONCLUSIONS: It will be worthwhile to survey and evaluate the opinion of additional members of the medical profession and of patients and others with a stake in the health system--comparing and delineating results from different countries--so that a more comprehensive picture can be drawn of "the good doctor".

Germany↗

PubMed1998

The validation of statements by IDUs based on the analysis of blood traces on their used syringes.

The objective of this study was to study the correlation between statements made by injecting drug users (IDUs) and the analytical observation of their used syringes, with regard to needle and syringe non-sharing and HIV serology. A survey was carried out on 137 IDUs participating in different needle exchange programmes (NEPs) throughout the Basque Autonomous Community (BAC). The used syringe they handed over in exchange for a new one was kept to study the 'DNA fingerprint' and the presence of HIV. The DNA fingerprint carried on 123 syringes belonging to different injectors who stated that they had not shared them with other IDUs, confirmed that this was so in 98% of the cases. HIV analysis was applied to the 137 syringes and 63 (46%) had HIV antibodies. The consistency was 89% for the cases who voluntarily declared themselves to be HIV-positive and 76% for the cases who declared themselves to be HIV-negative. For the unknown cases, six (31.6%) syringes were HIV-positive. This study supports the validity and reliability of the surveys, based on statements made by the IDUs themselves, on their behaviour. The prevalence of HIV infection in the IDU population must be based on detection of antibodies against HIV.

Cross-Sectional Studies↗

PubMed2006

Recollection rejection of false narrative statements.

Our research was focused on a false-memory editing operation that is posited in fuzzy-trace theory-recollection rejection. The main objectives were (a) to extend model-based measurement of this operation to a narrative task that ought to ensure high levels of recollection rejection and (b) to study five manipulations that ought to influence recollection rejection by affecting the accessibility of verbatim traces of narrative statements: recency of narrative presentation, narrative repetition, type of false-memory item, testing delay, and repeated testing. The results showed that the narrative task did indeed yield high levels of recollection, with an estimated 49% of gist-consistent distractors being rejected in this way on initial memory tests. Consistent with current theoretical conceptions of false-memory editing, the results also showed that recollection rejection increased as a function of manipulations that should enhance the accessibility of verbatim traces of narrative statements, with repeated testing delivering especially large increases in verbatim accessibility.

Attention↗

PubMed2004

A statement of principles for health care journalists.

Many journalism organizations have published codes of ethics in recent years. The Association of Newspaper Editors, for example, lists 47 different codes on its website. But an organization of health care journalists felt that none of those codes addressed the unique challenges of covering complex health care topics. The Association of Health Care Journalists (AHCJ) is an independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ has written a statement of principles for its 750 members. In it, AHCJ states some of the unique challenges faced by journalists covering health care, and offers suggestions on how to face those challenges. Bioethicists are invited to comment on the statement, and to help generate continued discussion of the issues addressed therein.

Codes of Ethics↗

PubMed2006

The U.S. Public Health Service and smoking in the 1950s: the tale of two more statements.

During the 1950s, the United States Public Health Service prepared two statements on the link between smoking and lung cancer that have not been recognized by other historians. This article employs extended discussions of these two statements as vehicles to explore both internal developments at the federal health agency and larger questions surrounding the disciplinary emergence of chronic disease epidemiology. The primary cast of characters includes Surgeons General Leonard A. Scheele and Leroy E. Burney, Lewis C. Robbins (a lower-ranking Public Health Service officer, who had chief responsibility for the agency's smoking-related programs from 1958 through 1962 and who left behind a daily professional diary), and Journal of the American Medical Association (JAMA) editor John H. Talbott. These men, and others, are seen grappling (at varying levels of engagement) with the appearance of what we now recognize as a profoundly different way of understanding chronic disease causation, which centers on survey-taking and statistical analysis of risk factors.

Chronic Disease↗

PubMed1985

Statements on career intentions as predictors of career choices.

In the study reported here, the author examined the relevance of students' statements on career intentions to predictions of career choices. Similar career intentions questionnaires were administered to the members of the 1973 University of Toronto Faculty of Medicine graduating class at the end of their first undergraduate year and three years later at graduation. Ten years after graduation, the professional activities and geographic locations of the class members were determined using available directories and registers. The study provided evidence of considerable congruence between the early statements on career intentions and the actual career dispositions 10 years after graduation.

Canada↗

PubMed1991

Gender bias of Ohio physicians in the evaluation of the personal statements of residency applicants.

Sexism has been documented at every level of medical training as well as in the community of practicing physicians. Although there is speculation in the literature about sexist attitudes and perceived sexual discrimination influencing a medical student's choice of specialty, there are few data on gender bias in the evaluation of residency candidates applying in different specialties. In 1989, the authors created six personal statements of interest in a residency, each from a different type of fictitious residency candidate (three men, three women, at three levels of medical school achievement) and mailed one or another of the statements, chosen at random, to the 2,478 board-certified Ohio physicians practicing in six specialties in which U.S. women in residencies were underrepresented (less than 12%) compared with the percentage of women in medical schools, and to the 3,586 board-certified Ohio physicians in another six specialties in which women in residencies were overrepresented (more than 38%). The physicians consistently rated the women candidates more favorably than they did the men candidates.

Attitude of Health Personnel↗