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Morbidity is defined as a state of being unhealthy or of experiencing an aspect of health that is “generally bad for you”, and postoperative morbidity linked to paediatric cardiac surgery encompasses a range of conditions that may impact the patient and are potential targets for quality assurance.
As part of a wider study, a multi-disciplinary group of professionals aimed to define a list of morbidities linked to paediatric cardiac surgery that was prioritised by a panel reflecting the views of both professionals from a range of disciplines and settings as well as parents and patients.
We present a set of definitions of morbidity for use in routine audit after paediatric cardiac surgery. These morbidities are ranked in priority order as acute neurological event, unplanned re-operation, feeding problems, the need for renal support, major adverse cardiac events or never events, extracorporeal life support, necrotising enterocolitis, surgical site of blood stream infection, and prolonged pleural effusion or chylothorax. It is recognised that more than one such morbidity may arise in the same patient and these are referred to as multiple morbidities, except in the case of extracorporeal life support, which is a stand-alone constellation of morbidity.
It is feasible to define a range of paediatric cardiac surgical morbidities for use in routine audit that reflects the priorities of both professionals and parents. The impact of these morbidities on the patient and family will be explored prospectively as part of a wider ongoing, multi-centre study.
From the perspective of the Democratic Party of the Left (PDS) and the left generally, the 1989-1994 period can be viewed as a political failure in as far as there was a right-wing outcome (albeit ephemeral) to Italy's transition. Yet, it is a failure which has to be viewed in the context of the deep undercurrents of change at work in Italy in this period and the constraints within which the PDS and its leader, Achille Occhetto, were operating
A new generation of radio telescopes with unprecedented capabilities for astronomy and fundamental physics will be in operation over the next few years. With high sensitivities and large fields of view, they are ideal for cosmological applications. We discuss their uses for cosmology focusing on the observational technique of HI intensity mapping, in particular at low redshifts (z < 4). This novel observational window promises to bring new insights for cosmology, in particular on ultra-large scales and at a redshift range that can go beyond the dark energy domination epoch. In terms of standard constraints on the dark energy equation of state, telescopes such as Phase I of the SKA should be able to obtain constrains about as well as a future galaxy redshift surveys. Statistical techniques to deal with foregrounds and calibration issues, as well as possible systematics are also discussed.
Due to rising rates of obesity globally, the present study aimed to examine differences in overweight and underweight prevalence in Western Australian schoolchildren in 2008 compared with 2003.
Cross-sectional study at two time points; using two-stage stratified sampling, primary and secondary schools in both metropolitan and non-metropolitan Western Australia; sample selected was representative of the State's population figures.
Seventeen primary and thirteen secondary (2008) and nineteen primary and seventeen secondary (2003) schools. Government and non-government funded schools in metropolitan and non-metropolitan (regional/rural) Western Australia were recruited.
Height and weight were measured for 1708 (961 primary and 747 secondary) students in 2008 and 1694 (876 primary and 817 secondary) students in 2003.
Overweight and obesity prevalence in primary students was similar in 2008 (22·9 %) to 2003 (23·2 %; P > 0·05). In secondary girls overweight and obesity prevalence dropped from 23·1 % (2003) to 15·9 % (2008; P = 0·002). Secondary boys showed a slight decrease in overweight and obesity prevalence; however, this was not statistically significant (P = 0·102). Higher proportions of underweight in primary girls were observed in 2008 (9·9 %) compared with 2003 (4·2 %; P < 0·001) and in secondary girls in 2008 (9·4 %) compared with 2003 (5·5 %; P < 0·001).
Prevalence of overweight and obesity in Western Australian primary students was stable; however, it declined in secondary students. Both primary and secondary girls showed an increase in underweight prevalence. Public health interventions are needed for the high percentage of youth still overweight, whereas the observed increase in underweight girls warrants attention and further investigation.
Until the early 1990s, the Italian political system was regarded as anomalous among advanced democracies because of its failure to achieve alternation in government. Since then, that problem has been overcome, but Italy has been popularly viewed as continuing to be different to other democracies because it is ‘in transition’ between regimes. However, this position itself is becoming increasingly difficult to sustain because of the length of time of this so-called transition. Rather than focus on what is rather an abstract debate, it may be more fruitful to analyse what, in substance, is distinctive about Italian politics in this period: the manner in which a debate over fundamental institutional (including electoral) reform has become entangled in day-to-day politics. This can best be exemplified through an analysis of two key electoral consultations held in 2006: the national elections and the referendum on radically revising the Italian Constitution.
To categorise records according to primary cardiac diagnosis in the United Kingdom Central Cardiac Audit Database in order to add this information to a risk adjustment model for paediatric cardiac surgery.
Codes from the International Paediatric Congenital Cardiac Code were mapped to recognisable primary cardiac diagnosis groupings, allocated using a hierarchy and less refined diagnosis groups, based on the number of functional ventricles and presence of aortic obstruction.
A National Clinical Audit Database.
Children undergoing cardiac interventions: the proportions for each diagnosis scheme are presented for 13,551 first patient surgical episodes since 2004.
In Scheme 1, the most prevalent diagnoses nationally were ventricular septal defect (13%), patent ductus arteriosus (10.4%), and tetralogy of Fallot (9.5%). In Scheme 2, the prevalence of a biventricular heart without aortic obstruction was 64.2% and with aortic obstruction was 14.1%; the prevalence of a functionally univentricular heart without aortic obstruction was 4.3% and with aortic obstruction was 4.7%; the prevalence of unknown (ambiguous) number of ventricles was 8.4%; and the prevalence of acquired heart disease only was 2.2%. Diagnostic groups added to procedural information: of the 17% of all operations classed as “not a specific procedure”, 97.1% had a diagnosis identified in Scheme 1 and 97.2% in Scheme 2.
Diagnostic information adds to surgical procedural data when the complexity of case mix is analysed in a national database. These diagnostic categorisation schemes may be used for future investigation of the frequency of conditions and evaluation of long-term outcome over a series of procedures.
The recent argument that the notion of ‘transition’ should be set aside in attempting to explain the trajectory of Italian politics in the past two decades is to be welcomed, but does not go far enough in explaining why we, as Italianists, got our case wrong and how exactly we might get our case right today. The transitional ‘myth’ was born and maintained despite growing evidence of its inherently problematic nature, in both conceptual and empirical terms. The concept of ‘transition’ needs more serious conceptual treatment and empirical application, but even with this work it is unlikely to be concluded that Italy is in transition. Freeing Italy and Italianists from this conventional wisdom, while, at the same time, not abandoning the idea that something exceptional happened to Italian politics in the early 1990s will help enrich the debate on the nature of the political change that Italy has experienced in the past 17 years.
The Pisa conference was also the occasion for presenting three of the ECPR's prizes. The first was the ECPR's Lifetime Achievement Award for an outstanding contribution to European political science, which went to an American: Philippe Schmitter (European University, Florence, and formerly Stanford University). Second, the annual Jean Blondel Ph.D. Prize was awarded to Tanja Aalberts (Leiden University) for her dissertation on the politics of sovereignty. Finally, the Mattei Dogan Foundation Prize in European Political Sociology went to Giovanni Sartori (professor emeritus, University of Florence and Columbia University).