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BACKGROUND The fifth Millennium Development Goal target for 90% of births in low and middle income countries to have a skilled birth attendant (SBA) by 2015 will not be met. In response to this, policy has focused on increasing SBA access. However, reducing maternal mortality also requires policies to prevent deaths among women giving birth unattended. We(More)
BACKGROUND Provision of essential newborn care (ENC) can save many newborn lives in poor resource settings but coverage is far from universal and varies by country and place of delivery. Understanding gaps in current coverage and where coverage is good, in different contexts and places of delivery, could make a valuable contribution to the future design of(More)
INTRODUCTION Ethnic differences in the birth prevalence of congenital heart defects (CHDs) have been reported; however, studies of the contemporary UK population are lacking. We investigated ethnic variations in incidence of serious CHDs requiring cardiac intervention before 1 year of age. METHODS All infants who had a cardiac intervention in England and(More)
OBJECTIVES To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix. METHODS SETTING AND PARTICIPANTS Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged(More)
OBJECTIVE To implement routine in-house monitoring of risk-adjusted 30-day mortality following paediatric cardiac surgery. DESIGN Collaborative monitoring software development and implementation in three specialist centres. PATIENTS AND METHODS Analyses incorporated 2 years of data routinely audited by the National Institute of Cardiac Outcomes Research(More)
OBJECTIVE The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. METHODS Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were(More)
OBJECTIVE During the early phase of evaluation of a new intervention, data exist for present practice. The authors propose a method of constructing a fair comparator group using these data. In this case study, the authors use the example of external aortic root support, a novel alternative to aortic root replacement. DESIGN A matched comparison group, of(More)
Outcomes following paediatric cardiac surgery have long been the subject of clinical, regulatory, media and public scrutiny. There are several reasons for this. The work is among the most technically challenging, resource intensive and emotionally charged clinical activity undertaken. In the UK, past events, public inquiries and intentions to reduce the(More)
Tackling childhood malnutrition is a global health priority. A key indicator is the estimated prevalence of malnutrition, measured by nutrition surveys. Most aspects of survey design are standardised, but data 'cleaning criteria' are not. These aim to exclude extreme values which may represent measurement or data-entry errors. The effect of different(More)
BACKGROUND Delivery of essential newborn care is key to reducing neonatal mortality rates, yet coverage of protective birth practices remains incomplete and variable, with or without skilled attendance. Evidence of changes over time in newborn care provision, disaggregated by care practice and delivery type, can be used by policymakers to review efforts to(More)