3 results
Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits. Report of panel-led discussion held at SAPC in July 2014
- Sheena Dungey, Simon Glew, Barbara Heyes, John Macleod, A. Rosemary Tate
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- Journal:
- Primary Health Care Research & Development / Volume 17 / Issue 5 / September 2016
- Published online by Cambridge University Press:
- 18 January 2016, pp. 448-452
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Background
Electronic healthcare records provide information about patient care over time which not only affords the opportunity to improve patient care directly through effective monitoring and identification of care requirements but also offers a unique platform for both clinical and service-model research essential to the longer-term development of the health service. The quality of the recorded data can, however, be variable and can compromise the validity of data use both for primary and secondary purposes.
ObjectivesIn order to explore the challenges and benefits of and approaches to recording high quality primary care electronic records, a Clinical Practice Research Datalink (CPRD) sponsored workshop was held at the Society of Academic Primary Care (SAPC) conference in 2014 with the aim of engaging GPs and other data users.
MethodsThe workshop was held as a structured discussion, led by an expert panel and focused around three questions: (1) What are the data quality priorities for clinicians and researchers? How do these priorities differ or overlap? (2) What challenges might GPs face in provision of good data quality both for treating their patients and for research? Do these aims conflict? (3) What tools (such as data metrics and visualisations or software components) could assist the GP in improving data quality and patient management and could this tie in with analytical processes occurring at the research stage?
ResultsThe discussion highlighted both overlap and differences in the perceived data quality priorities and challenges for different user groups. Five key areas of focus were agreed upon and recommendations determined for moving forward in improving quality.
ConclusionsThe importance of good high quality electronic healthcare records has been set forth along with the need for a practical user-considered and collaborative approach to its improvement.
Do early infant feeding practices vary by maternal ethnic group?
- Lucy J Griffiths, A Rosemary Tate, Carol Dezateux and the Millennium Cohort Study Child Health Group
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- Journal:
- Public Health Nutrition / Volume 10 / Issue 9 / September 2007
- Published online by Cambridge University Press:
- 01 September 2007, pp. 957-964
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Objective
To examine UK country and ethnic variations in infant feeding practices.
DesignCohort study.
SettingInfants enrolled in the Millennium Cohort Study, born between September 2000 and January 2002.
SubjectsA total of 18 150 natural mothers (11 286 (8207 white) living in England) of singleton infants.
Outcome measuresBreast-feeding initiation, breast-feeding discontinuation and introduction of solid foods before 4 months.
Explanatory variablesMaternal ethnic group, education and social class.
ResultsSeventy per cent of UK mothers started to breast-feed, of whom 62% stopped before 4 months. Median age at discontinuing breast-feeding was 14, 13, 10 and 6 weeks in Scotland, England, Wales and Northern Ireland, respectively. Thirty-six per cent of UK mothers (34% in England) introduced solids before 4 months. White mothers were more likely to discontinue breast-feeding (62%) and introduce solids early (37%) than most other ethnic minority groups; those stopping before 4 months were more likely to introduce solids early compared with those continuing to breast-feed beyond this age (adjusted rate ratio (95% confidence interval): 1.3 (1.1–1.2)). Educated mothers were less likely to stop breast-feeding before 4 months (white mothers, 0.8 (0.8–0.9); non-white mothers, 0.9 (0.8–1.0)) than those with no/minimal qualifications but, among ethnic minorities, were more likely to introduce solids early (1.3 (1.0–1.6)). Socio-economic status was positively associated with breast-feeding continuation among white women, and with age at introduction of solids among non-white women.
ConclusionsWe have identified important geographic, ethnic and social inequalities in breast-feeding continuation and introduction of solids within the UK, many of which have not been reported previously. The factors mediating these associations are complex and merit further study to ensure that interventions proposed to promote maternal adherence to current infant feeding recommendations are appropriate and effective.
five - Children’s health
- Edited by Shirley Dex, Heather Joshi
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- Book:
- Children of the 21st Century
- Published by:
- Bristol University Press
- Published online:
- 22 January 2022
- Print publication:
- 12 October 2005, pp 133-158
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Summary
Children in the UK are growing up against a background of changing family size and structure as well as changing demographic, economic and societal circumstances, which together have important implications for their health (Peckham, 1998). It is important to understand how the changes in patterns of caring for children and family context influence health in early childhood and the adoption of child health promoting behaviours by parents and carers. In recent years, there has been increasing interest in the contribution of these changes to obesity, asthma and related allergic diseases, autoimmune conditions, and disorders of social communication and behaviour (Gent et al 1994; Bach, 2002; Lobstein et al, 2004). The factors underlying these trends remain poorly understood, although they are clearly of great public health and human importance. The importance of an interdisciplinary perspective combining social, environmental and biological approaches to elucidate their causes is increasingly recognised.
Plan of this chapter
In this chapter, after considering the data sources in more detail, we describe the health during infancy of the cohort children through investigating the baby's birthweight, its infant weight at 8-9 months, and the early nutrition and patterns of breastfeeding. A range of parental and community influences on the baby's health are then considered – namely, parental smoking and alcohol use, immunisation, health problems and other use of services. Finally, the chapter examines indicators of good health in infancy and concludes with the implications of the findings for child health policy.
Data sources
At the first contact with the families when the children were aged around 9 months, information was obtained by parental (usually maternal) report on a wide range of measures. This included those relevant to the prevention of illness and promotion of health in the child, such as breastfeeding, parental smoking and immunisation status, and to conditions and illnesses that have implications for growth and development. Also included were measures which provide a baseline for examining later patterns and trajectories which will change with increasing age – for example, birthweight and bodyweight.
Data were also enhanced with respect to child health information by verifying maternal reports at the time of interview from information recorded in the personal child health record (Walton et al, 2005) and, subsequently, by linkage to routine birth registration records and health service information either at the individual or health service level (Bartington et al, 2005; Tate et al, 2005).