AIMS This study implemented and evaluated procedures to help clinicians make effective referrals to 12-Step self-help groups. DESIGN Randomized controlled trial. Setting Out-patient substance use disorder treatment. Participants Individuals with substance use disorders (SUDs) entering a new treatment episode (n = 345) who were assigned randomly to a standard referral- or an intensive referral...

AIM To assess effectiveness of guidelines for referral for elective surgical assessment. METHOD Systematic review with descriptive synthesis. DATA SOURCES Medline, EMBASE, CINAHL and Cochrane database up to 2008. Hand searches of journals and websites. SELECTION OF STUDIES Studies evaluated guidelines for referral from primary to secondary care, for elective surgical assessment for adults...

BACKGROUND The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger. METHODS Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and char...

BACKGROUND AND PURPOSE Helicopter transportation of patients with acute stroke who have received recombinant tissue-type plasminogen activator is commonly considered the best option. We evaluated if transportation by helicopter can reduce complications and improve clinical outcomes in patients with acute stroke. METHODS We conducted a review of consecutive patients with acute ischemic stroke ...

To study why women present in late labour we interviewed 70 parturients in our labour room for a period of 8 days in March 1990. When presenting 19% were 8-10 cm dilated and 81% were 0-7 cm dilated. The group was stratified into those in early labour (0-7 cm of cervical dilatation) and in late labour (8 cm or more) and compared for all variables studied. Only a few differences were statisticall...

BACKGROUND Community health workers (CHW) manage simple childhood illnesses in many developing countries. Information on CHWs' referral practices is limited. As part of a large cluster-randomised trial, this study assessed CHWs' adherence to dosing and referral guidelines. METHODS Records of consultations of children aged 2-59 months with fever managed by CHWs were analysed. Appropriate use o...

INTRODUCTION Transport of patients undergoing extracorporeal membrane oxygenation is currently available in 5 referral centers in our country. METHODS Retrospective case series of patients managed by our mobile extracorporeal membrane oxygenation team and transferred to San Gerardo University Hospital from December 2004 to December 2012. RESULTS 42 patients were transported. The mean age wa...

OBJECTIVE To investigate the relation between general practitioners' referral rates to individual specialties and the individual areas of expertise of the referring doctors. DESIGN Data collected on referral patterns in one group practice over nine months. SETTING General practice in suburban Birmingham consisting of five partners and a trainee. RESULTS In 395 referrals there were large d...

BACKGROUND Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes....

BACKGROUND Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential. This paper examines referral patterns for sick children, and factors that influence caretakers' compliance with referral of sick children to hig...