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Objectives: To analyse the association between patients' socioeconomic position (SEP) and the use of emergency departments (EDs)., Methods: This population-based study included all visits to ED in 2012 by inhabitants of the French Midi-Pyrénées region, recorded by the Regional Emergency Departments Observatory. We compared ED visit rates and the proportion of non-severe visits according to the patients' SEP as assessed by the European Deprivation Index., Results: We analysed 496,388 visits. The annual ED visit rate increased with deprivation level: 165.9 [95% CI (164.8-166.9)] visits per 1000 inhabitants among the most advantaged group, compared to 321.9 [95% CI (320.3-323.5)] per 1000 among the most disadvantaged. However, the proportion of non-severe visits was about 14% of the visits, and this proportion did not differ according to SEP., Conclusions: Although the study shows a difference of ED visit rates, the probability of a visit being non-severe is not meaningfully different according to SEP. This supports the assumption that ED visit rate variations according to SEP are mainly explained by SEP-related differences in health states rather than SEP-related differences in health behaviours.

Approximately 43% of children in the United States (32 million) are currently living with at least 1 of 20 common chronic childhood illnesses. The most common chronic childhood illnesses are asthma, cystic fibrosis, diabetes, obesity, malnutrition, developmental disabilities, cerebral palsy, consequences of low birthweight, and mental illness. For all chronically ill pediatric populations, the outcome of health-related quality of life (HRQOL) is particularly important because many of these children have not and will not be cured, and will continue to manage their chronic illness into adulthood. Advances in biomedical science and technology continue to improve efficacy of treatments and care for chronically ill children, adolescents, and their families, which highlight the importance measurement of HRQOL as a treatment and health status outcome. The construct of HRQOL is subjective, multidimensional, dynamic, and unique to each individual. It includes aspects of physical, psychological, social function, and goal attainment. Outcomes of HRQOL now include the financial implications for these children and their families, as well as financial and organizational consequences for healthcare planning and delivery of services.This article reviews the importance of HRQOL as a health outcome for chronically ill children. A historical overview and synthesis of the conceptualization and measurement of HRQOL for the chronically ill pediatric population is provided. Current research investigations that have measured health outcomes using individual scales tailored to children's specific symptoms health outcomes, such as PROMIS®-Patient Reported Outcomes Measurement Information System-are reviewed. The clinical applications of HRQOL outcomes research include facilitation of patient-healthcare provider communication, improved patient satisfaction, identification of hidden morbidities, a positive impact on clinical decision making, and improvement of patient outcomes over time.

Purpose: To determine the extent to which alterations in health-related quality of life (HRQOL) and special healthcare needs are experienced by children born prematurely, compared to those born at term., Study Design and Methods: A descriptive comparative design was utilized. A total of 96 children (preterm N = 47, term N = 49) completed the PedsQL 4.0 Generic Core Scales 8- to 12-year-old self-report version. Parents of both groups of children completed the PedsQL 4.0 Generic Core Scales parent-proxy version, the Children with Special Health Care Needs (CSHCN) Screener, and a demographic data form., Results: Special healthcare needs were experienced by more than one half of the premature children evaluated. Mean HRQOL scores were significantly different between the children born prematurely and their peers born at term. Parents of both groups reported higher HRQOL scores than their children self-reported., Clinical Nursing Implications: Given the sustained high rate of premature birth, understanding of current health status of children born prematurely is critical for maternal-child nurses. Advocacy and coordination of care are important to improve the healthcare provided to families of children born prematurely. Future nursing research should incorporate assessment of special healthcare needs and HRQOL of children.

Background: Our objective was to analyse the influence of education on the link between functional limitation (FL) and self-rated health (SRH) in two countries, France and the USA., Methods: The data of the North American NHANES study (n = 9254) and the French National Health Survey (n = 25 559) were used. FL was measured by the ADL and IADL scales. We constructed a logistic regression model with SRH as the outcome and included variables for education, FL and the interaction between education and FL. All results were adjusted for age., Results: Poor SRH was more frequently reported in France than in the USA (24.1% vs. 18.4% for men, 29.0% vs. 19.7% for women). The most highly educated persons in the USA had similar FL (25.4% for men, 32.9% for women) to the least educated French persons (22.8% for men, 31.8% for women). In the USA, FL was associated more strongly with poor SRH in the most educated men than in the least educated. In France, the same interaction was observed although the link was weaker than in the USA. FL was more strongly associated with poor SRH in the most educated women than in the least educated in both countries., Conclusion: Functional limitation had a greater impact on the most highly educated persons in both France and the USA. Using SRH as a measure of health for evaluating social inequalities could lead to underestimation of the true magnitude of functional health inequalities existing within and between countries.

A three-year National League for Nursing grant aimed at faculty development in the use of simulation as a teaching-learning strategy to promote and evaluate student learning outcomes was funded in 2007 by the Laerdal Medical Corporation. The focus of the faculty development project was the creation of nine web-based courses written by nine United States authors with the assistance of eight contributing partners from seven different countries. The process is described from the view of the international participants who worked together with the US experts.The significance of the work, the process, the challenges and barriers, and the benefits and rewards of the work are described. Recommendations for working on a multisite, international collaborative project are also discussed.