Data Collection Template Research Articles

LO05: In patients presenting to the ED with STEMI, is the provision of morphine associated with worse patient outcomes?

Introduction: ST-elevation myocardial infarction (STEMI) presenting to the ED is a significant health burden. The provision of IV morphine with doses titrated to provide comfort is recommended in the AHA STEMI Guidelines, yet there is limited evidence of safety in this setting. The primary objective of this study was to measure potential harm associated with the provision of IV morphine in STEMI patients presenting to the ED. Methods: This was a two centre retrospective chart review from an urban, inner city, academic ED with an annual census of 85,000 visits, and an affiliated community hospital with 35,000 annual visits. Consecutive patients from April 2009 to January 2015 presenting to the 2 EDs with a diagnosis of STEMI were identified in the ED database. Eight trained research assistants, blinded to the study hypothesis, used standardized data collection templates. The primary investigator double collected 20% of all data to ensure completeness and accuracy. Results: We included 311 patients with STEMI (124 received morphine [M]; 187 no morphine [nM]). The ages of the two groups were similar (mean 64 yrs [M] & 67 yrs [nM]; median 63 yrs [M] & 66 yrs [nM]; IQR 45-81 [M] and 45.5-86.5 [nM]); as were the proportion of female patients (21.0% [M] & 23.5% [nM]. The pre-STEMI Charlson comorbidity scores (mean 2.6), median time to first ECG (11 min [M] & 16 min [nM]), and mean time-to-needle for PCI (96.8 min [M] & 92.0 min [nM]) were similar between groups. The mean CCU length of stay (LOS) (9.3 days vs 6.3 days) and hospital LOS (7.4 days vs 4.6 days) were longer for patients receiving morphine than those not receiving morphine. Rates of congestive heart failure, acute kidney injury and cardiac arrest in hospital were unchanged between the groups. Unadjusted mortality was similar (10.5% [M] vs 13.3% [nM]) between groups. Binary logistic regression controlling for age, Charlson score, first and peak troponin values demonstrated an association between receiving morphine in the ED and an increased risk of death at 30 days (OR 8.1; 95% CI 7.1.-9.1). Conclusion: The provision of morphine to patients with STEMI in the ED may be associated with increased CCU and hospital LOS. When controlling for age, pre-STEMI Charlson score, first and peak troponin values, receiving morphine was associated with an increased risk of death at 30 days. Further research to elucidate this association is warranted.

EFFECT OF MERGERS AND ACQUISITIONS STRATEGIES ON FINANCIAL PERFORMANCE OF FINANCIAL SERVICES SECTOR

Purpose: The purpose of this study was to establish the effect of mergers and acquisitions strategies on financial performance of firms in the financial services sector in Kenya.Methodology: The study adopted a mixed methodology research design. The study population included all the 51 merged financial service institutions in Kenya. Purposive sampling was used. Primary data was obtained from questionnaires and a secondary data collection template was also used. The researcher used quantitative techniques in analyzing the data. Descriptive analysis for the study included the use of means, frequencies and percentages. Inferential statistics such as correlation analysis was also used. Panel data analysis was also applied. Further, a pre and post merger analysis was used.Results: Cost efficiency was found to have a positive and significant effect on financial performance of merged institutions. Diversification had no significant effect on financial performance of merged institutions. Synergy had a significant relationship with financial performance of merged institutions. Board size had a significant relationship with financial performance of merged institution and there was a significant relationship between the moderating effect of economic growth and financial performance of merged institutions.Unique Contribution to Theory, Practice and Policy: The study recommended that policy makers (government) should be able to create or promote the enabling environment for facilitating mergers and acquisitions that concerns infrastructure provision, as a way of achieving cost reduction that could motivate similar mergers in other institutions in Kenya, stakeholders are to identify where their most immense profit pools lie and focus on improving those units responsible for them, the management of the financial services institutions should embrace diversification and financial innovation on product strategies as this will help in generating more income for the banks.

MODERATING EFFECT OF ECONOMIC GROWTH ON FINANCIAL PERFORMANCE OF MERGED INSTITUTIONS

Purpose: The purpose of the study was to determine the moderating effect of economic growth on financial performance of merged institutions Methodology: The study adopted a mixed methodology research design. The study population included all the 51 merged financial service institutions in Kenya. Purposive sampling was used. Primary data was obtained from questionnaires and a secondary data collection template was also used. The researcher used quantitative techniques in analyzing the data. Descriptive analysis for the study included the use of means, frequencies and percentages. Inferential statistics such as correlation analysis was also used. Panel data analysis was also applied. Further, a pre and post merger analysis was used.Results: There was a significant relationship between the moderating effect of economic growth and financial performance of merged institutions.Unique contribution to theory, practice and policy: The government and Central Bank of Kenya to come up with strategies and policies to protect the financial services sector due to its immense contribution to the economy of the country by formulating policies aimed at controlling the effects of rapid fluctuations of the macro economic factors and their effects on the sector.

Extension modules for storage, visualization and querying of genomic, genetic and breeding data in Tripal databases.

Tripal is an open-source database platform primarily used for development of genomic, genetic and breeding databases. We report here on the release of the Chado Loader, Chado Data Display and Chado Search modules to extend the functionality of the core Tripal modules. These new extension modules provide additional tools for (1) data loading, (2) customized visualization and (3) advanced search functions for supported data types such as organism, marker, QTL/Mendelian Trait Loci, germplasm, map, project, phenotype, genotype and their respective metadata. The Chado Loader module provides data collection templates in Excel with defined metadata and data loaders with front end forms. The Chado Data Display module contains tools to visualize each data type and the metadata which can be used as is or customized as desired. The Chado Search module provides search and download functionality for the supported data types. Also included are the tools to visualize map and species summary. The use of materialized views in the Chado Search module enables better performance as well as flexibility of data modeling in Chado, allowing existing Tripal databases with different metadata types to utilize the module. These Tripal Extension modules are implemented in the Genome Database for Rosaceae (rosaceae.org), CottonGen (cottongen.org), Citrus Genome Database (citrusgenomedb.org), Genome Database for Vaccinium (vaccinium.org) and the Cool Season Food Legume Database (coolseasonfoodlegume.org). Database URL: https://www.citrusgenomedb.org/, https://www.coolseasonfoodlegume.org/, https://www.cottongen.org/, https://www.rosaceae.org/, https://www.vaccinium.org/

A review of specialist palliative care provision and access across London - mapping the capital.

Palliative care provision varies by diagnosis, geography, and setting. The Minimum Data-set provides high-level data on provision, but comprehensive comparative information about specialist palliative care (SPC) provision is lacking. The London Cancer Alliance – now RM Partners’ Accountable Cancer Network - palliative care group (West/South London) and PallE8 (North/East London), with Marie Curie, sought to address this gap. The aim was to provide comparative data on SPC provision across London to support commissioners and providers to assess provision, identify gaps, and reduce inequity. A data-collection template was developed through expert consensus. Demographic, diagnostic, and service data was collected, plus models of care, staffing levels, and use of clinical outcome/experience measures. Results were collated by organisation and CCG. Cleaned data was provided back to each organisation for verification before final analyses.ResultsAll 50 adult SPC providers in London participated, representing hospitals, hospices and community services. •Patients in all 32 CCGs have access to hospice beds, with 322 beds from 15 providers (4 NHS) for a population of 9,323,570 (with 47,583 deaths annually).•SPC in London sees more non-cancer patients than is reported nationally; 79% of hospital advisory, 74% of community, and 88% of hospice in-patient services have higher proportions of non-cancer patients.•Considerable variation in out-of-hours availability of both hospital SPC and community SPC services across London; only 9 of 30 hospital and 17 of 26 community services provide seven-day visiting.•Wide variation in the models of community-based SPC; proportions of community patients attending day services vary from 1 in 4, to 1 in 17, just 13 CCGs have H@H-type provision, with few Rapid Response or Care Coordination services. ConclusionsThis detailed survey demonstrates important gaps in availability and provision of SPC services. Recommendations are made for commissioners and providers to join together to address these. It also gives a comprehensive view of rapidly changing models of community-based care, to inform innovation and service development.

EFFECT OF BOARD SIZE ON THE FINANCIAL PERFORMANCE OF MERGED INSTITUTIONS

Purpose: The purpose of this study was establishing the effect of board size on the financial performance of merged institutions.Methodology: The study adopted a mixed methodology research design. The study population included all the 51 merged financial service institutions in Kenya. Purposive sampling was used. Primary data was obtained from questionnaires and a secondary data collection template was also used. The researcher used quantitative techniques in analyzing the data. Descriptive analysis for the study included the use of means, frequencies and percentages. Inferential statistics such as correlation analysis was also used. Panel data analysis was also applied. Further, a pre and post merger analysis was used.Results: Board size had a significant relationship with financial performance of merged institution.Unique contribution to theory, practice and policy: It was recommended that, firms are place a remarkable degree of emphasis on the area of corporate governance and to some extent embark on eliminating CEO duality. The study also recommends a board size (6 and 8) for better financial performance. This will reduce the problem of free rider and enhance effective monitoring and decision making. It will also bring about cohesion among the board members.

EFFECT OF SYNERGY ON THE FINANCIAL PERFORMANCE OF MERGED INSTITUTIONS

Purpose: The purpose of the study was to determine the effect of synergy on the financial performance of merged institutions.Methodology: The study adopted a mixed methodology research design. The study population included all the 51 merged financial service institutions in Kenya. Purposive sampling was used. Primary data was obtained from questionnaires and a secondary data collection template was also used. The researcher used quantitative techniques in analyzing the data. Descriptive analysis for the study included the use of means, frequencies and percentages. Inferential statistics such as correlation analysis was also used. Panel data analysis was also applied. Further, a pre and post merger analysis was used.Results: Synergy had a significant relationship with financial performance of merged institutions.Unique contribution to theory, practice and policy: The study recommended that institutions should critically evaluate the overall business and operational compatibility of the merging institutions and focus on capturing long-term financial synergies. They should increase their scope to create high performing supply chains with significant long-term upside that provide sustained value for customers and stakeholders.

EFFECT OF DIVERSIFICATION ON THE FINANCIAL PERFORMANCE OF MERGED INSTITUTIONS

Purpose: The purpose of the study was to assess the effect of diversification on the financial performance of merged institutions.Methodology: The study adopted a mixed methodology research design. The study population included all the 51 merged financial service institutions in Kenya. Purposive sampling was used. Primary data was obtained from questionnaires and a secondary data collection template was also used. The researcher used quantitative techniques in analyzing the data. Descriptive analysis for the study included the use of means, frequencies and percentages. Inferential statistics such as correlation analysis was also used. Panel data analysis was also applied. Further, a pre and post merger analysis was used.Results: Diversification had no significant effect on financial performance of merged institutions.Unique contribution to theory, practice and policy: The study findings call for a re-assessment of the literature on diversification. Further research is necessary to study why sometimes the diversification-performance relationship is positive, others negative, and often quadratic. Further research is needed to investigate whether diversification effects on performance depends on the industries considered. This study recommends that companies with a weak and unstable capital base should seek to consolidate their establishments through mergers and acquisitions. Through mergers and acquisitions, these companies will be able to extend their market share and revenue base hence increase their profitability. In addition, mergers and acquisition leads to a higher CAR which improves the financial soundness of the companies.

Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

IntroductionSurvival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching of the emergency medical services. AimTo analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. MethodAn observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template. ResultsThe sensitivity for recognition of OHCA was 40.9% (95% CI: 37.1–44.7%) in the Capital Region of Denmark and 78.4% (95% CI: 73.2–83.0%) in the Skåne Region in Sweden (p<0.001). With additional data from the emergency call recordings, the sensitivity was 80.7% (95% CI: 77.7–84.3%) and 86.0% (95% CI: 81.3–89.8%) for the two regions (p=0.06). The majority of the non-recognised OHCA were dispatched with the highest priority. ConclusionThe accuracy of OHCA recognition was high and comparable. We identified large differences in data registration practices despite the use of similar dispatch tools. This raises a discussion of definitions and transparency in general in scientific reporting of OHCA recognition, which is essential if used as quality indicator in emergency medical services

Building up Systematic Client-Centred Data as a Base for Clinical Outcome within Outpatient Neurorehabilitation

Objective: This study describes the development and use of a specific database supporting personnel within outpatient neurological rehabilitation to reflect on existing interventions and improve future rehabilitation. Methods: Five outpatient rehabilitation centres in one county council in Sweden were involved in developing and implementing a systematic data collection template within the existing digital medical record system. Data were collected to get more information on the effects of outpatient stroke rehabilitation in patients who received rehabilitation the first year after a stroke (ICD-I64) and patients who received further rehabilitation 1 year or more after a stroke (ICD-I69). Data analysis included evaluation of balance, movement, activity/participation, health-related quality of life, and self-rated health. Results: The ICD-I64 group had positive results after treatment (p < 0.05) for all variables and the ICD-I69 group had positive results for balance and activity/participation. Conclusions: The use of systematic data collection provided a platform for employees and managers to discuss and use clinical results to improve the type and quality of rehabilitation interventions.

English

This qualitative phenomenological research study represents the personal and professional lived experiences of midlevel leaders’ effective management of virtual committees of practice (VCoP) in medical device companies in the Atlanta metro area. In-depth interviews were conducted with 15 leaders of VCoP from different medical device functional specialties. The study used a combination of the modified van Manen (1990) and van Kaam methods (Moustakas, 1994) to facilitate the analysis of the data gathered through in-depth interviews. This method served as the template for data collection and analysis. The research study revealed common themes after an analysis of data. Six emergent themes were identified: (a) empowerment, (b) communication, (c) trust, (d) encouragement/inspiration, (e) integrity, and (f) connecting with individuals. The research findings revealed a leadership model that relies on the development of genuine leaders/follower relationships to lead a VCoP effectively.

Demand-side interventions for maternal care: evidence of more use, not better outcomes

BackgroundReducing maternal and neonatal mortality is essential to improving population health. Demand-side interventions are designed to increase uptake of critical maternal health services, but associated change in service uptake and outcomes is varied. We undertook a literature review to understand current evidence of demand-side intervention impact on improving utilization and outcomes for mothers and newborn children.MethodsWe completed a rapid review of literature in PubMed. Title and abstracts of publications identified from selected search terms were reviewed to identify articles meeting inclusion criteria: demand-side intervention in low or middle-income countries (LMIC), published after September 2004 and before March 2014, study design describing and reporting on >1 priority outcome: utilization (antenatal care visits, facility-based delivery, delivery with a skilled birth attendant) or health outcome measures (maternal mortality ratio (MMR), stillbirth rate, perinatal mortality rate (PMR), neonatal mortality rate (NMR)). Bibliographies were searched to identify additional relevant papers. Articles were abstracted using a standardized data collection template with double extraction on a sample to ensure quality. Quality of included studies was assessed using McMaster University’s Quality Assessment Tool from the Effective Public Health Practice Project (EPHPP).ResultsFive hundred and eighty two articles were screened with 50 selected for full review and 16 meeting extraction criteria (eight community mobilization interventions (CM), seven financial incentive interventions (FI), and one with both). We found that demand-side interventions were effective in increasing uptake of key services with five CM and all seven FI interventions reporting increased use of maternal health services. Association with health outcome measures were varied with two studies reporting reductions in MMR and four reporting reduced NMR. No studies found a reduction in stillbirth rate. Only four of the ten studies reporting on both utilization and outcomes reported improvement in both measures.ConclusionsWe found strong evidence that demand-side interventions are associated with increased utilization of services with more variable evidence of their impact on reducing early neonatal and maternal mortality. Further research is needed to understand how to maximize the potential of demand-side interventions to improve maternal and neonatal health outcomes including the role of quality improvement and coordination with supply-side interventions.

An ISA-TAB-Nano based data collection framework to support data-driven modelling of nanotoxicology.

Analysis of trends in nanotoxicology data and the development of data driven models for nanotoxicity is facilitated by the reporting of data using a standardised electronic format. ISA-TAB-Nano has been proposed as such a format. However, in order to build useful datasets according to this format, a variety of issues has to be addressed. These issues include questions regarding exactly which (meta)data to report and how to report them. The current article discusses some of the challenges associated with the use of ISA-TAB-Nano and presents a set of resources designed to facilitate the manual creation of ISA-TAB-Nano datasets from the nanotoxicology literature. These resources were developed within the context of the NanoPUZZLES EU project and include data collection templates, corresponding business rules that extend the generic ISA-TAB-Nano specification as well as Python code to facilitate parsing and integration of these datasets within other nanoinformatics resources. The use of these resources is illustrated by a “Toy Dataset” presented in the Supporting Information. The strengths and weaknesses of the resources are discussed along with possible future developments.

Parkinson's Disease Case Ascertainment in the EPIC Cohort: The NeuroEPIC4PD Study

Background/Aims: Large epidemiological prospective studies represent an important opportunity for investigating risk factors for rare diseases such as Parkinson's disease (PD). Here we describe the procedures we used for ascertaining PD cases in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: The following three-phase procedure was used: (1) elaboration of a NeuroEPIC4PD template for clinical data collection, (2) identification of all potential PD cases via record linkage and (3) validation of the diagnosis through clinical record revision, in a population of 220,494 subjects recruited in 7 European countries. All cases were labelled with the NeuroEPIC4PD diagnoses of ‘definite', ‘very likely', ‘probable', or ‘possible' PD. Results: A total of 881 PD cases were identified, with over 2,741,780 person-years of follow-up (199 definite, 275 very likely, 146 probable, and 261 possible). Of these, 734 were incident cases. The mean age at diagnosis was 67.9 years (SD 9.2) and 458 patients (52.0%) were men. Bradykinesia was the most frequent presenting motor sign (76.5%). Tremor-dominant and akinetic rigid forms of PD were the most common types of PD. A total of 289 patients (32.8%) were dead at the time of the last follow-up. Conclusions: This exercise proved that it is feasible to ascertain PD in large population-based cohort studies and offers a potential framework to be replicated in similar studies.

Review of the Umthombo Youth Development Foundation scholarship scheme, 1999-2013.

IntroductionStaffing of rural and remote facilities is a challenge throughout the world. Umthombo Youth Development Foundation (UYDF) has been running a rurally based scholarship scheme since 1999. The aim of this review is to present data on the number of students selected, their progress, graduation and work placement from inception of the scheme until 2013.MethodsData were extracted from the UYDF data base using a data collection template to ensure all important information was captured.ResultsSince 1999, 430 rural students across 15 health disciplines have been supported by UYDF. The annual pass rate has been greater than 89%, and less than 10% of students have been excluded from university. All graduates have spent time working in rural areas (excluding the 32 currently doing internships) and 72% (52/73) of those with no work-back obligation continue to work in rural areas.Discussion and conclusionThe UYDF model is built around local selection, compulsory academic and peer mentoring and social support, comprehensive financial support and experiential holiday work. The results are encouraging and highlight the fact that rural students can succeed at university and will come back and work in rural areas. With 46% of the South African population situated rurally, greater thought and effort must be put into the recruitment and training of rural scholars as a possible solution to the staffing of rural healthcare facilities. The UYDF provides a model which could be replicated in other parts of South Africa.

Barriers to Implementation of Facility-based Kangaroo Mother Care for Pre-term and Low Birth Weight Infants in River Nile State, Sudan; 2014

Background: Prematurity and low birth weight (LBW) currently account for approximately 40% of neonatal deaths in developing countries. Objectives: To identify major factors that limit the introduction of kangaroo mother care (KMC) services in River Nile State, Sudan. Methods: A facility based qualitative cross-sectional study conducted in two hospitals (Atbara and Al-Damar hospital). A total of seven pediatricians working in these two hospitals were interviewed using semi – structured interview. Analysis: Analysis of the data was done manually. The interviewers' responses were entered into a data collection template. The data were reviewed and common themes were identified. Results: Prematurity and low birth weight were a major health problem. Respiratory distress syndrome, hypothermia and sepsis were the leading causes of death. Problems facing pediatricians when caring for the preterm were; lack of incubators, non-functioning incubators, insufficient and untrained staff especially nurses beside rapid turnover. Only two of our pediatricians had heard about KMC but all of them were willing to adopt it in their units. Lack of Original Research Article Abdalla and Ali; BJMMR, 9(4): 1-7, 2015; Article no.BJMMR.18741 2 awareness among mothers, health staff and the community, and the community health culture were the main two obstacles to KMC implementation. Financial support, staff training and isolated wards were needed for mothers' privacy. Knowledgeable practitioners to develop evidence-based policies were important for KMC implementation. Raising awareness among mothers, health cadre especially nurses caring for mothers and their babies and the community about KMC. Conclusion: Lack of knowledge among health cadre, mother, families and community were obstacles to KMC. Awareness need to be raised.

‘Total cost of ownership’ of scholarly communication: managing subscription and APC payments together

ABSTRACTManaging subscription journals and open access charges together has created challenges which may in part be dealt with by offsetting the two revenue streams against each other. In order to do this, it is necessary to have reliable financial data about the extent of the two interacting markets. Jisc Collections has been undertaking data collection regarding universities' article publication charge (APC) expenditure. This process is difficult without a standardized way of recording data, so Jisc Collections has developed a standard data collection template and is helping institutions to release data openly. If available data become more comprehensive and transparent, then all parties (libraries, publishers, research funders, and intermediaries) will have better knowledge of the APC market and can more accurately predict the effects of offsetting.

The participatory design of a performance oriented monitoring and evaluation system in an international development environment

This article illustrates the application of the impact monitoring and evaluation process for the design and development of a performance monitoring and evaluation framework in the context of human and institutional capacity development. This participative process facilitated stakeholder ownership in several areas including the design, development, and use of a new monitoring and evaluation system, as well their targeted results and accomplishments through the use of timely performance data gathered through ongoing monitoring and evaluation. The process produced a performance indicator map, a comprehensive monitoring and evaluation framework, and data collection templates to promote the development, implementation, and sustainability of the monitoring and evaluation system of a farmer's trade union in an African country.

South African pharmacists impact on antibiotic hang-time in the intensive care unit patients

Background: The International Guidelines for Management of Severe Sepsis and Septic Shock recommend the administration of effective intravenous antimicrobials within the first hour of recognition of septic shock.With every hour of delay in the administration of appropriate antimicrobial therapy, mortality increases by 7.6%. The time from the written antibiotic order to actual intravenous administration or “hang-time” can often be several hours due to logistics within the hospital. Netcare (Ltd), a 54 private sector hospital system across South Africa implemented the practice of administering antimicrobials within an hour following prescription through a national antibiotic stewardship pharmacist-driven “hang-time” process improvement protocol. Methods & Materials: This pre-post intervention study was implemented by pharmacists in the Intensive Care Units (ICU) of thirty-nine hospitals in collaboration with nursing and infection prevention practitioners. A four-week baseline study was conducted to determine “hang-time” compliance within one hour. A data collection template was developed and a weekly measure of compliance to “hang-time”withinonehourwasdocumented retrospectively. Following this, a “hang-time” poster was used to create awareness in the units and rigorous training sessions were conductedby thewardpharmacists to nursing staff, including all shifts, regarding the importance of the early administration of antimicrobials to decrease patientmortality and enhance best patient care. In addition, ward pharmacists added the most commonly prescribed antibiotics to the ward stock to help decrease nursing delays in the administration timeof antibiotics.Wardpharmacists prospectively collectedup to23weeksof “hang-time” compliancedatapost intervention. Statistical analysiswas done using a 2-tailed Fisher’s Exact test. Results: In total 7,750 (pre=1,976andpost=5,774)patient charts were reviewed for “hang-time” compliance. A significant improvement in “hang-time” compliance within one hour was observed between the pre-intervention week one (41%) and post intervention week 23 (82%) p<0.001. Conclusion: A stewardship process improvement protocol with ward pharmacist’s interventions significantly improved the hang-time of antibiotics in ICU patients with sepsis. Stewardship programs with limited resources should consider implementing hang-time protocols. Future studies will measure the impact of “hang-time” compliance on patient mortality.

Paediatric chronic fatigue syndrome: Complex presentations and protracted time to diagnosis

The diagnosis and management of paediatric chronic fatigue syndrome (CFS) remain ongoing challenges for paediatric clinicians, particularly given its unknown aetiology and the little research on effective treatments for this condition. The aim of this study was to describe the presenting features of new patients attending a specialist chronic fatigue clinic at a tertiary-level Australian children's hospital. The medical records of all patients with an initial consultation at the chronic fatigue clinic over a 12-month period were reviewed using a standardised data collection template. Functional impact was based on school attendance and classified according to the National Institute of Health and Clinical Excellence guidelines (2007). A total of 99 patients attending the clinic were identified. Of these, 59 were diagnosed with CFS. Median age was 15.4 years with almost two-thirds of patients of female sex. Median time between symptom onset and diagnosis was 15.5 months. There was a high occurrence of fatigue, sleep disturbance, pain, postexertional malaise, and autonomic and cognitive symptoms in the group. The functional impact of CFS was classified as mild for 20%, moderate for 66% and severe for 14% of patients. Most young people diagnosed with CFS experience symptoms for a protracted period, with considerable functional impact prior to initial tertiary service consultation. This audit has identified important areas for research, practice development and education in relation to the management of patients with CFS.