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The influence of the recent IAPT initiative is also already seen in DHCFT, whereby the uptake of the IAPT advocated RCADS was found in some case notes.
Case notes were found for a relatively large proportion of cases (75.4%, data not shown), but some case notes were clearly incomplete.
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In some cases, notes were taken.
In some cases noted improvements were maintained at subsequent follow-ups.
It is interesting to note, however, that analysis of Apelin and Aplnr mutant mice has in some cases noted discrepancies in what would be expected to be identical phenotypes (Charo et al., 2009; Ishida et al., 2004; Kuba et al., 2007).
As some individuals' case notes comprised many entries over several years, search terms to were used to identify and retrieve notes which referred to key themes identified a priori and during preliminary analyses.
It is likely that the real number of maternal deaths is even higher, as some registers and case notes were missing, and because even where they were available, the information needed to identify a death as pregnancy-related was not always recorded.
As we were restricted to requesting information available from case notes, some analyses, such as gene mutations were limited by clinical practice and small sample sizes.
Of the 24 missing case notes some limited information was available on 19: ten were deaths at the two referral hospitals and 9 deaths were at either primary or district hospitals.
Some relied on reviews of case notes and, even if this retrospective reporting of data was reliable, some of the studies were hampered by focusing on relatively few symptoms of mania [e.g. Lazaro et al. (2007) only examined three symptoms].
Case notes Salary: £21,000 a year.
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