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Biomedical subjects

C Waddington

Publications and source records attributed to C Waddington.

12 recordsLinked to original sources
PubMed1997

Treatment of conductive hearing loss with ossicular chain reconstruction procedures.

Middle ear infections and ossicular disorders can cause conductive hearing loss. Ossicular disorders include fibrous unions in which scar tissue replaces the long process of the incus; disarticulations caused by previous surgical procedures or cholesteatomas; fixation from otosclerosis, cholesteatomas, or congenital malformations; and dislocations caused by trauma. Surgical reconstruction procedures, with the insertion of partial or total ossicular replacement prostheses, help restore conductive hearing. Patients who undergo these delicate procedures have significant hearing deficits and require sensitive, skilled perioperative nursing care.

Ear↗
PubMed1996

Financing.

Explore the source record for details and available documents.

Developing Countries↗
PubMed1994

Thyroplasty type I for unilateral vocal cord paralysis.

Unilateral vocal cord paralysis may occur with trauma, neoplasms, mechanical or central nervous system dysfunction, or following extensive aortic and mediastinal vascular surgery or thyroidectomy. Thyroplasty type I is a form of laryngeal framework surgery (ie, phonosurgery) used to treat unilateral vocal cord paralysis. A silicone implant is placed inside a surgically created window in the thyroid cartilage and pushes the paralyzed cord medially, allowing the moving cord to touch the paralyzed cord and close the opening. The procedure is performed under monitored local anesthesia with sedation so the patient can phonate during the procedure. Airway compromise is the main complication associated with this procedure.

Contraindications↗
PubMed1991

Ten questions to ask about revolving drug funds.

For any health financing scheme, the key issue is how to raise sufficient resources to provide a reasonable service when poverty means that many people are unable to afford such a service. A revolving drug fund is a scheme where drugs are sold at cost-price, plus a mark-up, and the revenue is used to replenish the drug stocks. Probably the most difficult part of establishing an RDF is setting prices. There should be sufficient mark-up to cover exempt treatments, transport costs, inflation and currency devaluations. Adequate records must be kept. If the amount of money and/or drugs in the RDF appears to be declining, the reason can be established. RDFs should not be seen in isolation from other considerations of the health care system. Drugs should not be sold without an adequate check on prescribing habits. Care should also be taken that the money-making potential of drugs does not distract from preventive activities.

Drug Therapy↗
PubMed1987

Primary health care is not cheap: a case study from Guinea Bissau.

In 1977 the Ministry of Health in Guinea Bissau started two regional community health projects. In this article we describe the progress of the Tombali project. Three aspects are discussed: the "Learning Process Approach" used in the project; measurement of the effectiveness of the project and the problems of collecting and interpreting these data; and the ratio of investment to recurrent costs and the proportions borne by government and by villagers. Primary health care projects evolve slowly, and the importance of the willingness of project workers, donor agencies, and the national government to work without a blueprint plan is emphasized. We discuss ways of evaluating the success of primary health care schemes; the measurement of any change in health status is difficult and discounts other benefits that may result, such as encouraging community participation and involving villagers in government activities. Both government and villagers contribute significantly to the scheme, the government and donors bearing most of the investment costs, while most of the recurrent costs fall on the villagers. The data show that for neither government nor villagers is the scheme a cheap option to secure health care for rural populations. Finally, we discuss the lessons to be learned by national governments, donor agencies, and health workers from this attempt to implement a primary health care program.

Budgets↗
PubMedDate not supplied

Capacity building in health economics opportunities for training in developing countries.

This paper provides an overview of the opportunities available for training in health economics in the regions of Africa, Asia and Latin America, following a WHO forum on Capacity Building in Health Economics held in Geneva in December 1995. It describes in brief the training opportunities available throughout Asia, Africa and Latin America. It then gives a detailed resume of courses available for students and professionals at Chulanlongkorn University, Thailand, the University of Cape Town, South Africa and the University of the West Indies, Trinidad. It also describes the international and regional networks which have developed and now provide further opportunities for training. The final section of this paper looks to the future and suggests that although continued financial and academic support will be needed from the countries of the North, the development of regional capacities in health economics should be as much as possible through regional resources, and regional strategies should be a priority.

Delivery of Health Care↗
PubMedDate not supplied

Allocating resources: community involvement is not easy.

Resources for health care are limited in all societies; decisions have to be made about who gets what health care. A case study is discussed. Jaymee Bowen was a British child whose Health Authority refused to provide free treatment for her advanced leukaemia. The media advertised her case and public opinion was mobilized in favour of treating her with public funds. Cost-effectiveness can be used to identify treatments that provide value-for-money. The public can express an opinion on what kinds of care are wanted--for example, what are the relative benefits of preventing morbidity or mortality, or of helping children rather than young people? Rational criteria can be developed with public involvement--in the case of Jaymee Bowen, the proposed treatment really did not appear to offer value-for money. But some individual cases that contradict the 'rational' criteria for the population as a whole will always be able to attract public sympathy and interest.

Bone Marrow Transplantation↗
PubMedDate not supplied

Recurrent costs in the health sector of developing countries.

Widespread concern exists about the recurrent cost problems faced in the health sector of developing countries, and about the difficulties likely to be faced in the 1990s and beyond in seeking to expand further the movement to primary health care. The article accepts that the problem is a real one, and seeks first to define and measure it, and to put together some of the evidence on the scale of the problem. Next, the analysis involves an examination of its causes, and hence its solutions, exploring in some detail issues of budgetary control, management decision making, project selection, and the prospects for mobilizing additional recurrent funds to, and within, the health sector. The article concludes by drawing attention to the complex aetiology of the recurrent cost problem, and offers a five-point plan of action if the problem is to be tackled seriously.

Capital Expenditures↗