Search PubMed⌕ Search

Biomedical subjects

G Durham

Publications and source records attributed to G Durham.

At least 19 recordsLinked to original sources
PubMed2004

Implementation of the Australian core public health functions in rural Western Australia.

OBJECTIVE: To assess the implementation of the Australian core functions of public health in rural Western Australia. METHODS: Cross-sectional surveys (n=26) and semi-structured key informant interviews (n=64) with public health practitioners throughout each of the eight rural health regions in Western Australia. A scoring system was utilised to categorise responses that were frequently part of current practice (score=2), sometimes undertaken (score=1) and rare or not undertaken at all (score=0). RESULTS: Functions with reasonably good coverage (mean score 1.0) included: preventing and controlling communicable and non-communicable diseases; promoting and supporting healthy lifestyles; planning, funding, managing and evaluating health gain; ensuring safe and healthy environments; and contributing to healthy growth and development through all life stages. Lower levels of coverage were found for: assessing health needs; developing healthy public policy and fiscal measures; strengthening communities; and improving health for Aboriginal people and other vulnerable groups. CONCLUSIONS: There are limitations in the capacity of the rural public health workforce in Western Australia to implement the core public health functions. While some areas were defined as being adequately addressed, gaps in implementation appeared across all nine functions. IMPLICATIONS: The Australian core functions can be utilised to broadly assess current public health practice, however further development of the functions and their measurement, plus methods to align accountability measures for current public health practice with the core functions, are required.

Cross-Sectional Studies↗
PubMed2000

A case study of health goals in New Zealand.

OBJECTIVE: This paper outlines the New Zealand experience in using health goals and examines its strengths and weaknesses from an 'insiders's' perspective. METHOD: This paper reports on a review of the New Zealand health goals framework conducted in 1996-97. The review centred on a discussion paper, written submissions on it, and consultation meetings with the public, the public health sector and relevant government agencies. RESULTS: It is argued that the framework usefully shaped public health activity in New Zealand and should be retained with a focus on strengthening public health action. Health goals have been developed in New Zealand at a time of considerable change in the health sector. Although this change has been disruptive, it has also provided benefits such as the emergence of new providers. The strengths of the New Zealand framework have included: its inclusiveness, the consultation that occurred in developing it, and the monitoring and reporting system. Ongoing challenges, such as reorienting the health sector and developing a formal intersectoral strategy, are also identified. CONCLUSION: The paper concludes that the current health goals framework has the potential to frame future public health action in New Zealand, but that the increasing mainstreaming of the public health function poses some risk. IMPLICATIONS: The insight provided by the New Zealand case on the implementation of a health goals framework may assist public health planners in other jurisdictions.

Forecasting↗
PubMed1999

Youth suicide.

Explore the source record for details and available documents.

Adolescent↗
PubMed1999

Public health funding mechanisms in New Zealand.

The funding of population-based public health services (health protection, health promotion and disease prevention) has received little attention in the international literature on health reforms, and yet these services are of fundamental importance to the health of populations and to the economy. This article provides justification for health policy-makers placing more emphasis on the level of public health funding compared with funding on personal health services, and accountability arrangements for its expenditure, when considering options to improve the performance of their health sectors. The New Zealand experience of funding public health services is described within the context of the health reforms. The strengths and weaknesses of the adopted approach are analysed.

Financing, Government↗
PubMed1998

Is confidence in immunisation declining?

There is no regular immunisation coverage information in New Zealand that is reliable. Immunisation benefit data do provide an indication of trends. The benefit data show a decline in coverage in 1997, after several years of improving coverage. The reasons for the decline are not known, but media reports which dented public and professional confidence in immunisation may have played a role.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed1997

Measles control.

Explore the source record for details and available documents.

Child↗
PubMed1991

1991 cervical screening recommendations: a working group report.

The Department of Health and the Cancer Society invited a working group to review the 1985 recommendations on cervical screening. Minor modifications have been made to the earlier recommendations in the light of more information about the effectiveness of different screening policies, and in the expectation that comprehensive cytology registers to ensure recall and follow up of abnormalities will be in place shortly. All women from the age of 20 up to 70 years should be offered cervical screening every three years. Any woman who has never had sexual intercourse or who has had a hysterectomy with complete removal of the cervical epithelium for a benign condition need not be screened. Women should have a second smear within one year if they have never had a smear before or if more than five years have passed since their last smear. But recall through the register should not be more frequently than three yearly for women with a history of normal smears.

Adult↗
PubMed1990

General practitioners' ability to predict outcome for elderly patients admitted to acute medical beds.

This study investigated general practitioners' expectations about the management of their elderly patients following admission to acute medical beds. They were asked to predict the length of stay, main type of hospital care and outcome of the admission. There was very poor agreement between the predicted and the observed length of stay, type of care and outcome. The general practitioners underestimated the length of stay and severity of outcome, and overestimated the amount of acute medical intervention patients would receive in hospital. These results suggest that there is an urgent need to improve the level of communication between general practitioners and secondary care services.

Aged↗
PubMed1990

Alternatives to the admission of some elderly patients to acute medical beds.

There is evidence that admission to an acute medical ward is not the best way to look after many elderly patients. This study investigated 83 general practitioners' preferences for the management of 200 elderly patients admitted to the medical beds at Wellington Hospital. For 63.5% of the patients this admission had been by their own doctor and 84% of these patients had been cared for by this doctor for longer than one year. Admission to an acute medical bed was the preferred option for only 48% of patients. Augmented home care was considered a possible option for 31.5% of patients but was mentioned as one of the preferred options for only 9.0%. Admission to a general practitioner bed was the preferred option for 16.5% of patients. The results of this study suggest that area health boards should provide more choices for the management of acute illness in elderly patients.

Aged↗