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Biomedical subjects

M Calnan

Publications and source records attributed to M Calnan.

71 records · Page 4Linked to original sources

The health belief model and participation in programmes for the early detection of breast cancer: a comparative analysis.

Extravagant claims have been made about the power of the Health Belief Model (HBM) to explain both decisions to adopt patterns of health behaviour and to use preventive health services. However, studies where information on beliefs are collected before information on behaviour are not common. The analyses presented here are based on prospective studies examining how far the variables which make up the HBM predict attendance at (i) a class teaching breast self-examination and (ii) a clinic providing mammography. The results show that different dimensions of the HBM are amongst the best predictors of attendance at each of the different services although the overall variance explained by the HBM in both sets of analysis was small.

Attitude to Health↗

The functions of the hospital emergency department: a study of patient demand.

Explanations of patient use of hospital emergency departments have tended to emphasize either patient preferences for hospital treatment or the barriers that restrict patient use of their family practitioner. The weakness in these approaches has been the oversight of situations in which many accidents and some sudden illnesses occur. The object of this study is to examine what part social circumstances play in influencing patients' decisions to go to a hospital emergency department. An analysis of data collected from interviews with the sample of patients at a hospital emergency department suggests that social circumstances may be an important influence on patient demand for hospital service. The policy implications of these findings are discussed.

Emergency Service, Hospital↗

The politics of health: the case of smoking control.

The policy of the United Kingdom government towards the control of smoking has been characterized by a non-interventionist approach such as persuasion and industrial self-regulation, as opposed to more direct intervention through fiscal policy or control over tobacco production and sales. The effectiveness of the policies adopted by the UK government is difficult to assess, although there has been a reduction over the last ten years in the proportion of smokers in the population. However, evidence from other countries shows that a more comprehensive programme including direct legislation controlling tobacco advertising has a much stronger impact on tobacco consumption. The determinants of the UK government's policy position are analysed and the evidence suggests that this policy position is determined in part by the power of the vested interests in the maintenance of tobacco production, as well as the confusion of interests within the government itself.

Government↗

Social networks and patterns of help-seeking behaviour.

Previous research has suggested that patterns of help-seeking behaviour are influenced by who the sufferer consults when deciding whether to seek medical care or not. This research has been extended to include episodes of illness and injury where more formal contacts are brought into the consultation process. The results show that the perceived urgency with which medical care is required is influenced by who the person has contact with. Some groups such as the police, bystanders and neighbours and friends may be more likely to suggest that the sufferer should seek medical attention than other consultants. This difference was explained in terms of the social, economic, moral and legal pressures associated with these people's positions.

Adolescent↗

Managing 'minor' disorders: pathways to a hospital accident and emergency department.

Empirical research examining the decision-making processes involved in the management of problematic signs and symptoms has either focused on a specific condition or examined more general decision rules. The problem with these approaches is the difficulty in identifying which elements are specific to certain complaints and which are more generally applicable. The study presented here shows a comparison of the processes involved in the decision to seek medical care for sufferers with different types of complaint. This comparison identified various different elements in the decision-making processes which were shown to have considerable implications for their pattern of help-seeking behaviour and their pathways to the hospital accident and emergency department.

Decision Making↗

The hospital accident and emergency department: what is its role?

The problem over the use of accident and emergency departments is portrayed in terms of a typical conflict between professional and lay needs. However, in contrast with the more common image of the professional hospital doctor successfully developing both structural and interactional strategies for maintaining professional dominance over the patient, it is argued that the structural characteristics of the accident and emergency department pose control problems for the profession. These control problems have been exacerbated by developments in other areas of the health service and have led to the development of policies which emphasize both clinical and social elements of patient need. Although there is apparent recognition by providers of the importance of taking into account patient need, the proposed policies are based on professional images of how patients 'ought' to use the service. What is clearly lacking is comprehensive data on how the public and the community wishes to use the service and how they actually use the service. Data from national and local studies on patient felt needs and patient demand for the hospital accident and emergency departments are presented and the implications for policy are discussed.

Decision Making↗

Tonsillectomy and circumcision: comparisons of two cohorts.

Changes in the prevalence of tonsillectomy and circumcision in eleven year olds are described in two birth cohorts spaced 12 years apart. Both types of operation were less prevalent in the later (1958) cohort; tonsillectomy fell by a fifth and circumcision by more than half. These falls were confined to tonsillectomy before the age of six and circumcision under one year. Social class differences in tonsillectomy were found in both cohort studies but the strong social class gradient in circumcision reported in the 1946 cohort had vanished in the 1958. Regional and birth rank differences are found for both types of operation; these show substantial changes over time. These results are discussed in the context of changing professional opinions about the worth of these operations.

Child↗

Incidence of insulin-dependent diabetes in the first sixteen years of life.

The incidence of insulin-dependent diabetes in the first 16 years of life in a nationally representative sample was 1-42 per 1000 population. This incidence is larger than that found in previous studies of diabetes in comparable age-groups and suggests an overall increase in incidence in this country. 23% of the diabetics had a history of diabetes in a first-degree relative, which is higher than reported previously. There was no evidence to suggest any association between prenatal and postnatal infections and diabetes.

Adolescent↗

Developmental correlates of handedness in a national sample of 11-year-olds.

Some developmental correlates of hand preference in a large nationally representative sample of 11-year-old schoolchildren were examined. Non-right handedness was found to have slight, but statistically significant, associations with deficits of performance on certain standardized attainment and ability tests; with "poor speech" as assessed impressionistically by teachers in school; and with "poor control of hands" as similarly assessed by teachers. Non-right handedness was not associated with defects of articulation or stammering as assessed by doctors in a medical examination; nor withperformance on a clinical speech test; nor with writing productivity or syntactic maturity. There were substantial sex differences in the frequencies of non-right handedness, but no social class differences.

Child↗

Speech problems in a national survey: assessments and prevalences.

In this paper we present data on the prevalence of speech problems in a nationally representative group of children according to three modes of assessment. There was a large measure of disagreement between the assessments. Sex, social class, birth order and family size differences were examined. There was indirect evidence to suggest that the social class differences in the teacher's assessments of poor speech could be explained in terms of differences in children's dialect and language rather than a reflection of speech deficits. Finally we examined the relationship between parental assessment and the three modes of assessment. Overall, the degree of concurrence was low.

Birth Order↗

Community carousel.

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Attitude of Health Personnel↗

Changing perceptions.

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Community Health Nursing↗