Search PubMed⌕ Search

Biomedical subjects

S Duckett

Publications and source records attributed to S Duckett.

At least 37 records · Page 2Linked to original sources
PubMed1996

The new market in health care: prospects for managed care in Australia.

Most developed countries are experiencing, or moving at full speed, to implement new forms of health delivery based in part on capitation arrangements and stronger accountability of health service providers. Proposals for introduction of capitation or managed care have been advanced in Australia but have attracted strong opposition from the medical profession. This paper reviews the policy issues surrounding the introduction of managed care, including how Australia's current institutional forms may evolve into managed care provision.

Australia↗
PubMed1995

Oh, Calcutta!

Explore the source record for details and available documents.

Community Health Services↗
PubMed1995

Designing a funding system for rehabilitation services. Part 2: Policy objectives and options for achieving efficiency and quality of care.

This paper examines the objectives of a funding policy for rehabilitation services. A casemix funding system comprises two sets of instruments: a classification system and a payment system. Attention is given to identifying which policy objectives are best pursued through each of these instruments. The paper then analyses the effect of various instruments on creating incentives for efficiency and quality, and assesses policy options with regard to their capacity for dealing with the heterogeneity of rehabilitation patients and controlling various forms of gaming. In conclusion, the paper canvasses four major areas warranting consideration in advancing policy: the use of a blended payment system; dealing with functional gain; the development of an information base; and the focus on designated rehabilitation units.

Australia↗
PubMed1995

Medicare: where to now?

Although it is now more than ten years since Medicare was introduced, Medicare is still a relevant response to ensuring access to health care. However, marginal improvements to Medicare are needed in three areas. First, in terms of bureaucratic issues, rational development of health policy suffers from problems associated with the contemporary division of Commonwealth and State responsibilities. Secondly, more sophisticated methods for priority-setting, which take account of both the technical and allocative efficiency issues, are needed. Finally, Medicare needs to be enhanced by improving its ability to meet the diverse and varying needs of patients with long-term illnesses: improvement in 'coordinated care' is necessary. Approaches to meeting these needs are canvassed.

Australia↗
PubMed1995

Designing a funding system for rehabilitation services. Part 1: Rationale and recent developments.

Part 1 of this paper presents a critical review of several aspects of risk-sharing in rehabilitation that need to be taken into account in designing a funding system. It argues the case for the development of a new rehabilitation payment system separate from both the acute care casemix system and funding arrangements for long-term residential care. The paper then outlines a number of recent developments in the United States and in Australia that draw attention to the need for such a separate system, and details the current provisions for funding rehabilitation in Victoria. An analysis of existing rehabilitation classification systems is given to set the scene for proposing further developments, which are taken up in part 2 of the paper (to be published in the next issue of Australian Health Review).

Australia↗
PubMed1993

Levy-Reid hypothesis.

The inconsistencies in the research findings looking to test for the Levy-Reid hypothesis on the relationship between hand posture and laterality have been accounted for in various ways. Some authors (Cohen, 1991; Weber and Bradshaw, 1981) have suggested that existing methodologies for experimentally establishing laterality of language functioning are unreliable. To overcome this constraint, we have taken Halsey, Blauenstein, Wilson, and Wills' (1980) suggestion of using cerebrovascular accident (CVA) patients in which laterality of expressive speech has been established incontrovertibly. We examined 74 CVA subjects assessing hand posture, handedness, and side of stroke. Our findings lend support for Levy-Reid, nevertheless further examination of the hypothesis using a cross-cultural sample underscores the impact education and culture have on hand posture.

Aphasia↗
PubMed1992

Biopsy diagnosis of familial Alexander's disease.

A 26-year-old woman presented with headaches, incoordination and a cerebellar mass (1982). The CT scan revealed dilated ventricles and a hypodense space-occupying lesion adjacent to the fourth ventricle. Neuronal loss, gliosis and masses of Rosenthal fibers were seen in biopsy. There was no evidence of neoplasm. A second biopsy 2 years later was similar to the original specimen. A diagnosis of Alexander's disease was suggested. Later that year the patient's 11-year-old brother manifested a clinical picture initially diagnosed as brainstem glioma, but whose biopsy was characteristic of Alexander's disease. There has been a gradual deterioration of these siblings over the past 6 years (1986-1991). No evidence of neoplasm has appeared.

Adult↗
PubMed1991

Ossified mucin-secreting choroid plexus adenoma: case report.

This is the first report of a fully documented case of an ossified mucin-producing benign choroid plexus tumor. This was a chance finding in a man who complained only of posttraumatic low back discomfort. The ossification of the tumor appears to have been therapeutic. Mucin production may be a defense mechanism.

Adenoma↗
PubMed1990

Methods to establish priorities for health care.

There is no right way to rank health care projects or patients requiring treatment. Different people or interests, either explicitly or implicitly, adopt different criteria: medical, economic, ethical, or political. This paper discusses the nature of these criteria and presents some strategies for improving our processes for setting priorities for health care expenditure.

Australia↗
PubMed1989

Slow recovery of central axons in acrylamide neuropathy.

To study the differential vulnerability of central versus peripheral axons, we observed serial changes in conduction over comparable segments of central and peripheral axons of the primary sensory neuron in 17 rats with acrylamide neuropathy using somatosensory evoked potentials. Central conduction abnormalities persisted even after peripheral conduction and clinical abnormalities had recovered. Morphometric studies showed prompt restoration of the largest-diameter fibers in the peripheral nerve after clinical recovery but persistent or even more severe loss of large- and medium-sized fibers in the cervical gracile tract. This finding suggests that recovery from central-peripheral distal axonopathy begins in the largest peripheral axons, perhaps even at the expense of central axons, and that clinical recovery can occur at a time when central conduction remains abnormal. The selective central axonopathy found in certain chronic degenerative disorders may be a consequence of this slow central recovery process associated with chronic or intermittent metabolic derangements.

Acrylamides↗
PubMed1989

Effects of collateral blood vessel ligation and electrical conditioning on blood flow in dog latissimus dorsi muscle.

Utilization of skeletal muscle as a myocardial substitute requires it to undergo two major modifications: mobilization to the site of action and adaptation to continuous activity. We have examined the effects of collateral blood vessel ligation, which would accompany mobilization, on blood flow in control and electrically conditioned canine latissimus dorsi (LD) muscle. Blood flows were measured at rest and during a vigorous isometric fatigue test. In 22 control muscles, electrical stimulation during the fatigue test resulted in a sevenfold increase in muscle blood flow (0.26 +/- 0.18 ml/g/min at rest, 1.69 +/- 0.84 ml/g/min during stimulation). No difference was detected in flow to distal and proximal portions of the muscle. In three muscles where collateral vessels were ligated immediately before measurement of blood flow, flow in the proximal portion of the muscle was not significantly different from control, but in the distal portion, stimulation failed to elicit an increase in flow (0.12 +/- 0.13 ml/g/min at rest, 0.16 +/- 0.07 ml/g/min during stimulation). In animals allowed a 3-week recovery period following collateral vessel ligation, stimulation-induced increases in blood flow were detected but remained lower than control. Muscles which had been conditioned by continuous electrical stimulation for 6-7 weeks at 2 or 10 Hz generated less peak isometric tension than controls (peak tension = 4.5 +/- 1.7 kg control, 2.4 +/- 0.7 kg following 2 Hz conditioning, 1.6 +/- 0.4 kg following 10 Hz conditioning). However, these muscles demonstrated an increased resistance to fatigue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphatases↗
PubMed1989

Developing a mandate for change: planning as a political process.

The three main questions dealt with in this article are: 'why have community participation in planning?' 'what is community participation?' and 'how can community participation be practised?' Planning in this context should be understood in a strategic sense as social policy development and implementation at a regional level. In answer to the first question, two common approaches to social planning and their shortcomings are briefly discussed, with reference to a taxonomy from Alan Walker's book Social Planning, A Strategy for Socialist Welfare. Community participation in social planning is a key characteristic of an alternative approach which addresses or avoids altogether the fundamental shortcomings of the other two. Issues of the practice of community participation in regional planning are examined through a description and analysis of the planning process undertaken by the Western Metropolitan Region of the Health Department Victoria. Some general conclusions regarding current trends in policy formation and public sector administration are also drawn.

Community Participation↗
PubMed1988

Epstein-Barr virus infection complicated by acute rhabdomyolysis.

A patient presented with infectious mononucleosis complicated by acute rhabdomyolysis following physical exertion. This infrequent complication should be identified and treated quickly to prevent serious sequelae of rhabdomyolysis, which may include renal failure and disseminated intravascular coagulation.

Acute Disease↗