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Biomedical subjects

D Dunt

Publications and source records attributed to D Dunt.

25 records · Page 2Linked to original sources
PubMed1993

Delivery of traditional hospital services to patients at home.

The high cost of traditional inpatient care, advances in the delivery of depot antibiotics and narcotics, and the demands of patients for realistic alternatives to frequent hospitalisation have led to programs for the provision of acute hospital care in the home. We review the progress of overseas hospital-in-the-home programs and the issues that such service delivery has raised for clinicians and administrators. The potential application in Australia is examined and priorities for preparative research are suggested. It seems inevitable that for a select number of conditions in a select group of patients, home hospital services will become a reality in this country.

Australia↗
PubMed1989

General practitioner involvement in non-procedural medicine in public hospitals in Melbourne, Australia.

This study is a survey of general practitioners practising in an area in Melbourne, Australia, where there are two medium sized public hospitals with limited general practitioner admitting rights. A questionnaire was mailed to the 207 general practitioners practising in the study area; 167 (81%) responded. Seventy one per cent of respondents had public hospital admitting rights and 73% aimed to manage as many medical patients in hospital as possible. The main reasons given for such involvement were patient expectation, professional satisfaction and the benefits to patients, beyond that of reassurance, which followed from continuity of care. About half of respondents (52%) agreed that their role was a liaison or coordinating one alongside hospital specialists. Fifty-four per cent of respondents overall had in fact managed at least two medical patients in public hospitals in the past 12 months. Lack of availability of general practitioner beds and specialist dominance in public hospitals rather than inadequate time or remuneration were perceived to be the main barriers to hospital practice. Almost three-quarters of respondents (72%) believed general practitioners would be excluded from public hospitals in the foreseeable future. They blamed specialist dominance and general practitioner apathy equally for this predicted state of affairs. A debate on the desirability or otherwise of such an exclusion is overdue within the medical community in order to consider what will otherwise be a fait accompli.

Australia↗
PubMed1988

Recurrent and non-recurrent croup: an epidemiological study.

A community-based study investigating the natural history of recurrent and non-recurrent croup is described. Daily temperature data were collected during 1977-83, in order to analyse seasonal variation and the effect of atmospheric temperature on the number of croup episodes per calendar month. A case-control study of 137 cases--consisting of 75 children with recurrent croup and 45 children with non-recurrent croup--and 236 controls matched by age and sex was also conducted. It aimed to study associations between croup and other selected diseases in the patients and their families. Recurrent croup differed from non-recurrent croup in its natural history in a number of ways. There was a winter and autumn peak in the number of episodes per month. These episodes occurred on days with significantly lower maximum and minimum temperatures. Recurrent croup was significantly associated with a patient history of asthma and wheezy bronchitis and a family history of croup. In contrast, non-recurrent croup showed an autumn peak only, as well as no association with atmospheric temperature or other disease in the patients and their families. This study confirms and extends observations indicating that recurrent croup involves a persistent and inherited airways hyper-reactivity that is triggered by viral and other stimuli, including those related to temperature.

Asthma↗
PubMed1987

Occupational lower-back injuries in a primary medical care setting: a five-year follow-up study.

A cohort study with follow-up that describes the clinical characteristics and outcome five years later of patients with new occupational lower-back injuries, who were seen at a primary-care occupational health clinic in 1979, is presented. Follow-up data were obtained for 119 cases, 63% of all eligible cases. Occupational lower-back injuries constituted 9.5% of new occupational injuries that were seen at the clinic. Men aged less than 50 years accounted for 82% of all cases, and lifting was the most common method of injury. Forty-three per cent of patients were able to return to alternative duties without any absence from work and the majority (82%) of patients had returned to work in fewer than five days. Between 1979 and 1984, 48% of those studied had experienced recurrences of occupational lower-back injury that required medical treatment; half these recurrences occurred on more than three occasions. At five-year follow-up, 93% of patients were in work, although 70% of respondents stated they were still suffering back pain. Fewer than one-third of patients were receiving medical or other treatment at the time of follow-up. Only 2% of patients had undergone surgery and only 8% of patients were engaged in legal action in pursuit of a workers' compensation claim. This primary medical-care study challenges a number of popular stereotypes concerning occupational back injuries.

Absenteeism↗