Biomedical subjects
Publications and source records attributed to G Durham.
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.
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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.
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.
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.
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"Your Pregnancy" is a health information booklet distributed to all pregnant women in New Zealand free of charge. Evaluation of the accessibility, acceptability, and effectiveness of the booklet was undertaken. Two groups of women were surveyed 4-5 months after their first babies were born. The first group of women (n = 281) was surveyed before the booklet was introduced and the second group (n = 267) after its distribution. The overall response rate was 79 per cent. Accessibility of the booklet was assessed from the survey of the second group of women. The majority of women received the booklet eventually, but only 62 per cent in the first trimester. Of those women who received the booklet, 73 per cent passed it on to others. Evaluation of the booklet's acceptability was undertaken by calling for submissions from professional and lay groups (n = 41) on all aspects of the booklet and from analysis of responses to the second survey. The booklet was generally acceptable to women and health professionals. Effectiveness of the booklet was gauged by comparing the two groups of women on the extent to which their needs for information had been met, the ease with which they could question others about their pregnancy, locus of control, self-care and self-knowledge. The only variable which showed a change between the two surveys was an improvement in the extent to which women's needs for information had been met.
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