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Biomedical subjects

G Moon

Publications and source records attributed to G Moon.

30 records · Page 2Linked to original sources
PubMed1995

Psychiatric morbidity: a multilevel approach to regional variations in the UK.

STUDY OBJECTIVE: To establish whether regional variations in psychiatric morbidity in Britain constitute a distinctive geography of mental health arising from factors that are context-specific at area level or whether these variations are an artifact generated by sampling fluctuations and differing population compositions in areas. DESIGN: Multilevel modelling techniques were applied to data from the 1984-85 health and lifestyle survey. The outcome was the prevalence of psychiatric morbidity as recorded by the application of the general health questionnaire in this survey. SETTING: The analysis was undertaken simultaneously at the individual level, electoral ward level, and regional level for England, Wales, and Scotland. PARTICIPANTS: A total of 6572 adults were selected from the electoral register. MAIN RESULTS: Regional variations were detected in crude aggregate general health questionnaire scores but these were found to be the result of sampling fluctuations and varying regional population compositions rather than higher level contextual effects. There was certainly no evidence of a clear north-south distinction in psychiatric morbidity as was suggested by earlier work. In addition, the local neighbourhood did not seem to have any importance beyond the type of people who lived there. A number of individual characteristics was shown to be associated with mental wellbeing but a large degree of individual variation remained unexplained. CONCLUSIONS: In terms of low level psychiatric disturbance it seems that the characteristics of individuals have greater importance than the characteristics of areas, although the latter may still operate as important mediating factors. Multilevel modelling represents a robust statistical method of examining area variations in health outcomes and further work needs to be conducted, particularly on more serious psychiatric conditions.

Adult↗
PubMed1993

Police surgeons.

Explore the source record for details and available documents.

Alcoholic Intoxication↗
PubMed1993

Do places matter? A multi-level analysis of regional variations in health-related behaviour in Britain.

A number of commentators have argued that there is a distinctive geography of health-related behaviour. Behaviour has to be understood not only in terms of individual characteristics, but also in relation to local cultures. Places matter, and the context in which behaviour takes place is crucial for understanding and policy. Previous empirical research has been unable to operationalize these ideas and take simultaneous account of both individual compositional and aggregate contextual factors. The present paper addresses this shortcoming through a multi-level analysis of smoking and drinking behaviours recorded in a large-scale national survey. It suggests that place, expressed as regional differences, may be less important than previously implied.

Adolescent↗
PubMed1991

Multilevel assessment of immunisation uptake as a performance measure in general practice.

OBJECTIVE: To provide a measure of general practitioners' performance regarding uptake of immunisation against pertussis, taking account of the impact of patient characteristics on levels of uptake. DESIGN: Multilevel model of immunisation status against six measures of patient characteristics (level 1 predictor variables) with practice constraints as level 2 variables. SETTING: 126 practices in southern England. SUBJECTS: 2048 infants identified from infant surveillance and immunisation records. MAIN OUTCOME MEASURES: Top 10 practices with respect to uptake of pertussis immunisation according to a "null" model (model A) and according to a model that included six level 1 variables (model B); differences in ranking between the two models. RESULTS: Practices with low numbers of infants' requiring immunisation had imprecise and unstable uptake rates (range 0%-100%). With the multilevel procedure, after controlling for patient characteristics, practices in suburban catchment areas comprised largely of mature or young professionals performed best. Most improved performances when patient characteristics were taken into account were in practices in areas with a stable population and local authority housing--one such practice improved its ranking by 47 places. CONCLUSIONS: Crude uptake rates are inadequate performance indicators. Alternative approaches suggest that praiseworthy efforts to raise immunisation rates in unpromising areas are unrewarded by simple target based assessments.

Achievement↗
PubMed1991

Ecological and individual effects in childhood immunisation uptake: a multi-level approach.

Analyses of childhood immunisation uptake have traditionally been conducted at either the ecological or the individual scale. In this paper the problems stemming from these distinct strategies are explored and the potential of a multi-level modelling approach taking simultaneous account of processes at both levels is discussed. This discussion is set in the context of a case-study of pertussis immunisation uptake using data gathered from routine child health surveillance and immunisation uptake monitoring. The role of multi-level modelling in medical geographic research is briefly evaluated.

Case-Control Studies↗
PubMed1990

Conceptions of space and community in British health policy.

Several recent United Kingdom health policy initiatives include ideas implicitly or even explicitly involving geographical space as a central theoretical construct. Neighbourhood nursing is perhaps the best known recent example. These initiatives are not without common features, and the paper commences with a typology of the roles which geographical space plays in health policy. A second section gives specific consideration to neighbourhood nursing. Thirdly the paper outlines the social theoretic debates surrounding geographic inputs to health policy: ideas such as community and locality. It is suggested that spatial conceptions in health policy reflect a complex amalgam of sociological assumptions which might fruitfully be considered in the light of Giddens' concept of locale.

Community Health Centers↗
PubMed1990

Loaves & fishes by the sea. One answer to resource allocation.

How can community units ensure that services are provided on the basis of need rather than history? This article describes the efforts being made in Portsmouth and South East Hampshire (one of the country's largest health authorities) to meet this fundamental challenge. The approach taken is to match information on workloads, health care needs and neighbourhoods to facilitate effective resource management.

Catchment Area, Health↗
PubMed1988

Health education and baseline data: issues and strategies in nutrition campaigning.

A central problem for health education is the lack of baseline data concerning relevant issues such as smoking, alcohol consumption or nutrition. In the absence of this information there is little detailed knowledge of the public's habits or willingness to change those habits. Furthermore, the social context and spatial variation of these factors is unknown. Often the only way in which suitable information can be acquired is through social surveys. This paper uses a case study of a nutrition survey to outline a general framework for the collection of baseline data. The approach centres around postcode based data linkage. The effectiveness of the approach is considered and its shortcomings noted.

Health Education↗