Biomedical subjects

Hugh Cross

Publications and source records attributed to Hugh Cross.

4 recordsLinked to original sources

PubMed2006

Interventions to address the stigma associated with leprosy: a perspective on the issues.

This paper presents a perspective on stigma as an effect of leprosy. It identifies some of the strengths and weaknesses of current approaches to stigma reduction in leprosy and presents a rationale for considering alternative strategies. It is suggested that models used to explain health behavior in developed societies are inappropriate for explaining leprosy stigma or for developing strategies to address it. The author recommends due consideration of the alternative logic that characterizes cultural belief systems in countries where leprosy is a challenge. Criticism of the common practice of information dissemination as a strategy to address leprosy stigma is defended and the merits and limitations of an integrated health service in India is discussed. The author defends the suggestion that the principal objective of stigma interventions should be "normalization". An example of a Nepalese project based on empowerment theory is given to demonstrate how the transformation of identity from outcast to positive change agent, can effect "normalization".

Health Knowledge, Attitudes, Practice↗

PubMed2005

A Delphi consensus on criteria for contraindications, assessment indicators and expected outcomes related to tibialis posterior transfer surgery.

A team of experts in the field of reconstructive surgery for leprosy-affected people was identified. Using the Delphi method, an exercise was undertaken to ascertain whether a consensus on essential criteria and indicators for Tibialis Posterior Transfer (TPT) could be reached among the team. This paper describes the Delphi Exercise, giving results at each stage of consensus development. The final outcome was that essential criteria, including contraindications for surgery, pre- and post- operative assessments and expected outcomes, were agreed. The criteria are presented with recommendations.

Consensus↗

PubMed2005

Consensus methods: a bridge between clinical reasoning and clinical research?

Evidence-Based Practice does head the "hierarchy of evidence" upon which developments in clinical practice should be based. There are, however, situations where evidence is either unavailable, unclear, or results between studies are at variance. Consensus is a reliable contingency, and approaches to reaching consensus have acceptable construct validity (Nominal Group Technique, Delphi, and Consensus Development Conference). Consensus is reached when: (i) the method of investigation tightly controls communication to reduce the obscuring "noise" of divergent discussion; (ii) statistical measures of agreement or dissent screen out the bias that would otherwise be produced by the dictate of vociferous minorities or coalitions that may represent vested interests; (iii) all participants contribute equally to the product of the investigation.

Biomedical Research↗

PubMed2005

STEP: an intervention to address the issue of stigma related to leprosy in Southern Nepal.

This paper focuses primarily on the extent to which a Stigma Elimination Programme (STEP) affected the social participation of people affected by leprosy in southern Nepal. The Participation Scale (popularly known as The P Scale) was applied to compare leprosy affected people who participated in STEP groups with a control group comprising leprosy affected people who lived in villages where STEP had not been implemented. It was found that STEP participants had significantly higher levels of participation compared with controls and that their levels of social participation were higher than would be expected even for the general population. It was also found that leprosy affected people without visible deformity or ulceration (whether in the STEP group or not) do not appear to suffer participation restriction in southern Nepal.

Efficiency, Organizational↗