PubMed Health⌕ Search

Biomedical subjects

P S Hill

Publications and source records attributed to P S Hill.

18 recordsLinked to original sources
PubMed2005

Identifying competencies for Australian health professionals working in international health.

A profile of the roles performed by Australian health professionals working in international health was constructed to identify the core competencies they require, and the implications for education and training of international health practitioners. The methods used included: literature review and document analysis of available training and education; an analysis of competencies required in job descriptions for international health positions; and consultations with key informants. The international health roles identified were classified in four main groups: Program Directors, Program Managers, Team Leaders and Health Specialists. Thirteen 'core' competencies were identified from the job analysis and key informant/group interviews. Contributing to international health development in resource poor countries requires high level cultural, interpersonal and teamwork competencies. Technical expertise in health disciplines is required, with flexibility to adapt to new situations. International health professionals need to combine public health competencies with high level personal maturity to respond to emerging challenges.

Australia↗
PubMed2001

Tactics at the interface: Australian Aboriginal and Torres Strait Islander health managers.

Over the past thirty years in Australia, there has been a recognition of the need for increasing Aboriginal and Torres Strait Islander participation in the management of their health services as part of the strategy to improve the poor health of Australia's indigenous peoples. The proliferation of Aboriginal Community-Controlled Health Services and the vigorous advocacy of groups such as the National Aboriginal Community Controlled Health Organisation have significantly contributed to this recognition. This, combined with additional management opportunities in government service, has drawn attention to difficulties in recruiting and retaining appropriately experienced Aboriginal and Torres Strait Islander managers, particularly in the northern states of Australia.

Adaptation, Psychological↗
PubMed2000

Planning and change: a Cambodian public health case study.

This paper questions the appropriateness of highly structured strategic planning approaches in situations of complexity and change, using the Cambodian German Health Project as a case study. Based on participant observation and organisational analysis in the Cambodian public health sector, the paper examines the rhetoric of values, objectives and strategies outlined in the original project documents and their assumptions and implications, and the responses to the changing political situation. It demonstrates the limitations of these planning processes in complex situations of high uncertainty, with little reliable information and a rapidly changing environment. Having highlighted the limitations of the strategic planning process in these circumstances, the paper recommends changes that shift the focus away from planning towards informed strategic management, that monitors the changing environment and is given freedom to respond to emerging risks and opportunities. The Cambodian German Health Project was initiated in October 1995 as a bilateral health aid project between the German government and the government of the Kingdom of Cambodia, but was disrupted by the "events of 5-6 July, 1997", as the military action is officially described. Project planning had included an intensive goal oriented planning process (ZOPP) undertaken in collaboration with counterparts from the Ministry of Health, Provincial Health Departments and other bilateral, international and non-government stakeholders. Following the military action, the project was initially suspended, then substantially re-drafted within a new framework of assistance, and eventually re-established after an interval of eight months. The paper will examine these planning processes and responses in the light of Mintzberg's (1994 The rise and fall of strategic planning. New York: Prentice-Hall) argument that strategic planning fails because of three conceptual fallacies implicit in the process: (1) The fallacy of predeterminism allows planners to assume that goals, results, appropriate activities and required inputs can confidently be predicted based on past and current experience, when the reality is that both the internal and external environments are subject to change that may not be predictable. (2) The fallacy of detachment suggests that the functions of planning and implementation are discrete management functions, and that objective, rational decisions in determining activities and inputs are sufficient to successfully achieve project goals and results. (3) The fallacy of formalisation provides an expectation that the processes of planning will "capture" the creative insight required for successful strategic development, and reach a binding consensus despite the complex interactions and relationships that characterise bilateral aid projects.

Cambodia↗
PubMed2000

Bilateral health aid: lessons from Europe.

OBJECTIVE: The objective of this study is to document current issues in policy and planning for development assistance in health from the perspective of key bilateral aid donors in Europe, and to explore its relevance for Australia. METHODOLOGY: This study is based on seventy-seven interviews and documentary analysis undertaken between July and December 1999 with policy, technical and field staff of major European bilateral aid donors, the World Health Organisation (WHO), and key academic institutions. Notes were taken of interviews, and relevant documentation collected. Forty-five key interviews were tape recorded and transcribed for analysis. RESULTS: The shift towards program and Sector Wide Approaches in development assistance reflects broader political changes in Europe since the collapse of the Communist block. Increasingly, achieving an impact on poverty is seen as linked to better governance, improved policy frameworks, and collaboration between donors and partner governments, and between donors themselves, reflected in the broad support for Sector Wide Approaches to development assistance. CONCLUSIONS: These perspectives bring new demands to donors such as Australia: structural changes, procedural changes, collaborative approaches to programs, closer relationships with counterparts. IMPLICATIONS: The uncertainty in which health sector reform operates necessitates a reflective and adaptive approach to management of aid, and responsiveness to monitoring and evaluation and the development of new knowledge. Given Australia's strategic positioning in its sphere of influence, the experience from Europe should inform the development of our own future directions.

Australia↗
PubMed1993

Human immunodeficiency virus notifications for aborigines and Torres Strait Islanders in Queensland.

OBJECTIVE: To describe the epidemiology of HIV infection based on notifications of HIV infection in Aboriginal and Torres Strait Islander people in Queensland and to review their implications for Aboriginal and Torres Strait Islander communities. DESIGN: Descriptive study of data obtained through HIV notifications to the AIDS Medical Unit, Specialised Health Services, Queensland Health from 1 July 1985 to 31 August 1991. SUBJECTS: Aboriginal and Torres Strait Islander people of Queensland. MAIN OUTCOME MEASURES: Centers for Disease Control (CDC) classification of HIV infection, as at 31 August 1991. RESULTS: Twenty-nine individuals identified as Aboriginal or Torres Strait Islander were notified as positive for HIV antibodies in the period 1 July 1985 to 31 August 1991. Of those diagnosed, three were female and 26 male. At 31 August 1991, only 10 were asymptomatic (CDC Group II, III), eight were symptomatic (AIDS-related complex) and 11 were diagnosed as having AIDS. Seven of those with a diagnosis of AIDS had died by the end of the study period. By comparison, 1158 non-Aboriginal or Torres Strait Islander people were notified for the same time period. Of these, 48 were female, 1105 were male and five were transsexual. In the non-Aboriginal and Torres Strait Islander group, 633 were asymptomatic and 297 were diagnosed with AIDS. By the end of the study period, 228 had died. CONCLUSIONS: The data show an estimated prevalence of diagnosed HIV infection in Aboriginal and Torres Strait Islander people in Queensland comparable with the rest of the population. Cases are distributed throughout the State, though some clustering is evident. There has been a stable pattern of notifications over the past five years. The proportion of asymptomatic (CDC groups II, III) HIV-positive Aboriginal and Torres Strait Islander clients was significantly lower than for the non-Aboriginal and Torres Strait Islander group. These data have implications in terms of projections of total cases, diagnosed and undiagnosed, and relative access to the advantages attending early diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The metabolic effects of oxytocin are mediated by a uterine type of receptor and are inhibited by oxytocin antagonist and by arginine vasopressin in the dog.

Infusion of oxytocin (OT) into normal dogs, in doses which produced plasma levels of OT in the physiological range, has been shown to increase plasma levels of glucose, insulin and glucagon and increase rates of glucose production and uptake. This study sought to determine whether there was a correlation between these metabolic effects and the oxytocic potency of four less potent oxytocic analogues when infused into normal dogs. The rank order of oxytocic potency of all 4 correlated well with the rise in plasma glucose levels, and in 3 of the 4 with the rise in plasma insulin levels. An antagonist of the oxytocic effect of OT suppressed the usual OT-induced rise in plasma glucose, insulin and glucagon as well as the increased glucose production and uptake. Arginine vasopressin (AVP) infusion, which by itself did not produce any metabolic effects, blocked completely the effects of OT infusion to raise plasma glucose and insulin levels and increase glucose production and uptake. The data suggest that the metabolic effects of OT in the dog are mediated by OT receptors that are similar to those producing the oxytocic effects. Whether the inhibition by AVP of the metabolic and hormonal effects of OT occurs at the receptor or post receptor level or via other mechanisms remains to be determined.

Animals↗
PubMed1992

Cultural identification in aboriginal and Torres Strait Islander AIDS education.

The emergence of the disease AIDS in the early 1980s has resulted in a unique response. Medical, sociocultural, political, sexual, moral and racial issues have all been raised. This paper examines the way in which participation of Aboriginal and Torres Strait Islander people has resulted in the culturally appropriate and distinctive approaches evident in health education materials produced in Aboriginal and Torres Strait Islander communities. Specific cultural issues relevant to AIDS education are considered, including the use of visual and narrative communication for AIDS education; the significance of the specific concepts related to communication on sexual issues; perceptions of AIDS as alien and genocidal; the use of the Dreaming in AIDS educational resources; and implications for AIDS education.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Oxytocin antagonists with changes in the Asn5 position shed light on hormone-oxytocin receptor interactions.

Since oxytocin agonists and antagonists have different structure-activity relationships, we have investigated the stereostructural and stereoelectronic requirements of the Asn5 residue in oxytocin antagonists by the synthesis of four analogues of the potent, prolonged acting oxytocin antagonist [Pen1,D-Phe2,Thr4,Orn8]-oxytocin (I) in which Asn5 was replaced respectively with Thr (II), Leu5 (III), Asp5 (IV) and Tyr5 (V). These analogues had pA2 values in the antioxytocic in vitro rat uterine assay of 7.23 (I), 7.16 (II), 6.67 (III), 7.21 (IV), and 6.76 (IV), respectively. All were also found to be weakly potent in the in vivo anti-vasopressor assay in the rat. These studies demonstrate very different structural and stereoelectronic requirements for oxytocin agonists and antagonists when they interact with the oxytocin uterine receptor.

Amino Acid Sequence↗
PubMed1990

Oxytocin- and vasopressin-binding sites in the rat uterus: competition binding and inhibitory pA2 studies with oxytocin and oxytocin antagonists.

Recent reports have presented evidence suggesting that there are distinct oxytocin (OT) and vasopressin (VP) receptors in the human and rabbit myometrium. In this study we have investigated whether OT and arginine vasopressin (AVP) activate the same or two different receptor systems in the rat uterus in producing their uterotonic action and whether the myometrial OT/VP receptors are similar to the V1 receptors in the vascular smooth muscle cells. We compared the dose-response characteristics of OT and AVP by the in vitro cumulative dose-response curve technique. We determined the ligand-receptor binding characteristics of [3H]OT and [3H]AVP on uterine membrane fractions from nonpregnant and pregnant rats. Specific OT antagonists were used in competition receptor binding assays and in antioxytocic pA2 bioassays against OT and AVP to determine whether OT antagonists can discriminate between OT- and AVP-binding sites in the myometrium. We also compared the in vitro antioxytocic (OT receptor-mediated action) and the in vivo antivasopressor (V1 receptor-mediated action) potencies of a series of six OT antagonists. Our results show that OT- and AVP-binding sites in the nonpregnant rat uterus have similar binding characteristics and cannot be distinguished by the dose-response study, radioligand receptor binding assays, or OT antagonists in the competition binding and pA2 assays. However, in the term pregnant parturient uterus, the two binding sites can be clearly differentiated. OT receptor density, but not AVP, was markedly increased at term pregnancy. All six OT antagonists studied in this investigation were more potent in antagonizing the uterotonic response to OT than the vasopressor response to AVP. The antioxytocic:antivasopressor potency ratios, however, were different between the antagonists, ranging from nearly equal (0.91) to low (0.1). The results above suggest that there are distinct OT- and AVP-binding sites in the rat myometrium. The myometrial OT/AVP receptors are similar to but not the same as the V1 receptors in the vascular smooth muscle cells.

Animals↗
PubMed1988

Ventral tegmental oxytocin induces grooming.

Bilateral microinjection of oxytocin (OXY) into the ventral tegmental area (VTA) of rat brain produced a significant increase in grooming behaviors at doses from 100 pg to 400 ng. Sites in the caudal region of the VTA were sensitive to lower doses of OXY than sites in the rostral region of the VTA. The time course of action of OXY in the grooming paradigm indicated onset beginning immediately after injection, and termination at 60-75 minutes after injection. Comparison of OXY-induced grooming in male, female, and ovariectomized, estrogen-treated female rats showed no differences in potency for OXY among these groups, suggesting that the grooming effects of OXY are not regulated by sex steroids. Analysis of locomotor activity in rats microinjected with OXY 200 ng bilaterally into the caudal VTA revealed that OXY had no effect on ambulatory locomotion, suggesting that this peptide may activate neurons within the VTA which mediate grooming but not locomotion. The OXY receptor antagonist, [Pen1, pMePhe2, Thr4, Orn8]-OT, blocked OXY-induced grooming when both were simultaneously microinjected into the VTA. The dopamine D-2 receptor antagonist, haloperidol, and the D-1 receptor antagonist, SCH 23390, when microinjected into the VTA five minutes before microinjection of OXY into the VTA, did not block OXY-induced grooming, suggesting that OXY is not working through a dopamine autoreceptor on the VTA neurons. Systemic pretreatment with haloperidol and SCH 23390 effectively blocked grooming induced by OXY in the VTA, suggesting that OXY is directly stimulating OXY receptors on VTA neurons to release dopamine at postsynaptic sites regulating grooming behaviors.

Animals↗
PubMed1984

Uterine prolapse complicating pregnancy. A case report.

A patient developed uterine prolapse during pregnancy. Conservative management consisted of bed rest and use of a pessary. A viable infant was delivered at 30 weeks' gestation following premature rupture of the membranes. A review of the literature suggests that maintaining conservative treatment of these patients throughout pregnancy can result in uneventful, normal, spontaneous delivery.

Adult↗
PubMed1983

Alcoholism. Images, impairments, interventions.

Diagnosis of alcoholism requires a vigilant attitude and aggressive pursuit of supporting evidence by the primary care physician. Because the alcoholic is characteristically defensive and commonly denies the diagnosis, the physician must be persistent and honest when confronting the patient. Effective treatment is available through programs comprising patient and family education, psychotherapy, medical supervision, involvement in Alcoholics Anonymous, use of disulfiram (Antabuse), and follow-up care. Since the recovering alcoholic is vulnerable to relapse, long-term maintenance of sobriety requires not only abstinence from alcohol but also avoidance of psychoactive and narcotic drugs.

Alcoholism↗
PubMed1978

Driving offenders and the defensive driving course--an archival study.

Two hundred and seventy-five drivers who had been required by court order to attend a Defensive Driving Course (DDC) were compared on six posttreatment driving measures obtained from archival data with 275 drivers who also had had a court appearance and standard treatment. The DDC group showed greater reductions in serious and accident-promoting convictions but no greater reduction in accidents when compared with the standard treatment comparison group.

Accidents, Traffic↗
PubMedDate not supplied

[The human immunodeficiency virus (HIV) in Australian Aborigines of Queensland and Torres Strait Island].

The authors report on 29 notifications of Human Immunodeficiency Virus infection in Aborigines and Torres Strait Islanders in Queensland from 1 July 1985 to 31 August 1991. Despite previously expressed concerns regarding the potential for a Pattern II (heterosexual) epidemic, based on reported data for other Sexually Transmitted Diseases, there have been no published reports confirming HIV infection in the Aboriginal and Torres Strait Islander population prior to this study. Although the prevalence of diagnosed HIV infection is comparable to that of the remaining population, there are early indications of differences in the pattern of infection and transmission.

Female↗