Biomedical subjects

Pauline Gulliver

Publications and source records attributed to Pauline Gulliver.

7 recordsLinked to original sources

PubMed2005

The epidemiology of home injuries to children under five years in New Zealand.

OBJECTIVE: This paper describes the epidemiology of injuries sustained by children under five in the home. METHODS: Cases were selected from the New Zealand Health Information Service public hospital morbidity and mortality data, and included all 0-4 year olds where the place of injury occurrence was classified as 'home'. The circumstances of injury were coded according to the Supplementary Classifications of External Causes of Injury and Poisoning (E-codes) of the International Classifications of Diseases. Age-specific rates of death or hospitalisation due to injury were calculated using the population of 0-4 year olds in New Zealand for each year as the denominator. RESULTS: The rate of death from an injury sustained at home between 1989 and 1998 was 13 per 100,000 population per year. The main causes of death were suffocation, submersion, homicide and fire. The rate of hospitalisation in children aged 0-4 years from an injury sustained in the home between 1989 and 2000 was 737 per 100,000 population per year. The most frequently recorded causes of hospitalisation were falls, scalds, poisonings and cut/piercing incidents. CONCLUSION AND IMPLICATIONS: Although there has been an apparent decrease in the number of children hospitalised for injuries sustained in the home environment, it is not possible to determine if this is a 'real' change or a result of other factors affecting the data. While children continue to be killed and injured as a result of preventable incidents in the home environment, injury prevention strategies should be continued and strengthened.

Accident Prevention↗

PubMed2005

Usual water-related behaviour and 'near-drowning' incidents in young adults.

OBJECTIVE: To describe usual water-related behaviour and 'near-drowning' incidents in a cohort of young New Zealand adults. METHOD: This was a cross-sectional study based on data collected as part of the Dunedin Multidisciplinary Health and Development Study, which is the study of a cohort (n = 1,037) born between 1 April 1972 and 31 March 1973 in Dunedin, New Zealand. The data analysed were collected at age 21 (1993/94). Each study member was given a face-to-face interview using a structured questionnaire. RESULTS: Males reported a higher level of water confidence, exposure to risk behaviours, and exposure to unsafe locations, and more 'near-drowning' incidents, than the females, but protective behaviour did not differ. Males and females who were 'confident' in the water were more likely to be exposed to unsafe water locations, and water-confident males were more likely to drink alcohol before water activities, but not boating. A total of 169 'near-drowning' incidents were reported by 141 study members (63% males). 'Near-drowning' incidents were associated with unsafe swimming environments for males (p < 0.001) and boating within two hours of consuming alcohol for females (p = 0.002). CONCLUSIONS: This study described usual water-related behaviour and has provided preliminary evidence of the factors associated with 'near-drowning' incidents among a high-risk age group. Larger case-control studies are required to further investigate risk factors for 'near-drowning'. IMPLICATIONS FOR PRACTITIONERS: Further investigation is required to determine the effectiveness of providing water skills acquisition in both safe and unsafe environments on 'near-drowning' experience.

Adult↗

PubMed2004

Influences during adolescence on perceptions and behaviour related to alcohol use and unsafe driving as young adults.

OBJECTIVE: To investigate whether aggression, parent and peer influences, and previous traffic-related experiences at ages 15 and 18 impacted on (a) differences between the perceived safe and estimated legal alcohol consumption limit, and (b) driving while impaired (DWI) behaviour at age 21. METHOD: The study population was a birth cohort involved in a longitudinal investigation of health and development. At the ages of 15 and 18, study members completed questionnaires assessing parent and peer attachment, experience travelling with an alcohol impaired adult or youth, aggression, and previous crash experience. At age 21, study members were questioned about how much alcohol they perceived they could drink and still drive safely, and whether they had driven after 'perhaps consuming too much alcohol'. For each participant their legal alcohol consumption limit was estimated using their height and weight. Path analysis was used to determine whether variables measured at ages 15 and 18 predicted differences between the perceived safe and estimated legal alcohol consumption limit and driving while impaired, both measured at age 21. RESULTS: Insufficient females drove while impaired at age 21, who also had complete data on all other variables, to conduct path analysis for this outcome. For males, aggression at ages 15 and 18, travelling with an impaired youth at age 18, and previous crash experience at age 18 predicted DWI behaviour at age 21. Only aggression at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit for the males. For females, aggression at ages 15 and 18, and travelling with an impaired adult at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit. CONCLUSION: The results show that aggressive behaviours and adult and/or youth modelling of drink driving behaviours in mid- to late-adolescence are related to differences between perceived safe and estimated legal alcohol consumption limit for both genders and driving while impaired for males.

Adolescent↗

PubMed2004

Why do we keep on meeting like this? The board as ritual in health and social care.

Despite their prevalence and longevity in many forms of social organization, most research on formal meetings suggests that they do not fulfil the instrumental purposes (e.g. setting strategy) that their constitutions propose. A three-year study of the Joint Commissioning Board for mental health in Somerset, UK, revealed that it was no exception. However, many of the participants on the Board suggested that it fulfilled important purposes that drew attention to its role as ritual. This paper examines the role of the Board in the light of the literature on ritual--in particular the work of the neo-Durkheimian tradition flowing from the work of Douglas--and locates the importance of the meeting in the formation of social solidarity. This theoretical perspective illuminates issues around classification and language which explain the disempowerment felt by some members of the Board. Finally, this paper identifies the challenges in engaging a broader range of stakeholders (including users and carers) in these rituals.

Ceremonial Behavior↗

PubMed2002

Joint commissioning. Going halves.

Joint commissioning and provision of mental health services in Somerset failed to produce significant benefits to users over its first two years. Users considered access to services deteriorated and concerns remain that there is no alternative to hospital admission in crises. Users and carers were included as non-voting members of the commissioning board, but users felt less involved in care planning than previously. The combined health and social care trust does not seem to have delivered anything which has not been achieved elsewhere without the transfer of social care staff to a new employer.

Continuity of Patient Care↗

PubMed2002

Governance of partnership between health and social services: the experience in Somerset.

As one part of a larger study of the integration of mental health and social care, the present paper explores the role of the Joint Commissioning Board in the governance arrangements for health and social partnership in Somerset, UK. A short review of the literature on joint planning and joint commissioning revealed that such partnership has proved problematic, and that the role of non-executive directors and councillors is usually overlooked. Furthermore, the research on corporate boards suggests that their performance does not match the prescriptions made for them. Following a description of the methodology of the study, the present paper reports the findings of the activity of the Joint Commissioning Board from three data sources: (1) observation of meetings; (2) analysis of documentation; and (3) participant interviews. All three sources support the view, put forward in the Discussion section, that the Board does not play a proactive role in the setting and monitoring of policy and priorities. Nonetheless, it is argued, the Board plays a central and constructive role in the governance of partnership: as the symbol of interagency partnership; as the vehicle for sustaining commitment to mental health; and as the method of bringing additional elements of public accountability to the commissioning and providing of health and social care. Locating this ritual function of the Board within the broader sociological literature, the Discussion section goes on to suggest the implications both for the future of governance of partnership and for further research in this area.

Community Mental Health Services↗

PubMed2002

Balancing professional and team boundaries in mental health services: pursuing the holy grail in Somerset.

The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge.

Adaptation, Psychological↗