Yvonne H Carter's research while affiliated with La Trobe University and other places
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Publications (121)
To evaluate the evidence on the transition process from child to adult services for young people with palliative care needs.
Systematic review.
Child and adult services and interface between healthcare providers.
Young people aged 13-24 years with palliative care conditions in the process of transition.
Young people and their families' experiences...
intimate partner abuse is common worldwide, damaging the short- and long-term physical, mental, and emotional health of survivors and children. Advocacy may contribute to reducing abuse, empowering women to improve their situation by providing informal counselling and support for safety planning and increasing access to different services. Advocacy...
Intimate partner abuse is common in all societies and damages the health of survivors and their children in the short and long term. Advocacy may decrease the impact of this abuse on women's health.
To assess the effects of advocacy interventions conducted within or outside of health care settings on women who have experienced intimate partner abus...
The National Health Service (NHS) was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines.
Cascade approach to sampling, followed by telephone su...
To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. Data sources: Seven electronic databases were searched for the period January 1994--November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metalib). Key journals and reference lists of...
To evaluate the effectiveness of multifactorial assessment and intervention programmes to prevent falls and injuries among older adults recruited to trials in primary care, community, or emergency care settings.
Systematic review of randomised and quasi-randomised controlled trials, and meta-analysis.
Six electronic databases (Medline, Embase, CENT...
Recent contributions to the policy implementation literature have applied Kingdon's model of ‘policy windows’ to the implementation of policy on health inequalities in the UK, and have identified the key role played by ‘policy entrepreneurs’ at local as well as national level. Despite this, the picture that emerges is of frustration of central poli...
Graduates entering medicine need to achieve the same learning outcomes as school leaver medical students in less time. Time is not the only consideration, and rather than just compress five-year courses into a four-year time-frame, curriculum planners have often taken the opportunity to introduce innovations for small cohorts as schools begin these...
Four-year fast-track courses for graduates started in the UK in 2000, and are now offered at 14 UK medical schools. Graduate entry medicine (GEM) started five years earlier in Australia, and of course in the USA it has been the norm for students to begin studying medicine after university graduation. This paper reviews the aspirations for GEM and l...
Research in medicine and healthcare does not simply ‘develop’. The allocation
of research funding and the priorities for the design and focus of health research programs, are driven by policies that are usually set at the national level. It is often assumed that research policymaking is an essentially neutral activity
that is based on the identific...
To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals.
Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome me...
Maps are increasingly understood as socio-cultural and political constructs, rather than mirrors of nature. Drawing on the insights of cultural cartographers, this paper presents a critical analysis of a specific instance of map-making in health policy, namely the growing use of care pathways in care planning and service delivery. Widely regarded t...
Recent organizational changes reflect the need to be more responsive to local populations and have included fostering a closer structural relationship between primary care and public health. In light of this, we explore the distribution of the specialist public health workforce and the relationship with population deprivation and need.
Questionnair...
An increasing proportion of research in primary care is locally undertaken in designated research practices. Capacity building to support high quality research at these grass roots is urgently needed and is a government priority. There is little previously published research on the process by which GP practices develop as research organizations or...
Personal Medical Services (PMS) contracts, introduced in 1997, provide a new financial model for providing general practice. The aim of this study was to measure the costs
and
consequences of the PMS first wave contracts for sites that aimed to increase the accessibility and the quality of care for vulnerable population groups; to describe the prob...
Recent re-structurings of the National Health Service (NHS) in England have illustrated the British government's commitment to a policy of devolving resources and responsibilities to local levels. As a result, public health teams are now located in 303 primary care trusts, and are more numerous, and much smaller, than previously. These changes have...
To identify issues surrounding the future training needs of the specialist public health workforce following the most recent restructuring of the National Health Service (NHS) in England.
All directors of public health (DsPH) based in strategic health authorities and nine senior staff working in public health at the regional level were invited to p...
Need to be learnt side by sideTeaching clinical skills to undergraduates focuses on examination, planning treatment, safe prescribing, and procedures such as venepuncture, suturing, and cardiopulmonary resuscitation.1 Curriculums for communication skills aim to develop effective (clear and sensitive) communication with patients, carers, and colleag...
A variety of community-based medical undergraduate modules have been developed over the last six years that complement more traditional hospital teaching. To monitor and enhance the quality of this teaching, a system was designed that regularly and accurately fed back student evaluation to the general practice tutors. An evaluation of the effective...
To determine the capacity and development needs, in relation to key areas of competency and skills, of the specialist public health workforce based in primary care organizations following the 2001 restructuring of the UK National Health Service.
Questionnaire survey to all consultants and specialists in public health (including directors of public...
Few studies have explored the development of practices as research organisations. This paper reports the findings of a study exploring the development of UK research practices and the impact of practice roles on research. Twenty-eight qualitative interviews were undertaken with research team members in a maximum variety sample of 11 research practi...
Smoking deception is often ignored, but is important in health care. In this trial it was assessed at both study entry and outcome. At study entry, 1,044 males at a primary care clinic were asked smoking status and tested for breath carbon monoxide (CO). Of self-reported non-smokers, 57/402 (14%) were actually smokers, as were 59/251 (24%) of self-...
Studies have shown that smokers rationalize smoking by self-exempting beliefs. This study explored lay beliefs about smoking in Kelantan, Malaysia, using focus groups among outpatients, medical students and staff, and a questionnaire survey of 193 male smokers. In focus groups, patients said they could do something to make smoking safe. When asked,...
This paper describes an evaluation of a computer-assisted learning (CAL) resource for primary care researchers. A two-phase approach was adopted involving a questionnaire survey and follow-up telephone interviews with a purposive sample of respondents. Results indicate wide support for this approach to self-directed learning, particularly for those...
Devolved accountability for primary care has been introduced into the UK through a range of local contracts for personal medical services (PMS) authorized by the 1997 NHS (Primary Care) Act. These four exemplary case studies illustrate the PMS pilot programmes and represent a diversity of emerging organizational developments that appear to be respo...
In England, there are particularly pressing problems concerning access to adequate primary care services. Consequently, innovative ways of delivering primary care have been introduced to facilitate and broaden access.
The aim of this study was to review the evidence of seven recent innovations in service provision to improve access or equity in acc...
Recent UK government policy calls for a strong public health function within health and local authority services. The recent restructuring of the National Health Service has drastically changed the organizational structure of Public Health, and has resulted in concerns over the capacity and capabilities of the specialist public health workforce. Th...
Palliative care is an integral part of the general practitioner's role and palliative care teaching and training should be available for GP registrars during vocational training.
This study was carried out to evaluate the content, amount and nature of generic palliative care teaching during vocational training in the UK.
A postal questionnaire surv...
• Palliative care should be available for all patients regardless of diagnosis. • A core undergraduate curriculum is essential for medical and nursing undergraduates. • Palliative care should be assessed within the undergraduate curriculum. • Postgraduate teaching should be experiential and learner centred utilising patients or bereaved carers as t...
"Child protection training is essential for all health professionals engaged in services for children. It is not an optional extra" (Barry Capon, Chair of Independent Inquiry into Death of Lauren Wright).
Editor—Death is still society's final taboo, as the article by Ellershaw and Ward showed.1 All medical schools in the United Kingdom now include some teaching on palliative care in their undergraduate curriculum, but most of the emphasis has been on the care of patients dying of advanced cancer. Much palliative care teaching continues to be didacti...
The Personal Medical Services (PMS) pilot sites, launched in England in 1997 by the Secretary of State for the then Conservative government, introduced a local contract for primary care, aimed at promoting flexibility, innovation and policy participation. As part of the National Evaluation of PMS, this paper considers the professional and organisat...
Homelessness is a social problem that affects all facets of contemporary society. This paper discusses the concept of homelessness in terms of its historical context and the dominance of the pervasive 'victim blaming' ideologies, which, together with the worldwide economic changes that have contributed to a fiscal crisis of the state, and the resul...
Objective - To describe and discuss the development and peer evaluation of a new system called Distributed Health Information System, which can be used by clinicians in primary care to access health information. Setting- Department of General practice and Primary Care, Queen Mary, University of London, and selected clinicians, and informaticists fr...
This longitudinal study was designed to assess the effect of an educational training package for primary health care teams in accident prevention for older people, with reference to the incidence of accidents and their associated economic consequence.
Nineteen general practices in the West Midlands serving a population of 138 397 were allocated ran...
Objective- To describe the development and evaluation of a new system called Distributed Health Information System, which can be used by clinicians in primary care to access health information to enhance evidence-based patient care and personal professional development. Design- A combination of both software development and quantitative research me...
Our aim was to investigate the extended primary care team's experience of aggression and violence from patients, in order to promote the formulation of multiprofessional team procedures for critical incident management and organizational development.
A qualitative study based on in-depth interviews and focus groups with primary health care teams an...
To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings.
Systematic review of published quantitative studies. SESRCH STRATEGY: Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001.
Surveys that...
Background:
Since the early 1990s the United Kingdom (UK) Department of Health has explicitly promoted a research and development (R&D) strategy for the National Health Service (NHS). General practitioners (GPs) and other members of the primary care team are in a unique position to undertake research activity that will complement and inform the re...
A questionnaire survey undertaken among general practitioner registrars in North Thames in 1998 revealed significant deficiencies in their child protection training. A minority expressed confidence at the prospect of dealing with child protection cases in the future. A new, interactive training package was subsequently developed and delivered to a...
The movement of medical education into the community has accelerated the development of a new model of general practice in which core clinical services are complemented by educational and research activities involving the whole primary care team.
To compare quality indicators, workload characteristics, and health authority income of general practic...
People with HIV and AIDS in the developed world are living longer and healthier lives following the introduction of highly active antiretroviral therapy. The medical management of stable HIV infection could eventually fit into the more normal pattern of chronic disease management in the United Kingdom (UK). Routine monitoring of many chronic condit...
This paper describes the design and evaluation of the community-based obstetrics and gynaecology module at St Bartholomew’s and the Royal London School of Medicine and Dentistry. This module sets out to comply with the General Medical Council’s recommendations of encouraging students to consider the community perspective, and places less emphasis o...
General practice-based research activity is increasing rapidly, particularly for large, collaborative, multi-centre studies. We conducted semi-structured interviews with general practitioners and other professionals at practices in the East London and the City Health Authority area, to investigate the difficulties presented by becoming involved in...
We are currently completing a review of the evidence for screening for domestic violence, which the United Kingdom National Screening Committee commissioned us to undertake. We note the Committee's proposal to change the definition of screening which it originally adopted, and the commentary written by Wald (Wald N. The definition of screening. J M...
In the past 10 years, significant developments in general practice teaching and research have led to the considerable growth of academic general practice as a discipline. This paper reviews issues relating to these developments, particularly career pathways and training aspects.
The need to extend these advances to the broadening arena of primary h...
General practice p 994
Older people frequently fall. This is a serious public health problem, with a substantial impact on health and healthcare costs.1 These guidelines translate trial evidence about prevention of falls into recommendations that can be implemented in different settings, with the aim of reducing the rate of falls and injurious fall...
The University Linked Practices (ULP) programme links general practices involved in undergraduate medical education with computer services provided through the school of medicine and dentistry. In-depth interviews were conducted with 26 staff involved in teaching undergraduate medical students in 15 general practices across east London and Essex. T...
Editor—Dickinson in her editorial stated that there are serious doubts about the contribution of breast screening to a fall in breast cancer deaths.1 This statement is based on the controversial article by Gotzsche and Olsen,2 which at the time of its publication attracted much media attention. The repetition of this allegation without a more balan...
The very notion of academic general practice is problematic for some—conjuring up images of ivory towers, and GPs working in sheltered environments, protected from the demands of ‘real’ or ‘front-line’ practice. The academic section of any discipline is marked out by its responsibilities for its ‘futures’ component, i.e. education and research for...
Undergraduate medical education is moving away from its traditional hospital setting into the community. Alongside this, there is a growing need to prepare medical students for workplaces that rely on information technology. The distribution of students to locations throughout the community presents major challenges regarding access to facilities u...
Following the Tomlinson report of 1992, London Initiative Zone Educational Incentives (LIZEI) funding was introduced for a three-year period to improve recruitment, retention, and educational opportunities for general practitioners working within inner London.
To test the hypothesis that general practices that show evidence of good organisation ach...
Acute paediatric admissions have risen steadily over the past 20 years. During the same period, practice-based child health clinics have increased, although provision is less common in areas of deprivation where hospital use is greatest.
To investigate the contribution of practice-based, preventive child health services to rates of hospital utilisa...
Objectives:
The aim of this paper is to discuss the increasing use of computers in undergraduate medical education and explore the why, what and how of providing IT facilities to undergraduate medical students when they are on placement in general practice. Adequate computing facilities are usually available within hospitals and medical schools, h...
EDITOR—Kannus promotes physical activity for the prevention of injurious falls among elderly people.1 He acknowledges the uncertainty that surrounds the effectiveness of specific exercise programmes tested as interventions in randomised controlledtrials. This is in contrast to the epidemiological evidence from longitudinal cohort or case-control st...
The City and East London General Practice Database Project was launched in 1992 to provide a framework for describing and understanding the nature of general practice in east London using routinely available administrative data from all practices in the area. It has provided an opportunity to use information on practices for research, health planni...
Two major changes are taking place in undergraduate medical education: a shift from hospital to the community and the development of problem-based learning, with its foundation in evidence-based practice. In order for these changes to be successful, students need access to the same computing facilities as in the hospital or medical school, and unde...
Editor—McColl et al present findings about the attitudes towards evidence based medicine of general practitioners in Wessex, but they lack information from other members of the primary care team.1 Comprehensive evidence based practice will require the involvement of all members of staff. As part of a baseline needs assessment before the implementat...
Recent changes in the organization of the National Health Service have created new roles and responsibilities for academic general practice. Previous work on the constraints and opportunities of a career in academic general practice is largely anecdotal and is often based on the views of more senior members of the profession.
To survey the research...
Unintentional injury to children aged under 5 caused 428 300 deaths globally in 1990. Not surprisingly, the majority are in the developing world, with 740 deaths annually per million of the population aged less than 5, compared with 249 per million a year in developed countries. However, injuries account for 15.6% of deaths after the perinatal peri...
EDITOR—Sidebotham and Pearce's audit of child protection procedures in an accident and emergency department should raise general awareness that children in any such departments need special consideration.1 It should also raise specific awareness that non-accidental injury often presents to accident and emergency departments. It is interesting that...