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Implementing community services can be a very complex process where people end up “not seeing the wood for the trees” and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management-control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there. [ABSTRACT FROM AUTHOR]

Primary immune deficiency disorders (PIDs) are a group of diseases associated with a genetic susceptibility to recurrent infections, malignancy, autoimmunity, and allergy. The molecular basis of many of these disorders has been identified in the last two decades. Most are inherited as single gene defects. As discussed in this paper, identifying the underlying genetic defect plays a critical role in many areas-including patient management, diagnosis, identifying atypical presentations, family studies, providing prognostic information, prenatal diagnosis, and defining new diseases. New Zealand is a geographically isolated, developed country in the South Pacific. We have introduced a dedicated customized genetic testing service for PID patients in New Zealand. This accredited diagnostic program offers rapid turnaround times for genetic tests and minimizes the risk of laboratory errors. Here we review the clinical indications for genetic testing for PIDs based on cases referred to the molecular immunology diagnostic service at Auckland City Hospital. [ABSTRACT FROM AUTHOR]

In 2005 the Health, Work, and Retirement (HWR) Longitudinal Study was established at Massey University in order to identify the later-midlife factors that lay the basis for community participation, independence, and health in later life. Information was collected via postal questionnaire on physical and mental health, psychosocial factors, work and retirement attitudes, and socioeconomic and demographic indicators of a sample of 6662 community-dwelling adults aged 55–70 years. This report provides an overview of these results, and highlights the impact that the transition from work to retirement has on the health and retirement adjustment of older people with respect to independence, well-being, and social participation. [ABSTRACT FROM AUTHOR]