Biomedical subjects
Publications and source records attributed to H Williams.
A study of 46 closings and mergers in New York City over a 15-year period shows the importance of public funding for the viability of hospitals and the need for sound institutional planning for hospital survival. Regulatory agencies may deny hospitals public funds if they do not respond to their communities.
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The single radial haemolysis test is conveniently practical and economical and promises to have wide applicability in the study of influenza antibodies in human populations. It can also be adapted for preliminary examination of new virus isolates during epidemics. Using this test a rather higher proportion of the population in the Highland Region of Scotland were found to possess antibody to a recent epidemic strain of influenza (A/Scotland/74) than was the case in the south of England. Antibody was detected and apparently evenly spread throughout all but the most remote island communities. Some evidence of the spread of the subsequent variant, A/Victoria/75, was obtained. Most of the school children in our study had high antibody titres to recent strains but the proportion with high antibody titres to these strains declined speedily from the age of 17 years onwards.
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In a medical survey of an urban population in Ghana, abnormal cardiovascular findings were present in 25% of the population aged from 15 to 64 years. This was largely due to hypertension and to cardiomegaly of obscure origin. The prevalence of valvular heart disease was comparatively low. Abnormal cardiovascular findings were commonest in the lowest third of the socio-economic stratum and next most frequent in the highest third. Abnormal findings were not related to smoking or drinking habits; these seem to be only marginally important in the population at present.
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Although many of the fundamental biological features of toxoplasmosis are today well appreciated, the practical problem of prevention of its most serious consequence--disabling congenital disease, remains unsolved. The reasons vary in different communities, but are concerned with detection of the chief mode of spread, assessment of incidence, delineation of vulnerable antenatal women in latently infected populations, and assessment of the risks of therapeutics. The results of some of the approaches to these problems in Scotland are reported and discussed.
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A curriculum for the training of medical students was designed and implemented in a functioning clinical setting. The multidisciplinary, multiprofessional staff of a primary care center participated with professional educators in an iterative process for curriculum development. A three-stage plan was conceived: behaviorally oriented educational objectives were constructed, instructional methodologies to satisfy these objectives were created, and evaluation instruments were designed. Throughout each stage the educators facilitated the process by teaching the staff the necessary techniques for the design and implementation of the curriculum. The curriculum that resulted from this process is focused on those issues that are important to team delivery of primary care. An important outcome of the project is the increased enthusiasm and competence of the professional staff in the teaching of students in the health professions.
Twenty-seven patients with inflammatory and degenerative arthritis, who had been treated with either ketoprofen and flurbiprofen, for a period of up to twenty-four months, were examined for evidence of ocular toxicity. A practical method for examining the ocular structures and assessing visual function is described. A number of ophthalmic abnormalities were noted but these were related to previous or present eye disease or degeneration. It was considered that no ocular toxic sideeffects could be attributed to either drug during the period of treatment.
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