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Biomedical subjects

I W Webster

Publications and source records attributed to I W Webster.

At least 19 recordsLinked to original sources
PubMed1992

Do Australian researchers accept committee review and conduct ethical research?

We sought researchers' views on the ethics of research practice and the Australian system of review of research proposals by research ethics committees (RECs). Researchers were found to be supportive of review of research proposals, even though they thought that the process of review was time consuming and demanding. However, our findings suggest that not all researchers present their research proposals for review by committees, and that some researchers deviate from their approved proposals without seeking approval for those deviations from an REC. Researchers supported monitoring of research by RECs.

Advisory Committees↗
PubMed1991

Innovative bridging program for overseas trained doctors.

Most overseas trained doctors wishing to practise in Australia are required to sit for examinations set by the Australian Medical Council (AMC) before they can seek registration through State medical boards. In 1989, the South Western Sydney Area Health Service, which is responsible for the delivery of health services to 650,000 people, initiated a bridging program with the joint aim of providing overseas trained doctors with the opportunity to undertake a comprehensive program of study and facilitating the recruitment of doctors into the area. The program comprises two integrated components, each extending over five months. Stage 1 relates to the AMC's multiple choice questionnaire (MCQ) examination; stage 2 prepares candidates for the clinical examination. In addition, provision is made for developing awareness of professional responsibility, standards and ethical bases for the practice of medicine in Australia. Participants are also required to study English and communication skills throughout the program. Acceptance into the program is based on a number of criteria including successful completion of a screening test and an interview. Progression to the Clinical Course requires that candidates pass the MCQ Course and undertake to work in the area. The program has been funded jointly by State and Commonwealth Government bodies. Results obtained by program participants in the MCQ and clinical examinations conducted by the AMC have been well ahead of the national average.

Australia↗
PubMed1991

Visual acuity and contrast sensitivity in relation to falls in an elderly population.

Visual acuity and contrast sensitivity were measured in 95 residents of a hostel for the aged (mean age = 83 years) using a dual-contrast letter chart and the Melbourne Edge Test (MET). Vision (as measured by visual acuity, the MET, low-contrast visual acuity, and difference between high- and low-contrast acuity) decreased significantly with age and all four measures were significantly correlated. Subjects with a clinical eye disorder had poorer vision than those without a disorder although the differences were not significant. Visual acuity and contrast sensitivity were not associated with body sway when subjects were standing on a firm base. However, when the subjects were placed in a situation which provided reduced support (standing on a compliant surface), body sway was associated with poor visual acuity and contrast sensitivity. There was also a difference in contrast sensitivity between those who fell one or more times in a year of follow-up and those who did not fall. It appears that reduced vision may be a predisposing factor to postural imbalance and falls in elderly persons.

Accidental Falls↗
PubMed1991

Postural stability and associated physiological factors in a population of aged persons.

A battery of 13 visual, vestibular, sensorimotor, and balance tests was administered to 95 elderly persons (mean age 82.7 years) to examine the relationships between specific sensorimotor functions and measures of postural stability. When subjects stood on a firm surface, increased body sway was associated with poor tactile sensitivity and poor joint position sense. When subjects stood on a compliant surface (which reduced peripheral sensation) with their eyes open, increased body sway was associated with poor visual acuity and contrast sensitivity, reduced vibration sense, and decreased ankle dorsiflexion strength as well as reduced joint position sense. Increased body sway with eyes closed on the compliant surface was associated with poor tactile sensation, reduced quadriceps and ankle dorsiflexion strength, and increased reaction time. Poor performance in two clinical measures of postural stability was associated with reduced sensation in the lower limbs as measured by joint position sense, tactile sensitivity and vibration sense, reduced quadriceps and ankle dorsiflexion strength, and slow reaction times. The prevalence of vestibular impairments was high in this group, but vestibular function was not significantly associated with sway under any of the test conditions. The results suggest that reduced sensation, muscle weakness in the legs, and increased reaction time are all important factors associated with postural instability. An analysis of the percentage increases in sway under conditions where visual and peripheral sensation systems are removed or diminished, compared with sway under optimal conditions, indicated that peripheral sensation is the most important sensory system in the maintenance of static postural stability.

Aged↗
PubMed1991

Physiological factors associated with falls in an elderly population.

OBJECTIVE: To determine whether a battery of 13 sensorimotor, vestibular, and visual tests discriminates between elderly fallers and elderly non-fallers. DESIGN: One-year prospective study. SETTING: Conducted at a 124-bed Hostel for Aged Persons, in Sydney, Australia. PARTICIPANTS: Ninety-five persons aged between 59 and 97 years (mean age 82.7 years) took part in the study. Of the 29 non-participants, four were ill, five were absent (on holidays, etc), and 20 declined. Residents were generally independent in activities of daily living although personal care assistance was available. RESULTS: Eighty-four participants were available for follow-up. In the follow-up year, 40 subjects experienced no falls, 11 subjects fell one time only, 33 residents fell on two or more occasions. There was a total of 145 falls. Discriminant function analysis identified proprioception in the lower limbs visual contrast sensitivity, ankle dorsiflexion strength, reaction time, and sway with the eyes closed as the variables that significantly discriminated between subjects who experienced multiple falls and subjects who experienced no falls or one fall only. This procedure correctly classified 79% of subjects into multiple faller or non-multiple faller groups. Quadriceps strength was poorer in the multiple fallers compared with the non-fallers and once-only fallers, although the difference was not statistically significant. There was little difference in the mean scores for the tests of vestibular function in the non-fallers, once-only fallers, and multiple fallers. CONCLUSION: It appears that this approach highlights some key physiological factors that predispose elderly individuals to falls.

Accidental Falls↗
PubMed1990

Reviewing the reviewers: a survey of institutional ethics committees in Australia.

Completed questionnaires were received from 89 (88%) of the 101 Australian institutions identified as having an ethics committee which reviewed research on human subjects. The majority (75%) of committees complied with national requirements to include a layman, a laywoman, a minister of religion, a lawyer and a medical graduate with research experience in their membership. On average, the committees considered 41 research protocols in the year from mid 1987 to mid 1988. The proposed projects were from the medical sciences, including health services and epidemiology research (80% of projects), and the behavioural and social sciences (20% of projects). Less than half the committees monitored research projects in progress as a general practice. Most of the monitoring that was conducted was based on a report from the researcher on the progress of the study. Although monitoring, frequency of meetings, selection of committee members, member involvement in the review of their own protocols and provisions for expedited review gave cause for concern, most committees were found to follow the national guide-lines.

Australia↗
PubMed1990

Visual field dependence in elderly fallers and non-fallers.

Two tests of visual field dependence (a measure of reliance upon the spatial framework provided by vision in the perception of the upright)--roll vection and the rod and frame test--were administered to 136 participants aged fifty-nine to ninety-seven years. It was found that the fifty-nine participants who had experienced one or more falls in the past year were significantly more visually field dependent in both tests compared with the seventy-seven participants who had not fallen. Mean error in perception of the true vertical in the rod and frame test was 20.7 degrees for the fallers and 17.2 degrees for the non-fallers. Mean error in perception of the true vertical in the roll vection test was 6.6 degrees for the fallers and 3.6 degrees for the non-fallers. The test of roll vection was the better discriminator between fallers and non-fallers, which may be due in part to less misunderstanding of the required task by the participant. The results suggest that tilted or rolling visual stimuli may be factors leading to postural instability and falls in the elderly. The findings support the claim that greater dependence on visual information shown by fallers may be the result of reduced proprioceptive and vestibular function resulting from increased age and chronic health problems.

Accidental Falls↗
PubMed1989

Older persons' definitions of good health: implications for general practitioners.

General practitioners are the major providers of health-care services for the older population in Australia. Care that is provided for older persons within the general-practice setting remains crisis-orientated. Nevertheless, many of the disabling health problems of older persons neither can be "solved" nor cured. Therefore, the older population is a unique population in which to study what constitutes good health and ways in which good health can be maintained. This article describes the perceptions of a group of older persons about their health. They define good health in a remarkably non-medical way. General practitioners need to take into account this knowledge when considering ways to improve the health of these patients.

Aged↗
PubMed1979

Health status of Seventh-Day Adventists.

A comparison of health status between 779 Seventh-day Adventists, who have a strong commitment to heal-related life styles, and two other groups of people--8363 persons referred by general practitioners and 9825 volunteers--was made. The Seventh-day Adventists showed less impairment of systolic and diastolic blood pressures, of plasma cholesterol and plasma urate concentrations, and of lung ventilatory capacity; and less obesity at most specific ages. With increasing age, the level of breathlessness, reported heart disease, hypertension, and hypertensive and diuretic therapy in this sample approached that of the comparative groups, possibly because of natural attrition of high-risk persons in the latter. Depression, sleeplessness, use of sedatives and tranquillizers were lower in the Seventh-day Adventists; although, once again, a drawing together of the three groups in older age categories was evident. It is concluded that the life style of Seventh-day Adventists is conducive to lessened morbidity, delayed mortality, and decreased call on health services in comparison with the general population.

Adolescent↗
PubMed1978

Recognizing and helping narcotic addicts in general practice.

It is rare for many general practitioners to be consulted by a narcotic addict. It can be a disturbing experience. Those who practise in urban areas of low socioeconomic status where there is high youth unemployment are more likely to meet addicted young people, but the experiences are uneven, even in this context.

Australia↗
PubMed1977

Health status of a group of narcotic addicts in a methadone treatment programme.

This study, which arose out of a concern for the health status of narcotic addicts already in a treatment programme, has demonstrated that there is a severe level of impairment of general health. A summary of important findings is reported. Narcotic addiction leads to secondary medical morbidity and mortality, but health impairment also follows the gross disorder of living which has its roots in childhood, and early adolescent experience. Successful prevention and rehabilitation needs to be based on this knowledge.

Adult↗