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Biomedical subjects

I W Webster

Publications and source records attributed to I W Webster.

At least 37 records · Page 2Linked to original sources

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↗

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↗

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↗

Bridging the gap--health care for the homeless.

In Australia and other countries concern exists about the extent of homelessness. Because we live in a period in which access to adequate shelter is an increasing problem for many persons, we report on the health needs of long-term homeless persons. Little attention was given to their health needs during the International Year of Shelter for the Homeless in 1987.

Adult↗

Sleep-related respiratory disturbance and dementia in elderly females.

Sleep-related respiratory disturbance was studied with a microprocessor-based portable monitoring system in female residents of a retirement village aged greater than or equal to 75 years. Comparisons were made between 29 demented subjects Mini-Mental State Examination Score (MMSE) less than 21 and 48 controls (MMSE greater than 25). Respiratory disturbance index (RDI, the number of episodes of apnea and hypopnea/hour of total sleep time) was higher in the demented subjects: mean RDI (+/- SD) 18.5 +/- 18.6 vs 7.3 +/- 10.8, p = .004. The number of minutes per hour of sleep spent with disturbed breathing was greater in demented subjects than in controls (p = .01). These differences between demented subjects and controls persisted after adjustment for age and relevant medical history. Other possible confounders, namely body mass index and use of sedatives, were not significant. We conclude that respiratory disturbance during sleep is more prevalent in elderly demented females than in controls.

Aged↗

Predicting abstainers in a smoking cessation programme administered by general practitioners.

Pre-treatment characteristics which predicted successful outcome in one hundred cigarette smokers participating in a general practitioner administered smoking cessation programme were identified. Successful outcome was assessed using three types of criteria: quit smoking by the end of treatment, remained abstinent for six months and remained abstinent for three years. Seventeen pre-treatment variables predicted immediate response to treatment, but this decreased to six variables for six months sustained abstinence and to only one variable (smoking when ill in bed) for three years sustained abstinence. Low cigarette dependence, no smoking related health problems, and a non-smoking social environment characterized subjects most likely to have stopped smoking at the end of treatment and to have remained abstinent for six months.

Adolescent↗

An initiative for teaching about alcohol and other drugs in Australian medical schools.

Education in Australian medical schools is presently under review, including teaching about alcohol and other drugs. In August 1986, the Alcohol and Drug Foundation, Australia (ADFA) presented to the Deans of Australasian medical faculties (including those of Fiji, Papua New Guinea, and New Zealand) a number of options to develop the alcohol and other drugs content of medical courses. It was proposed that a coordinator of education in alcohol and other drugs be appointed in medical faculties; this proposal had been modelled on the US Career Teacher Training Program in Alcohol and Drug Abuse. The Deans expressed interest in ADFA's proposal. This paper discusses the role of undergraduate medical education in alcohol and other drugs, and the background to, and some guide-lines from, the ADFA proposal.

Alcoholism↗

Three year evaluation of a programme by general practitioners to help patients to stop smoking.

A controlled study was undertaken to measure the effectiveness of general practitioners' use of an intensive programme to help patients to stop smoking. Two hundred cigarette smokers who attended a general practice were allocated to either a treatment (n = 100) or a non-intervention control (n = 100) group. After the initial visit treatment consisted of an educational consultation and four follow up visits. Smoking state was assessed biochemically at six months and three years. Thirty five patients in the treatment group were abstinent at three years compared with eight in the control group (p less than 0.001). Sixty four patients attended the educational consultation and first follow up visit; of these, 45 were not smoking at the first follow up visit, 30 maintained abstinence up to six months, and 22 were still not smoking after three years. Among the 37 patients who completed the treatment programme and attended all the follow up visits 57% were abstinent at three years. The results of this study suggest that general practitioners can help patients to stop smoking.

Adolescent↗

A smoking cessation programme for use in general practice.

The effectiveness of a smoking intervention programme based in general practice was evaluated at six months by a randomized controlled trial. In the programme, general practitioners achieved a 33% success rate compared with 3% in a control group. Reported abstinence was checked by blood tests for cotinine, carboxyhaemoglobin and thiocyanate. The majority of patients considered that their chances of success were greater if a doctor administered the programme, and that having the results of lung function and blood tests explained in relation to the risks of cardiovascular and respiratory diseases constituted a strong incentive to stop smoking. Two cases illustrating a successful and a failed outcome of the programme are described. If one quarter of general practitioners in Australia adopted this programme in their practice, approximately 150,000 new abstainers could be expected each year.

Adolescent↗

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↗