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Biomedical subjects

J Walker

Publications and source records attributed to J Walker.

At least 559 records · Page 31Linked to original sources
PubMedDate not supplied

The behaviour of 3-year-old children who were born preterm.

The behaviour of 3-year-old children born preterm was compared with that of full-term children of the same age. The preterm group were born between 32 and 37 weeks gestation, and weighed between 1500 g and 2500 g at birth, and thus (in comparison to even earlier, lower birthweight babies) comprised a 'low risk' group. The children and their mothers were interviewed at home and information obtained about the following: behaviour, the number of accidents requiring medical attention, language development, maternal mental health and demographic data. The preterm group did not show an excess of behaviour problems overall but they did show significantly more problems when certain individual behaviours were considered, namely sleep related problems, tempers and dependence. The preterm group had also had significantly more accidents. The nature of the behavioural differences suggested they represented styles of parental management rather than neurological impairment in the preterm group. There was no evidence of language delay in either group and no significant association between child behaviour and maternal mental health. This study showed that consideration of socioeconomic factors is important. Children from manual socioeconomic groups showed significantly more behaviour problems than children from non-manual groups, and mothers from manual groups had significantly poorer mental health.

Analysis of Variance↗
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A system to manage records for credentialed providers.

There has been a rapid growth in and evolution of information management to assure appropriate and timely awarding of privileges for credentialed providers. Proprietary software might not meet the needs of a particular facility. In this article, Jackie Walker and William F. Perry describe how, using commercially available database management software, information management can be tailored to the needs of an individual institution and altered as necessary.

Credentialing↗
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A four-year longitudinal investigation of the social skills and behavior problems of students with learning disabilities.

This longitudinal, prospective study investigated the social skills and behavior problems of three groups of students (10 students per group) from kindergarten through third grade: learning disabilities (LD), low achievement (LA), and average/high achievement (A/HA). Social skills and behavior problem rating scales were completed by teachers on all students during kindergarten through third grade. Students in the LD and LA group exhibited significantly lower social skills and higher levels of behavior problems than their A/HA peers, but no significant differences for either measure were found between the LD and LA groups. Scores on the cooperating/responding factor of the social skills rating scale increased over time, but scores on the outgoing/initiating factor of the social skills rating scale did not change significantly over time. Discussion focused on the finding that students in the LD and LA groups did not differ significantly on social skills or behavior problems over time, though both groups demonstrated more behavior problems and lower social skills than the A/HA students.

Child↗
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Factors associated with the detection of Entamoeba histolytica in homosexual men.

In a study of bowel parasites in 128 Australian homosexual men attending a sexually transmitted diseases (STD) clinic, Entamoeba histolytica was detected in 37%, Giardia intestinalis in 3% and at least one protozoan in 81% of the group. There was no evidence of pathogenicity of E. histolytica, nor was there any association between the detection of E. histolytica and sexual practices, gastrointestinal symptoms, proctitis, human immunodeficiency virus antibody result or T-cell subset values. However it was noted that those subjects with an elevated IgM greater than 4 g/l were more likely to harbour E. histolytica trophozoites than those with a level below 4 g/l (OR 6.54, 95% CI 1.3-32.8). Travel to South-East Asia, India, China, Africa, South America or the Pacific islands in the previous 3 years emerged also as an independent factor (OR 2.70, 95% CI 1.12-6.53) associated with detection of E. histolytica.

Adult↗
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Mood assessment in chronic pain patients.

This pilot study was designed to identify the mood state of patients attending two pain clinics in the South of England and to identify the factors which are predictive of mood in patients with chronic pain. Patients were asked to complete a questionnaire which included a short bipolar mood profile, together with verbal rating scales to assess pain and contributory coping variables. The most commonly occurring negative moods were tension, worry and irritability. Lack of information was the best predictor of negative mood. Other variables which were found to be associated with negative mood included lack of sleep, occupation and emotional support, and financial problems.

Adaptation, Psychological↗
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Familial Brown's syndrome.

We present findings in two siblings with bilateral Brown's syndrome and review other reported familial cases.

Child, Preschool↗
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Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support.

CONTEXT: Music has been found to be an effective nonpharmacologic adjunct for managing anxiety and promoting relaxation in limited trials of critically ill patients receiving mechanical ventilation. No data are available to determine the effect of the intervention over repeated trials or to determine whether patients or staff will use music intervention independently. OBJECTIVE: To test the feasibility of a patient-initiated music intervention protocol over a 3-day trial and to discern the associated barriers to adherence by study participants and nursing staff. DESIGN: Descriptive pilot study. SETTING: Two adult critical care units contained in 1 university-affiliated tertiary care center in the urban Midwest. PATIENTS: Five alert, critically ill adults receiving mechanical ventilatory support. INTERVENTION: Patient-selected music listening via audiotapes and head-phones with frequency and length of session determined by each patient. MAIN OUTCOME MEASURES: Anxiety, heart rate, respiratory rate, blood pressure, and identified barriers to protocol adherence. RESULTS: Subjects averaged 2 self-initiated music interventions (mode = 3; range = 1-5) and listened for an average of 67.8 minutes per session (SD 34.3; mode = 50; range = 25-120 minutes). Barriers to this intervention included inaccessibility of the equipment and lack of knowledge and experience of the nursing staff. Due to missing data, physiological measures were not interpretable. CONCLUSIONS: Patient-initiated music is a feasible intervention protocol: subjects were able to request music independently and nursing staff were cooperative. Findings will be used in future studies to refine the protocol and attendant measures to implement music intervention in the critical care setting and to develop detailed staff education materials.

Adult↗
PubMedDate not supplied

Attitudes concerning mouthguard use in 7- to 8-year-old children.

The purpose of this study was to determine the acceptance of 3 types of mouthguards 1) stock, 2) boil and bite, and 3) custom-made by 7-8 year old children playing organized soccer. Three teams volunteered to participate and the type of mouthguard was randomly selected for each team. The children were fitted for the mouthguards and after wearing them, a questionnaire was returned to the investigator. Eighty two percent of the children wearing custom made mouthguards and 87% of the boil and bite ranged from happy to enthusiastic about its use. None of the children provided stock mouthguards reported liking their use. Only 1 child in the custom group failed to wear the appliance during practice and games while the children in the stock group ranged from 20% to all of the time. Ninety five percent of the parents believe that children should wear mouthguards when injuries may occur. However, only 24% of the parents would be willing to pay $25.00 for this protection. It is concluded that mouthguards will be used by children during organized sports activities if they fit.

Athletic Injuries↗
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Taking pains.

Explore the source record for details and available documents.

Acute Disease↗
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Interpreting hospital mortality data. The role of clinical risk adjustment.

This study uses national Medicare data as well as data that were abstracted to calibrate the Medicare Mortality Predictor System to assess the usefulness of a risk adjustment system in interpreting hospital mortality rates. The majority of variation in annual hospital death rates for the four conditions studied (stroke, pneumonia, myocardial infarction, and congestive heart failure) is chance variability that results from the relatively small numbers of patients treated in most hospitals in a year. For hospitals in the highest and lowest quartiles of observed death rates, the difference between observed rates and those predicted by the Medicare Mortality Predictor System is not quite on third smaller than the difference between observed rates and unadjusted national rates. Risk adjustment methods do not show whether the unexplained difference in mortality rates results from differences in effectiveness of care or unmeasured differences in patient risk at the time of admission. Risk-adjusted mortality rates, therefore, should be supplemented by review of the actual care rendered before conclusions are drawn regarding effectiveness of care.

Aged↗