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Biomedical subjects

K Wilkins

Publications and source records attributed to K Wilkins.

At least 37 records · Page 2Linked to original sources
PubMed1996

Traditional vs. flexible programmes: training in family and community medicine.

The aims of this study were to gain an understanding of the concerns of those in control in Canadian Family Medicine, and to gain an understanding of the experiences of trainees in the traditional postgraduate year 2 (PGY-2) and in a flexible PGY-2 at the University of Toronto (U of T) Department of Family and Community Medicine (DFCM) in 1994. Qualitative methodology was used in the study to find out the feelings and experiences of these groups. It was found that national and departmental bodies in Family Medicine are concerned with competency and are open to trying different processes. Trainees in the flexible programme had a strong sense of control according to the study. They identified their educational needs, had confidence in their assessments, and spoke the language of continuous learning. Residency programmes need to be flexible and trainee-centred.

Attitude↗
PubMed1996

Tuberculosis, 1994.

In 1994, a total of 2,074 people in Canada were diagnosed with tuberculosis, a rate of 7.1 cases per 100,000 population. The same year, tuberculosis and its late effects caused 150 deaths-just over one in every 1,400 deaths. Although tuberculosis is no longer a major health problem in Canada or a leading cause of death, some groups are particularly susceptible to the disease: Aboriginal people, residents of low-income households, immigrants, and the elderly. In the first two instances, the occurrence of tuberculosis is associated with poor living conditions. The risk of tuberculosis among immigrants is high because of the greater likelihood of exposure in their countries of origin. Among the elderly, the potential for developing active tuberculosis is relatively high due to exposure decades ago when the disease was far more prevalent. Since 1980, the rate of pulmonary tuberculosis has declined, while the rate of extra-pulmonary tuberculosis has remained steady. As a result, the proportion of cases attributable to extra-pulmonary tuberculosis has risen.

Adult↗
PubMed1996

Chronic conditions, physical limitations and dependency among seniors living in the community.

The majority (75%) of people aged 55 and over who live in the community, as opposed to living in long-term health care institutions, report having at least one chronic condition. However, only about one in six has some physical limitation. As well, one in six men and one in four women who live in the community need help with everyday activities such as housework or meal preparation. With advancing age, the prevalence of most chronic conditions increases, as does the prevalence of physical problems and dependency. The contribution of particular conditions to physical limitations and dependency varies. According to Statistics Canada's 1994-95 National Population Health Survey, the conditions most strongly related to physical limitations and to the need for help with activities of daily living were epilepsy and the effects of stroke, neither of which affected a large percentage of the household population aged 55 and over. By contrast, arthritis/rheumatism, non-arthritic back problems and cataracts, which were also associated with physical limitations and dependency, affected a relatively large percentage of community-dwelling seniors. This article shows the prevalence of specific chronic conditions, physical limitations and dependency among people aged 55 and over living in the community, by sex and age. Logistic regression is used to examine relationships between each chronic condition and the existence of physical limitations and dependency.

Activities of Daily Living↗
PubMed1995

Deaths 1993.

Explore the source record for details and available documents.

Adolescent↗
PubMed1994

Volatile organic compounds from household waste.

Ninety volatile organic compounds were identified in the headspace of biodegradable and mixed household waste by GC/MS. Most of them could be attributed to biological waste, microbiological growth in biological waste or packaging materials. Although none of the compounds were present at concentrations exceeding their threshold limit values, it is possible that in closed garbage cans or containers organic sulfur compounds could contribute to the reported gastrointestinal problems of collection personnel.

Biodegradation, Environmental↗
PubMed1994

Immunogenicity of high-titre AIK-C or Edmonston-Zagreb vaccines in 3.5-month-old infants, and of medium- or high-titre Edmonston-Zagreb vaccine in 6-month-old infants, in Kinshasa, Zaire.

The effect of measles vaccine potency was evaluated among 485 children aged 6 months, and the effect of vaccine strain was evaluated among 538 children aged 3.5 months, in Kinshasa, Zaire. Children aged 6 months were randomly assigned to receive either high-titre Edmonston-Zagreb (EZ-H), potency 5.7 log10/dose, or medium-titre EZ (EZ-M), potency 4.7 log10/dose, those aged 3.5 months were randomly assigned to receive either AIK-C, potency 5.5 log10/dose, or EZ-H, and were revaccinated with EZ-M vaccine at age 9.5 months. Measles antibodies were measured using the plaque reduction neutralization assay. Among children vaccinated at age 6 months, the seroresponse was significantly higher after EZ-H than EZ-M vaccine, with 92 and 83% seroconverting by 6 months postvaccination and 59 and 40% respectively having antibody titres > 200 mIU. Among children vaccinated at age 3.5 months, only 24% (AIK-C) and 22% (EZ-H) attained antibody titres > or = 200 mIU 6 months postvaccination. After revaccination at age 9.5 months, 81% of children in the AIK-C group and 73% in the EZ-H group had antibody levels > 200 mIU (p = 0.056). A retrospective survey was conducted in January 1993 to determine the mortality experience of vaccine groups, and information was obtained for 94% of the children. A total of 44 deaths (4%) were identified, with no significant differences between groups when stratified by age at vaccination.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1994

Measles control in Kinshasa, Zaire improved with high coverage and use of medium titre Edmonston Zagreb vaccine at age 6 months.

BACKGROUND: To improve measles control in Kinshasa, Zaire, a project to increase vaccine coverage was begun in 1988, and in 1989, the city vaccination programme changed measles vaccination policy from Schwartz vaccine at age 9 months to medium titre Edmonston Zagreb (EZ) vaccine at age 6 months. We report the impact of the programme on measles incidence and mortality. METHODS: Data on vaccine coverage were obtained from cluster sample surveys conducted every 1-2 years and from routine reports of vaccine doses administered. Data on measles incidence and mortality were obtained from sentinel surveillance sites. The serological response to EZ measles vaccine was evaluated at a health centre in 1989 and in a community survey in 1990. RESULTS: Measles vaccine coverage estimated in cluster surveys increased from 50% of the 1984 birth cohort to 89% of the 1989 birth cohort, accepting either a home-based record or a verbal history of vaccination. Reported measles incidence per 10,000 [corrected] population decreased by over 90%, from 37.5 in 1980 (early vaccination years) to 1.6 in 1991. There was a relative decrease in the proportion of cases aged < 9 months (32% of cases in 1986-1987 and 23% of cases in 1990-1991) and an increase in the proportion aged > 23 months (29% of cases in 1986-1987 and 43% in 1990-1991). According to ELISA assays, 74-76% of children seroresponded to EZ vaccine administered at age 6-7 months under routine programme conditions. CONCLUSIONS: Measles can be controlled in urban areas, although it is difficult to determine how great a contribution vaccination at age 6 months makes over and above the achievement of high coverage.

Antibodies, Viral↗
PubMed1994

Rehabilitation for convicted drinking drivers (second offenders): effects on mortality.

The mortality experience of convicted drinking drivers (second offenders) (N = 347) randomly assigned to rehabilitation and control groups in two Ontario cities was examined. Over a follow-up period ranging between 8 and 13 years, 14 (11.0%) of the controls and 17 (7.7%) of the rehabilitation group died. Direct comparisons of the randomly assigned control and treatment groups revealed a tendency for lower total mortality and significantly lower mortality from accidental and violent death in those assigned to rehabilitation. Additional comparisons involving a combined rehabilitation group (N = 487) (rehabilitation participants randomly and not randomly assigned) confirmed these observations.

Accidents, Traffic↗
PubMed1994

Non-Hodgkin's lymphoma and agricultural practices in the prairie provinces of Canada.

OBJECTIVES: The aim of this study was to provide an update of a cohort study (1971-1985) that previously reported a significant trend in the risk of non-Hodgkin's lymphoma among male Saskatchewan farm operators according to fuel-oil expenditures and herbicide spraying for farms less than 1000 acres (2570 hectares) by including two additional Canadian prairie provinces, two additional years of follow-up, and data from the 1981 Census of Agriculture. METHODS: Information on farmers from 1971 records of the Census of Agriculture was linked to 1971 records of the Census of Population, to 1981 records of the Census of Agriculture, and to death records. Poisson regression was used to estimate risks according to herbicide spraying and fuel and oil expenditures. RESULTS: The addition of a further two years of follow-up resulted in lower risk estimates associated with herbicide spraying for Saskatchewan. No excess risk was observed between herbicide spraying and non-Hodgkin's lymphoma for Alberta or Manitoba in the 1971 data. However, a significantly increased risk of non-Hodgkin's lymphoma according to acres sprayed with herbicides was observed for the three provinces combined when the herbicide spraying data from the 1981 Census of Agriculture was used [> or = 380 acres (> or = 939 hectares) sprayed, rate ratio 2.11, 95% confidence interval 1.1-3.9]. CONCLUSIONS: Although the current results are not entirely consistent with the original Saskatchewan analysis, they support the overall finding of an association between herbicides and risk of fatal non-Hodgkins lymphoma. Prospective cohort studies are needed to overcome the limitations of existing epidemiologic studies.

Adult↗
PubMed1994

Summary report of the workshop on data for monitoring tobacco use.

Health Canada convened a workshop in Ottawa in March 1994 in order to consider existing measures of tobacco use in Canada and to develop consensus on a standard set of measures for monitoring tobacco use in the future. The impetus for the workshop was the growing awareness of inconsistencies in definition and approach that have arisen over many years of monitoring, and a concern that future efforts to control tobacco use could be hampered by inadequate data. This report proposes standard definitions of key terms, identifies core topics, briefly discusses major data quality issues and offers a set of survey questions to monitor the elements of tobacco use.

Canada↗
PubMed1993

Trends in rates of admission to hospital and death from asthma among children and young adults in Canada during the 1980s.

OBJECTIVE: To update reports of increases in the rates of admission to hospital and death from asthma among children and young adults in Canada during the 1970s by examining data for the 1980s. DESIGN: Age-standardized rates were calculated from data for people less than 35 years of age at the time of death from asthma, bronchitis or other respiratory conditions (from 1980 through 1989) and at the time of admission to hospital for treatment of these diseases (from 1980 through 1988). Standardized mortality ratios were calculated with the death rate for Canada as the expected rate. SETTING: Data for all of Canada were examined by sex, age group and province. RESULTS: In contrast to sharp increases in the rate of death from asthma observed from 1970 through the early 1980s among Canadians less than 35 years of age, the rate showed no net change between 1980 and 1989; on average, there were 58 deaths in this age group annually. During the decade, the rates of death from asthma were three times higher in Saskatchewan and Alberta than in Newfoundland. The national rate of hospital admission/separation for asthma, however, increased greatly, though changes in the rate varied by province. Increases of over 90% were observed in Prince Edward Island and New Brunswick, whereas little overall change occurred in Newfoundland, Manitoba and Saskatchewan. The rate of hospital admission/separation for asthma was highest in Prince Edward Island and lowest in Manitoba and British Columbia. Although the rates of hospital admission/separation for asthma among boys aged less than 15 years of age were consistently 50% higher than those among girls of that age, the rate among people aged 15 through 34 years was twice as high among females as males. A slight decrease in the rates of death from respiratory conditions other than asthma was observed, together with a steady, fairly substantial decline in the rates of hospital admission/separation for these conditions. CONCLUSIONS: Whether there is any relation between increases in rates of admission to hospital for asthma and trends in the rates of death from asthma during the decade will require further study.

Adolescent↗
PubMed1993

Multiple myeloma mortality and agricultural practices in the Prairie provinces of Canada.

A cohort study of agricultural practices and the mortality experience (1971 to 1987) of male farmers in Manitoba, Saskatchewan, and Alberta has been conducted. The census records of 156, 242 male farmers identified on the 1971 Census of Agriculture and the corresponding Census of Population were linked to mortality records through 1987. We observed associations between multiple myeloma mortality and fuel/oil expenditures (relative risk for top quartile of exposure = 1.69, 95% confidence interval = 1.08 to 2.65). No significant associations were found between multiple myeloma and herbicide use or with selected sociodemographic variables.

Adult↗
PubMed1993

Mortality in a sample of convicted drinking drivers.

Mortality rates for 639 drinking drivers were calculated. The sample consisted of all individuals convicted of a second offence in two Ontario cities (Oshawa and North Bay) between 1973 and late 1978. There were 53 deaths (51 males, 2 females) in the sample prior to the end of 1986. Among males, significant excess total mortality was observed (Standardized Mortality Ratio = 1.7); similar trends were observed among females. Age-related excess mortality and excess mortality by cause were strikingly similar to mortality patterns observed among alcoholics.

Accidents, Traffic↗
PubMed1992

Herbicides and cancer.

Herbicides are a heterogeneous class of chemicals used in agriculture, forestry, and urban settings to kill weeds, shrubs, and broad-leaved trees. The role of herbicides in the etiology of cancer is controversial. Potential studies for review were identified through a MEDLINE search and from a check of references in related review articles. This review of the literature shows reasonable evidence suggesting that occupational exposure to phenoxy herbicides results in increased risk of developing non-Hodgkin's lymphoma. Several studies have noted large increases in risk of soft-tissue sarcomas with phenoxy herbicide exposure. In contrast, others have failed to observe increased risks, and evidence of an exposure-risk relationship is lacking. Although there have been too few appropriate studies for adequate assessment of risk of cancer at other sites, some findings have linked herbicide exposure with cancers of the colon, lung, nose, prostate, and ovary as well as to leukemia and multiple myeloma. Future studies must better identify and quantify the nature of herbicide exposures. In the interim, it seems only prudent to monitor and promote safety practices among persons occupationally exposed to phenoxy herbicides, particularly farmers and professional sprayers.

Animals↗
PubMed1992

Selective posterior rhizotomy to treat spasticity associated with cerebral palsy: a critical review.

Selective posterior rhizotomy for the treatment of spasticity has become a widely used procedure. The historical evolution of this procedure is reviewed with an emphasis on the physiological basis for the procedure. The proper screening and selection criteria, perioperative management, operative technique, and postoperative therapy are discussed. Results from a series of 25 patients are reviewed. Ten of these patients were operated on for a goal of improved ease in caretaking and this was achieved. In seven patients, the goal was to improve independent functioning (ambulation was not considered possible) and this was achieved. Eight patients underwent the procedure to improve ambulation and this was achieved.

Cerebral Palsy↗