Biomedical subjects
Publications and source records attributed to M K Walker.
The Stroop test was adapted to assess disruption to processing of body-shape stimuli. Women are usually considered to be more concerned with personal body-shape and weight issues than men. This analysis yielded no differences between men and women when processing body-shapes and weight stimuli.
The Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) is a psychometrically sound self-report instrument for assessing women's attitudes towards their own bodies. The BAQ responses of a large sample of patients with eating disorders (ED) diagnosed in accordance with DSM-III-R criteria were compared with those from a normative population and from diverse groups of psychiatrically and physically ill patients. The ED group was distinct, and showed extreme responses in the area of weight and shape concerns. But a better discrimination between the ED and other populations was achieved using subscales that related to 'body disparagement' (an intense loathing of the body) and 'attractiveness', rather than to weight and shape concerns. ED patients may have a more pervasive disturbance in body-related attitudes than is currently widely accepted. Patients with anorexia and bulimia nervosa showed very similar attitudes despite the symptomatic differences between the groups.
Aging is a complex, normal, and inevitable process affecting all living things. The physiologic changes of aging, by definition, are postmaturational, occurring after adult maturity is achieved. Changes with aging are primary, irreversible, and progressive. While the processes of aging are neither pathology nor disease, they present important changes in structure and function that alter drug disposition, metabolic rate, and excretion. These changes present special challenges to clinicians in critical care settings for whom pharmacotherapy is a common treatment modality. This article explores the physiologic changes associated with aging and the implications of these changes for management of critically compromised elders. Drug metabolism, distribution, utilization, and excretion in older adults are examined.
A measure has been developed which assesses a broad range of attitudes which women hold towards their bodies. The Ben-Tovim Walker Body Attitudes Questionnaire (BAQ) is a 44-item self-report questionnaire whose subscales encompass six distinct aspects of body experience (feelings of overall fatness, self-disparagement, strength, salience of weight, feelings of attractiveness and consciousness of lower body fat). The development of the BAQ involved administering increasingly refined versions to a wide range of female respondents. The final version appears to have satisfactory psychometric properties. When the BAQ scores of 29 patients with anorexia nervosa were compared with those of a large community sample, a more complex pattern of deviant attitudes appeared than would previously have been suspected. The BAQ appears to have potential as a research instrument in this and other fields in which the measurement of attitudes towards the body is important.
The body-related attitudes of female current, ex, and never-smokers were compared using a new questionnaire that assesses a wide range of attitudes towards the body. In a population survey, current smokers felt less attractive than those women who had never smoked, but they did not experience themselves as being less strong and fit than the non-smokers. There were no significant inter-relationships of smoking status, attitudes and body weight. The implications of these observations for anti-smoking campaigns are briefly discussed.
In a double blind, crossover study of the response of autistic subjects to fenfluramine, event-related potentials (ERPs) were recorded from 7 subjects on an attention-demanding auditory choice reaction time task (ACRT). ACRT, IQ and biochemical measures were taken after 5 months placebo and 5 months fenfluramine treatment. After fenfluramine treatment blood serotonin levels fell, urinary catecholamine levels fell and the HVA/DA ratio rose. IQ and ACRT performance improved. On the ACRT subjects were asked to press a button to a rare target (500 Hz, P = 0.14) and to ignore higher pitched rare (2,000 Hz, P = 0.14) and frequent non-targets (1,000 Hz). After fenfluramine treatment N1 latencies increased. The scalp distribution of ERP maxima changes slightly with treatment. P3 maxima elicited by rare non-targets were recorded more rostrally after fenfluramine treatment. After rare non-targets N1 amplitudes at Fz decreased but P3 amplitudes at Pz increased. Early negativity after the rare non-target (particularly on the right side) was negatively correlated with the HVA/DA ratio. Subtraction of the P3 component elicited in a passive condition where no response was required from the active condition showed that P3 positivity to targets was halved with treatment. (In contrast Nd increased on fenfluramine treatment). Overall, N1 and P3 components showed greatest responsiveness to rare non-targets on fenfluramine. N1 but not P3 changes may represent slight improvement of attention-related function with treatment. Small changes in ERP latency and distribution, associated with the neuroleptic action of fenfluramine may be partly responsible for a mild improvement of IQ and ACRT performance on medication.
Anorexia Nervosa (A.N.) is a relatively common eating disorder with well recognised psychological and physiological features. A study of 14 female patients with A.N. revealed a number of dermatological disorders, including lanugo hair, xeroderma and hyperpigmentation. Laboratory investigations revealed various abnormalities including elevated Beta-carotene levels, abnormal sex hormone and thyroid function. An unusual finding was the development of acne in a small subset of patients at the time of weight gain, during recovery from A.N. Anorexia Nervosa represents a useful model for the interaction between eating disorders, endocrine function and the skin.
We report a 12 month double-blind randomized crossover trial of fenfluramine in 20 children with the syndrome of autism. On active drug most of the children lost weight and blood serotonin levels fell by an average of 60%. There was a fall in urinary dopamine (DA) and noradrenaline (NA) levels and increased excretion of homovanillic acid (HVA). Some of the children showed improvement in tests of cognitive and language function, although the results did not achieve overall statistical significance. Event-related brain potentials (ERPs) were obtained in seven subjects on an auditory choice reaction time task. Side effects of the drug included irritability and lethargy. Fenfluramine may have a limited place in the management of some patients with autistic disorder.
This study investigated the effect of mirror feedback on body-width estimation in 66 normal adolescent girls. The presence of the mirror had no substantive effect on their estimating behaviour. The authors argue that the result cast further doubt on width estimation as a valid method for accessing the internalized image of the self.
Fragmentation in care is of primary concern to nurses and other individuals involved in the provision of health services. Currently, fragmentation is related to the changes that have occurred in health delivery systems, increased emphasis on cost containment, the appropriate and effective delivery of nursing care, and the increasing prevalence of chronicity in populations requiring health services. This paper examines the fragmentation of care that results under current health care delivery structures for individuals with the diagnosis of cancer and their families. Transitional care, which the clinical nurse specialist is prepared uniquely to implement, is discussed for its potential to impact positively the elements of care rendered to individuals and families living with the realities of cancer.
The hypothesis that patients with anorexia nervosa exaggerate the perceived size of food was tested. Video recordings of five items of food and four neutral objects of a similar size were made such that the size of each object increased steadily from half to twice its normal size. Each of the nine objects was placed on a ledge inside a dummy television screen next to the video screen, the food items alternating with the neutral objects, and 20 female patients with anorexia nervosa and 20 female controls matched for age were asked to adjust the size of the video recording to that of the real object. Although there was no overall difference in perceptual accuracy between patients and controls, both groups perceived the food items as being bigger than the neutral objects, the patients exaggerating the size of the food significantly more than the controls. These results imply that patients with anorexia might start eating more easily when admitted if their food were presented as small portions on large plates.
Event-related potentials (ERPs) were recorded from midline (Fz, Cz, Pz) and lateral sites (F3, F4, P3, P4) in autistic children (n = 7) and age-matched controls (n = 9) on an auditory choice reaction time task. Subjects were asked to press a button to an infrequent target (500 Hz, P = 0.14) and to ignore higher pitched infrequent (2000 Hz, P = 0.14) and frequent (1000 Hz) non-targets. Autistic subjects made twice as many errors of omission as controls and showed a higher criterion (beta) for targets. Maximum ERP peak amplitudes showed a more varied scalp distribution in the autistic group. N1 latencies were consistently shorter in the autistic group and in 3 subjects the target P3 latencies were markedly longer than for the controls. Compared to controls, the N1 amplitude of the autistic response was larger to the rare stimuli (particularly to non-targets). The amplitude of the P3 component was smaller in the autistic group (particularly to the target). The stimuli were also presented in a passive condition requiring no response. After subtraction of the waveform obtained in the passive condition from that obtained in the active condition or subtraction of the waveform elicited by the rare non-target from that elicited by the target, N1 target amplitude was larger in control than in autistic children. Autistic subjects showed more early negativity to the rare non-target at left frontal and a larger P3 to the target at right parietal sites. ERPs of autistic children are more responsive to stimulus features (e.g. high/rare non-target tone) and less responsive to their associations or meaningfulness (e.g. target P3). Attention-related ERPs of autistic children show signs of precocious (right dominance for P3) and delayed development (P3 not maximal at parietal sites).
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Fifty right-handed females thought about answer to verbal and spatial reasoning questions asked by a questioner seated either in front of or behind them. Ss in the questioner-in-front condition predominantly exhibited left lateral eye movements regardless of the question type, while the lateral eye movements of the questioner-in back Ss showed no directional trend in response to either question type. S's self-reported anxiety was not associated with lateral eye movements in either questioner-location condition.
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Toxic shock syndrome (TSS) is a recently recognized condition associated with toxin-producing strains of Staphylococcus aureus. Patients affected with this syndrome are frequently young and have multisystemic complaints such as fever, headache, edema, myalgia, scarlatiniform rash, conjunctival injection, confusion, diarrhea, oliguria, hypotension and shock, This is followed by desquamation of the skin, especially the palms and soles. The majority of cases reported have been in menstruating women who used vaginal tampons regularly. Because similarities exist between toxic shock syndrome and Kawasaki's disease (mucocutaneous lymph node syndrome), as well as other conditions, proper diagnosis and management are of the utmost importance.
Fetal sex preferences of pregnant women are based on psychological, physiologic, economic, and sociologic factors. Parental responses to the knowledge of fetal/infant sex range from feticide to preferential treatment of the preferred-sexed child. This study describes the sex preferences, sex beliefs, attempted sex preselection techniques, and desire to know the fetal sex of 243 second-trimester gravidas. Data demonstrated a willingness to disclose sex preferences, with 81% declaring a preference. The majority of women (81%) also wished to know the sex of their child prior to delivery regardless of their acknowledgment of a sex preference. The results of this survey offer implications for research on the phenomena relating to sex preference.
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