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Biomedical subjects

R Wilkins

Publications and source records attributed to R Wilkins.

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

The health of Canada's immigrants in 1994-95.

The "healthy immigrant effect" observed in other countries also prevails in Canada. Immigrants, especially recent immigrants, are less likely than the Canadian-born population to have chronic conditions or disabilities. The effect is most evident among those from non-European countries, who constitute the majority of recent immigrants to Canada. This article compares the health status, health care utilization, and health-related behaviour of immigrants with the Canadian-born population, and is based on self-reported data from the 1994-95 National Population Health Survey. Health status is examined in terms of chronic conditions, disability and health-related dependency. The indicators of health care utilization are hospitalization, contact with physicians and dentists, and unmet needs for health services. The health-related behaviours analysed are smoking and leisure time physical activity.

Adolescent↗
PubMed1996

Health expectancy by immigrant status, 1986 and 1991.

Analyses based on census data, vital statistics, and data from the Health and Activity Limitation Surveys show that immigrants, especially those from non-European countries, had a longer life expectancy and more years of life free of disability and dependency than did the Canadian-born. But while immigrants were less likely than the Canadian-born to be disabled, they were only slightly less likely to be dependent on others for help with activities of daily living. The reasons for immigrants' longevity and good health are likely related to the "healthy immigrant effect."

Activities of Daily Living↗
PubMed1995

"Is this man your daddy?" suggestibility in children's eyewitness identification of a family member.

Studies of natural language development suggest that overextension of family memberships terms, such as daddy or papa, occurs in children in the second year of life, but rarely persists thereafter. However, in British Courts it is common for the testimony of 3- and even 4-year-olds to be dismissed on the grounds that these children may not be reliably identifying their father or stepfather when they claim that daddy was the perpetrator of abuse. This study examined whether 3-year-olds could be persuaded to confirm that a stranger who was labelled as daddy was their own father. A mock interview with experienced disclosure interviewers was conducted. Five of the 17 children--all from blue-collar families--misidentified a photograph of their own father when an identification question was repeated. Rather than undermining the validity of all preschoolers testimony, it is suggested that the responses of some children to apparently mundane questions of fact are influenced by contextual factors, including repetition of the question and the perceived omniscience of the interviewer.

Child Abuse↗
PubMed1995

Percutaneous endovascular covered stenting of a distal superficial femoral artery occlusion.

Peripheral vascular disease is a common problem in the elderly population. This is commonly treated nowadays by percutaneous transluminal angioplasty (PTA). When PTA is used in the treatment of superficial femoral artery (SFA) occlusions 35% reocclude within 1 year. Endovascular stents (uncovered) have been used to try to overcome this problem; however, results have been disappointing with reocclusion rates similar to PTA. In order to try to reduce this problem covered endovascular stents have been developed. We report the first known case in the UK of one of these stents being used in the treatment of SFA disease.

Aged↗
PubMed1994

Maternal demographic characteristics and rates of low birth weight in Canada, 1961 to 1990.

Vital statistics on live births were used to examine trends in the demographic characteristics of mothers and rates of low birth weight (LBW) (under 2,500 grams) among children born to residents of Canada (excluding Newfoundland) from 1961 to 1990. The total number of live births with known birth weight declined from 458,000 in 1961 to 397,000 in 1990 (-13%). Over those three decades, the number of LBW infants dropped from 33,100 to 22,000 (-34%), and the proportion of live births accounted for by LBW infants (LBW rate) fell from 7.2% in 1961 to 5.5% in 1990 (-24%). An infant's birth weight is related to the mother's health and socio-economic environment. In urban Canada, the LBW rate was about 1.4 times higher in the lowest income neighbourhoods than in the highest. It was also higher among unmarried mothers than their married counterparts (7.3% vs. 5.0% in 1990), and greater among teenage mothers than those aged 20 to 34 (6.7% vs. 5.4% in 1990). The LBW rate was higher among first-borns than second children (6.0% vs. 4.9% in 1990). From 1961 to 1990, the proportion of births occurring outside marriage rose (especially in Quebec), as did the proportion of mothers of "parity 1" (those giving birth to their first child). Conversely, the proportion of births to teenage mothers declined. The LBW rate generally dropped across all maternal demographic characteristics examined, and in every region, over the period studied. The strongest decline was among unmarried mothers (from 11.3% in 1961 to 7.3% in 1990). By region, Quebec had consistently higher LBW rates than the other three regions. However, Quebec's LBW rate declined dramatically between 1961 and 1990, especially among unmarried mothers (from 13.8% to 7.5%). The LBW rate, standardized to the 1961 distribution of maternal age, parity and marital status, declined from 7.2% in 1961 to 5.1% in 1990 (-29%). By 1990, Quebec's standardized LBW rate (5.2%) was very close to the Canadian average (5.1%), while the Maritimes had the highest standardized LBW rate (5.3%). Thus, after standardization there was an almost complete reversal of the regional ranking which had prevailed in 1961.

Adolescent↗
PubMed1994

Magnetic resonance imaging visualization of hemorrhage into a suprapatellar pouch in a child with hemophilia.

PURPOSE: Magnetic resonance imaging (MRI) was used for evaluation of refractory joint swelling in a 7-year-old boy with hemophilia. PATIENT AND METHODS: This patient with no evidence of an inhibitory had refractory left knee swelling despite receiving appropriate factor VIII concentrate infusions. RESULTS: A plain radiograph showed soft tissue swelling and a calcification in the left suprapatellar region. On MRI a discrete suprapatellar pouch could be detected and was subsequently surgically resected. CONCLUSION: We believe that MRI should be considered when evaluating children with hemophilia who have refractory joint swelling and no evidence of an inhibitor.

Child↗
PubMed1993

Sex and drugs and nuclear war: secular, developmental and type A influences upon adolescents' fears of the nuclear threat, AIDS and drug addiction.

Researchers are divided over the significance of teenagers' expressed fear of nuclear war. This study of 3556 secondary school pupils examined whether (1) fear of nuclear war remains a feature of adolescent concern during the current east-west détente; (2) the examination of responses in a large sample reveals age and sex differences in such expressed fears; (3) worry about 'real world' issues like nuclear war, AIDS and drug addiction relates more generally to Type A proneness in adolescents. The results suggest that fewer teenagers spontaneously raise fear of nuclear war than in previous "pre-Glasnost" research in Britain, that such concern is expressed differentially according to the child's age and sex and that secondary school pupils who express concern about nuclear war and AIDS are more likely to show significantly higher Type A identification.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Delusions in children and teenagers admitted to Bethlem Royal Hospital in the 19th century.

The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital ('Bedlam') in the 19th century were analysed with particular reference to the frequency and types of delusions. Delusions were present in 700 (65%), among whom there were significantly more boys than girls. There was a statistically significant rise in the frequency of delusions from 1830 to the end of the century. Sixty-six per cent of the patients were discharged cured and, taken overall, the presence of delusions did not affect the prognosis: specifically, delusions did not worsen the prognosis in those diagnosed as suffering from mania or melancholia. Nevertheless, the prognosis was worse in boys with single paranoid delusions, or paranoid delusions in combination with auditory hallucinations of people, and worse for girls with delusions of exaltation in combination with other types of delusions.

Adolescent↗
PubMed1993

Use of postal codes and addresses in the analysis of health data.

This article describes various ways of using postal codes and addresses to analyze health data. It gives examples of files that contain data suitable for coding to small areas, explains how the coding can be done efficiently using the Postal Code Conversion File (PCCF), and shows various ways of analyzing the resulting data. It also points out limitations of the data and methods, and suggests ways of avoiding or working around some of the problems frequently encountered. Examples are given of several types of analytical studies based on data coded to local area through use of postal codes and addresses. Examples are also given of simpler types of analysis not requiring recourse to the PCCF, which are based on only the first three characters of the postal code.

Abstracting and Indexing↗
PubMed1993

How far is it to the nearest hospital? Calculating distances using the Statistics Canada Postal Code Conversion File.

This report demonstrates how to calculate distances between points described in terms of latitude and longitude, using the Postal Code Conversion File (PCCF) and other files available from the Geography Division of Statistics Canada. Examples based on hospital data show how the results can be summarized in the form of tables, figures, or maps. Aerial distance to the nearest hospital is a crude but objective indicator of geographic accessibility to hospital services. Distances were calculated between enumeration area centroids for the population and blockface or enumeration area centroids for the hospitals. The median aerial distance to the nearest hospital facility in Canada was less than 3 km, while the mean distance was about 6 km. For teaching hospitals, the median aerial distance was a little less than 30 km, while the mean distance was a little more than 90 km. As most health files for administrative and research purposes contain postal codes, these techniques have potentially wide application.

Abstracting and Indexing↗
PubMed1993

Birth weight percentiles by gestational age in Canada.

OBJECTIVE: To develop current birth weight norms by gestational age for singleton and twin births in Canada. METHODS: Birth weight data were obtained from vital statistics and health department birth registrations for over one million live births in Canada from 1986-1988. Unlikely combinations of birth weight and gestational age were defined within each stratum of multiplicity, gender, and gestational age as records with birth weights more than two interquartile ranges above the 75th percentile or below the 25th percentile. Birth weight percentiles (from first to 99th) by gestational age and sex were calculated for singleton and twin live births. RESULTS: Of the total records, 0.4% were missing data on birth weight or gestational age, and an additional 0.4% were identified as extreme outliers and were excluded from the analysis. Charts of birth weight by gestational age show percentiles 1, 3, 5, 10, 25, 50, 75, 90, 95, 97, and 99 by sex for singleton and twin live births. CONCLUSIONS: The large data base assembled for this analysis provides current, stable birth weight-gestational age percentiles for classifying newborns from a developed country as small, appropriate, or large for gestational age. Compared with birth weight distributions from the 1970s, these current norms are heavier for full-term infants and the interdecile range for preterm infants is narrower. We recommend that birth weight norms be updated every 5-10 years.

Birth Weight↗
PubMed1991

Wire-guided balloon coloplasty--a new treatment for colorectal strictures?

A new technique for dilatation of colorectal anastomotic strictures--wire-guided balloon coloplasty--is described. It is suitable for high strictures, may be performed without general anaesthetic and is repeatable. It does not require endoscopy and may be used to relieve obstructive symptoms in both benign and malignant strictures so avoiding the need for a defunctioning colostomy.

Aged↗