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Biomedical subjects

R Wilton

Publications and source records attributed to R Wilton.

8 recordsLinked to original sources
PubMed1995

Characteristics of diaphragm muscle fibre types in hibernating squirrels.

Muscle samples from the diaphragms of 7 full-awake (FA), 10 winter-awake (WA), and 8 hibernating (H) squirrels (Spermophilus lateralis) were quick frozen, sectioned and processed for NADH-TR reaction end-product and myofibrillar-ATPase. Both WA and H squirrels showed small increases in diaphragm weight, reductions in body weight, and hence, significant increases in the diaphragm weight to body weight ratio compared to FA squirrels. They also showed increases in muscle fibre type cross-sectional areas and in the oxidative capacity of type 2b fibres as well as a reduction in capillary density. Furthermore, there also was an increase in the proportion of type 2b fibres in the diaphragm of the H squirrels. Thus, despite the dramatically reduced ventilation associated with hibernation, H squirrels exhibited (1) hypertrophy of the diaphragm which may represent an adaptive response that enables them to work against a stiffer chest wall, and (2) an increased oxidative capacity which enables them to fuel this with fat.

Animals↗
PubMed1994

Evaluating the accuracy of transcribed computer-stored immunization data.

OBJECTIVE: To evaluate the accuracy of immunization records transcribed into a computer-based immunization tracking system and to assess factors that contribute to inaccurate or incomplete immunization record keeping. DESIGN: Computer-stored immunization records were analyzed for 2098 children up to 2 years of age at the time of their most recent well-child visit to the UCLA Children's Health Center over a 12-month period. For children whose immunizations were not up to date, the computer-stored records were analyzed for sources of inaccuracy by comparison with the handwritten records from which the computer-stored data were transcribed. RESULTS: An underimmunization rate of 22.5% (472 of 2098) was observed based on analysis of the computer-stored records. Comparison of the computer-stored and handwritten records revealed an overall transcription error rate of at least 10.2%. In addition, 38.4% of these apparently underimmunized children had received unrecorded immunizations from providers outside UCLA. When transcription errors were corrected and other available sources of immunization data were taken into account, the estimated rate of underimmunization decreased from 22.5% to 10.9%. CONCLUSION: Unavoidable inaccuracies can diminish the utility of the data recorded in an immunization tracking system. Some inaccuracies are related to the process of transcription, but failures to record and communicate immunization data consistently also contribute to the inaccuracy of computer-stored immunization records.

Child Health Services↗
PubMed1993

Insurance coverage and residents' experience in a pediatric teaching clinic.

To examine the relationship between insurance coverage and the diagnostic content of residents' experience in a hospital-based pediatric teaching clinic, we analyzed outpatient problem lists for 6543 patients seen in our clinic over a 15-month period. Problem-list contents were categorized using diagnostic clusters. The frequency distribution of clustered problems was compared for patients with four types of insurance coverage: indemnity insurance, health maintenance organization, Medicaid, and no insurance. The four insurance categories differed in the overall distribution of problems, but the differences could not be attributed to a disparity in the frequency of any single diagnosis or diagnostic cluster. We conclude that there was no important effect of insurance coverage on the diagnostic content of residents' experience in a teaching clinic.

Child↗
PubMed1993

Evaluating the accuracy of transcribed clinical data.

This study evaluated the accuracy of data transcribed into a computer-stored record from a handwritten listing of pediatric immunizations. The immunization records of 459 children seen in the UCLA Children's Health Center in March, 1993 were transcribed into a clinical computer system on an ongoing basis. Of these records, 27 (5.9%) were subsequently found to be inaccurate. Reasons for inaccuracy in the transcribed records included incomplete written records, incomplete transcription of written records, and unavailability of immunization records from multiple health-care providers. The utility of a computer-stored clinical record may be adversely affected by unavoidable inaccuracies in transcribed clinical data.

Child↗
PubMed1992

User-specific interfaces for clinical data-management systems: an object-based approach.

Multiple user-specific visual interfaces are desirable in any computer-based clinical data-management system that is used by different people with different jobs to perform. The programming and maintenance problems of supporting multiple user interfaces to a single information system can be addressed by separating user-interface functionality from data-management subsystems, and by building user interfaces from object-based software components whose functionality is bound to an underlying server-client data-management architecture. Experience with this approach in a patient-tracking system suggests that this object-based approach is viable in the design of a user interface for a clinical information system.

Child↗
PubMed1991

Non-categorical problem lists in a primary-care information system.

An ambulatory-care patient-tracking system has been implemented that records non-categorical problem descriptions in the outpatient problem list. The system does not restrict physicians to the use of predefined diagnostic categories. Instead, the system stores patient problems in a database as free-text records. Subsequent diagnostic categorization and coding is accomplished through prompted free-text input and appropriate reference databases. This system design allows an outpatient problem-list summary to reflect non-categorical health-status information in addition to coded medical diagnoses.

Ambulatory Care Information Systems↗