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S J Williams

Publications and source records attributed to S J Williams.

At least 73 records · Page 4Linked to original sources
PubMed1994

Sport and exercise headache: Part 1. Prevalence among university students.

Sport- and exercise-related headaches have been recognized over the last 20 years, but their prevalence is unknown. A nine-page questionnaire was used to study the prevalence of sports headaches among two contrasting populations of Otago University students: medical students (n = 178) and physical education students (n = 190). Both populations had a similar response rate of approximately 80%. It was found that 35% of respondents had experienced sport- and exercise-related headaches among the two populations, with similar rates for men and women seen in both. Comparison of the two populations showed no significant difference in the rate of sports headache among women, whereas the men physical education students has a significantly higher rate of sports headache than the men medical students. A high frequency of trauma-related headaches in contact sports accounted for this higher rate among the men physical education students. This study demonstrated that sport-and exercise-related headaches are a common problem among university students.

Adolescent↗
PubMed1994

Sport and exercise headache: Part 2. Diagnosis and classification.

A group of 129 subjects (67 men and 62 women) experiencing sports headache was established using a questionnaire. A wide range of information was gathered, focusing on the mode of onset, time course, characteristic features and associated symptoms of sports-related headache. Criteria for the varieties of sports headaches were established using head trauma and then migraine to divide subgroups of sports headaches. Cases were classified into four categories: effort migraine, trauma-triggered migraine, effort-exertion headache, and post-traumatic headache. The percentages of each sports-related headache found were: effort migraine 9%, trauma-triggered migraine 6%, effort-exertion headache 60%, post-traumatic headache 22% and miscellaneous 3%. Sports migraine accounted for 15% of the total sports headache sample. Effort-exertion headache was the most common type of sports headache. Although effort-exertion headache could be separated into subjects who had an acute severe headache induced by anaerobic exercise (exertion headache) from those having a substantial headache lasting hours initiated by aerobic exercise (effort headache), most subjects with effort-exertion headache in this study appeared not to fall into any discrete subgroups. Trauma-related headaches were experienced mainly by men in contact sports, while women more commonly had non-trauma-related headache in running and jogging.

Adolescent↗
PubMed1993

Marketing prevention to elderly Medicare beneficiaries enrolled in an HMO. The San Diego Medicare Preventive Health Project.

A comprehensive marketing effort--using direct mail, telemarketing, and orientation seminars--to enroll elderly participants in a Medicare preventive health services demonstration project was undertaken in 1989. Out of the more than 11,000 eligible members in a large Medicare HMO plan in San Diego County, 1,800 (16.2%) agreed to participate. The authors describe the recruiting effort in detail and postulates reasons why the elderly resisted enrolling in the study. These results have important policy implications for the nation's Medicare program and are relevant to promoting other useful health care services in this population.

Aged↗
PubMed1992

Mammography knowledge and intentions among insured women.

UNLABELLED: METHOD. A survey was conducted among 1,113 randomly selected insured state university employees to evaluate knowledge of the American Cancer Society mammography guidelines, awareness of insurance coverage for screening mammograms, previous guideline adherence, and future mammography intentions. RESULTS: The survey, which included two mailings with follow-up phone cells of nonresponders, had a refusal rate of 6%. Respondents were relatively more likely to know the guideline for older age groups; 77% knew the guidelines for women 50+. Over one-third of the responders were not aware that their insurance policy covered screening mammograms. For women who had never had a mammogram, insurance knowledge was significantly related to intentions to have a mammogram in the future. Previous screening adherence, as well as future intentions, was positively related to the age of the respondent. The results are contrasted with those of previous studies, and the implications for the content of future breast cancer screening campaigns are discussed.

Adult↗
PubMed1992

Breast and cervical cancer screening in older women: the San Diego Medicare Preventive Health Project.

BACKGROUND. This study presents rates and correlates of cancer screening, including mammography, clinical breast exam, breast self-examination, and Pap tests, in older women. Age was the predictor of main interest. RESULTS. Among a sample of female Medicare beneficiaries ages 65 and older, who were members of a health maintenance organization, there was a significant, inverse relationship between age and mammography adherence, while controlling for health status, physician utilization, education, and income. The proportions of subjects ages 65-74 and 75+ never having had a mammogram were 17 and 32%, respectively, and the proportions having had annual mammograms were 40 and 28%, respectively. Pap test frequency showed a trend toward an inverse relationship with age, controlling for demographic and health-related variables. In the youngest age group (65-69), 52% had annual Pap tests, whereas in the oldest group (80+), only 36% had annual Pap tests. Age did not predict frequency of clinical breast exam, and the relationship of age to breast self-examination was inconclusive. The role of the physician in promoting cancer screening is discussed.

Age Factors↗
PubMed1992

Compliance with a 12-month assessment in an elderly cohort participating in a preventive intervention study: the San Diego Medicare Preventive Health Project.

Non-compliance in long-term cohort studies contributes to bias in the estimation of study parameters and loss of power in hypothesis testing. This paper identifies baseline factors associated with non-compliance in a 12-month health assessment among elderly participants in the San Diego Medicare Preventive Health Project, a randomized preventive intervention study. A non-complier was defined as a study subject contacted by telephone by study personnel to schedule an appointment for the 12-month health assessment but who would not or could not attend. Of the almost 1600 contacted subjects, 14.1% did not participate in the evaluation. Using logistic regression, non-compliance was found to be associated with older age, intervention group assignment, nonsingle family residence, no alcohol use, and, to a lesser extent, depression. No interactions between group assignment and other baseline factors were detected. These results may be useful in designing cohort maintenance strategies where greater resources may be devoted to participants at higher risk of non-compliance and attrition.

Aged↗
PubMed1992

Prevalence of sleep apnoea in patients over 40 years of age with spinal cord lesions.

Twenty two patients over the age of 40 with stable spinal cord damage underwent overnight sleep studies to investigate the prevalence of sleep apnoea. Ten patients had some evidence of obstructive sleep apnoea (OSA). Hypoxic events were scored as number of dips of SaO2 more than 4% below the preceding 10 minute average (> 4% SaO2 dip rate). All the patients had more than five such dips per hour and six had clearly abnormal dip rates of more than 15 per hour. Two other patients had dip rates above 10 per hour without apnoeas but periods of central hypoventilation mainly during rapid eye movement (REM) sleep. OSA appears to be more common in older patients with spinal cord injury than in the general population. Possible relevant factors include patient selection, reduced ventilatory function secondary to spinal cord damage, sleep posture and medication.

Adult↗
PubMed1991

Gallbladder sepsis after stent insertion for bile duct obstruction: management by percutaneous cholecystostomy.

Of 364 patients undergoing insertion of a biliary endoprosthesis in 1989, six (1.6 per cent) developed gallbladder sepsis. Three patients had cholangiocarcinoma, two had carcinoma of the pancreas and one had a benign biliary stricture. Two of the five patients with malignancy had gallbladder stones, and the patient with a benign stricture developed stones after 3 years of stenting. Three patients developed gallbladder sepsis early after endoprosthesis insertion (less than 6 days), while in the other three it occurred late (greater than 6 months). All six patients failed to respond to antibiotics and were successfully managed by percutaneous cholecystostomy; the patient with a benign biliary stricture also had cholecystolithotomy. The gallbladder drainage tubes were removed or became dislodged at intervals varying from 2 weeks to 6 months without complications. Percutaneous cholecystostomy is the treatment of choice for gallbladder sepsis unresponsive to antibiotics in patients with a biliary endoprosthesis in situ.

Adenoma, Bile Duct↗
PubMed1991

Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings.

This paper describes the results of the first-stage of a study carried out in the spring of 1988 in the South East of England. The study looked at general and specific aspects of consumer satisfaction with general practitioner services, general dental care services and hospital in-patients care. It also examined which specific consumer criteria were the key predictors of overall satisfaction within each of these particular medical care settings. A related aim was to assess the degree of congruence or divergence of consumer criteria across these differing medical care settings. The evidence suggests that whilst general levels of consumer satisfaction are high (i.e. 83-97%), questions of a more detailed and specific nature revealed greater levels of expressed dissatisfaction (e.g. 38% of the sample felt that they could not discuss personal problems with their GP, 51% felt their dentist was not easy to reach at weekends/holidays, whilst 35% felt hospital doctors did not give sufficient information). Whilst different areas of dissatisfaction were found in each specific medical care setting examined, what was particularly striking was the degree of convergence of the key predictors of overall consumer satisfaction across the medical care settings. That is to say, our findings clearly suggest that issues concerning 'professional competence', together with the nature and quality of the patient-professional relationship, are the key predictors of overall consumer satisfaction with general practice, dental and hospital care [e.g. GP giving sufficient information correlated 0.64 (P less than 0.001) with overall GP satisfaction scores; competent dentist 0.52 (P less than 0.001) with overall dental satisfaction scores; and full confidence in hospital doctors 0.49 (P less than 0.001) with overall hospital satisfaction scores]. The theoretical importance and policy implications of these findings, particularly in the light of the recent NHS reforms, are discussed.

Adolescent↗
PubMed1991

Postnatal maturation of spiral ganglion neurons: a horseradish peroxidase study.

Using an in vitro cochlear preparation from postnatal hamsters, spiral ganglion cells (SGCs) were labeled retrogradely following extracellular injections of HRP into the cochlear nerve. In 24 cochleae from hamsters between postnatal days (P) 0 and 10, the neuronal morphology of 201 SGCs and their peripheral axons were analyzed. From P 0 to 3, labeled SGCs had few distinguishable features. Although SGCs could be traced separately to inner hair cells (IHCs) and outer hair cells (OHCs), they all had roughly bipolar-shaped cell bodies. Approximately half of the labeled SGCs had peripheral axons that spiraled some distance before entering radial fiber bundles. From P 3 to 7, SGCs increased in size by nearly 30% and the number of SGCs with spiraling peripheral axons decreased to near zero. At P 10, the central axon diameter to peripheral axon diameter ratios distinguished two populations of SGCs. The hair-cell innervation patterns of SGCs also changed morphologically as a function of postnatal age. At P 0, radial fiber (RF) terminals of peripheral axons contacted as many as 8 IHCs; by P 3, RFs contacted typically one or two IHCs. The terminal portions of peripheral axons contacting OHCs did not show any appreciable spiral until P 2. By P 5, individual outer spiral fibers (OSFs) had greater spiral lengths underneath row-3 OHCs and the number of OHC contacts was also greatest for row-3 OSFs. These data suggest that SGCs undergo a systematic maturational process. Furthermore, the morphological differentiation of SGCs occurs after they have established separate inner and outer hair cell innervations.

Age Factors↗
PubMed1991

Key determinants of consumer satisfaction with general practice.

Consumer satisfaction is an increasingly important issue, both in the evaluation and the shaping of health care, yet the relationship between specific criteria of health care and overall levels of consumer satisfaction with primary care is rarely addressed. The study reported here, based upon the results of a postal questionnaire of a random sample of adults in the south east of England (response rate 62%, n = 454), attempts to address this issue. Whilst general levels of satisfaction were high (95%), questions of a more detailed and specific nature revealed greater levels of dissatisfaction (e.g. 38% felt unable to discuss personal problems with their GP, 26% expressed dissatisfaction with the level of information they received, and 25% were dissatisfied with the length of time spent in consultation). Key dimensions such as communication (0.64; p less than 0.001), the nature and quality of the doctor-patient relationship (0.61; p less than 0.001) and the GP's professional skills (0.58; p less than 0.001)--vis-a-vis issues such as access, availability and type of service provision--were found to be the criteria which were most strongly associated with overall levels of satisfaction with general practice. The policy implications of these findings in the light of the recent Government White Papers, Promoting Better Health and Working for Patients, are discussed.

Adolescent↗
PubMed1991

Thyroxine replacement in post-radioiodine hypothyroidism.

Thyroxine replacement dose in 70 patients with post-radioiodine (for Graves' thyrotoxicosis) hypothyroidism was compared with that in 34 patients with autoimmune hypothyroidism matched for age and sex and diagnosed during the same period. Median replacement dose in the post-radioiodine group (100 micrograms daily) was significantly lower (P = 0.006) than in the autoimmune hypothyroid group (137.5 micrograms daily). Furthermore there was marked variation in the time elapsing from onset of post-radioiodine hypothyroidism to achievement of a given maintenance dose. These findings may be explained by persistence of non-TSH mediated thyroid function, after radioiodine therapy for Graves' thyrotoxicosis. The observations indicate the potential risk of overtreatment with thyroxine in post-radioiodine hypothyroidism unless the dose is carefully titrated against serum TSH levels. Final thyroxine requirements may not be evident in the initial phase of treatment and patients with apparently low maintenance thyroxine requirements require long-term follow up.

Adolescent↗
PubMed1990

Relationship between regional myocardial blood flow and the distribution of 99mTc-sestamibi in the presence of total coronary artery occlusion.

This study was designed to assess the relationship between the distribution of the monocationic 99mTc-hexakis-2-methoxy, 2-methylpropylisonitrile (99mTc-sestamibi) and regional myocardial blood flow (RMBF) in swine. The left anterior descending coronary artery (LAD) was totally occluded and dipyridamole (0.4 mg/kg) was intravenously infused over 4 minutes. 99mTc-sestamibi and 201Tl were coinjected intravenously and a set of microspheres (15 microns) labelled with 113Sn or 55Nb was injected via a left atrial cannula. Animals were put to death at different times after injection of 99mTc-sestamibi/201Tl and the left ventricle was sectioned for gamma spectroscopy. Regression analysis of regional myocardial distribution of 99mTc-sestamibi or 201Tl versus microsphere-determined RMBF demonstrated a linear relationship with flow up to 2.5 ml/min/gm. The myocardial uptake for both 99mTc-sestamibi and 201Tl at higher flow levels was shown not to follow a linear relationship to microsphere-determined RMBF. The first-pass myocardial extraction fractions (%EF) of 99mTc-sestamibi and 201Tl in dogs were 65.5 +/- 2.5% and 82 +/- 3%, respectively (p less than 0.001), at resting flow. At flow levels above the resting flow, a significant decrease in the first-pass extraction fraction for both tracers was shown. At hyperemic flow levels (two to three times the resting flow), the %EF for both tracers are not significantly different. These data provide a basic validation for the utility of 99mTc-sestamibi as a reliable myocardial perfusion imaging agent.

Animals↗