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Biomedical subjects

S J Williams

Publications and source records attributed to S J Williams.

156 records · Page 9Linked to original sources
PubMedDate not supplied

'Breathtaking': the consequences of chronic respiratory disorder.

Chronic obstructive airways disease (COAD) is a major, though neglected, medical and social problem in the United Kingdom today. Dyspnoea is one of the most distressing and disabling symptoms of COAD, which is itself the largest single cause of absence from work in the United Kingdom. This paper reports on 92 patients suffering from COAD, who were interviewed in order to assess impairment, disability and handicap, and a smaller subsample of 24 of these patients who were followed-up using open-ended, semi-structured, tape-recorded interviews in order to cover in more detail some of the issues raised in the first quantitative stage of the study. Low correlations were found between lung function and disability (-0.38 p less than 0.001), accounting for only 14% of the variance, and high correlations between measures of dyspnoea and disability (-0.90 p less than 0.001). Major areas of disability and handicap included: household management, ambulation, sleep and rest, recreation and pastimes, and work. Financial problems and difficulties, housing problems and problems of social isolation were also frequently reported. The paper then attempts to explore the relationship between impairment, disability and handicap, drawing on both the quantitative and qualitative data collected in order to illustrate the variable nature of this relationship. The paper concludes by suggesting both the need for a more integrated approach to the care and rehabilitation of COAD patients and their families, and for a complementary social perspective and approach to COAD and its treatment.

Activities of Daily Living↗
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Assessing the consequences of chronic respiratory disease: a critical review.

This paper offers an overview of problems involved in assessing respiratory disablement. Health status and quality of life research have become of increasing importance but critical gaps remain, especially in relation to the multidimensional consequences of chronic obstructive airways disease (COAD). It is argued that much existing psychosocial research has been long on the 'psycho' and short on the wider social consequences and dimensions of respiratory disablement. Many general measures of quality of life and disability are not well suited to assessment of these problems. There is a need to supplement general instruments with more disease-specific measures--many for breathlessness, the most disabling symptom of COAD, have been crude and insensitive. There is also a need to augment predominantly quantitative techniques with qualitative data derived from patients' and carers' perspectives. Wider implications of disability assessment at the welfare policy level are discussed, and the paper concludes by suggesting future research areas on respiratory disablement.

Activities of Daily Living↗
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HealthLine--marketing and public education wrapped up in one.

A service which can promote both marketing and public education is especially useful in these highly competitive times, writes Bridget Larsen Wright, M.P.H., et al. HealthLine, an information service for the general public, was developed to promote these areas, and Wright explains how a Southern California clinic implemented the service, and provides some preliminary results.

California↗
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Where is group practice headed?

A CRAHCA educational program was held recently to determine the changes in the health service environment that are most likely to occur in the near future, and how these changes will affect medical group practice.

Canada↗
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What skills do physician leaders need now and in the future?

The role of the physician leader is moving beyond traditional medical staff issues. A recent national survey of physician leaders shows a growing need for education on specific technical, leadership, and practical skills. The results reveal the medical leadership skills that physician executives consider important today, and provide a window to the future about the skills that will be important tomorrow. Physicians say they need training now in quality assurance, clinical benchmarking, decision-making, and strategic planning. And when they gaze into the future and see the rapid changes throughout health care, they say they'll need more training in communication, organizational change, effective listening, and systems thinking.

Attitude of Health Personnel↗
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Epidemiologists in the United States: an assessment of the current supply and the anticipated need.

We provide 1985 estimates of the work force of epidemiologists in the United States, the number of graduates from training programs in epidemiology, and a projection of the future need for these health professionals. Our methods included a search of mailing lists from professional organizations, mail contact with graduate training programs, telephone interviews with experts, and a review of job announcements in professional journals. The study indicates that the current work force of epidemiologists in the United States is estimated to include 4,600 persons, more than half of whom are physicians; most epidemiologists are located in either a state with a major federal public health agency or one with a large population; and programs in epidemiology graduate an average of 475 persons with one or two years of master's level education and approximately 80 with doctoral-level education each year. After considering the factors that influence the supply of epidemiologists, we project a substantial need for more epidemiologists in the future than current sources will provide.

Education, Medical, Graduate↗
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The demand for doctorally prepared public health personnel in institutions of higher education.

We examined the demand for doctorally prepared public health personnel in academia. We developed an unduplicated list of positions advertised during 1983 in several of the nation's public health journals. Based on this, we identified a total of 217 available positions. We surveyed the persons who placed the advertisements regarding their perceptions of the applicant pool, their experiences in filling the positions, and their perceptions of the future supply of doctorally prepared public health personnel. Of the respondents, 93% were in institutions of higher education. Based on their response, it appears that the current supply of doctorally prepared public health personnel is short and is likely to continue to be limited. Respondents had difficulty filling the advertised positions, based on the amount of time necessary to fill the position, and a number of positions had to be modified in order to be filled. Thirty-two percent of the respondents replied that the pool of applicants was low or poor. Thirty-four percent felt there was a shortage of such personnel, and a similar percentage felt there would be a future shortage. Based on our data, we believe that there is now a shortage of doctorally educated public health personnel for academic positions and that this shortage is likely to continue.

Advertising↗
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Longitudinal effects of preventive services on health behaviors among an elderly cohort.

This study examines the longitudinal (48 months) effects of a preventive services intervention trial with Medicare beneficiaries. The health promotion intervention incorporated a series of workshops and targeted individualized counseling dealing primarily with nutrition and exercise. All subjects completed a health risk appraisal (HRA) questionnaire, which served as a dependent measure. Results show significant, positive changes in intervention subjects in two activity outcomes, aerobic activity and stretching exercises. Although previous research on this cohort found significant positive changes in nutrition behaviors at 12-month follow-up, these differences were not sustained over the three-year follow-up period. The results offer encouragement that continued research on health promotion will eventually produce protocols for select activities that will improve the status of seniors' health.

Aged↗