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Biomedical subjects

S M Williams

Publications and source records attributed to S M Williams.

At least 145 records · Page 8Linked to original sources
PubMed1992

Measuring care and dependency of elderly people in residential homes: an unreliable exercise.

OBJECTIVES: to determine the correlation between a scale measuring the amount of care required by people in rest homes and two scales, the Booth scale and the composite scale which measure dependency. To examine the scales for retest reliability. SUBJECTS: one hundred and twenty-five people aged 47 to 98 years, median age 84 years, living in seven rest homes in Dunedin. METHOD: subjects were assessed using the care, Booth and composite scales and the assessment repeated after four weeks. RESULTS: the care scale test-retest reliability based on rank order correlates was 0.86. For the physical care items retest reliability was high but supervision and the management of behavioural problems showed poor retest reliability. Correlation between the care scale and the two dependency scales was only moderate (composite scale 0.64, Booth scale 0.55). Behavioural problems and the time for supervision were assessed on the care scale only and it was these components which accounted for most of the poor correlation between the care and dependency scales. CONCLUSION: the time required for the management of behavioural problems and supervision for some people in rest homes was considerable. Measurement of this was difficult and made assessment of individual residents in homes unreliable.

Activities of Daily Living↗
PubMed1992

Technique for revision of continent ileostomy.

A technique is described for revising an incompetent nipple valve of a continent ileostomy. The procedure involves preserving the incompetent valve and using it as a collar around the base of the new valve to improve function.

Adult↗
PubMed1992

Molecular genetic analysis of Drosophila rDNA arrays.

Large repeated DNA arrays are a major component of the eukaryotic genome, but we know little about their internal organization. Understanding their architecture, however, is critical for describing genome structure and for inferring the mechanisms that shape it. One repeated family that is yielding a picture of how structure, function and recombination mechanisms come together is the ribosomal DNA (rDNA) of Drosophila melanogaster.

Animals↗
PubMed1992

Cycling health beliefs, crash experiences and night cycling behaviour of 13 year olds.

The relationship of selected health beliefs to self-reported crash experiences, cycling at night and the use of tail-lights at night was examined for a sample of 730 13 years olds. The questions relating to cycling health beliefs were similar to those asked by Weinstein in his study of unrealistic optimism about susceptibility to a range of health problems. They included: vulnerability, worry, controllability, chance, barriers, seriousness, apprehension and safety. The majority of 13 year olds interviewed did not exhibit a strong optimistic bias regarding their vulnerability and skills as safe cyclists. In general the majority considered a crash involving a car would most likely be serious and only a minority said they were not worried about being involved in such a crash. In addition, the majority did not consider that crashes are a matter of chance or that there are significant barriers to adopting safety measures. They tended to consider the chances of being apprehended by a traffic officer for failure to use a tail-light at night as being low. Overall the univariate analyses failed to show a consistent pattern of relationships between health beliefs and the two cycling behaviours. The same was true for crash experiences. The joint effects of beliefs and crash experience on the use of a light at night were examined using logistic regression. The results suggest that the health beliefs work in an additive way as far as boys are concerned, but that they have very little influence on the behaviour of girls. The model for boys suggests that the variables have a relatively small influence on behaviour.

Accidents, Traffic↗
PubMed1992

Distinguishing between persistent and transient impaired glucose tolerance using a prediction model.

Screening for impaired glucose tolerance (IGT) and Type 2 (non-insulin dependent) diabetes was carried out in 777 people and those with high blood glucose levels completed three 2-h oral glucose tolerance tests (OGTT). Blood lipid levels, fasting and 2-h insulin levels, body mass index, and blood pressure were also measured and family history of Type 2 diabetes recorded. Fifty people were identified with IGT and of these 21 were found to have persistent IGT and 29 transient IGT. A model including the variables body mass index, fasting and 2-h insulin levels, fasting triglycerides and family history of Type 2 diabetes was developed using the Speigelhalter-Knill-Jones weighting method to predict subjects with persistent IGT. This model could be useful in identifying people with persistent IGT and therefore eliminate the need for repeat OGTTs which are time consuming and expensive.

Blood Glucose↗
PubMed1992

Dentures, prosthetic treatment needs, and mucosal health in an institutionalised elderly population.

A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua regions showed that 80.5 percent were fully edentulous. Full upper and lower dentures were worn by 64 percent of the total sample, and 31 percent of the dentate group wore one or more partial dentures. Prosthetic treatment needs were dominated by full dentures: 18 percent of upper dentures and 26 percent of lower dentures were considered to need replacement. A further 24 percent of full lower dentures required relining. Only 7 percent of the dentures were named. One third of the subjects had mucosal lesions, the most common lesions being angular cheilitis (present in 18 percent of subjects), traumatic ulcers (14 percent), atrophic glossitis (12 percent), and leukoplakia (present in 8 percent of subjects). No malignant lesions were found.

Aged↗
PubMed1991

Knowledgeable non-compliance with prescribed drugs in elderly subjects--a study with particular reference to non-steroidal anti-inflammatory and antidepressant drugs.

Knowledgeable non-compliance with non-steroidal anti-inflammatory drugs (NSAIDs) and antidepressant drugs was investigated in a community-based sample of elderly people. Everyone 70 years and over living in a defined area and taking one of the above drugs, and at least one other prophylactic or symptomatic drug, was studied. Non-steroidal anti-inflammatory drugs and antidepressant drugs are commonly regarded as symptomatic only and knowledgeable non-compliance is consequently high. They are also regarded as less important than drugs which produce no immediate relief of symptoms but which the patient recognizes as needing to be taken regularly to maintain health. In our study, compliance with non-steroidal anti-inflammatory drugs and antidepressant drugs was highest in those who were compliant with a prophylactic drug and were also taking a symptomatic drug. The greater the number of tablets the patient was taking the more likely he or she was to be compliant with the NSAID. Compliance with NSAIDs and antidepressant drugs requires clear label instructions and the patient knowing the purpose of the medication.

Aged↗
PubMed1991

Competency and the colonoscopist: a learning curve.

The first 334 consecutive unassisted studies of a trainee colonoscopist were audited to analyse the relationship between experience and a target 90% completion rate of colonoscopy. The cumulative sum (cusum) score was applied to examine the time trend for the attaining of the target 90% completion rate. This technique described a learning curve which showed, in this instance, that approximately 100 studies were necessary before a 90% completion rate was approached. A further 100 studies were required before this target completion rate was achieved consistently. A trend for continued improvement above the 90% completion rate level was also seen after 200 studies. Polypectomy was completed in 117 of the 123 studies where indicated. Cusum analysis may be a useful method for monitoring the progress of the trainee colonoscopist and the attainment of satisfactory competence. Training requirements, therefore, might better emphasize the attainment of an acceptable completion rate rather than an arbitrary quota per se.

Clinical Competence↗
PubMed1991

Dental status and treatment needs of a New Zealand institutionalised elderly population.

A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua districts showed that approximately two-thirds were aged 80 or over, and 19.5 percent were dentate, with a mean 13.3 teeth per dentate subject. A mean of 4.6 teeth per dentate subject had caries of either the crown or root, or both. Older males had substantially higher extraction requirements than other subjects. The periodontal needs of the sample were generally low and dominated by the need for calculus removal.

Aged↗
PubMed1990

The stability of high blood pressure in Dunedin children: an eight year longitudinal study.

Resting blood pressures were recorded for children in the Dunedin Multidisciplinary Health and Development Study at two year intervals five times from age seven to fifteen. Correlations between pairs of readings were modest but significant, and higher for systolic (0.39 to 0.62) than for diastolic blood pressure. However, although children with normal blood pressure were likely to continue to have normal blood pressure, high blood pressures at age seven, nine, eleven and thirteen were not stable--only 28% of those whose systolic blood pressure at age seven was in the highest 5% had two subsequent readings in the highest 5%. On the other hand 56% of those in the highest 20% had two subsequent readings in the highest 20%, and 9% had all subsequent readings in the highest 20%. We do not believe that adult essential hypertensives can be recognised early by annual blood pressure measurement in childhood and the assignation of blood pressure rank according to a set of normal values.

Adolescent↗
PubMed1990

Superstructure of the Drosophila ribosomal gene family.

Determining the spatial organization of middle repetitive DNA has proven difficult for several reasons. Repeated arrays are often so large that molecular methods alone cannot resolve their organization, and the lack of phenotypic markers within arrays limits the value of classical genetic analysis. We have characterized the superstructure of one repeated gene family, the ribosomal gene family of Drosophila melanogaster, by a combination of recombinational and molecular analyses of spacer-length variants. The resulting genetic maps demonstrate that some spacer variants are widely dispersed, while others are limited in their distribution. Moreover, exchange among ribosomal DNA (DNA encoding rRNA) arrays was often unequal, leading to a prediction of little or no relationship between physical location in an array and relatedness of gene family members. Extensions of our procedure may be generally useful for mapping the superstructure of repetitive DNA.

Animals↗
PubMed1990

Prediction of possibly preventable death: a case-control study of postneonatal mortality in southern New Zealand.

The postneonatal mortality rate in three southern regions of New Zealand was 8.1 per 1000 live births for 1979-1984. The possibly preventable postneonatal mortality rate was 7.1 per 1000 live births and data on 377 possibly preventable deaths and 936 randomly selected controls were used to develop a two-stage risk-scoring system. Logistic regression analysis was undertaken separately on two sub-samples of the total sample. The data were used to evaluate three other previously published scoring systems. The four variables used in our birth score (mother's age, parity, marital status, and birth weight) have all appeared in other scoring systems, and this score could identify a group of infants in southern New Zealand with an estimated 1.7% mortality rate in the first year of life. It is suggested that currently the only valid use of risk-scoring in this region is for the definition of a high-risk population for the purpose of evaluating potential intervention strategies.

Case-Control Studies↗
PubMed1990

Growth velocity before sudden infant death.

Weight velocities of 136 infants who died from sudden infant death syndrome (SIDS) were compared with those of 136 controls matched for sex, birth weight, and type of feeding. It was found that the SIDS infants gained weight more slowly overall and that the differences were significantly different for infants who were not breast fed in the last two weeks in which it was possible to estimate their growth velocity. Breast fed infants had more periods of growth below the 25th centile than expected. These differences are unlikely to be useful in the prediction of which babies are likely to die from SIDS as there are frequent episodes of poor growth in infants who do not die.

Birth Weight↗
PubMed1990

Blood pressure level, trend, and variability in Dunedin children. An 8-year study of a single birth cohort.

In a birth cohort of children in the Dunedin Multidisciplinary Health and Development Study in New Zealand, resting blood pressures were recorded biennially five times from age 7 to 15 years. Using previously described methods, we examined the level, trend, and variability of blood pressures in those children with at least three readings. The level, trend, and variability of height, weight, and body mass index were compared among six separate groups of children. Two groups were categorized on the basis of high systolic pressure levels, one with low variability and the other with high variability, which was thought to resemble adult labile hypertension. Two additional groups were categorized on the basis of increasing and decreasing blood pressure trends; the fifth group had consistently low blood pressures, and the sixth group consisted of the remaining children. There were significant differences among the groups for the level of all the physical measurements and for the trend of body mass index. No significant differences were found among the groups for gender or socioeconomic status. A parental history of high blood pressure, stroke, or heart attack was significantly more common in the first two groups.

Adolescent↗
PubMed1989

Dopamine synaptic complex with pyramidal neurons in primate cerebral cortex.

Dopamine (DA)-containing projections to the cerebral cortex are considered to play an important role in cognitive processes. Using a recently developed monoclonal antiserum directed against DA and an antibody directed against tyrosine hydroxylase in combination with Golgi impregnation and electron microscopy, we have observed that DA and tyrosine hydroxylase afferents establish symmetric membrane specializations with the soma, dendritic shafts, and spines of identified pyramidal cells in the prefrontal, cingulate, and motor cortex of primates. The axospinous contacts invariably formed part of a synaptic complex in which the dendritic spine of a pyramidal neuron was the target of both a DA-positive symmetric and an unlabeled asymmetric bouton. This arrangement allows direct DA modulation of the overall excitability of cortical projection neurons by altering local spine responses to excitatory inputs.

Animals↗
PubMed1989

Reciprocal recombination and the evolution of the ribosomal gene family of Drosophila melanogaster.

The role of reciprocal recombination in the coevolution of the ribosomal RNA gene family on the X and Y chromosomes of Drosophila melanogaster was assessed by determining the frequency and nature of such exchange. In order to detect exchange events within the ribosomal RNA gene family, both flanking markers and restriction fragment length polymorphisms within the tandemly repeated gene family were used. The vast majority of crossovers between flanking markers were within the ribosomal RNA gene region, indicating that this region is a hotspot for heterochromatic recombination. The frequency of crossovers within the ribosomal RNA gene region was approximately 10(-4) in both X/X and X/Y individuals. In conjunction with published X chromosome-specific and Y chromosome-specific sequences and restriction patterns, the data indicate that reciprocal recombination alone cannot be responsible for the observed variation in natural populations.

Animals↗