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Biomedical subjects

D Hewson

Publications and source records attributed to D Hewson.

8 recordsLinked to original sources
PubMed1997

Coping with loss of ability: "good grief" or episodic stress responses?

Traditional grief models, which tend to prescribe "good grief" responses, are often applied to responses to loss of ability (loss of sensory, motor, intellectual or reproductive functioning). A brief review of relevant research concludes that the assumptions of grief models lack empirical support, both in the bereavement and the loss of ability contexts. It is argued that stress provides an appropriate framework for conceptualising loss of ability responses, especially the frequently observed recurrent pattern of stress (chronic sorrow). An Episodic Stress Response Model is proposed which avoids prescriptions and notions of pathology. It distinguishes between primary and secondary stress episodes and different types of stress demands (recognition, adjustment, comfort, and stress reduction).

Adaptation, Psychological↗
PubMed1990

Amiloride disposition in geriatric patients: importance of renal function.

1. The absorption and disposition of the potassium sparing diuretic amiloride were determined in nine elderly patients aged 71 to 87 years and in eight young (25 to 38 years) subjects following oral administration of 5 mg amiloride HCl daily to steady-state. 2. The maximum and steady-state plasma amiloride concentrations were significantly (P less than 0.05 and P less than 0.001) higher in the elderly patients. The renal clearance of amiloride was lower in the elderly than in young subjects (102 +/- 36 ml min -1 vs 300 +/- 64 ml min-1, P less than 0.001) as was the urinary excretion of amiloride (36 +/- 13 vs 62 +/- 18% of the dose, P less than 0.01). 3. The steady-state plasma amiloride concentration correlated significantly (r2 = 0.61, P less than 0.001) with amiloride renal clearance and with creatinine clearance (r2 = 0.59, P less than 0.001). There was a very strong positive correlation between renal amiloride clearance and creatinine clearance (r2 = 0.76, P less than 0.001). The slope of the regression line was 2.5 indicating substantial proximal tubular secretion of amiloride. 4. Sodium and potassium excretion, along with urine volume were significantly (P less than 0.05) lower in the elderly (by 39, 45 and 34% respectively). 5. The disposition of amiloride was highly dependent on renal function, with higher plasma amiloride concentrations in the elderly reflecting diminished renal function. The dose of amiloride should be titrated to individual response, and the lower potassium excretion in the elderly patients suggests that the dose of amiloride could be reduced in this group of patients.

Adult↗
PubMed1987

Compensable back pain and migrants.

Ten years of cases of compensable back pain from a rehabilitation centre were reviewed for evidence that is relevant to the strongly negative stereotypes that are held commonly about migrant workers. The prevalence of migrant workers with back injuries was found to be similar to that in the occupations with higher accident liabilities in the surrounding municipalities. The relative proportion of musculoligamentous injuries and the more objectively confirmable back injuries was not related to the country of birth. Better predictors of treatment outcome were: the time that had elapsed between the injury and admission to the Centre; whether the referral was direct or indirect after the previous treatment; and the degree of fluency in English. It is concluded that the stereotypes that describe migrant workers as accident-prone or malingerers cannot be supported and that the vulnerability of migrant workers to the "accident-victim syndrome" can be accounted for without reference to ethnic characteristics.

Accidents, Occupational↗
PubMed1987

Childbirth research data: medical records or women's reports?

Medical records and women's reports were compared as sources of data for childbirth research. Three weeks after they had given birth in 1982 at five teaching hospitals in Sydney, Australia, 397 low-risk primiparous women in a random sample were interviewed about their birth experiences. The women's reports were compared with data from their medical records. Error sources in data collection were identified at four points: from the actual event to hospital recording, in the abstraction of data from medical records, in women's memory of the actual events, and in women's reporting of their encoded information. Both corrected data sources were accurate for most major variables. It is concluded that both data sources are subject to variation from the actual events they represent and that the assumption that medical records are always more accurate and acceptable is not supported.

Adolescent↗
PubMed1978

The relation of social factors to physical and psychiatric illness.

A study in social factors associated with illness status was conducted in an Australian suburban community. Forty six per cent of adults reported a chronic physical condition and twenty four per cent were psychiatrically impaired. Life event stress, adverse childhood experience and poor social support were related to both physical psychiatric illness. Low occupation status was associated with poor physical health and a poor coping style was associated with psychiatric illness. Twenty per cent of the physical illness and thirty seven per cent of the psychiatric impairment could be attributed to the presence of social factors.

Adult↗