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Biomedical subjects

I W Webster

Publications and source records attributed to I W Webster.

At least 19 recordsLinked to original sources
PubMed1992

Do Australian researchers accept committee review and conduct ethical research?

We sought researchers' views on the ethics of research practice and the Australian system of review of research proposals by research ethics committees (RECs). Researchers were found to be supportive of review of research proposals, even though they thought that the process of review was time consuming and demanding. However, our findings suggest that not all researchers present their research proposals for review by committees, and that some researchers deviate from their approved proposals without seeking approval for those deviations from an REC. Researchers supported monitoring of research by RECs.

Advisory Committees↗
PubMed1991

Innovative bridging program for overseas trained doctors.

Most overseas trained doctors wishing to practise in Australia are required to sit for examinations set by the Australian Medical Council (AMC) before they can seek registration through State medical boards. In 1989, the South Western Sydney Area Health Service, which is responsible for the delivery of health services to 650,000 people, initiated a bridging program with the joint aim of providing overseas trained doctors with the opportunity to undertake a comprehensive program of study and facilitating the recruitment of doctors into the area. The program comprises two integrated components, each extending over five months. Stage 1 relates to the AMC's multiple choice questionnaire (MCQ) examination; stage 2 prepares candidates for the clinical examination. In addition, provision is made for developing awareness of professional responsibility, standards and ethical bases for the practice of medicine in Australia. Participants are also required to study English and communication skills throughout the program. Acceptance into the program is based on a number of criteria including successful completion of a screening test and an interview. Progression to the Clinical Course requires that candidates pass the MCQ Course and undertake to work in the area. The program has been funded jointly by State and Commonwealth Government bodies. Results obtained by program participants in the MCQ and clinical examinations conducted by the AMC have been well ahead of the national average.

Australia↗
PubMed1991

Visual acuity and contrast sensitivity in relation to falls in an elderly population.

Visual acuity and contrast sensitivity were measured in 95 residents of a hostel for the aged (mean age = 83 years) using a dual-contrast letter chart and the Melbourne Edge Test (MET). Vision (as measured by visual acuity, the MET, low-contrast visual acuity, and difference between high- and low-contrast acuity) decreased significantly with age and all four measures were significantly correlated. Subjects with a clinical eye disorder had poorer vision than those without a disorder although the differences were not significant. Visual acuity and contrast sensitivity were not associated with body sway when subjects were standing on a firm base. However, when the subjects were placed in a situation which provided reduced support (standing on a compliant surface), body sway was associated with poor visual acuity and contrast sensitivity. There was also a difference in contrast sensitivity between those who fell one or more times in a year of follow-up and those who did not fall. It appears that reduced vision may be a predisposing factor to postural imbalance and falls in elderly persons.

Accidental Falls↗
PubMed1991

Postural stability and associated physiological factors in a population of aged persons.

A battery of 13 visual, vestibular, sensorimotor, and balance tests was administered to 95 elderly persons (mean age 82.7 years) to examine the relationships between specific sensorimotor functions and measures of postural stability. When subjects stood on a firm surface, increased body sway was associated with poor tactile sensitivity and poor joint position sense. When subjects stood on a compliant surface (which reduced peripheral sensation) with their eyes open, increased body sway was associated with poor visual acuity and contrast sensitivity, reduced vibration sense, and decreased ankle dorsiflexion strength as well as reduced joint position sense. Increased body sway with eyes closed on the compliant surface was associated with poor tactile sensation, reduced quadriceps and ankle dorsiflexion strength, and increased reaction time. Poor performance in two clinical measures of postural stability was associated with reduced sensation in the lower limbs as measured by joint position sense, tactile sensitivity and vibration sense, reduced quadriceps and ankle dorsiflexion strength, and slow reaction times. The prevalence of vestibular impairments was high in this group, but vestibular function was not significantly associated with sway under any of the test conditions. The results suggest that reduced sensation, muscle weakness in the legs, and increased reaction time are all important factors associated with postural instability. An analysis of the percentage increases in sway under conditions where visual and peripheral sensation systems are removed or diminished, compared with sway under optimal conditions, indicated that peripheral sensation is the most important sensory system in the maintenance of static postural stability.

Aged↗
PubMed1991

Physiological factors associated with falls in an elderly population.

OBJECTIVE: To determine whether a battery of 13 sensorimotor, vestibular, and visual tests discriminates between elderly fallers and elderly non-fallers. DESIGN: One-year prospective study. SETTING: Conducted at a 124-bed Hostel for Aged Persons, in Sydney, Australia. PARTICIPANTS: Ninety-five persons aged between 59 and 97 years (mean age 82.7 years) took part in the study. Of the 29 non-participants, four were ill, five were absent (on holidays, etc), and 20 declined. Residents were generally independent in activities of daily living although personal care assistance was available. RESULTS: Eighty-four participants were available for follow-up. In the follow-up year, 40 subjects experienced no falls, 11 subjects fell one time only, 33 residents fell on two or more occasions. There was a total of 145 falls. Discriminant function analysis identified proprioception in the lower limbs visual contrast sensitivity, ankle dorsiflexion strength, reaction time, and sway with the eyes closed as the variables that significantly discriminated between subjects who experienced multiple falls and subjects who experienced no falls or one fall only. This procedure correctly classified 79% of subjects into multiple faller or non-multiple faller groups. Quadriceps strength was poorer in the multiple fallers compared with the non-fallers and once-only fallers, although the difference was not statistically significant. There was little difference in the mean scores for the tests of vestibular function in the non-fallers, once-only fallers, and multiple fallers. CONCLUSION: It appears that this approach highlights some key physiological factors that predispose elderly individuals to falls.

Accidental Falls↗
PubMed1990

Reviewing the reviewers: a survey of institutional ethics committees in Australia.

Completed questionnaires were received from 89 (88%) of the 101 Australian institutions identified as having an ethics committee which reviewed research on human subjects. The majority (75%) of committees complied with national requirements to include a layman, a laywoman, a minister of religion, a lawyer and a medical graduate with research experience in their membership. On average, the committees considered 41 research protocols in the year from mid 1987 to mid 1988. The proposed projects were from the medical sciences, including health services and epidemiology research (80% of projects), and the behavioural and social sciences (20% of projects). Less than half the committees monitored research projects in progress as a general practice. Most of the monitoring that was conducted was based on a report from the researcher on the progress of the study. Although monitoring, frequency of meetings, selection of committee members, member involvement in the review of their own protocols and provisions for expedited review gave cause for concern, most committees were found to follow the national guide-lines.

Australia↗
PubMed1990

Visual field dependence in elderly fallers and non-fallers.

Two tests of visual field dependence (a measure of reliance upon the spatial framework provided by vision in the perception of the upright)--roll vection and the rod and frame test--were administered to 136 participants aged fifty-nine to ninety-seven years. It was found that the fifty-nine participants who had experienced one or more falls in the past year were significantly more visually field dependent in both tests compared with the seventy-seven participants who had not fallen. Mean error in perception of the true vertical in the rod and frame test was 20.7 degrees for the fallers and 17.2 degrees for the non-fallers. Mean error in perception of the true vertical in the roll vection test was 6.6 degrees for the fallers and 3.6 degrees for the non-fallers. The test of roll vection was the better discriminator between fallers and non-fallers, which may be due in part to less misunderstanding of the required task by the participant. The results suggest that tilted or rolling visual stimuli may be factors leading to postural instability and falls in the elderly. The findings support the claim that greater dependence on visual information shown by fallers may be the result of reduced proprioceptive and vestibular function resulting from increased age and chronic health problems.

Accidental Falls↗
PubMed1989

Older persons' definitions of good health: implications for general practitioners.

General practitioners are the major providers of health-care services for the older population in Australia. Care that is provided for older persons within the general-practice setting remains crisis-orientated. Nevertheless, many of the disabling health problems of older persons neither can be "solved" nor cured. Therefore, the older population is a unique population in which to study what constitutes good health and ways in which good health can be maintained. This article describes the perceptions of a group of older persons about their health. They define good health in a remarkably non-medical way. General practitioners need to take into account this knowledge when considering ways to improve the health of these patients.

Aged↗
PubMed1988

Bridging the gap--health care for the homeless.

In Australia and other countries concern exists about the extent of homelessness. Because we live in a period in which access to adequate shelter is an increasing problem for many persons, we report on the health needs of long-term homeless persons. Little attention was given to their health needs during the International Year of Shelter for the Homeless in 1987.

Adult↗
PubMed1988

Sleep-related respiratory disturbance and dementia in elderly females.

Sleep-related respiratory disturbance was studied with a microprocessor-based portable monitoring system in female residents of a retirement village aged greater than or equal to 75 years. Comparisons were made between 29 demented subjects Mini-Mental State Examination Score (MMSE) less than 21 and 48 controls (MMSE greater than 25). Respiratory disturbance index (RDI, the number of episodes of apnea and hypopnea/hour of total sleep time) was higher in the demented subjects: mean RDI (+/- SD) 18.5 +/- 18.6 vs 7.3 +/- 10.8, p = .004. The number of minutes per hour of sleep spent with disturbed breathing was greater in demented subjects than in controls (p = .01). These differences between demented subjects and controls persisted after adjustment for age and relevant medical history. Other possible confounders, namely body mass index and use of sedatives, were not significant. We conclude that respiratory disturbance during sleep is more prevalent in elderly demented females than in controls.

Aged↗
PubMed1988

Predicting abstainers in a smoking cessation programme administered by general practitioners.

Pre-treatment characteristics which predicted successful outcome in one hundred cigarette smokers participating in a general practitioner administered smoking cessation programme were identified. Successful outcome was assessed using three types of criteria: quit smoking by the end of treatment, remained abstinent for six months and remained abstinent for three years. Seventeen pre-treatment variables predicted immediate response to treatment, but this decreased to six variables for six months sustained abstinence and to only one variable (smoking when ill in bed) for three years sustained abstinence. Low cigarette dependence, no smoking related health problems, and a non-smoking social environment characterized subjects most likely to have stopped smoking at the end of treatment and to have remained abstinent for six months.

Adolescent↗
PubMed1987

An initiative for teaching about alcohol and other drugs in Australian medical schools.

Education in Australian medical schools is presently under review, including teaching about alcohol and other drugs. In August 1986, the Alcohol and Drug Foundation, Australia (ADFA) presented to the Deans of Australasian medical faculties (including those of Fiji, Papua New Guinea, and New Zealand) a number of options to develop the alcohol and other drugs content of medical courses. It was proposed that a coordinator of education in alcohol and other drugs be appointed in medical faculties; this proposal had been modelled on the US Career Teacher Training Program in Alcohol and Drug Abuse. The Deans expressed interest in ADFA's proposal. This paper discusses the role of undergraduate medical education in alcohol and other drugs, and the background to, and some guide-lines from, the ADFA proposal.

Alcoholism↗
PubMed1986

Three year evaluation of a programme by general practitioners to help patients to stop smoking.

A controlled study was undertaken to measure the effectiveness of general practitioners' use of an intensive programme to help patients to stop smoking. Two hundred cigarette smokers who attended a general practice were allocated to either a treatment (n = 100) or a non-intervention control (n = 100) group. After the initial visit treatment consisted of an educational consultation and four follow up visits. Smoking state was assessed biochemically at six months and three years. Thirty five patients in the treatment group were abstinent at three years compared with eight in the control group (p less than 0.001). Sixty four patients attended the educational consultation and first follow up visit; of these, 45 were not smoking at the first follow up visit, 30 maintained abstinence up to six months, and 22 were still not smoking after three years. Among the 37 patients who completed the treatment programme and attended all the follow up visits 57% were abstinent at three years. The results of this study suggest that general practitioners can help patients to stop smoking.

Adolescent↗