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Biomedical subjects

J P Newell

Publications and source records attributed to J P Newell.

At least 19 recordsLinked to original sources
PubMed2001

Probable locally acquired mosquito-transmitted malaria in Georgia, 1999.

In July 1999, the Centers for Disease Control and Prevention received notification of a case of malaria in a 32-year-old female native of Colquitt County, Georgia, who had no history of travel into an area where malaria transmission is endemic. An epidemiological investigation confirmed the absence of risk factors, such as blood transfusion, organ transplantation, malariotherapy, needle sharing, or past malaria infection. Active case finding revealed no other infected persons in Colquitt County. Light trapping and larvae-dipping failed to identify adult or larval anophelines; however, Colquitt County is known to be inhabited by Anopheles quadrimaculatus, a competent malaria vector. The patient's home was located near housing used by seasonal migrant workers from regions of southern Mexico and Central America where malaria is endemic, one of whom may have been the infection source. The occurrence of malaria in this patient with no risk factors, except for proximity to potentially gametocytemic hosts, suggests that this illness probably was acquired through the bite of an Anopheles species mosquito.

Adult↗
PubMed1998

Sequential changes in gas exchange following traumatic fat embolism.

We present a young man who developed fat embolism syndrome following a fractured femoral shaft. By intermittently measuring oxygen saturation with a pulse oximeter and varying the inspired partial pressure of oxygen we were able to quantify the development of shunt and ventilation/perfusion (V/Q) mismatch over the course of his illness. Shunt and low V/Q gradually improved in the week following admission but deteriorated following general anaesthesia for nailing of the femur.

Accidents, Traffic↗
PubMed1991

Changing the medical school curriculum to improve patient access to primary care.

The problems of access to health care by the underinsured demand a systematic response. One of the critical components of that response is medical curriculum reform, with the intent to graduate adequate numbers of physicians to do primary care, to work with the underinsured and the uninsured, and to practice in rural areas. One state, Minnesota, has developed a unique response to these needs, demonstrating problem solving very much in keeping with many of the recommendations in the literature. Highlighted in this article is the University of Minnesota's Rural Physician Associate Program, a predoctoral curriculum innovation functioning for 20 years to help resolve the issue of physician maldistribution in the state. The Rural Physician Associate Program provides students with many of the skills needed to provide primary care, it is cost-effective, and it has brought a number of benefits to the participating communities.

Cost-Benefit Analysis↗
PubMed1981

Teaching anaesthetics to medical students. The design and evaluation of a course in a new clinical school.

The paper describes the rationale and implementation of anaesthetics teaching in the new 2 1/4-year clinical medical course at Cambridge University. A programme designed to monitor and evaluate the teaching established, and the results are reported. Significant improvements in students' knowledge of anaesthetics and their experience of practical procedures were noted, as compared to a control group. It is concluded tha the course achieves the dual aims of providing an introduction to the scope and vocabulary of modern anaesthesia and giving students the opportunity to practise a variety of specified practical skills.

Anesthesiology↗
PubMed1980

Physical fitness training in patients.

Patients recovering after heart valve surgery are not in an optimum state of 'cardiorespiratory fitness'. To examine this proposition a controlled trial of physical training was undertaken in patients recovering from the replacement of a single heart valve. Patients were allocated to a test or control group two weeks after operation. Each patient performed a submaximal exercise test at entry, and twelve and twenty-four weeks after this test. The Canadian Air Force exercise programme was undertaken by the test group, while the control group continued normal activities for the twenty-four weeks between the first and last exercise test. A regression line of submaximal heart rate on oxygen consumption was calculated from the data of each exercise test in each patient. Alterations in this line were used as an 'index' of changes in 'cardiorespiratory fitness'. The individual results showed a consistent improvement in 'cardiorespiratory fitness' over the first 12 weeks in both groups. Only patients in the test group continued to improve between 12 and 24 weeks. Thus the exercise programme modified the recovery of 'cardiorespiratory fitness' after operation. A physical fitness rehabilitation programme may help these patients gain maximum benefit from correctiv surgery.

Adolescent↗
PubMed1980

Physical training after heart valve replacement.

A controlled trial was undertaken to examine the efficacy of physical training in patients recovering from the replacement of a single heart valve. Patients were allocated to a test or control group two weeks after operation. Each patient performed a submaximal exercise test at entry, and 12 and 24 weeks after this test. The Canadian Air Force exercise programme was undertaken by the test group, while the control group continued normal activities for the 24 weeks between the first and last exercise group. A regression line of submaximal heart rate on oxygen consumption was calculated from the data of each exercise test in each patient. Alterations in this line were used as an "index" of changes in "cardiorespiratory fitness". The individual results showed a consistent improvement in "cardiorespiratory fitness" over the first 12 weeks in both groups. Only patients in the test group continued to improve between 12 and 24 weeks. Thus the exercise programme modified the recovery of "cardiorespiratory fitness" after operation. Results in patients who developed clinical complications, and were excluded from the trial, predicted a deteriorating clinical condition. This finding suggested that sequential exercise tests are of value after cardiac surgery.

Adolescent↗
PubMed1980

Anaesthesia for bronchoscopy: examination of a standard technique.

An anaesthetic technique for bronchoscopy is described, based on increments of methohexitone given in strict relation to body weight and time, suxamethonium being used to produce relaxation. There was no awareness in the 75 patients studied, while the recovery was rapid and unrelated to the duration of bronchoscopy. The efficacy of small aliquots of lignocaine in reducing injection pain was the same whether given before, or mixed with, the initial methohexitone injection. Other sequelae relating to the anaesthetic technique were minimal.

Adult↗
PubMed1979

Effect of the Canadian Air Force training programme on a submaximal exercise test.

Validation of the submaximal heart rate/oxygen consumption relationship as an index of 'cardiorespiratory fitness' requires the demonstration of systematic alterations in this relationship concomitant with interventions designed to alter physical fitness. To fulfil those criteria a longitudinal training/de-training study was undertaken. Previously sedentary adult subjects undertook the Canadian Airforce 5BX-XBX exercise programme. Submaximal exercise tests were performed before and after training, and following several weeks cessation of training. A regression line of submaximal heart rate on submaximal oxygen consumption was calculated from the data of each submaximal exercise test. Alterations in the regression lines were examined for each subject individually by testing statistically for difference in slope and elevation between any pair of lines. Subjects who undertook the training/de-training study demonstrated significant systematic alterations in the elevation of the regression lines concomitant with periods of training and de-training. The reproducibility of the submaximal heart rate/oxygen consumption relationship was examined in two additional groups of subjects. Group A repeated a submaximal test on 3 or 4 successive days; Group B were tested before and after 16 weeks of normal activity. Subjects in Group A demonstrated non significant, random alterations in the regression lines on repeated testing and subjects in Group B demonstrated random, though on occasion significant, alterations in the regression lines. The elevation of the submaximal heart rate/oxygen consumption relationship is therefore a valid index for detecting sequential changes in 'cardiorespiratory fitness' in individual subjects.

Adolescent↗
PubMed1979

A comparison of the oxygen consumption/body weight relationship obtained during submaximal exercise on a bicycle ergometer and on a treadmill.

It is widely accepted that the relationship between oxygen consumption and body weight obtained during exercise on a bicycle ergometer differs from that obtained during treadmill walking. Experimental evidence to support this claim is lacking. To examine this difference a group of subjects (body weight 41--81 kg) undertook a predetermined level of submaximal exercise on a bicycle ergometer and a treadmill. Oxygen consumption was measured in a steady state at rest (i.e. sitting on the bicycle ergometer and standing on the treadmill) and during the two modes of exercise. A significant positive correlation between oxygen consumption and body weight was obtained under all four conditions of measurement. At rest the two regression lines did not differ in slope or elevation. During exercise the slope and the elevation of the line obtain from treadmill walking were significantly greater than from bicycle ergometer exercise. The 'metabolic cost' of bicycle ergometer exercise, (Vo2 during exercise--V02 at rest), showed no significant correlation with body weight. In contrast, there was a significant positive correlation during walking. It is suggested that these differences have arisen due to a different proportion of the total body weight supported by the subject in the two forms of exercise.

Adult↗
PubMed1976

Method for continuous measurement of carbon dioxide output.

An open-circut flow-through technique for the continous measurement of carbon dioxide output in man has been described. A stream of room air is drawn past the subject who respires freely from it. The difference in the concentration of carbon dioxide between room air from which the subject inspires and the expired gas/room air mixture is measured and expressed as a voltage. This voltage is amplified by a factor proportional to the rate of flow of room air to yield a continous measurement of carbon dioxide output. This technique has no systematic error and a random error (95% tolerance limits) of +/-3.4, +/-1.7, and +/-1.4% at mean carbon dioxide outputs of 254, 846, and 1,906 ml/min, respectively.

Carbon Dioxide↗
PubMed1976

An information system for family practice. Part 3: gathering encounter data.

This paper describes the development of a system for recording encounter data in family practice. The system has been developed by the Department of Family Medicine, University of Western Ontario, and came about as a natural addition to a previously reported method for describing and defining a practice population. The system gathers information on each encounter and includes data concerning the patient, the provider, the location, and certain other details concerning the encounter, including all problems dealt with on that occasion. The storage and analysis of these data are carried out by a computer. The uses of such data are many, and some of them will be dealt with in the fourth and last paper in this series.

Family Practice↗
PubMed1976

An information system for family practice. Part 4: encounter data and their uses.

This paper describes the ways in which encounter data from the family practice teaching units of the Department of Family Medicine, University of Western Ontario, have been used for teaching, service, and research. The fact that family physicians may deal with several problems at one visit is emphasized, as is the need to report morbidity in terms of the population at risk, so that comparisons can be made with other work. The value of encounter data in studies of patient utilization and resident experience is noted. The validity of the data has been examined and the extent of underrecording assessed. The system has helped to encourage the spirit of inquiry in its users.

Family Practice↗
PubMed1976

The arthritic complaint in primary care: prevalence, related disability, and costs.

Surveys conducted in five areas of Southern Ontario obtained clinical and service utilization data from 5,478 adults over 25 years of age. The two week period prevalence rates of arthritic and rheumatic (AR) complaints were 1.72 per cent and 2.14 per cent among two groups of users of primary care. In free-living general populations, the rates ranged from 6.23 per cent to 8.84 per cent. It was shown that only 25 per cent of complainants with AR symptoms sought health services. Of all adults seen by family physicians in one year, 28 per cent presented at least once with an AR complaint. While 20 per cent of all respondents reported some physical impairment, 43 per cent of those with AR complaints had impairment. The excess impairment was two per cent. Complaints with AR symptoms used health services at costs 78 per cent higher than the average expenditures in the same communities. The essential role of the primary care practitioner in the identification and control of AR disorders is strongly supported.

Adult↗
PubMed1976

An information system for family practice. Part 1: Defining the practice population.

Information systems for family practice are vital in its development as an academic discipline, in the teaching and learning process which ultimately improves the quality of care, and in the planning processes which must be used to rationalize the distribution of scarce resources in the health-care field. The provision of sufficient data for these purposes demands a flexible system, generally one based on the computer as a data storing and analyzing tool. Such a system has been developed in the teaching practices of the Department of Family Medicine, University of Western Ontario; the methods employed and the uses for that system are to be described in a series of four papers. This first paper describes the methods developed for gathering demographic information on the practice population.

Demography↗