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Biomedical subjects

J Wilks

Publications and source records attributed to J Wilks.

At least 19 recordsLinked to original sources
PubMed2000

Randomised controlled trial of early surgery versus watchful waiting for glue ear: the effect on behavioural problems in pre-school children.

This trial was designed to compare early surgery with watchful waiting for persistent bilateral otitis media with effusion (OME) in terms of hearing loss and behavioural problems in pre-school children. A randomised controlled trial compared the effects of early treatment with ventilation tubes versus watchful waiting for 9 months. Results were analysed by intention-to-treat. One hundred and eighty-two pre-school children (date of birth between 1 April 1991 and 31 December 1992), mean age of 2.9 years (SD 0.85) with at least a 3-month history of bilateral OME and hearing loss of greater than 25 dB were treated in Bristol Children's Hospital between November 1993 and January 1996. Bilateral ventilation tubes were inserted within 6 weeks of randomisation or within 6 weeks of reassessment after 9 months of watchful waiting, with a final assessment at 18 months. The main outcome measures were behavioural problems, measured by the Richman Behaviour Checklist, and hearing loss at 4000 Hz in the better hearing ear. Early surgical intervention significantly reduced behavioural problems by 17% (95% CI, 2% - 33%). This difference was largely mediated by concurrent hearing loss. After 18 months, there was no longer a significant difference (95% Cl, -19% to +10%). However, the majority (85%) of the Watchful Waiting group had required surgery and 22% of all children still had behavioural problems.

Child Behavior Disorders↗
PubMed2000

Overseas visitors admitted to Queensland hospitals for water-related injuries.

OBJECTIVE: To determine the number of overseas visitors admitted to Queensland hospitals for water-related injuries over three years, the causes of their injuries, the resulting conditions treated, and the type of hospitals to which they were admitted. DESIGN: Retrospective analysis of admissions of overseas visitors to Queensland hospitals over the three financial years 1995/96, 1996/97 and 1997/98. PATIENTS: 296 overseas visitors admitted for water-related injuries, identified from hospital records by their usual place of residence. MAIN OUTCOME MEASURES: Number of admissions, causes of injuries, conditions treated, and bed days occupied by these patients at different types of hospitals (metropolitan, regional and rural public hospitals, and private hospitals). RESULTS: The 296 overseas visitors accounted for a total of 596 separate admissions, many of these the result of patients with decompression illness being admitted several times to a regional hospital hyperbaric chamber for treatment as day patients. The largest number of injuries involved the use of diving equipment. The main conditions treated were decompression illness (54.7%), fractures and dislocations (15.5%), and drowning and non-fatal submersion (14.9%). Overall, overseas visitors admitted to hospital following a water-related incident occupied 1215 bed days; 90% of these admissions were to regional hospitals. CONCLUSIONS: The main reason for admission of overseas visitors is for decompression illness, suggesting that the prevention of injuries among scuba divers requires further coordinated efforts by health and tourism authorities.

Adolescent↗
PubMed1999

Early surgery compared with watchful waiting for glue ear and effect on language development in preschool children: a randomised trial.

BACKGROUND: Otitis media with effusion (OME) is the most common cause of hearing loss in children and is generally treated by elective surgery. We compared in children with persistent OME the effect on speech and language development of immediate surgery (ventilation-tube insertion) and watchful waiting before surgery. METHODS: We did a randomised controlled trial with masked outcome assessment in Bristol Children's Hospital, Bristol, UK. We included 186 children born between April 1, 1991, and Dec 31, 1992, who had confirmed bilateral OME and bilateral hearing impairment of 25-70 dB of at least 3 months' duration. Children were randomly assigned surgery within 6 weeks (n=92), or 9 months of watchful waiting (n=90), after which bilateral tube insertion was done if required. We assessed hearing loss, expressive language, and verbal comprehension at 9 months and 18 months. FINDINGS: At 9 months, standardised scores for expressive language and verbal comprehension differed between groups with marginal significance after adjustment for baseline differences (p=0.04 and p=0.028, respectively). At 9 months, verbal comprehension and expressive language skills in the watchful-waiting group were 3.24 months behind those in the early-surgery group. The watchful-waiting group was delayed on these two measures compared with their age-expected levels. 18 months after randomisation, 85% of children in the watchful-waiting group had received surgery and groups did not differ significantly. INTERPRETATION: There is some benefit from ventilation-tube insertion for expressive language and verbal comprehension but the timing of surgery is not critical.

Acoustic Impedance Tests↗
PubMed1999

International tourists, motor vehicles and road safety: a review of the literature leading up to the Sydney 2000 Olympics.

The number of international visitors to Australia is forecast to rise to 4.6 million in the year 2000, the main attraction being the Olympic Games in Sydney. While the Olympic Games are expected to directly attract 132,000 international visitors as athletes, officials, judges, journalists and spectators, a further 1.49 million visitors will be attracted to Australia because of the global spotlight on the country in the years leading up to and during the staging of the event. Pre- and post-Games travel will also involve large numbers of tourists moving about in other Australian states and territories. For example, 50% of the extra tourists are expected to visit Queensland, 25% Victoria, 13% Western Australia and 9% the Northern Territory. In order to provide the best possible experience for all of these visitors, it is essential that potential causes of travel-related illness and/or injury are anticipated, and that procedures are established in each state to minimize harm and to deliver appropriate health care if it is required. Ideally, procedures and resources should be coordinated to achieve maximum effectiveness.

Accidents, Traffic↗
PubMed1998

Revising current two-process accounts of spacing effects in memory.

Memory for repeated items improves when presentations are spaced during study. In Experiment 1A, words were repeated either immediately or after 6 intervening items. Intentional learning occurred under either focused or divided attention. Retention was tested by either free recall or yes-no recognition. Divided attention did not affect the influence of spacing in free recall, whereas it removed the spacing effect in recognition. In Experiment 1B, recognition memory was tested after incidental semantic study of words performed under either focused or divided attention. An equivalent spacing effect occurred in both attentional conditions. In Experiments 2 and 3, recognition memory for unfamiliar faces was assessed. A reliable spacing effect was found under both intentional learning and incidental structural study. These data are, collectively, incompatible with current theories of spacing effects. A theoretical proposal to account for these new findings is outlined.

Attention↗
PubMed1997

Travel and Health Research in Australia.

Travel and tourism is a major industry in Australia, employing 6.9% of the nation's workforce (535,600 persons) and generating AUS$46.9 billion in 1993-94.1 While economic and marketing analyses have traditionally dominated the field of tourism research in Australia, health and safety issues that impact on the business of tourism are now emerging.2 Travel medicine is still a small specialty area, though it has established a legitimate role within the tourism industry by providing services in prevention and treatment. To date, little attention has been given to empirical research, even though field studies are a critical component in the provision of accurate medical advice for patients. This paper reviews the Australian research that is available and identifies areas where further work should be conducted.

Journal Article↗
PubMed1997

Managing patient records and documenting service delivery: the results of a 'best practice' remote area nursing program.

This paper describes a 'best practice' demonstration program for monitoring nursing services in remote locations. A four-phase project involving paper- and computer-based patient information systems was implemented at nursing clinics on islands off the coast of Queensland. Patient demographics, diagnoses and details of health service provision were recorded. Results showed a marked improvement in the detail of patient records over the program period. Monitoring of services also provided useful planning and policy information for company management, while a systematic approach to maintaining patient records addressed several medico-legal issues.

Benchmarking↗
PubMed1996

Tourists as inpatients in Queensland regional hospitals.

This study analysed medical record data from seven regional hospitals in Queensland to determine the types of medical conditions and injuries that resulted in overseas and interstate tourists being admitted to hospital. From a total of 135,128 admissions to the participating hospitals, 695 (0.51 per cent) were identified as overseas tourists and 3479 (2.57 per cent) were from interstate. The main reasons for admission of overseas tourists, based on principal diagnoses, were injuries and poisonings (37.6 per cent), circulatory disorders (11.7 per cent), digestive conditions (9.8 per cent), and genito-urinary disorders (8.8 per cent). For interstate tourists, the main reasons for admission were genito-urinary disorders (19.8 per cent), injuries and poisonings (15.4 percent), neoplasms (11.4 per cent) and circulatory disorders (10.6 per cent). These findings are discussed in relation to current literature in the field of travel medicine, emphasising the burden of care placed on the admitting hospital's resources, and the growing number of visitors to Queensland needing health care.

Catchment Area, Health↗
PubMed1996

Golf-related injuries seen at hospital emergency departments.

Golf-related injuries are reported for 300 patients attending emergency departments of south-east Queensland hospitals over a six and a half year period. The main mechanisms of golf-related injury were being hit by a club (37%), hit by a ball (28%), sprains/strains (9.67%) and slips/falls (7%). For adult players, the main source of injury was being hit by a ball, while for children and adolescents being struck by a golf club accounted for 77 percent of hospital presentations. In the total study group, 46 people (15%) were admitted to hospital following their presentation at the emergency departments. Injury prevention and player education strategies are suggested as a means of reducing injuries in this popular sport.

Adolescent↗
PubMed1995

Tourist health services at tropical island resorts.

An unfamiliar holiday environment may give rise to a range of common and unique medical conditions and injuries. Based on a six-month retrospective analysis of clinic records, the present study reports a detailed profile of health services provided for guests at three tropical island tourist resorts. A total of 1183 clinic visits were analysed; 735 (62 per cent) concerned medical conditions, while 448 (38 per cent) were related to injuries. The most common medical conditions treated were respiratory, digestive, skin problems, eye disorders, and genito-urinary complaints. Injuries included lacerations, bites and stings, sprains and fractures. Health services consisted mainly of medication, specialist nursing care and first aid. Study findings highlight the advantages of using an internationally accepted classification system for primary health research, and the critical role of the nurse in tourist health services.

Australia↗
PubMed1995

A profile of therapeutic opioid dependent persons in Queensland.

This paper describes the philosophy and practice of the Drugs of Dependence Unit, Queensland Health, with regard to the collection and evaluation of dangerous drug prescription data. Using patient information extracted from the Monitoring of Dangerous Drugs Computer System and patient files at the unit, the paper presents a profile of 335 therapeutic opioid dependent persons who constituted the entire therapeutic caseload of the unit as at June 1992. The data include medical history, drug details, initial and final diagnosis, an escalation factor, and prognosis. Profile findings detail the prescribing patterns of medical practitioners and highlight the importance of continuous monitoring and review in the care and management of therapeutic opioid dependent persons.

Australia↗
PubMed1994

An evaluation of the Taxi Subsidy Scheme for the Disabled.

This paper reports on an evaluation of the Taxi Subsidy Scheme for the Disabled (TSSD). The evaluation focused on members of the TSSD in terms of their eligibility for Home and Community Care (HACC) Program Services. Using a probability sample in the Brisbane metropolitan area, the project found evidence that at least 79 per cent of TSSD members (under the relevant category) were entitled to such membership, as they also fulfil the requirements prescribed under the Home and Community Care Act 1985. However, the evaluation also found evidence that current utilisation of HACC Program Services does not truly reflect the need for these services within the community.

Adolescent↗
PubMed1992

Effect of television advertising of alcohol on alcohol consumption and intentions to drive.

The alcohol consumption of 120 male and female college students was measured as they viewed a 90-min videotape of popular prime-time television programmes. Independent measures were the sex of the student, their drinker classification (light or moderate-heavy) and the number of alcohol advertisements (0, 6, 12) shown during the screening of the television programmes. Dependent measures were the number of drinks consumed, and the intentions of students to drive a motor vehicle after viewing the videotaped programmes. As predicted, males consumed more alcohol than females, and moderate-heavy drinkers consumed more than light drinkers. Male and female students who viewed six alcohol advertisements consumed more alcohol than students shown no alcohol advertisements or 12 alcohol advertisements. Analysis of intentions to drive after viewing the programmes revealed that the number of drinks consumed was not a significant covariate of driving intentions. Rather light drinkers of both sexes were less likely to intend to drive than moderate-heavy drinkers. Males exposed to alcohol advertisements were less likely to intend to drive than males who did not view alcohol advertisements. Different levels of exposure to alcohol advertisements did not influence the driving intentions of college females.

Journal Article↗