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Biomedical subjects

K Wilton

Publications and source records attributed to K Wilton.

8 recordsLinked to original sources
PubMed2006

Calcaneal bone mineral density in older patients who have fallen.

BACKGROUND: Annually, 35-40% of those aged >65 years fall; up to 5% of such falls result in fracture. Fracture is determined both by propensity to fall and by bone fragility. AIM: To determine osteoporosis prevalence and predictors in patients who have fallen. DESIGN: Observational cross-sectional study. METHODS: We measured calcaneal BMD in 408 consecutive patients aged >50 years attending after falling. Fall number, fracture history, weight, height, and risk factors for falls and osteoporosis were recorded. T scores (SD above or below the mean for young adults) were derived in both sexes, and Z scores (SD above or below age-related normal score) in females. RESULTS: In females (n = 300, 74%), mean (SD) T score was -1.1(1.6), and mean Z score was 0(1.4); 127 (42%) had osteoporosis (T score < - 1.6). ROC curves confirmed significant relationships between osteoporosis and age, weight and height (all p < 0.0001). Incorporating fracture history, our model (fracture aged >50 years, age >83 years, weight <57 kg, height <153 cm as dichotomous variables) predicted osteoporosis with 91% sensitivity, 34% specificity. Of 108 male fallers, 36 (33%) had osteoporosis. Age, height and weight all predicted osteoporosis (p < 0.02). The resulting model (fracture aged >50 years, age > or =80 years, weight < or =68 kg, height < or =167 cm as dichotomous variables) predicted osteoporosis with 92% sensitivity, 30% specificity. DISCUSSION: Osteoporosis prevalence is not increased in female fallers compared to age-related norms; empirical use of osteoporosis treatment solely on the basis of falls thus appears inappropriate. In both sexes, the factors predicting osteoporosis were age, height and weight. Where BMD is not practical, possible or economical, our model may be a sensitive means of predicting fallers with osteoporosis.

Absorptiometry, Photon↗
PubMed2006

The costs of falls in the community to the North East Ambulance Service.

BACKGROUND: This study set out to quantify the immediate costs to the North East Ambulance Service (NEAS) of attending to fallers. METHODS: Data from the Newcastle, UK area were collated by NEAS to identify those aged over 65 who had fallen and required an assistance only call or were subsequently transported to an Accident and Emergency (A&E) department. The 2001 census data for the total population served by NEAS in Newcastle were obtained. RESULTS: The total population of Newcastle over the age of 65 was 41,338. Over 7 months NEAS attended to 1504 falls in Newcastle (at 115 pounds sterling per call out, this equates to 172,960 pounds sterling). The faller was transported to A&E on 1339 occasions, while 165 falls required assistance only (11% of total) (36 falls requiring NEAS assistance per 1000 Newcastle population aged over 65 in 7 months). The total time on site for ambulance crews attending to fallers was 377.1 h (15.7 days in 7 months or 2.25 days per month). As the cost of emergency ambulance time is 123 pounds sterling/h, the total cost was 46,383.30 pounds sterling. Therefore, in Newcastle, attending to fallers in the community costs NEAS 376,018 pounds sterling per year (145.83 pounds sterling per fall or 9.10 pounds sterlingper person over the age of 65 per year). CONCLUSION: NEAS attend to a significant number of older people who fall in the community. In Newcastle alone the cost of this service equates to over 2 days of emergency ambulance crew time per month. Studies are needed to determine whether responding to falls in the community differently would be cost effective.

Accidental Falls↗
PubMed1998

Cooperative learning and social acceptance of children with mild intellectual disability.

The effects of the participation of non-disabled children in a cooperative learning programme on their social acceptance of classmates with mild intellectual disability was examined. A sample of 24 children with mild intellectual disability in the 9-11-year-old age-range was identified from educational psychologists' case records. All of the children were receiving mainstreaming special education programmes at the time of the study. Twelve of the children had previously attended special education classes, while the remainder had always attended regular classes. Half of the children's regular classes were randomly assigned to either receive an experimental cooperative learning programme or to serve as control classrooms. The non-disabled children in the experimental classes showed significant increases in their social acceptance (sociometric ratings) of the children with mild intellectual disability, both immediately following the programme and 5 weeks later, but no such increases were evident in the children in the control classrooms. This pattern held for both the former special class pupils and the children with mild intellectual disability who had never attended special classes. The results confirm the usefulness of cooperative learning strategies for enhancing the social acceptance of children with mild intellectual disability in mainstreaming special educational programmes, regardless of the nature of their previous special educational provisions.

Child↗
PubMed1986

Stress levels in families with intellectually handicapped preschool children and families with nonhandicapped preschool children.

Family stress levels were examined using the Questionnaire on Resources and Stress (QRS) in 42 New Zealand families with preschool intellectually handicapped (moderately and severely retarded) children and 42 families with nonhandicapped preschool children. Maternal age was employed as a blocking factor (less than 30 years versus 30 years and above). The families with intellectually handicapped children showed significantly higher stress levels on 13 of the 15 QRS scales, but maternal age did not appear to be implicated in family stress levels. The results suggest that stress levels are somewhat elevated in families with preschool children, the tendency being particularly marked in families with intellectually handicapped children. The implications of these findings for family intervention and support programmes are considered, together with the need for research into the various ecological contexts of the individual, family, peer group and social institutions, as well as of the interactions within and between these contexts as mediators of coping resources in families with intellectually handicapped children.

Adult↗
PubMed1978

Mother-child interaction in high-risk and contrast preschoolers of low socioeconomic status.

Children's activities with their mothers and the techniques used by mothers while interacting with their child were examined in older (30--46 months) and younger (12--27 months) low SES preschool children from high-risk (in terms of cultural-familial retardation) and contrast homes. Older high-risk children interacted less often with their mothers and spent less time in "highly intellectual" activities than did the contrast children. The mothers of older high-risk children, in comparison with the contrast group, engaged less often in didactic teaching, showed less encouragement of their child's activities, and their attempts to control their child's activities more often resulted in failure. The differences between younger high-risk and contrast groups however were nonsignificant. Implications for future home intervention programs for high-risk low SES children are discussed.

Age Factors↗