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Biomedical subjects

T J Walker

Publications and source records attributed to T J Walker.

12 recordsLinked to original sources
PubMed2006

Ageing of the baby boomer generation: how demographic change will impact on city and rural GP and nursing workforce.

INTRODUCTION OBJECTIVE: To compare the impact of ageing on the GP and nursing rural and city workforce. METHOD: Cohort analysis of Australian Bureau of Statistics census data. The data was used to examine the age distribution of the city and rural GP and nursing workforce; patterns of attrition for those 50 years and over; and the impact of changes in working hours. RESULTS: The rural GP and nursing workforce is significantly older than their city counterparts (p<0.001) with the 'baby boomer' generation making up 52% of city GPs but 59% of rural GPs in 2001. While a large proportion of city and rural GPs continued to work past the age of 65 years, rural GPs left the workforce at a significantly younger age than city doctors (p<0.001). Rural nurses are older than their city peers (p<0.001) but retire at an older age than city nurses (p<0.001). In 1986, a significantly higher proportion of rural GPs in all age cohorts worked more than 41 hours per week compared with their city counterparts (p<0.001). By 2001, rural 'generation X' GPs were no more likely to work long hours than those in the city (p<0.001). However, significantly more rural than city 'baby boomers' continued to work long hours. CONCLUSIONS: Rural GPs are retiring faster than city GPs and strategies to attract rural GPs and nurses will be critical to ensure adequate rural health care and that current rural workforce shortage do not worsen.

Adult↗
PubMed2001

Determination of total menstrual blood loss.

OBJECTIVE: To develop and validate a simple method of measuring total menstrual blood loss using a pictorial representation of blood loss, the menstrual pictogram. DESIGN: A prospective evaluation of total menstrual blood loss measurement by the menstrual pictogram compared to the alkaline hematin technique. SETTING: Academic menorrhagia research clinic. PATIENT(S): One hundred twenty-one women; 62 women complaining of heavy menstrual blood loss, 59 women who considered their menstrual blood loss to be normal. INTERVENTION(S): Participants were asked to complete the menstrual pictogram through the period and collect their feminine hygiene products for an alkaline hematin assessment. MAIN OUTCOME MEASURE(S): Percentage agreement between blood loss measured by the gold standard alkaline hematin method and the menstrual pictogram. Extraneous blood loss was measured using a semiquantitative pictorial method. RESULT(S): The menstrual pictogram had a high level of agreement for blood collected on feminine hygiene products compared with the alkaline hematin method. Some women also lose a significantly large amount of extraneous blood, which is not proportional to the alkaline hematin blood loss assessment. CONCLUSION(S): The menstrual pictogram provides a simple means of measuring menstrual blood loss. It is no longer appropriate to ignore extraneous blood loss, particularly as there is no correlation between extraneous blood loss and that measured on feminine hygiene products.

Adult↗
PubMed2001

Platelet angiotensin II binding may be a useful prognostic indicator for the development of pre-eclampsia in women with pregnancy-induced hypertension: preliminary communication.

This was a preliminary investigation to assess the value of platelet angiotensin II binding as a prognostic indicator for subsequent pre-eclampsia in women admitted with non-proteinuric pregnancy-induced hypertension. Platelet angiotensin II binding was measured in 26 women at the onset of their symptoms. All were primparous, had singleton pregnancies, were normotensive at booking and had an unremarkable medical history. The blood pressure of seven women resolved and returned to normal; 11 women remained stable throughout the remainder of their pregnancy, their blood pressure remained elevated but they did not develop significant proteinuria. Eight women developed pre-eclampsia. Platelet angiotensin II binding in the pre-eclamptic group was significantly higher compared to those who remained stable (P = 0.042) or those whose condition improved (P = 0.021). We conclude that angiotensin II binding measured at the time of admission to hospital for non-proteinuric pregnancy-induced hypertension may have a role in predicting the onset of pre-eclampsia or eclampsia.

Journal Article↗
PubMed2000

Impact of the Internet on entomology teaching and research.

The Internet is affecting entomology teaching and research. Internet tools help students communicate and easily find and access information. Entomology instructors who adopt these tools may discover they are surprisingly time consuming to implement. Requiring students to use the Internet teaches them to glean from the glut of available information and to communicate electronically, both vital skills in today's workplace. The Internet helps meet the growing need for distance education by providing a medium that allows students to conveniently access course materials and to communicate with the instructor and other students. Researchers benefit from using the Internet for one-to-one and one-to-many communication and from access to large cooperative databases, for example, in molecular biology and systematics. Perhaps the greatest impact on research will be the migration to the Web of journals and other specialized research literature. This may permit free access and will change the content and format of journal articles. In the online version of this chapter, the hyperlinks in the Literature Cited section are active.

Animals↗
PubMed1999

Failure of platelet angiotensin II binding to predict pregnancy-induced hypertension.

OBJECTIVE: To determine whether measurement of platelet angiotensin II binding at 20 weeks' gestation identifies women destined to develop pregnancy-induced hypertension. METHODS: Over a 2-year period, we recruited 325 unselected, normotensive primigravidas from the hospital antenatal department after their routine 20-week scan appointments. Each woman had a singleton pregnancy, was normotensive at the time of entry into the study, and had an unremarkable medical history. Ninety-three nonpregnant women were recruited from the hospital staff for comparison. Platelet angiotensin II binding was measured in all participants. After delivery, the case notes were screened to determine pregnancy outcome. RESULTS: Two hundred sixty-seven women remained normotensive to delivery, 30 developed nonproteinuric pregnancy-induced hypertension, 23 developed proteinuric pregnancy-induced hypertension, four had transient hypertension, and one was diagnosed subsequently as having essential hypertension. The median platelet angiotensin II binding for the nonpregnant subjects was 15.7 fmol/10(9) platelets, which differed significantly from the value for normotensive pregnant subjects (4.8 fmol/10(9) platelets, P < .001) and from the value for those who developed either nonproteinuric pregnancy-induced hypertension (4.95 fmol/10(9) platelets) or proteinuric pregnancy-induced hypertension (7.2 fmol/10(9) platelets, P < .001). There was no significant difference between pregnant women who remained normotensive and those who developed nonproteinuric or proteinuric pregnancy-induced hypertension. CONCLUSION: Measurement of angiotensin II binding in the second trimester has no value as a screening test for nonproteinuric or proteinuric pregnancy-induced hypertension.

Adolescent↗
PubMed1997

Epidemiology of vancomycin usage at a children's hospital, 1993 through 1995.

OBJECTIVE: To describe the epidemiology of vancomycin usage at a children's hospital. METHODS: A cohort study of patients at Egleston Children's Hospital who were charged for the receipt of vancomycin from October, 1992, through October, 1995, was performed. Data were obtained from pharmacy charge records in the hospital's medical records information system. RESULTS: During the study period there were 3589 patient hospitalizations in which vancomycin was used. Patients receiving vancomycin were predominantly male (56.6%) and white (62.4%), ranged in age from 0 to 31 (median, 3.8) years and had an average length of stay of 6.0 days. The total number of vancomycin doses was 105,704; the median number of vancomycin doses during each patient hospitalization was 11.0 (range, 1 to 1215). The total charge for vancomycin used was $2,009,746; the median charge for vancomycin per patient was $297.50 (range, $11 to 19,864). The majority (75.7%) of vancomycin doses were given on the hematology (27.6%), neurosurgery (17.9%), cardiothoracic surgery (13.4%), neonatology (9.7%) or general pediatrics (7.1%) services. Overall surgery service patients were significantly more likely to receive vancomycin than were medicine service patients (1267 doses/6221 admissions vs. 1954/19,446; relative risk, 2.03; P < 0.001). During the study period the number of vancomycin doses decreased significantly (P < 0.001). CONCLUSIONS: This study shows the value of evaluating antimicrobial use through a pharmacy database. Although vancomycin use decreased during the study period, large amounts of vancomycin are still being prescribed primarily on subspecialty service patients. Interventions to reduce vancomycin use should focus on these groups.

Adolescent↗
PubMed1996

Uptake of desflurane during anaesthesia.

The amount of desflurane required to maintain an end-expired concentration of 8% was measured in 30 ASA 1 and 2 patients undergoing elective spinal surgery. The anaesthetic was administered using a computer-controlled closed circle system. After an initial period during which the expired concentration of desflurane was stabilised (4 min) the rate of uptake showed a bi-exponential decline. Mean cumulative usage of desflurane was 10.1 ml of liquid at 30 min, 14.8 ml at 60 min, 25.4 ml at 120 min, 35.8 at 180 min.

Anesthesia, Closed-Circuit↗
PubMed1986

Accuracy of a pulse-echo boundary tomogram.

An ultrasonic tomogram was developed with a view to providing the outline of a cross section of the ulna in vivo. The construction and design of the instrument was undertaken to obtain a resolution as close as possible to theoretical limits. The apparatus was constructed to be used in conjunction with a system for assessing bone mineral content using a conventional clinical x-ray set. It had been expected that the information from the two instruments would make it possible to obtain a precise spatial plot of bone density. It was thought that the tomograph would respond only to reflections at the bone--soft tissue interface, where there is a large change in acoustic impedance, but in vivo trials have shown that other soft tissue interfaces give rise to reflection, which makes the performance unsatisfactory. However, some interesting results have been obtained from solid objects in water, which have shown that there is a limitation on the accuracy of the plot depending on the angle of incidence of the ultrasonic beam and not dependent on errors of mechanical or electronic origin. Some theory is put forward to account for irregularities in plots for these objects.

Humans↗
PubMed1969

Blood pressure in a Scottish island community.

A survey of mean blood pressure levels in age-and-sex-matched samples of the population of the island of Tiree appears to support the local belief that blood pressure is higher on the island than on the mainland. This conclusion may be related to the observation of a greater mean width of the heart, measured radiologically, in the island population compared with the mainland population. The greater mean body weight observed in the island compared with the mainland may be a factor. Blood pressure in men between the ages of 40 and 59 years is higher in Tiree than in selected samples in England and America.

Adolescent↗