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Biomedical subjects

B Neale

Publications and source records attributed to B Neale.

3 recordsLinked to original sources

The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1,038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples.

Adolescent↗

Contracting for palliative care.

In this paper the role of purchasing authorities, as set out in the current U.K. policy literature, is reviewed in the context of recent developments in palliative care. The notion of the purchasing cycle, from need assessment and strategic planning through to contracting and monitoring is outlined, along with core features of recent health and social care legislation in Britain: quality assurance, consumer choice and value for money. The role of providers and service users in the purchasing process is examined and the relationship between purchasers across the health/social care divide is explored. The implications of contracting for the voluntary sector provision of palliative care are also assessed. The review highlights the difficulties under the new legislation in reconciling the aim of efficiency with that of quality assurance, and of separating out the roles of purchasers and providers in a context where palliative care service developments have been provider-led. These factors reinforce the requirement to turn the purchaser-provider split into an effective partnership. Finally, the review highlights the need to address the current imbalances in the purchasing cycle by giving adequate attention to aggregate need assessment and strategic planning.

Contract Services↗

Munchausen syndrome by proxy: a study of psychopathology.

Munchausen Syndrome by Proxy (the fabrication of illness by a mother in her child) is often a serious form of child abuse that has been recognized increasingly over recent years. Approximately one-half of the mothers in this study had either smothered or poisoned their child as part of their fabrications. Lifetime psychiatric histories are reported for 47 of the mothers. Thirty-four had a history of a Factitious or Somatoform disorder, 26 a history of self harm, and 10 of alcohol or drug misuse. Nine mothers had a forensic history independent of convictions related to child abuse. Nineteen of these mothers were interviewed from 1-15 years after the original fabrications. The most notable psychopathology was the presence of a personality disorder in 17 of the mothers, which were predominantly Histrionic and Borderline types. Most subjects, however, met the criteria for more than one category of personality disorder.

Adolescent↗