PubMed Health⌕ Search

Biomedical subjects

B Parry-Jones

Publications and source records attributed to B Parry-Jones.

10 recordsLinked to original sources
PubMed2001

Needs-led assessment: the challenges and the reality.

The NHS & Community Care Act 1990 heralded a new era in community care in the UK. Needs-led assessment and case management were to form the cornerstone of high quality care. Practitioners were challenged to alter their attitudes and practice to accommodate the needs-led approach. Previously they had assessed need to ascertain eligibility for statutory services, now they were required to identify "need" per se. The pivotal role given to assessment meant the success, or otherwise, of the reforms lay in part on the ability of practitioners to make this transition. However, to make needs-led assessment a reality, practitioners would have both to overcome conceptual barriers--need being an unclear concept, with no clear framework existing to assess need--and also to deal successfully with the conflicting requirement to ration services. In order to investigate whether the shift to needs-led practice had been possible, the opinions of social and healthcare practitioners providing services for older people in North Wales were sought through semi-structured interviews in 1994-1995 and 1998-1999. Supports and constraints to practice were also explored. Practitioners indicated that whilst they welcomed the needs-led philosophy, putting it into practice was difficult, if not impossible. The main constraints were a lack of resources (financial, service provision and staffing) and the conceptual difficulty of separating "need" from the "need for a particular service". Ever-tightening budgets and service eligibility criteria over the period of the study indicate that a shift of focus from assessment of need to rationing has taken place.

Aged↗
PubMed1994

Post-traumatic stress disorder: supportive evidence from an eighteenth century natural disaster.

Post-traumatic stress disorder was first recognized as a diagnostic category embracing reactions in response to overwhelming environmental stress 'outside the range of usual human experience' in DSM-III (APA, 1980). Such abnormal stressors are by no means a product of the twentieth century but have featured, sporadically, in all societies from the earliest civilizations. Longitudinal investigations of traumatic stress have rarely gone further back than the nineteenth century, and have been concerned, almost exclusively, with adverse effects following railway accidents and military combat. The present study, utilizing a mid-eighteenth century medical source, presents an analysis of the impact of a natural disaster on members of a peasant family trapped in an avalanche in the Italian Alps in 1755.

Disasters↗
PubMed1994

Merycism or rumination disorder. A historical investigation and current assessment.

BACKGROUND: In the 'fashionable' field of eating disorders, there has been a notable gap in the historiography of rumination, allowing considerable scope for constructing a comprehensive historical profile of this disorder. METHOD: A wide-ranging examination of printed material, both etymological and medical, backed by a Medline computer search, uncovered extensive sources, some of considerable rarity, including case reports from the early 17th century onwards. Extracted data focused on incidence, sex distribution, age range, outcome and causation, and the findings are discussed in relation to diagnostic criteria in DSM-III-R and ICD-10. RESULTS: While confirming the frequency of rumination in infants and the mentally retarded, the study demonstrated, particularly, the need to recognise its occurrence in normal adults, occasionally as a collateral behaviour in anorexia and bulimia nervosa, and suggested that its prevalence, distorted by secrecy, exceeded estimated levels. CONCLUSIONS: In future reviews of classification, existing anomalies and inadequacies in the status and description of rumination would benefit from integrating some of the historical conclusions.

Adult↗
PubMed1993

Self-mutilation in four historical cases of bulimia.

Current theories suggest that there is a relatively frequent association of self-mutilative behaviour with eating disorders, particularly with the modern binge-purge syndrome, bulimia nervosa. In order to consider this association on a historical dimension, 25 bulimic cases, reported from the late 17th to the late 19th century, were investigated. These were found to include four examples of self-mutilative behaviour, in three males and one female: these cases are described and discussed. The historical evidence lends some support for the suggested connection between eating pathology and self-mutilation.

Adolescent↗
PubMed1992

Pagophagia, or compulsive ice consumption: a historical perspective.

Pagophagia, or the excessive consumption of ice or iced drinks, is popularly regarded as a novel manifestation of pica, which has emerged, predominantly in the USA, over the last 30 years. However, a sampling of historical sources reveals that not only are there warnings in the writings of both Hippocrates and Aristotle concerning the dangers of excessive intake of cold or iced water, but a series of medical works, from the sixteenth century on, incorporate discussion and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of disordered eating.

Adolescent↗
PubMed1992

A bulimic ruminator? The case of Dr Samuel Johnson.

Utilizing a wide range of eighteenth- and nineteenth-century biographical sources, the eating pathology of Dr Samuel Johnson is illustrated and examined. His presenting symptoms are considered in the light of modern criteria for eating disorders and current research on bulimia nervosa and rumination disorder.

Bulimia↗
PubMed1992

Pica: symptom or eating disorder? A historical assessment.

In DSM-III-R, pica, with anorexia nervosa, bulimia nervosa and rumination disorder of infancy, is accorded the status of a separate eating disorder. However, in the Draft of ICD-10, only anorexia nervosa and bulimia nervosa are listed under eating disorders. Pica in children, and feeding disorder in infancy and childhood, are incorporated with enuresis, encopresis, and feeding, movement and speech disorders in a separate "heterogeneous group of disorders". Extensive research on the history and terminology of eating disorders from the 16th to the 20th century suggests that, historically, pica was regarded as a symptom of other disorders rather than a separate entity. This paper aimed to locate and assess chronologically significant definitions and accounts of pica, to provide a fuller clinical description of a condition which, despite its current relevance, has received little detailed historical examination, and to give some consideration to the multiple aetiological theories which have been put forward. The historical findings are related to the descriptive criteria for pica in DSM-III-R and Draft ICD-10.

Anemia, Hypochromic↗
PubMed1991

Historical terminology of eating disorders.

Using a wide range of rare, early printed sources, including literary material, some of the first English language dictionaries, medical lexicons and medical texts, the historical origins, development and application of five terms relating to eating abnormalities are investigated. It is demonstrated that four of these, which are in current psychiatric usage, exhibited notable consistency of meaning and application over many centuries.

Feeding and Eating Disorders↗