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Biomedical subjects

J Leff

Publications and source records attributed to J Leff.

At least 19 recordsLinked to original sources
PubMed1994

The effects of family work training on mental health nurses' attitude to and knowledge of schizophrenia: a replication.

The association between expressed emotion and the outcome of schizophrenia is well established, and the efficacy of family work for schizophrenia has been demonstrated. Mental health nurses are an expanding group in mental health service provision but their training does not include family work. Although there is some evidence that training mental health nurses in schizophrenia family work increases their knowledge of, and changes their attitudes towards schizophrenia, very little research has been conducted in this area. This paper replicates a previous study, and investigates whether mental health nurses can change their attitude and beliefs, and increase their knowledge about schizophrenia. Knowledge increased and attitudes changed during the initial period (3 months), and the gains were maintained throughout the 9-month course. However, in order to incorporate the skills learnt into their routine practice, mental health nurses will continue to need ongoing recognition, support, and enthusiasm from colleagues and managers.

Accreditation↗
PubMed1994

Stress reduction in the social environment of schizophrenic patients.

Patients with schizophrenia are sensitive to short term social stressors in the form of life events, and the long term stress of living with high Expressed Emotion (EE) relatives. A number of family interventions have been evaluated in controlled trials. A comparison of successful and unsuccessful interventions indicates the optimal type of intervention for patients in high EE environments.

Adaptation, Psychological↗
PubMed1994

Neutrophil-generated free radicals: possible mechanisms of injury in adult respiratory distress syndrome.

The acute lung injury resulting from adult respiratory distress syndrome (ARDS) is thought to be largely mediated by activated neutrophils. Because activated neutrophils produce the superoxide radical, which is both bacterial and cytotoxic to host cells, this oxygen-derived free radical is likely responsible for at least part of the neutrophil-mediated lung injury. In a rat model of ARDS resulting from intratracheal instillation of interleukin-1, recombinant human manganous superoxide dismutase significantly decreased lung leak. One detrimental action of proteases released by adherent neutrophils may be the degradation of extracellular superoxide dismutase (ECSOD), which normally binds to the heparan sulfate on the surface the endothelium. We found that rabbit ECSOD incubated with either trypsin or activated neutrophils loses affinity for heparin. Furthermore, soluble ECSOD is elevated in the serum of patients with ARDS, consistent with this hypothesis.

Animals↗
PubMed1994

The TAPS Project. 22: A five-year follow-up of long-stay psychiatric patients discharged to the community.

A group of 114 long-stay patients in Friern and Claybury Hospitals was assessed while in hospital, and then again one year and five years after discharge to community placements. Neurotic symptoms, verbal and non-verbal behaviour and, most notably, negative symptoms all improved between the two community follow-up interviews. Patients were living under much less restrictive conditions in the community, and their appreciation of this freedom continued to grow over the years. Their social networks were enriched by an increase in the number of friends in the first year after discharge and in the number of confidants in the subsequent four years. There were no adverse outcomes, but these conclusions cannot yet be said to apply to all long-stay residents of mental hospitals.

Activities of Daily Living↗
PubMed1994

Working with the families of schizophrenic patients.

As schizophrenia is a heterogeneous condition with a variety of possible causes, it is sensible to combine biological and social treatment. Neuroleptic drugs give partial protection against environmental stress, but need to be supplemented. The programme developed on the basis of research on relatives' expressed emotion begins with education about schizophrenia for patients and relatives. Family sessions in the home are run in parallel with a relatives' group, and are aimed at improving communication, teaching problem-solving skills, lowering criticism and overinvolvement, reducing social contact between patient and relatives, expanding social networks, and lowering expectations. Individual work with the patient is often undertaken alongside the family sessions, and includes social-skills training, anxiety management, and a cognitive approach to persistent psychotic symptoms. Therapists take a central role in coordinating the variety of services needed by patient and relatives.

Antipsychotic Agents↗
PubMed1993

The TAPS Project. 10: The long-stay populations of Friern and Claybury hospitals. The baseline survey.

As part of the TAPS project, the baseline long-stay populations of Friern and Claybury Hospitals were compared using the TAPS assessment schedules. Each hospital has reduced bed numbers by two-thirds, and although the two have been subjected to different influences, their remaining long-stay patients were similar, and characterised by severe problems with hygiene, florid psychotic symptoms, a high prevalence of negative symptoms, and impoverished social networks.

Adult↗
PubMed1993

The TAPS Project. 13: Clinical and social outcomes of long-stay psychiatric patients after one year in the community.

The first prospective, controlled study of a large, long-stay, in-patient population as their hospital services were reprovided in the community is reported. Two-hundred-and-seventy-eight patients were matched individually with similar patients who remained in hospital. Clinical and social outcomes over a one-year follow-up are presented for the first three years of the reprovision process. Compared with matches, the leavers at follow-up had more diverse social networks that contained a higher proportion of contacts named as friends. The care facilities in the community allowed more opportunities for patient autonomy than the hospitals across all aspects of the environments measured. At follow-up, more leavers than matches wanted to remain in their current placement, while fewer leavers than matches said there was nothing they liked about their current placement. More leavers than matches found their medication helpful.

Activities of Daily Living↗
PubMed1992

The International Pilot Study of Schizophrenia: five-year follow-up findings.

A five-year follow-up of the patients initially included in the International Pilot Study of Schizophrenia was conducted in eight of the nine centres. Adequate information was obtained for 807 patients, representing 76% of the initial cohort. Clinical and social outcomes were significantly better for patients in Agra and Ibadan than for those in the centres in developed countries. In Cali, only social outcome was significantly better.

Activities of Daily Living↗
PubMed1992

Problems of transformation.

Despite the progressive reduction over many years in patient populations of psychiatric hospitals in America and many European countries, there have been few attempts to evaluate this policy. The Team for the Assessment of Psychiatric Services (TAPS) was established to monitor and evaluate the closure of two large psychiatric hospitals in North London. A number of important problems have been identified in the course of the TAPS research programme. These include: the inertia of the planning process, the selection of the best patients first for discharge at the expense of the more disabled, the accumulation of new long-stay patients entering the admission wards of psychiatric hospitals, the policy of introducing patients into the community as unobtrusively as possible, and the difficulties of deinstitutionalising staff. Despite these problems, evidence is presented that discharge of long-stay patients into the community has been relatively successful.

Activities of Daily Living↗
PubMed1992

The perception of emotion by schizophrenic patients.

Studies which have examined the perception of emotion by schizophrenic patients have produced conflicting results, an outcome which may, in part, be due to difficulties in presenting a realistic portrayal of emotion. This study exposed 32 schizophrenic patients in remission and ten controls to five videotaped scenes of emotional situations played by actors. The schizophrenic patients were divided into three groups, namely those living with high-EE relatives, those living with low-EE relatives and those living alone, in order to test the hypothesis that patients in a high-EE environment are less able to identify emotionally charged situations. Measures of electrodermal activity and self-ratings of tension were recorded concomitantly. The schizophrenic patients in all groups were as adept at identifying emotions as were the controls. There was no difference between the groups in electrodermal activity and subjective tension for all video scenes, except for the one which portrayed the only pleasant interaction; the high-EE group was significantly more aroused on both measures, which were independent of each other.

Adaptation, Psychological↗