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Biomedical subjects

J Nicholson

Publications and source records attributed to J Nicholson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Mothers with mental illness: I. The competing demands of parenting and living with mental illness.

OBJECTIVE: The purpose of this study is to understand the parenting experiences of women with mental illness from the perspectives of mothers and case managers employed by the state department of mental health. METHODS: Six focus groups of mothers and five focus groups of case managers met to discuss the problems facing mothers with mental illness and to recommend solutions. Focus-group transcripts were coded and items grouped by themes in qualitative analyses to explore the conflicts mothers face in meeting the dual challenges of parenting and living with mental illness. RESULTS: Mothers and case managers identified sources of conflict in four thematic categories: the stigma of mental illness, day-to-day parenting, managing mental illness, and custody of and contact with children. CONCLUSIONS: Many of the issues of mothers with mental illness are generic to all parents; others are specific to the situation of living with mental illness. Mothers with mental illness must play a role in developing standards for clinical care and the research agenda in this area.

Adaptation, Psychological↗
PubMed1998

Mothers with mental illness: II. Family relationships and the context of parenting.

OBJECTIVE: This study explores the experiences of mothers with mental illness regarding their family relationships. METHODS: Six focus groups of mothers with mental illness and five focus groups of case managers met to discuss problems facing mothers with mental illness and to recommend solutions. Focus groups were audiotaped, and transcripts were coded and analyzed qualitatively to describe ways in which husbands and partners, grandparents, and other family members contribute to the context of parenting for mothers with mental illness. RESULTS: Mothers with mental illness and case managers described a range of relationships and attitudes of family members and provided examples of the ways in which family members contribute both positively and negatively to parenting. CONCLUSIONS: Although family members may seem to be natural supports for mothers with mental illness, their involvement in the context of parenting may not be entirely positive. The contributions of family members to the context of parenting for mothers with mental illness must be considered by treatment providers if unintentional negative outcomes are to be avoided.

Adaptation, Psychological↗
PubMed1998

Nasogastric drug administration.

Nurses working in one trust frequently requested advice on the preparation of drugs for nasogastric administration, prompting a survey of their knowledge in this area. As a result, guidelines were prepared to aid nurses and alert them to potential problems.

Clinical Protocols↗
PubMed1997

Role of preterminal protein processing in adenovirus replication.

Preterminal protein (pTP), the protein primer for adenovirus DNA replication, is processed at two sites by the virus-encoded protease to yield mature terminal protein (TP). Here we demonstrate that processing to TP, via an intermediate (iTP), is conserved in all serotypes sequenced to date; and in determining the sites cleaved in Ad4 pTP, we extend the previously published substrate specificity of human adenovirus proteases to include a glutamine residue at P4. Furthermore, using monoclonal antibodies raised against pTP, we show that processing to iTP and TP are temporally separated in the infectious cycle, with processing to iTP taking place outside the virus particles. In vitro and in vivo studies of viral DNA replication reveal that iTP can act as a template for initiation and elongation and argue against a role for virus-encoded protease in switching off DNA replication. Virus DNA with TP attached to its 5' end (TP-DNA) has been studied extensively in in vitro DNA replication assays. Given that in vivo pTP-DNA, not TP-DNA, is the template for all but the first round of replication, the two templates were compared in vitro and shown to have different properties. Immunofluorescence studies suggest that a region spanning the TP cleavage site is involved in defining the subnuclear localization of pTP. Therefore, a likely role for the processing of pTP-DNA is to create a distinct template for early transcription (TP-DNA), while the terminal protein moiety, be it TP or pTP, serves to guide the template to the appropriate subcellular location through the course of infection.

Adenoviruses, Human↗
PubMed1996

Chickenpox in mid-trimester pregnancy: always innocent?

A case of congenital varicella infection is presented, in which despite profound cerebral damage, the cardinal features of cicatricial skin lesions and limb shortening were absent. The case is compared with previously described cases, and with published series, in which this combination is uncommon. The risks of maternal varicella infection to the developing fetus are discussed in the light of recent prospective studies which demonstrate a rather lower risk than had previously been thought to be the case.

Brain↗
PubMed1996

Impact of Medicaid managed care on child and adolescent emergency mental health screening in Massachusetts.

OBJECTIVE: The study evaluated the impact of Medicaid managed care on decision making during emergency mental health screening and the outcomes of such screening for children and adolescents. METHODS: Data on client attributes and on system characteristics (payer, referral source, and disposition) were available for 297 Medicaid and non-Medicaid episodes of emergency mental health screening that occurred one year before the implementation of a statewide managed Medicaid program in Massachusetts and 393 episodes that occurred one year after implementation. Outcomes included changes in the volume of service provided and in the pattern of dispositions, particularly inpatient admissions. RESULTS: Although the total volume of child and adolescent emergency screening episodes significantly increased after implementation of Medicaid managed care, inpatient admissions decreased significantly. Among episodes not covered by Medicaid, no significant changes were noted after implementation on any variables. In the Medicaid group, significant differences were found in client attributes and system characteristics. After implementation the volume of emergency screening episodes for Medicaid clients increased significantly, and inpatient admissions decreased significantly. The pattern of dispositions changed significantly, with increased use of newly available crisis stabilization services. CONCLUSIONS: Although implementation of Medicaid managed care achieved the short-term goal of a decrease in hospitalizations, and probably concomitant savings, issues of quality of care for children and adolescents, and savings over the longer term, remain to be addressed.

Adolescent↗
PubMed1996

"Sylvia Frumkin" has a baby: a case study for policymakers.

"Sylvia Frumkin" was a pseudonym given to a 32-year-old woman with chronic mental illness described by Susan Sheehan in her books Is There No Place on Earth for Me? This paper presents the case of "Gloria Morrison," a patient similar to Ms. Frumkin, who is also a mother. Issues raised by the case in three areas are discussed. Issues for the service delivery system include developing better assessment, prediction, and reduction of the risk that a parent's mental illness may pose to a child's safety and well-being; targeting supportive and educational interventions to relatives and foster parents caring for children of severely mentally ill patients; and tailoring programs and services to the needs of such patients and their children. Clinical treatment issues include offering treatment options through agencies other than the department of social services; developing protocols for the care of severely mentally ill pregnant and postpartum women; focusing on issues of loss; and providing parenting skills training. Issues in the area of family support include increasing providers' awareness of family burden and alleviating conflicts between the family and patient.

Child↗
PubMed1995

Conformational changes induced by DNA binding of NF-kappa B.

The transcription factor NF-kappa B makes extensive contacts with its recognition site over one complete turn of the double helix. Structural transitions, in both protein and DNA, that accompany formation of the DNA-protein complex were analysed by proteinase sensitivity and circular dichroism (CD) spectroscopy. In the absence of DNA chymotrypsin cleaved p50 after residues Y60 and N78, while proteinase K cleaved p50 after residues S74 and Q180. Previous experiments had indicated that trypsin cleaved p50 after K77. Cleavages after Y60, S74, K77 and N78 were blocked in the presence of bound DNA, whereas cleavage after Q180 was enhanced. Y60, S74, K77 and N78 are all located in the p50 N-terminal domain AB loop, whereas Q180 is located in the mainly alpha-helical region between p50 N-terminal domain beta-strands G' and H. As only Y60 makes direct contact with the DNA it is likely that the AB loop is highly unstructured in the absence of DNA, but is held in a rigid, proteinase-resistant structure by bound DNA. These conclusions were supported by CD spectroscopic studies of recombinant p50 and p65 homodimers, which indicated that both species changed conformation when binding DNA. Examination of the near UV CD spectra revealed that with some DNA sequences the bound and free forms of the DNA assumed different conformations. While this was evident for a fully symmetrical, high affinity recognition site DNA, it was not apparent with less tightly bound DNA.

Base Sequence↗
PubMed1995

Mothers with severe mental illness caring for children.

This research identifies and describes the Massachusetts population of Department of Mental Health (DMH) case-managed women with severe mental illness who are caretakers of their minor children (N = 314), and compares their demographic and clinical characteristics and service utilization with those of a matched, randomly selected group of DMH case-managed noncaretaking women (N = 328) using the Client Tracking System database. Caretakers were significantly younger, had less formal education, and had higher rates of marriage than did noncaretakers. They are diagnosed more often with major affective disorders and less often with psychotic disorders. Caretakers demonstrate higher levels of functioning and are less likely to have a representative payee. Although caretakers function better, the groups do not differ significantly in their use of DMH services. This is the first systematic, statewide effort to specify the unique characteristics of this substantial group of women with severe mental illness who are caring for their children.

Adaptation, Psychological↗
PubMed1995

Patient-focused care and its role in hospital process re-engineering. Describes a programme of change implemented at the Derbyshire Royal Infirmary.

Examines the concept of patient-focused care and how it fits into hospital process re-engineering. Describes the project undertaken at the Derbyshire Royal Infirmary, to implement patient-focused care and care pathway development in accident and emergency, and trauma and orthopaedics. Concludes with an insight into how care pathways have been used to improve hospital documentation, reduce duplication of information and provide a rich source of data for effective clinical audit.

Critical Pathways↗
PubMed1994

Determination of tellurium in urine by isotope dilution gas chromatography/mass spectrometry using (4-fluorophenyl)magnesium bromide as a derivatizing agent and a comparison with electrothermal atomic absorption spectrometry.

The antitumor drug AS-101 [ammoniumtrichloro (dioxoethylene-O,O')tellurate(IV)] is the first tellurium-containing compound that has been identified as possessing immunomodulating properties and minimal toxicity. We have developed a stable isotope dilution gas chromatography/mass spectrometry method using 120Te as an internal standard and (4-fluorophenyl)magnesium bromide as a derivatizing agent for Te determination in urine. The urine samples were digested using HNO3 + H2O2 prior to derivatization with lithium bis(trifluoroethyl)dithiocarbamate at a pH of 3. The trifluorodiethyldithiocarbamate of tellurium was reacted with the Grignard reagent in anhydrous diethyl ether to obtain Te-(FC6H4)2 for GC/MS analysis. All isotope ratio measurements were made by selected ion monitoring with a Finnigan MAT 8230 organic mass spectrometer using a 10-m fused silica capillary column. Overall percision values for the five major Te isotopes relative to 130Te were 0.6-3.1% when 10-ng samples of chelated Te were analyzed. No appreciable memory or carry-over effect was observed when two synthetic mixtures differing in 120Te:130Te ratios by a factor of 50 were sequentially analyzed. The isotope dilution GC/MS method was validated by determining Te in urine samples and comparing the values with electrothermal atomic absorption spectrometry. Te concentrations were determined in the 100-500 micrograms/L range with CVs of 1-4%.

Gas Chromatography-Mass Spectrometry↗
PubMed1994

Parents with severe mental illness and their children: the need for human services integration.

This article presents the findings and recommendations of a statewide interagency task force on parents with mental illness who have young children. Based on testimony from consumers, providers, and advocates, the task force concluded that this is a substantial and neglected public policy issue requiring an intergovernmental, services integration approach. Recommendations were made in the areas of services, policies and procedures, and service coordination.

Adult↗