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Biomedical subjects

Louise Bell

Publications and source records attributed to Louise Bell.

5 recordsLinked to original sources

Clinical assessment of behavioral coping responses: preliminary results from a brief inventory.

Patients and clinicians sometimes take coping with chronic pain primarily as a process of gaining more control over pain. An alternate approach might include helping the pain sufferer to discriminate parts of their situation that can be effectively controlled from those that cannot. When faced with situations that do not yield to attempts at direct control patients may gain better results from leaving those situations as they are and investing their efforts elsewhere. This study was designed to examine this type of expanded view of coping with pain, a view that includes both attempts at control and acceptance. 200 adults seeking treatment for chronic pain were the subjects of this investigation. They completed a number of self-report inventories including a measure called the Brief Pain Coping Inventory, an inventory assessing accepting responses to pain as well as pain management responses standardly targeted by cognitive-behavioral treatment methods. Preliminary results showed that the BPCI yields scores with adequate temporal consistency and validity. Further results showed that a number of the responses assessed by the BPCI were reliable predictors of patient functioning. In general less frequent struggling to control pain, fewer palliative and avoidant coping responses, and more explicit persistence with activity despite acknowledged pain were associated with less depression and anxiety and greater life functioning. These results demonstrate that, in some instances, attempts at avoidance and control of chronic pain may be less helpful compared with a willingness to experience pain and focus on functioning.

Activities of Daily Living↗

Patient-centred quality improvement audit.

PURPOSE: This article aims to describe the research process, and the development of the instrument now employed in auditing patients' perceptions of quality improvement in a community health care trust in a coastal town in Essex, England. DESIGN/METHODOLOGY/APPROACH: The new instrument is currently being implemented and the findings thus far are described. FINDINGS: The instrument has measured health outcomes in terms of quality improvement from the users' perspective, and has also highlighted gaps between what the service offers in terms of quality and users' perceptions of what is delivered. The study demonstrates the importance of the professional role in quality improvement. ORIGINALITY/VALUE: Patient-centred quality improvement audit should be undertaken regularly so that both non-clinical managers and health care professionals can establish whether or not they are providing services that are patient-friendly and effective from the user's viewpoint. In the course of their work, professionals and managers discuss patients and speak on their behalf in various forums, and knowing what patients actually expect and perceive before speaking on their behalf may be of great benefit in such instances.

Aged↗

"To protect or not to protect?" Complaining vulnerable adults? That is the challenge.

PURPOSE: Hidden camera television documentaries filmed in care home settings have shown evidence of the abuse of vulnerable adults, been widely discussed in the mass media and have brought the attention of the mass population to the importance of these issues. Governmental documents have also emphasised the need to protect vulnerable adults. It is therefore known that vulnerable adults exist and require protection from abuse in any shape or form. However, this paper aims to argue that protecting vulnerable adults and the current mechanisms for encouraging such individuals to make their views known to services are not mutually compatible. The main technique vulnerable adults may use, the complaints procedure, currently may not be sufficient to enable vulnerable adults to express themselves and their anxieties adequately. DESIGN/METHODOLOGY/APPROACH: The paper provides a case study which clearly demonstrates the nature of the problems, and then recognises and describes a number of levels which could be explored to learn more about these issues. RESEARCH LIMITATIONS/IMPLICATIONS: Potential solutions are explored by the authors, who draw conclusions about the need for further research into this area. ORIGINALITY/VALUE: This paper defines a gap between adult protection and complaints procedures, questioning both their efficacy and abilities to meet their stated aims. The paper also highlights that the nature of these may not sufficiently enable complaining vulnerable adults to express their views of services.

Aged↗

Human papillomavirus gene expression in cutaneous squamous cell carcinomas from immunosuppressed and immunocompetent individuals.

Epidermodysplasia verruciformis (EV)-type human papillomavirus (HPV) DNA have been detected by PCR in squamous cell carcinomas (SCC) from both organ transplant recipients (OTR) and immunocompetent individuals. Their role in skin cancer remains unclear, and previous studies have not addressed whether the viruses are transcriptionally active. We have used in situ hybridization to investigate the transcriptional activity and DNA localization of HPV. EV-HPV gene transcripts were demonstrated in four of 11 (36%) OTR SCC, one of two (50%) IC SCC, and one of five (20%) OTR warts positive by PCR. Viral DNA co-localized with E2/E4 early region gene transcripts in the middle or upper epidermal layers. Non-EV cutaneous HPV gene transcripts were demonstrated in one of five (20%) OTR SCC and four of 10 (40%) OTR warts. In mixed infections transcripts for both types were detected in two of six (33%) cases. Our results provide evidence of EV-HPV gene expression in SCC; although only a proportion of tumors were positive, the similarly low transcriptional activity in warts suggests this is an underestimate. These observations, together with emerging epidemiological and functional data, provide further reason to focus on the contribution of EV-HPV types to the pathogenesis of cutaneous SCC.

Carcinoma, Squamous Cell↗

Developing service quality in mental healtlh services.

Through a literature review, this paper demonstrates that there is a lack of knowledge about quality management within the mental health services. Ideas about quality from the wider services sector are then discussed, and a case study of a mental health scenario is provided. It is argued that health service generally, and mental health services in particular, have much to gain from becoming more closely aligned with the wider field of knowledge of quality management. Concludes that the wider techniques of managing service quality may prove useful, particularly in mental health services, due to the nature of such services and their inherent variability.

Bibliometrics↗