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Biomedical subjects

N Wellman

Publications and source records attributed to N Wellman.

16 recordsLinked to original sources
PubMed2005

Developing services for the carers of young adults with early-onset psychosis--listening to their experiences and needs.

The care-giving experience of carers of young adults with early onset psychosis is relatively unexplored. New carers are less likely to be engaged with local services for carers and families, than those more established in their caring role. Understanding the experience of these carers provides some valuable insight into the value of caring and in guiding service development. This paper reports on a study designed to explore carers' experiences of caring for a young adult diagnosed with a first psychotic episode and their needs in relation to the development of an early intervention for psychosis service. A phenomenological approach was used. Eleven carers were given a semi-structured interview in their own homes. All of the carers in the study had a son with early onset psychosis. The outcome revealed that all carers were providing a comprehensive range of practical, emotional and financial support for their son including initiating and sustaining engagement between them and local mental health services. Many carers were felt to be invisible and silent partners in care and felt under-valued by mental health services.

Adaptation, Psychological↗
PubMed2003

Incorporating psycho-educational family and carers work into routine clinical practice.

There is growing evidence of the benefits of family and carers interventions using a psycho-educational model for carers of people with psychosis. In order to get this work into clinical practice, a network of interrelated services for carers and families of people with psychoses has been established in Reading, Berkshire. This paper reports the experience of the authors in establishing these services using a series of practice development initiatives including training for staff, education programmes, integration projects and collaboration across organizations. This work illustrates change processes through which evidence-based practice has been incorporated into routine clinical care and in which research-based assessment and evaluation tools have being used in routine clinical practice to measure outcomes.

Caregivers↗
PubMed2002

HOVIS -- The Hertfordshire/Oxfordshire Violent Incident Study.

Violence in psychiatric inpatient units is a major and growing problem. Research interest has primarily focussed on patient characteristics. The role of staff factors and the antecedents of violent incidents has been neglected, despite the fact that staff factors and behaviour may be more readily amenable to change than patient characteristics. The HOVIS study sought to obtain the views of a sample of mental health nurses in current clinical practice about staff-related factors, which they perceive to contribute to, or protect against, the occurrence of violent incidents. A total of 108 nurses working in psychiatric acute admission, intensive care and low secure units, in two NHS Trusts were interviewed using a specially designed semistructured interview schedule. These nurses identified a variety of behaviours, clinical skills, personal characteristics and interpersonal skills that they believe impact on the occurrence of violent incidents. These findings are discussed in relation to their possible training and managerial implications.

Adult↗
PubMed2002

Trauma for all: a pilot study of the subjective experience of physical restraint for mental health inpatients and staff in the UK.

Violence and aggression is common in psychiatric inpatient units. Despite the near universal prevalence of restraint, there is very little published research on either the efficacy or the subjective effects of restraint on staff or patients. In this pilot study, semistructured interviews were given to the patients and staff involved in six untoward incidents in which the patient participant had been subject to manual physical restraint. Participants were interviewed as soon as possible after the occurrence of the incidents. The interviews asked the patient and staff participants to identify and discuss the factors that they found helpful and unhelpful during and in the immediate aftermath of these incidents. The incidents generated strong emotions for all concerned. The patients valued staff time and attention but felt that they received too little attention. Both nurses and patients discriminated between permanent and temporary staff. Patients reported feeling upset, distressed and ignored prior to the incidents and isolated and ashamed afterwards. Postincident debriefing was valued by all but was patchy for staff and rarer still for patients. Patients feared the possibility of being restrained. Half of the patients and several staff members reported that the incidents had reawakened distressing memories of previous traumatic events. Further research on the subjective effects of restraint is urgently needed.

Humans↗
PubMed2000

No evidence for a parent-of-origin effect detected in the pattern of inheritance of schizophrenia.

BACKGROUND: Schizophrenia is a complex genetic disorder with no clear pattern of inheritance. Epigenetic modification of genes may thus play a role in its transmission. METHODS: In our study, 439 families with at least two ill siblings with schizophrenia (208 with unilineal transmission) were examined for evidence of a parent-of-origin effect (e.g., evidence of parental imprinting on the familial transmission of schizophrenia). RESULTS: No significant difference in the prevalence of maternal compared with paternal transmission was found. In addition, affected male subjects did not differ from affected female subjects in the proportion of their offspring diagnosed with schizophrenia. CONCLUSIONS: Although the transmission of schizophrenia may be influenced by epigenetic events, our study fails to find evidence that one epigenetic mechanism, a parent-of-origin imprinting effect, determines whether an individual expresses the illness.

Adult↗
PubMed2000

Failure to establish linkage on the X chromosome in 301 families with schizophrenia or schizoaffective disorder.

The hypothesis that a gene for susceptibility to psychosis (specifically in the X-Y homologous class) is located on the sex chromosomes has been proposed. Such a gene would account for the excess of sex chromosome anomalous males and females in populations of patients with psychosis, a tendency towards concordance by sex within families, and sex differences associated with psychosis and its underlying brain pathology. In earlier studies we observed small positive LOD scores in Xp11, and in a more recent and larger cohort of 178 sibling pairs, a peak multipoint nonparametric LOD score of 1. 55 at the locus DXS8032 in Xq21. The present study with a new set of markers extended the cohort to 301 ill sibling pairs and their parents. Despite the increase in sample size, the LOD score did not increase. A peak NPL of 1.55 was observed at the locus DXS1068 in proximal Xp, a region remote from the previous report. Separating families into those who were more likely to have X chromosome inheritance (maternal with no male to male transmission) did not yield stronger findings. In spite of the evidence that psychosis is related to a sex-dependent dimension of cerebral asymmetry, it is concluded that no consistent linkage of schizophrenia to the X chromosome can be demonstrated. In the context of the general failure of replication of linkage in psychosis, the possibility that the genetic predisposition to psychosis is contributed to by epigenetic modification rather than variations in the nucleotide sequence has to be considered.

Chromosome Mapping↗
PubMed2000

Lack of evidence for linkage to chromosomes 13 and 8 for schizophrenia and schizoaffective disorder.

A previous report [Blouin et al., 1998: Nat Genet 20:70-73] suggesting linkage to chromosomes 13q32 and 8p21 in families with schizophrenia led us to investigate these regions in a large set of 301 multiplex families with schizophrenia. Multipoint analyses failed to reveal evidence for linkage to any portion of chromosome 13, while only a weakly positive score was present on 8p using the identical marker reported in the earlier report. Failure to confirm the Blouin et al claims in a substantially larger cohort adds emphasis to the inconsistency of the findings concerning linkage in schizophrenia. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:235-239, 2000.

Chromosomes, Human, Pair 13↗
PubMed2000

Staff development, anxiety and relaxation techniques: a pilot study in an acute psychiatric inpatient setting.

Psychiatric inpatients often complain of problems with anxiety, but a computerised search of the nursing literature failed to find any publications detailing nurse-led, individual or group anxiety management work specifically aimed at psychiatric inpatient populations. In the UK, psychiatric inpatient populations are characterized by people with clinical diagnoses of schizophrenia and major affective and personality disorders. This is a very different population from that treated in the vast majority of published trials of cognitive and other approaches to anxiety management. A pilot study was conducted on four psychiatric acute admission wards to determine the practicality of treating a convenience sample of psychiatric inpatients with self-reported anxiety problems along broadly cognitive lines. Patients attended a course of three anxiety management groups (AMGs) run by nurses and were given homework and other exercises to complete. Patients reported significant reductions in anxiety after completion of the treatment. The AMGs were facilitated by staff nurses under the supervision of a clinical nurse specialist, and not by fully trained therapists as in most treatment studies relating to anxiety. Further studies, particularly randomized controlled trials, are needed to explore the efficacy and practicality of nurses delivering brief psychological interventions to psychiatric inpatients.

Acute Disease↗
PubMed1996

Bacterial biofilms and the bioelectric effect.

Bacterial biofilms are acknowledged to be a major factor in problems of ineffective sterilization often encountered in clinics, hospitals, and industrial processes. There have been indications that the addition of a relatively small direct current electric field with the sterilant used to combat the biofilm greatly increases the efficacy of the sterilization process. The results of the experiments reported in this paper support the concept of the "bioelectric effect" as reported by J.W. Costerton, B. Ellis, K. Lam, F. Johnson, and A.E. Khoury (Antimicrob. Agents Chemother, 38:2803-2809, 1994). With a current of 1 mA flowing through the chamber containing the biofilm, an increase in the killing of the bacteria of about 8 log orders was observed at the end of 24 h (compared with the control with the same amount of antibacterial agent but no current). We also confirmed that the current alone does not affect the biofilm and that there appear to be optimum levels of both the current and the sterilant that are needed to obtain the maximum effect.

Anti-Bacterial Agents↗
PubMed1996

Why nutrition care should be incorporated into HEDIS 3.0.

Good nutritional status is integral to an individual's ability to prevent injury and chronic disease. It affects quality of life, healing, and the costs associated with treatment of disease, illness, and injury. Therefore, measures to assess provision of nutrition care should be incorporated into HEDIS 3.0. Managed care plans and purchasers of health care benefit when the appropriate nutrition screening and interventions are provided. Every managed care organization serves members at nutritional risk. Those at the greatest risk include the elderly, pregnant women, young children, and people with chronic and acute conditions. Nutrition care is low-cost, easily implemented, and can often be incorporated into existing services.

Aged↗
PubMed1994

Management development. The MESOL (Management Education Scheme by Open Learning) experience.

Explores and attempts to reconcile some of the differences between traditional professional and academic management qualifications and those based on the NVQ competence model. Based on the experience of Universities and Higher Education institutions delivering open learning MESOL materials to the UK health and social care sector, focuses on the different assessment methodologies used by each. Concludes that it is necessary to differentiate clearly between the traditional input/knowledge-based model and the competence-based approach of the NVQ. This will allow candidates to contextualize and consolidate learning in the workplace prior to revisiting their performance at a later date.

Administrative Personnel↗
PubMedDate not supplied

Psychiatric intensive care: a developing specialty.

Care of acutely ill psychiatric patients is a problematic area for the NHS. This article charts the development of the specialty of psychiatric intensive care and discusses the major issues for staff and patients.

Attitude of Health Personnel↗