Biomedical subjects

V Bell

Publications and source records attributed to V Bell.

31 records · Page 2Linked to original sources

PubMed1988

[Rehabilitation of pension--which course do psychiatric patients follow after their first inpatient treatment in a psychiatric hospital? Results of a prospective longitudinal study].

Placing persons having a mental illness in the open labour market has in recent years become increasingly difficult. The question therefore arises whether an attempt should be made to improve occupational access through rehabilitative measures, or whether pensioning would not be the more appropriate action. In the framework of a prospective 5-year catamnestic study of first-admission psychiatric patients, the course taken by them was investigated, as well as the factors that had been relevant in the decision to pension the patients, or to provide rehabilitative services. It was found that pensioning and rehabilitative measures differ in no essential degree as to their shares, and that both types of approach had occurred in only very few cases. Disease-specific factors (psychopathological symptoms, readmission) are suggested to be involved concerning the route taken. Pensioning on the one hand, and rehabilitation service provision on the other, are linked with the age and diagnoses of the patients, as well as the extent of their social activities.

Alcoholism↗

PubMed1987

Prognoses about vocational achievement behavior of first admitted psychiatric patients under special consideration of the diagnoses of depressive illnesses.

In this study prognoses about the posthospital vocational achievement behavior of 55 first admitted depressive patients were made at the time of discharge. With a structured and standardized questionnaire the patients themselves, the treating physicians, and the nurses were interviewed. As a first step of analysis the prognoses of the three groups were compared with each other and tested in respect of differences. This comparison was made with other psychiatric diagnoses too, whereby endogenic depressive patients and neurotic depressive patients were discriminated. In the second step of analysis the prognoses of the three 'rater groups' were compared with the real vocational reintegration of 1 year after discharge. The result was that the prognoses of the treating physicians and the nurses were more compatible with reality than those of the patients themselves.

Achievement↗

PubMed1987

Pharmacokinetics and pharmacodynamics of flestolol, a new short-acting, beta-adrenergic receptor antagonist.

The pharmacokinetics and pharmacodynamics of flestolol, a new short-acting, beta-adrenergic receptor antagonist, were examined in nine healthy subjects after a constant intravenous infusion of 5 micrograms/kg/min for 72 hours. Flestolol blood levels were determined by high-performance liquid chromatography. In all subjects, flestolol blood concentration attained steady state 30 minutes after initiation of infusion. The mean +/- standard deviation steady-state concentration of flestolol was 31.1 +/- 12.0 ng/mL. The elimination half-life averaged 7.2 minutes. The mean +/- standard deviation total body clearance was 181 +/- 66 mL/min/kg. The apparent volume of distribution and the area under the curve averaged 1.89 L/kg and 2.23 micrograms-hr/mL, respectively. Flestolol did not cause any significant change (P greater than .05) in the heart rate or systolic or diastolic blood pressure from the baseline. Flestolol significantly (P less than .05) attenuated the isoproterenol-induced increase in heart rate and systolic blood pressure and decrease in diastolic blood pressure in comparison with baseline. The average maximum reduction in isoproterenol tachycardia was in the range of 63% to 79% during flestolol infusion. There was a rapid recovery from beta blockade after termination of flestolol infusion; the recovery averaged 96% 20 minutes after the infusion was stopped. We conclude that flestolol exhibits a very short half-life and is cleared mainly by extrahepatic routes. It is an effective beta blocker and possesses a short duration of action.

Adrenergic beta-Antagonists↗

PubMed1986

Effects of esmolol on airway function in patients with asthma.

In a double-blind, randomized, crossover study in ten patients with asthma, the effects on specific airway resistance of esmolol, a new ultra-short-acting beta 1-selective adrenoceptor blocker, were compared with those of placebo. Specific airway resistance was measured during increasing doses of esmolol infusion, during dry air provocation tests, and following isoproterenol inhalation. These same studies were later carried out on six of ten patients following intravenous propranolol infusion. All patients were able to tolerate the maximum dose of esmolol (300 micrograms/kg/min); treatment differences between esmolol and placebo were not found. In contrast, intravenous propranolol produced marked symptomatic bronchoconstriction after the lowest dose (1 mg) in two of six patients. Esmolol produced slight but statistically significant enhancement of patients' sensitivity to dry air provocation. Similarly, a slight but significant inhibition of bronchomotor sensitivity to isoproterenol was noted during esmolol infusion. After infusion of 5 mg of intravenous propranolol, one of four patients had a clinically significant increase in sensitivity to dry air. It is concluded that esmolol, because of its short duration of action and relative lack of effect on airway resistance, may be preferred over propranolol in patients with asthma who require treatment with an intravenous beta-blocking agent.

Adrenergic beta-Antagonists↗

PubMed1986

Predictors for the social adjustment of first admitted psychiatric patients.

In a prospectively designed follow-up study of 258 first admitted psychiatric patients, 1 year after discharge 224 patients and 175 significant others were asked about the social adjustment of these patients and some predictors for this aspect of outcome could be identified. The sample consisted of five different diagnostic groups: organically caused psychiatric diseases, schizophrenic psychoses, affective psychoses, neurotic or personality disorders and alcohol or drug dependency. The study shows that statements about the social adjustment of psychiatric patients largely depend on the diagnostic group, both with respect to degree of adjustment and the predictors. Schizophrenic patients were found to be less well socially adjusted than the other patients, with the exception of the alcohol- and drug-addicted patients. For schizophrenic patients, post-hospital social adjustment was primarily determined by indicators of mental illness, such as psychopathological symptoms and length of hospitalization. The social adjustment of addicted patients was primary influenced by vocational variables. For the patients with organic psychiatric disorders, affective psychoses or neurotic/personality disorders, prediction by pre-hospital or hospital variables did not prove to be very useful.

Adolescent↗

PubMed1986

Tolerance and beta-adrenergic blocking activity of flestolol, a short-acting beta blocker.

The tolerance and beta-adrenergic blocking activity of flestolol, a short-acting beta-blocker, was investigated in 30 subjects. Flestolol infused intravenously at doses up to 100 micrograms/kg/min was found to be well tolerated. A dose-dependent attenuation of isoproterenol-induced tachycardia and increase in systolic blood pressure occurred with flestolol at doses ranging from 0.5 to 15.0 micrograms/kg/min. The average percent reduction in isoproterenol-induced tachycardia (beta-blockade) at each dose of flestolol, 0.5, 2.5, 5.0, 15.0, and 50.0 micrograms/kg/min, was 15.1%, 45.9%, 67.0%, 85.9%, and 90.3%, respectively. The onset of beta-blockade occurred within 30 minutes. After the end of flestolol infusion there was a marked reduction in beta-blockade within 6 minutes, with complete recovery from beta-blockade within 30 to 45 minutes. There was a statistically significant (P less than 0.01) positive correlation between flestolol dosage and its blood levels (r = 0.91) as well as between the flestolol-induced beta-blockade and its dosage (r = 0.62).

Adult↗

PubMed1986

[Occupational reintegration of psychiatric patients hospitalized for the first time in the year following their discharge--results of a prospective longitudinal study].

A short-term occupational prognosis had been given for first-admission psychiatric patients, occasioned by information from the field that, in case of mentally ill persons, measures for their vocational rehabilitation frequently either are started too late, or are inappropriate in scope, because associated impairments are insufficiently dealt with, underrated, or even overlooked at all in the early stages of the illness. Following Wing's concept of disability, an attempt was moreover made to identify barriers for occupational resettlement. The findings provided the basis for considering the question of scope and type of within-clinic or external measures to be initiated, or stepped up, to facilitate these clients' access to gainful employment and, hence, able to positively influence the future course of their condition.

Germany, West↗

PubMed1986

[Occupational handicaps as risk factors for the readmission of psychiatric patients hospitalized for the first time--results of a prospective longitudinal study].

In dealing with the issue of readmission of psychiatric patients into in-patient care, the focus had in the past primarily been on clinical variables such as diagnosis, or severity of the clinical picture. The present study, however, had centered on occupational variables, such as vocational training, occupational status, periods of gainful employment, and unemployment. This complex was studied in a sample of psychiatric patients, with analyses directed at: percentage of the initial sample readmitted after a catamnestic period of 1 and 2 1/2 yrs. resp., diagnostic groups with increased readmission incidence, and occupational variables associated with the need for readmission. Summing up, it may be stated that occupational handicaps arose in particular in the diagnostic groups of endogenous psychoses, whereas in other groups (such as neuroses, alcoholism) the issue of "social handicaps", in particular, had been in the foreground.

Germany, West↗

PubMed1985

[The need and actually successful work-related rehabilitation measures for first-admission psychiatric patients].

Presented are the findings of a follow-up study of 258 psychiatric patients who had for the first time been admitted to inpatient psychiatric treatment in 1979. Using standardized forecasting instruments, the patients themselves, their treating physician, and a member of the care staff were asked to give their views of the patient's occupational outlook, his chances for resettlement, and the need for vocational rehabilitation services following discharge. The needs statements made at discharge are contrasted with the vocational and job-related rehabilitation measures actually initiated and carried out in the year following discharge; additionally, the patients' vocational situation at discharge is compared with their situation twelve months later, and the course of the rehabilitation measures provided is described. Along with the discrepancies between needs statements and amount of vocational rehabilitation services actually initiated and carried out, the empirical findings point to a non-specific, dispersive approach to providing rehabilitation services. The possible causes for this discrepancy between needs and service provision, with its rather serious implications, as well as the doubtful effectiveness of the rehabilitation services provided are discussed, practice-related consequences are outlined.

Adult↗

PubMed1984

[Familial stresses as a sequel of psychiatric diseases in a relative. Results of an interview with relatives].

The results of interviews with relatives of 179 patients committed to psychiatric treatment are reported. The relatives were interviewed in 1980, one year after discharge of the patient--who had been hospitalized for psychiatric problems for the first time--usually in the family setting. Our main interest was to investigate the concern of the relatives induced by the illness of a family member, and to take stock of the nature and extent of family stress at a relatively early stage of a psychiatric illness. We also wished to know what support the relatives had received, and from what sources, and from what other sources they would have wished such support. The results confirm what other investigators have suggested, i.e that community-centred care apparently leads to an increase in family stress, and that outpatient services and facilities have, to date, played a very minor role in overcoming the problems in the families of psychiatric patients.

Affective Disorders, Psychotic↗

PubMed1983

[After care behavior of first-admission psychiatric patients during the year after their discharge].

228 patients who had been admitted for the first time to a psychiatric hospital were questioned one year after their discharge in respect of the use they made of the medical and non-medical facilities or institutions. The article describes the actual state of affairs in the after-care behaviour of the psychiatric patients, and goes into details with regard to the diagnosis-specific differences in their behaviour. It is especially in this group of patients that a great demand exists with regard to treatment facilities. 90% of the patients have some kind of contact with our health system, and almost 3/4 have undergone treatment for mental disturbances. The main burden of medical outpatient follow-up of psychiatric patients continues to rest with the family physicians. This is equally true for almost all groups of diagnosed diseases. The patients with schizophrenic psychoses represent the only difference, since they will tend to preferably look up a neurologist for the treatment of their mental complaints.

Affective Disorders, Psychotic↗

PubMed1979

The man who became angry once: a study of overcontrolled hostility.

Recent developments in the study of violent behaviour have led social scientists to examine the concept of Overcontrolled Hostility. This case report describes the history of an overcontrolled individual who was examined in a Maximum Security Hospital after having shot his wife. The presentation of this case includes a brief theoretical perspective, as well as the results of psychiatric and psychological examinations.

Adult↗

PubMedDate not supplied

[Quantification of dementia-related disabilities in daily behavior with the DAFS (Direct Assessment of Functional Status): reliability and validity of a German test version].

The DAFS (Direct Assessment of Functional Status) is a new test for the assessment of competence of demented patients in situations of everyday life. The present study assesses objectivity, temporal stability, concurrent and discriminative validity of a German version of the DAFS. Sixteen patients with a DSM-III-R-diagnosis of dementia of the Alzheimer's type, 8 of which with a mild (MMSE 18-25) and 8 with a moderate (MMSE 12-17) dementia, and 8 control subjects without any symptoms of dementia (MMSE 28-30), matched with the patient groups in age, gender and education, were assessed three times within 3 weeks with the DAFS and once with the NOSGER (an ADL rating scale). The DAFS showed high objectivity (correlation between two test administrators r = .97) and stability (2 week retest reliability r = .98) and was able to discriminate significantly between the study groups and with a strong effect size. Correlations with the total score and the IADL subscale score of the NOSGER were high (r = .81 and r = .86, resp.), whereas correlations with the mood and the disturbing behavior subscale were much lower (both r = .54). This investigation could demonstrate that the DAFS is an objective, stable and valid test instrument. It has a high power to discriminate between demented and non-demented subjects as well as between various degrees of severity of illness. The test items are highly relevant for everyday functioning and the test itself is a good and necessary addition to the use of ADL or IADL rating scales.

Activities of Daily Living↗