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Biomedical subjects

Y Reid

Publications and source records attributed to Y Reid.

14 recordsLinked to original sources
PubMed2001

The longer term outcomes of community care: a 12 year follow-up of the Camberwell High Contact Survey.

BACKGROUND: There is as yet little evidence available regarding the long-term outcomes of people with severe and enduring mental illness who have been cared for primarily in the community. METHODS: A 12-year follow-up was carried out of the clinical and social problems and needs for care of a group of long-term mentally ill patients (N = 81) who were heavy users of psychiatric services when originally assessed in the Camberwell High Contact Survey between 1983 and 1985. The MRC Needs for Care Assessment Schedule used in the original baseline study was repeated at follow-up. RESULTS: The clinical and social functioning of the group had remained relatively stable, with high levels of problems and needs at both time points and little evidence of significant improvement or deterioration. The majority had remained in contact with services. There was some increase in levels of unmet as well as met needs, and a decrease in ratings of unmeetable needs, which may have been due to changes in clinical practice. CONCLUSION: The challenge for current service providers is not only to keep clients stable, but also to help improve the clinical and social functioning of people who may no longer be the highest priority of current community mental health services. This could be approached by identifying the continuing needs of this group, and persistently delivering active treatments.

Adolescent↗
PubMed1999

Mental health, "burnout" and job satisfaction in a longitudinal study of mental health staff.

BACKGROUND: This study examines whether the adoption of a more community based model in an inner city psychiatry service is accompanied by increasing "burnout", deteriorating mental health and decreasing job satisfaction amongst staff. METHOD: Questionnaires were sent annually for 3 consecutive years to all mental health staff working in three adult mental health sectors in inner London. Main outcome measures were the 12-item General Health Questionnaire, Maslach Burn-out Inventory and a general job satisfaction measure. RESULTS: There was no significant change over time in the outcome measures, once confounding by job and demographic variables was examined. Being based in the community was associated with higher GHQ-12 scores (P = 0.02) when compared to in-patient staff over the 3 years. CONCLUSIONS: These results suggested that working in the community may be more stressful than working in in-patient services. However, there was no evidence to suggest that levels of stress are increasing over time, either in community-based or hospital-based staff.

Adult↗
PubMed1999

Explanations for stress and satisfaction in mental health professionals: a qualitative study.

BACKGROUND: High levels of burnout and poor psychological well-being, but also relatively high levels of job satisfaction, have been found among mental health staff, especially those based in community settings. AIMS: In order to investigate the basis of these findings, a qualitative interview study was carried out, exploring mental health staff's views of their work and of its effects on them. METHOD: A semi-structured interview was administered to a purposive sample of 30 professionals, including junior and senior members of each profession in both hospital and community settings. Interviews were transcribed verbatim and analysed using QSR NUD.IST software. RESULTS: For most professionals, contact with colleagues was one of the major rewards of the job. There was surprisingly little evidence of conflict or difficulties defining roles between disciplines, except for the social workers, for whom difficulty in defining roles in relation to other professions was a major preoccupation. Reported stresses differed between community and hospital staff. Community staff tended to find their contacts with patients highly rewarding, but also to feel burdened by a strong and uncomfortable sense of being constantly responsible for their clients' well-being and actions. Ward staff, on the other hand, identified as central difficulties in their job lack of autonomy, responsibility and scope for developing an independent therapeutic role. They felt demoralised by revolving door' patients and by violence and the need to restrain patients.

Burnout, Professional↗
PubMed1999

Improving support for mental health staff: a qualitative study.

BACKGROUND: High levels of both burnout and job satisfaction have been found in recent studies of mental health professionals. A qualitative methodology was used in a related study to explore reasons for these findings and to investigate staff's accounts of their strategies for coping with their work, and their views of support provided for them and how their jobs might be made less stressful and still more satisfying. METHOD: A semi-structured schedule was used to interview a purposive sample of 30 mental health staff drawn from three South London geographical sectors, selected to include junior and senior members of each profession in both hospital and community settings. Interviews were transcribed and analysed using QSR NUD.IST software. RESULTS: Informal contacts with colleagues were the most frequently mentioned way of coping with the difficult and demanding aspects of work in both hospital and community settings, closely followed by time management techniques. The main formal sources of support described by staff were individual supervision and staff support groups. Accounts of the former were generally positive, but there was great variation in opinions about whether support groups are useful. Almost all the interviewees believed that their jobs could be improved by further training. For community mental health staff the main training gaps were the development of skills in various forms of clinical intervention, whilst ward staff identified the need for further skills in diffusing potentially confrontational and aggressive situations.

Burnout, Professional↗
PubMed1998

Smoking and smoking cessation among men whose partners are pregnant: a qualitative study.

Smoking among partners of non-smoking pregnant women has been linked to adverse pregnancy outcome, including low birthweight. Paternal smoking also increases the risk of infant respiratory infections and sudden infant death syndrome, irrespective of maternal smoking status. Furthermore, men's smoking habits are probably one of the strongest influences on the extent to which women are able to quit smoking in pregnancy and maintain cessation post birth. In four focus group discussions, male smokers whose partners were pregnant discussed their beliefs about passive smoking in pregnancy, the barriers they perceived to quitting in pregnancy and their preparedness to support maternal cessation. Men were largely unaware that their own smoking could pose a specific risk to the fetus, but when pregnant women are smokers, men believed their own smoking habits were unimportant. For men, barriers to quitting during their partners' pregnancy were: lack of understanding as to how passive smoking can affect the fetus, including a belief that the fetus is "protected" inside its mother; lack of motivation to quit early in pregnancy due to the baby not being "real"; and concern about stress-induced marital discord associated with cigarette withdrawal. These findings are discussed with regard to messages and strategies which may influence men to quit during their partners' pregnancy.

Female↗
PubMed1993

A strategy for evaluating a novel smoking intervention device.

The Victorian Smoking and Health Program (VSHP) was established in 1985 to (1) determine the views of smokers making a quit attempt regarding the acceptability and usefulness of a novel self-help smoking cessation device (the QUITZ pack), (2) define a potential market by determining the correlates of use of the QUITZ pack, and to (3) determine how the QUITZ pack compared to existing resources with proven acceptability and usefulness. Telephone interviews were conducted of 120 smokers who rang the QUITZ office for resources to help in a quit attempt. The results showed that most people found the QUITZ pack to be acceptable, both on first receiving it (68% acceptable) and after they had had the resource for at least a week (61% acceptable). The QUITZ pack was used in some way by 58% of the people to whom it was sent. No significant associations were found between the use of the pack and any of the demographic, smoking history, or motivational factors examined. Around a third of smokers to whom it was sent rated the QUITZ pack as being either quite or very useful in their cessation attempt. Of those who reported using the QUITZ pack, 61% rated it as being quite or very useful. For those who used the pack and made a quit attempt, more respondents rated a self-help guide (the CanQuit book) (87%) and any other personally chosen strategy (87%) as being quite or very useful, than rated any components of the QUITZ pack in this way.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Occurrence of craniosynostosis in neonates exposed to cocaine and tobacco in utero.

The occurrence of craniosynostosis (premature closure of cranial sutures) has been reported to be 3 to 5 per 10,000 live births. The incidence is even lower among African-American infants. The District of Columbia General Hospital serves primarily the African-American population with approximately 2000 deliveries a year. In the last 10 years, three neonates with craniosynostosis have been born at DC General Hospital; all three infants were African Americans. These infants were exposed to cocaine and tobacco in utero, which suggests a possible association between intrauterine cocaine and tobacco exposure and premature closure of cranial sutures. Possible pathogenesis of craniosynostosis in association with cocaine and tobacco use is discussed.

Adult↗
PubMed1992

Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners.

OBJECTIVE: To compare three approaches for marketing a quit smoking intervention kit to general practitioners. DESIGN: Randomised trial of (a) personal delivery and presentation by an educational facilitator with a follow up visit six weeks later; (b) delivery to the receptionist by a friendly volunteer courier with a follow up phone call six weeks later, or (c) postal delivery with a follow up letter six weeks later. SETTING: Melbourne, Australia. SUBJECTS: 264 randomly selected general practitioners. DATA COLLECTION: A research assistant visited each doctor four months after delivery and measured use of components of the kit. A questionnaire measuring perceptions of aspects of the kit and its delivery was completed by doctors. Costs of each approach were calculated. RESULTS: Doctors receiving the educational facilitator approach were significantly more likely than those receiving the other two approaches to have seen the kit, to rate the method of delivery as engendering motivation to try the kit, to have used one of the "intensive intervention" components from the kit, to report that they found the kit less complicated, and to report greater knowledge of how to use the kit. There were no significant differences in use of "minimal intervention" components of the kit, ratings of overall acceptability of delivery, perceptions of cultural and structural barriers to using the kit, and ratings of the overall acceptability of the kit. The cost of the educational facilitator approach ($A142/doctor) was 24 times that of the mailed approach. The volunteer courier approach ($A14) was twice the cost of the mailed approach. CONCLUSION: Educational facilitators and volunteer couriers do not seem to be cost effective strategies for distributing smoking interventions.

Adult↗
PubMed1991

Density-dependent regulation of epidermal growth factor receptor expression.

Previous studies have demonstrated that binding of peptide growth factors such as epidermal growth factor (EGF) decreases as cell density increases. We now report that binding of EGF to MDA 468 breast carcinoma cells is reduced as cells increase in density with time in culture. Cells at low density bound more EGF per cell than cells at higher density. The reduction of EGF binding was due to a reduction in receptor number. Metabolic labeling of MDA 468 cells with [35S]-methionine followed by immunoprecipitation of the EGF receptor (EGFR) indicated that the amount of total receptor protein was decreased. Using RNA blot hybridization, we found that high-density cells contained decreased amounts of EGFR transcripts. Northern analysis revealed that both the 10- and 5.6-kilobase mRNA transcripts encoding the EGFR were decreased. These data suggest that increasing cell density with time in culture results in modulation of EGFR content, with changes at the level of both protein and mRNA expression.

Blotting, Northern↗
PubMed1972

Method for preclinical evaluation of antiplaque agents.

A preclinical method for the evaluation of antibacterial agents for use against dental plaques associated with caries and periodontal disease is proposed. The method is applicable to screening agents and to defining, in vitro, the minimal conditions required for maximal antiplaque effect. As a model of antiplaque agents, chlorhexidine was assessed in vitro against preformed plaques of microorganisms conducive to dental caries and periodontal disease. The agent was bactericidal to plaques of nine strains of Streptococcus mutans and one strain of Actinomyces viscosus when used in a single treatment for 20 min at 2 x 10(-1)%, in two 2-min treatments on the same day, or in daily 2-min treatments at this same concentration. Using the last of these experimental conditions, we then tested chlorhexidine in vivo by topical application to the maxillary teeth of infected hamsters and found it to be effective in controlling plaques of S. mutans and A. viscosus.

Animals↗
PubMedDate not supplied

Interrelationships of general internal medicine and preventive/community medicine.

Clinical preventive medicine, efforts by clinicians to prevent disease in individual patients, is an important component of preventive medicine as a whole. Yet clinicians, including internists, apparently do not provide many preventive services of established effectiveness. This paper describes one approach to improving the practice of clinical preventive medicine: increased cooperation between general internists--one of the nation's largest groups of primary care physicians--and specialists in preventive/community medicine. The paper summarizes a larger report prepared by two societies representing these disciplines: the Society for Research and Education in Primary Care Internal Medicine and the Association of Teachers of Preventive Medicine. It was found that the two disciplines have many common goals, and much to offer each other, but do not often collaborate. The report concludes with 14 recommendations for improving the practice of clinical preventive medicine, which suggest that such improvement can be achieved in part through strengthening working relationships between general internists and preventive/community medicine specialists.

Internal Medicine↗