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PubMedDate not supplied

[The characteristics of the formation of spontaneous neuronal activity in the trigeminal sensory nuclei of surviving slices of rat brain stem in postnatal ontogeny].

An attempt was made to characterize the development of neurones of sensory trigeminal nuclei--basic structure of sensory provision of alimentary behaviour at late stages of postnatal ontogenesis. The method of the brain-stem slices of rat pups [correction of ratlings] aged 2.4 and 8 weeks was applied. An increase with the age was shown of the number of neurones with spontaneous activity (44%-2 weeks; 69%-8 weeks), growth of discharges frequency, appearance of cells population with high-frequency spontaneous activity by the fourth week and an increase of such neurones number by the eighth week. Three types of background-active neurones were singled out: episodic, continuous and group; the dynamics of correlations change of these types with the age was shown. No significant changes of rest potential with the age were found, though there was a tendency to its increase between the 2-nd and 8-th weeks of postnatal development.

Aging↗

PubMed2006

The influence of phenotypic and genetic effects on maternal provisioning and offspring weight gain in mice.

Close interactions between mother and offspring are said to result in a coevolution of parental and offspring genotypes such that offspring are adapted in their solicitation behaviour to obtain maternal provisioning that maximizes their fitness. Few empirical studies have been conducted in this field and it remains unclear whether maternal provisioning and offspring weight gain are influenced by the same set of maternal and offspring phenotypic and genotypic factors. Using a cross-foster, split-litter design in mice, we found that overall maternal provisioning and offspring weight gain are significantly correlated but are affected by a different set of parameters, except for the effect of maternal bodyweight. While the level of maternal provisioning was influenced by both offspring and foster mother genotype, offspring weight gain was only affected by the number of males in the mixed litter. We suggest that this disparity may hint at the inefficiency of offspring solicitation behaviour or effects of sibling competition.

Animals↗

PubMed1999

Parental provisioning, nestling departure decisions and prefledging mass recession in Cassin's auklets.

We investigated how parental provisioning and nestling departure behaviour interact to produce prefledging mass recession in Cassin's auklets, Ptychoramphus aleuticus. Under our hypothesis, auklet parents are reluctant provisioners and should be increasingly likely to terminate or reduce provisioning of their single nestling as it matures. For the nestling, remaining in the nest presents a risk of losing mass (if the parent does not provision) but also a possibility of additional provisioning. As the nestling matures and becomes increasingly capable of independence, the benefits of remaining in the nest decrease and nestlings should be increasingly likely to fledge. Nestlings also should be more likely to fledge when the expectation of additional provisioning is low. Data on parental provisioning (based on growth increments) and nestling departure were consistent with our hypothesis. Older and heavier nestlings had smaller growth increments than younger and lighter nestlings, suggesting that parents were reluctant to provision old and heavy nestlings. Older and heavier nestlings also were increasingly likely to fledge. We hypothesized that nestlings might use the intensity of mass loss to gauge parental reluctance to provision, and accordingly, nestlings were increasingly likely to fledge after experiencing a greater amount of mass loss. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗

PubMed2005

Rehabilitation interventions after mild head injury.

PURPOSE OF REVIEW: This review examines current management and rehabilitation strategies for mild traumatic brain injury, with emphasis on the need to address multiple potential causative factors in order to enhance outcomes and to conduct more controlled efficacy studies. RECENT FINDINGS: Whilst most individuals who sustain mild traumatic brain injury make a good recovery, a proportion experience significant ongoing disability. In some cases this is due to diffuse axonal injury and cognitive impairment, but in others symptoms are exacerbated by factors such as pain, stress, personality issues or litigation, or in children, previous head injury, behavioural or learning difficulties. Provision of information early after injury results in reduced symptom reporting in adults and children. There is also a need, however, to address these other factors in treatment. Psychological therapy using a cognitive behavioural approach may be helpful, but controlled evaluations of such interventions have been lacking. Recent uncontrolled studies have examined the impact of computer-mediated interventions to remediate visual and verbal processing and oculomotor problems and the impact of quantitative electroencephalography. More rigorous efficacy studies of these approaches are needed. Guidelines for management of sports-related concussion and timing of return to play also require a more solid scientific basis. SUMMARY: The evidence base for management of mild traumatic brain injury is still very limited. There is a need to conduct more carefully controlled prospective studies and examine the influence of factors not directly related to the brain injury as a basis for formulating more uniform management guidelines.

Cognition Disorders↗

PubMed1995

An economic analysis of the resettlement of people with mild learning disabilities and challenging behaviour.

New models of care are needed following the closure of long-stay mental handicap hospitals. Based on an evaluation of a recently established assessment and treatment service in south-east England, this paper is concerned with the costs and likely benefits of different patterns of services for people with mild learning disabilities and severely challenging behaviour. Different models of provision are compared in terms of their costs and quality of life opportunities for clients. The assessment and treatment services provided a better understanding of the care needs, and achieved a reduction in challenging behaviours. It was therefore possible to give access to care settings closer to a normal life. For approximately 25% additional expenditure, 20 out of 34 clients who received the service moved to community placements, including three who had been referred following a breakdown in the community. If community care is to be implemented as a policy for clients with learning disabilities and serious challenging behaviours, it is necessary to recognise the financial implications. Better quality of life opportunities for this client group are associated with higher costs. When seen in the dynamic context of the costs and quality of life opportunities of the subsequent care, a high cost assessment and treatment service may be a good investment. On current evidence, the additional benefits of community homes, with a closer association with the local community, and greater freedom for clients is bought only at quite a high cost.

Adult↗

PubMed2006

HIV prevalence and trends from data in Zimbabwe, 1997-2004.

BACKGROUND: This paper brings together data from a variety of reports to provide a basis for assessing future steps for responding to and monitoring the HIV epidemic in Zimbabwe. METHOD: Data reported from four antenatal clinic (ANC) surveys conducted between 2000 and 2004, two small local studies in Zimbabwe conducted from 1997 through 2003, four general population surveys from 1999 through 2003, and service statistics covering 1990 through 2004 were used to describe recent trends in HIV prevalence and incidence, behaviour change, and programme provision. RESULTS: HIV prevalence among pregnant women attending ANCs declined substantially from 32.1% in 2000 to 23.9% in 2004. The local studies confirmed the decline in prevalence. However, prevalence continued to be high. Sexual behaviour data from surveys suggests a reduction in sexual experience before age 15 years among both males and females age 15-19 years, and in the proportions of males and females aged 15-29 years reporting non-regular sexual partners in the past 12 months. Reported condom use with non-regular partners has been high since 1999. Condom distribution and HIV counseling and testing increased from 2000 to 2004. DISCUSSION: On the basis of examination of data from a variety of sources, the recent decrease in HIV prevalence may be related to recent reductions in early-age sexual activity and non-regular sexual partnerships and increases in condom use. Comparison of data from sentinel surveillance systems, population based serosurveys, local studies, and service statistics provide increased confidence that a decline in HIV prevalence in Zimbabwe is actually happening in the population.

Adolescent↗

PubMed1999

Supporting individuals with intellectual disability and challenging behaviour in integrated work settings: an overview and a model for service provision.

An overview of supported employment and its historical context is examined, and supported employment for individuals with both intellectual disability and challenging behaviour is discussed. A proposed model for working with such individuals is briefly outlined. This model is based on previous work in the field, and is characterized by a multi-component approach which addresses the issues of both support and behavioural intervention.

Behavior Therapy↗

PubMed2006

A review of the evidence for the effectiveness of primary prevention interventions for hepatitis C among injecting drug users.

BACKGROUND: Hepatitis C (HCV) prevalence is most common amongst injecting drug users where up to 98% of the population can be infected despite a low prevalence of HIV. This review considers the evidence for the effectiveness of primary prevention interventions to reduce incidence or prevalence of hepatitis C. METHODS: Systematic review of the major electronic medical databases: Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library (Evidence Based Health). Either intervention or observational studies were included if they described an intervention targeting injecting drug using populations with the outcome to reduce either the prevalence or incidence of hepatitis C infection. RESULTS: 18 papers were included in the final review from 1007 abstracts. Needle exchange programmes reduce the prevalence of HCV though prevalence remains high. Similarly the effectiveness of methadone maintenance treatment is only marginally effective at reducing HCV incidence. There is limited evidence evaluating either the effectiveness of behavioural interventions, bleach disinfectants, or drug consumption rooms. CONCLUSION: Primary prevention interventions have led to a reduction in HIV incidence, have been less effective at reducing HCV incidence. Global prevalence of HCV remains disturbingly high in injecting drug users. A robust response to the global health problem of HCV will require provision of new interventions. Behavioural interventions; distribution of bleach disinfectant; other injecting paraphernalia alongside sterile needle distribution; and evaluation of drug consumption rooms merit further expansion internationally and research activity to contribute to the emerging evidence base. Whilst the prevalence of HCV remains high, nevertheless many current interventions aimed at primary HCV prevention have been shown to be cost-effective due to their significant positive impact upon prevalence of HIV.

Journal Article↗

PubMed2005

Behavioural and energetic responses to body state in male and female barn swallows (Hirundo rustica).

Females and males often have different roles when attending young. The factors responsible for shifts in the balance of effort when both sexes provision their young are not clear. This study asked if sex-specific behaviour and provisioning rules in barn swallows (Hirundo rustica) were dependent on individual body-state or affected by the state of their provisioning partner. To assess this male and female barn swallows underwent overnight warming manipulations whilst provisioning 10-14 day old nestlings, a time when energetic demands are maximal. The overnight warming treatment reduced thermoregulatory costs and provided birds with extra energy reserves at dawn. Only one member of a pair was manipulated in this way, whilst their partners were left un-manipulated to assess their response to their partner's elevated body-state. The energetic and behavioural responses to these manipulations were followed over the subsequent 24-h. I found that warmed male and female barn swallows increased their energy expenditure and nest visitation rates to the same extent after manipulation, implying a trade-off in resource allocation, which was biased towards reproductive effort. There was no effect of gender. Males paired with manipulated females showed no energetic or behavioural adjustments, however, females paired with manipulated males tended to increase both energy expenditure and nest visitation. This study provides evidence that energy reserves constrain behaviour, and that male and female swallows normally follow the same state-dependent rules when provisioning young.

Analysis of Variance↗

PubMed1999

Validating the Ontario Child Health Scale in a UK population.

The Ontario Child Health Scale (OCHS) was one of the first scales to seek to assess a broad range of formally defined psychiatric disorders using a checklist format. The performance of the teacher version of this instrument is reported in a UK population of children attending a special educational provision for emotionally and behaviourally disordered (EBD) pupils. Against DSM-IV criteria the instrument proved to have retained its convergent and discriminant validity, although it was somewhat less effective in detecting internalizing disorders and discriminating oppositional defiance from other behavioural disorders. Overall the results confirm the usefulness of this instrument as a screening tool in a UK population.

Adolescent↗

PubMed2005

"Not that sort of practice": the views and behaviour of primary care practitioners in a study of advance provision of emergency contraception.

BACKGROUND: Advance supplies of emergency contraception (EC) were made available to women aged 16-29 through general practice and family planning services in Lothian, Scotland. Although this intervention was not associated with an overall reduction in abortion rates in Lothian, it was hypothesized that some general practices may have been more successful than others in promoting and delivering the intervention. OBJECTIVE: To investigate, using comparative case studies, whether, and why, some general practices were more successful in promoting and delivering advance supplies of EC than others. METHODS: Eleven purposively sampled general practices from the 97 participating in the intervention were studied. The number of packs of advance supplies distributed was recorded and distribution rates per 100 eligible women per practice calculated. 44 semi-structured interviews with staff were used to describe the mechanisms through which advance supplies were distributed and health professionals' views of the intervention. RESULTS: Distribution rates varied from 0.9 to 32.0 per 100 eligible women. Respondents described three mechanisms through which advance supplies were distributed: passive, reactive and proactive. Views about EC, and the suitability of their patient population for advance supplies, varied and configured specific practice contexts that facilitated or hindered the delivery of advance supplies. Favourable views and pro-active mechanisms were associated with higher distribution rates, less favourable or ambivalent views and passive delivery mechanisms with lower distribution rates. CONCLUSION: If primary care professionals are to actively engage with a sexual health promotion agenda they need to develop appropriate interpersonal skills and address their values, attitudes and cultural competences.

Adolescent↗

PubMed2006

An evaluation of a brief motivational intervention among young ecstasy and cocaine users: no effect on substance and alcohol use outcomes.

AIMS: To investigate whether a stimulant- and alcohol-focused brief motivational intervention induces positive behaviour change among young, regular users of MDMA ('ecstasy'), cocaine powder and crack cocaine. DESIGN AND MEASUREMENTS: A randomized trial of the intervention versus a control group who received written health risk information materials only. All participants completed a baseline self-assessment questionnaire before randomization. Outcome measures were self-reported period prevalence abstinence from ecstasy, cocaine powder and crack cocaine and the frequency and amount of stimulant and alcohol use in the previous 90 days, recorded at 6-month follow-up via self-completion questionnaire and personal interview. PARTICIPANTS AND SETTING: A total of 342 adolescent and young adult stimulant users (aged 16-22 years) were recruited and 87% were followed-up. The intervention was delivered by a team of 12 agency youth drug workers and two researchers at five locations in Greater London and south-east England. FINDINGS: There were no significant differences in abstinence for ecstasy, cocaine powder or crack cocaine use between the experimental and control groups. Contrasting follow-up with baseline self-reports, there were no between-group effects for changes in the frequency or amount of stimulant or alcohol use. Participant follow-up data suggested that the baseline assessment was a contributing factor in within-group behaviour change among experimental and control condition participants. CONCLUSIONS: Our brief motivational intervention was no more effective at inducing behaviour change than the provision of information alone. We hypothesize that research recruitment, baseline self-assessment and contact with study personnel are influences that induce positive reactive effects on stimulant use.

Adolescent↗

PubMedDate not supplied

Impact of discharge from day surgery on patients and carers.

This article outlines the increase in the amount and complexity of day-case surgery currently being undertaken in the UK. The continuing increase in day surgery has led to a corresponding rise in patient and lay carer involvement throughout the pre- and postoperative period. The impact day surgery expansion is having on patients and their carers' contribution to care are therefore highlighted as challenging issues for modern day-case surgery. Utilizing the evidence available from the literature, the article focuses specifically on the contemporary issues concerning patient and lay carer experiences of discharge from a day surgery facility. The main challenges identified are pain management, recovery behaviour and community care provision. The clinical application of the issues raised within these themes is considered and recommendations for future practice are highlighted.

Ambulatory Surgical Procedures↗

PubMed1986

Emotional sequelae of chronic inflammatory bowel disease in children and adolescents.

It is clear that further study needs to be made of the link between emotional disorder and chronic inflammatory bowel disease in children. It is commonly accepted that such a link exists in ulcerative colitis and although there is at present no proof in either direction it seems highly probable that such a relationship is also present in Crohn's disease. We have seen that the families of children with Crohn's disease appear to find it much more than ordinarily difficult to accept such a relationship, but an objective study is projected to explore the presence of psychiatric illness in our patients and their families. Such a study will be extremely time consuming, requiring the services of a part-time research worker, and the exigencies of clinical service have so far prevented its being set in motion. We feel that our experience in St Bartholomew's Hospital during the past seven years has very clearly demonstrated the value of close liaison between the Child Psychiatry Unit and the Paediatric Inflammatory Bowel Disease Clinic, and the much greater efficacy of such a liaison as against referrals made to a separate Psychiatric Unit. It should be emphasized, however, that a liaison of this sort is time consuming, and in our experience has involved child psychiatrists, social workers, child psychotherapists and behaviour therapists. Thus the provision of such a service is expensive both in time and money. Where a new Paediatric Inflammatory Bowel Disease Clinic is being projected there must be very careful forward planning, looking particularly at financial implications if a psychiatric liaison team is to be included.

Adolescent↗

PubMed1997

Stress and blood donation: effects of music and previous donation experience.

Making a blood donation, especially for first-time donors, can be a stressful experience. These feelings of stress may inhibit donors from returning. This paper applies stress theory to this particular problem. The effects of a stress management intervention (the provision of music) and previous donor experience were examined in relation to pre- and post-donation mood, environmental appraisals and coping behaviour. Results indicated that the provision of music had detrimental effects on environmental appraisals for those who have donated up to two times previously, but beneficial effects for those who had donated three times before. These effects were, to an extent, moderated by coping processes but not perceived control. It is recommended that the provision of music is not used as a stress management technique in the context of blood donation.

Adaptation, Psychological↗

PubMedDate not supplied

The provision of secondary cardiac prevention measures in a hospital cardiac clinic population and the relationship to psychological variables.

BACKGROUND: Implementing preventive measures in patients with established heart disease is one of the most effective health promotion activities, but there is little research on the relationship between cognition and secondary preventive behaviour. AIM: To determine the provision of secondary cardiac prevention measures among patients with established heart disease attending a cardiac outpatient clinic. METHODS: The study was conducted in an outpatient department over a 14-week period in 1999. Management of risk markers was noted from the medical records and lifestyle and psychological variables were self-reported. RESULTS: Of 294 patients with heart disease, 41% were available for study. Fourteen per cent were current smokers, one-quarter of males and one-third of females had a body mass index (BMI) greater that 30. Almost 90% attend their GP bimonthly, 67% had a normal systolic and 88.3% a normal diastolic pressure, 34% had normal cholesterol levels and 75% were on aspirin. Lifestyle variables were significantly affected by patient cardiac knowledge, sense of control over their heart disease and perceptions of their illness. CONCLUSIONS: These results highlight the potential health gain available to patients with established heart disease. The results also suggest that psychological factors may play a role in patients' health behaviours.

Coronary Disease↗

PubMedDate not supplied

Providing family care in hospital.

Using the delphi technique, this study aimed to identify supportive nursing behaviours and some factors that inhibit the effective provision of family-centred palliative care in a hospital. Supportive nursing behaviours were identified and priority was given to the issues of symptom control, privacy, time and communication. Factors that hinder effective provision of family care focused mainly on the problems involved in balancing priorities, issues of disclosure and managing family conflict. The findings identified key areas of family-centred palliative care that warrant further investigation.

Delphi Technique↗

PubMed2003

[Veterinary Services: how to establish quality assurance in developing countries].

The authors put forward a methodological proposal for introducing quality assurance into animal health service provision in developing countries, based on the experience of Brazil. This proposal is based on three key elements. The first and most important element is the continuing development of those involved in the process, not only from the technical and administrative standpoint (know-how), but also in terms of modelling new forms of behaviour and attitudes for the provision of services (social and personal skills). This requires a culture of ethical values, motivation and team working to ensure that those involved in the process become committed, highly effective employees who identify with the Veterinary Service's objectives as if they were their own. The second key element of this methodology is to consider the various health services to be provided as processes and to treat each of these services as a set of activities, inputs and procedures that are systematically organised for delivering the specified animal health service. Working with processes not only makes it possible to properly plan each service, it also facilitates the identification, analysis and effective resolution of any problems that may arise while the service is being delivered. The third key element of the proposed methodology is the constant control and improvement of the processes making up the various health services, in particular using the Deming cycle (plan--do--check--act). The proposed strategy calls for realism and pragmatism in order to avoid creating false expectations by developing over-ambitious quality systems. It is advisable to avoid major publicity at the start of activities and to create well-defined, localised improvement programmes with anticipated results that are simple, direct and discernible to any observer within a short time frame. In the early stages, the term "quality" needs to be replaced with "better service delivery". It is necessary to ensure that staff is given some type of acknowledgement or feedback when positive results are achieved. Great emphasis must be placed on staff motivation and awareness-raising activities.

Animals↗