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Biomedical subjects

A Sims

Publications and source records attributed to A Sims.

At least 19 recordsLinked to original sources
PubMed1999

Domains of social communication handicap in autism spectrum disorder.

OBJECTIVE: To investigate whether specific "social communication" handicaps could be identified in autism spectrum disorder using the Autism Diagnostic Observation Schedule and to compare the results with those found in a previous factor-analysis study using the Autism Diagnostic Interview-Revised. METHOD: All subjects were evaluated with both instruments. J.R. and P.E.T. independently diagnosed autism, Asperger's disorder, or pervasive developmental disorder--not otherwise specified in 51 children. Items from the Autism Diagnostic Observation Schedule that represented social communication behaviors were factor-analyzed. RESULTS: Three factors were identified: joint attention, affective reciprocity, and theory of mind. These are the same social communication domains that were identified in the previous study. CONCLUSIONS: These 3 social communication domains have been discussed in the literature regarding normal development and in previous research on autism spectrum disorders. If these domains are replicated in larger sample sizes, they could be used to monitor the results of pharmacological and psychotherapeutic interventions in autism spectrum disorders.

Adolescent↗
PubMed1998

The phenomenology of post-traumatic stress disorder. A symptomatic study of 70 victims of psychological trauma.

This study analyses and categorises the subjective experiences and psychological symptoms of those involved in a major disaster but not themselves physically injured. It examines the concept of post-traumatic stress disorder (PTSD) and relates it to other psychiatric diagnoses and also to the particular nature of the disaster. 70 police officers are the subjects of this study, 59 men and 11 women, all of them involved in the Hills-borough Football Stadium Disaster. Assessment included detailed psychiatric history and examination with an account of the events experienced by the informants and their psychological reaction to this at the time and subsequently. Psychiatric diagnosis was made and quantified measurements were also recorded, including a rating scale for the criteria of PTSD, the General Health Questionnaire and rating scales for depression and anxiety. Severity of PTSD symptoms was associated with higher scores on rating scales for both depressive and anxiety symptomatology. Subjective depressive symptoms and depersonalisation were associated with severity of PTSD. Frustrated helplessness was a recurring theme in the psychopathology. Alcohol consumption of those who were already drinkers increased. Social functioning at work and in marriage deteriorated with increased severity of PTSD. Although PTSD has features that distinguish it from other conditions, the degree of distress and long-term disability is more related to depressive symptomatology than to the severity of PTSD itself.

Adaptation, Psychological↗
PubMed1997

Funding a primary care led NHS: achieving a model for more equitable allocation of healthcare resources at a sub-district level.

BACKGROUND: Current resource allocation for health services have developed in a haphazard and inequitable way. This project aimed to determine a fairer and more rational way to distribute health authority's (HA's) money to general practitioners (GPs). METHODS: A dataset was developed to examine the way resources were spent on patients at the level of general practice. Important managerial aspects of the project were addressed. This involved the establishment of the 'Equity Group' of GPs to work with the HA. The group sought a measure of health need that was rigorous and scientifically based but was also practical and politically acceptable to GPs and the HA. The York Relative Needs Index (RNI) was chosen, and applied to populations at practice level. An implementation plan was then developed by the Equity Group. RESULTS: Results demonstrated considerable inequalities between practices in age-adjusted use of healthcare resources. There was low correlation between the level of need in practices and the per capita expenditure. Applying the York RNI to practice populations indicated current practice allocations were within the range 82-126 per cent of their needs-based target. The managerial implications of the proposed changes are described. CONCLUSIONS: The new methods for resource allocation appear to be an advance on the unplanned methods which have evolved. Full evaluation of the long-term results of redistributing health resources will be needed. Important aspects of this project were the participation of GPs and general development of the concept of equity in North Derbyshire.

Age Factors↗
PubMed1997

Social class variation in place of cancer death.

The aim of this research was to describe the distribution of place of death for cancer. An analysis of place of death for all 831 cancer deaths in 1995 among Doncaster Health Authority's residents was carried out. The data were extracted using the Public Health Mortality File. It was found that there is statistically significant evidence that place of death is associated with social class. Social class I and II with 15% of all cancer deaths contributed 24% of hospice deaths, 14% of hospital deaths and 12% of home deaths. Social class III with 24% of all cancer deaths contributed 58% of hospice deaths, only 9% of hospital deaths and 35% of home deaths. Social classes IV and V with 61% of cancer deaths contributed only 18% of hospice deaths, 77% of hospital deaths and 53% of home deaths. The reasons for these differences may be to do with access to services, perceptions of different services by patients and general practitioners and the availability of social support within different sections of the community.

England↗
PubMed1993

Who pays for community care? The same old question.

Trends in mental health service funding over the past 40 years show that the programme of hospital closures has not resulted in a significant release of resources to fund community based services. Far from being excessive, the current provision of residential services (both NHS and non-NHS) for mentally ill people is now below levels recommended as sufficient by the government, the Royal College of Psychiatrists, and the National Schizophrenia Fellowship. What clinical research evidence there is suggests that more rather than fewer residential places are required. This situation is likely to be compounded by the recent transfer of responsibility for funding private and voluntary residential care from the Department of Social Security to local authority social services departments.

Community Mental Health Services↗
PubMed1993

Analysis of cationic nutrients from foods by ion chromatography.

This paper describes the feasibility of combining two relatively new technologies to generate data on the cationic nutrient content of foods. Single-column ion chromatography was used to monitor several analytes following the use of a microwave digestion scheme aimed at rapid, multiple sample digestion. The result is a more streamline and productive approach to multi-sample preparation and multi-analyte determination when investigating the cation content of foods. Linearity and limits of detection for the chromatographic procedure were established. Sample size as well as digestion acid type and amount were investigated during the microwave process. The method was applied to a variety of food matrices to evaluate its scope. Results generated with this method compare favorably to those from atomic absorption. Finally, capillary ion electrophoresis (Waters' trade name: Capillary Ion Analysis), a subset of capillary electrophoresis which has been optimized for ion analysis, was applied to the sample digests to investigate the usefulness of this technology to the analysis of mono-/divalent cations from foods.

Cations↗
PubMed1993

Top teams.

Explore the source record for details and available documents.

Medicine↗
PubMed1993

Clinical management. The case of the consultant psychiatrist.

Review the management role of consultant psychiatrists in the light of recent NHS reforms. Tries to identify the needs of clinicians and their patients and what is causing dissatisfaction within the profession. Examines various reforms. Concludes that although difficult, the care leadership within the psychiatric area should lie with the consultant psychiatrist who should have the experience necessary in order to define the qualifications and care necessary for each patient.

Mental Health Services↗
PubMed1993

The scar that is more than skin deep: the stigma of depression.

The stigma of depression is a major factor hindering effective treatment. In 1992, the Royal College of Psychiatrists and the Royal College of General Practitioners launched a 'defeat depression' campaign. This aimed to reduce the stigma associated with depression by improving public awareness of the condition and by improving health professionals' knowledge of the illness. The mental health team and general practitioners can work together to encourage people to seek help to alleviate this distressing illness.

Attitude to Health↗
PubMed1991

An investigation of the safety of the blood reinfusion step used with tunneled venous access devices in children with cancer.

Infection has been identified as the most serious potential complication of the indwelling catheter. As a result, the primary nursing goal using the catheters is to prevent infection. Nurses must frequently manipulate the catheters when securing blood specimens and are concerned that this manipulation may serve as a source of infection for the immunocompromised pediatric oncology patient. One particular step in catheter manipulation during blood sampling is blood reinfusion, ie, residual blood in the catheter is withdrawn and set aside while a second sample is collected for laboratory analysis but is subsequently returned to the patient through the catheter. The purpose of this study was to examine this nursing procedure for its potential of contaminating the blood sample that was to be reinfused, or for the potential of reinfusing a sample that contained preexisting pathogens independent of the procedure itself. An experimental design was used with 21 patients randomly assigned to an experimental group (unclean procedure to exaggerate the potential to incur pathogens during the process), and 21 randomly assigned to a control group (usual clean procedure followed with the reinfusion sample). The usual blood sampling procedure was altered for all participants as the typical amount of blood that normally constitutes the reinsertion sample was not reinserted, but was instead used to complete certain microbial analyses. Of the 42 participants, 17 were male and 25 were female; 35 were white and seven were black; 22 were diagnosed with leukemias and 20 with solid tumors. The age range for participants was 2 to 20 years (mean = 9.4 years, SD = 4.8).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Historical aspects of anxiety.

Although the syndromes of anxiety have only been recognized this century, the belief that the emotion of fearful apprehension could cause physical illness has a much longer history. James Vere wrote his book entitled "A physical and moral enquiry into the causes of that internal restlessness and disorder in man which has been the complaint of all ages" in 1778. The earliest accounts of phobia, as anxiety associated with specific circumstances have been ascribed to two cases from Hippocrates, whilst one of the earliest accounts in the English language may be that of William Shakespeare in The Merchant of Venice describing a supposed phobia for cats. Robert Burton (1621) described various anxiety disorders in classical detail in his 'Anatomy of Melancholy'.

Anxiety↗
PubMed1988

Epidemiological survey of the "natural" mortality in psychiatry.

The authors reviewed articles published from 1838 dealing with excess of "natural" mortality in psychiatric "in-" and "out" patients. The high natural mortality rate has always existed and is still observed today despite the quality of somatic care. The excess is observed in every country, ethnic group, sex, age or site of treatment but does not seem to be associated with specific organic pathology. The risk of "natural" mortality (suicide and accidents excluded) remains 2 to 5 times greater than in normals. Hypotheses concerning the phenomenon are reviewed or suggested.

Adult↗