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Biomedical subjects

M Farrell

Publications and source records attributed to M Farrell.

At least 37 records · Page 2Linked to original sources
PubMed1999

Treasure Weekend: supporting bereaved siblings.

The importance of allowing bereaved siblings the opportunity to be involved and mourn the loss of a sibling family member has gained increasing recognition. Child family members may need support in the same way that parents might need support to cope with a devastating loss. However, there are often few support services specifically focused to support bereaved children. Therefore, this article describes how a children's hospice provides specific support for bereaved siblings, by providing an opportunity for bereaved siblings to share a residential support weekend, known as the Treasure Weekend. The article describes the rationale, aims and the experience of the children's hospice, in facilitating this support service.

Adolescent↗
PubMed1998

Socioeconomic status, standard of living, and neurotic disorder.

BACKGROUND: Evidence on the association between socioeconomic status and the prevalence of neurotic disorder is contradictory. We studied the association between three elements of socioeconomic status and the prevalence of neurotic psychiatric disorder in a representative sample of adults aged 16-64 living in private households in the UK. METHODS: A cross-sectional survey of 10,108 adults aged 16-65 resident in private households in the UK was selected by a multi-stage, clustered, random-sampling design. Neurotic disorders were defined using a standardised interview, the revised clinical interview schedule (CIS-R). Data for 9570 people were available for this study. FINDINGS: We used housing tenure and access to cars as measures of standard of living; both were associated with the prevalence of neurotic disorder even after adjustment for other socioeconomic and demographic variables, including Registrar General's Social Class and educational attainment. Those people with no access to a car had an odds ratio for neurotic disorder of 1.4 (95% CI 1.1-1.7), compared with those who had access to two or more cars. People who rented their homes were also at increased risk (1.3 [1.1-1.5]). We estimated that about 10% of the neurotic disorder in the UK could be attributed to the increased prevalence of those without cars who rented their homes. There was a complex interaction between Registrar General's Social Class and sex, and there was no independent association with educational attainment. INTERPRETATION: There is an independent association between low standard of living and the prevalence of neurotic psychiatric disorder. The UK has experienced one of the largest increases in income inequality within western market economies over the past 20 years, and this inequality may have had adverse consequences for the mental health of the population.

Adolescent↗
PubMed1998

MCP-1, MCP-2 and MCP-3 expression in multiple sclerosis lesions: an immunohistochemical and in situ hybridization study.

Chemokines are low molecular weight chemotactic cytokines that have been shown to play a central role in the perivascular transmigration and accumulation of specific subsets of leukocytes at sites of tissue damage. Two major families have been defined depending on the positioning of four conserved cysteines. The CXC chemokines predominantly attract neutrophils, whereas the CC chemokines predominantly attract monocytes and other leukocyte cell types. Members of the monocyte chemotactic protein (MCP)-1 family form a major component of the CC family of chemokines and are considered the principal chemokines involved in the recruitment of monocytes/macrophages and activated lymphocytes. In this study we addressed the expression and distribution of MCP-1, -2 and -3 in multiple sclerosis (MS) lesions of differing ages and levels of inflammatory activity using immunohistochemistry and in situ hybridization. In acute and chronic-active MS lesions immunoreactivity for MCP-1, -2 and -3 was prominent throughout the lesion center with reactivity diminishing abruptly at the lesion edge. Hypertrophic astrocytes were strongly reactive and inflammatory cells showed variable reactivity. Outside of the lesion only hypertrophic astrocytes were reactive. The results obtained by in situ hybridization for MCP-1 were in agreement with those obtained by immunostaining. In more chronic lesions immunoreactivity for MCP-1, -2 and -3 was considerably diminished, and in chronic-silent lesions immunoreactivity was restricted to a few scattered reactive astrocytes. Normal control brains showed no immunoreactivity for MCP-1, -2 and -3. Although the cellular distribution of all three members of this family was similar, antibodies to MCP-3 gave prominent staining of the extracellular matrix that was not noted for MCP-1 and -2. These results support the conclusion that members of the MCP family of chemokines are involved in the development of MS lesions in the central nervous system.

Adult↗
PubMed1998

The influence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity .

BACKGROUND: Women are consistently reported to have a greater prevalence of depressive disorders than men. The reason for this is unclear, and is as likely to be social as biological. There is some evidence that the excess of depression is greater during women's reproductive lives. Data from the National Survey of Psychiatric Morbidity were used to test the hypothesis that the excess disappeared in the post-menopausal years and that obvious social explanations for this were inadequate. METHOD: Subjects (N = 9792) from a random sample of the British population provided data for the analysis. Psychiatric assessment was carried out by lay interviewers using the CIS-R. Subjects with ICD-10 depressive episode or mixed anxiety/depression were compared with the remainder. Social variables that were likely to contribute to a post-menopausal decline in depressive disorders were controlled in logistic regression analyses. RESULTS: There was a clear reversal of the sex difference in prevalence of depression in those over age 55. This could not be explained in terms of differential effects of marital status, child care, or employment status. CONCLUSIONS: This large and representative survey adds considerably to the increasingly held view that the sex difference in prevalence of depression is less apparent in later middle age. This may be linked to the menopause, and our attempts to explain it in terms of obvious conditions among social variables were not successful. More specific studies are required to clarify the finding.

Adolescent↗
PubMed1998

The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome.

AIM: To develop a brief, multi-dimensional instrument for assessing treatment outcome for people with drug and/or alcohol problems. The Maudsley Addiction Profile (MAP) is the first instrument to be developed in the United Kingdom for this purpose. DESIGN: Field testing with quota-recruitment of problem drug users and problem alcohol users in treatment with researcher and clinician-administered test-retest interviews. SETTING: Two community and two inpatient services at the Bethlem Royal and Maudsley Hospital, London. PARTICIPANTS: Subjects (160 drug users and 80 alcohol users) interviewed by eight interviews (four researchers and four clinicians), each of whom interviewed 30 subjects on two occasions. MEASURES: Sixty items across substance use, health risk, physical/psychological health and personal/social functioning domains. FINDINGS: Average completion time of the MAP was 12 minutes. The questionnaire was acceptable to a majority of subjects and performed well with both researcher and clinician interviewers. Internal reliability and feasible concurrent validity assessments of the scales and items were highly satisfactory. Test-retest reliability was good, average intraclass correlation coefficients across eight substances were 0.94 and 0.81 across health risk, health problems, relationship conflict, employment and crime measures. CONCLUSIONS: The MAP can serve as a core research instrument with additional outcome measures added as required. The collection of a set of reliable quantitative measures of problems among drug and alcohol users by research or treatment personnel for outcome evaluation purposes need not be time-consuming.

Adult↗
PubMed1998

Hearing the voices of women in war through continuous quality improvement.

During the war in Bosnia-Herzegovina (BIH), the infrastructure of the health care system was destroyed and health officials, health care providers, and women experienced the war from their own perspectives. Using the principles of continuous quality improvement (CQI), these perspectives were honored and served as the basis for an international training program to hear the voices of women in war and the concerns of those who cared for them. With the results of a comprehensive national survey of all partners, the World Health Organization's European Regional Office held a five-day workshop that used CQI methods. The facilitators and 18 nurses, midwives, and physicians from six cantons developed interventions to address the women's needs, as detailed from the women's stories and from the professional perspectives of governmental authorities and health providers. The effort illustrates the ways in which the principles and tools of CQI can be used to capture the needs of the users of the services with those responsible for restructuring the health service and those with overall responsibility for the health of woman throughout the country.

Bosnia and Herzegovina↗
PubMed1998

Care tracker: a new approach to nursing care in ambulatory settings.

The shift from inpatient to ambulatory settings and the increasingly large and diverse numbers of ambulatory clients require reengineering and cost-effective approaches to managing ambulatory care. With data on 921 encounters in 12 ambulatory clinics, we developed CARE TRACKER, an instrument to describe nursing encounters by type, intervention, staff, time, and cost. Distinguishing nursing from medical interventions is an appreciable improvement over the traditional practice of bundling nursing as part of overhead costs. If managers can track the care delivered, they can better calculate staffing requirements, staff mix, inservice needs, and the costs of their existing and projected services.

Ambulatory Care↗
PubMed1998

Trends in the global healthcare environment: the developed countries.

The purpose of this paper is to examine trends in the global healthcare environment, especially the developed countries. The developed countries are examined in detail as they have influenced the changes that have occurred in the delivery of healthcare in Australia. The countries discussed include the United States, Canada, Europe and Australia. The most concerning trend is the increase in healthcare spending. There has been a marked rise in the cost of hospital and other institutionalised care and health insurance. The ageing population and the increased use of sophisticated and expensive equipment have also increased costs. Other issues identified are, the declining number of hospitals beds, the shift from care in the hospitals or institutions to care in the home or community, the increase in continuum of care programs, the establishment of health care networks, focus on service quality, the lack of security about gaining health insurance and the focus on treatment rather than prevention.

Australia↗
PubMed1997

v-Rel prevents apoptosis in transformed lymphoid cells and blocks TNFalpha-induced cell death.

The v-Rel oncoprotein belongs to the Rel/NF-kappaB family of transcription factors. It transforms chicken lymphoid cells in vitro and induces fatal lymphomas in vivo. In this study, we used a tetracycline-regulated system to characterize the role of v-Rel in cell transformation. We show that the continued expression of v-Rel is necessary to maintain the viability of transformed lymphoid cells and enables primary spleen cells to escape apoptosis in vitro culture. In agreement with a possible role for v-Rel in the inhibition of programmed cell death, its inducible expression in HeLa cells prevented TNFalpha-induced apoptosis. While the repression of v-Rel was accompanied by the rapid degradation of IkappaBalpha, changes in the steady-state levels of the apoptosis inhibitors Bcl-2 and Bcl-X(L) were only observed following the onset of cell death in transformed lymphoid cells. This suggests that the anti-apoptotic activity of v-Rel may affect other apoptosis inhibitors or other factors in the death pathway. Together, these findings demonstrate that v-Rel blocks apoptosis and suggest that this activity may be an important component of its transforming function.

Animals↗