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Biomedical subjects

S Reeves

Publications and source records attributed to S Reeves.

At least 19 recordsLinked to original sources
PubMed2006

The effect of social demographic factors, snack consumption and vending machine use on oral health of children living in London.

OBJECTIVE: To investigate the effect of socio-economic status, sugar, snack consumption and vending machine use on the prevalence and severity of caries (DMF) in children. DESIGN: An observational study was carried out in a dental practice in inner city London. Sixty children were asked to complete a questionnaire and a three day food and drink diary. After a dental examination the number of decayed (D), missing (M) or filled (F) teeth provided a DMF score. Anova and Pearsons correlations were used to analyse the data statistically. RESULTS: Children from social groups I and II consumed significantly less (P < 0.05) sugar, confectionery, crisps and used a vending machine less often than children from other social groups. Children from Social groups I, II and III had significantly lower DMF scores. The average DMF from social group I children was 0.5 +/- 0.6, whilst group IV children had the greatest incidence and a DMF of 4.6 +/- 0.8. Significant correlations were identified between DMF and sugar, confectionery and crisp consumption and vending machine use, and a negative correlation between DMF and vegetable consumption. CONCLUSIONS: Socio-economic status and access to vending machines were found to have a significant effect on sugar intakes, foods choices, and dental health. The removal of vending machines from schools or at least installing 'healthy' vending machines is recommended. Health promotion programmes that account for social groups and snacking habits that are cost effective are required.

Adolescent↗
PubMed2006

Re-examining the evaluation of interprofessional education for community mental health teams with a different lens: understanding presage, process and product factors.

This paper revisits the formative evaluation of a pilot project that offered in-service interprofessional education (IPE), which is designed to enhance the collaborative practice, to two UK community mental health teams (CMHTs). While the IPE was well received and resulted in some improvements in team functioning, wider successes were elusive. Specifically, collaborative action plans were not implemented, and the pilot programme was ultimately not rolled out to other CMHTs. The purpose of this paper is to test the usefulness of the presage-process-product (3P) framework for analysis as a means to untangle the complex web of factors that promoted and inhibited success in this initiative. The framework, which captures key features of the initiative as a dynamic system, proved effective, yielding new insights, making connections clearer and highlighting the critical importance of presage. We argue that use of the 3P model during the development of in-service IPE could ensure that planning oversights are minimized, thereby improving outcomes.

Attitude of Health Personnel↗
PubMed2005

Migrant status, age, gender and social isolation in very late-onset schizophrenia-like psychosis.

BACKGROUND: Data from two retrospective first contact studies suggest that the risk of developing very-late onset schizophrenia-like psychosis (SLP) may be raised in older migrant than British-born populations resident in the UK. OBJECTIVE: To investigate whether the relative excess of SLP observed amongst younger and male migrants in the above studies might have been explained by differences in the age-gender structures of migrant and British-born denominator populations. A secondary aim was to examine the associations of migrant group status and gender with markers of social isolation. METHOD: Eighty-six new referrals of SLP to the Mile End (1997-2003) and Maudsley (1995-2000) hospitals were identified from two retrospective case note studies. Local census data were used to estimate the denominator populations and to calculate rate ratios for migrant and British-born cases of SLP. Case notes were re-examined, to assess markers of social isolation in migrant and British-born patients. RESULTS: Migrant patients were more likely to be male (odds ratio = 4.8; CI(odds) = 1.8-13.2) than British-born patients. The ratio of first contact rates for migrant compared to British-born populations were highest amongst men. There was a lower mean age of onset of SLP in migrant than British-born patients (t = 4.30, 95% CI = 3.78-10.27), which was largely explained by a higher mean age of illness onset in British-born women. There were no differences between migrant and British-born patients with respect to markers of social isolation. Male patients were more likely to have never married than women (odds ratio = 0.28; 95% CI odds = 0.09-0.89). CONCLUSIONS: The age-gender structure of the background population is not sufficient to explain the socio-demographic differences between migrant and British-born patients with SLP. Male patients may be more socially isolated.

Age of Onset↗
PubMed2003

Psychosis and schizophrenia-like disorders in the elderly.

Non-organic, non-affective psychoses that have their first onset in late life have been the subject of diagnostic dispute for many years. Do they represent the late manifestation of more typical schizophrenia but with a delayed onset? Are they cases of "symptomatic schizophrenia" in which some organic brain change associated with ageing gives rise to schizophrenic symptoms? A recent International Consensus established that while cases of schizophrenia are sometimes delayed in their onset to 40 to 59 years of age (late-onset schizophrenia), onset after the age of 60 years is generally associated with a different symptom profile and associated risk factors (very late-onset schizophrenia-like psychosis). In this paper we review the data on the very late-onset schizophrenia-like psychosis patient group and suggest research directions for the future.

Age of Onset↗
PubMed2002

Ageing and the nigrostriatal dopaminergic system.

BACKGROUND: Brain dopamine has been the focus of numerous studies owing to its crucial role in motor function and in neurological and psychiatric disease processes. Whilst early work relied on postmortem data, functional imaging has allowed a more sophisticated approach to the quantification of receptor density, affinity and functional capacity. This review aims to summarise changes in the nigrostriatal dopaminergic system which accompany normal ageing. METHODS: A literature search focussed on postmortem and neuroimaging studies of normal ageing within the nigrostriatal dopaminergic tract. The functional significance of age-related effects was also considered. RESULTS: There are significant reductions in pre- and post-synaptic markers of brain dopamine activity during normal ageing: However the rate of decline (linear or exponential), the effects of gender and heterogeneity and the mechanisms by which these changes occur remain undetermined. Limited data suggest there is a significant association between postsynaptic receptor density and specific aspects of motor and cognitive function. CONCLUSION: The identification of strategies to improve dopaminergic transmission may delay the onset of motor and cognitive deficits associated with normal ageing. In order to develop effective preventative strategies, the causative mechanisms underlying age-related changes and the interaction between synaptic structure and function need to be more clearly elucidated.

Adolescent↗
PubMed2002

Service contact and psychopathology in very-late-onset schizophrenia-like psychosis: the effects of gender and ethnicity.

BACKGROUND: Epidemiological data on very-late-onset (>60 years) schizophrenia-like psychosis (SLP) are scarce. There are only two published follow-up studies. OBJECTIVE: To examine the associations of gender and ethnicity with health service contact and psychopathology in SLP. METHOD: We identified all new referrals of SLP to the Maudsley hospital between 1995-2000. Demographic details and information on the course of the illness were obtained from case notes. Those patients who agreed to take part were seen at home and assessed with respect to psychopathology and neurological side effects. RESULTS: The median duration of illness at the time of assessment was 3 years (range 1-6 years). Male patients were more likely to be admitted to hospital compulsorily and to be lost to follow-up than female patients. Caribbean-born patients were more likely to refuse to take part than British-born patients. Of the 26 (48%) patients who were interviewed, 38% were experiencing paranoid symptoms, 94% of patients receiving medication were in regular contact with a community psychiatric nurse (CPN). Treatment response was dose related and was not increased by the use of a depot. CONCLUSION: The effects of gender and ethnicity on outcome need to be further investigated through larger studies. High loss to follow-up amongst male patients may be indicative of a poor prognosis. Regular contact with a CPN may be more important than the use of a depot in maintaining treatment response.

Africa↗
PubMed2001

Interprofessional education: effects on professional practice and health care outcomes.

BACKGROUND: As patient care becomes more complex, effective collaboration between health and social care professionals is required. However, evidence suggests that these professionals do not collaborate well together. Interprofessional education (IPE) offers a possible way forward in this area. OBJECTIVES: To assess the usefulness of IPE interventions compared to education in which the same professions were learning separately from one another. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE (1968 to 1998) and Cinahl (1982 to 1998). We also hand searched the Journal of Interprofessional Care (1992 to 1998), the Centre for the Advancement of Interprofessional Education Bulletin (1987 to 1998), conference proceedings, the 'grey literature' held by relevant organisations, and reference lists of articles. SELECTION CRITERIA: Randomised trials, controlled before and after studies and interrupted time series studies of IPE interventions designed to improve collaborative practice between health/social care practitioners and/or the health/well being of patients/clients. The participants included chiropodists/podiatrists, complementary therapists, dentists, dietitians, doctors/physicians, hygienists, psychologists, psychotherapists, midwives, nurses, pharmacists, physiotherapists, occupational therapists, radiographers, speech therapists and/or social workers. The outcomes included objectively measured or self reported (validated instrument) patient/client outcomes and reliable (objective or validated subjective) health care process measures. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the eligibility of potentially relevant studies. MAIN RESULTS: The total yield from the search strategy was 1042, of which 89 were retained for further consideration. However none of these studies met the inclusion criteria. REVIEWER'S CONCLUSIONS: Despite finding a large body of literature on the evaluation of IPE, these studies lacked the methodological rigour needed to begin to convincingly understand the impact of IPE on professional practice and/or health care outcomes.

Attitude of Health Personnel↗
PubMed2001

A systematic review of the effects of interprofessional education on staff involved in the care of adults with mental health problems.

Interprofessional education (IPE) is commonly advocated in policy documentation as a means of enhancing collaboration between heath and social care staff. However, little is known about the effects of this type of education. This paper reports findings from a systematic review which was commissioned to search and begin assessing the quality of the published evidence relating to the effects of IPE on staff involved in the care of adults with mental health problems. Results from this study indicate that there is a current lack of rigorous evidence into the effects of IPE in this field. Conclusions from this work are made in connection to mental health policy and recommendations are offered for strengthening the evaluation of IPE.

Adult↗
PubMed2001

'Real life' clinical learning on an interprofessional training ward.

This paper describes the multi-method evaluation of an interprofessional training ward placement for medical, nursing, occupational therapy and physiotherapy students. Unique in the UK, and an extension of pioneering work in Sweden (Wahlström et al. 1997, Wahlstroöm & Sandén 1998), this interprofessional clinical placement allowed senior pre-qualifying students, under the supervision of practitioners, to plan and deliver interprofessional care for a group of orthopaedic and rheumatology patients. This responsibility enabled students to develop both their profession-specific skills in a real-world setting and the quality of their interprofessional teamwork. Student teams were supported by facilitators who led reflective sessions and acted as a resource for the students' problem-based learning. The training ward was evaluated by a multi-method approach, incorporating interviews, observations and questionnaires with students, patients and clinical staff. The evaluation findings have been grouped into a number of themes which offer an insight into the varying perspectives of training ward students, patients and staff. This paper pays particular attention to the nursing perspective of the interprofessional training ward pilot.

Education, Nursing↗
PubMed1998

Emerging themes: an exploratory research project of an interprofessional education module for medical, dental and nursing students.

This paper will detail themes emerging from the first stage analysis of a project that was commissioned by the Department of Health. In evaluating the effectiveness of interprofessional teaching and learning opportunities for undergraduate medical, dental and nursing students, the project will also reveal wider institutional problems and opportunities in shared curriculum development. The research focuses on an existing Community Module within the medical and dental curriculum, which has incorporated BSc nursing students. Based on pre-module focus groups, semistructured interviews and an extract from a reflective project diary, the paper will describe the emerging themes of personal interest to the researchers concerning student perceptions and expectations of their shared learning. This early data suggests that in their first term at college, the students reveal inconsistencies in their stereotypical attitudes towards the 'status' of their intended professions. They also demonstrate attitudes that challenge traditional views. The students also offer similar discrepancies in their views on the value of interprofessional learning. It would be premature to draw any firm conclusions from this preliminary analysis of selected data. However, the analysis provides early evidence of the key cultural, professional and institutional issues central to the planning and implementation of interprofessional curricula.

Attitude of Health Personnel↗
PubMed1995

Handling controlled substances: upgrading the system.

To provide safe patient care and to meet legal standards, an automated medstation replaced the manual controlled substances system. Using the medstation streamlines documentation, captures patient charges and reduces floor stock's inventory carrying charges.

Drug and Narcotic Control↗
PubMed1995

Continuous quality improvement as an ideal in hospital practice.

Continuous quality improvement (CQI) is an important part of successfully managing change in health care. This article describes a CQI plan and process created to develop a comprehensive plan for a rapidly evolving organization. Four key components of the planning process are described: initial initiatives, customer service orientation, teamwork approach, and physician involvement. A case study is also included to illustrate how one CQI plan and process was implemented and evaluated.

Consumer Behavior↗
PubMed1984

Crown gall oncogenesis: evidence that a T-DNA gene from the Agrobacterium Ti plasmid pTiA6 encodes an enzyme that catalyzes synthesis of indoleacetic acid.

Stable incorporation of tumor-inducing (Ti) plasmid sequences, the T-DNA, into the genomes of dicotyledonous plants results in the formation of crown gall tumors. Previous genetic studies have suggested that the products of the genes encoding transcripts 1 and 2, which are encoded by the TL-DNA region of pTiA6, are responsible for inducing the auxin-independent phenotype of crown gall tissues. Here we report the construction of a plasmid, pMTlacT2, which directs the synthesis of the Mr 49,800 polypeptide encoded by the transcript 2 gene. Cell-free extracts prepared from Escherichia coli harboring this plasmid converted indoleacetamide to indoleacetic acid, the natural auxin of plants; extracts prepared from plasmidless strains of E. coli or strains harboring the cloning vehicle pBR322 did not carry out this reaction. We conclude that the transcript 2 gene of pTiA6 codes for an enzyme that participates in auxin biosynthesis, probably an indoleacetamide hydrolase.

DNA Restriction Enzymes↗