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Biomedical subjects

S Simmons

Publications and source records attributed to S Simmons.

At least 37 records · Page 2Linked to original sources
PubMed1994

Quality of life in community mental health care--a review.

There has been growing interest in the concept and measurement of quality of life in recent years, originally in the field of general health care, and more recently in community mental health. Measures designed to assess quality of life have been used to assess individual clients' problems, to assess the needs of a particular population, or for research purposes. However there is no generally agreed definition of quality of life itself, or of its associated constructs. As a result of this many ways are used to assess quality of life, ranging from those measures which are generally 'objective', using checklists or rating scales, to those which assess quality of life with little or no predetermined structure for the results. The purpose of this selective review is to focus on some of the range of definitions and concepts of quality of life and approaches to its measurement, with a view to illuminating the most appropriate approaches (both for clinical and research purposes) in the field of community care of those with enduring psychiatric illness.

Community Mental Health Services↗
PubMed1994

Social networks: their relevance to mental health nursing.

Research into social networks has been advancing over several decades, originally in relation to the general population and more recently in relation to their influences on health and mental health. The recent full implementation of the Community Care Act, with its stress on the role of carers and networks, reinforces the need for mental health nurses to be aware of these issues. This selective review examines some of the ways in which social networks can be analysed, explores the relationship between social networks and social support, and considers the effects of social networks and social support on mental health. Research into the social networks of people with long-term mental ill-health is discussed, and implications for mental health nursing in all care settings are addressed.

Community Mental Health Services↗
PubMed1994

Use of a portable ultrasound device to measure post-void residual volume among incontinent nursing home residents.

OBJECTIVE: To determine the accuracy of a portable ultrasound device for the assessment of post-void residual (PVR) volume among incontinent nursing home (NH) residents. DESIGN: Prospective, clinical series. SETTING: Seven community-based nursing homes. STUDY POPULATION: Two hundred one consecutively assessed incontinent NH residents who were participating in a larger clinical trial. MEASUREMENTS: PVR volumes measured by trained research associates using a portable ultrasound device and by in-and-out catheterization were compared. The accuracy of the ultrasound was calculated using the volume obtained by catheterization as the gold standard. RESULTS: The ultrasound demonstrated excellent test-retest and interrater reliability. For low PVRs, the device was highly sensitive (.90) for PVR < 50 mL and .95 for PVR < 100 mL) and moderately specific (.71 for PVR < 50 mL and .63 for PVR < 100 mL). For PVRs of more than 200 mL (n = 26), the ultrasound had a sensitivity of .69 and a specificity of .99. CONCLUSION: The portable ultrasound we used was reliable and reasonably accurate for assessing PVR in a representative sample of incontinent NH residents. Because the sensitivity for clinically significant urinary retention (PVR > 200 mL) was only .69, repeated measurements may be necessary to exclude high PVR in individual NH residents. Recent changes in ultrasound design should improve its ease of use and accuracy. Although measuring PVR by ultrasound is much easier and more comfortable than catheterization for both NH residents and staff, the cost of the device may be a barrier to its widespread use in the NH setting.

Aged↗
PubMed1993

The dark side of incontinence: nighttime incontinence in nursing home residents.

OBJECTIVE: To describe the characteristics of nighttime urinary incontinence in a sample of nursing home (NH) residents. DESIGN: Prospective descriptive study of a convenience sample of incontinent NH residents. SETTING: Four NHs. PARTICIPANTS: 136 incontinent NH residents. MEASUREMENTS: Frequency and volume of incontinent and continent voids for three 10-hour daytime and three 10-hour nighttime data collection periods. RESULTS: The frequency of nighttime incontinence was the same as during the day, but the volume of nighttime incontinent voids and total nighttime volume were higher than during the day. There was substantial between- and within-subject variability in volumes, but the distribution of ratios of night/total volumes approximated a normal curve. Diuretic use was associated with relatively low nighttime volumes. CONCLUSION: About one-quarter of the NH residents we studied produced substantially more urine at night than during the day. Several medical, behavioral, and environmental approaches should be considered for reducing the frequency and volume of nighttime incontinence in this population.

Aged↗
PubMed1992

An integrated approach to curriculum development.

This paper explores some aspects of what is meant by integration in a nursing curriculum, by looking at both integration of course content and subject matter, and a consequent move away from separated academic disciplines towards a thematic approach, and at integration of the student group, so that different groups of nurse learners study and learn together for a certain proportion of the programme. We consider reasons for adopting an integrated approach by discussion: issues related to learners and the learning context (these include theories of how adults learn and our perspective on the part to be played by experiential learning); the potential implications for client/patient care and the need for transferable skills to work as a member of a team; and staff development for the teachers, including moves away from possible isolation towards team-teaching. We then go on to describe a model for curriculum development devised in our own institution and based on these principles, which incorporates the development of learners professionally, educationally and personally. This paper discusses the topic from a mainly theoretical perspective, and many of the issues will be relevant to a wide range of courses.

Clinical Competence↗
PubMed1992

Mental health, race and ethnicity: a retrospective study of the care of ethnic minorities and whites in a psychiatric unit.

A retrospective case-note study of 152 discharged psychiatric patients (77 subjects of ethnic minority origin and 75 whites) examined for details of follow-up arrangements on discharge, compliance rate with out-patient appointments and details on length of stay, status on admission, employment status, record of illicit drug taking and diagnosis. The results show that in the areas of diagnosis, possible illicit drug involvement, status on admission and length of stay, there are significant differences between Afro-Caribbean subjects and others.

Adult↗
PubMed1989

An exercise in curriculum development--the process of putting theory into practice.

Many nurses coming on post-registration courses have widely varying backgrounds and levels of experience. In addition they seek to develop their knowledge base and therapeutic skills, as well as address their personal and professional development. As adult learners they may have a clear idea of their own objectives for the course, and will often benefit most from a student-centred approach to learning. This paper describes the process of reviewing and redesigning a post-registration course in community psychiatric nursing, using this knowledge and a curriculum development model as a starting point. The review particularly addressed the role and influence of student assessment, and the concepts of integration within the curriculum, and student/teacher negotiation of elements of the course.

Community Health Nursing↗
PubMed1983

Effects of injected sympathomimetic amines on plasma catecholamines and circulatory variables in man.

We measured blood pressure, heart rate (HR), and plasma catecholamine responses to a 5-minute infusion of 0.3 mg/kg d-amphetamine (d-A) and to graded bolus injections of tyramine (Tyr) to a similar increment in systolic pressure (BPs), in 9 and 7 healthy people, respectively. Both sympathomimetic agents dramatically increased BPs (mean increases peaking at 39 and 36 mm Hg for d-A and Tyr), associated with increased plasma norepinephrine (NE) (224 and 149 pg/ml) but unassociated with changes in plasma epinephrine or HR. The time course of BPs and NE responses to Tyr was much shorter than to d-A, but the pattern was similar. The results are consistent with the hypotheses that both agents increase BPs via increased synaptic cleft NE, and that circulating plasma NE reflects "spillover" from the cleft into the general circulation.

Blood Pressure↗
PubMed1983

Effect of oral hygiene instruction on brushing skills in preschool children.

This study provides new information on the assessment of toothbrushing skills in preschool children. 420 children aged 2-4 years were given a single lesson on toothbrushing. Their levels of toothbrushing skills, in terms of the locations of the tooth surfaces brushed, were recorded before and after the lesson. The number of skills per child possessed before the lesson (innate skills) and the number acquired from the lesson, both increased with age. A high correlation was found between the proportion of children innately possessing a particular skill and the proportion who subsequently learned it from the lesson. An effectiveness index was devised to help compare the relative difficulty and utility of teaching different skills at different ages.

Age Factors↗
PubMed1983

Dental health status of recipients of community dental health services.

A new information system was used routinely to monitor clinical dental services. Data on 20,729 courses of treatment support the validity and usefulness of continuously collected information about dental health status. Patients who had not attended a community clinic within the year before examination did not need courses of treatment that differed appreciably from those for patients who had attended within the previous year. Patients who attended without scheduled appointments had a lower prevalence of caries free primary dentitions than those with such appointments. Dentists with patients having more caries free permanent dentitions provided a higher number of courses of treatment a year.

Adolescent↗
PubMed1982

Behavioral, biochemical and neuroendocrine responses to amphetamine in normal twins and 'well-state' bipolar patients.

An i.v. injection of dextroamphetamine (0.3 mgm/kg) was given to 13 pairs of normal monozygotic twins, three pairs of normal dizygotic twins and 11 patients with bipolar affective disorder in remission and off medications. Behavioral excitation in response to amphetamine was highly correlated in monozygotic twins; it was predicted by the baseline variables of high plasma MHPG, low serum prolactin and low pulse; it correlated with a rise in cortisol; and it was not correlated with plasma amphetamine level. Pre-infusion baseline MHPG and growth hormone and prolactin responses to amphetamine also were concordant in twins. Plasma amphetamine level, pulse and blood pressure and cortisol responses were not concordant, suggesting significant environmental influences. Haloperidol pretreatment in one pair of twins abolished the excitation response but did not reduce increases in cortisol and growth hormone. This suggests a role for dopamine in the excitation response but predominant serotonergic and noradrenergic mediation of the hormonal responses. None of the responses or baseline measures distinguished patients from controls. Thus, no consistently altered sensitivity to monoaminergic stimulation by amphetamine in bipolar affective disorder was demonstrated in this study. This is one of the first reports of familial (possibly genetic) variation in a psychostimulant drug response in man. The responses identified as concordant may be useful in characterizing other pathologic conditions.

Adolescent↗
PubMed1982

Red cell ouabain-sensitive Na+-K+-adenosine triphosphatase: a state marker in affective disorder inversely related to plasma cortisol.

Ouabain-sensitive Na+-K+-stimulated ATPase was measured in red cell membranes using a spectrophotometric assay. The mean enzyme level in patients in the depressed state (1.2 nM/mg protein per min +/- 0.18 SEM) was lower lower than that in well-state patients (2.0 +/- 0.26) and hypomanic patients (2.4 +/- 0.31). Lithium treatment itself did not alter ATPase levels. Levels in patients in the well state were not significantly different from controls and thus ATPase does not constitute a "trait" marker for affective illness. Plasma cortisol level was higher in well-state patients (15.9 micrograms/dl +/- 1.46) than in controls (11.5 +/- 0.75). There were no significant differences in cortisol in these single morning samples during different mood states. Cortisol level correlated negatively with ATPase level in the total group of patients (r = 0.42, p less than 0.005), especially in those who were euthymic. These data indicate a relationship between cortisol and ATPase levels in affectively ill patients. Ouabain-sensitive NaK ATPase may be useful as an indicator of state in affective illness; plasma cortisol may be continuously elevated in some individuals with affective disorder.

Adult↗