Showing papers by "Northampton Community College published in 2011"

Disease-associated epigenetic changes in monozygotic twins discordant for schizophrenia and bipolar disorder

Abstract: Studies of the major psychoses, schizophrenia (SZ) and bipolar disorder (BD), have traditionally focused on genetic and environmental risk factors, although more recent work has highlighted an additional role for epigenetic processes in mediating susceptibility. Since monozygotic (MZ) twins share a common DNA sequence, their study represents an ideal design for investigating the contribution of epigenetic factors to disease etiology. We performed a genome-wide analysis of DNA methylation on peripheral blood DNA samples obtained from a unique sample of MZ twin pairs discordant for major psychosis. Numerous loci demonstrated disease-associated DNA methylation differences between twins discordant for SZ and BD individually, and together as a combined major psychosis group. Pathway analysis of our top loci highlighted a significant enrichment of epigenetic changes in biological networks and pathways directly relevant to psychiatric disorder and neurodevelopment. The top psychosis-associated, differentially methylated region, significantly hypomethylated in affected twins, was located in the promoter of ST6GALNAC1 overlapping a previously reported rare genomic duplication observed in SZ. The mean DNA methylation difference at this locus was 6%, but there was considerable heterogeneity between families, with some twin pairs showing a 20% difference in methylation. We subsequently assessed this region in an independent sample of postmortem brain tissue from affected individuals and controls, finding marked hypomethylation (>25%) in a subset of psychosis patients. Overall, our data provide further evidence to support a role for DNA methylation differences in mediating phenotypic differences between MZ twins and in the etiology of both SZ and BD.

National Diet and Nutrition Survey: UK food consumption and nutrient intakes from the first year of the rolling programme and comparisons with previous surveys

Abstract: The National Diet and Nutrition Survey (NDNS) is a cross-sectional survey designed to gather data representative of the UK population on food consumption, nutrient intakes and nutritional status. The objectives of this paper were to identify and describe food consumption and nutrient intakes in the UK from the first year of the NDNS Rolling Programme (2008-09) and compare these with the 2000-01 NDNS of adults aged 19-64y and the 1997 NDNS of young people aged 4-18y. Differences in median daily food consumption and nutrient intakes between the surveys were compared by sex and age group (4-10y, 11-18y and 19-64y). There were no changes in energy, total fat or carbohydrate intakes between the surveys. Children 4-10y had significantly lower consumption of soft drinks (not low calorie), crisps and savoury snacks and chocolate confectionery in 2008-09 than in 1997 (all P< 0.0001). The percentage contribution of non-milk extrinsic sugars (NMES) to food energy was also significantly lower than in 1997 in children 4-10y (P< 0.0001), contributing 13.7-14.6% in 2008-09 compared with 16.8% in 1997. These changes were not as marked in older children and there were no changes in these foods and nutrients in adults. There was still a substantial proportion (46%) of girls 11-18y and women 19-64y (21%) with mean daily iron intakes below the Lower Reference Nutrient Intake (LRNI). Since previous surveys there have been some positive changes in intakes especially in younger children. However, further attention is required in other groups, in particular adolescent girls.

The public sphere, social networks and public service media

Abstract: The traditional Habermasian concept of the national public sphere created by the mass media of newspapers and television is said to have transformed to a multi-layered sphere of online and social networks which are increasingly important in engaging and mobilizing citizenship and in shaping the discourse within which rational discussion takes place. This article argues that the democratizing and empowering functions of the Internet and the new social media is being exaggerated and represent technological optimism for a number of reasons: the open participation of the Internet can turn chaotic; there is a problem of inclusiveness; censorship might be an issue; the Internet has become a major arena for corporate activity; the Internet's content is highly partisan; and above all, extensive dialogue and critical discussion (the very essence of the public sphere) is often absent on the Net. The article argues that open-platform Public Service Media (PSM) are capable of developing more comprehensive and inclusi...

Time banking and health: the role of a community currency organization in enhancing well-being.

Abstract: Time banking is an international movement that seeks to transform traditional asymmetric social service models into social networks in which members both provide and receive services that are assigned equal value. Time banks have been shown to enhance social capital, and there is some evidence for improved health. This article, based on a survey of 160 members of a hospital-affiliated time bank, examines the likelihood and predictors of improvement in physical and mental health as a result of membership. Men, people with lower income, and those who were not working full-time reported highest levels of participation in exchanging services; attachment to the organization was greatest among women, older members, people with less education, and those with the highest participation levels. Multivariate analyses revealed that physical health improvement attributed to membership was significantly predicted by attachment to the organization and living alone; mental health gains were predicted by general health changes, average number of exchanges, and attachment to the organization. We conclude that a sense of belonging, a dimension of social capital, is key to improved well-being and that time banking may be particularly valuable in promoting health and belonging among older and lower-income individuals and those who live alone.

A Quick and Simple Screening Method for Pathological and Problem Gamblers in Addiction Programs and Practices

Abstract: Despite high rates of comorbidity among pathological gambling, substance use disorders, and other psychiatric conditions, health professionals rarely screen their clients for gambling problems. We report on the performance of the NODS-CLiP, an existing brief, three-item screen for problem and pathological gambling, and an alternative four-item screen that demonstrates improved sensitivity, good positive and negative predictive power, and invariance across key demographic groups . Given the high rates of comorbidity, routine and accurate identification of gambling-related problems among individuals seeking help for substance abuse and related disorders is important. The original and the alternative brief screens are likely to be useful in a range of clinical settings.

Public health sector and food industry interaction: it’s time to clarify the term ‘partnership’ and be honest about underlying interests

Abstract: In the context of concerns about unhealthy diets, obesity and chronic diseases in Europe and around the world, the food industry is making a growing number of pledges to be ‘part of the solution’. Governments, too, are looking for ways to promote healthy eating at the population-level. Emerging in this environment are initiatives that bring together the food industry and institutions of the state, increasingly described as ‘partnerships’ or ‘public–private partnerships’. By working together, so the rationale goes, public and private sector bodies can more effectively achieve shared goals than could have been achieved alone, reach consensus about needed action, pool expertise, ideas, skills and resources, reach a broader range of populations, and reduce the costs of regulation.1 Although some academics, professionals and policy-makers have concerns or are cautious about these initiatives,2 partnerships have seemingly become de rigueur . The public health commissioner of the European Union (EU) said in 2006: ‘You cannot legislate on what people eat. You have to form public–private partnerships. We are all… part of the problem and are all part of the solution.’ First Lady Michelle Obama describes her anti-obesity initiative, ‘Let’s Move’, as a ‘public–private partnership that, for the first time, sets national goals to end childhood obesity in a generation’. At the global level, the World Health Organization’s 2008–13 Action Plan for Non-Communicable Diseases explicitly calls for the involvement of the private sector as one of the international ‘partners’. Industry leaders, meanwhile, are suggesting that ‘only through new and innovative public–private sector partnerships can we truly make a difference’.3 As public health officials nod their heads in support of ‘partnerships’ with the food industry, what are they actually talking about? For when we start looking more closely at existing examples, we see ‘partnership’ means a whole lot of things. Take …

Social climate along the pathway of care in women's secure mental health service: variation with level of security, patient motivation, therapeutic alliance and level of disturbance.

Abstract: Background Social climate has been measured in a variety of therapeutic settings, but there is little information about it in secure mental health services, or how it may vary along a gender specific care pathway. Aim To assess social climate in women's secure wards and its variation by level of security and ward type, therapeutic alliance, patient motivation, treatment engagement and disturbed behaviour. Method Three-quarters (80, 76%) of staff and nearly all (65, 92%) of patients in the two medium-security wards and two low-security wards that comprised the unit completed the Essen Climate Evaluation Schema (EssenCES) and the California Psychotherapy Alliance Scale (CALPAS); patients also completed the Patient Motivation Inventory (PMI). Pre-assessment levels of disturbed behaviour and treatment engagement were recorded. Results Social climate varied according to ward type and level of security. EssenCES ratings indicative of positive social climate were associated with lower levels of security; such ratings were also associated with lower behavioural disturbance and with higher levels of motivation, treatment engagement and therapeutic alliance. Conclusion This serial cross-sectional survey indicated that use of the EssenCES alone might be a good practical measure of treatment progress/responsivity. A longitudinal study would be an important next step in establishing the extent to which it would be useful in this regard. Copyright © 2010 John Wiley & Sons, Ltd.

Coercive treatments in forensic psychiatry: a study of patients' experiences and preferences

Abstract: The aim of this study was to report on forensic rehabilitation inpatients' experiences and preferences for physical restraint, seclusion and emergency intra-muscular medication using mixed qualitative and quantitative methods. Of 252 inpatients, 79 met the study inclusion criteria and 57 (72%) agreed to take part. Just over half thought they should have been subjected to coercive treatment. Although coercive treatments were generally perceived as negative experiences, 16% of participants reported the last episode of seclusion or restraint had been a positive experience for them. The figure for emergency intra-muscular medication was 36%. Eleven percent of participants said they had made an advance statement but none could be found in their records. Most participants preferred intra-muscular medication to seclusion. Participants made suggestions as to how to improve their experiences of coercive treatments. Patients' views on coercive treatments should be incorporated into their care plans and they should ...

One Hundred Years of College Mental Health

Abstract: Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student b...

The meaning of reporting forgetfulness: a cross-sectional study of adults in the English 2007 Adult Psychiatric Morbidity Survey

Abstract: Method: we analysed data from the English 2007 Adult Psychiatric Morbidity Survey, representative of people in private households. Participants were asked whether they had noticed problems with forgetting in the last month, or forgotten anything important in the last week; and completed the modified Telephone Interview for Cognitive Status.Results: of those contacted, 7,461 (57%) participated. After excluding participants screening positive for dementia, 2,168 (31.7%) reported forgetfulness in the last month, while 449 (6.4%) had forgotten something important in the last week. Reporting forgetfulness was not associated with age. In a multivariate analysis including cognition and age, the only significant associates of reporting forgetfulness were anxiety, depressive and somatic symptoms.Conclusions: our hypothesis that subjective forgetfulness prevalence would rise with age in a non-demented population was not supported. Although subjective forgetfulness can be an early symptom of future or mild dementia, it is common and non-specific and-at population level-is more likely to be related to mood than to be an early symptom of dementia. Asking those presenting with subjective forgetfulness additional questions about memory and functional decline and objective forgetfulness is likely to help clinicians to detect those at risk of dementia.

Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

Abstract: Background: Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events. Methodology/Principal Findings: Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I 2 and publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16–0.34; p,0.001) and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03–0.63; p=0.01) through vaccinating immunocompromised patients compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified. Conclusions/Significance: Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias and confounding and the presence of heterogeneity mean the evidence reviewed is generally weak, although the directions of effects are consistent. Areas for further research are identified.

‘The public gets what the public wants’? The uses and abuses of ‘public value’ in contemporary British cultural policy

Abstract: The aim of this article is to examine the adoption and use of the term ‘public value’ in both the broadcasting and the wider cultural arena. It examines the ideas, tensions and contradictions that exist in such a notion, asking whether it is simply empty rhetoric, or whether it tells us something more. It argues that the term stands as an example of a failed approach to policy‐making, being neither successfully technocratic, offering a clear methodology for assessing value, nor successfully rhetorical in the way that ‘the public good’, or ‘public service broadcasting’ can be deemed to have been. It also explores the means by which certain policy ideas are transmitted, briefly flourish and then dissipate, arguing that this may beat the cost to a longer‐term more sustainable mode of cultural policy‐making.

Steam as the working fluid for power recovery from exhaust gases by means of screw expanders

Abstract: Rankine cycle systems, using steam as a working fluid, are not well suited to the recovery of power from heat sources in the 300–450 °C temperature range, such as internal combustion engine exhaust gases, mainly due to the relatively large enthalpy of vaporization of water. Admitting the steam to the expander as vapour approximately 50 per cent dry, would be preferable but turbines cannot be used to expand vapours from this state. However, screw expanders can operate well in this mode. It is shown that, apart from being environmentally benign and free from flammability risks, a screw-driven wet steam cycle system can recover power from engine exhaust gases, with comparable efficiencies to turbine-driven systems using organic fluids at a significantly lower cost per unit output.

Expectations and experience of moving to a care home: Perceptions of older people with dementia

Abstract: Large numbers of people with dementia live in care homes. Decisions about permanent care are usually made by family members and professionals with little involvement from people with dementia. This...

Young people’s representations of language brokering

Abstract: In recently arrived immigrant families, children and young people often act as language brokers for their parents and other adults. In public and academic debate, this activity is sometimes portrayed negatively as imposing excessive burdens of responsibility on the young people. This paper reports an analysis of qualitative data from a broader study of young people's representations of conflicting roles in child development. Interview participants were monolingual and bilingual students, aged 15-18 years. Half of the latter had had personal experience of language brokering. The paper examines differences within this sample in their representations of a young person's involvement in language brokering. Monolingual students were not generally negative in their attitudes to bilingualism and language brokering, but many showed only a vague understanding of them and perceived them as unusual or 'strange'. Bilingual speakers, on the other hand, and in particular those with language brokering experience, saw these activities as 'normal' and often showed a richer and more subtle appreciation of what was involved. These differences illustrate ways in which personal experiences influenced individuals' representations of language brokering. Implications for an understanding of developmental scripts emphasising independence and interdependence between young people and their parents are discussed.

Differential effects of the (+)‐ and (–)‐gossypol enantiomers upon Entamoeba histolytica axenic cultures

Abstract: — The in-vitro anti-amoebic effects of (±)-, (+)-, (–)-gossypol and emetine were tested against axenic trophozoites from five Entamoeba histolytica strains. The (–)-isomer was more active than the racemate and the (+)-isomer. These results indicate that the gossypol anti-amoebic activity is mainly due to its content of (–)-gossypol in all strains tested.

Enduring love: attitudes to family and inheritance law in England and Wales

Abstract: This paper reports on findings from a large-scale study of public attitudes to inheritance law, particularly the rules on intestacy. It argues that far from the assumption that the 'family' is in terminal decline, people in England and Wales still view their most important relationships, at least for the purposes of inheritance law, as centred on a nuclear family model. However, there is also widespread acceptance of re-partnering and cohabitation, producing generally high levels of support for including cohabitants in the intestacy rules and for ensuring that children from former relationships are protected. We argue that these views are underpinned by a continuing sense of responsibility to the members of one's nuclear family, arising from notions of sharing and commitment, dependency and support, and a sense of lineage.

Suicide in high security hospital patients

Abstract: Purpose People with mental disorder and people who are violent are separately recognised as being at high risk of suicide. People detained in high security hospitals are recognised for their violence to others, but perhaps less so for their suicide potential. We aimed to investigate suicide rates among such patients during and after their high security hospital residency, and to establish risk factors for suicide.

Problem drug use, drug misuse and deliberate self-harm: trends and patient characteristics, with a focus on young people, Oxford, 1993–2006

Abstract: Background Drug misuse is related to self-harm and suicide. However, relatively little is known about deliberate self-harm (DSH) in patients with drug problems and whether drug misuse by DSH patients is increasing.

A computerized system for reporting medication events in psychiatry: the first two years of operation.

Abstract: The aim of this paper is to describe the first 2 years of operation of an electronic system for reporting medication events in psychiatry (Medi-Event system). We have carried out a descriptive analysis of all medication events (errors, near misses and adverse drug reactions) reported between 1 March 2008 and 28 February 2010 at a large, specialist UK psychiatric hospital. A total of 406 medication errors, 40 near misses and no adverse drug reactions were reported in the study period, representing a very large increase in reporting frequency with respect to the previous paper system. The majority (88.8%) of incidents were medication administration errors. The most common error types were failure to sign for a drug and omission of a drug without valid clinical reason. Although most errors were of minor severity, 6.3% were rated as moderate or serious. Distraction was cited as the most common contributory factor, also poor communication and being unfamiliar with the ward. In conclusion, use of the Medi-Event system increased the reporting of medication errors. Analysis of the pattern of errors, as well as of contributory factors and suggestions for error prevention, may help reduce the frequency of medication events and hence improve patient care.

Uncovered interest parity and the efficiency of the foreign exchange market: a re-examination of the evidence

Abstract: In this paper, we find that the traditional approach to testing UIP is misleading because of the significant difference in volatility between the change in the log of the exchange rates and the forward premium, and also because of the presence of conditional heteroskedasticity in the data. This difference has an effect on the estimates of the relevant slope parameter and on the estimates of the uncertainty about the parameter. We show by means of a bootstrap simulation experiment that the econometric rejections of UIP can be spurious and that an alternative methodology is needed to test for foreign exchange markets efficiency. We introduce a set of more direct and economically meaningful profitability-based tests of market efficiency based on UIP. Our results are far more favourable than the existing literature to foreign exchange market efficiency

The development of the St Andrew’s-Swansea Neurobehavioural Outcome Scale: validity and reliability of a new measure of neurobehavioural disability and social handicap.

Abstract: Primary objective: Neurobehavioural disability (NBD) has a major impact on long-term psychosocial outcome following acquired brain injury (ABI). A recent review highlighted that a reliable and valid measure that can adequately capture the subtle and varied characteristics of NBD has yet to be developed. In this paper, the work underpinning the ‘St Andrews-Swansea Neurobehavioural Outcome Scale’ (SASNOS) is described using a conceptual framework underpinned by the WHO ICF. The intention is that SASNOS will provide a reliable and valid means of measuring NBD.Methods and procedures: Three hundred and thirty-six sets of ratings were made regarding ABI and neurologically healthy samples. The initial pool of 117 items was subjected to exploratory factor analysis and Rasch analysis. Reliability and validity of the new measure were determined using a range of appropriate statistical methods.Main outcomes: Forty-nine items were retained, falling into five principal factors. Content and construct validity are calcu...