Health visiting and refugee families: issues in professional practice.

Aim: This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London.

Background: Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees.

Altered mitochondrial function and cholesterol synthesis influences protein synthesis in extended HepG2 spheroid cultures.

Cultures of hepatocytes and HepG2 cells provide useful in vitro models of liver specific function. In this study, we investigated metabolic and biosynthetic function in 3-D HepG2 spheroid cultures, in particular to characterise changes on prolonged culture. We show that HepG2 cells cultured in spheroids demonstrate a reduction in mitochondrial membrane potential and respiration following 10 days of culture.

Should doctors wear white coats?

Objective: To compare the views of doctors and patients on whether doctors should wear white coats and to determine what shapes their views.

Methods: A questionnaire study of 400 patients and 86 doctors was performed.

Results: All 86 of the doctors' questionnaires were included in the analysis but only 276 of the patients were able to complete a questionnaire.

Can intensive three-day programmes improve nurses' communication skills in cancer care?

Effective communication is widely regarded as a crucial component of patient care that can determine patient satisfaction, compliance and recovery. The plethora of communication skills training programmes available to health professionals is also a testament to the importance of this element of care. However a review of studies evaluating the effectiveness of such training programmes concluded that little behavioural change in health professionals' communication skills was evident.

The expression of DJ-1 (PARK7) in normal human CNS and idiopathic Parkinson's disease.

Two mutations in the DJ-1 gene on chromosome1p36 have been identified recently to cause early-onset, autosomal recessive Parkinson's disease. As no information is available regarding the distribution of DJ-1 protein in the human brain, in this study we used a monoclonal antibody for DJ-1 to map its distribution in frontal cortex and substantia nigra, regions invariably involved in Parkinson's disease. Western blotting of human frontal cortex showed DJ-1 to be an abundant protein in control, idiopathic Parkinson's disease, cases with clinical and pathological phenotypes of Parkinson's disease with R98Q polymorphism for DJ-1, and in progressive supranuclear palsy (PSP) brains.

Sooner or later? Issues in the early diagnosis of dementia in general practice: a qualitative study.

Objective: The aim of this study was to explore the perspectives of primary care practitioners on the early diagnosis of dementia.

Methods: A total of 247 GPs, 146 community nurses, 36 practice nurses, 79 community mental health nurses and others working in a range of hospital, residential and community settings attended 24 one-day workshops in 21 cities and towns in the UK. A nominal group approach was used relating to the early diagnosis of dementia in the community.

Human CRP gene polymorphism influences CRP levels: implications for the prediction and pathogenesis of coronary heart disease.

Objective: C-reactive protein (CRP) concentrations are predictive of cardiovascular disease, and levels are heritable, in part. We identified novel polymorphisms in the CRP gene and assessed their influence on CRP level.

Methods And Results: CRP was measured in 250 male army recruits before and after strenuous exercise and perioperatively in 193 coronary artery bypass graft (CABG) patients.

What are you like?: A personality profile of cancer and palliative care nurses in the United kingdom.

Occupational psychology has long been concerned with the proposed link between personality and occupational success or stress. The role of the cancer and palliative care nurse can be challenging and stressful, and the aim of the current study was to explore the existence of a personality profile for nurses working in this area. For this study, 178 nurses undertaking degree and diploma studies in cancer and palliative care at a specialist palliative care unit in northwest England completed the 16PF personality inventory and a demographic questionnaire.

Cerebral amyloid angiopathy and motor neurone disease presenting with a progressive supranuclear palsy-like syndrome.

We describe a 68-year-old woman who presented with falls, mild limb bradykinesia, axial rigidity, and a severe supranuclear gaze palsy, which failed to benefit from levodopa. She subsequently developed severe apraxia, progressive dysarthria, dysphagia, and a frontal cognitive impairment. Pyramidal weakness with fasciculations and widespread chronic partial denervation appeared shortly before her death from bronchopneumonia, 6 months after disease onset.

Modulation of inhibitory autapses and synapses on rat CA1 interneurones by GABA(A) receptor ligands.

To determine whether autaptic inhibition plays a functional role in the adult hippocampus, the action potential afterhyperpolarisations (spike AHPs) of CA1 interneurones were investigated in 25 basket, three bistratified and eight axo-axonic cells. The spike AHPs showed two minima in all regular-spiking (5), burst-firing (3) and in many fast-spiking cells (17:28). The fast component had a time-to-peak (TTP) of 1.

The essence of cancer care: the impact of training on nurses' ability to communicate effectively.

Background: The importance of effective communication between health professionals and patients with cancer is widely recognized. Training programmes aimed at improving key communication skills are becoming increasingly available.

Purpose: To evaluate a communication skills programme delivered to 308 cancer nurses as part of degree/diploma courses.

The upregulation of CC chemokine receptor 7 and the increased migration of maturing dendritic cells to macrophage inflammatory protein 3beta and secondary lymphoid chemokine is mediated by the p38 stress-activated protein kinase pathway.

Using the p38 stress-activated protein kinase (p38SAPK) inhibitor, SB203580, increased responsiveness of monocyte-derived dendritic cells (MoDCs) to secondary lymphoid chemokine (SLC) and macrophage inflammatory protein 3beta (MIP3beta), following lipopolysaccharide-induced MoDC maturation, was shown to be mediated by the p38SAPK pathway. This was due to the complete abrogation of upregulation of CC chemokine receptor 7, the receptor for MIP3beta/SLC. Once mature, MoDCs utilized both the p38SAPK and phosphoinositide-3 kinase pathways to migrate in response to SLC or MIP3beta.

Applying community-oriented primary care methods in British general practice: a case study.

Background: The '75 and over' assessments built into the 1990 contract for general practice have failed to enthuse primary care teams or make a significant impact on the health of older people. Alternative methods for improving the health of older people living at home are being sought.

Aim: To test the feasibility of applying community-oriented primary care methodology to a relatively deprived sub-population of older people in a relatively deprived area.

Design and implementation of a computer decision support system for the diagnosis and management of dementia syndromes in primary care.

Background: Diagnosis and management of dementia is a complex process and primary care physicians are under-equipped to deal with uncertainties in the provision of optimal care for the patient.

Objective: To develop a computer decision support system (CDSS) which could assist physicians with diagnosis and management and improve patient care.

Methods: A design group including general practitioners derived logic pathways for diagnosis and management of dementia and validated them with a multiprofessional expert group.

An assessment of dual-role primary care nurses in the inner city.

The integration of primary care nursing roles into single posts, closely associated with GPs, has been advocated in the UK and in Europe. However, there has been little exploration of the benefits and difficulties of integrating roles in the UK. In this article, we assess three posts in inner London that combine health visiting and district nursing.

The effect of fibrinogen genotype on fibrinogen levels after strenuous physical exercise.

We have examined the effect of two beta-fibrinogen gene promoter polymorphisms (-455G>A and -854G>A) on the fibrinogen response to severe exercise in a group of male army recruits undergoing basic training. Fibrinogen was measured pre-training and again serially after severe 48 h final military exercise (FME). Out of 884 subjects, 762 completed training of whom 250 were selected for post-FME study.

Is the prevalence of coronary heart disease falling in British men?

Objective: To assess whether long term trends over time in acute coronary heart disease (CHD) event rates have influenced the burden of prevalent CHD in British men.

Design: Longitudinal cohort study.

Participants: 7735 men, aged 40-59 at entry (1978-80), selected from 24 British towns.

Effect of a COL1A1 Sp1 binding site polymorphism on arterial pulse wave velocity: an index of compliance.

-Reduced arterial compliance precedes changes in blood pressure, which may be mediated through alterations in vessel wall matrix composition. We investigated the effect of the collagen type I-alpha1 gene (COL1A1) +2046G>T polymorphism on arterial compliance in healthy individuals. We recruited 489 subjects (251 men and 238 women; mean age, 22.

Differences in HDL-cholesterol:apoA-I + apoA-II ratio and apoE phenotype with albuminuric status in Type I diabetic patients.

Aims/hypothesis: To examine whether the HDL-cholesterol:apoA-I + apoA-II ratio and the epsilon2 allele are related to albuminuria at baseline and whether they are risk factors for progression of albuminuria in a cohort study of patients with Type I (insulin-dependent) diabetes mellitus.

Methods: At baseline, the study cohort comprised 617 patients, aged 15-60 years, from seven European diabetic centres of the EURODIAB study. Albumin excretion rate, measured in a central laboratory, was categorised as normoalbuminuria at 20 microg/min or less, microalbuminuria between 20 and 200 microg/min or macroalbuminuria at 200 microg/min or over.

Laxatives and faecal incontinence in long-term care.

High levels of faecal incontinence and laxative use in long-term care settings for older people are revealed in this study. Further research, together with more considered prescribing policies are needed, the authors suggest.

Professional competence in medicine.

Professional competence in medicine is under the microscope following a year of government and media attention directed at the performance of doctors and outcomes for patients. The ability of the profession to self-regulate has been questioned and the roles of the state, the universities, the Royal colleges and the postgraduate deans are shifting. This paper provides a context for considering these important changes.