Understanding dyslexia and nurse education in the clinical setting.

Clinical practice and dyslexia is becoming an important topic with the introduction of disability legislation and changes in nursing school entrance requirements. This paper considers the issues surrounding nursing and dyslexia, drawing on the available evidence. Firstly, the strengths dyslexics can bring to nursing are considered, along with difficulties they can experience, although the evidence is limited, with papers being anecdotal or speculative at times. The attitudes of institutions and healthcare professionals towards dyslexia are also addressed, along with what they can do to support dyslexic nurses and student nurses. Strategies for individual students are also suggested, which nursing educators could encourage students to use. Finally, the issue of disclosure is discussed, and suggested reasons why some dyslexic students choose not to disclose.

Guidelines to the United Kingdom Disability Discrimination Act (DDA) 1995 and the Special Educational Needs and Disability Act (SENDA) 2001 with regard to nurse education and dyslexia.

This paper concerns the impact of disability legislation on nurse education, nurse educators and student nurses, in relation to academic work and clinical placement, with regard to dyslexia. The two United Kingdom acts considered are the Disability Discrimination Act (DDA), 1995 and the Special Educational Needs and Disability Act (SENDA), 2001, which is an amendment to the DDA. The paper examines and defines the main points of the acts, such as discrimination; less favourable treatment and its justification; reasonable adjustments; making adjustments in advance; disclosure and confidentiality requests; substantial disadvantage; current systems and regulations and concludes by raising issues which require clarification.

Sexual health and women with bipolar disorder.

AIM: The aim of this paper is to illustrate the importance of sexual health promotion strategies for women with bipolar disorder in order to stimulate interest and debate in this area of care. BACKGROUND: Sexual health promotion is an important aspect of holistic nursing care. However, the literature indicates that nurses are reluctant to discuss sexual health and sexual behaviour with their clients. People with bipolar disorder warrant special consideration with regards to sexual health because the nature of the manic, or hypomanic, mood state is associated in some cases with sexually risky behaviour. For women with bipolar disorder, the associated risks include the threat of unplanned pregnancy or sexually transmitted diseases. To ignore sexual health and sexual behaviour in mental health care increases the vulnerability of women who may already be at risk of sexual exploitation. CASE EXAMPLE: A brief case example is included to demonstrate how the sexual health of a young woman with bipolar disorder was promoted. The sexual health promotion that was incorporated into her care enabled her to make a choice about appropriate contraception, and also provided her with the opportunity to explore acceptable boundaries in different types of interpersonal relationships. As a result of the episodic nature of Bipolar disorder, it is impossible to state whether the positive outcomes from this strategy will be enduring or not. CONCLUSION: Consideration of sexual health is an essential element of the care of women with Bipolar disorder. To ignore it is to neglect an important sphere of human behaviour that can be affected by the condition.

Attitudes towards future testing for bipolar disorder susceptibility genes: a preliminary investigation.

The discovery of susceptibility genes for the major psychiatric illnesses may lead to the development of presymptomatic and prenatal tests. In a preliminary study we assessed the attitudes of 147 bipolar patients, 90 attendees at their family doctor (GP) and 32 psychiatrists to the possible development of genetic tests for bipolar disorder susceptibility genes. Our results suggest that patients and the public will look favourably on the development of presymptomatic (but not prenatal) testing for bipolar disorder susceptibility genes. Psychiatrists, who will have to administer such tests, appear significantly more cautious.

A functional polymorphism in the promoter of monoamine oxidase A gene and bipolar affective disorder.

The genes encoding for the enzymes monoamine oxidase (MAO) A and B are good candidates to investigate bipolar affective disorder. A 30 bp repeat in the MAOA promoter was recently demonstrated to be polymorphic and to affect transcriptional activity. In a family-based association design we found that none of the different repeat copies was preferentially transmitted from mothers (n = 131) to their children affected with bipolar disorder (chi(2) = 2.75, 4 d.f., p = 0.6). Following on our previous finding of an excess of low-activity genotypes of catechol-O-methyltransferase in patients with a rapid cycling form of illness, we examined for a similar trend with MAOA alleles. In an extended sample we found a non-significant trend for patients with an ultra-rapid cycling form of illness (n = 29) to have a higher frequency of low-activity alleles compared with 92 bipolar patients with a non-rapid cycling course of illness (chi(2) = 2.37, 1 d.f., p = 0.13).