Biomedical subjects

L Mason

Publications and source records attributed to L Mason.

At least 19 recordsLinked to original sources

PubMed2004

Single dose oral naproxen and naproxen sodium for acute postoperative pain.

BACKGROUND: Postoperative pain is often poorly managed. Treatment options include a range of drug therapies such as non-steroidal anti-inflammatory drugs (NSAIDs) of which naproxen is one. Naproxen is used to treat a variety of painful conditions including acute postoperative pain, and is often combined with sodium to improve its solubility for oral administration. Naproxen sodium 550 mg (equivalent to 500 mg of naproxen) is considered to be an effective dose for treating postoperative pain but to date no systematic review of the effectiveness of naproxen/naproxen sodium at different doses has been published. OBJECTIVES: To assess the efficacy, safety and duration of action of a single oral dose of naproxen or naproxen sodium for acute postoperative pain in adults. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE and the Oxford Pain Relief Database for relevant studies. Additional studies were identified from the reference list of retrieved reports. The most recent search was undertaken in July 2004. SELECTION CRITERIA: Included studies were randomised, double blind, placebo-controlled trials of a single dose of orally administered naproxen or naproxen sodium in adults with moderate to severe acute postoperative pain. DATA COLLECTION AND ANALYSIS: Pain relief or pain intensity data were extracted and converted into dichotomous information to give the number of patients with at least 50% pain relief over four to six hours. Relative risk estimates (RR) and the number-needed-to-treat (NNT) for at least 50% pain relief were then calculated. Information was sought on the percentage of patients experiencing any adverse event, and the number-needed-to-harm was derived. Time to remedication was also estimated. MAIN RESULTS: Ten trials (996 patients) met the inclusion criteria: nine assessed naproxen sodium; one combined the results from two small trials of naproxen alone. Included studies scored well for methodological quality. Meta-analysis of six trials (500 patients) that compared naproxen sodium 550 mg with placebo gave a RR for at least 50% pain relief over 4 to 6 hours of 4.2 (95% confidence interval (CI) 2.9 to 6.0) and an NNT of 2.6 (95% CI 2.2 to 3.2). Three trials (334 patients) assessed naproxen 400 mg and naproxen sodium 440 mg, giving a RR of 4.8 (95% CI 2.75 to 8.38). Two small studies indicated that naproxen 200 mg and naproxen sodium 220 mg may provide effective postoperative pain relief. There was no significant difference between the number of patients experiencing any adverse event on treatment compared with placebo. Weighted mean time to remedication for naproxen sodium 550 mg was 7.6 hours compared with 2.6 hours for placebo. REVIEWERS' CONCLUSIONS: Naproxen sodium 550 mg, naproxen 400 mg and naproxen sodium 440 mg administered orally are effective analgesics for the treatment of acute postoperative pain in adults. A low incidence of adverse events was found but reporting was not consistent.

Acute Disease↗

PubMed2004

Single dose oral indometacin for the treatment of acute postoperative pain.

BACKGROUND: Indometacin is a non-steroidal anti-inflammatory drug (NSAID) used most commonly for the treatment of inflammation and pain resulting from rheumatic disease (arthritis), and less commonly in postoperative pain management. When taken for chronic pain conditions, indometacin has been associated with a high incidence of adverse events. The benefits and harms of orally-administered indometacin for postoperative pain are not clear. OBJECTIVES: To determine the efficacy of a single dose of oral indometacin compared with placebo in treating acute postoperative pain in adults, and to analyse information relating to adverse events. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials in The Cochrane Library (Issue 3, 2004), MEDLINE, EMBASE and the Oxford Pain Relief Database for relevant studies. Additional studies were sought from the reference lists of retrieved reports. SELECTION CRITERIA: Studies were included in the review if they were randomised, double blind, placebo-controlled clinical trials using a single oral dose of indometacin in adults with acute postoperative pain. DATA COLLECTION AND ANALYSIS: Trials were assessed independently by two authors. Pain relief or pain intensity data were extracted and converted into dichotomous information to give the number of patients with at least 50% pain relief over four to six hours. The relative benefit for at least 50% pain relief was calculated. MAIN RESULTS: One trial of 59 women with post-episiotomy pain met the inclusion criteria. The dose of indometacin assessed against placebo was 50 mg, and the results concluded that indometacin was not significantly better than placebo for relieving postoperative pain at four to six hours. There was insufficient information to conduct further efficacy analyses or assess adverse events. REVIEWERS' CONCLUSIONS: Conclusions about the clinical efficacy of indometacin for postoperative cannot be made until more trials are conducted for a variety of surgical procedures, and different doses of indometacin are assessed.

Administration, Oral↗

PubMed2001

Factors associated with intended staff turnover and job search behaviour in services for people with intellectual disability.

Staff turnover is a major problem in services for people with intellectual disability (ID). Therefore, understanding the reasons for staff turnover is vital for organizations seeking to improve their performance. The present study investigates the factors directly and indirectly associated with an intention to leave an organization and actual job search behaviour amongst staff in services for people with ID. As part of a large-scale survey of staff in services for people with ID, information was collected from 450 staff concerning intended turnover, job search behaviour and a wide range of factors potentially associated with these outcomes. Path analyses revealed that work satisfaction, job strain, younger staff age and easier subjective labour conditions were directly associated with intended turnover. The same factors, with the exception of younger staff age, were also directly associated with job search behaviour. Factors indirectly associated with these outcomes included wishful thinking, alienative commitment to the organization, lack of staff support, role ambiguity, working longer contracted hours, having a low-status job, a lack of influence over decisions at work and less orientation to working in community settings with people with ID. The models of staff turnover empirically derived in the present study confirm and extend previous research in this area. The implications for organizations are discussed.

Adult↗

PubMed2001

The instruction in pelvic floor exercises provided to women during pregnancy or following delivery.

OBJECTIVES: to examine the instruction in pelvic floor exercises given to women during pregnancy or following delivery, to assess the quality of any instruction provided, and to consider these in light of the women's views about the service. DESIGN: a postal questionnaire was sent to a sample of women when they reached 34 weeks of pregnancy and a second at 8 weeks postpartum. A sub-sample of women who reported symptoms of stress incontinence at 8 weeks postpartum were interviewed about the instruction in pelvic floor exercises that they received during their pregnancy, or in the puerperium. PARTICIPANTS: of the 918 women who were sent the first questionnaire, 717 returned it completed (78%). Five-hundred-and-seventy-two of 894 women (64%) completed the second questionnaire. Forty-two of 179 symptomatic women (23%) took part in an interview. FINDINGS: 55% of women received some form of instruction in pelvic floor exercises by 34 weeks of pregnancy. Eighty-six percent received instruction following birth. The way the information was given varied, ranging from a brief reminder, to exercising in a class with an instructor. The information was provided by a range of health professionals, and no single profession appeared to undertake responsibility for the service. As a result, the views of the service varied. A few women reported that they had received good quality instruction, others were critical of it, and a small number reported that they had received no instruction at all. The widespread practice of leaving a leaflet by the women's beds during their stay in hospital, was criticised by a large proportion of the women. KEY CONCLUSION: the instruction in pelvic floor exercises by health service professionals was provided on an ad hoc basis. In many instances, the programme of instruction did not meet recommendations made in the literature. It is likely that the success of randomised controlled trials reported in the literature would not be repeated in the 'real world' Implications for practice: there is a need for the service to be reorganised so that all women receive high-quality instruction during pregnancy, with a reminder to exercise following birth. This could help to prevent, or relieve, the symptoms of stress incontinence that frequently occur at these times.

Adult↗

PubMed2001

Women's reluctance to seek help for stress incontinence during pregnancy and following childbirth.

OBJECTIVE: to identify whether women were made aware of stress incontinence around the time of childbirth, whether symptomatic women sought help from professionals caring for them at this time, to look at what help they receive in the first instance and to understand why some of those experiencing it chose not to seek help. DESIGN: a qualitative survey was conducted using semi-structured interviews. SETTING: interviews were conducted in participants' own homes. PARTICIPANTS: 42 women who reported symptoms of stress incontinence at eight weeks postpartum, and 15 women who were symptomatic one year following the birth of their baby. FINDINGS: women were reluctant to seek help, although they were often inconvenienced and troubled by the condition. This was predominantly due to the nature of the condition itself, although the relationship with their health care professionals was also a consideration in some cases. The majority of women were not provided with information on the condition but wanted health professionals to provide a warning that the condition could occur. They also wanted health professionals to seek out information about symptoms, rather than the women themselves having to broach the subject. The first line of treatment at this time was usually a recommendation to perform pelvic floor exercises. IMPLICATIONS FOR PRACTICE: health professionals caring for women during pregnancy or following the birth of their baby need to raise awareness of the condition, the treatment available, and to be pro-active in seeking out those experiencing incontinence rather than expecting women to approach them for help.

Adolescent↗

PubMed2000

Defining mechanisms of action of interleukin-11 on the progression of radiation-induced oral mucositis in hamsters.

Oral ulcerative mucositis is a common toxicity associated with drug and radiation therapy for cancer. It impacts on quality of life and economic outcomes, as well as morbidity and mortality. Mucositis is often associated with dose limitations for chemotherapy or is a cause for dose interruption for radiation. The complexity of mucositis as a biological process has only been recently appreciated. It has been suggested that the condition represents a sequential interaction of oral mucosal cells and tissues, pro-inflammatory cytokines and local factors such as saliva and the oral microbiota. The recognition that the pathophysiology of mucositis is a multifactorial process was partially suggested by the observation that interleukin-11 (IL-11), a pleotropic cytokine, favorably altered the course of chemotherapy-induced mucositis in an animal model. In the current study, we evaluated a series of biologic and morphologic outcomes to determine their roles and sequence in the development of experimental radiation-induced mucositis and to evaluate the effects of IL-11 in attenuating them. Our results suggest that IL-11 favorably modulates acute radiation-induced mucositis by attenuating pro-inflammatory cytokine expression. Data are also presented which help define the pathobiological sequence of mucositis.

Animals↗

PubMed2000

Body language--non-verbal cues.

Interviews for employment are significant events in peoples lives. Preparing for one and getting through it can be a memorable experience, good or bad. We all know that what we don't say can be as important as what we do say. In this fascinating piece of research Lesley Mason describes how she was able to relate the non-verbal communication of interview candidates to the outcome of the interview. Read on and find out what you were really saying as you sat, squirmed or twiddled your way through that last interview....

Cues↗

PubMed1999

The role of LY49 NK cell subsets in the regulation of murine cytomegalovirus infections.

The distributions and functions of NK cell subsets, as defined by the expression of Ly49 NK cell receptors, were examined in murine CMV (MCMV)-infected mice. MCMV induced a reduction in NK1.1+ cell number in the spleen and an increase in the peritoneal exudate cells. Within the splenic NK1.1+ population, proportional increases in Ly49A+ and Ly49G2+ cells but decreases in Ly49C+ and Ly49D+ cells were observed 3 days post-MCMV infection, but within the peritoneal NK1.1+ cell populations there were proportional decreases in Ly49A+ cells and increases in Ly49C+, Ly49D+, and Ly49G2+ cells. Lymphocytic choriomeningitis virus did not elicit a comparable NK cell subset distribution. Lymphokine-activated killer cells were sorted into different Ly49 NK cell subsets and adoptively transferred into C57BL/6 suckling mice. Regulation of MCMV synthesis in these suckling mice was shown to be an IFN-gamma-dependent, perforin- and Cmv-1-independent process, and each NK cell subset mediated anti-viral activity. In adult C57BL/6 mice, the control of MCMV in the spleen is mediated by a perforin-dependent mechanism, regulated in part by the Cmv-1 gene, which maps closely to the Ly49 family. In vivo depletions of either one or two of the Ly49 subsets in adult mice did not affect the ability of the residual NK cells to regulate MCMV synthesis. These data provide evidence of NK cell subset distribution and function in MCMV infection, but no individual subset was required for the Cmv-1-like regulation of MCMV synthesis.

Adoptive Transfer↗

PubMed1999

The prevalence of stress incontinence during pregnancy and following delivery.

OBJECTIVES: To examine the variation in findings from epidemiological studies which describe the prevalence of stress incontinence during and after pregnancy, and to undertake a prospective survey of the prevalence of stress incontinence during pregnancy and following childbirth in order to provide clarification of the findings presented in the literature. DESIGN: A review of the literature was undertaken using the Medline and Popline CD Rom. A postal questionnaire was sent to a sample of women when they reached 34 weeks' gestation and repeated at 8 weeks postpartum. PARTICIPANTS: 1008 women were recruited to the study when they attended the antenatal clinic at two hospitals in the north west of England. Seven hundred and seventeen (71%) women responded to the first questionnaire and 572 (57%) completed the second questionnaire. FINDINGS: The prevalence of stress incontinence during pregnancy reported in the literature ranges from 20 to 67%. Following delivery the reported prevalence is between 6 and 29%. In the present study 59% of women reported stress incontinence during pregnancy, and 31% following delivery. Ten per cent of the women had daily episodes of incontinence during their pregnancy, 2% of all women reported daily incontinence following delivery. An association was found between parity and stress incontinence, with women of higher parity being more likely to experience the condition. No difference in the prevalence of stress incontinence was found between women who had a normal delivery and those having an instrumental delivery. A caesarean section was found to be associated with a lower incidence of stress incontinence compared with a normal spontaneous delivery. KEY CONCLUSION: A high proportion of women experienced stress incontinence during pregnancy and/or following delivery. Some women reported severe symptoms, with leakage on a daily basis. Women of higher parity were more likely to suffer from the condition. Whilst women who had a normal spontaneous delivery or an instrumental delivery reported a similar level of stress incontinence, women who had a caesarean section were less likely to have the condition.

Adult↗

PubMed1999

The feasibility of using automated data to assess guideline-concordant care for schizophrenia.

This study examines the feasibility of using automated computer data versus written medical record data to identify patients receiving guideline concordant treatment for schizophrenia. Central elements of care derived from published practice guidelines for schizophrenia were examined for a convenience sample of 28 patients who received acute inpatient treatment. The results showed that automated data were superior to medical record data for identifying some elements of guideline-concordant treatment. Not only were the elements of care examined in this study clinically significant and within the current capabilities of the existing computer information system, but they are also likely related to patient outcomes. Implications for clinical care, future research, and health care quality improvement efforts are discussed.

Adult↗

PubMed1999

Organizational culture and staff outcomes in services for people with intellectual disabilities.

Organizational culture has been shown by organizational psychology to influence important aspects of staff behaviour. In particular, mismatches between staff perceptions of real and ideal organizational cultures have been shown to be associated with a range of negative outcomes for staff, such as stress, sickness and staff turnover. The present study investigates organizational culture in services for people with intellectual disabilities. The aim was to discover the prevalent organizational cultures in these services, and associations between organizational culture and staff outcomes. As part of a large-scale survey of staff in services for people with intellectual disabilities, information concerning organizational culture and staff outcomes was collected from 450 staff. A self-report measure of real and ideal organizational culture produced nine dimensions of organizational culture: (I) tolerant/staff-oriented; (2) achievement-oriented; (3) innovative; (4) analytical; (5) social relationships; (6) rewarding staff; (7) stable work environment; (8) demanding; and (9) conflict management. These nine dimensions of organizational culture showed generally adequate psychometric properties. While there was some variation in organizational culture across services, there is little variation across staff with different job titles. Overall, the staff rated real organizational cultures to be relatively high in achievement orientation and fostering social relationships, and relatively low in managing conflict and providing rewards for staff. Staff rated ideal organizational cultures to be high in rewarding staff, being tolerant/staff-oriented and fostering social relationships, and low in demands on staff. Except for the dimension of making demands on staff, where staff rated organizations as considerably higher than ideal, staff generally rated organizations as being less than ideal on all dimensions of organizational culture. Organizational psychology theory predicts that poor 'person-organization fit' (i.e. a greater mismatch between real and ideal organizational culture) will be associated with a range of negative staff outcomes. This theory was largely supported by findings of the present study. The implications for practice and for future research are discussed.

Adaptation, Psychological↗

PubMed1999

Factors associated with staff stress and work satisfaction in services for people with intellectual disability.

Staff stress and morale have been identified as major issues affecting the quality of services for people with intellectual disability. The present study investigates factors directly and indirectly associated with staff general distress, job strain and work satisfaction amongst staff in services for people with intellectual disability. As part of a large-scale survey of staff in services for people with intellectual disability, information was collected from 450 staff concerning general distress, job strain and work satisfaction, and a wide range of factors potentially associated with these outcomes. Path analyses revealed that three factors accounted for 28% of the variance in general distress scores: (I) wishful thinking, (2) stress linked to work-home conflict and (3) role ambiguity. Six factors accounted for 50% of the variance in job strain scores: (I) wishful thinking, (2) stress linked to a lack of staff support, (3) alienative commitment, (4) role ambiguity, (5) stressors linked to a low status job and (6) working longer contracted hours. Six factors accounted for 66% of the variance in work satisfaction scores: (I) stress linked to a low status job, (2) support from supervisors, (3) influence over work decisions, (4) alienative commitment, (5) support from colleagues and (6) older staff age. A range of factors indirectly associated with the three outcome measures was also identified. The models of general distress, job strain and work satisfaction empirically derived in the present study confirm and extend previous research in this area. The implications for organizations and future research are discussed.

Adult↗

PubMed1999

The experience of stress incontinence after childbirth.

BACKGROUND: Epidemiological studies have reported prevalence of stress incontinence ranging from 23 to 67 percent during pregnancy and 6 to 29 percent after childbirth, but little is known about how the condition affects women at this time. The purpose of this study was to examine the effects of stress incontinence on women in their childbearing years. METHODS: Interviews were conducted with 42 women who experienced stress incontinence at 8 weeks postpartum and 15 women who reported symptoms one year after delivery. Analysis of the qualitative data involved exploring themes and patterns, relationships and connections, contradictions and contrasts, and the language used within individual accounts and across the spectrum of narratives. RESULTS: The results are presented within a framework that the women themselves adopted: day-to-day activities, putting the condition in some form of perspective, and feelings and emotions. For some women, stress incontinence had a great impact on their lives in terms of both their daily routine and psychologically, but others described it as a minor inconvenience that rarely disturbed their routine. Major concerns comprised the restrictions placed on the women, the worry or continual awareness stemming from the condition, and feelings of embarrassment associated with it. Twelve months after childbirth the effects appeared to have lessened, but a few women were still significantly affected, both physically and psychologically. CONCLUSIONS: Although many women experience physical and psychological symptoms of stress incontinence after delivery, this study demonstrated that few sought professional care or advice for their symptoms. Health professionals should be aware of the prevalence, and women's responses to, stress incontinence so that they can initiate appropriate support and care. Further research on stress incontinence on childbearing women is necessary.

Activities of Daily Living↗

PubMed1998

Differential effects of the rejection of bone marrow allografts by the depletion of activating versus inhibiting Ly-49 natural killer cell subsets.

Natural killer cells mediate the specific rejection of bone marrow cell (BMC) allografts in lethally irradiated mice. The Ly-49 family of molecules present on subsets of murine NK cells appears capable of binding class I MHC molecules, resulting in transmission of an inhibitory signal to the NK cell. These Ly-49 family members have been shown to have an immunoreceptor tyrosine-based inhibitory motif that is responsible for the inhibitory signal. However, a new Ly-49 family member was found that lacks this motif, Ly-49D, and evidence suggests that this may be an activating receptor. We therefore compared the role of the activating Ly-49 member with NK cells bearing inhibitory Ly-49 receptors in BMC rejection. Depletion of Ly-49D+ NK cells in H-2b mice abrogated their ability to reject H-2d BMC allografts. Similarly, Ly-49C+ NK cells also were shown to mediate the specific rejection of H-2d BMC. When both subsets were depleted, an additive enhancement of BMC engraftment was observed, indicating that both subsets play a role in the rejection of allogeneic H-2-homozygous H-2d BMC. However, rejection of H-2(b x d) or D8 (H-2b, Dd transgene) BMC allografts was unaffected by Ly-49C+ NK cell depletion in H-2b mice. In marked contrast, depletion of Ly-49D+ NK cells in H-2b mice totally abrogated the rejection of H-2(b x d) heterozygous BMC in support of in vitro data suggesting that Ly-49D+ NK cells receive activating signals. Therefore, NK subsets demonstrate a differential ability to reject H-2 homozygous and heterozygous BMC.

Animals↗

PubMed1998

Work transitions.

The healthcare environment is changing rapidly. Work reorganization and redesign can lead to department and unit closures, resulting in work transitions for many staff members. The authors describe the findings of focus groups held with staff and management on units that have closed. These interviews highlight the difficulties encountered with change and provide suggestions to reduce uncertainty during department or unit closures.

Academic Medical Centers↗

PubMed1998

Social network factors associated with perceived quality of life. The San Luis Valley Health and Aging Study.

Demographic and social network factors associations with perceived quality of life (PQOL) were examined in a sample of rural Hispanic and non-Hispanic White (NHW) elderly. A 20-item PQOL scale measured participants' satisfaction with multiple facets of their lives. Age, gender, marital status, and living alone were not associated with this outcome. Hispanic persons with higher incomes had consistently higher ratings of quality of life compared to NHWs. More education was associated with a higher PQOL rating only among NHWs. More close friends and relatives, visiting in homes, and participation in outside activities were all independently related to PQOL. Interaction tests showed that the impact of social networks was stronger in NHWs. These findings suggest that network size and contact are important social factors that can improve quality of life for both ethnic groups. However, differences may need to be examined when judging the magnitude of these associations and when planning interventions.

Aged↗

PubMed1998

Day surgery: improving care through follow up contact.

In this article I will outline the method of evidence based practice we have implemented during the last three years following the introduction of day surgery as a specific speciality in our Trust. I will outline the method of accessing information on a regular basis and how this information was used to improve the service we offer. Finally I will suggest how, as a group of professionals, we may take this initiative forward towards AD 2000.

Aftercare↗

PubMed1998

Client-centered care: Texas on the front line.

Client-centered care is a popular concept, particularly for consumers and the disabled community. Disability advocacy groups are focusing on client-centered care as a new concept that home care agencies should embrace to provide clients with more control over their care. However, implementing this strategy might not be as easy as it sounds.

Attitude to Health↗