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Biomedical subjects

Mary Walsh

Publications and source records attributed to Mary Walsh.

9 recordsLinked to original sources
PubMed2006

Comparison of nurse, system and quality patient care outcomes in 8-hour and 12-hour shifts.

BACKGROUND: Many nurses desire 12-hour shifts. However, there are concerns about implementation. OBJECTIVE: We sought to compare the effects of 8- and 12-hour shifts on nurse, system, and quality patient care outcomes. METHODS: We used a cross-sectional design with data collected from multiple sources in 2003-2004, including a nurse survey and administrative and patient records. We studied hospital nurses and patients in general adult wards, with outcomes including burnout, job satisfaction, scheduling satisfaction, preferences, intention to stay, and employee safety. System outcomes included recruitment and turnover, staffing, absenteeism, and related costs. A variety of quality patient care outcomes were measured from the 3 different types of data. RESULTS: Thirteen New York City hospitals participated; 805 surveys were examined from 99 nursing units (response rate 42%). Compared with nurses working 8-hour shifts, those working 12-hour shifts were on average more satisfied with their jobs, experienced less emotional exhaustion, 10 times more likely to be satisfied with schedules, 2 times as likely to perceive 12-hour schedules as important, and 58% less likely to report missing shifts; units with 12-hour shifts had lower vacancy rates and weeks to fill the position (all P values < or =0.05). There were no differences in patient outcomes. CONCLUSIONS: Nurses working 12-hour shifts were more satisfied. There were no differences in quality outcomes. Flexibility and choice in shift length are important elements in a positive nurse work environment. This study represents an innovative attempt by a labor-management bargaining group to make an evidence-based decision. We encourage others to conduct similar studies.

Adult↗
PubMed2005

In with the new, out with the old? Comparison of two approaches for psoas compartment block.

We compared the approaches of Winnie and Capdevila for psoas compartment block (PCB) performed by a single operator in terms of contralateral spread, lumbar plexus blockade, and postoperative analgesic efficacy. Sixty patients underwent PCB (0.4 mL/kg levobupivacaine 0.5%) and subsequent spinal anesthesia for primary joint arthroplasty (hip or knee) in a prospective, double-blind study. Patients were randomly allocated to undergo PCB by using the Capdevila (group C; n = 30) or a modified Winnie (group W; n = 30) approach. Contralateral spread and lumbar plexus blockade were assessed 15, 30, and 45 min after PCB. Contralateral spread (bilateral from T4 to S5) and femoral and lateral cutaneous nerve block were evaluated by sensory testing, and obturator motor block was assessed. Bilateral anesthesia occurred in 10 patients in group C and 12 patients in group W (P = 0.8). Blockade of the femoral, lateral cutaneous, and obturator nerves was 90%, 93%, and 80%, respectively, for group C and 93%, 97%, and 90%, respectively, for group W (P > 0.05). No differences were found in PCB procedure time, pain scores, 24-h morphine consumption, or time to first morphine analgesia.

Aged↗
PubMed2004

Extracellular pressure stimulates colon cancer cell adhesion in vitro and to surgical wounds by Src (sarcoma protein) activation.

BACKGROUND: We hypothesized that pressure stimulates colon cancer cell adhesion to surgical wounds. METHODS: We quantitated adhesion of murine 26/51 transplantable colon cancer cells by cell counting or chromium 51-labeling. Tumor cells were added to murine surgical wounds after 30 minutes preincubation under ambient or 15 mm Hg increased pressure. Src activation was assayed by immunoblotting for phosphorylated Src and inhibited by 4-amino-5-(4chlorophenyl)-7-(t-butyl)pyrazolo-[3-4-d]pyrimidine (PP2). RESULTS: Pressure stimulated colon 26/51 cell adhesion to murine wounds by 43% to 52% (n = 9, P <0.05 each). Pressure stimulated Src phosphorylation by 39% +/- 4% (n = 5, P = 0.004) in colon 26 cells. The Src inhibitor PP2 (20 mumol/L) did not inhibit Src phosphorylation at ambient pressure but prevented pressure stimulation of Src phosphorylation. Src blockade by PP2 did not affect basal adhesion of either tumor to murine wounds but completely blocked pressure stimulation of adhesion (n = 4, P <0.001 each). CONCLUSIONS: Increased pressure may activate cancer adhesion to surgical wounds via Src. Src antagonists might inhibit this process.

Animals↗
PubMed2004

Twenty propositions.

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Advance Directive Adherence↗
PubMed2003

Divalent cations modulate human colon cancer cell adhesion.

BACKGROUND: Iatrogenic tumor implantation within surgical sites can compromise curative cancer surgery. Cancer cell adhesion to extracellular matrix proteins is mediated by diverse matrix receptors, most notably integrins. Divalent cations may modulate integrin-ligand interactions in some cells. MATERIALS AND METHODS: We studied adhesion of SW620 and Caco-2 human colon cancer cells to collagen I, the dominant collagen of the interstitial matrix, and confirmed our results in primary human colon cancer cells from surgical specimens. Single cell suspensions in either HEPES/NaCl buffer or media supplemented with 0-1 mM Mn2+ or Mg2+, and 0-10 mM Zn2+ or Ca2+ were plated onto collagen-I-precoated dishes for 30 min. RESULTS: Supplementation of the HEPES/NaCl/BSA buffer with 1 mM Mn2+, Mg2+, Zn2+, or Ca2+ affected adhesion differently. Mn2+ (1 mM) markedly promoted SW620 adhesion vs control (21.17 +/- 0.08-fold). Mg2+ (1 mM) had a similar but lesser effect (14.71 +/- 0.02-fold). However, 1-10 mM Ca2+ inhibited basal cell adhesion by 22.0 +/- 3.1 to 88.0 +/- 7.3 % inhibition. Ca2+ (2.5-10 mM) also inhibited Mn2+-induced adhesion. Zn2+ stimulated basal adhesion slightly at lower concentrations but inhibited Mn2+-stimulated adhesion similarly to Ca2+ at higher concentrations. Results were duplicated in conventional serum containing culture medium supplemented with these cations. Caco-2 cells and primary cancer cells yielded similar results. All results are significant to P < 0.01. DISCUSSION: Integrin-mediated colon cancer cell adhesion is affected by extracellular divalent cation concentrations. Washing the surgical site with dilute calcium or zinc solutions might diminish perioperative tumor implantation.

Adenocarcinoma↗
PubMed2000

Tobacco Use by Chinese American Men: An Exploratory Study of the Factors Associated with Cigarette Use and Smoking Cessation.

PURPOSE: There is little information on cigarette use and smoking cessation in Asian Pacific Islanders. This study explored factors associated with tobacco use in the largest Asian American ethnic group - Chinese American men. METHODS: Chinese American men age 17 or older, recruited by convenience sampling, were interviewed by a male trilingual and bicultural interviewer. Open&shy;ended, semi&shy;structured interviews were coded using PRECEDE framework under two categories&colon; cigarette use and smoking cessation. FINDINGS: Smoking, favorably perceived and valued, plays an important role in Chinese society. Lack of appropriate information and some beliefs pose challenges to effective tobacco control. Participants expressed willingness to adhere to no smoking rules and regulation. Attitudes and perceptions in the U.S. towards cigarette smoking, which differ from those in China, reinforce attitudes more favorable to smoking cessation. CONCLUSIONS: Themes elicited challenge mainstream smoking cessation approaches for Chinese American men. Further exploration of these results are needed to develop effective tobacco control in this and possibly other Asian American populations.

Journal Article↗
PubMedDate not supplied

Presidential address.

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Fluid Therapy↗