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Biomedical subjects

Stanton Newman

Publications and source records attributed to Stanton Newman.

7 recordsLinked to original sources
PubMed2006

Relationship between white cell count, neuropsychologic outcome, and microemboli in 161 patients undergoing coronary artery bypass surgery.

OBJECTIVE: Neuropsychologic impairment remains a problem after coronary artery bypass grafting. Relatively few studies have examined the potential role of the perioperative inflammatory response. This study aimed to determine whether there was any association between perioperative white cell count, microemboli, and cognitive performance after surgical intervention. METHODS: White cell count and differential were prospectively measured perioperatively in 161 patients undergoing coronary artery bypass grafting. A neuropsychologic test battery (9 tests) was administered preoperatively and 6 to 8 weeks postoperatively in all 161 patients. Cerebral microemboli during cardiopulmonary bypass were also recorded by means of a transcranial Doppler scan of the right middle cerebral artery. RESULTS: There was no correlation between microemboli and white cell counts at any time point. There were weak but significant inverse correlations between both preoperative (r = -0.19, P = .02) and postoperative (r = -0.21, P < .01) white cell count and a measure of overall neuropsychologic test performance (total z change score). There was a weak but significant positive correlation between the neutrophil count 10 minutes after bypass and the intraoperative microemboli count (r = 0.23, P = .01). CONCLUSIONS: The correlation between white cell count and neuropsychologic outcome suggests that an inflammatory response might have a role in determining cognitive outcome after coronary artery surgery with cardiopulmonary bypass. The positive correlation between the microemboli during cardiopulmonary bypass and the neutrophil count 10 minutes after bypass is compatible with microemboli contributing to the inflammatory response. The patients' preoperative inflammatory status might also be predictive of the response to surgical intervention.

Cognition Disorders↗
PubMed2005

Evaluation of the UCL diabetes self-management programme (UCL-DSMP): a randomized controlled trial.

Self-management has been described as the cornerstone of care for diabetes. Many self-management studies are limited by poor methodology and poor descriptions of the intervention. The current study developed a theoretically based self-management programme for patients with type 2 diabetes, which was evaluated via a randomized controlled trial. At immediate post-intervention and three-month follow-up the intervention group showed significant improvement relative to controls on self-management behaviours, quality of life and illness beliefs. A trend towards improved HbA1c was also observed. Documentation in a manual and development of a training programme for facilitators ensures the programme is replicable.

Aged↗
PubMed2003

A systematic review of psychosocial outcomes following education, self-management and psychological interventions in diabetes mellitus.

Self-management and psychological interventions for diabetes have become increasingly common and have shown some positive impact on glycemic control. The association of such interventions with psychosocial outcomes is however, less clear. The current review examines the impact of these interventions on psychosocial outcomes including depression, anxiety, adjustment and quality of life. A systematic search of the literature was performed on Medline, Embase and Psychlit. Reference lists were screened for studies that met inclusion/exclusion criteria. Studies were coded on outcomes both over time and relative to control groups. In addition studies were classified as being principally educational, self-management or psychological in type, and the different components in the intervention were determined. Thirty-six studies were identified. Detrimental effects were not generally seen following any type of intervention. Depression seemed to be particularly improved following psychological interventions, whilst quality of life improved more following self-management interventions. A number of methodological issues, such as the specificity of measure used, characteristics of the population and type of intervention were however, influential in the impact of interventions on outcomes. It is recommended that future studies would benefit from being larger with controlled designs, using diabetes specific measures and providing clearer descriptions of intervention components. This will allow greater understanding of what contexts different interventions are most suited to, and which components are key to, improving psychological well-being and quality of life.

Adult↗
PubMed2003

Psychoeducational interventions in rheumatic diseases: a review of papers published from September 2001 to August 2002.

A large number of psychoeducational intervention studies have been developed for use with patients with rheumatic disease. The interventions vary considerably in the components they include and in the extent of the benefits they find. Recent meta-analyses of studies in rheumatoid arthritis (RA) report moderate short-term benefits, but it remains necessary to further examine which components are most important in bringing about change. A significant recent development in psychoeducational interventions is the move toward a generic intervention-the Chronic Disease Self-Management Program (CDSMP). A randomized controlled trial of this program has been performed, but statistical analysis for arthritis have not been reported separately.

Adaptation, Psychological↗
PubMedDate not supplied

Self-management interventions for chronic illness.

An increasing number of interventions have been developed for patients to better manage their chronic illnesses. They are characterised by substantial responsibility taken by patients, and are commonly referred to as self-management interventions. We examine the background, content, and efficacy of such interventions for type 2 diabetes, arthritis, and asthma. Although the content and intensity of the programmes were affected by the objectives of management of the illness, the interventions differed substantially even within the three illnesses. When comparing across conditions, it is important to recognise the different objectives of the interventions and the complexity of the issues that they are attempting to tackle. For both diabetes and asthma, the objectives are concerned with the underlying control of the condition with clear strategies to achieve the desired outcome. By contrast, strategies to deal with symptoms of pain and the consequences of disability in arthritis can be more complex. The interventions that were efficacious provide some guidance as to the components needed in future programmes to achieve the best results. But to ensure that these results endure over time remains an important issue for self-management interventions.

Arthritis, Rheumatoid↗