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Biomedical subjects

K Lovell

Publications and source records attributed to K Lovell.

17 recordsLinked to original sources
PubMed1998

Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: a controlled study.

BACKGROUND: Unanswered questions from controlled studies of posttraumatic stress disorder concern the value of cognitive restructuring alone without prolonged exposure therapy and whether its combination with prolonged exposure is enhancing. METHODS: In a controlled study, 87 patients with posttraumatic stress disorder of at least 6 months' duration were randomly assigned to have 10 sessions of 1 of 4 treatments: prolonged exposure (imaginal and live) alone; cognitive restructuring alone; combined prolonged exposure and cognitive restructuring; or relaxation without prolonged exposure or cognitive restructuring. RESULTS: Integrity of audiotaped treatment sessions was satisfactory when rated by an assessor unaware of the treatment assignment. Seventy-seven patients completed treatment. The pattern of results was similar regardless of rater, statistical method, measure, occasion, and therapist. Exposure and cognitive restructuring, singly or combined, improved posttraumatic stress disorder markedly on a broad front. Gains continued to 6-month follow-up and were significantly greater than the moderate improvement from relaxation. CONCLUSION: Both prolonged exposure and cognitive restructuring were each therapeutic on their own, were not mutually enhancing when combined, and were each superior to relaxation.

Adolescent↗
PubMed1995

User satisfaction with in-patient mental health services.

Although a wealth of literature regarding lay evaluation or satisfaction with health services exists, a paucity of literature is available about satisfaction with mental health services. Much of this literature is fraught with methodological problems. The study described, using both quantitative and qualitative methodology, investigated how users of in-patient mental health services evaluated these services with particular reference to the areas of the admission process, treatment, ward environment and safety. The findings confirmed the broad outcomes reported in the literature, in that they demonstrated the mismatch between quantitative and qualitative data. Global satisfaction ratings were generally positive; however, more specific questions yielded less positive outcomes. Semi-structured interviews reported some important areas of dissatisfaction, including a lack of information regarding treatment and services. Fears relating to safety were expressed equally by male and female users. Further work in this area is required with larger samples, and with specific reference to the experience of ethnic minorities and those detained under the Mental Health Act.

Female↗
PubMed1994

Post-traumatic stress disorder: evaluation of a behavioral treatment program.

The relative values of imaginal and real-life exposure exercises were tested in this study by randomizing 14 patients who met DSM-III-R criteria for PTSD at least 6 months after the initiating trauma to one of two groups. Group 1 (n = 7) had four, weekly, hour-long sessions of imaginal exposure followed by four, weekly, hour-long sessions of live exposure. Group 2 (n = 7) had the reverse order of four live exposure sessions followed by four imaginal exposure sessions. both groups improved significantly on both PTSD-specific measures and measures of general health post-treatment, and significantly further on 7 out of 12 measures at follow up 12 months post-treatment. Clinical improvement was in the older of 65-80% reduction in target symptoms. On one measure only (problem 2--phobic avoidance), live exposure yielded more improvement than imaginal exposure whether given first or second. The importance of both live and imaginal exposure to all relevant cues, behavioral and cognitive, is discussed, together with the value of self-exposure homework for patients with PTSD.

Adolescent↗
PubMed1994

Compensation equity between men and women in academic medicine: methods and implications.

BACKGROUND: Compensation inequity by gender is a problem across occupations in the United States. Most compensation-monitoring efforts in academic medicine have been informal. The authors developed an analytic method for formal, ongoing evaluation of compensation equity in academic medicine. METHOD: A historical cohort study was conducted at Michigan State University College of Medicine using data from 1990, 1991, and 1992 to (1) evaluate methods for monitoring compensation equity, (2) test the feasibility of compensation-equity monitoring as part of administrative information systems, and (3) determine whether compensation inequity existed in a case study of faculty salaries. Internal market adjustments for specialty, clinical or basic science "type," and calendar- or academic-year appointments were made before establishing a male cohort for each female faculty member. RESULTS: The method developed appears feasible for routine administrative monitoring of compensation equity. When the compensations of women of each type and rank were compared with the compensations of their male cohorts, inequities appeared to exist for basic scientists, but not clinicians, based on a criterion of the groups' compensations being 4% or more below those of their cohorts for two successive years. CONCLUSION: The authors suggest that formal monitoring of compensation equity is an important and feasible administrative undertaking to correct historical inequities. This is an area in which leadership by U.S. medical colleges is needed.

Cohort Studies↗
PubMed1994

Should treatment distinguish anxiogenic from anxiolytic obsessive-compulsive ruminations? Results of a pilot controlled study and of a clinical audit.

In a small pilot controlled study over 8 weeks, 12 obsessive-compulsive ruminators listened for 2 h daily to their own audiotaped voice either (1) describing their anxiogenic thoughts (exposure) but omitting anxiolytic thoughts (mental/cognitive rituals), or (2) reading neutral prose or poetry. Taking all patients, both groups improved similarly. However, exposure patients who became anxious early in exposure slightly more improved. Consistent with this, in a clinical audit of 57 ruminators treated by trainee clinicians over 12 years, outcome improved significantly once practice changed so that exposure only involved anxiogenic thoughts, not anxiolytic thoughts, the latter being stopped.

Adult↗
PubMed1991

Behavioural treatment of AIDS-focused illness phobia.

Seven cases are described in which the central symptoms were fear of contracting AIDS, avoidance of related cues, rituals and reassurance-seeking. Associated features include previous illness phobias and obsessive-compulsive disorder. Treatment with exposure and response prevention (plus a cognitive session in one case), led to improvement sustained up to three months after discharge, although one patient stopped treatment prematurely. Controlled trials of behavioural treatment in hypochondriasis are required.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Immunohistochemical characterization of rat central and peripheral nerve tumors induced by ethylnitrosourea.

Ethylnitrosourea-induced central and peripheral nerve tumors in Sprague-Dawley rats were tested for GFAP (Glial Fibrillary Acidic Protein), S-100 protein, NSE (Neuron Specific Enolase) and Anti-Leu 7 (HNK-1) immunoreactivity utilizing the ABC method (avidin-biotin-complex) for GFAP, S-100 protein and NSE, and the PAP method (peroxidase-antiperoxidase) for Anti-Leu 7. Peripheral nerve neurinomas were consistently positive for S-100 protein and consistently negative for GFAP and Anti-Leu 7. Neurinomas would occasionally exhibit positive staining for NSE (2 of 55 tumors). The staining intensity for S-100 protein varied from strongly positive in differentiated neurinomas to weakly positive in anaplastic tumors. Neoplastic and reactive astrocytes exhibited positive staining for both S-100 protein and GFAP. Variation in the GFAP staining intensity of glial tumors correlated with the degree of differentiation as anaplastic tumors did not stain with the same intensity as their more differentiated counterparts. Oligodendrogliomas exhibited occasional immunoreactivity to S-100 protein (3 of 36 tumors). NSE reactivity in oligodendrogliomas was rarely observed (1 tumor in 36) and immunoreactivity against GFAP or Anti-Leu 7 was consistently absent. Anti-Leu 7 and NSE proved to be of little value in the classification of ENU-induced neural tumors.

Animals↗
PubMed1981

Noninvasive evaluation of exercise training in college-age men.

The purpose of this study was to assess noninvasively the effects of intense aerobic training on cardiac structure and function in a group of healthy, college-age men (25 experimental and 11 control, mean age 22 years). Echocardiographic, electrocardiographic (ECG), and fitness measurements were obtained before and after a 3-month endurance training program and compared with similar measurements obtained in nonexercising subjects. The supervised training program consisted of 50-minute jogging sessions 5 days a week at 85% of maximal heart rate. Compared with the control group, echocardiography after training showed an increase in left ventricular (LV) end-diastolic dimension (p less than 0.05). LV posterobasal wall thickness, septal wall thickness and ejection fraction did not change significantly. ECG measurements revealed a decrease in resting heart rate (p less than 0.05) and an increase in R-wave voltage in leads V5 and V6 (p less than 0.01). The measured maximal oxygen consumption increased by 16% (p less than 0.001). These data indicate that intense aerobic training in college-age men results in a significant increase in resting LV end-diastolic dimension and volume. The increase in maximal stroke volume associated with exercise training may be partially explained by these changes in cardiac dimensions.

Adipose Tissue↗
PubMedDate not supplied

Behavioural treatments in post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) is increasingly becoming recognised as a serious mental health problem (Department of Health, 1991). Psychological treatments for PTSD remain in their infancy, though limited research has demonstrated the efficacy of behavioural and cognitive-behavioural interventions.

Adult↗
PubMedDate not supplied

The use of nurses' holding power in a large psychiatric hospital.

The use of nurses' holding power is a poorly explored aspect of psychiatric inpatient care. This study examined the use of Section 5(4) at the Maudsley Hospital, London, since the introduction of the 1983 Mental Health Act. Between 1983 and 1996 nurses' holding powers were used on 25 occasions. Seventy two per cent of patients detained under Section 5(4) of the Mental Health Act 1983 were subsequently detained under Section 5(2). Results were broadly consistent with previous studies, although some significant inconsistencies were observed which can probably be attributed to small sample sizes. Further, multicentre research is needed in order that substantive conclusions can be drawn.

Commitment of Persons with Psychiatric Disorders↗