Kathy Armour - Academia.edu (original) (raw)

Papers by Kathy Armour

Research paper thumbnail of Evidence for a Pathogenic Role of Nitric Oxide in Inflammation-Induced Osteoporosis

Journal of Bone and Mineral Research, 1999

Inflammatory disease is associated with increased production of nitric oxide (NO) and activation ... more Inflammatory disease is associated with increased production of nitric oxide (NO) and activation of the inducible nitric oxide synthase (iNOS) pathway. Several studies have addressed the role of NO as a mediator of cytokine effects on bone cell activity in vitro. Stimulatory and inhibitory actions have been found, however, depending on the concentrations produced and model system used. In view of this, it has been difficult to predict whether increased production of NO during inflammation is likely to increase bone loss or prevent it. We have investigated the pathogenic role of NO in an animal model of inflammation-induced osteoporosis (IMO). NO production was increased in IMO when compared with controls (+344%; p < 0.01), and this was accompanied by activation of inducible NOS (iNOS) in the bone marrow space. Bone mineral density (BMD) was reduced in IMO when compared with controls (-64%; p < 0.01), and this was found to be associated with reduced osteoblast numbers (-44%; p < 0.05) and increased osteoclast numbers (+38%; p < 0.01). The NOS inhibitor L-NMMA reversed the deleterious effects of IMO on bone mass and bone turnover, but L-NMMA had no effect on bone mass in control animals. This study has important implications for many inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, and inflammatory bowel disease which are associated with increased NO production and osteoporosis. Our data not only suggest that iNOS activation and increased NO production contribute to the pathogenesis of osteoporosis in these situations, but also suggest that NOS inhibitors could be of therapeutic value in the prevention and treatment of such bone loss. (J Bone Miner Res 1999;14:2137-2142)

Research paper thumbnail of Estrogen Upregulates Endothelial Constitutive Nitric Oxide Synthase Expression in Human Osteoblast-Like Cells

Research paper thumbnail of Inhibition of bone resorption in vitro and prevention of ovariectomy-induced bone loss in vivo by flurbiprofen nitroxybutylester (HCT1026)

Arthritis & Rheumatism, 2001

Objective. Inhibitors of prostaglandin production, such as nonsteroidal antiinflammatory drugs (N... more Objective. Inhibitors of prostaglandin production, such as nonsteroidal antiinflammatory drugs (NSAIDs), and pharmacologic nitric oxide (NO) donors, such as organic nitrates, have been suggested to protect against bone loss in both humans and experimental animals. Recently, a new class of nitrosylated NSAID (known as NO-NSAIDs) has been developed, which combines the properties of a NO donor with those of a cyclooxygenase (COX) inhibitor. This study investigated the effects of one of these compounds, flurbiprofen nitroxybutylester (HCT1026), on bone metabolism in vitro and in vivo.

Research paper thumbnail of PA14 The legacy of cancer: why a health promoting approach is so important in palliative care

BMJ supportive & palliative care, 2015

A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole ... more A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole family. Research has mainly focused on carers, with little emphasis on the wider, long-term implications. To explore the cancer beliefs of patients with advanced cancer and their relatives. The focus was on their lived experiences and how these affected their beliefs, attitudes and constructions of cancer risk. 27 in-depth, semi-structured interviews were conducted with advanced breast, colorectal or lung cancer patients and their close relatives. Interviews were recorded and transcribed verbatim. Data was analysed using the constant comparison method. A core category of fear, helplessness and fatalism emerged from the data. Family history was the most salient cancer risk factor and a diagnosis of advanced cancer increased perceptions of vulnerability for first-degree relatives. For relatives, the uncertainty and chaotic loss of control that accompanied an advanced cancer diagnosis resul...

Research paper thumbnail of Hypovitaminosis D in Hospice patients in a Caucasian West Midlands Population

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of THE EMOTIONAL RESPONSES OF STAFF TO MOVING TO A NEW HOSPICE BUILDING

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of PA2 Satisfaction with information received: perceptions of the patient and the informal caregiver

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of P73 Does the attachment style of hospice workers predict their emotional response to a move into a bespoke new build unit?

Supportive and Palliative Care

Research paper thumbnail of I worry about my family getting it': are we ignoring patient's agenda at the end of life?

Supportive and Palliative Care

Research paper thumbnail of LIVING IN THE SHADOW OF CANCER: THE EXPERIENCE OF FIRST DEGREE RELATIVES OF PATIENTS WITH ADVANCED COLORECTAL CANCER

Supportive and Palliative Care

It is widely accepted that a diagnosis of cancer affects the entire family. However, research has... more It is widely accepted that a diagnosis of cancer affects the entire family. However, research has centred on primary caregivers, and little is known about the impact on the wider family. The literature has concentrated on female relatives of breast cancer patients. Studies involving relatives of colorectal cancer patients have focused on their attitudes to screening, or behavioural interventions, and have not attempted to identify their experiences, beliefs or needs. To gain an in depth understanding of the experiences, beliefs and needs of first-degree relatives of patients diagnosed with advanced colorectal cancer. Semi-structured interviews were conducted with adult children or siblings of patients with advanced colorectal cancer, referred to a palliative care service. Interviews explored their experience of a cancer diagnosis in the family and their beliefs about cancer. Data was transcribed verbatim and analysed qualitatively using a constant comparison method. 5 categories eme...

Research paper thumbnail of PA22 The arts of connexion

BMJ Supportive & Palliative Care, 2015

There is growing evidence that creative arts interventions improve perceived physical and mental.... more There is growing evidence that creative arts interventions improve perceived physical and mental. However, there is little research into arts interventions in relation to palliative care and the published studies in arts and health have focussed on visual arts with little attention to dance. A one year clinical audit was followed by a ten week pilot research study explored whether creative movement enabled people to feel more connected to themselves and each other, whether it supported the development of their collective voice and their ability to advocate for themselves and their peers. The service was offered on a group basis in Day Therapy and on a one-to-one basis for patients in the in patient unit. Dance sessions were run weekly and evaluated at each session on a simple scale measuring connectedness to oneself and each other in the group, and the joy derived from attendance. Healthcare professionals reported that the sessions offered patients a chance to reconnect with the memories of their physicality, whilst also offering an experience that proferred joy, the opportunity to participate in a social group and focussed on sharing support. A patient&#39;s daughter who co-participated in a session reported &quot;Two days before {my mother} died we had a movement session together; we have never felt so together as we did after that session&quot;. Whilst palliative care has long recognised the arts, there are benefits to be gained from collaborating and further research is needed to understand the nature and impact of creative interventions.

Research paper thumbnail of Health promoting approaches to palliative care: reducing the longer term impact of advanced cancer

BMJ supportive & palliative care, 2015

A diagnosis of advanced cancer has a profound impact on the whole family. However, research has m... more A diagnosis of advanced cancer has a profound impact on the whole family. However, research has mainly focused on patient and carers needs or short-term interventions; with little emphasis on their own coping strategies or the wider impact on health. 27 semi-structured interviews were conducted with patients with advanced breast, colorectal or lung cancer and their close relatives. Questions focused on their experiences, coping strategies and the impact of these on cancer beliefs and attitudes. Interviews were transcribed verbatim and data analysed using the constant comparison method. Patients had more positive attitudes to cancer than relatives, whilst adapting to and accepting dying. They described multiple approaches to coping which centred on regaining control. These included seeking and accessing information, adopting positive attitudes to living with progressive disease, increasing connectedness to their loved ones and leaving a legacy. A legacy was often a hope that their si...

Research paper thumbnail of Requirement of the inducible nitric oxide synthase pathway for IL-1-induced osteoclastic bone resorption

Proceedings of the National Academy of Sciences, 2000

Nitric oxide has been suggested to be involved in the regulation of bone turnover, especially in ... more Nitric oxide has been suggested to be involved in the regulation of bone turnover, especially in pathological conditions characterized by release of bone-resorbing cytokines. The cytokine IL-1 is thought to act as a mediator of periarticular bone loss and tissue damage in inflammatory diseases such as rheumatoid arthritis. IL-1 is a potent stimulator of both osteoclastic bone resorption and expression of inducible nitric oxide synthase (iNOS) in bone cells and other cell types. In this study, we investigated the role that the iNOS pathway plays in mediating the bone-resorbing effects of IL-1 by studying mice with targeted disruption of the iNOS gene. Studies in vitro and in vivo showed that iNOS-deficient mice exhibited profound defects of IL-1-induced osteoclastic bone resorption but responded normally to calciotropic hormones such as 1,25 dihydroxyvitamin D3 and parathyroid hormone.

Research paper thumbnail of Activation of the inducible nitric oxide synthase pathway contributes to inflammation-induced osteoporosis by suppressing bone formation and causing osteoblast apoptosis

Arthritis & Rheumatism, 2001

Objective Osteoporosis is a major clinical problem in chronic inflammatory diseases such as rheum... more Objective Osteoporosis is a major clinical problem in chronic inflammatory diseases such as rheumatoid arthritis. The mechanism of bone loss in this condition remains unclear, but previous studies have indicated that depressed bone formation plays a causal role. Since ...

Research paper thumbnail of The icecap-scm tells you more about what i'm going through"-measuring the quality of life amongst patients receiving supportive and palliative care

BMJ supportive & palliative care, 2015

The ICECAP Supportive Care Measure (ICECAP-SCM) is a self-complete questionnaire developed to rat... more The ICECAP Supportive Care Measure (ICECAP-SCM) is a self-complete questionnaire developed to rate quality towards the end of life, particularly for economic evaluation. It measures a person's capability to experience a good life and death. The study aimed to determine the feasibility of completing ICECAP-SCM alongside EQ-5D-5L and ICECAP-A (measures commonly used for economic evaluation). Each measure was completed by hospice patients (n=33), close persons (n=22) and healthcare professionals (HCPs n=17) in a 'think aloud' semi-qualitative interview. Five raters identified the frequency of error (e.g. misunderstanding, poor memory) from interview transcripts. Qualitative data were analysed using constant comparison, focusing on issues affecting response. Amongst patients, fewest errors were identified for ICECAP-SCM (3.9%) and the most for EQ5D-5L (9.7%). Amongst close persons there were also fewest errors in the ICECAP-SCM (4.5%) compared to ICECAP-A (5.5%) and EQ-5D-5L...

Research paper thumbnail of Evidence for a Pathogenic Role of Nitric Oxide in Inflammation-Induced Osteoporosis

Journal of Bone and Mineral Research, 1999

Inflammatory disease is associated with increased production of nitric oxide (NO) and activation ... more Inflammatory disease is associated with increased production of nitric oxide (NO) and activation of the inducible nitric oxide synthase (iNOS) pathway. Several studies have addressed the role of NO as a mediator of cytokine effects on bone cell activity in vitro. Stimulatory and inhibitory actions have been found, however, depending on the concentrations produced and model system used. In view of this, it has been difficult to predict whether increased production of NO during inflammation is likely to increase bone loss or prevent it. We have investigated the pathogenic role of NO in an animal model of inflammation-induced osteoporosis (IMO). NO production was increased in IMO when compared with controls (+344%; p < 0.01), and this was accompanied by activation of inducible NOS (iNOS) in the bone marrow space. Bone mineral density (BMD) was reduced in IMO when compared with controls (-64%; p < 0.01), and this was found to be associated with reduced osteoblast numbers (-44%; p < 0.05) and increased osteoclast numbers (+38%; p < 0.01). The NOS inhibitor L-NMMA reversed the deleterious effects of IMO on bone mass and bone turnover, but L-NMMA had no effect on bone mass in control animals. This study has important implications for many inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, and inflammatory bowel disease which are associated with increased NO production and osteoporosis. Our data not only suggest that iNOS activation and increased NO production contribute to the pathogenesis of osteoporosis in these situations, but also suggest that NOS inhibitors could be of therapeutic value in the prevention and treatment of such bone loss. (J Bone Miner Res 1999;14:2137-2142)

Research paper thumbnail of Estrogen Upregulates Endothelial Constitutive Nitric Oxide Synthase Expression in Human Osteoblast-Like Cells

Research paper thumbnail of Inhibition of bone resorption in vitro and prevention of ovariectomy-induced bone loss in vivo by flurbiprofen nitroxybutylester (HCT1026)

Arthritis & Rheumatism, 2001

Objective. Inhibitors of prostaglandin production, such as nonsteroidal antiinflammatory drugs (N... more Objective. Inhibitors of prostaglandin production, such as nonsteroidal antiinflammatory drugs (NSAIDs), and pharmacologic nitric oxide (NO) donors, such as organic nitrates, have been suggested to protect against bone loss in both humans and experimental animals. Recently, a new class of nitrosylated NSAID (known as NO-NSAIDs) has been developed, which combines the properties of a NO donor with those of a cyclooxygenase (COX) inhibitor. This study investigated the effects of one of these compounds, flurbiprofen nitroxybutylester (HCT1026), on bone metabolism in vitro and in vivo.

Research paper thumbnail of PA14 The legacy of cancer: why a health promoting approach is so important in palliative care

BMJ supportive & palliative care, 2015

A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole ... more A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole family. Research has mainly focused on carers, with little emphasis on the wider, long-term implications. To explore the cancer beliefs of patients with advanced cancer and their relatives. The focus was on their lived experiences and how these affected their beliefs, attitudes and constructions of cancer risk. 27 in-depth, semi-structured interviews were conducted with advanced breast, colorectal or lung cancer patients and their close relatives. Interviews were recorded and transcribed verbatim. Data was analysed using the constant comparison method. A core category of fear, helplessness and fatalism emerged from the data. Family history was the most salient cancer risk factor and a diagnosis of advanced cancer increased perceptions of vulnerability for first-degree relatives. For relatives, the uncertainty and chaotic loss of control that accompanied an advanced cancer diagnosis resul...

Research paper thumbnail of Hypovitaminosis D in Hospice patients in a Caucasian West Midlands Population

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of THE EMOTIONAL RESPONSES OF STAFF TO MOVING TO A NEW HOSPICE BUILDING

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of PA2 Satisfaction with information received: perceptions of the patient and the informal caregiver

Supportive and Palliative Care

ABSTRACT

Research paper thumbnail of P73 Does the attachment style of hospice workers predict their emotional response to a move into a bespoke new build unit?

Supportive and Palliative Care

Research paper thumbnail of I worry about my family getting it': are we ignoring patient's agenda at the end of life?

Supportive and Palliative Care

Research paper thumbnail of LIVING IN THE SHADOW OF CANCER: THE EXPERIENCE OF FIRST DEGREE RELATIVES OF PATIENTS WITH ADVANCED COLORECTAL CANCER

Supportive and Palliative Care

It is widely accepted that a diagnosis of cancer affects the entire family. However, research has... more It is widely accepted that a diagnosis of cancer affects the entire family. However, research has centred on primary caregivers, and little is known about the impact on the wider family. The literature has concentrated on female relatives of breast cancer patients. Studies involving relatives of colorectal cancer patients have focused on their attitudes to screening, or behavioural interventions, and have not attempted to identify their experiences, beliefs or needs. To gain an in depth understanding of the experiences, beliefs and needs of first-degree relatives of patients diagnosed with advanced colorectal cancer. Semi-structured interviews were conducted with adult children or siblings of patients with advanced colorectal cancer, referred to a palliative care service. Interviews explored their experience of a cancer diagnosis in the family and their beliefs about cancer. Data was transcribed verbatim and analysed qualitatively using a constant comparison method. 5 categories eme...

Research paper thumbnail of PA22 The arts of connexion

BMJ Supportive & Palliative Care, 2015

There is growing evidence that creative arts interventions improve perceived physical and mental.... more There is growing evidence that creative arts interventions improve perceived physical and mental. However, there is little research into arts interventions in relation to palliative care and the published studies in arts and health have focussed on visual arts with little attention to dance. A one year clinical audit was followed by a ten week pilot research study explored whether creative movement enabled people to feel more connected to themselves and each other, whether it supported the development of their collective voice and their ability to advocate for themselves and their peers. The service was offered on a group basis in Day Therapy and on a one-to-one basis for patients in the in patient unit. Dance sessions were run weekly and evaluated at each session on a simple scale measuring connectedness to oneself and each other in the group, and the joy derived from attendance. Healthcare professionals reported that the sessions offered patients a chance to reconnect with the memories of their physicality, whilst also offering an experience that proferred joy, the opportunity to participate in a social group and focussed on sharing support. A patient&#39;s daughter who co-participated in a session reported &quot;Two days before {my mother} died we had a movement session together; we have never felt so together as we did after that session&quot;. Whilst palliative care has long recognised the arts, there are benefits to be gained from collaborating and further research is needed to understand the nature and impact of creative interventions.

Research paper thumbnail of Health promoting approaches to palliative care: reducing the longer term impact of advanced cancer

BMJ supportive & palliative care, 2015

A diagnosis of advanced cancer has a profound impact on the whole family. However, research has m... more A diagnosis of advanced cancer has a profound impact on the whole family. However, research has mainly focused on patient and carers needs or short-term interventions; with little emphasis on their own coping strategies or the wider impact on health. 27 semi-structured interviews were conducted with patients with advanced breast, colorectal or lung cancer and their close relatives. Questions focused on their experiences, coping strategies and the impact of these on cancer beliefs and attitudes. Interviews were transcribed verbatim and data analysed using the constant comparison method. Patients had more positive attitudes to cancer than relatives, whilst adapting to and accepting dying. They described multiple approaches to coping which centred on regaining control. These included seeking and accessing information, adopting positive attitudes to living with progressive disease, increasing connectedness to their loved ones and leaving a legacy. A legacy was often a hope that their si...

Research paper thumbnail of Requirement of the inducible nitric oxide synthase pathway for IL-1-induced osteoclastic bone resorption

Proceedings of the National Academy of Sciences, 2000

Nitric oxide has been suggested to be involved in the regulation of bone turnover, especially in ... more Nitric oxide has been suggested to be involved in the regulation of bone turnover, especially in pathological conditions characterized by release of bone-resorbing cytokines. The cytokine IL-1 is thought to act as a mediator of periarticular bone loss and tissue damage in inflammatory diseases such as rheumatoid arthritis. IL-1 is a potent stimulator of both osteoclastic bone resorption and expression of inducible nitric oxide synthase (iNOS) in bone cells and other cell types. In this study, we investigated the role that the iNOS pathway plays in mediating the bone-resorbing effects of IL-1 by studying mice with targeted disruption of the iNOS gene. Studies in vitro and in vivo showed that iNOS-deficient mice exhibited profound defects of IL-1-induced osteoclastic bone resorption but responded normally to calciotropic hormones such as 1,25 dihydroxyvitamin D3 and parathyroid hormone.

Research paper thumbnail of Activation of the inducible nitric oxide synthase pathway contributes to inflammation-induced osteoporosis by suppressing bone formation and causing osteoblast apoptosis

Arthritis & Rheumatism, 2001

Objective Osteoporosis is a major clinical problem in chronic inflammatory diseases such as rheum... more Objective Osteoporosis is a major clinical problem in chronic inflammatory diseases such as rheumatoid arthritis. The mechanism of bone loss in this condition remains unclear, but previous studies have indicated that depressed bone formation plays a causal role. Since ...

Research paper thumbnail of The icecap-scm tells you more about what i'm going through"-measuring the quality of life amongst patients receiving supportive and palliative care

BMJ supportive & palliative care, 2015

The ICECAP Supportive Care Measure (ICECAP-SCM) is a self-complete questionnaire developed to rat... more The ICECAP Supportive Care Measure (ICECAP-SCM) is a self-complete questionnaire developed to rate quality towards the end of life, particularly for economic evaluation. It measures a person's capability to experience a good life and death. The study aimed to determine the feasibility of completing ICECAP-SCM alongside EQ-5D-5L and ICECAP-A (measures commonly used for economic evaluation). Each measure was completed by hospice patients (n=33), close persons (n=22) and healthcare professionals (HCPs n=17) in a 'think aloud' semi-qualitative interview. Five raters identified the frequency of error (e.g. misunderstanding, poor memory) from interview transcripts. Qualitative data were analysed using constant comparison, focusing on issues affecting response. Amongst patients, fewest errors were identified for ICECAP-SCM (3.9%) and the most for EQ5D-5L (9.7%). Amongst close persons there were also fewest errors in the ICECAP-SCM (4.5%) compared to ICECAP-A (5.5%) and EQ-5D-5L...