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Biomedical subjects

H Kotses

Publications and source records attributed to H Kotses.

At least 37 records · Page 2Linked to original sources
PubMed1989

Living with asthma: Part II. Beyond CARIH.

This article focuses on the evolution and assessment of additional self-management programs and strategies following the original development and evaluation of Living with Asthma. In particular, it describes the basis and philosophy underlying a self-management program for adults with asthma. In doing so, it introduces strategies that can be used by adults to process and evaluate the information they gather, and to make decisions as to what steps to take to predict and prevent asthma attacks. These strategies rely upon techniques ranging from the use of decision-making trees to the calculation of conditional probabilities to enhance the patients' knowledge that an attack is apt to occur within a prescribed period. It is hoped that further refinement of these procedures will not only provide greater control over asthma, but may help reverse the recent trend of increased mortality due to the disorder.

Adult↗
PubMed1989

A reinterpretation of psychologically induced airways changes.

Psychologically induced airways changes in asthmatic individuals may be a function of variation in general activation level, not variation in asthma severity. The evidence for this hypothesis derives from work showing that healthy individuals exhibit psychologically induced airways changes similar to those exhibited by asthmatics. Individuals from both normal and healthy populations display increases in bronchomotor tone in response to stress and decreases in bronchomotor tone in response to relaxing stimulation. Although these responses are not limited to asthmatics, they are not irrelevant to asthma. Knowledge of specific relationships between airways changes and psychological factors is helpful in the management of asthma.

Asthma↗
PubMed1988

The effects of suggestion on the total respiratory resistance of nonasthmatic female subjects.

Bronchodilation suggestion, bronchoconstriction suggestion, or neutral suggestion was given to thirty nonasthmatic female subjects; the effect of the suggestion on the total respiratory resistance (Rt) of the subjects was examined. Subjects were told either (a) that they would inhale a substance which would make their breathing better, (b) that they would inhale a substance which would make their breathing worse, or (c) that they would inhale a substance which would have no effect on their breathing. In actuality, no subject inhaled any substance. Those subjects who were told that their breathing would worsen exhibited a reliable increase in R1, whereas those subjects who were told that their breathing would become better or that their breathing would not be affected exhibited no reliable change in Rt. This study confirmed earlier work, showing that bronchoconstriction suggestion increases Rt in healthy individuals. Furthermore, this study showed that bronchodilation suggestion alone is not sufficient to produce a decrease in Rt.

Adult↗
PubMed1988

Measures of asthma severity recorded by patients.

Twenty-nine children with asthma made daily recordings of the severity of their asthma for 8 months. Each child recorded four measures of severity: a medication usage score, a morning peak expiratory flow rate (PEFR), an evening PEFR, and a subjective rating of overall severity. We determined the relationships between the four measures. Except for the morning and evening PEFRs, the relationships between the measures were weak; the PEFR measures were highly related to one another. The relationship between PEFR scores and medication usage scores increased following biofeedback relaxation training.

Adolescent↗
PubMed1987

The effect of changes in facial muscle tension on respiratory resistance.

The relationship between changes in facial electromyographic (EMG) levels and respiratory resistance was examined. Thirty adult males were assigned equally to 1 of 3 groups; a facial muscle tension increase group (EMG increase), a facial tension decrease group (EMG decrease), and a noncontingent group (EMG noncontingent). Biofeedback procedures, based on EMG recordings made form electrodes positioned over the frontalis muscles, were used to effect muscle tension changes. Individuals in the EMG increase group exhibited increases in facial tension, but individuals in the EMG decrease group failed to show muscle tension changes. Respiratory resistance increased in individuals in the EMG increase group but did not change in individuals in the EMG decrease group. Like the EMG decrease group subjects, EMG noncontingent group subjects changed neither in facial tension nor in respiratory resistance. The results provided some support for a hypothesis linking facial muscle tension and respiratory resistance.

Adolescent↗
PubMed1985

Improving the ability of peak expiratory flow rates to predict asthma.

A major problem in the behavioral management of childhood asthma concerns recognition of the early signs of impending episode. An objective measure commonly used to aid recognition of early warning signs is the peak expiratory flow rate (PEFR). This study examined the ability of PEFRs to predict asthma within a 12-hour period; the prediction method used was based on prior and conditional posterior probabilities. Twenty-five children with asthma recorded their PEFR twice daily, and also recorded the date and time of their asthma episodes. Conditional posterior probabilities and the ratio of hits to misses were computed for each subject at successively lower flow rates. The average improvement in predictability from the prior probability to the highest posterior probability was 491%. The ratio of hits to misses and the number of episodes predicted, however, decreased as the posterior probability increased. Selection of the PEFR at lower posterior probabilities resulted in fewer prediction errors and led to prediction of a higher number of episodes than selection of the PEFR at the highest posterior probability.

Adolescent↗
PubMed1985

Effects of instructions on pulmonary function values.

This study examined the influence of specific components of standard forced expiratory maneuver instructions on spirometric values. Thirty-six subjects received instructions and practice in performing the forced expiratory maneuver prior to experimental manipulation of instructions. Instructions to begin with a maximal inhalation and then to blow into the spirometer as hard, fast, and long as possible were reiterated prior to every maneuver. During the instruction manipulation period, subjects were additionally instructed to blow either harder, faster, or longer. Overall, instructions to blow harder resulted in the most stable pattern of increase in all measures (IC, FVC, FEV1, FEF25-75%, and FEV1/FVC); instructions to blow longer consistently led to decreases in some values.

Adolescent↗
PubMed1984

Effects of noncontingent feedback on EMG training, EMG responses, and subjective experience.

Various types of noncontingent feedback have been used as control procedures in EMG training; however, their effects on such training have received little attention. Experiment 1 in the present study examined the effects of noncontingent feedback on EMG training, and Experiment 2 assessed the effects of feedback characteristics on EMG responses. In Experiment 1, three noncontingent feedback groups (yoked control, randomly fluctuating tones, and decreasing tones) and one contingent group underwent 20 minutes of training for frontal EMG decreases. Procedures in Experiment 2 were identical to those in Experiment 1 except that subjects were instructed merely to listen to the feedback tones. Results of Experiment 1 indicated that contingent and noncontingent fluctuating feedback groups achieved significantly lower EMG levels than noncontingent decreasing and yoked control groups. In Experiment 2, however, no differences in EMG activity were found among groups. In both experiments, groups did not differ in terms of subjective variables such as frustration, suspiciousness about the tone, or length of time attending to the tone. Results of these two experiments suggest that differences in EMG responses to various types of noncontingent feedback result from interactions between characteristics of the feedback stimulus and instructions to decrease the stimulus.

Adolescent↗
PubMed1984

Pulmonary changes induced by frontal EMG training.

Earlier research suggested that the effects of facial muscle tension changes on other responses are not widespread but limited to a rather narrow set of pulmonary events. Further evidence in support of the specificity of the facial muscle-pulmonary relationship was provided in the present study by monitoring changes in several responses as a function of muscle tension training. Feedback training for increases and decreases in muscle tension at both facial and limb muscle sites was given to adult males. The effects of these manipulations on PEFR, RR, and HR were examined. Increases in facial muscle tension resulted in PEFR decreases whereas increases in limb muscle tension did not. Decreases in facial muscle tension were not observed as a function of training and no PEFR changes resulted from these conditions. Neither RR nor HR were related to the facial EMG changes observed during feedback training. These observations demonstrated the specificity inherent in the relationship between facial muscle tension and PEFR, and lent support to the hypothesis that these two responses are linked reflexively.

Adolescent↗