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Biomedical subjects

P Butcher

Publications and source records attributed to P Butcher.

At least 19 recordsLinked to original sources
PubMed1995

Psychological processes in psychogenic voice disorder.

Using Freud's hysterical conversion model as a basis for reviewing the psychological features in psychogenic voice disorder, this paper describes research findings which show that individuals with this condition are not usually suffering from severe psychopathology but tend to be women who are experiencing high levels of stress (commonly associated with interpersonal relationship conflicts, low self-esteem, the burden of responsibility and feelings of powerlessness), and have above-average musculoskeletal tension as well as difficulties in voicing their feelings or views. The review indicates that the psychoanalytic interpretation of psychogenic voice loss continues to have relevance. However, it is suggested that in most cases Freud's hysterical conversion model should be reformulated, reducing the core focus to unconscious conflicts, repression, denial and secondary gains, in order to emphasise the psychosocial causes and maintenance of intrapsychic conflict and physical dysfunction. It is also suggested that a reformulated psychoanalytic interpretation of psychogenic voice loss has a lot in common with a cognitive-behavioural conceptual model. A psychoanalytic approach may be valuable when focused on early trauma and repressed experiences or feelings, whereas cognitive-behavioural treatment strategies, such as stress management and assertiveness training, appear to be particularly relevant in this condition. The paper concludes by briefly considering some areas of future research.

Affect↗
PubMed1994

Association of cytomegalovirus infection with post-transplantation cardiac rejection as studied using the polymerase chain reaction.

The relationship between cytomegalovirus (CMV) infection and cardiac allograft rejection is controversial, some authors reporting a significant association, others not, on the basis of the results of conventional virological diagnosis by culture or serology. This problem was reinvestigated in 88 patients using a semi-quantitative nest polymerase chain reaction (PCR) procedure for detecting CMV DNA in endomyocardial biopsy specimens. Significantly more positive biopsies were obtained from patients with moderate (grade 2; P = 0.02) or severe (grade 3a-4; P = 0.03) rejection than with no or mild (grade 0-1b) rejection, whereas there was no significant association between rejection and CMV as diagnosed by virus isolation from urine, throat or blood, or by the detection of CMV-IgM. PCR-positive biopsies originated most frequently from CMV-antibody positive recipients (R+) of hearts from seropositive donors (D+), in association with moderate or severe rejection rather than with mild or no rejection The detection of CMV in the heart thus seemed to be related more to R+D+ serological status than to severity of rejection, that is, to circumstances that favoured co-infection with strains of CMV from both donor and recipient. Studies on sequential biopsy specimens from selected patients also provided evidence that CMV infection and rejection were not always related events. The PCR was able to differentiate latent from active CMV infection; moreover, some seronegative individuals gave repeatedly positive biopsies, thereby supporting the work of others that some patients undergo CMV infection without mounting a detectable antibody response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Speech therapy for psychogenic voice disorder: a survey of current practice and training.

A survey of speech therapists in the United Kingdom showed that they usually undertook the treatment of psychogenic voice disorders. Their pre-qualification education had provided advice that was usually reflected accurately in the experience they gained in practice, though during their education about a third had lacked any opportunity to treat or observe psychogenic voice disorders. The appropriate duration of treatment appears to be in doubt. At present, speech therapists acquire many of the psychological skills required for treatment after qualification. There is a substantial need for post-qualification courses, although more practical instruction on psychological treatment might advantageously be incorporated in initial education.

Humans↗
PubMed1988

The possible involvement of changes in phosphoinositol turnover in the responses of renal sodium transport to noradrenaline.

Noradrenaline stimulated the formation of [3H]inositol monophosphates from 3H-inositol-phospholipids in rat kidney cortex slices. This response was inhibited by the alpha 1-adrenoceptor antagonist prazosin but not by the alpha 2-adrenoceptor antagonist yohimbine, suggesting that the response was mediated via an alpha 1-adrenoceptor. This is in keeping with the ability of noradrenaline to increase sodium transport in this tissue by alpha 1-adrenoceptor stimulation.

Animals↗
PubMed1988

A personal effectiveness and stress management course for community health workers: a pilot study.

Since the role of a community health worker in an inner city area is potentially very stressful, there is a requirement to provide help, support and training to enable them to function successfully. An individual who has learned coping skills might also feel confident about teaching these skills to clients. This paper describes a short course intended to enable professionals such as health visitors, speech therapists, community nurses and physiotherapists to cope better with stress and to be more effective in their daily work with colleagues as well as in sharing skills with clients. The initial, actual knowledge of the participant and confidence in perceived knowledge and ability was assessed before and immediately after the training and at a 4-month follow-up and this was replicated in a second nurse. The preliminary results suggested that the course brought about highly significant changes which were generally maintained at follow-up.

Adaptation, Psychological↗
PubMed1988

Baroreflex control of jejunal blood flow and fluid transport in cats; effects of yohimbine, an alpha 2-adrenergic antagonist.

The aim of the study was to test the hypothesis that baroreceptor unloading increases jejunal fluid absorption rate via an alpha 2-adrenergic effect on electrogenic active transport. In 13 chloralose-anaesthetized cats, the carotid sinus baroreceptors were isolated and perfused with arterial blood, and we studied the effects of a graded decrease in carotid sinus pressure on intestinal vascular resistance, net fluid absorption rate and the potential difference between the intestinal lumen and the peritoneal cavity (PD). Experiments were performed in seven control animals and in six animals pretreated with yohimbine, an alpha 2-adrenergic antagonist, at a dose of 0.1 mg kg-1 i.v. Yohimbine per se had no significant effects on systemic arterial pressure, intestinal vascular resistance, net fluid absorption rate or PD. In the control animals, baroreceptor unloading induced an increase in systemic arterial pressure, intestinal vascular resistance and net fluid absorption rate, and a decrease in the PD. Yohimbine pretreatment did not significantly affect the systemic blood pressure response to baroreceptor unloading, but abolished the effect on intestinal vascular resistance and PD. After yohimbine treatment, decreases in carotid sinus pressure still enhanced net fluid absorption rate, but this response was observed in a higher range of carotid sinus pressures than in control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗
PubMed1988

International social security agreements: the U.S. experience.

International social security agreements are advantageous both for persons who are working now and for those whose working careers are over. For current workers, the agreements eliminate the dual contributions they might otherwise be paying to the social security systems of both the United States and another country. They also favorably affect the profitability and competitive position of American companies with foreign operations by reducing their cost of doing business. For persons who have worked both in the United States and abroad, and who are now retired, disabled, or deceased, the agreements often result in the payment of benefits to which the worker or the worker's family members would not otherwise have become entitled. Credit for social security coverage the worker earned in the United States and the other country can be combined, if necessary, to meet eligibility requirements, and partial benefits can be paid by one or both countries. Because international social security agreements benefit both workers and employers, the agreements program is supported by organized labor and the international business community. Since the first agreement was signed 15 years ago, every Presidential administration has endorsed the program. In view of this support, and the fact that the agreements enhance the image of the United States as a socially progressive member of the international community, it is expected that totalization agreements will be concluded with additional countries in the future.

Emigration and Immigration↗
PubMed1987

Neural control of electrogenic transport in the rat jejunum; interaction between intramural and adrenergic mechanisms.

The aim of the study was to test the hypothesis that extrinsic adrenergic neurons modulate electrogenic ion transport in the jejunum by inhibition of intramural secretory nerve activity. Isolated pieces of rat jejunum were mounted in the Ussing chamber. Noradrenaline (NA) was released from sympathetic nerve endings in the tissue by electrical stimulation of the mesenteric nerves or by the indirect sympathomimetic agent tyramine. Intramural neurons were activated by electrical field stimulation (EFS). Mesenteric nerve stimulation induced a frequency-related decrease in the transepithelial potential difference (PD) and short circuit current (SCC), effects which were abolished by the alpha-adrenergic antagonist phentolamine. A similar response was induced by the serosal application of tyramine and by exogenous NA. Tetrodotoxin (TTX), a nerve conduction inhibitor, had no significant effect on the response to NA, but attenuated the response to tyramine. Both NA and tyramine markedly attenuated the secretory response to EFS, but there was no significant effect of catecholamines on the secretory response to serosal theophylline. The results suggest at least two mechanisms behind the adrenergic modulation of electrogenic chloride secretion: (I) a ganglionic or presynaptic modulation of secretory nerve activity via innervated alpha-receptors, and (2) a modulation at the level of the enterocytes via non-innervated alpha-receptors. The latter effect does not seem to be mediated by the cAMP system.

Adrenergic Fibers↗
PubMed1987

Electrogenic and electroneutral components of the sympathetic effect on fluid absorption in the rat jejunum.

The aim of the study was to test the hypothesis that the sympathetic nerves to the jejunum enhance net fluid absorption rate by inhibiting an electrogenic flux of anions into the lumen. The design of the experiments was based on the observation that the effect of catecholamines on electrogenic transport is abolished by yohimbine, an alpha 2 adrenergic antagonist. Net electrogenic transport in jejunal segments of anaesthetized rats was estimated by measurement of the transepithelial potential difference (PD) and short-circuit current (SCC). Net fluid absorption rate was quantified by a gravimetric technique. The sympathetic nerves to the segment were stimulated electrically, both in vitro and in vivo. The effect of sympathetic nerve stimulation on SCC and net fluid transport was determined in the absence and presence of the alpha-adrenergic antagonists phentolamine (a non-selective alpha-adrenergic antagonist), prazosin (a selective alpha 1-antagonist) and yohimbine (a selective alpha 2-antagonist). Sympathetic nerve stimulation decreased PD and SCC and increased net fluid absorption rate. Phentolamine abolished both the electrogenic response and the effect on net fluid absorption rate, without having any significant intrinsic effects on either parameter. Prazosin per se markedly increased net fluid absorption rate, but did not significantly influence the sympathetic effect on SCC or net fluid absorption rate. Yohimbine abolished the electrogenic effect of sympathetic stimulation, and per se increased net fluid absorption rate in innervated but not in denervated segments. In innervated segments, the absorption rate during sympathetic nerve stimulation was similar in controls and yohimbine-treated animals. In denervated segments, yohimbine significantly attenuated the sympathetic response. The results suggest that the sympathetic nerves enhance fluid absorption rate via effects on both electrogenic and electroneutral epithelial transport. These two components of the sympathetic response seem to be mediated by different alpha-receptor mechanisms.

Adrenergic alpha-Agonists↗
PubMed1987

Cardiac receptor modulation of blood flow and fluid transport in feline jejunum.

The aim of the study is to determine the effects of selective cardiac receptor unloading on vascular resistance and net fluid transport in the small intestine. In anesthetized cats, cardiac receptors were unloaded by positive pressure ventilation (PPV). Arterial baroreceptor activity was artificially maintained constant. To test if the observed responses were due to a vagal reflex, experiments were performed both in animals with intact vagal nerves (n = 9) and after bilateral cervical vagotomy (n = 8). PPV-induced decreases in central blood volume (CBV) significantly increased intestinal vascular resistance (IVR) and net fluid absorption rate and decreased the transmural potential difference (PD). Cervical vagotomy per se also increased IVR and absorption rate and decreased PD. In vagotomized animals, decreases in CBV had no consistent effects on IVR, net fluid absorption rate, or PD. The results are compatible with cardiac receptor modulation of both blood flow and fluid absorption rate in the feline jejunum. Differences in the response patterns for the vascular and absorptive effects suggest that they may be mediated by separate efferent pathways.

Absorption↗
PubMed1986

Carotid sinus baroreceptor modulation of fluid transport and blood flow in the feline jejunum.

Carotid sinus baroreceptor control of jejunal fluid transport and vascular resistance was studied in chloralose-anesthetized cats. The carotid sinuses were isolated and perfused with blood from the femoral arteries. The aortic nerves were divided. In an isolated jejunal segment we measured net fluid transport rate, transmural potential difference (PD), and blood flow at a constant perfusion pressure of 75 mmHg. Carotid sinus pressure (CSP) was increased to 200-250 mmHg and was then lowered, in steps of approximately 25 mmHg, down to 50 mmHg. In the pressure interval from 90 to 200 mmHg, decreases in CSP increased jejunal vascular resistance and fluid absorption rate and decreased PD. In the interval from 50 to 90 mmHg, decreases in CSP increased vascular resistance and decreased PD but did not affect net fluid absorption rate. The results indicate that changes in baroreceptor activity may reflexly influence both vascular resistance and fluid transport rate in the feline jejunum, possibly via separate sympathetic mechanisms.

Animals↗
PubMed1986

The behavioural approach in medical practice.

This paper gives a description of the behavioural approach, behaviour therapy, and behavioural medicine in a medical and general hospital setting and describes the intimate link between behaviour and illness, showing how knowledge of the way learning takes place and influences behaviour can lead to a better understanding of the aetiology of illness and thus to appropriate treatment. A behavioural approach can be applied to the understanding and treatment of medical problems associated with sphincteric disturbances, such as childhood encopresis and urinary retention, as well as to the improvement of patient compliance and to the better management of pain. In the field of preventive medicine this approach is of importance in modifying behaviour associated with cardiovascular disorders, obesity, and smoking.

Adult↗
PubMed1985

Strategies for living: teaching psychological self-help as adult education.

This paper briefly describes some of the traditional approaches to teaching psychological skills and self-help techniques to non-psychologists. It is stressed that there have been few attempts to teach individuals a broad range of self-help strategies for dealing with psychological problems. The paper goes on to give a detailed description of a 12-week course of adult education evening classes designed for this purpose. During the course participants were taught strategies to improve self-awareness and relationships, to control anxiety, confront fears, reduce worrying thoughts, fight depression and cope with major life changes. In the main it appeared that students were able to assimilate and benefit from the techniques offered. It was concluded that adult education classes are an appropriate way of teaching psychological self-help, and provide a relevant alternative to more traditional treatment approaches.

Adult↗
PubMed1984

Existential-behaviour therapy: a possible paradigm?

A comparative discussion is presented of existential and behavioural psychotherapy, indicating where behavioural theory, empirical research and single case studies can be related to the existential emphasis on phenomenology and personal confrontation with death, freedom, isolation and meaninglessness. The conclusions are that: more recent emphasis on cognitive variables in behaviour therapy has brought the two conceptual systems closer together; and there is improvement in the understanding of aetiology and clinical effectiveness when the therapist incorporates existential-behavioural constructs and methods of working.

Attitude to Death↗
PubMed1983

Habitual rumination: a benign disorder.

Nine patients who habitually ruminated after meals underwent clinical tests and psychological questioning. Barium meal radiography showed no abnormalities. In one patient oesophageal manometry detected an abnormally large gastric pressure wave 20 minutes after food. Although four patients had family psychiatric histories and three histories of overdose, anorexia nervosa, and mild reactive depression, none had any present serious psychiatric disorder. Behavioural therapy to reduce rumination was successful in one patient. Most patients responded to reassurance that the habit was harmless. Since the condition is a distinct clinical syndrome it may be recognised early with minimal investigations if doctors are aware of its existence.

Adolescent↗