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Biomedical subjects

P M Miller

Publications and source records attributed to P M Miller.

At least 37 records · Page 2Linked to original sources
PubMed1994

Partners in adversity. IV. Coping and mood.

This paper presents details of an interviewer-based measure of coping, completed in the context of a study examining the mental health of three groups of married women following their exposure to recent severe adversity. For one group a marital partner had recently died and for another group a marital partner had recently experienced a myocardial infarction. The third group consisted of those women recently entering a Women's Aid refuge. Initial interviews were completed about 6 weeks following event experience. Coping and mood state were re-assessed about 4 months after the events that had recruited the samples to the study. The measures of coping response were adapted from the coping domains of 'fighting spirit', 'helplessness', 'fatalism', 'avoidance' and 'anger/frustration' assessed in the Mental Adjustment to Cancer Scale. Details are provided of the construction of a summary measure of coping response based upon the above domains and of its relationship with follow-up mood state after allowance for mood levels at initial interview.

Adaptation, Psychological↗
PubMed1994

The first year at medical school: some findings and student perceptions.

This paper will first summarize briefly some results from parallel studies of first-year medical students at the University of Edinburgh, Scotland and University of Houston, Texas, USA. These findings have been presented more fully elsewhere (Surtees & Miller 1990; Miller & Surtees 1991; Miller & Lloyd 1991; Miller 1994) and here the emphasis will be on the Edinburgh results. Following this, some new material will be set down, reflecting the Edinburgh students' comments to the interviewers about their courses.

Adaptation, Psychological↗
PubMed1993

Partners in adversity: I. Study design and context.

This paper presents results from a longitudinal study of three groups of married women undertaken in Edinburgh. Each study group was identified through their common experience of a particular stressful situation. Recruitment to the two principal study groups required that a marital partner had either recently died or had recently experienced a myocardial infarction (MI). The third group consisted of those women recently entering a Women's Aid refuge. Interviews were completed with 64 bereaved women, 143 women shortly following their partner's MI and 32 women entering a refuge. Where possible, follow-up interviews were undertaken about three months following the first interview. Detailed assessments were made of the 'target' stressful experiences, of any others that had occurred, and of the course and nature of the respondent's mental health during the study period. Additional assessments included measures of style of coping and of the support resources available and utilized. This report presents details of the design and methodology of the study and of the respondents' experiences of the specific stressors that recruited them to the study. It also provides the background to an examination and analysis of the sequencing of adverse experiences reported in the companion paper.

Adaptation, Psychological↗
PubMed1993

Partners in adversity: II. Measurement and description of stressful event sequences ('complexes').

Three groups of married women were studied with each defined by their experience of a different stressful incident (the target event). In the first (the Coronary Group), the husband had suffered a non-fatal myocardial infarction whilst in the second (the Bereaved Group), he had recently died. In the third (the Refuge Group) the subject had just entered a refuge run by Women's Aid in order to flee from her husband. This paper concentrates on the description and measurement of the sequence of these experiences and of others occurring within the same study time. The Bedford College core rating scheme together with other ratings were applied. In the Coronary group, the target event was rated as a severe threat in 46.9% of cases, and also rated as being of uncertain outcome and hopeless. Over one quarter of the sample received other ratings such as subject-focused and choice of action. Virtually all the bereavements were rated severe threat, loss, hopeless and subject-focused. The refuge target events were mostly rated of only moderate threat but differed widely on other characteristics. In the 6 months prior to the target event, other severe events tended to occur most frequently to the Refuge group and least frequently to the Coronary group. However, these other severe events were mostly connected with the target event and what had lead up to it. Issues concerning the measurement of the principal study events and the other stressors experienced are discussed.

Adaptation, Psychological↗
PubMed1993

Effect of parity on periparturient neutrophil function in dairy cows.

Impairment of periparturient neutrophil function in dairy cows has been described. This may contribute to increased susceptibility of cows to bacterial infections during the periparturient period. Susceptibility to many complications of the postpartum period is influenced by parity. The aim of this experiment was to determine whether parity influenced periparturient neutrophil function in Holstein cows. Cows (n = 46, of which 26 were calving for the first, second or third time, and 20 were of more advanced parity) were sampled during the last prepartum week, the first postpartum week, 3 weeks postpartum and 6 weeks postpartum. Neutrophils were isolated by centrifugation and hypotonic lysis of erythrocytes. Neutrophil superoxide anion production was determined by the superoxide dismutase inhibitable reduction of ferricytochrome c, and stimulus-induced shape change was determined at 0, 30, 60 and 120 s after exposure to zymosan activated bovine plasma. Superoxide anion production was significantly depressed in the first postpartum week in all cows. At this time, superoxide anion production was significantly lower in cows in their fourth or greater lactation than in cows in the first three lactations. Neutrophil shape change responsiveness was also influenced by parity; immediately prepartum, the shape change responsiveness differed between groups at 120 s after application of the stimulus, and during the first postpartum week shape change responsiveness was less in cows of advanced parity at 30, 60 and 120 s after application of the stimulus. We concluded that cows in the fourth or greater lactation suffered more profound periparturient impairment of neutrophil function than younger cows and that this may be a factor mediating their increased susceptibility to some postpartum complications.

Animals↗
PubMed1991

Social support and its interactions with personality and childhood background as predictors of psychiatric symptoms in Scottish and American medical students.

Two samples of first year medical students were studied, one in Houston, Texas, the other in Edinburgh, Scotland. Personality, measured on entry, and social support, measured prior to first year examinations, were used to predict scores at the latter time on anxiety self-ratings, depression self-ratings and the General Health Questionnaire. At both centres social support was implicated in symptomatology, but many significant effects were centre specific. Presence of a local friend in whom to confide, was important in Houston, while support from a relative and superficial support from classmates were salient in Edinburgh. In general, presence of support was associated with lower symptoms, but there were important exceptions similar in both centres. Students who did not have a boy/girl friend during the study period were less anxious than the rest. Regarding personality, students high on suspiciousness were more anxious and depressed when they had high levels of support. Among reserved (aloof and introspective) students both gain and loss of a boy/girl friend during the year were strongly associated with depressed mood. It is concluded that, particularly for students high in suspiciousness, reserve and shyness, the costs of social relationships sometimes outweigh the benefits.

Adult↗
PubMed1991

Treatment of essential tremor with methazolamide.

We treated 28 patients (16 women and 12 men) who had essential tremor with methazolamide. Their median age was 69 years (range, 34 to 89 years), and the median duration of tremor was 16 years (range, less than 1 to 69 years). Fifteen cases were familial and 13 were sporadic. Improvement in 10 patients who continued taking the drug ranged from moderate to complete relief. In addition, four patients had marked improvement and two had moderate improvement but discontinued use of the drug because of side effects. Five patients with a mild response and seven with no response also discontinued methazolamide therapy. The maximal mean daily dose was 203 mg for all patients and 129 mg (maintenance dose) for the patients who continued taking the drug. Side effects consisted primarily of somnolence, nausea, epigastric discomfort, anorexia, paresthesias, and numbness. No aplastic anemia was noted in any of the patients. The median duration of follow-up was 6 months (range, 10 weeks to 29 months). The therapeutic effect seemed unrelated to a family history of tremor, the effect of alcohol, or the responsiveness to propranolol or primidone. Methazolamide may be an effective drug in the treatment of some patients with essential tremor, particularly those with head and voice tremor.

Adult↗
PubMed1991

Parkinson's disease monotherapy with controlled-release MK-458 (PHNO): double-blind study and comparison to carbidopa/levodopa.

The potent and selective dopamine D-2 agonist, MK-458 [PHNO; (+)-4-propyl-9-hydroxynaphthoxazine] was administered as monotherapy to nine patients with Parkinson's disease in a double-blind, placebo-controlled 12-week investigation; ten other patients were randomized to placebo. MK-458 was formulated as a controlled-release preparation, using a hydroxypropyl methylcellulose-lactase (HPMC) matrix. Patients receiving MK-458/HPMC improved on a variety of measures of parkinsonism, compared to their baseline scores; in contrast, only trivial improvement was seen within the placebo group. We subsequently compared the anti-Parkinson response to MK-458/HPMC with the response to chronic carbidopa/levodopa monotherapy in an open label trial. Carbidopa/levodopa improved parkinsonism to a significantly greater degree than MK-458/HPMC. Doses of MK-458 used in these studies (up to 60 mg per day) were substantially higher than those in previously reported preliminary studies of this medication. We conclude that monotherapy with MK-458/HPMC results in a significant anti-Parkinson effect; however, the response falls short of that seen with carbidopa/levodopa.

Adult↗
PubMed1991

Psychological symptoms and their course in first-year medical students as assessed by the Interval General Health Questionnaire (I-GHQ).

Evidence is presented concerning the concurrent validity of the Interval General Health Questionnaire. This was used to describe the timing and course of spells of depression and anxiety symptoms in first-year medical students over their initial six months at university. A small subgroup of students who were continuously symptomatic were distinguished from other groups by the presence of a number of factors: they were slow to make friends, had inappropriate support from relatives, had a tendency to have rows, had steady girl/boyfriends and had 'vulnerable' personalities. By contrast, a large subgroup who were well throughout had experienced caring childhood backgrounds, seldom had girl/boyfriends, showed little tendency to have rows and had 'resilient' personalities. Other subgroups are also described. It is suggested that students who suffer from chronic minor symptomatic distress could be recognised early on and offered appropriate support from counselling services.

Adult↗
PubMed1990

The Interval General Health Questionnaire.

An adaptation of the LIFE procedure was used with a self-report questionnaire to assess 173 medical students, close to their enrollment and again about six months later. The assessment procedure enabled changes in symptoms of anxiety and depression over the interval between interviews to be recorded and the subsequent classification of the symptom patterns into course categories. While women scored markedly higher than men at initial assessment, this was not so at follow-up. Almost 25% of students reported the co-occurrence of at least five psychological symptoms at some time during the six months. For many students these were of a persistent nature. The adapted GHQ meets the dual demands of restricted interview time and the need to assess the more minor psychological conditions.

Adaptation, Psychological↗
PubMed1990

Affective disorders among women in the general population and among those referred to psychiatrists. Clinical features and demographic correlates.

In a study comparing depressive disorders detected in a field survey (n = 90) with patients referred to a specialist treatment setting (n = 63), the clinical features and demographic correlates of 'cases' of affective disorders proved to be similar. However, those in treatment settings appeared to have more people achieving definite case status. Hospital-referred cases were also more likely than community cases to be older and single, and this difference persisted even after controlling for chronicity of symptoms.

Adolescent↗
PubMed1990

Emergence of alcohol expectancies in childhood: a possible critical period.

Previous investigations with adolescents (aged 12-19) have shown alcohol-related expectancies to develop in childhood prior to significant drinking experience and to covary directly with drinking behavior. To chart the development of alcohol expectancies in children as young as age 6, a procedure was developed to be as independent as possible of age-related variation in reading and language development. This instrument was administered to 114 elementary school children of both genders, distributed across grades 1 to 5. Psychometric analysis provided evidence of the test's reliability and validity. Evaluation of the developmental pattern produced two primary findings: (1) there was an overall trend of increasingly positive expectancies with age; and (2) strikingly, the bulk of the increase was observed in the third and fourth grades. Children's expectancies may be less differentiated than adolescent or adult expectancies. These findings suggest that the precursors for later alcohol use and abuse are formed in childhood and that prevention efforts may need to begin as early as third grade.

Age Factors↗
PubMed1988

Ethylenediaminetetra(methylenephosphonic acid): genotoxicity, biodistribution, and subchronic and chronic toxicity in rats.

Ethylenediaminetetra(methylenephosphonic acid), EDITEMPA, was tested for oral toxicity in rats in a 13-wk feeding study (at doses of 0, 5, 50 and 500 mg/kg/day) and in a chronic feeding study (at doses of 0, 4, 20 and 100 mg/kg/day). EDITEMPA was also tested for genotoxicity in the Ames, mouse lymphoma, unscheduled DNA synthesis, and in vivo cytogenetics assays. Additionally, absorption, distribution and excretion (ADE) studies were conducted following administration of [14C]EDITEMPA to rats by gavage and via the feed and drinking-water. The principal finding in the 13-wk study was mild anaemia in male and female rats given 500 mg/kg/day, which was resolved during a 9-wk recovery period. In the chronic study, there was no substantial evidence of any treatment-related toxicity or carcinogenicity. Differences in survival of control and treated females (noted late in the study) were interpreted to represent unusually good survival in controls; however, a compound-related increase in mortality could not be completely ruled out. Tests for genotoxicity were all negative. ADE studies revealed that [14C]EDITEMPA was poorly absorbed from the gastro-intestinal tract and that most of the absorbed dose was rapidly excreted by the kidneys or sequestered in bone. The gavage route of administration led to four- to six-fold increases in bone EDITEMPA levels as compared with administration in the feed and drinking-water, respectively. These results suggest that no significant toxicity or carcinogenicity concerns arise from EDITEMPA when it is administered in the feed at the concentrations tested. Reversible anaemia was seen only at very high doses and was interpreted as being secondary to EDITEMPA's ability to interfere with iron absorption and utilization. Localization of EDITEMPA in bone indicated a high degree of affinity for mineralizing tissues, consistent with its chelating properties. There was, however, no effect on bone resorption or mineralization. A comparison of human drinking-water levels of 3500 ppm EDITEMPA (based on a no-effect level of 100 mg/kg/day in rats) with the estimated worst-case exposure in humans of 0.01 ppm suggested a safety margin greater than 1 x 10(5).

Administration, Oral↗
PubMed1988

Hospital-treated and general-population morbidity from affective disorders. Comparison of prevalence and inception rates.

In this study, we compare the rates of psychiatric disorders found among women in a random sample of the general population with those of patients referred to specialist services. Both these groups were drawn from the same geographical area. The ratio of prevalence rates is less than the ratio between inception rates in the two groups. When only those with affective disorders were considered, the results revealed that the point prevalence in the treated-disorders group was only 1% of the community-group prevalence, while the inception into care in the former group was nearly 6% of that in the latter. Single women and older women were over-represented in the hospital sample.

Adolescent↗
PubMed1987

Life events, psychiatric illness and the irritable bowel syndrome.

The frequency, severity, and characteristics of psychiatric illness and stressful life situations were assessed in 134 patients aged 18-60 years referred to a gastrointestinal clinic by their general practitioner. A functional disorder of the gastrointestinal tract was established in 72%. A formal psychiatric assessment in 64 randomly selected patients revealed a previous or current psychiatric disorder in 54% of the functional group and 12.5% of the organic group. Stressful life events before referral were assessed by a modification of the Bedford College methodology. Anxiety provoking life situations were found in 30%, a proportion which was not significantly different in the two groups. Psychiatric illness episodes and/or anxiety provoking situations, preceded the onset of bowel symptoms in two-thirds of the functional group, however, but in none of the organic group. Life situations alone did not appear to be associated with functional disorders unless they provoked an anxiety state.

Adolescent↗