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Biomedical subjects

S Pearce

Publications and source records attributed to S Pearce.

At least 55 records · Page 3Linked to original sources
PubMed1996

Fatigue in cancer: a phenomenological perspective.

Fatigue is a frequently encountered symptom in cancer populations. This study aimed to describe the experience of fatigue from the perspective of cancer patients who had recently completed a course of chemotherapy. A phenomenological method was used. The themes which emerged from the data indicated both a shared and individual experience of fatigue. These incorporated: the nature of fatigue; the causes, consequences, strategies for coping with fatigue; and the trajectory of the fatigue experience. Issues arising from the nature of phenomenological inquiry and the research were also elicited from this study. An understanding of the fatigue experience for this population and the use of phenomenology have implications for the nursing profession's knowledge base and for clinical practice.

Adaptation, Psychological↗
PubMed1996

Pain patients' bias in the interpretation of ambiguous homophones.

This study describes an investigation into the interpretation of ambiguous homophones by chronic pain patients and non-pain control patients. Participants were presented auditorily with a list of homophones and asked to write down the word they had just heard. Following a two-minute distraction task they completed a free-recall task. A significant bias towards pain interpretation was exhibited by the pain patients and this effect appears to be independent of anxiety and depression. Both groups reported awareness of the ambiguity of some words, and the analysis was repeated for each participant excluding the words reported to be ambiguous. Pain patients still showed the bias towards pain interpretation. The free-recall task also demonstrated a memory bias for pain stimuli in pain groups. The results provide further evidence that chronic pain is associated with biases in the processing of information. Future research should aim to investigate the role of these biases in the maintenance of chronic pain.

Anxiety Disorders↗
PubMed1995

Advanced colorectal cancer treated with combined 5-fluorouracil and folinic acid: the experience within a surgical department.

Thirty-seven patients with advanced colorectal cancer were treated with fluorouracil (5-FU) and folinic acid (FA) (Jan 1990-Dec 1992). Clinical assessment and administration of chemotherapy was incorporated as part of the daily work load of a busy general surgical unit. Records were available for all 37 patients and showed that 13 patients (Treatment failures, Group B) failed to receive more than 3 monthly cycles of treatment, while the remaining 24 received 6 or greater cycles (Treatment completed, Group A). There was no survival advantage demonstrated for the complete study cohort (n = 37) when compared to an historical group (n = 1038) of untreated patients. Median survival in Group A (14.2 months) was significantly greater (chi-squared, P < 0.0001) than survival in Group B (6.7 months). Toxicity was common with 43% experiencing mouth ulcers or stomatitis (13% severe). Three per cent had dose-limiting diarrhoea and myelotoxicity was minimal. There were six partial responses and 16 patients had no change in their disease status while on treatment. Current regimen of 5-FU/FA are well-tolerated with low toxicity but show no survival advantage for advanced colorectal cancer. However, these regimens may be administered within the confines of general surgical practice.

Adenocarcinoma↗
PubMed1995

Endorsement and memory bias of self-referential pain stimuli in depressed pain patients.

This study investigates information processing in chronic pain patients by comparing the responses of depressed pain patients, non-depressed pain patients and non-pain control subjects. Each subject contributed two scores: endorsement of adjectives as descriptors of themselves and their best-friends; and free recall of the presented words. The stimuli consisted of depression-related, pain-related and neutral control adjectives, and each content category was split into negative and positive valence. The four-way interaction between group, reference, content and valence was significant both in the recall data and the endorsement data. Further analysis revealed that depressed pain patients exhibited a bias towards self-referential negative pain words, but not towards self-referential negative depression information. These results are interpreted in line with content specificity theory of information processing and have implications for targeting cognitive interventions with pain patients.

Adult↗
PubMed1995

The 'dice' game: a new test of pragmatic language skills after closed-head injury.

There are few clinical tools available to assess communication skills following closed-head injury. This paper describes one such task in which the subject is required to explain a board game to a naive listener. The explanation is taped, transcribed and the content is quantified. Reliability studies demonstrated that the test can be consistently scored. A group of 43 normal subjects was investigated, and some variation in performance according to age and educational background was revealed. A group of 20 brain-injured male adults with executive-type deficits were then compared to a matched subgroup of the controls. The clinical group produced less essential information and relatively more unnecessary information than their non-brain-damaged counterparts. Qualitative features of discourse disorganization were also revealed.

Adolescent↗
PubMed1994

Interpretation bias in responses to ambiguous cues in pain patients.

Pain patients and control subjects responses to ambiguous cues were compared in two separate investigations. In the first, pain patients, control subjects and physiotherapists were asked to produce a list of spontaneous associations to ambiguous cues (such as terminal and growth). To control for mood effects the experiment was repeated with three more groups: Pain patients, osteopaths and a control group. Measures of anxiety and depression were incorporated in the analysis. Results indicate that pain patients systematically produce more pain related associations than the other groups, and that this effect is independent of anxiety and depression levels. The discussion concentrates on the implications of these findings both for the theory of pain processing and for clinical interventions.

Adult↗
PubMed1994

Post-operative fatigue following coronary artery bypass surgery: relationship to emotional state and to the catecholamine response to surgery.

Post-operative fatigue is an important subjective problem for surgical patients, but its basis is unknown, and the possibility of a psychological component has been neglected. To investigate its putative physiological and psychological bases, 74 patients undergoing coronary artery bypass graft surgery were studied. Circulating catecholamine levels were measured at intervals perioperatively and questionnaires were used to measure fatigue, depression and anxiety up to 30 days post-operatively. We tested whether fatigue was related either to the catecholamine or to the emotional responses to surgery. The second element to the design was a controlled randomized study: patients underwent different forms of psychological preparation or a no-treatment control procedure in an attempt to test whether post-operative fatigue was amenable to psychological manipulation. Psychological preparation had no effect. Fatigue at 30 days was greatest in patients whose noradrenaline levels were greatest perioperatively. Independently of this relationship, fatigue at 30 days correlated with concurrent levels of depression and anxiety. Post-operative fatigue has both physiological and psychological correlates.

Adaptation, Psychological↗
PubMed1994

Diagnostic pitfall; interpretation of CA 19-9 concentrations in the presence of hepatic dysfunction.

A 50 year old man is described with hepatic dysfunction and chronic pancreatitis in whom greatly increased concentrations of the pancreatic tumour marker CA 19-9 combined with an abnormal appearance at endoscopic retrograde cholangiopancreatography lead to the false suspicion of pancreatic carcinoma. CA 19-9 concentrations should be interpreted with caution in patients with intrinsic liver disease or biliary obstruction.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

Cerebral responses to pain in patients with atypical facial pain measured by positron emission tomography.

The localised PET cerebral correlates of the painful experience in the normal human brain have previously been demonstrated. This study examined whether these responses are different in patients with chronic atypical facial pain. The regional cerebral responses to non-painful and painful thermal stimuli in six female patients with atypical facial pain and six matched female controls were studied by taking serial measurements of regional blood flow by PET. Both groups displayed highly significant differences in responses to painful heat compared with non-painful heat in the thalamus, anterior cingulate cortex (area 24), lentiform nucleus, insula, and prefrontal cortex. These structures are closely related to the "medial pain system". The atypical facial pain group had increased blood flow in the anterior cingulate cortex and decreased blood flow in the prefrontal cortex. These findings show the importance of the anterior cingulate cortex and the reciprocal (possibly inhibitory) connections with the prefrontal cortex in the processing of pain in patients with this disorder. A hypothesis is proposed to explain the mechanisms of cognitive and pharmacological manipulation of these pain processes.

Adult↗
PubMed1993

Sex hormone binding globulin and non-protein-bound oestradiol in postmenopausal patients with primary biliary cirrhosis and normal controls.

Several studies have suggested that patients with primary biliary cirrhosis (PBC) have an increased risk of a number of medical conditions related to their oestrogen levels. This study has measured sex hormone binding globulin (SHBG) binding capacity, total oestradiol levels and percentage non-protein-bound (NPB) oestradiol and calculated the concentration of NPB oestradiol, in postmenopausal subjects in the following groups; normal controls, early PBC, advanced PBC and advanced PBC who were receiving therapy. Mean SHBG levels were higher in all groups of patients with PBC than in controls. No significant difference was observed in total or biologically active oestradiol between the four groups.

Aged↗
PubMed1993

Time-frequency analysis of infant cry: measures that identify individuals.

As part of a larger study designed to test the predictive power of recordings of infant cry for neurological development at a year of age, we have developed a summary measure of a cry which shows a very high consistency within an individual. This measure may be useful in making assessments of anatomical structure in the infant vocal tract.

Asphyxia Neonatorum↗
PubMed1993

Self-referential selective memory in pain patients.

The effect of self-reference on recall bias for pain stimuli was compared in chronic pain patients and controls. It was hypothesized that self-referential encoding would result in better recall of pain stimuli in chronic pain patients. In contrast, it was predicted that a non-pain control group would display no recall bias for pain-associated stimuli, regardless of the encoding reference. Subjects were tested in two conditions. The first condition (self-referential) involved encoding a list of words constructed from sensory pain, affective and neutral words. Elaboration at the encoding stage was achieved by asking subjects to imagine themselves in situations involving these words. Subjects were also asked to rate the likelihood of these situations occurring on a scale of 1 to 5 (from 1 = 'will not happen' to 5 = 'certain to happen'). The second condition (other-person reference) repeated this task in reference to another person with a matched list of words. A 2 x 2 x 3 factorial analysis of variance based on group x reference (self and other) x word type (sensory, affective and neutral) was carried out on recall scores, with the likelihood ratings as a covariate. Results reveal a significant three-way interaction. The analysis indicated that, while pain patients show an increase in recall of sensory words and a decrease in recall of neutral words when these are encoded in reference to themselves, control subjects show no difference in recall of these word types regardless of the encoding condition. The results support the notion that pain patients selectively recall more pain-associated words in comparison with other word types. However, this effect is only true for stimuli encoded in reference to themselves. It is proposed that this processing bias may contribute to the maintenance of a sense of helplessness and exacerbate the emotional impact of the pain experience.

Adult↗
PubMed1992

Selective memory for sensory and affective information in chronic pain and depression.

Mood congruity effects in induced mood states and affective disorders are well established. Recent evidence suggests that a similar process occurs in chronic pain patients, although the extent to which the memory bias is a consequence of the affective or sensory state of the subject in this group is unknown. In this study selective memory for sensory and affective pain-related information was investigated in depressed and non-depressed chronic pain patients and depressed psychiatric patients. A recall test comprising sensory, affective and neutral adjectives matched for frequency was followed by a recognition task, where the words of the recall test were randomized with an equal number of new adjectives matched for word type and frequency. Comparison of the three patient groups with normal controls revealed specific recall biases directly related to pain and depression in both chronic pain groups and the controls. Contrary to expectations, the depressed psychiatric patients failed to show a recall bias for affective adjectives: the possibility of cognitive avoidance as an explanation for this is discussed. Signal detection analysis of the recognition results suggested that selective memory in chronic pain and depression may to some extent be accounted for by differences in 'true memory', the contribution of response bias remaining less clear.

Adult↗
PubMed1991

Albumin-bound and non-protein-bound oestradiol and testosterone in postmenopausal breast disease.

Several studies have recently reported the percentage of non-protein-bound (NPB) oestradiol (E2) to be higher in patients with breast cancer than in normal controls. Using postmenopausal volunteers, we have examined the fractional binding of E2 and testosterone (T), as well as total E2 and T, sex-hormone binding globulin (SHBG), luteinising hormone (LH) and follicle stimulating hormone (FSH), in normal women, those at risk of developing breast cancer and women with breast cancer at first diagnosis and first recurrence. No significant differences were observed in either the concentration or in the percentage of NPB E2 or T, or in any of the other hormones measured. The validity of our observations were confirmed by expected relationships between E2, T, SHBG and body mass.

Breast Neoplasms↗
PubMed1990

The evaluation of a cognitive behavioural treatment programme in outpatients with chronic pain.

This study is an attempt to investigate the efficacy of an outpatient cognitive behavioural group programme for the rehabilitation of patients with chronic pain. The programme, which took place over one afternoon per week for seven weeks and was conducted by a multidisciplinary team, aimed to increase patients' skills for coping with chronic pain and its social, emotional and physical consequences. Measures of pain intensity, mood, coping skills, physical disability and medication consumption were obtained on four separate occasions: twice pre-treatment, immediately post-treatment and at one month follow-up. Repeated measures analysis of variance showed significant improvements in mood, coping skills, physical disability and analgesic consumption despite less clear-cut improvement in ratings of pain intensity. These results parallel the findings of similar studies in the U.S.A. and their implications for the provision of services to chronic pain patients in the U.K. is discussed.

Adaptation, Psychological↗