PubMed Health⌕ Search

Biomedical subjects

B W Carlson

Publications and source records attributed to B W Carlson.

9 recordsLinked to original sources
PubMed2001

Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial.

CONTEXT: Chronic tension-type headaches are characterized by near-daily headaches and often are difficult to manage in primary practice. Behavioral and pharmacological therapies each appear modestly effective, but data are lacking on their separate and combined effects. OBJECTIVE: To evaluate the clinical efficacy of behavioral and pharmacological therapies, singly and combined, for chronic tension-type headaches. DESIGN AND SETTING: Randomized placebo-controlled trial conducted from August 1995 to January 1998 at 2 outpatient sites in Ohio. PARTICIPANTS: Two hundred three adults (mean age, 37 years; 76% women) with diagnosis of chronic tension-type headaches (mean, 26 headache d/mo). INTERVENTIONS: Participants were randomly assigned to receive tricyclic antidepressant (amitriptyline hydrochloride, up to 100 mg/d, or nortriptyline hydrochloride, up to 75 mg/d) medication (n = 53), placebo (n = 48), stress management (eg, relaxation, cognitive coping) therapy (3 sessions and 2 telephone contacts) plus placebo (n = 49), or stress management therapy plus antidepressant medication (n = 53). MAIN OUTCOME MEASURES: Monthly headache index scores calculated as the mean of pain ratings (0-10 scale) recorded by participants in a daily diary 4 times per day; number of days per month with at least moderate pain (pain rating >/=5), analgesic medication use, and Headache Disability Inventory scores, compared by intervention group. RESULTS: Tricyclic antidepressant medication and stress management therapy each produced larger reductions in headache activity, analgesic medication use, and headache-related disability than placebo, but antidepressant medication yielded more rapid improvements in headache activity. Combined therapy was more likely to produce clinically significant (>/=50%) reductions in headache index scores (64% of participants) than antidepressant medication (38% of participants; P =.006), stress management therapy (35%; P =.003), or placebo (29%; P =.001). On other measures the combined therapy and its 2 component therapies produced similar outcomes. CONCLUSIONS: Our results indicate that antidepressant medication and stress management therapy are each modestly effective in treating chronic tension-type headaches. Combined therapy may improve outcome relative to monotherapy.

Adult↗
PubMed1999

Evaluation of a non-invasive respiratory monitoring system for sleeping subjects.

In a previous paper we introduced a non-invasive respiratory monitoring system (NIRMS) for monitoring respiratory movements during sleep. Unlike standard sleep laboratory methods, the NIRMS can be used in frail older adults to describe breathing patterns during sleep that will mark individuals with declining neurological function. The present study evaluates the use of the NIRMS as a respiratory monitor and identifies variables that can reliably detect changes in breathing patterns and the presence of other body movements. Data were obtained from eleven healthy adults (six women, five men) whose body mass indices ranged from 20 to 47 kg m(-2), and whose baseline respiratory rates ranged from 4 to 19 breaths per minute. We evaluated three variables derived from frequency and amplitude measurements of the NIRMS: (1) the interval between breathing cycles (the interbreath interval or IBI); (2) the period between breathing cycles (the interbreath frequency or IBF); and (3) the amplitude of breath cycles (AMP). The frequency of NIRMS waveform deflections correlated highly with the frequency of visually observed chest movements (r = 0.99). Compared with a subject's baseline, a standard deviation of IBI > 3.0 s consistently identified time segments with three or more apnoeic events. The IBF and AMP differentiated respiratory from other body movements. An IBF > 20 cycles/s or an AMP > 0.4 V identified experimentally introduced body movements much more accurately than wrist accelerometry (NIRMS detected 99% of events, kappa = 0.90; WA detected 50%, kappa = 0.70). These findings support the use of the NIRMS in monitoring changes in breathing patterns during sleep, especially in frail and cognitively impaired subjects.

Adult↗
PubMed1992

Finding the hypnotic virtuoso--another look: a brief communication.

Student volunteers who scored 9 (N = 20), 10 (N = 19), 11 (N = 26), and 12 (N = 15) on a live-administered Harvard Group Scale of Hypnotic Susceptibility (HGSHS:A) of Shor and E. Orne (1962) were retested with the individually administered Stanford Hypnotic Susceptibility Scale (SHSS:C) of Weitzenhoffer and Hilgard (1962). There appeared to be a break in HGSHS:A's predictive ability at 11 suggestions passed. Whereas a majority of Ss who passed at least 11 HGSHS:A suggestions retested in SHSS:C "virtuoso" range (i.e., passed at least 11 suggestions), a relatively small percentage of Ss who passed fewer than 11 HGSHS:A suggestions retested as SHSS:C virtuosos. These results are generally consistent with previous research (Register & Kihlstrom, 1986) using a standard taped-recorded HGSHS:A induction.

Amnesia↗
PubMed1991

Predicting asthma in individual patients.

The degree to which asthma attacks were related to seven environmental variables was determined for each of 17 individuals. Using stepwise regression procedures, cladosporium mold, ragweed pollen, and a change in temperature were significant predictors of asthma attacks in 5 of 17 individuals. The information provided by these analyses could prove useful in helping some individuals manage their asthma.

Adult↗
PubMed1991

Prediction of asthma episodes in children using peak expiratory flow rates, medication compliance, and exercise data.

Asthmatic patients demonstrate considerable variation in the extent to which their subjective evaluations and objective measures of airways obstruction correspond. The detection and prediction of asthma episodes have been improved through the use of objective pulmonary measures, such as peak expiratory flow rate (PEFR). Furthermore, information regarding adherence to medication regimens and specific asthma triggers (ie, exercise) may also improve the predictability of asthma in children. The utility of using PEFR values, medication compliance information, and exercise data for the prediction of asthma episodes in individual children was investigated in the present study. Individual logistic regression equations were calculated for ten asthmatic children. In predicting asthma episodes, PEFR was present in the model for nine out of ten subjects; exercise was included for two out of five subjects providing such data; whether an attack had occurred in the preceding 12-hour period was predictive for one out of ten participants; and whether an attack had been experienced in the previous 24 hours was present for four out of ten subjects. Hosmer-Lemeshow values indicated that the models fit the data well for nine subjects (alpha greater than .05). The mean model prediction rate (80.85%) was higher than the mean base rate (75.72%). The relative risk ratio values ranged from 0 to 5.72, with a mean of 3.50. These results suggest that the prediction of episodes may be enhanced by using PEFR, exercise, and time of day.

Adolescent↗
PubMed1990

Literalism as a marker of hypnotic "trance": disconfirming evidence.

The responses given by highly hypnotizable, hypnotic subjects and those of unhypnotizable subjects who simulated hypnosis to questions of the type, "Do you mind telling me your name?" and "Do you mind standing up?" were contrasted. The purpose was to examine Erickson's (1980) assertion that literalism (answering "yes" or "no" verbally or nonverbally without any cognitive elaboration) is a marker of hypnotic "trance." Simulators exhibited a greater rate of literalism than hypnotic "virtuosos" (i.e., extreme scorers on both group and individual hypnotizability measures). Hypnotized subjects and nonhypnotized subjects approached in the campus library responded comparably. Because less than a third of hypnotic virtuosos responded literally, our results strongly refuted Erickson's assertion that literalism is a cognitive feature of hypnosis.

Cognition↗
PubMed1990

Literalism and hypnosis: hypnotic versus task-motivated subjects.

To extend previous literalism research with hypnotized and simulating subjects, we compared literalism rates of hypnotized, highly hypnotizable subjects (N = 12) with nonhypnotized, task-motivated subjects (N = 12) who were also highly hypnotizable. Six questions of the type used by Erickson (e.g., "Do you mind telling me your name?") constituted tests of literalism (scored if response is "Yes" or "No," either verbally or nonverbally). Whereas Erickson claimed that 97% of his "deep trance" subjects and 90% of his "medium trance" subjects exhibited literal responses, we found that 87.5% of hypnotized, high-hypnotizable subjects' responses were nonliteral. Hypnotized and task-motivated subjects did not differ in their literal responding to the individual questions or when their scores were summed across questions. No support was secured for Erickson's assertion that literalism is a cardinal feature of hypnosis.

Adult↗
PubMed1981

An analysis of the movement to private psychiatric practice.

Survey data were analyzed from 900 psychiatrists who graduated between 1961 and 1976 from one of 17 state mental hospitals (SMHs) or ten university psychiatry residency programs in one of five states and are used to describe the differential influence of (1) foreign or US medical education, (2) SMH or university training program, and (3) years since graduation on the decision to take a job in either a private, public, or university medical school practice setting. Descriptive statistical models show that (1) about 25% of all respondents chose a private, 55% a public, and 20% a university for their first job, and (2) substantial numbers of both foreign and US medical graduates (FMGs, USMGs) left public jobs and chose and remained in private jobs, so that 55% of respondents had their current job in the private sector. Type of residency training was associated only with first job choice. Compared with USMGs, more FMGs initially took and remained in public jobs. These models highlight manpower problems. In fact, most of the respondents did not confine their work to a single kind of practice setting.

Humans↗