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Biomedical subjects

Emma Martin

Publications and source records attributed to Emma Martin.

6 recordsLinked to original sources
PubMed2006

Rehabilitation of executive dysfunction following brain injury: "content-free" cueing improves everyday prospective memory performance.

Prospective memory (PM) is often claimed to rely upon executive as well as mnemonic resources. Here, we examined the contribution of executive functions towards PM by providing intermittent support for monitoring processes using "content-free" cues, which carried no direct information regarding the PM task itself. Twenty participants with non-progressive brain injury and PM difficulties received brief training in linking a cue phrase "STOP!" with pausing current activity and reviewing stored goals. The efficacy of this strategy was examined with a PM task requiring participants to make telephone calls to a voicemail service at four set times each day for 10 days. Task content was encoded using errorless learning to minimise retrospective memory-based failures. On five randomly selected days, eight text messages reading simply "STOP!" were sent to participants' mobile telephones, but crucially not within an hour of a target time. Striking improvements in performance were observed on cued days, thus demonstrating a within-subjects experimental modulation of PM performance using cues that carry no information other than by association with participants' stored memory of their intentions. In addition to the theoretical insights, the time course over which the effect was observed constitutes encouraging evidence that such strategies are useful in helping to remediate some negative consequences of executive dysfunction. It is proposed that this benefit results from enhanced efficiency of goal management via increased monitoring of current and future goals, and the steps necessary to achieve them, perhaps compensating for under-functioning fronto-parietal attention systems.

Adult↗
PubMed2006

Late onset psychogenic nonepileptic attacks.

OBJECTIVE: To investigate differences between groups of patients with early vs late onset psychogenic nonepileptic attacks (PNEA). METHODS: The authors compared patients with onset of PNEA after age 55 years (n = 26) to patients whose onset of PNEA was before age 55 years (n = 241). The authors examined sociodemographic variables, factors potentially predisposing to PNEA, clinical semiology, and medical and psychiatric background. RESULTS: Patients with late onset PNEA were more likely to be male (p = 0.029) (p values are quoted uncorrected for multiple comparisons). They were less likely to report antecedent sexual abuse (p = 0.008), and more likely to have severe physical health problems (p < 0.001) and to report health-related traumatic experiences (p < 0.0001). There were no clear differences in PNEA clinical semiology. There was a trend to better baseline mental health in the late onset group. CONCLUSIONS: The data suggest a distinct subgroup of patients with late onset psychogenic nonepileptic attacks, in whom psychological trauma related to poor physical health plays a prominent role.

Age Distribution↗
PubMed2005

Successful withdrawal of oral long-acting nitrates to facilitate phosphodiesterase type 5 inhibitor use in stable coronary disease patients with erectile dysfunction.

INTRODUCTION: Vascular disease is the most common cause of male erectile dysfunction (ED). Phosphodiesterase type 5 (PDE5) inhibitors are effective in up to 80% of men but are contraindicated in the presence of oral nitrates, because of a potentially severe hypotensive interaction. AIMS: To see if stable coronary disease patients with ED could have their oral nitrates discontinued to allow safe use of a PDE5 inhibitor. METHODS: Prospective study of 425 men with ED and cardiac disease conducted in an outpatient cardiac sexual advice clinic. MAIN OUTCOME MEASURES: Discontinuation of oral nitrates to facilitate subsequent use of PDE5 therapy. RESULTS: Oral nitrates were being used by 88 (21%) coronary artery disease patients all of whom were clinically stable. Fifty-five (63%) of these men with a good exercise ability had their nitrates discontinued in the presence of continuing beta-blockade or calcium antagonist therapy. They were reviewed 1 week later. Only three restarted their nitrate therapy because of an increase in symptoms. Forty-nine of the 52 men no longer taking nitrates were treated with a PDE5 inhibitor which was effective in 22 out of 26 (85%) patients who have completed follow-up. Fifteen patients are currently undergoing clinic follow-up in order to optimize treatment, and nine patients have continued therapy with their family doctors. Importantly, there have been no adverse cardiac events. CONCLUSION: Oral nitrates can be discontinued in the presence of continuing beta-blockade and/or calcium antagonist therapy in stable coronary disease patients with ED to allow for the safe use of PDE5 inhibitors.

Administration, Oral↗