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Biomedical subjects

M Peyrot

Publications and source records attributed to M Peyrot.

At least 19 recordsLinked to original sources
PubMed2000

Endogenous opioid activity is associated with obsessive-compulsive symptomology in individuals with a family history of alcoholism.

Endogenous opioid activity has been associated with the regulation of mood and inhibition of the hypothalamic-pituitary-adrenal (HPA) axis. We assessed differences in psychological symptomology and naloxone sensitivity in non-alcoholic males and females with a family history of alcoholism (FHP) and without a family history of alcoholism (FHN). This was followed by assessment of the association between naloxone sensitivity and psychological symptomology. Psychological symptomology was measured using the Revised Symptom Checklist (SCL-90-R) during enrollment. Adrenocorticotropin was measured following intravenous administration of naloxone/placebo. FHP males reported more obsessive-compulsive symptomology as well as increased sensitivity to naloxone relative to other groups. A positive association was observed between degree of obsessive-compulsive symptomology and naloxone sensitivity, and the association was strongest among FHP males. These findings suggest that the increased risk of alcoholism in FHP subjects (especially males) may be associated with altered opioid activity, which is expressed through an elevated level of obsessive compulsive symptomology.

Adolescent↗
PubMed1999

Persistence of depressive symptoms in diabetic adults.

OBJECTIVE: To determine the level and pattern of persistent depressive symptoms among adults with diabetes and identify factors associated with increased risk of being persistently depressed. RESEARCH DESIGN AND METHODS: A self-report depression symptom inventory was administered to 245 patients at two initial time points--the beginning and end of a comprehensive outpatient diabetes education program--and at 6-month follow-up. RESULTS: Only 13% of subjects were persistently depressed (i.e., exceeded the criterion for depression symptoms at all three time points). The rate of being depressed at follow-up was 10% for those negative for depression symptoms at either of the initial time points, 36% for those positive at one initial time point, and 73% for those positive at both initial time points (P < 0.0001). Those at increased risk for being persistently depressed were those who did not graduate from high school, had more than two complications of diabetes, and were not treated with insulin. CONCLUSIONS: Persistent depressive symptomatology is present in a substantial number of diabetic adults and can be effectively predicted using simple screening instruments during initial contacts. Risk factors for being persistently depressed only partly overlap those for transient depressive symptoms and represent a possible biological dimension.

Adult↗
PubMed1999

A biopsychosocial model of glycemic control in diabetes: stress, coping and regimen adherence.

This study examines stress, coping, and regimen adherence as determinants of chronic and transient metabolic control in diabetes. We also examine the interaction of biologic vulnerability and psychosocial risk factors to see if Type 1 (insulin dependent diabetes mellitus) or Type 2 (noninsulin dependent diabetes mellitus) diabetes had greater responsiveness to psychosocial risk factors. Analyses of data from insulin-treated adults with Type 1 (N = 57) and Type 2 (N = 61) diabetes supported the biopsychosocial model. For Type 1 diabetes, self-controlling persons had better glycemic control and emotional persons had worse (because of differences in stress). All of these associations were mediated by regimen compliance. For Type 2 diabetes, self-controlling persons had better glycemic control for reasons other than regimen compliance. There was an interaction between biologic and psychosocial factors, with psychosocial factors accounting for more variance in glycemic control within Type 1 patients. Stable psychosocial resources (i.e., education, being married, and positive coping styles) were associated with better chronic glycemic control, while stress and regimen nonadherence were associated with worse transient glycemic control.

Adaptation, Psychological↗
PubMed1998

Direct-to-consumer ads can influence behavior. Advertising increases consumer knowledge and prescription drug requests.

This study examines the impact of direct-to-consumer (DTC) pharmaceutical advertising on prescription drug knowledge and the requesting behavior of consumers. The authors developed and tested a conceptual model of prescription drug knowledge and requests. Consumers' belief that drug advertising can educate them was associated with a greater amount of drug knowledge, and the belief they would upset physicians by asking for specific drugs was associated with less knowledge. The belief that drug advertising reduces prices was associated with greater probability of drug requests, and the belief that physicians should be the sole source of drug information was associated with lesser probability of request. Preference for generic drugs was associated with a lesser likelihood of requesting a specific drug. Media exposure and drug advertising awareness were associated with higher drug knowledge and a greater probability of drug requesting.

Advertising↗
PubMed1997

Levels and risks of depression and anxiety symptomatology among diabetic adults.

OBJECTIVE: To determine levels of depression and anxiety symptoms among adults with diabetes and identify factors associated with increased risk. RESEARCH DESIGN AND METHODS: This study administered self-report symptom inventories to patients at the beginning (n = 634) and end (n = 578) of an outpatient diabetes education program. Subjects (n = 246) contacted by mail 6 months later completed the same instruments. RESULTS: Rates of disturbance for depression (41.3%; 95% CI: 37.4-45.2%) and anxiety (49.2%; 95% CI: 45.3-53.1%) were higher than those typical in the general population (10-20%). Probability of disturbance ranged from 5-7% for those with the lowest risk profile to 82-92% for those with the highest risk profile. Diabetes-related complications were the only disease factor associated with significantly increased risk of disturbance. Women and those with less education were at much higher risk. Only 13% of those followed for 6 months were disturbed at all three time-points. CONCLUSIONS: Diabetes is associated with increased risk of psychological disturbance, especially for those with more diabetes-related complications. Sociodemographic factors account for much of the risk differential among people with diabetes.

Adult↗
PubMed1996

Causal analysis: theory and application.

Identified opportunities to make statistical analysis more closely approximate the conceptual issues that are apparent in current research in pediatric psychology. The paper proceeds by explicating the logic of multivariate analysis and its application to causal modeling. Causal modeling techniques are discussed and the ease of employing these techniques is evaluated. Several articles from earlier issues of this journal are reviewed in terms of the application of causal analysis.

Causality↗
PubMed1995

Synthesis and characterization of supramolecular biovector (SMBV) specifically designed for the entrapment of ionic molecules.

Supramolecular biovectors (SMBV) are nanoparticular drug carriers composed of an internal crosslinked solid core externally grafted with fatty acids and surrounded with a phospholipid layer. We show in this paper that the internal core can be derivatized with anionic ligands such as phosphate in order to allow the efficient entrapment of cationic molecules through a process akin to ion exchange. Synthesis of SMBV involved first a cross linking and derivatization step of polysaccharides followed by a homogenization, a drying and a regioselective acylation step. Acylated polysaccharide cores are thus obtained which can be loaded with drugs and wrapped with a phospholipid layer. The SMBVs obtained are characterized through their size, 20 nm, and their ability to filter through 0.22 microns pore size membrane. Gel permeation chromatography experiments performed with various phospholipid/acylated cores ratios indicate that SMBVs form entities distinct from liposomes and that the optimum phospholipid/acylated cores ratio for this specific type of SMBVs is close to 100%. The supramolecular structure of SMBVs and in particular the spatial proximity between acylated cores and phospholipids is demonstrated through resonance energy transfer experiments. The drug loading capability of SMBVs is illustrated by the preparation of gentamicin and doxorubicin loaded SMBV. The therapeutic potential of SMBVs is then discussed notably in the light of a possible biomimetism with low density lipoproteins (LDL).

Doxorubicin↗
PubMed1994

The effect of child physical abuse and neglect on aggressive, withdrawn, and prosocial behavior.

This study investigated aggressive, withdrawn, and prosocial behavior in physically abused (N = 21), nonabused-neglected (N = 26), and nonabused-nonneglected (N = 21) children aged 5 to 8 years. Multiple assessment techniques were used, specifically the Human Figure and Kinetic Group Drawings, children's verbal stories, and teacher ratings on the Pittsburgh Adjustment Survey Scales. All measurement techniques were able to discriminate among the three groups. Physically abused children displayed significantly more aggressive behavior than the neglected and nonmaltreated; neglected children were significantly more withdrawn than the physically abused and nonmaltreated; nonmaltreated children exhibited significantly more prosocial behavior than the abused and neglected. No single dimension adequately discriminated each of the three groups. Full discrimination was achieved only when aggressive, withdrawn, and prosocial behavior were combined in a multivariate analysis, indicating that effects of maltreatment must be viewed as multidimensional.

Aggression↗
PubMed1994

Short-term substance abuse prevention in jail: a cognitive behavioral approach.

This article describes a cognitive-behavioral program for substance abusers which was first implemented in the Baltimore City Jail in 1987. Similar but separate programs are provided for male and female inmates, consisting of twelve to sixteen contact hours over three to four weeks. In addition to conventional drug and alcohol information (physiologic and psychological effects, treatment options), the program emphasizes cognitive and behavioral skills which can prevent substance abuse, including training in consequential thinking, and stress and anger management. Over a two-year period, 607 males and 131 females were served, of whom 429 (59%) completed the entire program. Both males and females showed statistically significant improvement from pretest to posttest in all knowledge areas. Inmates gave high ratings to the program and group leaders reported substantial change in client attitudes toward drug and alcohol use. Knowledge scores at the end of the program were highest for those who scored higher at pretest, rated their group leader higher, and were rated by their group leader as more active participants. Client participation was the strongest predictor of program outcome.

Adult↗
PubMed1994

Structure and correlates of diabetes-specific locus of control.

OBJECTIVE: To examine the structure and correlates of diabetes-specific locus of control. RESEARCH DESIGN AND METHODS: Study participants were 165 adult patients from a comprehensive outpatient diabetes education program who completed a research protocol at the outset of the program. The protocol included measures of diabetes locus of control (DLC), glycemic control, self-care behavior, and emotional well-being. RESULTS: Scales measuring internal and powerful other DLC each had two components. One component of internal DLC, autonomy, was significantly associated with positive outcomes, and the other component, self-blame, was related to negative outcomes. The two components of powerful other DLC were differently correlated with various aspects of strict regimen adherence, and chance DLC was associated with a variety of measures reflecting a pattern of dysfunction. CONCLUSIONS: The concept of DLC appears to have explanatory power in accounting for health outcomes, especially when internal DLC measures of autonomy and self-blame are differentiated. It is important to find educational interventions that work effectively with patients who believe that health outcomes are controlled by chance, because they seem to be at special risk for health-related problems.

Blood Glucose↗
PubMed1993

Biogenic, psychogenic, and sociogenic models of adjustment to chronic pain: an exploratory study.

OBJECTIVE: Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health. METHOD: Patients from a medical school orthopedic clinic with an organic (N = 58) or a nonorganic (N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables. RESULTS: Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients. CONCLUSIONS: Social anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.

Adaptation, Psychological↗
PubMed1993

Consumer satisfaction and perceived quality of outpatient health services.

The authors examined factors related to consumer satisfaction and willingness to recommend the provider among 1,366 patients receiving examinations at a free-standing medical imaging facility. The nontechnical (nonmedical) characteristics of the service encounter were drawn from three conceptual domains--staff behavior, atmospherics, and information--and two subjective judgments regarding the medical service itself: examination comfort and perceived worth. The authors hypothesized that all of these factors are related to increased consumer satisfaction and willingness to recommend the provider. Data collection was based on a service script, and factor analysis was used to organize elements from each domain into a map of consumer perceptions. Multivariate logistic regression indicated that items from each domain were significantly related to patient satisfaction and willingness to recommend the provider.

Ambulatory Care Facilities↗
PubMed1992

Psychosocial problems and interventions in diabetes. A review of the literature.

This article reviews and organizes the recent literature on psychosocial problems and interventions in diabetes to see if it is possible to identify effective modes of treatment for numerous different psychosocial problems. An attempt was made to review extensively the references on psychosocial problems and to review exhaustively the references on psychosocial interventions. The review was organized under four major headings: psychological sequelae of medical crises, psychopathology in diabetes, stress and hassles in living with diabetes, and family dysfunctions. Results of the literature review were similar for all areas: although some studies suggested that these problems are especially severe for people with diabetes, the best-designed studies suggested that this was not so. Regardless of the prevalence of these problems in the diabetic population at large, individuals who suffer from these problems are at special risk for reduced physical and emotional well-being, so they need psychosocial interventions that effectively resolve their difficulties. Unfortunately, the literature on psychosocial interventions in diabetes is meager, and it lacks the systematic, quantitative evaluations necessary to identify effective modes of treatment for different psychosocial problems. It is possible to state tentatively that certain interventions have been used for specific problems with some indication that they can be effective. Issues for future research are identified. Addressing these issues might provide a foundation for making decisions about areas ripe for clinical trials, and ultimately determining which intervention is best suited for treating any given psychosocial problem.

Adult↗
PubMed1991

Differential effect of diabetes education on self-regulation and life-style behaviors.

OBJECTIVE: To examine the effect of diabetes education on self-regulation and life-style behaviors. RESEARCH DESIGN AND METHODS: Participants in an outpatient diabetes education program completed a protocol measuring several self-care behaviors and glycemic control at entry (n = 165) and 6 (n = 124) and 12 (n = 89) mo after the program. RESULTS: Improvement was noted at 6 mo for most self-care behaviors and glycemic control. At 12 mo, lower glycosylated hemoglobin levels were maintained (P less than 0.001) without increases in perceived hypoglycemia. Improvement was not maintained for those self-care behaviors that require change in life-style, i.e., diet and exercise. However, self-care behaviors that allow patients to self-regulate their glycemic control--self-monitoring of blood glucose and insulin dose self-adjustment--were improved at 12 mo over preprogram levels (P less than 0.001). Frequency of insulin self-adjustment continued to increase during the period between follow-ups. CONCLUSIONS: The findings suggest that diabetes education is effective in promoting self-regulation behaviors, although it has less effect on traditional regimen behaviors such as diet and exercise.

Activities of Daily Living↗
PubMed1990

Supplier-induced demand for pastoral care services in the general hospital: a natural experiment.

Assesses the effects the elimination of a pastoral care training program and a reduction in staff had on referral rates for pastoral care. Results showed a decrease in referrals initiated by pastoral care staff but an increase in pastoral care referrals initiated by medical staff and patients. Notes that when pastoral care staff were less available, the demand for their services became more apparent.

Chaplaincy Service, Hospital↗
PubMed1985

Narcotics anonymous: its history, structure, and approach.

Although Narcotics Anonymous (NA) is the oldest and largest self-help group for the support of drug abusers, it has received little study. This paper provides an overview of the history, structure, philosophy, and activities of the NA fellowship based on interviews with members, a survey of the NA literature, and observation at a residential therapeutic community employing the NA approach. The latter data provide a means of analyzing the relationship between NA and those implementing its program. Suggestions for research are advanced in recognition of Narcotics Anonymous as both underground social movement and major treatment modality for drug abusers.

Goals↗
PubMed1984

Anticholeraic effect of methylated casein in rat jejunum.

To explore the antisecretory effect of methylated casein (MC) cholera toxin was placed in isolated jejunal loops, and in vivo water fluxes were measured 3 h later in the presence or absence of MC. Secretion was observed in the loops filled with Ringer's solution only, but net absorption was observed in all 10 loops to which MC was added. Its actions was evident within 20 min, and was exerted directly on the luminal side of the epithelium. This response was dose-dependent and the antisecretory effect vanished after boiling MC and after ultrafiltration. In vitro, the antisecretory effect of MC consisted of reversing net Na and Cl fluxes from secretion to absorption (delta JNanet = 6.18 +/- 1.25 and delta JClnet = 5.10 +/- 1.66 microEq . h-1 . cm-2). This change was due to the enhancement of mucosal to serosal flux. Transepithelial potential difference and tissue conductance did not alter. Interestingly, MC did not interfere with intestinal function in the absence of stimulation by cholera toxin. In the presence of cholera toxin, MC and glucose both stimulated ionic absorption by different mechanisms, MC stimulating neutral NaCl absorption, and glucose stimulating electrogenic Na absorption. MC did not alter basal adenylate cyclase activity but it inhibited the cholera toxin-stimulated increase in activity. The present results indicate that methylated casein inhibits water and electrolyte secretion induced by cholera toxin in rat jejunum. Its availability, low cost, and curative effect from the luminal side constitute compelling indications for further investigation.

Adenylyl Cyclases↗