Biomedical subjects

P Meek

Publications and source records attributed to P Meek.

8 recordsLinked to original sources

PubMed2000

Fatigue patterns observed in patients receiving chemotherapy and radiotherapy.

The purpose of this study was to describe the patterns of cancer-related fatigue (CRF) and vigor in patients receiving chemotherapy or radiation therapy. Five studies that measured fatigue and vigor with the Profile of Mood States were used to describe the pattern of CRF and vigor during and after both types of treatment. Repeated-measures ANOVA was used to determine differences over time in each study. Results demonstrate different patterns of CRF for patients receiving chemotherapy and radiation therapy. Chemotherapy-related CRF peaks in the days after chemotherapy, whereas radiation therapy-related CRF gradually accumulates over the course of treatment. The CRF associated with both forms of treatment gradually declines over time. The prevalence, intensity, and persistence of CRF during treatment and for months after treatment is complete make this symptom one that cannot be ignored.

Adolescent↗

PubMed1999

Contingency contracting with monetary reinforcers for abstinence from multiple drugs in a methadone program.

Positive monetary contingencies for treating opioid dependence complicated by other drug use were examined. Participants (N = 102) entered 6-month methadone transition treatment (MTT) and were randomized into experimental conditions: 51 entered MTT with contingency contracts using monetary reinforcers and targeting abstinence from illicit drug and alcohol use, and 51 entered MTT without contingency contracts targeting abstinence. Outcomes were evaluated by random urinalysis and breath analysis. After 4 months of treatment, individuals in the contingency condition had longer periods of continuous abstinence (p<.005) and more drug-free tests overall (p<.04). Effects were limited, however, to the contracting period. The authors conclude that contingency contracting using monetary reinforcers may be a useful adjunct for achieving abstinence from multiple drugs of abuse during MTT.

Adolescent↗

PubMed1999

A cost-effectiveness and cost-benefit analysis of contingency contracting-enhanced methadone detoxification treatment.

We examined treatment costs in an ongoing study in which 102 opioid-addicted patients had been randomly assigned to either 180-day methadone detoxification or the same treatment enhanced with contingency contracting. In the latter condition, study participants received regular reinforcers contingent on negative urine toxicology screens and breath analyses for a range of drugs and alcohol. Both conditions involved psychosocial treatment, and all participants were stabilized to a daily methadone dose of approximately 80 mg during the first 4 months, followed by a 2-month taper. Individuals participating in the enhanced condition were more likely to provide continuously drug-free urine samples and alcohol-free breath samples during the final month of treatment than were participants in the control condition. Cost of treatment was calculated individually for each participant based on actual services received. First, unit cost for each service was determined, including adjusted staff salaries for direct treatment and opportunity cost of facilities utilized during service delivery. Next, we valued each patient's use of services during the first 120 days of the study and then added the cost of methadone, laboratory work, and contingent reinforcers. A subsample (n = 45) also provided data on health care utilization during treatment, which we valued using standard Medicare unit costs. The marginal cost of enhancing the standard treatment with contingency contracting was approximately 8%. An incremental cost of $17.27 produced an additional 1% increase in the number of participants providing continuously substance-free urine and breath samples during month 4 of the study. For every additional dollar spent on treatment, a $4.87 health care cost offset was realized; however, this difference was statistically insignificant due to extreme variances and small subsample size.

Cost-Benefit Analysis↗

PubMed1999

Additional construct validity of the Schwartz Cancer Fatigue Scale.

The purpose of this article is to report the results of additional construct validity testing of the Schwartz Cancer Fatigue Scale. Latent variable modeling was used to determine the best fit of the data to the model. Testing with a heterogeneous sample (n = 303) did not support the proposed model. Using exploratory techniques a six-item, two-factor scale was formed which demonstrated that all measures of fit were consistently strong, and that the standardized solution factors loaded strongly. Reliabilities for the total scale and subscales were all greater than 0.80. These results provide preliminary support for the reliability and validity of the two-factor model of the six-item Schwartz Cancer Fatigue Scale.

Adult↗

PubMed1998

Perception of fatigue and quality of life in patients with COPD.

INTRODUCTION: Although dyspnea is considered the primary activity-limiting symptom in patients with COPD, other symptoms, such as fatigue, are frequently reported. The purpose of this study was to determine the relationship between fatigue and pulmonary function, exercise tolerance, depression, and quality of life in patients with COPD. METHODS: Forty-one patients (age = 62+/-8 years; FEV1 = 1.08+/-0.55 L; FEV1 percent predicted = 35.8+/-17%) from two sites participated in the study. Spirometric measures of pulmonary function were carried out in each patient. The Multidimensional Fatigue Inventory was used to measure five subscales of fatigue: general, physical and mental fatigue, reduction in activity, and reduction in motivation. The St. George Respiratory Questionnaire, used to measure quality of life, has three subscale dimensions (symptom, activity, and impact), as well as an overall or total quality of life score. Depression was measured with the Centers of Epidemiological Studies Depression Scale. In 19 patients, exercise tolerance was determined with the 6-min walking distance. RESULTS: General fatigue correlated with FEV1, percent predicted (r = -0.32, p < 0.05), exercise tolerance (r = -0.55, p < 0.05), depression (r = 0.44, p < 0.01), and overall quality of life (r = 0.75, p < 0.01). Among the dimensions of fatigue, depression correlated with general and mental fatigue only. Physical dimensions of fatigue correlated with an increase in the severity of pulmonary impairment and reduction in exercise tolerance. The cognitive components of fatigue, such as reduction in motivation and mental fatigue, were not found to be highly correlated with physical dimensions of quality of life. All five subscales of fatigue showed relationship to the functional impact dimension and total impairment score in quality of life. CONCLUSIONS: These data show a relationship between dimensions of fatigue and pulmonary function, exercise tolerance, and quality of life in COPD. Based on these results, fatigue is an important symptom requiring evaluation and management in patients with COPD. These data clarified also the relationship between depression and fatigue in this patient population.

Exercise Tolerance↗

PubMed1997

Perspectives unifying symptom interpretation.

PURPOSE: To introduce the symptom interpretation model (SIM) and facilitate understanding symptoms from an intrapersonal perspective. Determining an individual's interpretation of symptoms is critical to understanding the resulting decisions. ORGANIZING CONSTRUCT: SIM is based on an illness representation model, knowledge structures theory, and propositions about reasoning. Individuals name and assign meaning to environmental stimuli. Based on this interpretation, behaviors are selected for symptom management. METHODS: Theory derivation was used to develop SIM for understanding comparisons of known and new symptoms in a behavioral outcomes context. CONCLUSIONS: Symptom familiarity reinforces patterns about symptom management. SIM enriches understanding of symptom experiences. Comprehensive assessment, including the intraindividual perspective, is essential to successful symptom management.

Disease↗

PubMed1990

Topographic segmentation of waking EEG in medication-free schizophrenic patients.

Lehmann has demonstrated that EEG topography can be used to segment EEG map series into a sequence of spatially stationary segments characterized by location of potential maxima and minima. We employed topographic segmentation techniques to study 9 channel EEGs recorded from 11 medication-free schizophrenic patients and 10 normal controls during resting and active task conditions, retesting 8 patients after neuroleptic treatment. To define EEG segments, average reference potential maps corresponding to global field power peaks in theta, alpha, and low beta activity were classified according to locations of extreme minimum and maximum values. Normals and schizophrenics did not differ in the number or types of switches between segments, or the frequency of hemisphere crossing of potential extrema. However, EEGs of normal subjects were characterized by significantly more (P less than 0.003) unused theta segment types (of a theoretically possible 36). Moreover, medication significantly (P less than 0.02) increased the number of unused theta segment types in EEGs of schizophrenics. We interpret these findings as evidence of increased spatial variability of brain electrical activity in schizophrenics and discuss their functional implications.

Adult↗

PubMed1989

The variety of relations between spatial frequency and reaction time.

While stimuli of lower spatial frequency often result in faster responses, this is not invariably the case. Some individuals respond faster to high frequency stimuli on tasks for which most others respond faster to low frequency stimuli. Past experience can also determine the degree to which a low frequency stimulus will mask a high frequency stimulus. These observations suggest that the effects of spatial frequency on visual information processing are under the control of higher level cognitive operations.

Adult↗