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Biomedical subjects

A Bergen

Publications and source records attributed to A Bergen.

At least 19 recordsLinked to original sources
PubMed2000

Using language intensity to increase the success of a family intervention to protect children from ultraviolet radiation: predictions from language expectancy theory.

BACKGROUND: Even though people are informed about skin cancer prevention, they do not always comply with prevention advice. From Language Expectancy Theory, it was predicted that messages with high language intensity would improve compliance with sun safety recommendations and that this effect would be enhanced with deductive argument style. METHODS: Parents (N = 841) from a pediatric clinic and elementary schools received sun safety messages (newsletters, brochures, tip cards) by mail that varied in language intensity and logical style. Effects on attitudes and behavior were tested in a pretest-posttest factorial design. RESULTS: As hypothesized, parents receiving messages with high- as opposed to low-intensity language complied more with sun safety advice. Messages with highly intense language were more persuasive when the arguments were formatted in a deductive style; low language intensity was more persuasive in inductively styled messages. CONCLUSIONS: By carefully adjusting messages features, health professionals can obtain further compliance beyond that produced by educating people about health risks and creating favorable attitudes and self-efficacy expectations. Highly intense language may be a good general strategy in prevention messages and works better when conclusions and recommendations are offered explicitly to recipients, especially when advice is aimed at reducing their personal risk.

Assertiveness↗
PubMed2000

Generalising to theory: the use of a multiple case study design to investigate needs assessment and quality of care in community nursing.

This paper outlines the detail of the case study method used in a project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act, 1990. It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a 'policy-practice gap' might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for 'generalising to theory' illustrated.

Community Health Nursing↗
PubMed2000

A taxonomy of needs assessment, elicited from a multiple case study of community nursing education and practice.

The role and expectations of community nurses in carrying out needs assessments changed when an internal quasi-market was introduced to the British health service under the National Health Service (NHS) & Community Care Act 1990. This paper reports on a study commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment in the context of this legislation. A multiple case study design was utilized and four cases identified, incorporating the geographical variation in England. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (n=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. Participants were interviewed after the observation period (n=33 practitioners), to determine the extent of formality they attached to each assessment, and to elicit information about aspects which may be embedded in everyday practice. Single and multiple case analyses across the four cases used an iterative process of pattern-matching, replication logic and explanation building. The preliminary analysis yielded a descriptive 'taxonomy' which could serve as a basis for classifying the variants of needs assessment and help to clarify the whole phenomenon. When applied further to the data, this revealed the complex interactions between the different ideals (relating to policy, nursing and ascribed worth), the various types (purpose, formality/specificity and complexity) and timing (in relation to client, service and practice issues) within needs assessment.

Community Health Nursing↗
PubMed2000

A case for case studies: exploring the use of case study design in community nursing research.

The case study has become an accepted vehicle for conducting research in a variety of disciplines. However, the meaning behind the term is not always made explicit by researchers and this has given rise to a number of assumptions which are open to challenge, and to questions about the robustness of the method. This paper explores some of the issues arising from one particular definition of case study research, used in a study by Yin which examined the practice of case management in community nursing. Four main areas are discussed. First, defining 'case' is seen to pose questions about the relationship of the phenomenon to its context, the degree of researcher control over case definition, the limits to what may constitute a 'case' and what is meant by the term 'unit of analysis'. Second, the relevance of external validity to case study research is supported through the use of a number of tactics, in particular Yin's concept of replication logic, which involves generalizing to theory, rather than to empirical data. Third, the use of method triangulation (multiple methods of data collection) is advanced as a means of enhancing construct validity in research where data converge around a particular theory. Finally, the relationship of the case study to theory construction, through the prior development of 'propositions' is discussed. Each of these issues is applied to the design and conduct of a research study based closely on Yin's multiple case study framework. Thirteen 'cases' were selected of case management practice and data were collected through interviews and examination of literature and documentation, to explore the suitability of community nurses for the role. It is concluded that, given the appropriate subject matter, context and research aims, the case study method may be seen as a credible option in nursing research.

Case Management↗
PubMed1999

Identification of four variants in the tryptophan hydroxylase promoter and association to behavior.

One of the most replicated findings in biological psychiatry is the observation of lower 5-hydroxyindoleacetic acid concentrations, the major metabolite of serotonin, in the brain and cerebrospinal fluid of subjects with impulsive aggression. Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in the synthesis of serotonin, however functional variants have not been reported from the coding sequence of this gene. Therefore, we screened the human TPH promoter (TPH-P) for genetic variants which could modulate TPH gene transcription. The TPH-P (2093 nucleotides) was screened for sequence variation by SSCP analysis of 260 individuals from Finnish, Italian, American Caucasian, and American Indian populations. Four common polymorphisms were identified: -7180T>G, -7065C>T, -6526A>G, and -5806G>T (designated as nucleotides upstream of the translation start site). In the Finns, the four polymorphisms had a minor allele frequency of 0.40 and in this population linkage disequilibrium between the four loci was complete. In the other populations the minor allele frequencies ranged from 0.40 to 0.45. TPH -6526A>G genotype was determined in 167 unrelated Finnish offenders and 153 controls previously studied for the TPH IVS7+779C>A polymorphism. A significant association was observed between -6526A>G and suicidality in the offenders. TPH -6526A>G and the previously reported intron seven polymorphism, TPH IVS7+779C>A, exhibited a normalised linkage disequilibrium of 0.89 in Finns. Normalized linkage disequilibrium was reduced in other populations, being 0.49 and 0.21 in Italians and American Indians, respectively. In conclusion, four TPH-P variants were identified which can be used for haplotype-based analysis to localize functional TPH alleles influencing behavior.

Adult↗
PubMed1999

Ancestral Asian source(s) of new world Y-chromosome founder haplotypes.

Haplotypes constructed from Y-chromosome markers were used to trace the origins of Native Americans. Our sample consisted of 2,198 males from 60 global populations, including 19 Native American and 15 indigenous North Asian groups. A set of 12 biallelic polymorphisms gave rise to 14 unique Y-chromosome haplotypes that were unevenly distributed among the populations. Combining multiallelic variation at two Y-linked microsatellites (DYS19 and DXYS156Y) with the unique haplotypes results in a total of 95 combination haplotypes. Contra previous findings based on Y- chromosome data, our new results suggest the possibility of more than one Native American paternal founder haplotype. We postulate that, of the nine unique haplotypes found in Native Americans, haplotypes 1C and 1F are the best candidates for major New World founder haplotypes, whereas haplotypes 1B, 1I, and 1U may either be founder haplotypes and/or have arrived in the New World via recent admixture. Two of the other four haplotypes (YAP+ haplotypes 4 and 5) are probably present because of post-Columbian admixture, whereas haplotype 1G may have originated in the New World, and the Old World source of the final New World haplotype (1D) remains unresolved. The contrasting distribution patterns of the two major candidate founder haplotypes in Asia and the New World, as well as the results of a nested cladistic analysis, suggest the possibility of more than one paternal migration from the general region of Lake Baikal to the Americas.

Asia↗
PubMed1998

Mutation screening of the 5-hydroxytryptamine7 receptor gene among Finnish alcoholics and controls.

Impaired central serotonin neurotransmission has been associated with increased aggression, impaired impulse control and diurnal activity rhythm disturbances among humans. Neuroanatomic distribution and pharmacological properties of the serotonin 5-HT7 receptor suggest that it may play a role in psychiatric disorders and in circadian rhythm regulation. In this study a point mutation causing proline279 --> leucine amino acid substitution in the 5-hydroxytryptamine7 (5-HT7) receptor gene was discovered. This 5-HT7Leu279 variant was observed in six of 825 individuals, all of whom are heterozygous for the substitution. Three of them are alcoholic offenders (3/255), two are relatives of an offender without the 5-HT7Leu279 allele (2/255) and one is a healthy control without any psychiatric diagnosis (1/248). The allele frequency of the 5-HT7Leu279 variant is 0.004 (6/758) among Finns. Although the 5-HT7Leu279 variant is approximately three times more common among alcoholic offenders than among healthy controls, it is not significantly associated with alcoholism or impulsivity in the present study. The 5-HT7Leu279 allele may, however, be a predisposing allele in a subgroup of alcoholic offenders with multiple behavioral problems.

Adult↗
PubMed1996

Mass allele detection (MAD) of rare 5-HT1A structural variants with allele-specific amplification and electrochemiluminescent detection.

A strategy is described that exploits allele-specific amplification (ASA-PCR) and electrochemiluminescence (ECL) detection technology to rapidly and cheaply screen large numbers of DNAs arranged in pooled matrices in order to identify individual nucleotide sequence variants. To demonstrate this strategy, a large genomic DNA collection was screened for two nucleotide variants in the 5-HT1A serotonin receptor gene and individual heterozygotes were identified. Conversion of two SSCP variants to allele-specific PCR polymorphisms was accomplished, and PCR product capture and ECL detection were enabled by the covalent addition of biotin to allele-specific PCR primers and ruthenium to the nonspecific PCR primer. A two-level DNA pooling strategy was used to reduce the number of individual PCR reactions required. Pooling experiments established that ASA-PCR with ECL detection is sufficiently sensitive to reproducibly detect a single specific allele in the presence of a 40-fold excess of genomic DNA from individuals negative for the specific allele. The detection sensitivity of the ECL device and the design of the pooled DNA arrays reduced the number of PCRs required to detect the rare individuals with the variant sequences by approximately 90%. This strategy is called mass allele detection (MAD).

Alleles↗
PubMed1996

Identification of a Ser857-Asn857 substitution in DRK1 (KCNB1), population frequencies and lack of association to the low voltage alpha EEG trait.

A nonconservative amino acid substitution (Ser857Asn) in the human delayed-rectifier potassium channel DRK1 (KCNB1 locus), a candidate gene for the low voltage alpha electroencephalogram (EEG) trait locus (LVEEG1) at 20q13.2, and its frequency in ethnic population samples are described. The frequency of Asn857 in seven different ethnic population samples, totalling more than 1600 individuals, ranged from zero to greater than 3%. However, no association was found between Asn857 and the low voltage alpha EEG trait (LVA) in a population of 105 subjects assessed for the EEG, 24 of whom actually had LVA.

Alleles↗
PubMed1996

The telephone survey method: a discussion paper.

The telephone survey method is discussed in the light of the experiences of one research team investigating case management practices among nurses working in the community using a multiple-method design. An account is given of the strategies employed to recruit a study sample, minimize non-response and bias and ensure the use of sound practices during data collection. The findings highlight the benefits of using the telephone survey method when recruiting respondents across a wide geographical area and/or working within a continually changing environment. However, the findings also highlight the challenge of non-response caused by non-contact and the resource implications of 'doing more' to recruit key informants via the telephone.

Case Management↗
PubMed1996

Establishing a framework for research: the example of needs assessment.

This paper explains the early planning stage of a study commissioned by the English National Board which will investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act 1990. Two focus groups, comprising 22 participants altogether, generated data which were used to augment and clarify issues explored in an initial literature review. Some of the methodological issues are explained. Traditional community nursing approaches to needs assessment appeared to value process and integration, while the new legislation emphasizes the separateness of assessment; there is a danger that it may be seen as a single event. The consumer views were both supportive and critical about each of the approaches; some important insights were gained, and a confident basis from which to launch the study identified. The approach offers one possible way to clarify the starting point of a project when carrying out a standard literature review seems insufficient. This may occur with under-researched or rapidly changing phenomena, or if a field of interest is the subject of multiple interpretations or lack of consensus.

Community Health Nursing↗
PubMed1994

Characterization of a gene coamplified with Ki-ras in Y1 murine adrenal carcinoma cells that codes for a putative membrane protein.

We report the sequence and genomic organization of a gene linked to Ki-ras in the mouse and coamplified in Y1 murine adrenal carcinoma cells. The entire 4.4-kb cDNA sequence as well as promoter and splice sites for each of the three exons was determined. The gene, designated KRAG (Ki-ras-associated gene) has a CG-rich first exon and promoter region and a long 3' untranslated region and encodes 216 amino acids. The putative 23.9-kDa protein has four potential transmembrane hydrophobic domains. The hydropathy plot resembles that of certain tumor-associated antigens, including CO-029 and ME491. A potential human homologue, EST05985, was identified and provisionally mapped to human chromosome 12, a chromosome syntenic to mouse chromosome 6, the previously mapped location of KRAG.

Adrenal Gland Neoplasms↗
PubMed1994

Case management in the community: identifying a role for nursing.

This paper describes the findings of a questionnaire survey designed to create a picture of current case management practices as they relate to community nursing. Eighty-three questionnaires were analysed in order to identify client groups, nurse details, functions of case management adopted, other services involved, titles used and advantages and disadvantages of the ways of working adopted. Findings suggest that interpretation of, and involvement in, case management is variable and that the practice potential for this model of care warrants further research.

Community Health Nursing↗
PubMed1993

Exploring consumer views of care provided by the Macmillan nurse using the critical incident technique.

This study focuses on descriptive accounts of one Macmillan nurse's work, as provided by key individuals coming into contact with this specialist professional service. Twenty respondents (eight patients, five carers, five district nurses and two general practitioners) were interviewed using a variation of the critical incident technique. Data were analysed in terms of meaningful observed events (critical happenings) that were perceived as effective or ineffective with respect to the delivery of high-quality nursing care. Some variations were found between groups of respondents in their perception of the nurse's role. However, there was a general emphasis on the possession of specialist knowledge of terminal cancer care and the positive impact of interventions to both the patient and to lay and professional carers. The critical incident technique was found to be a valuable method for eliciting detailed accounts of the work of the nurse in this specialized field of practice.

Attitude of Health Personnel↗
PubMed1992

Evaluating nursing care of the terminally ill in the community: a case study approach.

A multiple case study approach was used to evaluate the care of terminally ill people in the community of one Health Authority. Nine patients, and their visiting district and continuing care nurses, were interviewed to determine their different perspectives on need identification and resolution, using the Standard on Care of the Dying as a framework. Data were subjected to content analysis and categorized in relation to theory emerging from the literature. Needs were felt to be generally well met by the nurses, and patients indicated no serious areas of omission. However, a number of recurrent problems and issues were highlighted and recommendations put forward to redress them.

Caregivers↗