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Biomedical subjects

J Paley

Publications and source records attributed to J Paley.

11 recordsLinked to original sources
PubMed2003

Factor V Leiden detection by polymerase chain reaction-restriction fragment length polymorphism with mutagenic primers in a multiplex reaction with Pro G20210A--a novel technique.

Factor V Leiden (FVL) R506Q and Prothrombin G20210A are clinically important genetic mutations associated with increased susceptibility to venous thrombosis. The objective of our study was to design a polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) reaction that allows simultaneous detection of these two mutations. The reaction can be used in routine diagnostic settings. We have analysed 4504 alleles for each mutation with a mutagenic primer-based PCR system with a low failure rate. The system eliminates the false positive FVL G1691A results associated with other PCR/RFLP caused by rare confounding mutations adjacent to restriction endonuclease recognition sites. This multiplex PCR/RFLP reaction is rapid, robust and dependable.

3' Untranslated Regions↗
PubMed2001

An archaeology of caring knowledge.

BACKGROUND: There have been repeated attempts, especially during the last 20 years, to say precisely what caring in nursing is. Authors who undertake this task usually begin with the observation that the concept of caring is complex and elusive, and suggest that their contribution will help to clarify this most confused of notions. However, they are always followed by other authors, who do exactly the same thing. We seem to be no closer, now, to a clarification of caring than we have ever been. AIM: The paper offers a diagnosis of this situation, and explains why the project of retrieving caring from its elusiveness is an impossible one. I will suggest that this has nothing to do with the concept of caring, as such. Rather, the impossibility of the task follows from what these authors take to be knowledge of caring. METHOD: I present an analysis of some presuppositions about what knowledge is. These presuppositions pervade the literature on caring, and can be summarized as follows: knowledge of caring is an aggregate of things said about it, derived from a potentially endless series of associations, grouped into attributes on the basis of resemblances, and conceived as a holistic description of the phenomenon. Further, I suggest that this analysis is akin to the one which Foucault offers of sixteenth century knowledge. CONCLUSIONS: The analysis suggests that this way of knowing is approximately 350 years out of date, and explains why the task of arriving at knowledge (in this sense) is impossible. Moreover, Foucault's claim that sixteenth century knowledge is "plethoric yet absolutely poverty-stricken" applies, with equal force, to nursing's knowledge of caring.

Cultural Characteristics↗
PubMed2001

Positivism and qualitative nursing research.

Despite the hostility to positivism shown by qualitative methodologists in nursing, as in other disciplines, the epistemological and ontological instincts of qualitative researchers seem to coincide with those of the positivists, especially Bayesian positivists. This article suggests that positivists and qualitative researchers alike are pro-observation, proinduction, pro-plausibility and pro-subjectivity. They are also anti-cause, anti-realist, anti-explanation, anti-correspondence, anti-truth. In only one respect is there a significant difference between positivist and qualitative methodologists: most positivists have believed that, methodologically, the natural sciences and the social sciences are the same; most qualitative researchers are adamant that they are not. However, if positivism fails as a philosophy of the natural sciences (which it probably does), it might well succeed as a philosophy of the social sciences, just because there is a methodological watershed between the two. Reflex antagonism to positivism might therefore be a major obstacle to understanding the real reasons why qualitative research and the natural sciences are methodologically divergent; and less hostility on the part of qualitative nurse researchers might bring certain advantages in its wake.

Humans↗
PubMed2000

Asthma and dualism.

The rejection of Cartesian dualism can be taken to imply that the mind is implicated in health and illness to a greater degree than conventional medicine would suggest. Surprisingly, however, there appears to be a train of thought in antidualist nursing theory which takes the opposite view. This paper looks closely at an interesting example of antidualist thinking - an article in which Benner and her colleagues comment on the ways in which people with asthma make sense of their condition - and concludes that it places unduly stringent and arbitrary limits on the mind's role. It then asks how antidualism can lead to such a dogmatic rejection of the idea that states of the body are clinically influenced by states of mind. The answer to this question is that Benner assimilates very different philosophical theories into the same 'tradition'. On this occasion, she has combined Descartes, Kant and the Platonist ascetics into a single package, misleadingly labelled 'Cartesianism', and this move accounts for her unexpected views on the relation between mind and body in asthma.

Asthma↗
PubMed2000

Paradigms and presuppositions: the difference between qualitative and quantitative research.

The difference between qualitative and quantitative approaches to research is often said to be grounded in two distinct paradigms, each with its own, mutually contradictory, philosophical presuppositions. Quantitative research, the argument goes, presupposes objective truths and a singular, unequivocal reality; qualitative research presupposes a world which is inherently subjective, with no unequivocal reality. In this article, I try to show that the 'paradigm' interpretation of the difference between quantitative and qualitative research comes very close to being incoherent, since it either slides into extreme relativism or ends up contradicting itself. I argue, instead, that qualitative methods and quantitative methods are simply tools, fit for a range of scientific purposes. In common with other tools, whether maps or cutlery, they are useful in different types of situations; and it is rather strange to think that they have philosophical presuppositions 'built into' them. I illustrate this idea by comparing motorway maps with surveys and Ordnance Survey maps with ethnography. The article concludes by proposing an explanation of why it is tempting to argue in favour of the 'paradigm' interpretation, but also suggests that this is the wrong strategy.

Anthropology, Cultural↗
PubMed1998

Misinterpretive phenomenology: Heidegger, ontology and nursing research.

This paper argues that Heidegger's phenomenology does not have the methodological implications usually ascribed to it in nursing literature. The Heidegger of Being and Time is not in any sense antagonistic to science, nor does he think that everydayness is more authentic, more genuine, than scientific enquiry or theoretical cognition. It is true that social science must rest on interpretive foundations, acknowledging the self-interpreting nature of human beings, but it does not follow from this that hermeneutics exhausts all the possibilities. Positivist approaches to social science are certainly inconsistent with Heidegger's ontology, but realist approaches are not and structuration theory, in particular, can be seen as a sociological translation of his ideas. Social enquiry in nursing is not therefore confined to studies of lived experience. Indeed, lived experience research constitutes not a realization, but rather a betrayal, of Heidegger's phenomenology, being thoroughly Cartesian in spirit.

Existentialism↗
PubMed1997

Husserl, phenomenology and nursing.

Discussions of phenomenological research in nursing consistently appeal to either Husserl or Heidegger in justifying the technical and conceptual resources they deploy. This paper focuses on Husserl, and examines the relationship between his phenomenology and the accounts of it that are to be found in the nursing literature. Three central ideas are given particular attention: the phenomenological reduction, phenomena, and essence. It is argued that nurse researchers largely misunderstand these concepts and that, as a result, their version of Husserl's philosophy bears little resemblance to the original. A further consequence is that the project of identifying the 'essential structure' of a phenomenon, typically adopted by the nurse researchers who cite Husserl as an authority, comes close to being unintelligible. It is suggested that, while the methods used in 'phenomenological' nursing research may still have some legitimacy, they cannot achieve what they are alleged to achieve, and they should be detached from the framework of Husserlian ideas and terminology which is supposed to justify them.

Humans↗
PubMed1996

How not to clarify concepts in nursing.

Concept analysis and conceptual clarification form an identifiable genre within the nursing literature, with most recent examples drawing on the model proposed by Walker & Avant (1988). This paper argues that the Walker & Avant model is based on untenable assumptions, and that the writings of those who adopt it inevitably contain a serious flaw that vitiates the procedure and renders the results arbitrary. In particular, the relationship between concept and theory, a topic to which the philosophy of science has devoted much attention, has been misunderstood by these authors. Concepts are not the 'building blocks' of theory, but the niches created by theory; and any 'conceptual clarification' that anticipates theoretical commitment becomes a vacuous exercise in semantics.

Concept Formation↗
PubMed1996

Intuition and expertise: comments on the Benner debate.

The rift between "science' and "phenomenology' in current nursing theory is explored through an examination of two recent evaluations of the work of Patricia Benner, who has proposed a model of skill acquisition, latterly within a Heideggerian framework. English offers a critique of Benner's ideas from the perspective of cognitive psychology; while Darbyshire defends them against what he describes as a "positivist' attack. No attempt is made, in this paper, to evaluate Benner's work directly, but Darbyshire's response to the "critique' is analysed; and it is noted that, in making his defence, he invokes a network of concepts which he ascribes to a "traditional notion of objective science', and accuses English of subscribing to it. It is suggested that this "Cartesian' worldview is an outmoded myth, superseded by the philosophy of science during the last 30 years, and based on the rhetoric rather than the reality of scientific practice. Nursing is not, therefore, obliged to choose between "positivism' and a philosophy whose chief virtue is that it represents a "challenge' to positivism. It could instead build a scientific basis for research and theory by drawing, not on mid-century thinking, but on a more contemporary understanding of the nature of science.

Clinical Competence↗