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At least 433 records · Page 24Linked to original sources

PubMed1987

Anatomical dissociation of the substrates of medial forebrain bundle self-stimulation and exploration.

The purpose of this research was to determine whether brain stimulation reward and exploration are induced by activation of the same set of neurons along the medial forebrain bundle. The behavioral version of the collision test was utilized with electrodes in the lateral hypothalamus (LH) and the ventral tegmental area (VTA). A collision effect obtained between LH and VTA in one behavior at the exclusion of the other was treated as evidence of the involvement of two different sets of fibers. In 4 rats, a collision effect was observed only in self-stimulation, whereas in 1 rat, a collision was obtained in exploration at the exclusion of self-stimulation. Three animals showed no collision in either behavior. These data suggest that coexistence of self-stimulation and exploration following medial forebrain bundle stimulation can be explained by current spread on two different sets of fibers.

Animals↗

PubMed2001

Effect of age on object exploration, habituation, and response to spatial and nonspatial change.

To measure their ability to detect novel arrangements in a given environment, young (6 months old) and senescent (22-24 months old) male F344 rats were repeatedly exposed to a given spatial configuration of objects contained in an open field. After the rats were habituated to the novel environment (1 trial with no objects, followed by 3 trials with 5 salient objects), the spatial arrangement of the objects was modified (2 trials), and object novelty was tested (2 trials) by substituting a familiar object with a new one at the same location (nonspatial change). The results indicated that the senescent rats explored old objects less than young rats, particularly on Trial 2. On the 1st trial with displaced objects (Trial 5), the senescent rats explored the displaced objects less than the young rats. However, when a new object was placed in the field (Trials 7-8), there were no age differences in new object exploration. These results suggest that senescent rats have decrements in the ability to build spatial representations of the environment and to use this information to detect such changes, even though object recognition is not impaired with age.

Aging↗

PubMed2004

Feedback specificity, exploration, and learning.

Greater feedback specificity is generally considered to be beneficial for performance and learning, but the evidence for this generalization is limited. The authors argue that increasing the specificity of feedback is beneficial for initial performance but discourages exploration and undermines the learning needed for later, more independent performance. The results of their transfer experiment demonstrate that increasing the specificity of feedback positively affected practice performance, but its benefits did not endure over time or modification of the task. In addition, feedback specificity negatively affected levels of exploration during practice and interacted with exploration strategies to affect learning. The results suggest that those who received feedback of varying specificity may have learned through different but equally beneficial mechanisms.

Adult↗

PubMed1979

L-Dopa repairs deficits in locomotor and investigatory exploration produced by denervation of catecholamine terminal fields in the forebrain of rats.

In a previous study rats were shown to have decreased locomotor and investigatory exploration after bilateral microinjections of 6-hydroxydopamine into the anterolateral hypothalamus. These deficits correlate with the loss of catecholamine terminals in neocortical, limbic, and anteromedioventral striatal brain sites. To test whether this correlation was causal, central catecholamines were increased by the intraperitoneal administration of L-3,4-dihydroxyphenylalanine (L-dopa), 10--40 mg/kg) after inhibition of extracerebral L-amino acid decarboxylase. Such treatment repaired the deficits in locomotor exploration and investigation in 6-hydroxydopamine rats. Pretreatment with the catecholamine antagonist chlorpromazine (1--2 mg/kg) blocked the increase in locomotor exploration and investigation produced by L-dopa in 6-hydroxydopamine rats. The results suggest, but do not prove, that L-dopa produced these behavioral effects by increasing central catecholamines at the denervated catecholamine receptor sites in the forebrain. These data and the data from the previous study are complementary evidence for the hypothesis that forebrain catecholamine synaptic action is necessary for normal exploratory behavior.

Animals↗

PubMed1998

Spatial exploration induces a persistent reversal of long-term potentiation in rat hippocampus.

Experience-dependent long-lasting increases in excitatory synaptic transmission in the hippocampus are believed to underlie certain types of memory. Whereas stimulation of hippocampal pathways in freely moving rats can readily elicit a long-term potentiation (LTP) of transmission that may last for weeks, previous studies have failed to detect persistent increases in synaptic efficacy after hippocampus-mediated learning. As changes in synaptic efficacy are contingent on the history of plasticity at the synapses, we have examined the effect of experience-dependent hippocampal activation on transmission after the induction of LTP. We show that exploration of a new, non-stressful environment rapidly induces a complete and persistent reversal of the expression of high-frequency stimulation-induced early-phase LTP in the CA1 area of the hippocampus, without affecting baseline transmission in a control pathway. LTP expression is not affected by exploration of familiar environments. We found that spatial exploration affected LTP within a defined time window because neither the induction of LTP nor the maintenance of long-established LTP was blocked. The discovery of a novelty-induced reversal of LTP expression provides strong evidence that extensive long-lasting decreases in synaptic efficacy may act in tandem with enhancements at selected synapses to allow the detection and storage of new information by the hippocampus.

Animals↗

PubMed1999

Exploring the new world of the genome with DNA microarrays.

Thousands of genes are being discovered for the first time by sequencing the genomes of model organisms, an exhilarating reminder that much of the natural world remains to be explored at the molecular level. DNA microarrays provide a natural vehicle for this exploration. The model organisms are the first for which comprehensive genome-wide surveys of gene expression patterns or function are possible. The results can be viewed as maps that reflect the order and logic of the genetic program, rather than the physical order of genes on chromosomes. Exploration of the genome using DNA microarrays and other genome-scale technologies should narrow the gap in our knowledge of gene function and molecular biology between the currently-favoured model organisms and other species.

Animals↗

PubMed1999

Changing roles and identities in primary health care: exploring a culture of uncertainty.

This paper highlights a key area of analysis emerging from research undertaken in order to explore cultural differences between medicine and nursing, and implications for primary care. Concerns about the role of nursing in primary health care within the UK are of particular interest to the authors. A specific concern centres on the movement of health care work from one group of health workers to another, in particular from doctors to nurses. A number of studies show that work is moving from doctors to nurses and explore the policy drivers, notably the pressure to improve the cost-effectiveness of care. However, few studies reflect on how ideas, values and beliefs are being challenged, confirmed and used to justify new roles and identities. We are interested in exploring this latter aspect of the movement of health care work, and argue that changing roles and identities create a culture of uncertainty which has important implications for the future of primary health care nursing.

Cross-Cultural Comparison↗

PubMed2000

Exploration of the concept of hope in the Dominican Republic.

An ethnonursing study explored What is the meaning of hope (esperanza/esperar) to the Dominican people? What is the importance of the concept of hope to the people of the Dominican Republic? What are the universals and diversities in the meaning of hope for this cultural group and United States' (US) mainstream culture? Hope has been considered universal and recent research has demonstrated the effect of levels of hope or hopelessness on health. Nurse researchers have explored the meaning of hope to patients in the US and have developed instruments to measure levels of hope. However, little research has explored whether hope has different attributes in various cultural groups. From data gathered in a rural Dominican village, a definition of hope and its attributes were developed: 'Hope is an essential but dynamic life force that grows out of faith in God, is supported by relationships, resources and work, and results in the energy necessary to work for a desired future. Hope gives meaning and happiness'. This definition and its attributes were compared with definitions developed from research among mainstream US populations to propose universals and diversities of hope.

Adolescent↗

PubMed2001

The relationship between attendance at birth and maternal mortality rates: an exploration of United Nations' data sets including the ratios of physicians and nurses to population, GNP per capita and female literacy.

UNLABELLED: The relationship between attendance at birth and maternal mortality rates: an exploration of United Nations' data sets including the ratios of physicians and nurses to population, GNP per capita and female literacy. BACKGROUND: This is the third and final paper drawing on data taken from United Nations (UN) data sets. The first paper examined the global distribution of health professionals (as measured by ratios of physicians and nurses to population), and its relationship to gross national product per capita (GNP) (Wharrad & Robinson 1999). The second paper explored the relationships between the global distribution of physicians and nurses, GNP, female literacy and the health outcome indicators of infant and under five mortality rates (IMR and u5MR) (Robinson & Wharrad 2000). In the present paper, the global distribution of health professionals is explored in relation to maternal mortality rates (MMRs). The proportion of births attended by medical and nonmedical staff defined as "attendance at birth by trained personnel" (physicians, nurses, midwives or primary health care workers trained in midwifery skills), is included as an additional independent variable in the regression analyses, together with the ratio of physicians and nurses to population, female literacy and GNP. AIM: To extend our earlier analyses by considering the relationships between the global distribution of health professionals (ratios of physicians and nurses to population, and the proportion of births attended by trained health personnel), GNP, female literacy and MMR. <Design. Using a database on 155 countries, regression analyses were performed using numbers of physicians, and numbers of nurses, per 1000 population, the proportion of births attended by trained health personnel, GNP per capita and female literacy as independent variables and MMRs as the dependent variable. RESULTS: Linear regression analyses show positive associations for MMRs and the ratios of physicians to population (73%, n=136), ratios of nurses to population (56%, n=137), and the proportion of births attended by trained health personnel (83%, n=118). Multiple regression analyses reveal a more complex picture, with nurses disappearing altogether when regressed with physicians, GNP, female literacy and MMR. The three variables, attendance at birth by trained personnel, GNP and physicians per 1000 population explained 87% of the variation in MMR (n=112) when included in the multiple regression analysis. CONCLUSIONS: As in the previous papers, caution is required regarding the validity and reliability of the UN data sources used in these analyses. Maternal mortality rates are particularly susceptible to inaccuracies. Nevertheless, the strength of the positive correlations suggests that real relationships are identified between the independent variables and the dependent variable of MMR. The strength of the linear and multiple correlations between births attended by trained personnel and lower MMRs indicates that maternal deaths are substantially reduced when a high proportion of births are attended by health professionals, including primary health care workers trained in midwifery skills, with the maintenance of an aseptic environment, the identification of maternal and foetal complications, and the opportunity when necessary to transfer parturient mothers to centres with higher level skills and facilities.

Bias↗

PubMed2002

Developing an understanding of gender sensitive care: exploring concepts and knowledge.

BACKGROUND: In the United Kingdom (UK), concern about inequalities in health and health care has led to interest in gender sensitivity in health policy and practice. AIM: To develop an understanding of possibilities for gender sensitive care through exploring the concepts of gender and gender sensitivity and through reviewing relevant knowledge about gender and health. METHODS: The dimensions of the concept of gender and theories explaining gender relations are explored through a review of key social science texts. A discussion of gender sensitivity draws on Bowden's analysis of gender sensitive ethics. A literature review of evidence about gender and health identifies relevant knowledge for gender sensitive care. FINDINGS: Seven features of the concept of gender are identified. Gender sensitivity involves an understanding of the socio-political context of experience and relationships. The social context also affects health. Differences in male and female mortality and morbidity rates are likely to be related to differences in economic resources, differences in men and women's position in public and private worlds, to power in social relations and to sexuality and body image. Possibilities for gender sensitive care may be supported through feminist approaches and through a postmodernist understanding of the manner in which discourses shape our understanding of gender and gender relations. Valuing care is a feature of gender sensitivity. CONCLUSION: Gender sensitive care involves recognizing the significance of research related to social influences on health and understanding nursing in its socio-political context, and care in the context of gender relations. Experiential learning can synthesize learning across varied learning modes, bridging learning through experience and formal analysis. Exploring concepts, evidence about gender and health and personal experience will all be important in the development of gender sensitive care.

Body Image↗

PubMed2003

Exploring childhood immunization uptake with First Nations mothers in north-western Ontario, Canada.

BACKGROUND: Childhood immunization is an important component of preventive health care for young children. Successful control of vaccine-preventable diseases depends on high levels of immunization coverage. Immunization statistics show that on-reserve First Nations (Native Indian) children have lower vaccination coverage than children in the general Canadian population. There has been little research, however, conducted with First Nations populations on this topic. AIM OF THE STUDY: This study explored First Nations parents' beliefs about childhood immunizations and examined factors influencing immunization uptake. METHODS: This study used a qualitative descriptive design to explore the issue of childhood immunization uptake. Twenty-eight mothers from two First Nations communities in north-western Ontario, Canada, were interviewed about their perceptions of childhood immunizations and vaccine-preventable diseases. The interviews were transcribed and content analysis was used to examine the data. FINDINGS: Data analysis revealed the following six themes: (1) the fear of disease; (2) the efficacy of immunizations; (3) the immunization experience; (4) the consequences of immunization; (5) interactions with health professionals; and (6) barriers to immunizations. Participants were motivated to seek immunizations for their children by a fear of vaccine preventable diseases. A small proportion of mothers, however, questioned the effectiveness of vaccines in preventing disease. Traumatic immunization experiences, vaccine side-effects and sequelae, negative interactions with health professionals, and barriers such as time constraints and childhood illnesses all served as deterrents to immunization. CONCLUSIONS: The research outcomes highlight the varied beliefs of First Nations parents about childhood immunizations and the numerous factors that both positively and negatively influence immunization uptake. Further research is needed to explore the issue of childhood immunizations in First Nations communities and to determine strategies to improve uptake.

Adolescent↗

PubMed2004

Varicose veins: a qualitative study to explore expectations and reasons for seeking treatment.

BACKGROUND: Patients experience a wide range of symptoms from varicose veins and are seeking treatment from health care providers. However, there is little data on the relative effectiveness of the treatments available. Patients are therefore often confronted with a choice regarding treatment that they are ill-equipped to make. This lack of certainty and the resultant potential for variability in treatment decisions can mean that patients have expectations that are unrealistic or unfulfilled. AIMS AND OBJECTIVES: The aim of our study was to explore patients' expectations and reasons for seeking treatment for varicose veins. Additional aims included the exploration of symptoms associated with varicose veins and their impact on quality of life. DESIGN: Qualitative study conducted in a large NHS Trust. METHODS: A total of 16 patients, who had been referred to a specialist vascular service for the treatment of varicose veins, were recruited. Semi-structured interviews were used to explore the patients' reasons for seeking treatment. Framework analysis was used to analyse the data from the anonymized transcripts. RESULTS: Participants attributed a wide range of symptoms to their varicose veins, and were actively seeking treatment with the expectation that they would gain symptom relief. The symptoms attributed to their varicose veins had a significant negative impact on their quality of life and lifestyle. Improving the cosmetic appearance of their legs was seen as a secondary benefit. CONCLUSIONS: The perceived symptoms of varicose veins can impact on lifestyle and quality of life. Patients seek treatment with the expectation of treatment outcomes that are not supported by robust clinical evidence. Appropriate education and management of such expectations are an essential step in caring for this group of patients. RELEVANCE TO CLINICAL PRACTICE: Nurses are caring for patients with varicose veins in a range of clinical settings. When caring and providing information for this group of patients, nurses need to be aware of the impact of varicose vein symptoms and to understanding that patients may have unrealistic expectations or invalid reasons for seeking treatment.

Adult↗

PubMed2003

Recognizing childhood illnesses and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana.

OBJECTIVES: Interventions that promote appropriate care-seeking for severely ill children have the potential to substantially reduce child mortality in developing countries, but little is known about the best approach to address the issue. This paper explores the relative importance of illness recognition as a barrier to care-seeking and the feasibility and potential impact of improving recognition. METHODS: The study combined qualitative and quantitative methods including in-depth interviews exploring the local illness classification system, a Rapid Anthropological Assessment (RAA) recording narratives of recent episodes of child illness and a survey designed to test the hypotheses that emerged from the RAA. RESULTS: Several danger symptoms were not recognized by caregivers. There were recognition problems which may not be feasibly addressed in an intervention. Other significant care-seeking barriers included classifying certain illnesses as 'not-for-hospital' and untreatable by modern medicine; problems of access; and frequent use of traditional medicines. CONCLUSION: The recognition component of any care-seeking intervention should identify the type of recognition problem present in the community. Many of the care-seeking barriers identified in the study revolved around the local illness classification system, which should be explored and built on as part of any care-seeking intervention.

Adult↗

PubMed2002

Exploring nursing expertise: nurses talk nursing.

It has become increasingly important for practitioners to articulate their expertise in modern healthcare settings that demand high levels of accountability and evidence-based practice. The material presented within this article has been interpreted drawing from discourse analysis1 to help explore the discourses that shape and influence understandings of nursing practice. What we present are extracts from four of the 35 participant nurses who applied to take part in the Royal College of Nursing Institute's Expertise in Practice (pilot) Project (EPP). The material presented is used to provide a starting point for exploring how nurses talk about and construct expertise in nursing practice. The four nurse participants' clinical practice areas cover palliative care, mental health, intensive care and fertility care. The material reveals high levels of intensity in the nurse-patient relationship, 'maverick' nursing practices and ongoing reflexivity. All of these aspects appear to capitalize on expertise as a 'catalyst' that alters treatment pathways and maximizes patient-centred outcomes. Exploring a discourse of nursing expertise exposes the tacit situated nature of professional practice that is heterogeneous and most difficult to articulate and explain. It is proposed that expertise tends to be understood from traditional and dominant discourses of medicine, management and technology. Explaining expertise in practice exposes non-conventional practice that in itself can be isolating and challenging to the status quo of contemporary health-care.

Clinical Competence↗

PubMed2002

Screening for Type 2 diabetes: an exploration of subjects' perceptions regarding diagnosis and procedure.

AIM: To explore the psychological impact of a stepwise population-screening project for Type 2 diabetes. METHODS: As part of a stepwise population screening project for Type 2 diabetes in the Hoorn region, The Netherlands, an explorative interview study was conducted. The psychological impact of screening was studied using semistructured interviews in 40 subjects: 20 who were diagnosed with Type 2 diabetes, and 20 subjects who were at increased risk of having diabetes but who did not meet criteria for diabetes. Transcripts were analysed using techniques of content analysis. RESULTS: Newly diagnosed subjects reported limited understanding of their elevated blood glucose levels. None, with the exception of one, was alarmed by the diagnosis. Having Type 2 diabetes was not experienced as severe and no concerns were expressed. Adjusting diet was perceived as a major change by some. All newly diagnosed subjects had informed close relatives and friends of the diabetes, who were in general not alarmed by the news. Both groups positively judged the screening procedure. In general the screening procedure was considered as useful and not experienced as burdensome. CONCLUSIONS: This explorative study suggests that the psychological impact of screening in newly diagnosed subjects is limited. Both those who were and those who were not diagnosed with Type 2 diabetes judged the screening procedure positively.

Attitude to Health↗

PubMed2005

Preoperative use of enoxaparin increases the risk of postoperative bleeding and re-exploration in cardiac surgery patients.

OBJECTIVE: The purpose of this study was to investigate if the preoperative use of new platelet inhibitors and low-molecular-weight heparins may contribute to bleeding after cardiac surgery. DESIGN: Retrospective data review. SETTING: University teaching hospital. PARTICIPANTS: One hundred eleven patients divided in 5 groups. INTERVENTIONS: Patients were grouped according to preoperative antithrombotic regimen: group 1, control, no agents (n=55); group 2, clopidogrel (n=9); group 3, enoxaparin (n=17); group 4, any GP IIb/IIIa inhibitor (n=14); and group 5, any drug combination (n=15). Data included cumulative mediastinal chest tube drainage, allogeneic blood transfusions, total blood donor exposures, and re-exploration. MEASUREMENTS AND MAIN RESULTS: Use of any drug (groups 2-5) resulted in greater total blood transfusions and donor exposure (p=0.0003) than control, especially red cells (p=0.002) and platelets (p=0.006). A greater percentage of patients on enoxaparin required mediastinal re-exploration for nonsurgical bleeding versus control (3/17 v 0/55, p=0.001). The use of enoxaparin was associated with significantly higher chest tube output after the first 24 hours postoperatively (p=0.048). CONCLUSION: Newer antithrombotic agents were associated with greater transfusion rates and total donor exposures. Enoxaparin use was associated with greater overall blood loss and with higher incidence of mediastinal re-exploration. The relative risk-benefit ratio of reduced periprocedure morbidity versus increased bleeding complications has yet to be determined.

Analysis of Variance↗

PubMed2000

Late parathyroid function after successful parathyroidectomy guided by intraoperative hormone assay (QPTH) compared with the standard bilateral neck exploration.

BACKGROUND: Controversy continues between bilateral neck exploration and limited parathyroidectomy. One approach depends on gland size and histopathologic factors; the other approach limits excision to only hypersecreting glands. Both have excellent early operative success, but late recurrence rates with limited exploration are unknown. METHODS: Three hundred twenty consecutive patients with primary hyperparathyroidism were followed 6 to 313 months after successful parathyroidectomy. One hundred seventy-six patients had bilateral neck exploration with excision of enlarged glands (group I); 144 patients had glands excised based on hyper-secretion (group II). Calcium and intact parathyroid hormone (iPTH) levels were measured yearly. Parathyroid gland hypersecretion was determined by elevated iPTH levels. RESULTS: In group I, 1 gland was excised in 160 patients (91%); 19 of 176 patients (11%) had elevated iPTH levels. In group II, 139 patients (97%) had 1 gland excised; 19 of 144 patients (13%) had high iPTH levels. The number of patients with more than 1 gland excised in group I (9%) is 3 times higher than in group II (3%) (P <.05). There was no significant difference in the incidence of recurrent hyperfunctioning glands between the 2 different operative approaches (chi-squared test). CONCLUSIONS: Late parathyroid gland function was comparable with both approaches. Multiple gland excision based on size alone may lead to excision of normal functioning glands.

Calcium↗

PubMed1998

Scene exploration with Fourier-filtered peripheral information.

In a previous moving-window study it was found that scene exploration benefits more from peripheral information of high spatial frequency than of low spatial frequency. In the present study, degraded versions of realistic scenes were presented peripherally during the initial 150 ms of fixations, while the undegraded scene was presented foveally. The undegraded version of the scene was visible both foveally and peripherally during the later part of fixations. During the initial 150 ms, the peripheral part of scenes was low-pass, bandpass, or high-pass filtered, blanked, or decreased in luminance. In a no-change condition, the undegraded scene was presented throughout the whole fixation. Participants freely explored the scenes in the context of an object-decision task. It was found that degrading peripheral information during the initial part of fixations had minimal effect on scene exploration. No reliable differences were found among the three filter types. The results indicate that, in the context of an object-search task, peripheral information is of minor importance during the initial part of fixations.

Eye Movements↗