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PubMed2000

Interpretative repertoires of medication among the oldest-old.

The use of medical drugs is not founded on medical knowledge alone, but it is also dependent on lay logic and reasoning. This study set out to explore the views of the oldest-old on their medication. The data for the study came from narrative interviews with people aged 90 or over. Our aim was to look for different culturally shared interpretative repertoires used by the interviewees as they gave descriptions and accounts of their drug use and presented themselves as users of medical drugs. Three interpretative repertoires were identified. The moral repertoire stressed lay people's moral norms and presented them as morally acceptable and responsible users of drugs by explaining and minimizing. The patient repertoire was used by the respondents to show they had accepted the role of patient. The self-help repertoire was used by the respondents to emphasize that they had made their own choices in medical care despite the biomedical facts. These repertoires showed that not only the biomedical logic, but also other logics are valid in the everyday world where most medical drugs are used. A better understanding of cultural ideas of drug use would help to improve the care of older people.

Aged↗

PubMed1998

The interpretation of infant pain: physiological and behavioral indicators used by NICU nurses.

The purpose of this descriptive study was to identify the indicators used by neonatal nurses to interpret the experience of pain in infants in a Neonatal Intensive Care Unit (NICU). A sample of 72 NICU nurses completed a structured questionnaire to identify the physiological and behavioral indicators they used to interpret the experience of pain in the infants entrusted to their care. The 10 pain indicators used by more than 50% of the nurses, listed in decreasing order of frequency, were: fussiness, restlessness, grimacing, crying, increasing heart rate, increasing respirations, wiggling, rapid state changes, wrinkling of forehead, and clenching of fist. These findings are consistent with existing literature, are compatible with the stress cues identified in Als' Synactive Theory of Development, and lend support to the use of such measures for the assessment of infant pain.

Adult↗

PubMed2004

A new description of the reproductive system of Schistosoma mansoni (Trematoda: Schistosomatidae) analyzed by confocal laser scanning microscopy.

Classical schemes of the adult Schistosoma mansoni reproductive system have been described. In our study, whole adult worms derived from unisexual or mixed infections and stained with carmine chlorine were virtually and tomographically analyzed under confocal laser scanning microscopy. We found that: (1) there were morphological differences in the ovary, vitteline glands and testicular lobes between specimens derived from unisexual or mixed infections; (2) there was always a single lobed ovary (three or four lobes), presenting differentiation from the anterior to the posterior lobes, where the most mature oocytes were located; (3) the proximal segment of oviduct was connected to an ampullary dilatation, full of tailed spermatozoa, characterizing a seminal receptacle; (4) there was no long vitelline duct, but a short one that begins at the end of the proximal region of the vitelline gland; (5) long cells of Mehlis' gland placed radially around the ootype were not observed. Otherwise, the ootype was only lined by thick cuboidal epithelial cells with plaited bases and nuclei with flabby chromatin, making a clear distinction from the uterine epithelium. This morphological feature suggests that each cell represents a gland. (6) In coupled males, the specimens located inside the gynaecophoric canal had smaller testicular lobes, suckers, and body length and width when compared to their partners. Our results show that the reproductive system does not follow a unique pattern within flatworms. Due to its better resolution, confocal laser scanning microscopy, using a reflected mode with tomographic sections, allows new interpretations, modifying the adopted and current descriptions of the internal morphological structures of S. mansoni adult worms.

Animals↗

PubMed2001

Pressure-volume curve: methods and meaning.

The pressure-volume curve of the respiratory system is a physiological method used for diagnotic purposes to describe the static mechanical properties of the respiratory system. A renewal of interest in the pressure-volume curve has recently appeared because of experimental evidence regarding the information conveyed by the curve, a better understanding of the pathophysiologic factors influencing its interpretation and the beneficial results of clinical trials based on the use of the pressure-volume curve for ventilatory management of acute respiratory distress syndrome. Thus, adapting ventilatory settings to individual characteristics of the patients in terms of respiratory mechanics may be an extremely important aspect for a better management of the most difficult to ventilate patients with acute lung injury. There is considerable experimental evidence that both the opening-collapse phenomena and the excessive lung stretch may cause damage to the lungs. Therefore tools allowing an individual titration of ventilatory settings taking into account the constraints of the respiratory system seem highly desirable. The pressure-volume curve might be easily achievable at the bedside as a monitoring tool. The low-flow technique using ventilator technology has several potential advantages. It is hopeful to think that in the future the measurement of the P-V curve and the quantification of alveolar recruitment may be easily provided at the bedside and may help for the titration of the ventilatory settings in clinical practice. This review will focus briefly on the physiologic background, technique description, and recent advances concerning the interpretation of the P-V curve in the critically ill patients.

Humans↗

PubMed2005

When less is more: the consequences of affective primacy for subliminal priming effects.

This research investigates the consequences of the notion that one can distinguish early-evaluative (when exposure is short) and late-descriptive reactions (when exposure is long) to subliminally primed trait concepts. In three studies, it was found that the evaluative effects instigated by short exposure to primed concepts were bigger than the evaluative + descriptive effects instigated by long exposure: Less is more. Only when exposure was short, target interpretations were accompanied by evaluative inferences (Studies 1 and 3). Similarly, only when exposure was short, descriptively inapplicable trait primes affected the interpretation of an ambiguous target (Studies 2 and 3).

Affect↗

PubMed2006

Enterovirus surveillance--United States, 1970-2005.

PROBLEM: Enteroviruses are common human viruses associated with various clinical syndromes, from minor febrile illness to severe, potentially fatal conditions (e.g., aseptic meningitis, paralysis, myocarditis, and neonatal enteroviral sepsis). Multiple enterovirus serotypes exist. Individual serotypes have different temporal patterns of circulation and often are associated with different clinical manifestations. Changes in circulating serotypes might be accompanied by large-scale outbreaks. REPORTING PERIOD COVERED: 1970-2005. DESCRIPTION OF SURVEILLANCE SYSTEM: The National Enterovirus Surveillance System (NESS) is a voluntary, passive surveillance system that has monitored trends in circulating enteroviruses since 1961. Enterovirus detections by serotype with specimen type, collection date, and demographic information are reported monthly by participating laboratories to CDC, which summarizes the data and disseminates the results. For this analysis, the available data set for 1970-1982 included only information on serotype and state for each report; complete records were available for 1983-2005. RESULTS: During 1970-2005, a total of 52,812 enterovirus detections were reported to NESS (29,772 of them during 1983-2005). Laboratory participation and the numbers of reports declined throughout the 1990s, but they increased again after 2000. The 15 most commonly reported enteroviruses accounted for 83.5% of reports with known serotype, and the five most commonly reported serotypes (echoviruses [E] 9, 11, 30, and 6, and coxsackievirus B5) accounted for 48.1%. Predominant serotypes and ranking of individual enteroviruses changed over time. Long-term circulation patterns for individual serotypes varied but were consistent with epidemic (e.g., E9, E13, E30, and coxsackievirus B5) or endemic patterns (e.g., coxsackieviruses A9, B2, B4, and enterovirus 71). Children aged <1 year accounted for 44.2% of reports with known age. Male predominance was present among patients aged <20 years, but not among those aged >/=20 years (male/female ratio: 1.4 and 0.9, respectively). Enterovirus detections had prominent summer-fall seasonality, with June-October accounting for 77.9% of reports with known month of specimen collection. Cerebrospinal fluid was the most common specimen type, followed by respiratory and fecal specimens (49.8%, 26.9%, and 13.6%, respectively). Death was reported for 3.3% of detections with known outcome. Infections with coxsackievirus B4 (odds ratio [OR] = 3.3; 95% confidence interval [CI] = 1.7-6.0), and human parechovirus 1 (formerly E22) (OR = 3.7; CI = 1.7-7.6) were associated with higher risk for death, and infections with E9 were associated with lower risk for death (OR = 0.1; CI = 0-0.4) than infections with other enteroviruses. INTERPRETATION: NESS data allowed identification and description of a core group of consistently circulating enteroviruses that probably determine the disease burden associated with enterovirus infections. These data also are helpful in guiding outbreak investigations and identifying targets for development of diagnostic assays and antivirals. Efforts to update the reporting system initiated in the early 2000s (i.e., simplification of reporting forms and transition to electronic reporting) resulted in a substantial increase in reporting compared with the late 1990s. PUBLIC HEALTH ACTION: Efforts to increase laboratory participation in NESS should continue to allow for more complete and accurate surveillance for enteroviruses. Further improvement in the timeliness of feedback through the development of a NESS website to allow access to historic data and to the information on circulating serotypes can provide additional incentives to public health laboratories to participate in NESS.

Enterovirus↗

PubMed1981

Derivation and significance of valence molecular connectivity.

The physical basis for valence molecular connectivity was studied. The delta v and delta values are cardinal numbers describing the electronic structure of atoms in their valence states. The value delta v + delta describes the volume of a bonding atom while the value delta v - delta describes the electronegativity. By using the principle of electronegativity equalization, bond electronegativity is defined as (delta vi delta vj)-1/2, and the valence molecular connectivity index (l chi v) is derived as a sum of these bond descriptions. The valence chi index is interpreted in terms of the information encoded, describing both the volume and electronic characteristics of bonds in molecules. Examples of close relationships with molecular volume and electronic properties are shown. A new way of estimating valence state electronegativity is proposed from a count of exterjacent electrons divided by the quantum number squared for at least the first three quantum levels.

Amino Acids↗

PubMed1987

Models for temporal variation in cancer rates. I: Age-period and age-cohort models.

A main concern of descriptive epidemiologists is the presentation and interpretation of temporal variations in cancer rates. In its simplest form, this problem is that of the analysis of a set of rates arranged in a two-way table by age group and calendar period. We review the modern approach to the analysis of such data which justifies traditional methods of age standardization in terms of the multiplicative risk model. We discuss the use of this model when the temporal variations are due to purely secular (period) influences and when they are attributable to generational (cohort) influences. Finally we demonstrate the serious difficulties which attend the interpretation of regular trends. The methods described are illustrated by examples for incidence rates of bladder cancer in Birmingham, U.K., mortality from bladder cancer in Italy, and mortality from lung cancer in Belgium.

Adult↗

PubMed2006

Use of the spatial scan statistic to identify geographic variations in late stage colorectal cancer in California (United States).

OBJECTIVES: To identify geographic variations in colorectal cancer by stage at diagnosis in California using a descriptive analysis coupled with a spatial analysis and to discuss methodological considerations concerning the spatial statistical method. METHODS: We analyzed 59,076 colorectal cancer cases diagnosed in California from 1996 to 2000 by logistic regression and by a spatial scan statistic to identify areas with a higher and lower relative risk of late-stage colorectal cancer. RESULTS: In California, 57% of overall cases of colorectal cancer were diagnosed at a late stage. Californians diagnosed with late-stage colorectal cancer were more likely to be Hispanic and living in areas of lower socioeconomic status. The spatial scan identified two areas where the observed number of late-stage cancer was different than the number expected from the distribution in the rest of the state. CONCLUSIONS: Spatial scan analyses can complement descriptive statistics, but results must be interpreted with consideration of factors that affect the ability to detect meaningful differences such as the number of events observed, accuracy in geocoding rural versus urban addresses, and the difficulty of adjusting for covariates.

Aged↗

PubMed1990

The "laid-back" aortogram: an improved angiographic view for demonstration of coronary arteries in transposition of the great arteries.

Preoperative demonstration of coronary arterial anatomy may be important for babies undergoing the arterial switch operation. Echocardiography is clearly useful, but may not unequivocally show all coronary branches. Standard angiographic views can be confusing. An improved angiographic projection in which the frontal x-ray tube is caudally angled, resulting in a "laid-back" position of the image intensifier and cine camera, provides superior visualization of the coronary arteries and their relation to the aorta and the pulmonary artery. The balloon occlusion technique is used for opacification of the aortic root from the transvenous approach. Injection of 1 ml/kg of contrast delivered in 1/2 to 1 second provides the best images. The caudal aortogram is easier to interpret than standard views and facilitates description and recognition of various coronary patterns. The relation between the pulmonary artery and the aorta, the origins of the coronary arteries from the facing sinuses and their proximity to the intercoronary commissures, and the myocardial distribution of each coronary vessel are shown clearly. The caudal view therefore offers significant advantages over conventional projections for demonstration of coronary arterial anatomy in infants with transposition of the great arteries or double-outlet right ventricle.

Aortography↗

PubMed1995

[Introduction to meta-analytic methodology].

General considerations about meta-analysis and the different steps of this technique are successively discussed: definition of the main objective, identification of the outcome, description of the retrieval and selection of trials, description of the statistical analysis and interpretation of the results. Advantages and drawbacks of the meta-analytical technique are then described: 1) scientific approach, possible quantification of the therapeutic effect, increase of the power of a future clinical trial, synthesis of contradicting results, assessment of the homogeneity, subgroup analysis, analysis of sensibility, scientific collaboration, help for therapeutic information. 2) retrospective approach, inconsistency among trials, potential biases, persistence of some unsolved methodological problems, difficulties for a critical reading and for the interpretation of conclusions. In addition, some examples of published meta-analyses are given to illustrate the advantages and limits mentioned above.

Humans↗

PubMed2006

Bullying among Turkish high school students.

OBJECTIVE: The purpose of this study was to investigate school bullying among public high school students in Turkey. METHOD: This study used a survey to examine different aspects of bullying in schools. The participants (N = 692) were students chosen from five state high schools in Ankara in the 2000-2001 academic year. A self-administered questionnaire of 28 single or multiple-choice questions was devised by the authors to examine the students' perceptions of bullying in schools. Descriptive statistical analyses were used to interpret the data. RESULTS: Of the total of 692 students, everyone reported having been bullied. Thirty three point five percent had been bullied verbally, 35.5% had been bullied physically, 28.3% had been bullied emotionally, and 15.6% had been bullied sexually, at least once during the academic year. Victims were faced with one or more types of bullying. There were clear gender differences, with boys consistently experiencing more physical bullying including kicking-slapping, assault with a knife, rude physical jokes, and more verbal bullying including name calling and insulting-swearing (all significant at p < .001). Among the four types of bullying, the most common forms of bullying faced by girls and boys were the same in order: pushing (58.1% girls/63.5% boys) and name-calling (44.1%/61.8%). About one-third of the students stated that they did not get any help in coping with bullying. The main reason for bullying was pretending to be strong (43.1%). Among the four types of bullying in both genders, students generally reported negative views about the consequences on them including low psychological well-being, poor social adjustment, and psychological distress. CONCLUSIONS: Bullying is a serious problem in schools in Turkey and is a matter of recent concern. This is the first research investigating bullying in Turkey. At the present there is no policy at the central level to deal with bullying. It is expected that the results of this study will raise the awareness of students, teachers, school principals, and educational managers and parents to the problem.

Adolescent↗

PubMed2004

Using emulsion inversion in industrial processes.

Emulsion inversion is a complex phenomenon, often perceived as an instability that is essentially uncontrollable, although many industrial processes make use of it. A research effort that started 2 decades ago has provided the two-dimensional and three-dimensional description, the categorization and the theoretical interpretation of the different kinds of emulsion inversion. A clear-cut phenomenological approach is currently available for understanding its characteristics, the factors that influence it and control it, the importance of fine-tuning the emulsification protocol, and the crucial occurrence of organized structures such as liquid crystals or multiple emulsions. The current know-how is used to analyze some industrial processes involving emulsion inversion, e.g. the attainment of a fine nutrient or cosmetic emulsion by temperature or formulation-induced transitional inversion, the preparation of a silicone oil emulsion by catastrophic phase inversion, the manufacture of a viscous polymer latex by combined inversion and the spontaneous but enigmatic inversion of emulsions used in metal working operations such as lathing or lamination.

Journal Article↗

PubMed2003

Investigating protein domain combinations in complete proteomes.

Protein-related information is more accumulated rather than reduced to a synthetic view. Itemising properties of protein sequences is informative, so is the list of ingredients to do some cooking, but without a recipe, that is, quantification and chronology, understanding is incomplete. If the goal of accumulating information is to discover or reveal the function and related biochemical mechanisms, information has to be weighed and ordered. As a guideline, the weight of a piece of information should reflect how often it consistently occurs in various contexts. We propose a common sense approach to quantify and put data and information into perspective. Complete bacterial proteomes are individually mapped with the Pfam-A database of domains and protein family signatures in an attempt to assess the modularity of proteins at the level of a single proteome and the implications of a modular description of proteins for a functional interpretation. Poorly annotated proteins in the most documented bacteria (E. coli and B. subtilis) were considered in an attempt to formulate hypothesis on the basis of domain/module content.

Bacillus subtilis↗

PubMed2006

Modeling of soiling based on silica-soda-lime glass exposure at six European sites.

Samples of silica-soda-lime float glass, a material selected as a pertinent soiling sensor, were exposed for up to 28 months at four urban sites (Athens, Krakow, London and Prague) and at a semi-urban one (Monte Libretti, near Rome), sheltered from rain. This exhaustive experience permitted to complete and to test the generalisation ability of the results previously obtained on the same material, exposed according to the same protocol, during 24 months, at a single site (Paris). The model previously fitted for the Paris experiment, the Hill equation, could be successfully generalised for four other sites of exposure (Athens, Krakow, Prague and Rome). The analytical form of this model was interpreted in terms of a physical description of the soiling phenomenon. Some of the model coefficients were different from one site to another, depending on the specific environment of exposure (air pollution levels, meteorological factors), while the other ones were rather equivalent. The analysis of the model coefficients, on the one hand, led to an estimation of the period after which soiling is close to its saturation level, and on the other hand, it will permit to correlate these coefficients to the environmental factors, in order to select the most appropriate ones for building dose-response functions for soiling, with broad geographical application.

Journal Article↗

PubMed2005

[Laparoscopic versus mini-laparotomy cholecystectomy].

OBJECTIVES: To describe differences in operating time, pain scores, analgesic consumption, complications, length of hospital stay, and quality of life in laparoscopic cholecystectomy (LC) vs mini-laparotomy cholecystectomy (MLC). PATIENTS AND METHOD: Between 1991 and July 1999, we performed a study of 1041 patients with gallstones who underwent LC (group A, n = 421 patients) or MLC (group B, n = 620 patients). Age, sex, ASA score, pain scores (visual analog scale), analgesic and antiemetic consumption, operating time, complications and length of hospital stay were recorded. Nottingham Health Profile questionnaires were completed by a subgroup of 200 patients, and respiratory response was evaluated using a Fokuda spirometer before surgery and at 24 and 48 hours after surgery. Patient satisfaction and quality of life were evaluated. The results were interpreted using the SPSS program and descriptive statistics were performed with p = 0.05. RESULTS: The mean age was 48.9 +/- 14.2 years; 80.5% of the patients were women; 87.88% of the patients were ASA I. Elective surgery was performed in 89.78%. The mean operating time was 94 +/- 45 minutes in LC and was 108 +/- 48 minutes in MLC (p < 0.001). LC was associated with lower postoperative pain (0 = 68.88%), lower analgesic-antiemetic requirements (0 = 9.03%) and shorter length of hospital stay. Complications were significantly more frequent in group B (p = 0.05); two patients in group B died within 30 days of surgery (0.32%). CONCLUSIONS: LC appears to be associated with lower pain scores and analgesic-antiemetic requirements and shorter recovery times than MLC. The results in terms of quality of life in LC were excellent.

Adolescent↗

PubMed2000

A digital image analysis and neural network based system for identification of third-stage parasitic strongyle larvae from domestic animals.

A competitive learning vector quantization artificial neural network (ANN) was trained to identify third-stage parasitic strongyle larvae from domestic animals on the basis of quantitative data obtained from processed digital images of larvae. For this reason, various quantitative features obtained from processed digital images of larvae were tested as to whether they are variant or invariant to the shape taken by the motile larvae during image recording. A total of 255 images of 57 individual larvae in various shapes belonging to five genera were recorded. Following image processing, 16 features were measured, of which seven were selected as invariant to larva shape. By trial and error, two of those features, 'area' and 'perimeter', along with the quantitative features used in conventional identification, 'overall body length', 'width' and 'extension of sheath' (tip of larva to tip of sheath), were used as an effective training data set for the ANN. This ANN coupled with an image analysis facility and a knowledge relational database became the basis for developing a computer-based larva identification system whose overall identification performance was 91.9%. The advantages of this system are its speed and objectivity. The objectivity of the system is based on the fact that it is not subject to inter- and intra-observer variability arising from the user's profile of competency in interpreting subjective and non-quantifiable descriptions. The limitations of the system are that it cannot handle raw images but only data extracted from images, its performance depends on the reliability of the input vectors used as training data for the ANN, and its use is restricted only to well-equipped laboratories due to its requirement for expensive instrumentation.

Animals↗

PubMed1981

Fine-needle aspiration cytology in thyroid disease.

Fine-needle aspiration biopsy of palpable lesions of the thyroid is a diagnostic method routinely used in several medical centres, but still relatively new in others. Experience has shown that the technical steps involved in this biopsy procedure, that is, palpation, aspiration, smear making, fixation and staining, are critical for good results, and they are therefore reviewed and illustrated. Another prerequisite for the use of aspiration biopsy cytology is a specially interested cytopathologist who is familiar with the methodological aspects, as well as the interpretation of cells in aspirates. A description is given of the different cytological patterns in smears of fine-needle aspirates for clinical thyroid diseases, such as simple and toxic goitre, different types of thyroiditis (acute, subacute and chronic) as well as the various differentiated thyroid neoplasms (follicular, papillary, medullary), anaplastic carcinomas and lymphomas. The limits of cytological diagnosis are indicated and differential diagnostic aspects are discussed. diagnostic accuracy of aspiration biopsy cytology, with particular reference to tumour diagnosis, is high: no false positive diagnoses are made by experienced cytopathologists, whereas false negative tumour diagnosis can occur in about 10 per cent of cases. Such results are the reason for the special position of fine-needle aspiration biopsy among other methods in the diagnostic work-up of patients with thyroid disease.

Adenoma↗