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PubMed2002

Men with cancer. Changes in attempts to master the self-image as a man and as a parent.

Little is known about men's experience of how cancer affects their role as a father. The aim of this study was to gain an understanding of changes in these men's everyday family lives. The study had an interpretative descriptive design, utilizing the concept of transition as a fore structure. Eight men with different types of blood cancer and with children living at home were recruited for the study. Interviews, guided by the main components of the concept of transition, provided qualitative data for analysis. Through the interpretative process, the central theme--change in self-image as a man and as a parent--was generated. This theme consists of the subthemes gaining control, balancing emotions, subjective well-being, being open or not toward the family, and challenges in family life and to family well-being. The time after diagnosis influenced the process of transition. Self-image changes are more obvious shortly after diagnosis. Further study is needed to identify how nurses and other clinicians can assess the family's needs and support the parental role, especially in consideration of the findings of this study.

Adaptation, Psychological↗

PubMed1988

Development of the EEG of school-age children and adolescents. II. Topography.

Topographic aspects of EEG development of normal children and adolescents from 6 to 17 years are investigated with respect to various spectral parameters. The topographic distribution of spectral band power does not change between hemispheres across age. Changes take place, however, in the antero-posterior dimension. For the bands theta, alpha 1 and alpha 2 (and less so for delta) maturation starts at posterior derivations and ends at anterior derivations. For the band beta 2 (and to some extent also for beta 1), development progresses from Cz to Pz and further to occipital, lateral, central and frontal derivations. Principal component analysis (PCA) leads to a more parsimonious and better interpretable description of broad-band power and of its topographic distribution. Broad-band coherences increase with age, though to a modest degree. The different magnitudes of coherence between different regions can be largely accounted for by the interelectrode distances. Coherences, too, can be described in a more parsimonious and better interpretable way via PCA. The 3 components extracted reflect firstly the overall level of coherence, secondly the coherences of the occipital regions with all other regions and thirdly antero-posterior versus left-right coherences.

Adolescent↗

PubMed1990

Concurrent validity of the task-oriented assessment component of the Bay Area Functional Performance Evaluation with the American Association on Mental Deficiency Adaptive Behavior Scale.

This study was designed to test the concurrent validity of the revised Task-Oriented Assessment (TOA) component of the Bay Area Functional Performance Evaluation (BaFPE) (Bloomer & Williams, 1979) with Part 1 of the American Association on Mental Deficiency Adaptive Behavior Scale (ABS) (Nihira, Foster, Shellhaas, & Leland, 1969, 1974) and to develop a means of interpretation for the numeric scores on the TOA. Both measures were administered to 67 psychiatric inpatients within the first 14 days of admission. Low to moderate correlations were found between the TOA tasks and functional parameters and the ABS domains. Because the TOA shows low concurrent validity with the ABS, only limited interpretive descriptions for TOA scores could be developed.

Activities of Daily Living↗

PubMedDate not supplied

A functional classification of spinal instrumentation.

BACKGROUND CONTEXT: Spinal instrumentation systems have evolved far beyond the original Harrington design, with increasing complexity and capabilities. This review attempts to de-emphasize the "product names," as systems are often generically and inappropriately referred to as "Harrington rods," by introducing a functional classification for current systems. PURPOSE: The aim of this paper is to review the intended design purpose of current spinal instrumentation systems for more accurate interpretations of radiographs and complications. STUDY DESIGN: The principles involved in each type of instrumentation system are described, followed by the characteristic components and the normal appearance radiographically, with examples of complications, which should be recognized. METHODS: The historical contribution of specific systems in the developing art of internal fixation of the spine is provided as a background to understand the biomechanical forces imparted by spinal hardware. Recognizing the functional intent of spinal constructs will enhance descriptions of those images. RESULTS: Spinal instrumentation has been categorized into five functional types: Distraction and compression, segmental stabilization, coupled or derotation systems, translational or pedicle screw systems, and anterior instrumentation. CONCLUSIONS: Analysis of radiographs from a functional viewpoint can enhance the descriptive interpretation and specifically allow assessment of the success or of the presence of complications, which are crucial to the analysis of instrumentation effectiveness.

Equipment Design↗

PubMed2005

An empirical taxonomy of social-psychological risk indicators in youth suicide .

The current study integrates descriptive (though primarily social-psychological) statements about youth suicide into a coherent, empirically supported taxonomy. Drawing from relevant literature, a set of 107 items characterizing these contributions about youth suicide was created. Seventy-two participants sorted these statements according to their "face-value" by following two separate procedures. Analyses of these two data sets using multi-dimensional scaling resulted in a common "map" depicting inter-item (dis)similarities. Non-arbitrary rotation of this map revealed three bipolar and orthogonal dimensions labelled as under- and overengagement, rejection-turmoil, and self- to death-identification. It is suggested this dimensional analysis could provide a viable frame for examining and interpreting descriptions about suicide risk and may serve to extend theoretical accounts.

Adolescent↗

PubMed2001

The created environment for physical assessment by case managers.

Goals of gerontological nursing include maximizing health and confronting functional impairments. The health of older adults is often fragile because of age-related change, complicated by chronic illnesses. Identification of changes in health status permits responsive care and consultation but requires proficiency in physical assessment. In 1995, research was conducted in Alberta, Canada, on registered nurse case managers' reported use of assessment skills. Nineteen continuing-care facilities in 1 of 17 provincial health regions participated (N = 189). After expert review and pilot testing, questionnaires were distributed to two independent groups: nurse administrators/staff development coordinators and case managers (response rate = 73%). Qualitative data were subjected to descriptive, interpretive, and pattern coding. Reported are factors constraining or facilitating physical assessment in continuing care. Neuman's concept of the created environment provided a factor-organizing framework. A holistic view of environment and data source triangulation increased confidence in the comprehensiveness and credibility of results.

Adult↗

PubMedDate not supplied

The lived experience of nurses enrolled in the Regents College Nursing Program.

This qualitative research study was undertaken to investigate the experience of being a registered nurse (RN) student enrolled in a specific nontraditional nursing program, ie, Regents College Nursing Program (RCNP), from the perspective of the RCNP baccalaureate graduate. Fifteen RN bachelor's of science in nursing (BSN) graduates of RCNP participated in this descriptive phenomenological investigation in which participant interviews were tape-recorded, transcribed verbatim, and analyzed phenomenologically using Colaizzi's methodology. An exploration of the language of human experience and human expression yielded 101 themes within 20 theme clusters, yet the meaning of the experience was characterized by 8 major clusters that included recounting reasons for choosing RCNP, describing learning approaches for testing, describing the challenges of testing conditions, experiencing stress and describing its effects, describing feelings of uneasiness, describing responses to failure, providing support, and finding ways of mastering Regents. It also was discovered that an underlying theme of stress suggested a pervasive pattern throughout the thematic clusters: stress wove its way throughout the fabric of the experience and caused a disruption of the entire design. The interpreted description of the lived experience of these RN students uncovered reasons for RN baccalaureate program selection by nurses that supported previous research assumptions, isolated specific stressors affecting nurses involved in performance testing, and clarified specific needs of nurses, especially with regard to support networks and learning resources. The results of this study may provide future RN students with information to make a more informed decision about choosing RCNP for a baccalaureate program. In addition, a better understanding of adult learners may assist nurse educators in developing curricula that facilitate professional growth for RN students and relieve some of the possible stress associated with the education process.

Adaptation, Psychological↗

PubMed2026

A qualitative study of cancer survivors' exercise behaviour 4 months after a telerehabilitation program.

PURPOSE: Although telerehabilitation can improve access to exercise programs for cancer survivors, it is not known if these programs lead to ongoing change in exercise habits. This study explored participant experiences of exercise 4 months after finishing specialized cancer exercise-based telerehabilitation. METHOD: A qualitative study embedded in a randomized controlled trial evaluated exercise-based cancer telerehabilitation delivered in groups. Data were collected via semistructured interviews that were audio-recorded and transcribed verbatim. Seventeen adult cancer survivors (age 21 to 80) were purposively sampled 4 months after completing exercise-based cancer telerehabilitation. Data were coded independently by two researchers and analyzed inductively within an interpretive description framework. RESULTS: The overarching theme was telerehabilitation was perceived to facilitate positive exercise intentions. Participants said they were empowered to exercise through knowledge, opportunity, and connection gained through telerehabilitation. They described acting on their positive intentions to exercise to varying degrees following telerehabilitation, depending on their context. A subtheme was that exercise was challenging in their new reality created by cancer. Comorbidities, ongoing side effects, previous exercise experience, and personal factors were considered by some to influence their ability to exercise. CONCLUSION: Telerehabilitation may facilitate positive intent to maintain exercise. Cancer survivors may need ongoing support after telerehabilitation to act on positive exercise intentions due to health-related difficulties. IMPLICATIONS FOR CANCER SURVIVORS: Participation in telerehabilitation may be a positive first step to initiate exercise, but ongoing support to maintain positive behavior changes is likely to be needed for people without previous exercise experience.

Humans↗

PubMed2026

Factors associated with successful integration of pharmacists into residential aged care teams: A qualitative study.

BACKGROUND: Australia's Aged Care Onsite Pharmacist program aims to support quality use of medicines in residential aged care homes. This is a novel role introduced into existing teams in a complex environment. Factors associated with successful integration since implementation are currently unknown. AIM: This study aims to explore the perspectives of pharmacists and other stakeholders within aged care homes regarding successful integration of the novel aged care pharmacist service into healthcare teams. METHODS: A qualitative approach, using interpretive descriptive methodology, was used to explore perspectives. Semi-structured focus groups and interviews with pharmacists, nursing and care staff, allied health professionals, general practitioners, residents, and family members were undertaken. Data were collected via Zoom™, audio- and video-recorded, and transcribed verbatim. Two researchers undertook inductive thematic analysis to identify key themes. RESULTS: 30 participants across focus groups, focus-group interviews, interviews, and member-checking processes contributed. An overarching theme of proactivity and showing a genuine interest in others underpinned three key themes. Theme 1: Pharmacists needed to be seen, through physical presence and availability, as well as developing a distinct identity. Theme 2: Pharmacists needed to build trust, through collaboration in real time and demonstrating value. Theme 3: Pharmacists needed to develop an understanding of the aged care home environment, including social and contextual norms, as well as procedures, routines and roles. DISCUSSION: This research complements existing understandings of interprofessional collaboration and teamwork amongst healthcare professionals. Themes were interlinked; we used a sensitising framework, social cognitive theory, to present and explain the findings and interactions that can support pharmacist integration into existing teams. Aged care services should structure onboarding to prioritise early visibility, clarify roles and organisational needs, and foster in-person collaboration. Pharmacists should demonstrate proactivity and an authentic interest in all staff, residents and families.

Humans↗

PubMed1988

Evaluation of a computer-assisted method of analysing SDS-PAGE protein profiles in tracing a hospital outbreak of Serratia marcescens.

Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) profiles of bacterial proteins have been successfully used for taxonomical purposes. More recently this technique has been applied to epidemiological investigations in respect of various micro-organisms including Neisseria meningitidis, Staphylococcus aureus and Clostridium difficile. The main limitations of the methods so far described are lack of standardisation in extraction and separation as well as in the analysis of results. Although reproducibility in the same laboratory has been shown to be satisfactory, comparison of results among laboratories is still difficult. Moreover, assessment of differences and/or similarities among chromatograms or autoradiographs showing many bands depends upon qualitative descriptions. Interpretation of densitometric scannings is laborious and time-consuming. In this paper we present our experience of a completely standardised, fully computer-controlled procedure for SDS-PAGE (AMBIS System) in analysing 35S-methionine-labelled total proteins. The methodology proved very useful in monitoring a hospital outbreak of Serratia marcescens. It allowed us to make quantitative comparison in a shorter time as well as to handle easily a great amount of data and usefully integrate it with those obtained with other systems such as serotyping. Furthermore, when the two systems are used together, more precise information can be gained. In this epidemic, serotyping indicated the presence of two groups which would have been missed by PAGE analysis alone. Electrophoretotyping, however, focused on similarities of cellular proteins among the epidemic strains. This allowed us to distinguish them from epidemiologically unrelated strains of the same serogroup.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗

PubMed1998

Learning on clinical placement: the experience of six Australian student nurses.

Concerns about the adequacy of clinical education in nursing courses in Australia have escalated since the transfer of pre-registration nursing education into the tertiary sector. This descriptive, interpretative study, informed by the tradition of critical social science, sought to understand the clinical learning experiences of undergraduate nursing students. At the same time, it fostered an active participation of students in their own learning. Daily post-clinical conferences with the students were taped and transcribed verbatim to provide data for the study. Additional data was collected from informal discussions and observations of the students during the placement. Analysis revealed three main categories, which reflected the students' experiences. These included: (1) I don't belong; (2) doing and practising: progress at last; and (3) transitions in thinking. Feeling part of the team was closely linked to the opportunity to learn, emphasizing the important role not only of educators but also clinicians in undergraduate learning on clinical placement. Though the findings reflect age-long problems associated with student learning in the clinical field, it serves to remind all nurses of the importance they play in the learning process. This study reflects the importance of effective communication between the health and education sectors and the need to concentrate on strategies which will strengthen this bond.

Clinical Competence↗

PubMed2004

Large-scale database searching using tandem mass spectra: looking up the answer in the back of the book.

Database searching is an essential element of large-scale proteomics. Because these methods are widely used, it is important to understand the rationale of the algorithms. Most algorithms are based on concepts first developed in SEQUEST and PeptideSearch. Four basic approaches are used to determine a match between a spectrum and sequence: descriptive, interpretative, stochastic and probability-based matching. We review the basic concepts used by most search algorithms, the computational modeling of peptide identification and current challenges and limitations of this approach for protein identification.

Algorithms↗

PubMed2002

Nested clade analysis and the genetic evidence for population expansion in the phylogeography of the golden-striped salamander, Chioglossa lusitanica (Amphibia: Urodela).

The golden-striped salamander, Chioglossa lusitanica, is a streamside species distributed in the northwest of the Iberian Peninsula. We gathered cytochrome b mitochondrial DNA sequence data from samples across the species range and used nested clade distance analysis to assess evolutionary processes explaining the geographical distribution of mtDNA diversity in Chioglossa lusitanica. A significant association was observed between genetic structure and geography. The geographical patterns were explained by past fragmentation and restricted gene flow. Inferences were concordant with previous hypotheses (from allozyme data) involving an old fragmentation event and secondary contact near the Mondego River in central Portugal. A range expansion to the north from a southern refuge was supported by descriptive interpretations of mtDNA data and by complementary analyses suggesting population expansions, but not by formal nested clade analysis. The power of nested clade analysis to detect the genetic signature of range expansion deserves further testing.

Animals↗

PubMed2002

Student--teacher connection in clinical nursing education.

BACKGROUND: The trend toward humanistic nursing education has called for a transformed student-teacher relationship that fosters learning and growth of students and teachers. Although such a relationship has been claimed to form the basis for student-teacher connection and to be a positive influence on students' learning outcomes, there is a paucity of research exploring these claims. Neither the nature of student-teacher connection nor the processes by which it occurs have been described. AIMS: A research study was undertaken to explore and describe undergraduate nursing students' experiences of connection within the student-teacher relationship and the effects of student-teacher connection on students' learning experiences in clinical nursing education. RESEARCH DESIGN: The qualitative research approach of interpretive description was chosen for this study. Unstructured interviews and a focus group were used to collect data from eight undergraduate nursing students. Data were analysed using the process of constant comparative analysis, and revealed four interrelated major categories that formed a description of the students' experience of student-teacher connection. FINDINGS: This article presents part of the findings of this study. After describing the nature of student-teacher connection, the discussion focuses on the influence of teachers and other factors on the formation of student-teacher connection. Relevance is given to this discussion by describing the outcomes of connection for students' clinical learning experiences.

Adolescent↗

PubMed1999

Attitudes to using condoms in a group of Darwin women.

This study was a qualitative descriptive interpretive investigation into a group of women's attitudes to the use of condoms in Darwin, Northern Territory, Australia. Twenty women were interviewed using a semi-structured interview schedule. The participants' perception of who should be responsible for providing and ensuring use of condoms varied, as did their attitudes to condom use. Negative attitudes centred around the need to be prepared for sex, the nuisance value and the need to be careful of slip-ups, while positive attitudes centred around the lack of mess. Most women in a committed relationship did not use condoms other than for contraception because they trusted their partners to be faithful. Raising the issue outside of birth control suggested unfaithfulness. These women were on the whole more confident of their ability to negotiate condom use than had been found in previous studies. It was concluded that the safe sex message is not getting through to many women, that health promotion should continue to stress the message about safe sex and that advertising should stress the positive aspects of condom use.

Adolescent↗

PubMed1999

The Experience of Waiting for Diagnosis After an Abnormal Mammogram.

In order to better understand the experience of women following abnormal screening mammogram and before definitive diagnosis, we undertook a series of focus group interviews in six geographic areas in the province of British Columbia, Canada. While all 33 participants had experienced abnormal mammograms within the previous year, each group included women with a range of ages and diagnostic outcomes. Verbatim transcripts of all focus groups were subjected to qualitative secondary analysis using interpretive descriptive methods. Through a process of grounded inductive analysis, conceptual themes within the data were identified and tested. The findings of this study provide an experiential account of common patterns within the structure and process of waiting for diagnosis. The accounts depict the way the women experienced time, their individual and common responses to waiting, and the impact of health system factors, including provider communication. These findings confirm that, regardless of its outcome, waiting for definitive diagnosis after an abnormal screening mammogram is an intense and often agonizing experience for the women involved and for their families. Furthermore, our results highlight the relevance of such issues as information systems, support, coordination of services, and health care communication, and underscore the important role that service delivery factors can play in making such experiences bearable.

Journal Article↗

PubMed2000

Generation of patterns from gene expression data by assigning confidence to differentially expressed genes.

MOTIVATION: A protocol is described to attach expression patterns to genes represented in a collection of hybridization array experiments. Discrete values are used to provide an easily interpretable description of differential expression. Binning cutoffs for each sample type are chosen automatically, depending on the desired false-positive rate for the predictions of differential expression. Confidence levels are derived for the statement that changes in observed levels represent true changes in expression. We have a novel method for calculating this confidence, which gives better results than the standard methods. Our method reflects the broader change of focus in the field from studying a few genes with many replicates to studying many (possibly thousands) of genes simultaneously, but with relatively few replicates. Our approach differs from standard methods in that it exploits the fact that there are many genes on the arrays. These are used to estimate for each sample type an appropriate distribution that is employed to control the false-positive rate of the predictions made. Satisfactory results can be obtained using this method with as few as two replicates. RESULTS: The method is illustrated through applications to macroarray and microarray datasets. The first is an erythroid development dataset that we have generated using nylon filter arrays. Clones for genes whose expression is known in these cells were assigned expression patterns which are in accordance with what was expected and which are not picked up by the standards methods. Moreover, genes differentially expressed between normal and leukemic cells were identified. These included genes whose expression was altered upon induction of the leukemic cells to differentiate. The second application is to the microarray data by Alizadeh et al. (2000). Our results are in accordance with their major findings and offer confidence measures for the predictions made. They also provide new insights for further analysis.

Algorithms↗

PubMed2000

Uncertainty and expectations: taking care of a cardiac surgery patient at home.

Family members of postsurgical patients are, by necessity, taking on the caregiving role sooner without any specified resources to help them. The input of these caregivers is essential so nurses can understand their concerns, needs, and struggles and develop strategies to support the caregivers in their caregiving role. This study was designed to increase nursing knowledge regarding the experiences of being a caregiver of a cardiac surgery patient during the immediate postdischarge period. The qualitative research method of Interpretative Description, first described by Thorne, Kirkham, and MacDonald-Emes in 1997 guided the study. In-depth interviews were held with eight spousal caregivers. Findings revealed that the experience was molded by caregivers' past participation as a caregiver, as well as caregivers' and care recipients' outlook on life, their interpersonal relationship, and their expectations. Caregivers engaged in the process of caregiving that involved being vigilant and monitoring the care recipient's recovery, implementing strategies to assist the recovery process, and taking on a role to provide care and seek help as required. The encounter with caregiving affected all realms of caregivers' lives, and they experienced feelings of stress, vulnerability, and having to put their lives on hold; these feelings were often compounded by uncertainty.

Aged↗