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PubMed1999

Vigilance transitions in reaction time test: a method of describing the state of alertness more objectively.

Electrophysiological recordings are considered a reliable method of assessing a person's alertness. The aim of this study was to show, firstly, that changes in alertness during a Reaction Time Test (RTT) can be determined with certain adaptive scoring stages but not with R&K scoring and secondly, that the different adaptive stages can explain findings in reaction time. In 17 male patients (50.8+/-9.7 years, Body-Mass Index (BMI) 31.9+/-5.1 kg/m2) diagnosed with Obstructive Sleep Apnea Syndrome (OSAS) (Respiratory Disturbance Index (RDI) 53.3+/-24.1 /h sleep) a 90 min daytime vigilance test was performed twice, after the diagnostic polysomnographic investigation and after two nights spent with nCPAP. After a computerised adaptive segmentation analysis, a visual rule-defined classification system categorised alertness into one of 12 adaptive scoring stages. 6 of the 12 stages are described by the alertness conditions comparable to WAKE and NREM1.4 stages are nearly classified as NREM2-4, Rapid Eye Movement (REM) and Movement Time (MT), and one stage reflects the increase of alertness from drowsiness. The typical stage of an alert subject increased significantly from a median of 65.9% before therapy to 80.8% in the second investigation. The percentages of clearly drowsy stages decreased significantly. In contrast, there were no significant changes in the percentages of sleep stages according to R&K criteria for both investigations. According to R&K criteria 178 of 398 failed reactions (Reaction time >10 s) occurred in stage WAKE. According to adaptive scoring, only 12 failed reactions appeared in the alert stage. During the other failed reactions the electrophysiological recordings showed decreases in alertness. Neither the visual assessment nor the descriptive statistical results of R&K scoring were helpful to interpret the patient's alertness condition. In contrast, the patients' increases in alertness with nCPAP could be described by the adaptive scoring stages. This method could be a very useful procedure, when an expert opinion is necessary. It also has an actual context to the discussion of the effectiveness of CPAP in the treatment of OSAS.

Adult↗

PubMed1992

A model for variations in single and repeated egg counts in Schistosoma mansoni infections.

Faecal egg counts are often used to measure Schistosoma mansoni infection, but the considerable variation between successive counts complicates their interpretation. The stochastic model described in this paper gives a description of observed egg counts in a population and can be used as a tool to gain an insight into the underlying worm load distribution. The model distinguishes between two sources of variation in egg counts: (1) variation caused by the difference in worm load between individuals, and (2) the variability of egg counts for an individual with a given worm load. Empirical data, single and repeated measurements, from surveys in five villages in Burundi and Zaire have been used to fit and validate the model. We have discussed possible mechanisms that explain the differences in estimated values between the villages. The model indicates that the expected number of eggs in a stool sample per S. mansoni worm pair is lower than suggested by autopsy data and that, possibly as a consequence of immunity, the inter-individual variation in worm loads decreases with age.

Adolescent↗

PubMed1999

Blood transfusion from the recipient's perspective.

This paper reports on an interpretative research study that set out to develop a rich description of patients' experiences of the process of preparing for and receiving a blood transfusion. The themes of information-giving and receiving; reactions, both physical and emotional; and the care and treatment participants received through the experience are presented.

Adaptation, Psychological↗

PubMed1997

How to translate nursing care into costs and staffing requirements: part two in the Zebra system.

The purpose of this paper is to describe part two of the Zebra system-the activity study: how such a study can be conducted, which requirements must be met and how the data are processed and can be used. The activity studies described were conducted in two of the wards of the oncology department in the University Hospital of Lund, Sweden. The results of the studies make it possible to calculate the distribution of different activities for nurses and practical nurses during 24 hours and the total nursing care minutes per patient and category of care. Together with the patient classification, part one in the Zebra system, it is possible to calculate nursing costs per patient stay and the patients'staffing requirements. It will be possible to relate nursing costs and staffing requirements to actual nursing care given instead of fixed standard costs and staffing figures.

Data Interpretation, Statistical↗

PubMed2006

High resolution laser induced fluorescence spectroscopy of the [18.8] 3Phi(i)-X 3Phi(i) (0,0) band of cobalt monofluoride.

The fine and hyperfine interaction parameters in the [18.8] (3)Phi (upsilon=0) and X (3)Phi (upsilon=0) states of cobalt monofluoride, CoF, have been determined from an analysis of high-resolution laser induced fluorescence spectra of the [18.8] (3)Phi(3)-X (3)Phi(3) and [18.8] (3)Phi(4)-X (3)Phi(4) band systems. The previously reported pure rotational transitions of the X (3)Phi(4)(upsilon=0) state [T. Okabayashi and M. Tanimoto, J. Mol. Spectrosc. 221, 149 (2003)] were included in the data set. The hyperfine parameters for (59)Co (I=72) and (19)F (I=12) have been interpreted using atomic data together with a proposed molecular orbital description for the [18.8](3)Phi(i) and X (3)Phi(i) states. A comparison of the hyperfine parameters in the X (3)Phi state of cobalt monohydride, CoH, with those of the X (3)Phi state of CoF reveals that the bonding in the two molecules is significantly different. It is shown that, in a situation where the Omega substates of a multiplet degenerate electronic state are analyzed separately, the Fermi contact parameter b can be determined with fair accuracy from the apparent centrifugal distortion of the hyperfine structure.

Journal Article↗

PubMed1997

Drivers' fatigue studies.

This paper summarizes the results of several fatigue studies of bus and truck drivers using different approaches. It presents findings from 24 city bus drivers obtained by the use of biochemical and psychophysiological tests before and after 7 h of driving. It presents an acoustic speech analysis conducted on 34 bus drivers before and after driving. Also, for a small group of city bus drivers, a continual examination of heart rate was carried out by electrocardiorecorder. Questionnaire studies on fatigue are related to the responses of 200 long-distance truck drivers and 107 dump-truck drivers who work in one copper mine. The last approach deals with the analysis of long-distance truck drivers' activities (driving, loading-unloading, resting and sleeping) during trips, based on their individual records. On the basis of these different approaches to bus and truck drivers' studies, clear psychophysiological, speech and subjective changes have been demonstrated and, on a descriptive level, certain symptoms observed during prolonged driving have been interpreted as effects of drivers' fatigue.

Adult↗

PubMed1997

Fast Fourier transform analysis of dynamic data: sine wave stress-strain analysis of biological tissue.

We propose an improvement to the dynamic oscillation method using as an example the measurement of the tensile stiffness of the rabbit tracheal mucosal membrane. A sine wave oscillation technique was used to study the tissue mechanical properties. A mathematical model was developed using fast Fourier analysis. After mathematically eliminating the machine response, this analysis reveals the tissue frequency response over a wide range of frequencies. This study addresses the advantages of using Fourier analysis to interpret dynamic properties of biological tissue and provides a complete description of how to obtain the pure tissue response.

Animals↗

PubMed1989

On the utility of statistical modelling in reproductive studies.

The usefulness of mathematical modelling is discussed, with reference to a beta-binomial model which is used to describe both the implantation and birth statistics after assisted procreation. The relatively heavy computing effort required is emphasized, and contrasted with the rather simpler calculations associated with traditional statistical methods. The advantages of deriving a concise description of the data with a few important, and easily interpretable, parameters are also discussed. Numerical data provided by an IVF clinic are used to illustrate the mathematical procedures and to provide an assessment of the success of the modelling exercise.

Female↗

PubMed1998

Psychological testing for child and adolescent psychiatrists: a review of the past 10 years.

OBJECTIVE: To provide a review of psychological tests often used with children and adolescents. METHOD: A description of how psychological tests are used and how to interpret various types of scores is provided. Subsequently, psychological tests used to assess intelligence, academic achievement, neuropsychological functions, and personality are reviewed. RESULTS: There are numerous well-normed, reliable, and valid instruments that are available for assessing intellectual and academic functioning in children and adolescents. Neuropsychological tests, designed to assess objectively a wide range of cognitive functions, are available and extremely useful for designing treatment plans for patients with cognitive difficulties. Despite their popularity, most projective tests have relatively weak psychometric data supporting their reliability and/or validity. CONCLUSIONS: Psychological testing provides objective measures of behavior that are of considerable utility for evaluating children and adolescents. However, psychological test data, in isolation, will rarely be adequate for providing a DSM diagnosis, and test scores are best interpreted in the context of other clinical data. Psychological test data can be very useful for developing a comprehensive treatment plan that addresses the patient's cognitive and emotional needs.

Adolescent↗

PubMed2004

Clinical nurses' understanding of autonomy: accomplishing patient goals through interdependent practice.

OBJECTIVE: The purpose of the study was to enable nurse managers to identify strategies to support and enhance autonomous practice based on clinical nurses' understanding of autonomy. BACKGROUND: Findings from an organizational work-life satisfaction survey led a nursing management team to question how clinical nurses understand autonomy. The nursing literature offers inconsistent definitions of autonomy and interchangeable use of related concepts. METHODS: Twelve focus groups involving 43 nurses working in cardiovascular service units discussed instances of satisfaction and dissatisfaction with autonomy in their clinical practice and work life. Verbatim transcripts of group discussions were interpreted by a research team to identify salient examples and descriptions of autonomy. RESULTS: Nurses described autonomy as their ability to accomplish patient care goals in a timely manner by using their knowledge and skills to understand and contribute to the overall plan of care; assess patient needs and conditions; effectively communicate concerns and priorities regarding patient care; and access and coordinate the resources of the multidisciplinary team. CONCLUSIONS: These findings challenge assumptions about autonomy as independent decision making and practice. They highlight nurses' contributions to patient care goals through knowledge of how to get things done within hospital systems and through interdisciplinary coordination and collaboration.

Alberta↗

PubMed2003

Friction effects and clogging in a cellular automaton model for pedestrian dynamics.

We investigate the role of conflicts in pedestrian traffic, i.e., situations where two or more people try to enter the same space. Therefore a recently introduced cellular automaton model for pedestrian dynamics is extended by a friction parameter mu. This parameter controls the probability that the movement of all particles involved in a conflict is denied at one time step. It is shown that these conflicts are not an undesirable artifact of the parallel update scheme, but are important for a correct description of the dynamics. The friction parameter mu can be interpreted as a kind of an internal local pressure between the pedestrians which becomes important in regions of high density, occurring, e.g., in panic situations. We present simulations of the evacuation of a large room with one door. It is found that friction has not only quantitative effects, but can also lead to qualitative changes, e.g., of the dependence of the evacuation time on the system parameters. We also observe similarities to the flow of granular materials, e.g., arching effects.

Journal Article↗

PubMedDate not supplied

Use of quantitative models to design microbial transport experiments in a sandy aquifer.

A suite of numerical models was applied to the problem of designing field tracer and bacterial injection experiments in a sandy surficial aquifer near Oyster, Virginia. The models were constructed based on the integration of diverse characterization data including hydrologic, geophysical, geological, geochemical, and biological information. A one-dimensional particle-tracking model was used to analyze laboratory transport experiments conducted using intact core samples to prescribe transport parameters describing solute dispersion and bacterial fate. A geostatistical model of three-dimensional hydraulic conductivity variations was developed, conditioned on in situ measurements of hydraulic conductivity and interpretations of geophysical data, and used to generate alternative aquifer descriptions. A regional-scale, two-dimensional flow model was used to design pumping rates of a forced-gradient hydraulic control system. Information from these various models was then combined into a high-resolution, three-dimensional flow and transport model for the prediction of field-scale solute and bacterial transport. Model predictions were used in an iterative experimental design process to specify: (1) the locations of multilevel samplers for monitoring transport; (2) frequency and timing of sample collection during bromide tracer injection experiments; and (3) frequency and timing of sample collection during a bacterial injection experiment. At each stage of the design, information gained during the previous stage was used to refine the model and target subsequent experimentation.

Biodegradation, Environmental↗

PubMedDate not supplied

How psychometrically sound is the transplant evaluation rating scale for bone marrow transplant recipients?

This paper explores the psychometrics and clinical utility of the Transplant Evaluation Rating Scale (TERS) for bone marrow transplant recipients. On a sample of 345, the TERS exhibits good inter-rater reliability and internal consistency, better than the Psychosocial Levels System (PLS), its precursor, and thus psychometrically justifies the TERS revisions. Addressing a noted gap in the literature, this paper empirically evaluates the TERS weighting system and concludes that it provides no additional predictive utility relative to simply summing unweighted item scores. Finally, this paper's descriptive scale norms for the TERS provide guidance for clinical interpretation of TERS scores.

Adult↗

PubMed1991

Approaches to the identification and recording of nasal lesions in toxicology studies.

The identification, recording, and interpretation of nasal lesions can be a difficult task in toxicology studies. The objective of this article is to provide some guidelines for approaches to nasal toxicologic pathology, based on the author's experience and information available in the published literature. Identification of treatment-induced nasal lesions requires adequate in-life and post-mortem observation, and thorough histopathology. Histopathologic assessment is dependent upon high quality and consistent histologic preparations, adequate knowledge of nasal anatomy and histology, and experience with the range of aging, background, and treatment-induced lesions that may be encountered. In recent years there has been a marked increase in the number of articles reporting nasal pathology in studies for which materials were delivered by inhalation and by non-inhalation routes. Because of the increasing size of this database, it is recommended that standardized and systematic nomenclature be developed for these changes. The following points are considered to be particularly important: 1) alert animal care staff to clinical changes that may indicate nasal lesions; 2) screen animals for nasal disease, such as nasal nematodes in non-human primates; 3) record gross lesions during trimming of decalcified nasal tissues; 4) save spare tissue in fixative; 5) remember that the normal bilateral symmetry of the nose can be a valuable diagnostic aid; 6) avoid excessive lumping or splitting of diagnoses; 7) develop a logical order for recording of lesions (the approach preferred by the author is degenerative, inflammatory, regenerative, proliferative, for each of the epithelial types in a logical anatomical order, such as squamous, transitional, respiratory, and olfactory); 8) accurately determine the site of toxic responses; 9) keep a notebook of interesting or important observations and ideas if you are using a computerized data acquisition system; 10) consider the role of factors that may account for lesion distribution (regional dose and tissue susceptibility) during interpretation of tissue responses; and 11) during preparation of the descriptive narrative, clearly define what occurred, where and when it occurred, and consider the use of simple anatomical diagrams as an adjunct to the text. Adequate lesion detection and characterization by the toxicologic pathologist is often a critical feature of toxicology studies, and can play an important role in determination of human risks associated with exposure to xenobiotics. A systematic but flexible approach is recommended.

Aging↗

PubMed1996

[Capgras syndrome: evolution of the hypotheses].

OBJECTIVE: to trace the evolution of hypotheses concerning Capgras' syndrome. METHODS: The data consist of slightly over 60 studies published between 1866 and 1994 which were selected in terms of their innovative nature and relevance to the clinical description of the syndrome and to psychodynamic, neurological and neuropsychological interpretations. RESULTS: Two partially overlapping major stages can be identified in the evolution of hypotheses regarding the mechanisms of the syndrome. The 1st, beginning in 1923, is characterized by the predominance of psychodynamic interpretations. The 2nd, resulting from the observation of organic dysfunctions in a high percentage of cases, is distinguished by the advent of neurological interpretations, and by a few mixed hypotheses. CONCLUSIONS: Overall, this review highlights the broad diversity of viewpoints concerning the syndrome. It will be used as a basis for the following study, which is designed to show that it is possible to test each of the viewpoints experimentally.

Capgras Syndrome↗

PubMed2006

Evaluating rehabilitation using cost-consequences analysis: an example in Parkinson's disease.

OBJECTIVE: To use cost-consequences analysis to evaluate rehabilitation, and to discuss some practical limitations. DESIGN: Case study of a cost-consequences analysis. SETTING: Day hospital. SUBJECTS: People with Parkinson's disease without major cognitive loss, and their carers. INTERVENTION: A programme of multidisciplinary rehabilitation, delivered for one day per week over six weeks, and including 2 h of individual therapy (physical, occupational, speech and language, specialist nurse) and group activities on each occasion. MAIN MEASURES COSTS: direct and overhead costs of treatment; participant travel. CONSEQUENCES: patient outcomes (mobility, speech and language, disability, psychological well-being, health-related quality of life); carer outcomes (psychological well-being, health-related quality of life, strain); social service utilization; satisfaction. RESULTS: In this example the main costs were facility's overheads and hospital-provided transport. The consequences of the intervention were improved immediate outcomes for patients that diminished over four months, discovery of unmet social services need, high satisfaction. No benefits for carers were observed. CONCLUSION: A cost-consequences analysis provides a clear descriptive summary for decision-makers that is easier to interpret than cost-effectiveness, cost-utility and cost-benefit analysis. It is a useful technique in rehabilitation research where multiple outcomes and several perspectives (health service, patient, carer) are relevant. However limitations remain: it is difficult to capture all consequences because of data deficiencies and long-term effects; evaluations of individual interventions are partial and do not guarantee economic rationality; local studies may not be generalizable; fixed protocols impede the evaluation of alternative service configurations.

Aged↗

PubMedDate not supplied

TP5 triggers signal transduction involving mitogen activated protein kinases in monocytes.

The pentapetide thymopentin (TP5) corresponding to the aminoacids RKDVY represents the residues 32-36 of thymopoietin (TP), which was originally isolated from bovine thymus. Both were observed to induce T-cell differentiation and maturation. Recently however it was shown, that TP represents the N-terminal 49 aa of the human thymopoietin (TMPO) isoforms TMPO alpha, beta and gamma, which are localized in the nucleus. TP5 was investigated in a variety of diseases and showed efficacy by improving the immune balance, whereby different cells increased in cell number or activity. Findings which support the assumption of multifunctional efficacy and a description of TP and TP5 modulating T cells lack any interpretation on molecular level. In the present study we investigated the binding of TP5 on white blood cells. We identified monocytes and neutrophils as TP5-binding cells by displacing fluorescein-labelled TP5 with an excess of unlabelled TP5 in competition assays. Binding of TP5 on cell surface proteins resulted in cellular signalling and we report here that TP5 triggers signal transduction involving mitogen activated protein kinases p42/p44 (MAPKs) in monocytes.

Adjuvants, Immunologic↗

PubMedDate not supplied

Data analysis in qualitative research: a plea for sharing the magic and the effort.

This discussion of data analysis in qualitative research addresses the question of how authors describe this aspect of their research. I suggest that the tradition of organization of research papers from quantitative research is not a good fit for writing qualitative research. I argue for less jargon and more detailed description, with the analytic process integrated into the findings and interpretation.

Humans↗