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PubMed1976

Kinetics of adenosine 3':5'-monophosphate accumulation in dog thyroid slices.

Dog thyroid slices have been stimulated in vitro by thyrotropin. The kinetics of adenosine 3':5'-monophosphate (cyclic AMP) accumulation due to the activation of adenylate cyclase were measured. Experimental results have been interpreted by means of a numerical simulation based on a theoretical description of the overall process which consists of three steps: (a) the penetration of thyrotropin in the slices, (b) the binding of the hormone to the specific receptor and the consequent activation of adenylate cyclase, (c) the kinetics of cyclic AMP accumulation in each cell due to the interplay between synthesis and degradation. The numerical values of the parameters needed for the simulation were deduced from separate experiments. Diffusion of thyrotropin in the slices has been calculated from the kinetics of efflux of [3H]sucrose, and with or without albumin. Adenylate cyclase activity and activation by thyrotropin in homogenates and purified membranes were measured. Binding experiments of cyclic AMP on crude extract of dog thyroid lead to the conclusion that the maximal capacity of the specific binding site is close to the cyclic AMP content in resting thyroid cells. The purpose of this paper is to verify the validity of the current concepts about the mechanisms taking place in this process by comparing experimental results and theoretical simulation. It results from the study that for this system the time between the activation of adenylate cyclase and half maximal cyclic AMPaccumulation is equal to 3 min 45 s and the pool of cyclic AMP is renewed three times per minute. It has been also stressed that the thickness of the slices as well as inhibitors of phosphodiesterases change the apparent kinetics of cyclic AMP accumulation.

Adenylyl Cyclases↗

PubMed2000

Integrated literature review of continuity of care: Part 1, Conceptual issues.

PURPOSE: Continuity of patient care is a fundamental tenet of professional nursing, yet comprehension of the concept and related issues remains elusive. The purpose of this study was to explore issues associated with definitions, related concepts, and research methods of continuity of care through systematic literature-based study. In Part 1 of this two-part series, definitions and related concepts, factors, and variables associated with continuity of care were explored. DESIGN: Qualitative, integrated literature review of a sample of 38 nursing research articles about continuity of care, 1990-1995. METHODS: Ganong's (1987) stages of an integrative research review guided this study. A data collection tool was developed and pilot tested, and rules for data analysis and interpretation were established. Research articles were systematically analyzed and reported using descriptive analysis. FINDINGS AND CONCLUSIONS: No consensus was found in the literature about the conceptual definition of continuity of care. Continuity of patient care is a multifactorial concept affected by environmental influences, communication, patient, professional, and system factors.

Continuity of Patient Care↗

PubMed2000

A continuity of care integrated literature review, Part 2: Methodological issues.

PURPOSE: In Part 2 of this two-part series, research designs, methods, and measurement of continuity of care are explored. DESIGN: Qualitative, integrated literature review of a sample of 38 continuity of care nursing research article published 1990-1995. METHODS: Ganong's (1987) stages of the integrative literature research review process were followed. A data collection tool was designed and pilot tested, and rules for data analysis and interpretation were established. Research articles were systematically analyzed and reported using descriptive analysis. FINDINGS: Results showed few nursing models, primarily convenience sampling and nonexperimental cross-sectional study designs, varied data collection methods, and inadequate instrumentation. Measurement criteria were diverse and influenced by the perspectives of the measurer. CONCLUSIONS: Continuity of patient care was identified as a construct comprised of many related and tangential concepts in need of more sophisticated review. Recommendations for researchers are discussed.

Continuity of Patient Care↗

PubMed2000

Mandibular helical axis pathways during mastication.

Condylar and incisor trajectories are often used for the study of mandibular movements. Condylar trajectories, however, depend on the location of the reference point and can be interpreted erroneously. In contrast, the helical axis analysis yields an unequivocal description of rigid body kinematics. The aim of this study was to analyze the mandibular helical axis during mastication. Seven subjects without signs and symptoms of craniomandibular disorders and with class I occlusion were recorded by means of the opto-electronic system Jaws-3D during unilateral mastication of bread cubes (2-cm side). The helical axis was computed every 14 ms with a rotation threshold of 1 . Parameters describing its spatial orientation and position relative to the condyles were calculated. The helical axis changed orientation and position more pronouncedly during the closing than during the opening phases of mastication. The orientation varied significantly from beginning to end of closing but not of opening, indicating less fluctuation of the helical axis on opening than on closing. Also, the distance dCP between helical axis and reference condylar point varied more significantly (p < 0.05) on the working than on the balancing side: On the working side, dCP decreased during both opening and closing, whereas on the balancing side, dCP increased only for closing. Furthermore, the helical axis pathway often showed a bowing ventrally to the balancing condyle, indicating that, during closing, the balancing condyle still translated backward while essentially only rotation occurred around the working condyle. Thus, the helical axis changed its position and orientation continuously during mastication.

Adult↗

PubMed2003

Coronas and iridescence in mountain wave clouds.

We use Fraunhofer diffraction theory and meterological data to determine the nature of cloud-particle distributions and the mean particle sizes required for interpreting photographs of coronas and iridescence in mountain wave clouds. Traditional descriptions of coronas and iridescence usually explain these optical phenomena as diffraction by droplets of liquid water. Our analysis shows that the photographed displays have mean particle sizes from 7.6 to 24.3 microm, with over half the cases requiring diffraction by small (approximatley 20 microm) quasispherical ice particles rather than liquid water droplets. Previous documentation of coronas produced by ice particles are limited to observations in cirrus clouds that appear to be composed of small ice crystals, whereas our observations suggest that coronas and iridescence quite often can be created by tiny quasispherical ice particles that might be unique to mountain wave clouds. Furthermore, we see that the dominant colors in mountain wave-cloud coronas are red and blue, rather than the traditionally described red and green.

Journal Article↗

PubMed1999

Nature of clinical practice for specialists in orthopaedic physical therapy.

Clinical specialization is part of physical therapy's continued development as a profession. Clinical specialization in physical therapy has evolved with little discussion of how specialization is related to the development of professional expertise. The purposes of this paper were to compare the identified clinical competencies in orthopaedic physical therapy to selected clinical reasoning models and expertise development models in physical therapy and interpret these comparisons in light of current theoretical work in expertise. Descriptive content analysis using results from the 1993 Practice Analysis for Orthopaedic Physical Therapy Certified Specialists was done to link attributes identified in 3 selected theoretical models of clinical decision making and practice. Survey materials were linked to theories by use of a binary index (yes/no) of whether theoretical concepts were present or absent in the survey results. The attributes that characterize an expert physical therapy practitioner involve clinical reasoning, and the ability to teach patients. The skills of a master clinician were based not just on the application of knowledge, but also on thinking and reasoning that occurs with experience. We propose that knowledge is gained through the clinician's thinking and reasoning during practice which results in a transformation or change in the clinician's knowledge base. Describing the clinical specialization process in the context of expert theory provides a strong foundation for the specialization process in physical therapy.

California↗

PubMed2002

When wrong predictions provide more support than right ones.

Correct predictions of rare events are normatively more supportive of a theory or hypothesis than correct predictions of common ones. In other words, correct bold predictions provide more support than do correct timid predictions. Are lay hypothesis testers sensitive to the boldness of predictions? Results reported here show that participants were very sensitive to boldness, often finding incorrect bold predictions more supportive than correct timid ones. Participants were willing to tolerate inaccurate predictions only when predictions were bold. This finding was demonstrated in the context of competing forecasters and in the context of competing scientific theories. The results support recent views of human inference that postulate that lay hypothesis testers are sensitive to the rarity of data. Furthermore, a normative (Bayesian) account can explain the present results and provides an alternative interpretation of similar results that have been explained using a purely descriptive model.

Adult↗

PubMed2001

Detection of liver metastases: comparison of contrast-enhanced wide-band harmonic imaging with conventional ultrasonography.

OBJECTIVE: To compare the detection rate of conventional ultrasonography and contrast-enhanced wide-band harmonic ultrasonographic imaging in the detection of small liver metastases. METHODS: Consecutive patients with histologically proved gastrointestinal carcinoma liver metastases were studied. Biphasic helical computed tomography, conventional ultrasonography, and contrast-enhanced wide-band harmonic imaging were performed on all patients within a 5-day period. The biphasic helical computed tomographic scans were reviewed and interpreted by a skilled radiologist. The number of lesions and their descriptive characteristics were recorded for analysis. In addition, videotape recordings of the conventional ultrasonography and contrast-enhanced wide-band harmonic imaging were blindly reviewed, after which the number of detected lesions and their characteristics were then compared with those detected on biphasic helical computed tomography, considered the standard of reference. RESULTS: Twenty-eight patients (10 female and 18 male; age range, 45-72 years) were studied. Conventional ultrasonography detected 37 (59%) of all lesions visualized by biphasic helical computed tomography. The detection rate for contrast-enhanced wide-band harmonic imaging was significantly higher (61 [97%] of 63). In our series, two 10-mm lesions near the diaphragm were not visualized by wide-band harmonic imaging. CONCLUSIONS: The use of contrast-enhanced imaging techniques significantly improves the ultrasonographic detection of liver metastases. Our results achieved the sensitivity of biphasic helical computed tomography.

Aged↗

PubMed2000

'What happened to me': rural African American elders' experiences of stroke.

The purpose of this descriptive, qualitative study was to examine the experience of stroke from the perspective of rural African American elders and their family members. The qualitative method of narrative analysis was used to explain the stroke experience from the perspective of the participants. Descriptive narrative analysis was used to produce a report of the interpretive schemes that study participants used to create the significance of past events and to anticipate the consequences of future actions in regard to the stroke experience. The findings revealed five themes: Discovering Stroke, Delaying Treatment, Living with Uncertainty, Discovering the Impact of Stroke, and Reconstructing Life. The findings from this study have implications for both nursing practice and nursing research. First, the themes and patterns that resulted from the narrative analysis highlight issues of how, when, and why rural African American elders seek treatment for stroke symptoms. This information can assist practicing nurses in educating this target group on signs and symptoms of stroke, stroke prevention, and the emergent nature of stroke. Second, the study contributes significantly to understanding how individuals and their families live through and respond to the experience of stroke.

Activities of Daily Living↗

PubMed1999

[The empowerment of nurses in health services--a conceptual framework].

In a study of the empowerment of nurses in health services the conceptual framework served as departure in a survey of empowerment in health services in Gauteng. The aim with this part of the research methodology and the development of the conceptual framework was mainly to determine if theorists in the literature agree about the interpretation of the concept empowerment and the concepts underlined in the descriptions and definitions of the term "empowerment".

Decision Making, Organizational↗

PubMedDate not supplied

[Psychosomatic aspects of emesis gravidarum: somatic and psychosocial status of females in early pregnancy].

81 women were tested in early pregnancy with a personality questionnaire (FPI), a bodily symptoms checklist and a structured questionnaire with respect to various psychosocial events. Women with and without Emesis in early pregnancy differ significantly according to the following characteristics: Quality and quantity of past and present bodily symptoms, psychosomatic affect-resonance, calmness, occupational attitudes, description of family-relationship and expectancy to vomit. Results are interpreted that vomiting in early pregnancy seems to be a psychosomatic reaction, based on a extenuated perception of reality, in combination with difficulties "leaving home" as well an expectancy to vomit in pregnancy.

Attitude to Health↗

PubMedDate not supplied

[The dichotic listening test in the determination of cerebral dominance in normal subjects (author's transl)].

The dichotic listening test is supposed to produce lateral differences in performance that would be in relationship with the functional asymmetry of the brain. Although the existence of this relationship is beyond doubt, the review of the literature shows that it may be affected by many uncontrolled factors and that cerebral dominance in normal people cannot be predicted on the basis of the test of dichotic listening. Some attempts to identify those uncontrolled factors are examined here. It appears, in addition, that the main contribution of the structural interpretation of the auditory laterality effect is that it provided a description of the neural course of auditory information. Regarding the hypotheses that inferiority of one ear would be due either to a delay in reaching the processing centers, or to a loss of information as a consequence of a longer pathway, it is claimed that the first is inconsistent with some empirical data and the second is, until now, entirely speculative.

Auditory Perception↗

PubMedDate not supplied

[Morphofunctional architecture of the testicular veins in adults].

The correlation between varicocele and male sterility, mentioned by several authors, led us to study the disposition of the testicular veins, especially at the level of their ending, trying to provide an anatomical description, which may contribute with new etiopathogenic information, in order to interpret that pathologic entity. The arrangements of the muscular fiber bundles show a different disposition in the right and left side, mainly in their distinct orientation. The collagen and elastic tissue show an arrangement similar to the muscular fibers, in order to improve the blood flow, sometimes in the reno-testicular and sometimes in the cavo-testicular junction.

Adult↗

PubMed1993

[Fatal aspergillosis after cardiac transplantation. About 26 cases].

Complications due to infection by aspergillus and favorized by therapeutic immunodepression are a significant cause of mortality after cardiac transplantation, but are only rarely diagnosed before autopsy. A detailed description of the anatomical lesions and their localisation might help the interpretation of symptoms observed in vivo. In a series of 147 autopsies subsequent to cardiac transplantation, aspergillosis appeared as the cause of death in 26 cases. Three anatomoclinical presentations could be identified: early post-operative septic pyohaemia (14 cases), delayed septic pyohemia (7 cases) and forms with predominantly pulmonary involvement (5 cases). In the first category, cardiac lesions are the most evident with myocardial micro-abscesses and intracardiac masses of aspergillus presenting a variable risk of embolism. Pulmonary << target lésions >> (infarctus associated with a variable degree of aspergillus arterial thrombosis) were present in all cases. Visceral involvement completes the picture; the more frequent lesions being acute pancreatitis (9 cases), infarctogenic aspergillus emboli of the kidneys (11 cases), the spleen (9 cases) or the brain (6 cases). In 8 subjects, microscopical examination revealed other germs associated with aspergillus. The serious consequences of aspergillus infection after cardiac transplantation imply that every preventive precaution should be taken, especially in avoiding possible contamination of the air of the operating room by the installation of filters and the regular control of airways and air conditioning systems.

Abscess↗

PubMedDate not supplied

[Anatomic orientation in paranasal endoscopic surgery].

A major concern during endoscopic surgery of the paranasal sinuses are anatomic references, which aid in orientation and help to prevent complications. A step-by-step description is made of anatomical landmarks and how they should be interpreted during surgery. New landmarks are described, as well as typical difficult situations and their solution. Acoustic and tactile references supporting endoscopic orientationare described for the first time.

Endoscopy↗

PubMed1989

[Transesophageal, anatomic and Doppler echocardiography. Technic, indications, interpretation].

Cardiac ultrasonography completed by the Doppler technique has demonstrated his ability to visualize almost all of the anatomical pathology including description and semi-quantification of pathological blood flows within the heart. However, the physical properties of the ultrasound beam frequently limit the imaging process and Doppler flow studies. Absorption of ultrasound by the chest wall is a major determinant of quality and hence interpretation, together with the depth of the examined zone of interest. It's a common finding that echo-Doppler images are better in children than in obese adults. Moreover, strong echo-reflectors, such as calcification or prosthetic heart valves, create large acoustic shadowing effects behind which obtaining an ultrasound signal is difficult if not impossible. For this reason transesophageal echocardiography represents a new essential window into the heart. By positioning a transducer mounted on a fibroscopy sheath into the esophagus in close contact with the left atrium, images of unequaled quality are obtained. An image-resolution of the order of 1-2 mm explains the diagnostic quality in infectious aortic and mitral valve diseases for assessing small vegetations, annular abscesses, and regurgitant lesions by adding color-coded Doppler. The investigation of prosthetic valves dysfunction is completely renewed for detecting disinsertion and thromboses. Heart screening for systemic emboli includes mandatory how the visualization of left (and also right) auricles and the interatrial septum associated with contrast study. Lesions of the descending aorta (aneurysms, thromboses and especially dissections) are perfectly documented in combination with color-Doppler indicating true and false channels as well as re-entry sites. Lastly, other applications are being developed including global and segmental myocardial contractility at rest or even at stress, although this last application is still at the experimental stage. Transesophageal echocardiography therefore appears to constitute a real revolution as an added possibility to the cardiological use of ultrasound: the indication for this "window" being decided for the preferential cases described above only after having performed a standard echo examination. Very often, the indication will be raised by the echocardiographer who, after performing a conventional echo may consider that better or supplementary information could be obtained via the esophageal route. This technique performed by trained operators, is relatively simple, minimally traumatic and can be performed on an outpatient basis provided certain precautions, imposed by the preparation and the consequences of premedication received by the patient, are respected.

Aorta, Thoracic↗

PubMed2006

Classical and generalized Gibbs' approaches and the work of critical cluster formation in nucleation theory.

In the theoretical interpretation of the kinetics of first-order phase transitions, thermodynamic concepts developed long ago by Gibbs are widely employed giving some basic qualitative insights into these processes. However, from a quantitative point of view, the results of such analysis, based on the classical Gibbs approach and involving in addition the capillarity approximation, are often not satisfactory. Some progress can be reached here by the van der Waals and more advanced density functional methods of description of thermodynamically heterogeneous systems having, however, its limitations in application to the interpretation of experimental data as well. Moreover, both mentioned theories--Gibbs' and density functional approaches--lead to partly contradicting each other's results. As shown in preceding papers, by generalizing Gibbs' approach, existing deficiencies and internal contradictions of these two well-established theories can be removed and a new generally applicable tool for the interpretation of phase formation processes can be developed. In the present analysis, a comparative analysis of the basic assumptions and predictions of the classical and the generalized Gibbs approaches is given. It is shown, in particular, that--interpreted in terms of the generalized Gibbs approach--the critical cluster as determined via the classical Gibbs approach corresponds not to a saddle but to a ridge point of the appropriate thermodynamic potential hypersurface. By this reason, the classical Gibbs approach (involving the classical capillarity approximation) overestimates as a rule the work of critical cluster formation in nucleation theory and, in general, considerably.

Journal Article↗

PubMed1986

Behavioral, physiological and functional aspects of stereotyped behavior: a review and a re-interpretation.

Stereotypies are repetitive actions that are fixed in form and orientation and serve no obvious purpose. Their occurrence in farm animals submitted to intensive husbandry has been interpreted to indicate inadequate environmental design or welfare. Over recent years, detailed descriptive studies have led to a better understanding of the organization and development of stereotypies, particularly in pregnant sows housed in tether stalls. Stereotyped behaviors appear to emerge from elements of initial defensive reactions of animals to their environment. They develop via a progressive narrowing of the behavioral repertoire, until only self-directed behaviors are displayed. Pharmacological studies suggest that performance of stereotyped behavior depends on the brain dopamine systems that are involved in selection and initiation of motor movements. However, generalization of these data to natural stereotypies is doubtful. Recent evidence favors an involvement of brain opioid peptides in stereotyped behavior of sows, although the exact mechanisms remain unknown. Stereotypies are typically observed in situations of conflict or frustration. They have been claimed to have an adaptive function, either by providing self-generated sensory stimulation to compensate for the lack of environmental stimulation, or by allowing animals to discharge their tension or anxiety. However, there is little evidence in favor of either interpretation. On the basis of present knowledge, it is proposed that stereotyped activities gain strength because of the positive feedback effect of sensory stimulation on their underlying control systems, which leads to a progressive sensitization of these neural systems. Stereotypies would then be simply the outward expression of an activation of lower brain structures controlling motor behavior which occurs in the absence of normal inhibitory control by higher nervous functions.

Animals↗