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PubMed1995

1995 Volvo Award in clinical sciences. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations.

STUDY DESIGN: This was a prospective study of patients (study group) with symptomatic disc herniations and asymptomatic volunteers (control group) matched for age, sex, and work-related risk factors. OBJECTIVE: To determine the prevalence of disc herniation in a matched group of asymptomatic volunteers and to access the diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. SUMMARY OF BACKGROUND DATA: Disc herniations have been reported to occur in 20-36% of asymptomatic volunteers. A valid comparison of asymptomatic individuals and patients with disc herniations has not been performed. METHODS: Forty-six patients with low back pain and sciatica severe enough to require a discectomy were compared with 46 age-, sex-, and risk factor-matched (heavy lifting, twisting and bending, vibration, and sedentary activity) asymptomatic volunteers. Both groups had a complete clinical and magnetic resonance imaging examination and completed a questionnaire to assess differences in the psychosocial and work perception profiles. The prevalence and the severity of morphologic alterations (disc herniation, disc degeneration, and neural compromise) was analyzed by tow independent radiologists in a blinded fashion. Differences between both groups regarding MRI findings, work perception (occupational mental stress, intensity of concentration, job satisfaction, and job-related resignation) and psychosocial factors (anxiety, depression, self-control, social support, and marital status) were compared using multivariate techniques. Stepwise discriminating analysis was used to identify the best discriminating variables within the magnetic resonance image, work perception, and psychosocial categories in terms of the diagnostic accuracy to predict group membership (study [pain] or control [no pain] group). RESULTS: Matched controls had significantly more risk factors than a group of normal individuals. The present study has presented evidence that an age-, gender-, and occupational risk factors-matched group of asymptomatic patients shows a high incidence rate of disc herniations (76%). Although significantly less than the symptomatic group incidence of 96%, this represents a much higher prevalence rate than generally expected and reported in other studies of unmatched asymptomatic volunteers. Patients had more severe disc herniations (disc extrusions) than asymptomatic volunteers (35% vs. 13%). There was no significant differences regarding disc degeneration between both groups (96% vs. 85%). The only substantial morphologic difference between both groups was the presence of a neural compromise (83% vs. 22%), which was highly significant (P < 0.0001). There were significant differences between both groups regarding work perception (occupational mental stress, intensity of concentration, job satisfaction, and resignation; P < 0.027) and psychosocial factors (anxiety, depression, self-control, marital status; P < 0.0001). The best single predictor of a group membership was the extent of neural compromise. A combination of this factor with occupational mental stress, depression, and marital status was the best predictive model. With this model, the false-negative rate (potential overtreatment of disc morphology) was reduced by more than half compared with morphologic factors (nerve root compression) alone (22% vs. 11%). CONCLUSIONS: In an age-, sex-, and risk factor-matched group of asymptomatic individuals, disc herniation had a substantially higher prevalence (76%) than previously reported in an unmatched group. Individuals with minor disc herniations (i.e., protrusion, contained discs) are at a very high risk that their magnetic resonance images are not a causal explanation of pain because a high rate of asymptomatic subjects (63%) had comparable morphologic findings. The only highly significant difference between the study group and control group regarding morphologic fi

Adult↗

PubMedDate not supplied

Perceptions of improvement work in Swedish health care: implications for improvement practices.

This study explored perceptions of improvement work in Swedish health care. The article discusses effects that these perceptions may have on improvement processes. As part of a broader study surveying managers' (n = 2313) view of improvement work in Swedish health care, this study focused on those 845 managers who regarded their improvement work as bringing about benefits. Three underlying factors that may characterize the managers' perceptions are exposed. More than 50% of the respondents perceive a complexity in the practices and techniques associated with improvement work. Furthermore, approximately 50% of the managers recognize a conflict in the meeting between the improvement work and the organization. This indicates that adaptation is a primary concern in this work. The managers' perceptions also reveal that the experience of improvement work in Swedish health care may be positive, although the perception is that it does not necessarily generate more health care per monetary unit.

Administrative Personnel↗

PubMed2006

Subjective perception of cognitive deficit in psychotic patients.

The objective of this study is to evaluate the subjective perception of cognitive deficit and how it relates to the perception of patients' relatives. Differences between the subjective perception of cognitive deficits in 107 DSM-IV-diagnosed psychotic patients and that of their relatives or caregivers were evaluated using the GEOPTE Scale. Fair agreement was observed between patient and family perception of cognitive functions, although there were important differences on those items that correspond to social functioning. A high degree of correlation was detected between the scores on this scale and clinical global impression scores, as well as the physicians' global impression of cognitive impairment. Psychotic patients maintain insight as to their cognitive deficits, but they fail to conserve an awareness of their perception of social functioning.

Adult↗

PubMed2006

The effects of optical blur on motion and texture perception.

PURPOSE: The purpose of this study is to determine how decreased visual acuity affects performance on tasks of motion and texture perception. METHODS: Positive diopter lenses were used to match three subjects at five levels of decimal visual acuity (DVA) ranging from an uncorrected DVA of 1.6 to the lowest DVA of 0.2. Performance thresholds were determined at each acuity level for five different psychophysical tasks. The tasks assessed the perception of motion-defined form, global motion, maximum motion displacement (Dmax), texture-defined form, and global texture. RESULTS: Reducing visual acuity decreased performance on the tasks of motion-defined form identification, texture-defined form identification, and global texture integration. Performance on the Dmax task improved with a reduction in visual acuity. Performance on the global motion task was unaffected by changes in visual acuity. CONCLUSIONS: Visual acuity should be considered when interpreting the results of developmental or clinical studies of motion and texture perception. The only exception to this is global motion perception, at least when DVA is better than 0.2. The effect of blur on tasks of motion and texture perception may reflect the extent to which high spatial frequency information is required for performance on these tasks.

Humans↗

PubMed1980

Perceptions as hypotheses.

Perceptions may be compared with hypotheses in science. The methods of acquiring scientific knowledge provide a working paradigm for investigating processes of perception. Much as the information channels of instruments, such as radio telescopes, transmit signals which are processed according to various assumptions to give useful data, so neural signals are processed to give data for perception. To understand perception, the signal codes and the stored knowledge or assumptions used for deriving perceptual hypotheses must be discovered. Systematic perceptual errors are important clues for appreciating signal channel limitations, and for discovering hypothesis-generating procedures. Although this distinction between 'physiological' and 'cognitive' aspects of perception may be logically clear, it is in practice surprisingly difficult to establish which are responsible even for clearly established phenomena such as the classical distortion illusions. Experimental results are presented, aimed at distinguishing between and disconvering what happens when there is mismatch with the neural signal channel, and when neural signals are processed inappropriately for the current situation. This leads us to make some distinctions between perceptual and scientific hypotheses, which raise in a new form the problem: What are 'objects'?

Humans↗

PubMed2001

Socioeconomic determinants of health- and food safety-related risk perceptions.

Individual and societal perceptions of food-related health risks are multidimensional and complex. Social, political, psychological, and economic factors interact with technological factors and affect perceptions in complex ways. Previous research found that the significant determinants of risk perceptions include socioeconomic and behavioral variables. Most of these past results are based on two-way comparisons and factor analysis. The objective of this study was to analyze the significance of socioeconomic determinants of risk perceptions concerning health and food safety. A multivariate approach was used and the results were compared with earlier bivariate results to determine which socioeconomic predictors were robust across methods. There were two major findings in this study. The first was that the results in the multivariate models were generally consistent with earlier bivariate analysis. That is, variables such as household income, number of children, gender, age, and voting preferences were strong predictors of an individual's risk perceptions. The second result was that the gender of the respondent was the only variable found to be robust across all three classes of health and food safety issues across two time periods.

Female↗

PubMed2003

Risk communication and foodborne illness: message sponsorship and attempts to stimulate perceptions of risk.

Foodborne illness represents a serious health hazard in the United States. Since foodborne illness can often be prevented by an individual's behavior, messages aimed at promoting safe food-handling behaviors should be a major tool to reduce the incidence of foodborne illness. This article argues that to achieve adoption of safe food-handling practices in the home, food-safety messages should both stimulate risk perceptions and promote self-efficacy, feelings that one can successfully enact recommended behaviors. A content analysis of nationally distributed food-safety messages questioned if messages incorporated these features. Since food-safety communicators operate in complex environments with multiple and sometimes competing objectives, this study also questioned if sponsorship of foodborne illness prevention messages was related to the amount of content designed to alter risk perceptions associated with foodborne illness. Results of the quantitative content analysis found that copywriters generally included content designed to stimulate risk perception about foodborne illness but virtually ignored self-efficacy needs of the audience. A marked difference in tendencies to stimulate risk perceptions was found based on sponsorship. Both in volume and proportion, results show that governmentally sponsored messages more aggressively attempted to heighten risk perceptions associated with foodborne illness than did messages sponsored by privately funded communicators.

Communication↗

PubMed1991

Clients' perceptions: the use of case studies in developing theory.

This paper describes some aspects of a study which looked at clients' perceptions of health visiting, and how, if at all, these related to their perceptions of health needs. The researcher explored the alterations of these perceptions over time, and also examined how they related to professional perceptions. The background to this study is described. The methods used are outlined. The study was carried out in two phases. The first phase used semistructured interviews and diaries to explore 41 parents' perceptions at one point in time. In phase two, a series of three semistructured interviews were completed over a 10-month period with 19 primiparous parents, commencing antenatally, and with 10 of their health visitors. Analysis was by the grounded theory method. The eight concept areas which emerged from the data are listed. The paper goes on to discuss the use of case studies in developing a substantive theory. Finally, some of the implications which this study has for health visiting practice are outlined.

Community Health Nursing↗

PubMed2006

Hospital staff perceptions of parental involvement in paediatric hospital care.

AIM: This paper reports a study of hospital staff perceptions of parental involvement in children's hospital care. BACKGROUND: Previous research has shown that parents are expected and encouraged by hospital staff to be actively involved in the care of their hospitalized children. At the same time, parents have expressed a need for improved communication with paediatric hospital staff to clarify both parental and staff expectations and preferences about this involvement. Few studies, however, have studied hospital staff perceptions of parental involvement in the care of hospitalized children and their implications for clinical work. METHODS: A cross-sectional questionnaire study was conducted among paediatric hospital staff in October of 2003. Questionnaires were distributed to a total of 338 staff, including all physicians, Registered Nurses and nursing auxiliaries working on oncology, surgery and neurology units in three university children's hospitals in Sweden. RESULTS: A total of 207 questionnaires were returned, yielding a response rate of 61%. Exploratory and confirmatory factor analyses of the 26-item questionnaire resulted in the creation of two indices, Work Routines and Work Strain. Oncology staff reported having better work routines for involving parents in their children's care and they experienced less strain from parental demands compared with staff on other paediatric units. Staff perceptions and workplace routines regarding parental involvement did not differ statistically significantly by profession or by length of work experience. CONCLUSION: Staff perceptions of parental involvement may be related to clinical specialty. Oncology units may find it easier to establish routines for parental involvement, thereby experiencing less work strain in their interactions with parents. There is a need to further study staff perceptions of parental involvement and their implications for the staff work situation in both Sweden and other countries.

Adult↗

PubMed1984

Student perceptions of the learning environment in a new medical school.

Students' perceptions of their learning environment in the Faculty of Medicine of the University of Newcastle were tested in 1979, in the second year of the school's existence, when the first two cohorts of students were surveyed. It was thought important to re-test those same cohorts in 1982, when they were in the later years of the curriculum, to see whether their perceptions had changed, and also to test the perceptions of subsequent cohorts of students (still in the earlier years of the course) to examine whether the favourable perceptions of the earlier cohorts were being maintained. Accordingly, this paper reports the results of a cross-sectional study undertaken on all five years of Newcastle medical students in 1982, and it compares their perceptions with those obtained 3 years earlier.

Attitude of Health Personnel↗

PubMed1997

Maternal perception of sound provoked fetal movement for antepartum assessment of fetal well-being.

OBJECTIVE: To assess the reliability and application of maternal perception of sound provoked fetal movement for antepartum assessment of fetal well-being. METHODS: Six hundred singleton high risk pregnant women of at least 32 weeks gestation were studied on 684 occasions. The response was compared with a nonstress test (NST) performed before a 3 second vibroacoustic stimulation with an electronic artificial larynx. The result of maternal perception of sound provoked fetal movement was compared to the NST and the perinatal outcome using sensitivity, specificity, negative predictive value, positive predictive value, and accuracy. RESULTS: On 684 occasions, a positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 642 occasions (93.9%) and was accompanied by a reactive NST on 630 occasions; giving a specificity of 97.1% and a negative predictive value of 98.1%. Results of maternal perception of sound provoked fetal movement and NST, performed within a week of delivery, in 560 women were compared with perinatal outcome. The maternal perception of sound provoked fetal movement test had better sensitivity (64.7%) for poor perinatal outcome than the NST (58.8%). Both tests were not different in specificity (96.3% vs 96.5%), positive predictive value (35.5% vs 34.5%), negative predictive value (98.9% vs 98.7%), and accuracy (95.4% vs 95.4%). CONCLUSION: The findings suggested that maternal perception of sound provoked fetal movement may be an effective screening test to identify fetal compromise in antepartum period. This test is a simple and inexpensive test for evaluating fetal well-being in primary health care setting.

Acoustic Stimulation↗

PubMed1990

A commentary on Rönnberg's distinction between perception and cognition.

In a commentary on a note by Rönnberg (Rönnberg, J. On the distinction between perception and cognition. Scandinavian Journal of Psychology, 1990, 31, 154-156), it is argued that one of Rönnberg's criteria for theoretically distinguishing perception from cognition, that of different biological purposes, is invalid. Congruent with a broad definition of perception and cognition which most researchers agree upon, Rönnberg's two other criteria essentially state that how internally represented information is processed distinguishes between perception and cognition. However, the more strict criterion of whether explicit retrieval of information from memory is necessary is too dependent on a particular, rather limited theoretical framework. A third, less theory-dependent criterion of whether the information available in the stimulus is sufficient to account for comprehension may be useful in research which investigates hypotheses about similarities between perception and cognition.

Cognition↗

PubMed2005

A question of perception: Bourdieu, art and the postmodern.

Bourdieu and Darbel's classic study of European art museum audiences, The Love of Art (1991), remains one of the most influential academic studies of the social indices of art perception. Its findings were central to Bourdieu's on-going study of culture-mediated power relations, as found in the book Distinction (Bourdieu 1984), as well as social surveys of the behaviour of museum audiences across the world. Much in Bourdieu's account of art perception, however, has begun to appear dated and in need of supplementation. This paper will be a critical but sympathetic re-reading of Bourdieu's sociology of art perception in the light of recent criticisms of his approach. Whilst fine art and its institutions continue to function as sources of social identification and differentiation, this paper argues that the relationship between perception and stratification is somewhat looser than connoted in Bourdieu's work. Beyond the shift to a less rigid taxonomy of social formations, the immense expansion of the visual arts complex has opened up possibilities for the dissemination of art knowledge beyond the cultivated bourgeois. The erosion of boundaries between the aesthetic and the economic, between art and popular culture, are the result of processes of commodification that have placed museums alongside shopping malls within the realms of consumption and entertainment. New audiences have emerged from this mix with less dichotomized - that is, either cultivated or popular - ways of seeing culture that suggest a revision of Bourdieu's overly integrated account of class and cognition. An alternative, 'postmodern', approach to art perception is entertained, where an aesthetics of distinction is replaced by a culture of distraction, but this abstracts culture from any structural grounding. Capturing the shift to an accelerated cultural present, instead, requires a warping of Bourdieu's categories to account for broader patterns of culture and economy and the accentuation of modern visual culture.

Art↗

PubMedDate not supplied

Disparities between black and white patients with cancer pain: the effect of perception of control over pain.

CONTEXT: Pain continues to be a problem in ambulatory patients with cancer. Disparities in minority patients with pain have been previously identified. OBJECTIVE: To examine the effect of perception of control over pain on disparities in pain, symptom distress, and functional status in white and black patients with cancer. DESIGN: Cross-sectional, descriptive. SETTING: Outpatient clinic in a large urban cancer center. PATIENTS: A total of 281 patients who reported having pain within the last month and were receiving treatment in the cancer center. OUTCOME MEASURES: Pain intensity, pain-related distress, functional status, perception of control over pain. RESULTS: Black patients had significantly higher pain intensity, more pain-related distress, and reported more pain-related interference with function than white patients. Disparities in pain-related distress and functional status were significantly reduced and only disparities in pain intensity remained when perception of control over pain was held constant. CONCLUSIONS: Perception of control over pain is an important factor in understanding responses to pain. Increasing a patient's perception of control over pain may decrease disparities and increase functional status.

Adult↗

PubMed1994

Public perceptions of the potential hazards associated with food production and food consumption: an empirical study.

Although public perceptions of food-related hazards receive much media comment and debate, the research literature on such perceptions is sparse and piecemeal. In the reported study, 216 people completed a questionnaire relating to their perceptions of the "risk characteristics" of potential hazards associated with various aspects of food production and food consumption. Responses were examined via principal-components analysis to obtain a structural representation of risk perception of the kind provided by Fischhoff, Slovic, and their colleagues in their seminal psychometric work. A three-component solution accounting for 87% of the variance was obtained, with the dimensions labeled as "severity," "unknown," and "number of people exposed." The findings also yielded information pointing to evidence of the phenomenon of unrealistic optimism. We conclude that our findings offer a useful base upon which further in-depth research integrating different perspectives on risk perception with respect to food-related hazards may be developed.

Analysis of Variance↗

PubMed2006

Personal values, beliefs, and ecological risk perception.

A mail survey on ecological risk perception was administered in the summer of 2002 to a randomized sample of the lay public and to selected risk professionals at the U.S. Environmental Protection Agency (US EPA). The ranking of 24 ecological risk items, from global climate change to commercial fishing, reveals that the lay public is more concerned about low-probability, high-consequence risks whereas the risk professionals are more concerned about risks that pose long-term, ecosystem-level impacts. To test the explanatory power of the value-belief-norm (VBN) theory for risk perception, respondents were questioned about their personal values, spiritual beliefs, and worldviews. The most consistent predictors of the risk rankings are belief in the new ecological paradigm (NEP) and Schwartz's altruism. The NEP and Schwartz's altruism explain from 19% to 46% of the variance in the risk rankings. Religious beliefs account for less than 6% of the variance and do not show a consistent pattern in predicting risk perception although religious fundamentalists are generally less concerned about the risk items. While not exerting as strong an impact, social-structural variables do have some influence on risk perception. Ethnicities show no effect on the risk scales but the more educated and financially well-off are less concerned about the risk items. Political leanings have no direct influence on risk rankings, but indirectly affect rankings through the NEP. These results reveal that the VBN theory is a plausible explanation for the differences measured in the respondents' perception of ecological risk.

Adult↗

PubMed2003

The overcrowded emergency department: a comparison of staff perceptions.

OBJECTIVES: To study perceptions of physicians and nursing staff about real-time demands and capacity of an emergency department (ED). To use ED data to calculate proposed demand ratios called Real-time Emergency Analysis of Demand Indicators (READI) scores. To compare the READI scores with ED staff perceptions of demand and capacity. METHODS: This prospective study used a computerized clinical management system to provide data about ED demand and capacity. Physicians and staff charge nurses were surveyed about perceptions of ED demand and capacity. Results were compared with mathematical READI scores, which are proposed to objectively assess ED demand. Kappa scores were used to measure intrarater reliability between the physicians' and charge nurses' assessment of demand and between the staff assessments and the READI scores. RESULTS: Kappa scores of the perception of excess demand were as follows: between two physician groups, kappa = 0.392; between one physician group and charge nurses, kappa = 0.453; and between a second physician group and charge nurses, kappa = 0.243. Comparing respondents who indicated that demand had or had not exceeded capacity, one of the READI ratios, the Bed Ratio, showed a significant difference in mean, 0.245 (95% confidence interval = 0.153 to 0.336), between groups. CONCLUSIONS: Real-time data may be used to predict ED demand and resource needs. Subjective assessment of excess ED demand did not correlate between physician groups or between physicians and charge nurses. Although there was a trend toward predicting excess demand with one of the READI scores, these scores did not correlate to staff perceptions.

Emergency Service, Hospital↗

PubMed2004

Do ethnicity and gender have an impact on pain thresholds in minor dermatologic procedures? A study on thermal pain perception thresholds in Asian ethinic groups.

BACKGROUND AND OBJECTIVES: The perception of pain is a personal experience influenced by many factors, including genetic, ethnic and cultural issues. Understanding these perceptions is especially important in dermatologic patients undergoing minor surgical operations and who often differ in their pain response to surgical treatments. Little is known about how these differences affect the perception of experimental pain. The purpose of this study was to determine experimental pain perception differences in three distinct East Asian ethnic populations. METHODS: Pain thresholds were examined with a psychophysical computerized quantitative thermal sensory testing device (TSA 2001) in healthy volunteers recruited from three different Asian ethnic groups. Using the methods of limits, experimental pain perception threshold was measured on the forehead and volar aspect of the forearm in 49 healthy subjects. The measurements were then repeated after skin barrier perturbation with adhesive tape stripping of the stratum corneum. All three ethnic groups were analyzed separately with respect to age, gender educational level and skin type. RESULTS: A total of 20 Chinese, 14 Malay and 15 Indian subjects completed the study. Thermal pain thresholds were similar in all three ethnic groups before and after tape strippings. No significant differences were noted between genders. CONCLUSIONS: Using quantitative sensory thermal testing, we demonstrated that no significant differences in pain occur between different races and genders.

Adult↗