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Qualitative research sampling: the very real complexities.

In this article Anthony Tuckett discusses the complexities of qualitative research sampling. He analyses a research experience, together with the rationales for and limitations of qualitative research sampling. Further, he examines the reality of establishing and maintaining a purposeful/theoretical sample and how data saturation symbiotically interacts with constant comparison to guide sampling. Additionally sample limitations are countered. This paper is aimed at novice and experienced researchers in nursing interested in the practical reality of research, who are also mindful of the necessity for rigour.

Adult↗

The journey to accepting support: how parents of profoundly disabled children experience support in their lives.

Advances in medical knowledge and care have extended the lives of children with profound and multiple disabilities. In most cases it is the parents who meet the often complex and continual needs of their child with disabilities in their own home. This study explored the experience of support in the lives of such parents. The interpretive, hermeneutic phenomenology of Heidegger was employed to create a detailed and authentic account of the parents' experiences of support. Five interrelated themes emerged from data from in-depth interviews with six parents randomly selected from a purposive sample in a special school setting. The themes were: parents' feelings about support, the journey to accepting support, support as a loss, disability and the parent and the supportive relationship. Understanding the experience of support from the parent's perspective may lead to a consideration of flexible systems that challenge practice to ensure that supporters listen, learn, develop and deliver support in ways that are helpful.

Adaptation, Psychological↗

Nursing service managers' views on problems they experience in their everyday lives: Part 1.

During 1994 it became clear to the health care delivery system management team of the old Transvaal region (Gauteng, North West and Eastern Transvaal) that nursing service managers in leadership positions were experiencing great strain in their daily work situation and seemed fatigued and stressed. The problem identified was that if nursing service managers themselves were fatigued and stressed, this would become an obstacle in the provision of quality health care. Assistance was requested to provide a support programme for the nursing service managers. Prior to developing and implementing the support programme it was necessary to explore and describe nursing service managers' views on the problems they were experiencing in their everyday lives (personal and professional) and to ascertain their specific needs for support. A qualitative, exploratory, descriptive and contextual research design was utilised in this research. A questionnaire with open-ended questions was used for gathering data. A purposive sample of one hundred nursing service managers was included in this research. Sixty of the one hundred questionnaires were completed. Data were analysed by a qualitative descriptive method of analysis. Four major categories regarding nursing service managers' experience of problems in their daily lives, were identified: difficulty in relationship with diverse others; lack of sufficient group acceptance/support; value conflicts, and difficulty with self-acceptance Conclusions and recommendations were made and limitations discussed.

Adaptation, Psychological↗

Methodological issues for population-based research into dementia in developing countries. A position paper from the 10/66 Dementia Research Group.

The 10/66 Dementia Research Group has been formed to promote good-quality, internationally comparable research into dementia in developing countries through active research collaboration. In this position paper, we review existing research into dementia prevalence in developing regions of the world. Seven methodologically robust studies were identified. The prevalence of dementia, age-adjusted to the age structure of the Kerala population, ranged from 1.3% to 5.3% for all those aged 60 or over and from 1.7% to 5.2% for all those aged 65 and over. Two studies, from Ibadan, Nigeria and Ballabgarh, India, reported strikingly low prevalence figures. The reported prevalence for most studies was somewhat lower than the consistent figures for Europe reported by the EURODEM concerted action. Based on critical review of the literature, and on the practical research experience of members of the 10/66 group, recommendations have been made for procedure in the following areas: age limits for inclusion in dementia surveys, age ascertainment, sampling, scope for incidence studies, functional assessment and culture- and education-fair dementia diagnosis.

Age Distribution↗

Development and validation of a methodology for intracellular pH measurements of hybridoma cells under bioreactor culture conditions.

The intracellular pH (pH(i)) is an important factor in the regulation of different cellular processes. It might therefore be used as a marker of the physiological state of cells cultivated in a bioreactor environment. We developed and validated therefore a methodology that permits a reproducible and reliable pH(i) measurement under such bioreactor culture conditions, contrary to earlier reported measurements, carried out on cells resuspended in buffers under nongrowth conditions. The hybridoma cells were sampled from the culture, stained with the pH-sensitive dye BCECF-AM (BCECF = 2',7'-bis-carboxyethyl-5,6-carboxyfluorescein), and analyzed by flow cytometry. Such a measurement is perfectible to changes of the cells between the moment of sampling and of final analysis on the flow cytometer. All intermittent steps were for this reason studied in detail, either to determine the optimal conditions to be used or to characterize their influence on the final pH(i) value measured. Additional experiments were carried out, showing the representativeness of the measured pH(i) value for the pH(i) the cells possess really in the culture at the moment of sampling.

Animals↗

Child and parent perceptions of stimulant medication treatment in attention deficit hyperactivity disorder.

OBJECTIVE: To evaluate child and parent perceptions of treatment with stimulant medication in a sample of children with attention deficit hyperactivity disorder (ADHD). METHODOLOGY: Child and parent perceptions questionnaires were completed for 102 subjects participating in a double-blind, crossover trial of methylphenidate (MPH) and dexamphetamine (DEX). RESULTS: Most children viewed medication effects favourably, although 12.7% and 18.8% of children reported feeling worse than usual when taking MPH and DEX, respectively. There was disagreement between the child's and parents' perceptions of response in over one quarter of cases. Most disagreements involved parents viewing the child's response favourably, but the child rating reporting an unfavourable outcome. Side-effects were the main determinant of children's perceptions of adverse response. CONCLUSIONS: A substantial proportion of children with ADHD experience treatment with stimulant medication adversely. Side-effects are the principal determinant of negative child perceptions. Parental report is usually in agreement with child report; however, parental report alone is not infallible in providing reliable information regarding effects as experienced by the child.

Adolescent↗

Regression modeling of competing crude failure probabilities.

In a randomized trial of tamoxifen therapy for breast cancer, women can experience tumor recurrence or die from competing causes. One goal of analysis is to describe the effect of tamoxifen on the probabilities of recurrence or death from other causes. To this end, we propose a semi-parametric transformation model for the crude failure probabilities of a competing risk, conditional on covariates. The model is developed as an extension of the standard approach to survival data with independent right censoring. Estimation of the regression coefficients is achieved with a rank-based least squares criterion. Simulations show that the procedure works well with practical sample sizes. A separate estimating function is developed for the baseline parameter. Prediction of covariate-adjusted failure probabilities is considered. The methodology is motivated and illustrated with data from the tamoxifen trial.

Journal Article↗

Young women's degree of control over first intercourse: an exploratory analysis.

CONTEXT: While policymakers and researchers alike often seem to believe that young women's decision to initiate sexual intercourse is conscious and free of ambiguity, the actual degree of control that such young women exert over first intercourse has rarely been explicitly examined. METHODS: The 1995 National Survey of Family Growth asked all women who had experienced intercourse to rate, on a 1-10 scale, the wantedness of their first intercourse; they were then asked whether the experience was voluntary. Logistic regression analysis of data for women aged 15-24 who had experienced first premarital intercourse was performed to test the effect of background factors and wantedness scores on contraceptive use at voluntary first intercourse. RESULTS: Twenty-four percent of women aged 13 or younger at the time of their first premarital intercourse report the experience to have been nonvoluntary, compared with 10% of those aged 19-24 at first premarital intercourse. About one-quarter of respondents who reported their first intercourse as voluntary chose a low value (1-4) on the wantedness scale. Women whose first partner was seven or more years older than themselves were more than twice as likely as those whose first partner was the same age or younger to choose a low value (36% vs. 17%). Women whose partner had been seven or more years older were also less likely than other women to have used contraceptives at first intercourse. After the introduction of controls for demographic and background factors, partner age discrepancy and relationship status, wantedness of voluntary first intercourse was not independently related to the odds of contraceptive use at that intercourse. CONCLUSION: Characterizing women's first intercourse as simply voluntary or nonvoluntary is inadequate. Measures that take into account degrees of wantedness may help elucidate relationships between sexual initiation, contraceptive use and teenage pregnancy. The fact that substantial numbers of young women voluntarily participated in a first sexual experience about which they felt ambivalent or negative deserves the attention of program planners and service providers.

Adolescent↗

Analysis and optimization of structure-based virtual screening protocols. 2. Examination of docked ligand orientation sampling methodology: mapping a pharmacophore for success.

An important element of any structure-based virtual screening (SVS) technique is the method used to orient the ligands in the target active site. This has been a somewhat overlooked issue in recent SVS validation studies, with the assumption being made that the performance of an algorithm for a given set of orientation sampling settings will be representative for the general behavior of said technique. Here, we analyze five different SVS targets using a variety of sampling paradigms within the DOCK, GOLD and PROMETHEUS programs over a data set of approximately 10,000 noise compounds, combined with data sets containing multiple active compounds. These sets have been broken down by chemotype, with chemotype hit rate used to provide a measure of enrichment with a potentially improved relevance to real world SVS experiments. The variability in enrichment results produced by different sampling paradigms is illustrated, as is the utility of using pharmacophores to constrain sampling to regions that reflect known structural biology. The difference in results when comparing chemotype with compound hit rates is also highlighted.

Binding Sites↗

Gender differences in the induction of chromosomal aberrations and gene mutations in rodent germ cells.

Germ cell mutagenicity testing provides experimental data to quantify genetic risk for exposed human populations. The majority of tests are performed with exposure of males, and female data are relatively rare. The reason for this paucity lies in the differences between male and female germ cell biology. Male germ cells are produced throughout reproductive life and all developmental stages can be ascertained by appropriate breeding schemes. In contrast, the female germ cell pool is limited, meiosis begins during embryogenesis and oocytes are arrested over long periods of time until maturation processes start for small numbers of oocytes during the oestrus cycle in mature females. The literature data are reviewed to point out possible gender differences of germ cells to exogenous agents such as chemicals or ionizing radiation. From the limited information, it can be concluded that male germ cells are more sensitive than female germ cells to the induction of chromosomal aberrations and gene mutations. However, exceptions are described which shed doubt on the extrapolation of experimental data from male rodents to the genetic risk of the human population. Furthermore, the female genome may be more sensitive to mutation induction during peri-conceptional stages compared to the male genome of the zygote. With few exceptions, germ cell experiments have been carried out under high acute exposure to optimize the effects and to compensate for the limited sample size in animal experiments. Human exposure to environmental agents, on the other hand, is usually chronic and involves low doses. Under these conditions, gender differences may become apparent that have not been studied so far. Additionally, data are reviewed that suggest a false impression of safety when responses are negative under high acute exposure of male rodents while a mutational response is induced by low chronic exposure. The classical (morphological) germ cell mutation tests are not performed anymore because they are animal and time consuming. Nevertheless, information is needed to place genetic risk extrapolations on more solid grounds and thereby to prevent an increased genetic burden to future generations. It is pointed out that modern molecular methodologies are available now to experimentally address the open questions.

Animals↗

Community health workers: examining the Helper Therapy principle.

A community approach to the integration of health and social services for low-income pregnant women is being addressed through Community Integrated Service System (CISS) initiatives of the Maternal Child Health Bureau. This particular CISS program model was designed to enable low-income mothers to function in a Community Health Worker (CHW) role providing social support for at-risk pregnant women. Using Riessman's notion of "helper therapy," the model was also developed to enhance the potential for CHWs to gain helper benefits. The purpose of this exploratory study was to describe perceived helper benefits and stressors associated with the CHW role and to examine the usefulness of an instrument developed to assess benefits and stressors. The study findings revealed that the majority of CHWs perceived helper benefits that included positive feelings about self, a sense of belonging, valuable work experience, and access to health information and skills through training or contact with program staff. Stressors such as feeling inadequate to help, however, were associated with the helper role for some CHWs. Preliminary analysis of the Helper's Perception Measure indicated that it may be an effective measure and should be tested with a larger sample of CHWs.

Adult↗

A guide to issues in microarray analysis: application to endometrial biology.

Within the last decade, the development of DNA microarray technology has enabled the simultaneous measurement of thousands of gene transcripts in a biological sample. Conducting a microarray study is a multi-step process; starting with a well-defined biological question, moving through experimental design, target RNA preparation, microarray hybridisation, image acquisition and data analysis--finishing with a biological interpretation requiring further study. Advances continue to be made in microarray quality and methods of statistical analysis, improving the reliability and therefore appeal of microarray analysis for a wide range of biological questions. The purpose of this review is to provide both an introduction to microarray methodology, as well as a practical guide to the use of microarrays for gene expression analysis, using endometrial biology as an example of the applications of this technology. While recommendations are based on previous experience in our laboratory, this review also summarises the methods currently considered to be best practice in the field.

Animals↗

Suspended mothering: women's experiences mothering an infant with a genetic anomaly identified at birth.

PURPOSE: To develop an understanding of the experiences of women who give birth to an infant with a genetic anomaly not identified during the prenatal period. DESIGN: Exploratory design using selected qualitative methods. SAMPLE: Seven mothers of liveborn infants with a genetic anomaly characterized by physical attributes evident at birth. MAIN OUTCOME VARIABLE: Mother's expressions of suspended mothering. RESULTS: Two themes emerged that characterize the experience of suspended mothering: diminished maternal role and false protection. PRACTICE RECOMMENDATIONS: Facilitating maternal involvement in decision making requires giving women unbiased information in a supportive manner.

Adult↗

[Pilot study on personality disorders evaluation. Categorical DSM-IV vs. dimensional five factor models].

INTRODUCTION: This paper evaluates the relationship between a dimensional method of personality assessment (five factor model) and a categorical one (DSM-IV). METHODOLOGY: Thirty-eight consecutive outpatients without concurrent diagnosis of axis I, were assessed with the categorical instrument I.P.D.E. (International Personality Disorders Examination) and the dimensional one B.F.Q. (Big-Five Questionnaire). RESULTS: Extraversion differences were found among cluster and its components, Dominance and Dynamism. Extraversion, Dynamism, Cooperation and Persistence differences were found among personality disorders of cluster A. Personality disorders of cluster B were different in Mental Openness, Dynamism and Cooperation. Finally, Extraversion, Mental Openness, Dynamism, Cordiality, Openness to culture and Openness to experience differences were found among personality disorders of cluster C. CONCLUSIONS: This pilot study proposes the possibility of developing dimensional models to predict a possible personality disorder in future. Longitudinal studies with great samples are necessary to get this purpose, in where to be gathered a high percent from each personality disorder.

Adult↗

Hearing impairment.

The purpose of this chapter is to review the literature on hearing impairment, specifically the impact of hearing impairment on the functioning of elders, interventions that minimize the impact of hearing loss on functioning, and identification of issues raised by the review for nursing research. Computerized (MEDLINE, PsychINFO, and CINAHL) and manual searches were used to obtain research reports from a range of disciplines. Research articles including elders (> or = 60) and published between 1989 and 2001 were included. Twenty-five articles were selected for critical review, four written by nurses. The diversity of methodologies, the criteria used to define hearing impairment, the range of sample characteristics, and the assessment measures make comparisons across studies difficult. Most studies, however, support the negative impact of hearing impairment, especially on psychosocial functioning. Measures that are condition specific are generally more effective in capturing the impact of hearing loss than generic measures. Findings related to physical disability are less consistent. The results of intervention studies suggest that hearing devices can improve psychosocial and communication outcomes, but behavioral interventions have not shown long lasting benefit. For nurses to assist elders and their families manage the impact of hearing impairment, further research is needed in several areas that have been poorly explored. These include the dyadic experience of hearing impairment, the way in which culture influences the experience of hearing loss, the needs of hearing impaired individuals across settings, the long-term impact of ototoxic medications, and strategies to assist elders in coping with hearing impairment and utilizing available technologies.

Aged↗

Heterosexual intimate partner homicide: review of ten years of clinical experience.

Most of the literature on intimate partner homicide addresses violence between the two partners, spousal abuse, and family violence. There is less focus on the relationship of mental illness, intellectual functioning, and drug and alcohol abuse to these homicides. We investigated this type of homicide in a collection of forensic cases seen by the first author over a period of 10 years. Twenty-eight patients who underwent forensic psychiatric evaluation for heterosexual intimate partner homicide from August 1993 to June 2003 were studied using a retrospective case review methodology. We found that firearms were used as the method of killing more often by females than by males. We also compared method of killing with substance abuse and intoxication at the time of the homicide. Educational status indicates that this group of accused perpetrators is functioning at higher intellectual levels compared with a previously studied sample of filicides. We also found significant presence of serious mental illness in our sample of accused perpetrators of heterosexual intimate partner homicide.

Adult↗

Method development strategy for the analysis of anionic solutes by capillary electrophoresis.

A systematic approach to the development of methodology for the analysis of anionic solutes by capillary electrophoresis (CE) has been implemented. The strategy allows a rapid optimization of the experimental conditions and is based on the following steps: 1) A near optimum pH is chosen by inspection of the effective mobility versus pH curves of the sample components. The optimum pH lies in a region where the differences in the mobilities of all solutes are maximal. 2) An electrolyte system is selected by comparing the effective mobility of the electrolyte with the effective mobility of the primary components of the studied mixture. The appropriate electrolyte has a mobility as similar as possible to the mobility of the major components of the sample. 3) An initial experiment is run with the selected electrolyte system adjusted to the chosen pH and input values for other instrumental variables and electrolyte characteristics. 4) Depending on the degree of resolution obtained in the initial run, two important variables, the applied voltage and the electrolyte concentration, are then tuned in the proper direction, favoring the achievement of the highest resolution at the lowest possible analysis time. The proposed method development strategy was validated experimentally with a mixture of short-chained carboxylic acids and inorganic anions.

Anions↗