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PubMed1998

The determinants of infant mortality in Malaysia: a graphical chain modelling approach.

"A graphical chain modelling approach is used to study the determinants of neonatal and post-neonatal mortality in Malaysia. This approach provides an easily interpretable empirical description and illustrates explicitly the conditional independence structure between each pair of variables. The interpretation can be read directly from a mathematical graph. Besides examining the direct association of each determinant on mortality, we also examine the effects of socio-economic determinants on intermediate determinants to understand the pathways through which the socioeconomic determinants affect the chance of mortality. The data anlaysed come from the second Malaysian Family Life Survey, fielded between August 1988 and January 1989. "

Asia↗

PubMed2006

A phenomenological study of fatigue in patients with primary biliary cirrhosis.

AIM: This paper reports the findings of research on the lived experience of fatigue in patients with primary biliary cirrhosis - a type of chronic liver disease. BACKGROUND: Fatigue is a universal phenomenon, commonly associated with both acute and chronic illness, but also seen in healthy individuals. However, it is not often addressed in healthcare encounters despite its disabling nature, perhaps because of the multitude of contributing factors and the lack of effective treatments. It is a common and debilitating symptom in patients with primary biliary cirrhosis. Despite the prevalence of fatigue in this condition, patients' experiences of this symptom have not been researched. METHOD: An interpretive-phenomenological approach developed by van Manen was chosen and this combines features of descriptive and interpretive phenomenology. Eight participants were interviewed during 2005 about their fatigue experience. Thematic analysis was conducted. FINDINGS: Five themes were identified: an unreliable body, fatigue as always present yet insidious, planning a life to conserve energy, struggling to maintain normality and emotional consequences. These themes reflected the unrelenting, intrusive nature of fatigue into the lives of those affected. CONCLUSION: This research will provide empathic insight into the fatigue experience in this condition and generate communication about coping strategies. It will add to the body of research on fatigue in chronic conditions and may generate ideas for intervention research.

Activities of Daily Living↗

PubMed2002

The experience of physical restraint: a systematic review of qualitative research.

The objective of this review was to summarise the experience of physical restraint from the perspectives of the person subject to restraint and of their family. A review of interpretive and descriptive research was undertaken that entailed a comprehensive literature search. Studies were included in the review if they provided qualitative data on this experience. An interpretive data synthesis was undertaken to generate a composite description of the experience of restraint. Findings highlight the predominantly negative impact of physical restraint on the person restrained and their family. These findings support minimal use of restraint in health care and give voice to a relatively powerless and vulnerable group of people.

Anger↗

PubMed1980

Evaluation of describing and grading preclinical technical exercises.

A student's improvement in technical skill during preclinical technique courses is greatly aided if the student receives accurate descriptive feedback concerning the quality of his practice exercises and how his product could be corrected. A numerical or letter grade alone cannot do this. An evluation form was developed to enable the preclinical faculty to efficiently and effectively give descriptive feedback to large numbers of students. A survey was conducted to evaluate whether students could interpret the descriptive feedback accurately and whether this descriptive feedback was useful in helping them understand where improvements could be made.

Dental Restoration, Permanent↗

PubMed2006

[Analysis phenomenology and application to nursing research].

Phenomenology has been divided into three schools of thought arising from different philosophical assumptions and methods. There is descriptive phenomenology, interpretative phenomenology, and a combination of both. Phenomenology has been adopted as a study method to explore experiences in different nursing fields in Taiwan. Husserlian descriptive phenomenology professes to utilize the skills of epoché, bracketing, and phenomenological reduction not only in order to seek the essence of phenomena, but also to allow the researcher to get into the participant's life-world to gain a deeper understanding of their experience; in other words, to let the true phenomenon or essence be revealed. By contrast, Heideggerian interpretative phenomenology rejected the idea that one can completely suspend one's presuppositions, prejudices or preconceived ideas by simply Being-in-the-world. One is immersed in and absorbing from the world, so one will not be able to notice everything that one is gaining from the world. Heidegger also insisted that any interpretation is only valid when background is taken into account. This not only facilitates the researcher's deeper understanding of the other's experience, but also facilitates more accurate interpretation of context and meaning. When researchers seek to follow Husserl's idea of performing bracketing in descriptive phenomenology, in order to truly put the concept into practice, they should understand their prior assumptions and maintain a written journal of reflections throughout the study.

Existentialism↗

PubMed1997

Issues on functional analysis in behavioral assessment.

The rebirth of interest in functional analysis is described. Clarification among conflicting terms is offered as a way of facilitating research in the area. Three phases of functional approach to assessment are identified: (a) descriptive, (b) interpretive, and (c) verification. Five assessment methods common to assessment, generally, are shown to be useful in both descriptive and verification phases. Evaluation of functional approaches requires attention to the psychometric adequacy of these methods. Accuracy, reliability, and validity concepts are reviewed briefly and their application to functional strategies is described. The use of treatment validity in the functional analysis of functional analysis is mentioned as the ultimate strategy for evaluating the adequacy of this assessment approach. The paper ends with a discussion of problems of multiple control of behavior, behavioral classification systems, training parents and other mediators in the functional approach, cost-effectiveness, and the place of functional analysis in a reorganized health care delivery system.

Adult↗

PubMed2005

Flow cytometric analysis of micronuclei in erythrocytes.

The in vivo micronucleus (MN) test in bone marrow or peripheral blood erythrocytes is widely used as a short-term assay for the detection of agents able to induce chromosome aberrations in somatic cells and has also been shown to have good predictive potential for the identification of carcinogens and germ cell mutagens. The endpoint used is the scoring of micronuclei (MN) in bone marrow or peripheral blood erythrocytes of mice or rats. In this chapter, a detailed description of the flow cytometric micronucleus test will be given, as well as a more general description of the manual micronucleus assay. The DNA of MN is identified using the DNA-specific fluorescent stain Hoechst 33342; discrimination between polychromatic and normochromatic erthrocytes is based on staining with thiazole orange, a fluorescent probe with high RNA affinity. The use of flow-cytometric quantification of micronucleated polychromatic and normochromatic erythrocytes (MNPCE and MNNCE), beyond replacing manual enumeration, provides substantial advantages in terms of speed of analysis, as well as sensitivity. The general description of the MN assay briefly covers choice of animal species and strains, treatment regime, sampling times, and data interpretation. The description of the flow cytometric assay covers in detail erythrocyte preparation and purification, fixation, staining, data acquisition, and data analysis.

Animals↗

PubMed1996

Observer variation in the interpretation of bone scintigraphy.

To assess the reliability of bone scintigraphy, a random sample of 100 bone scans was reviewed twice by each of two physicians. Observer variation in the description and interpretation of bone scintigrams varied by diagnosis. Good to excellent k values were obtained for inter- and intraobserver variation in relation to metastasis or normal scans. For degenerative bone disease, as well as the specific agreement on major pathologies other than metastases, k values were found to be moderate. The agreement on the need for further radiographic studies was poor to moderate. The interpretation of bone metastases or normal scintigrams was found to be more reliable in a research setting than in the usual clinical framework, and the latter requires improvement. The interpretation of bone scintigraphy as consistent with degenerative changes is not reliable. The diagnosis should be evaluated by radiography.

Bone Neoplasms↗

PubMedDate not supplied

Getting your feet wet: becoming a public health nurse, part 1.

While the competencies and theory relevant to public health nursing (PHN) practice continue to be described, much less attention has been given to the knowledge derived from practice (clinical know-how) and the development of PHN expertise. A study was designed to address this gap by recruiting nurses with varied levels of experience and from various practice sites. A convenience sample of 28 public health nurses and seven administrators/supervisors were interviewed. A subsample, comprised of less-experienced public health nurses, were followed longitudinally over an 18-month period. Data included more than 130 clinical episodes and approximately 900 pages of transcripts and field notes. A series of interpretive sessions focused on identifying salient aspects of the text and comparing and contrasting what showed up as compelling, puzzling, and meaningful in public health nurses' descriptions. This interpretive analysis revealed changes in understanding of practice and captured the development of clinical know-how. In Part 1, we describe the sample, study design, and two aspects of clinical knowledge development--grappling with the unfamiliar and learning relational skills--that surfaced in nurses' descriptions of early clinical practice. In Part 2, which is to be published in the next issue of Public Health Nursing (SmithBattle, Diekemper, & Leander, 2004), we explore gradual shifts in public health nurses' understanding of practice that led to their engagement in upstream, population-focused activities. Implications of these findings for supporting the clinical learning of public health nurses and the development of expertise are described.

Adult↗

PubMed1984

Ethnography: contributions to nursing research.

Health and illness behaviour occur within a cultural context. Ethnographic methodology facilitates an investigation of the context in which people's health beliefs and practices evolve as well as serving to identify the cultural components of health and illness. Ethnography is primarily an inductive mode of research which may utilize several methods of data collection. Participant observation, used in conjunction with interviewing, is the most frequently used data-gathering technique. Sampling procedures in ethnography must be addressed in relation to persons interviewed and/or observed, events to be seen, topics to be considered and time frames to be established. The ethnographic method creates difficulties in establishing reliability as techniques for gathering data are highly individualistic and involve a complex admixture of observations, structured and unstructured interviews, and other procedures. The lengthy stay in a community, as well as the extensive and in-depth data-collection procedures contribute to validity of the findings and their interpretation. Data analysis is time consuming and complex. Ethnography is concerned with the context of discovery, rather than verification, and leads to narrative descriptions and interpretations of cultural phenomena. Ethnography is a means for gaining access to the health beliefs and practices of a culture. In a practice profession such as nursing, improved understanding of the meaning of clients' behaviour will enhance nursing judgements and improve nursing care.

Attitude to Health↗

PubMed1982

The quantification of pain: an analysis of words used to describe pain and analgesia in clinical trials.

In this study 116 subjects were asked to quantify the descriptive pain terms commonly used in analgesimetry by using the visual analog scale as a tool. The results showed highly variable responses. Several words that have been assigned the same value on an ordinal scale do not convey the same meanings as on the visual analog scale. The words some and terrible are probably the least useful terms to quantify pain. The word complete for describing pain relief showed the least variation. The data on global ratings varied greatly; 10% of the participants gave the same values to the terms very good and excellent. The unequal differences between descriptive terms that are commonly considered equidistant on an ordinal scale are clearly demonstrated. We propose an approach to quantifying pain that takes into account the interindividual variations in interpretation of descriptive pain terms.

Analgesics↗

PubMed2003

History and clinical significance of mechanical symptoms in blistering dermatoses: a reappraisal.

In the era before the advent of routine microscopy and immunopathology, mechanical symptoms were described in an attempt to facilitate clinical diagnosis of blistering dermatoses. A plethora of eponyms and signs were described, but no proper original quotations exist. All the eponyms haunt the student and specialist. In the case of an ominous and, therefore, very important clinical phenomenon termed the Nikolskiy sign, this creates confusion about the specific meaning of the term, obscuring diagnosis and delaying initiation of an adequate treatment of pemphigus. We try to set this record straight and go to the sources. Russian, German, French, and English, at the least, are required to properly interpret the relevant descriptions. We provide an accurate interpretation of the major mechanical symptoms pathognomonic for acantholysis, dermoepidermal separation, and peeling of the entire epidermis. Correct performance of the tests and proper interpretation of the results can serve as an invaluable diagnostic tool to assist in the preliminary bedside diagnosis of serious and potentially lethal bullous dermatoses.

Europe↗

PubMed2002

Age-time patterns of radiogenic cancer risk: their nature and likely explanations.

It is important for both radiation protection and scientific reasons to understand the age-time patterns of radiation cancer risk. This is surprisingly difficult even for acute exposures and much more so for prolonged exposures. I shall provide current information on this for solid cancers among atomic-bomb survivors, pointing out some of the difficulties in description and interpretation. I shall then take up some stochastic considerations regarding accumulation of mutations, which may help in dealing with these difficulties. These considerations are highly idealised, and their consequences should mainly be used only for guidance rather than as a primary basis for descriptive analyses. They are particularly suitable for this because they provide insights fairly independent of parameter values in the stochastic models involved.

Adult↗

PubMed1996

Characteristics of cleft palate speech.

In recent years, interest in the nature of cleft palate speech and the influences on speech quality has increased. This overview of contemporary research reveals new perspectives on cleft palate speech development and the phonological consequences of early articulatory constraints. Cleft palate speech is perceived as the result of the synthesis between physical, physiological, cognitive and linguistic development. Developmental influences on cleft palate speech are considered in the context of early vocalisations of cleft and non-cleft children, followed by an examination of the literature on the development of babble, the emergence of early words and consonant development in children born with cleft palate. Speech development is then discussed from a phonological perspective interpreting reported characteristics as 'cleft-type developmental processes', for example, lack of target stabilisation; compensatory articulations; active/passive strategies; and systematic sound preference. Given these influences on speech development the extent to which cleft palate speech should be regarded as an 'articulatory disorder' has been reconsidered. Descriptions and interpretations of nasal resonance, nasal emission, and nasal turbulence are followed by discussion of articulatory errors in place and manner and patterns of change in cleft palate speech. Finally, some of the available evidence on speech in relation to structural imperfections, such as unrepaired clefts, velopharyngeal insufficiency, oro-nasal fistulae, dental and occlusal deviations, and open-mouth posture is summarised briefly. These new perspectives aim to facilitate more effective clinical management and to provide indications for future research.

Child, Preschool↗

PubMed2002

Nurses' knowledge of error in blood pressure measurement technique.

Errors in measuring blood pressure may have significant impact on the investigation and treatment of patients. Errors arise from faults in measurement technique or the equipment used. In Australia, blood pressure measurement technique is taught to nurses during their undergraduate education and may not be reviewed again. This observational, descriptive study surveyed clinical nurses at a metropolitan teaching hospital at shift hand-over time. Participation was voluntary and anonymous by 78 nurses who answered a questionnaire to determine the need and focus for updating blood pressure measurement technique. Sixty-one per cent of participants conformed to currently accepted practice in identifying systolic blood pressure, and 71% diastolic blood pressure; 54% correctly interpreted a description of blood pressure sounds containing an auscultatory gap. Correct answers for assessment of faulty equipment were given by 58%, assessing cuff size by 57%, arm position for seated measurement by 14%, determination of inflation pressure by 29% and deflation rate 62%. Incidence of terminal digit preference was 32%. These findings indicate that knowledge of participants was inadequate to perform blood pressure measurement in a standardized manner, and prevent introduced error.

Australia↗

PubMed2003

Glissando: laryngeal motorics and acoustics.

The objective of this study was to investigate the laryngeal mechanisms and the acoustical signal during a glissando. In particular, glottal length, maximum glottal area, and vibratory amplitudes during a glissando maneuver of a healthy male adult were measured. An endoscopic high-speed system combined with a laser projection device was used to obtain quantitative data both in the time and spatial domains. Simultaneously to the endoscopic investigation, the acoustic signal was recorded. Fundamental frequency and sound pressure level derived from the acoustic recordings were compared to vocal fold length and glottis area derived from the high-speed recordings. Results were used for interpretation of the phonation mechanism during glissando by means of laryngeal and acoustic parameters. The transition between the chest register and the falsetto register was identified by the absence of vocal fold contact. A rather early onset of the falsetto register was observed at 160 Hz. Although fundamental frequency of the vocal folds increased linearly even at the transition point, sound pressure level dropped down. These data represent the first ever quantitative description and interpretation of the glissando based on both voice properties and laryngeal motorics. In the presented example of an untrained singer, the falsetto sets in at comparatively low frequencies. Although the chest-falsetto transition is rather smooth for laryngeal motorics and voice pitch, a sudden drop of voice intensity was observed.

Adult↗

PubMed1982

The quantitative nutrient-response relationship.

A quantitative mathematical model for the description of nutrientresponse relationships can be derived by the application of the concepts of a) specific nutrient-macromolecular interaction, b) response proportional to the extent of this interaction, c) law of mass action and d) saturation kinetics. This model can be used to produce the four-parameter mathematical model for physiological responses. The possible uses of the model are discussed, an idealized example is given, and the model is applied to the interpretation and description of a growth experiment in which male, weanling Sprague-Dawley rats are fed diets varying in concentration of an amino acid mixture.

Animals↗

PubMed2006

Stereology and the placenta: where's the point? -- a review.

The value of stereology for describing the three-dimensional (3D) structural composition and spatial arrangement of biological specimens from essentially two-dimensional (2D) thin sections is indisputable. By allowing economical quantitation of microscopical sections, stereology facilitates interpretations of normal and perturbed structure from the whole organ down to the subcellular levels. It incorporates the essential features of all sound study designs: (i) randomised sampling which is efficient and unbiased, and (ii) estimation tools which are simple, precise and unbiased or minimally biased. With these sampling and estimation tools, stereology offers a sure and safe option for characterising the total volumes, surfaces and lengths of placental compartments, the total numbers and mean sizes of nuclei or cells, and the spatial arrangements of tissues or intracellular ingredients. This review identifies the basic features of the stereological approach before indicating several ways in which stereology has been used to aid the description and interpretation of placental functional morphology from the whole organ to the molecular level. Examples include diffusive transport, villous growth, fetoplacental angiogenesis, trophoblast turnover, arterial vascular remodelling and high-resolution immuno-localization studies.

Animals↗