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Diagnosed with Hepatitis C: a descriptive exploratory study.

A descriptive exploratory study was carried out to elicit the felt-experience of Hepatitis C infection. A non-probability sampling strategy was employed which generated a sample of nine participants for in-depth interview. Data analysis revealed that the diagnosis had precipitated a transition in the participants' lives. Factors were identified that served as barriers and facilitators to their transition experience. At the time of data collection all of the participants were not experiencing indicators of a healthy transition. It was evident that the transitional experience was neither time-bound nor linear in nature.

Adaptation, Psychological↗

Computer aided field editing in the DHS context: the Turkey experiment.

"In this study two types of field editing used during the Turkey Demographic and Health Survey are compared. These two types of editing are computer aided field editing and manual editing. It is known that manual editing by field editors is a tedious job in which errors especially on skip questions can be missed; however, with the aid of computers field editors could quickly find all occasions on which an interviewer incorrectly followed a skip instruction. At the end of the experiment it has been found...that the field editing done with the aid of a notebook computer was consistently better than that done in the standard manual manner." (SUMMARY IN TUR)

Asia↗

Interlaboratory cholinesterase determinations and the effect on the results of statistical evaluation of cholinesterase inhibition.

Cholinesterase activity is often a key parameter in the regulatory assessment of cholinesterase-inhibiting agents such as organophosphorous and carbamate pesticides. Thus, the nature and characteristics of the methodology involved in the measurement of plasma (PChe), erythrocyte (R Che), and brain (BChe) cholinesterase activity takes on a heightened degree of importance. In this study an interlaboratory comparison of cholinesterase activity as determined by various laboratories was conducted in order to assess the influence that different methodologies may have on the results of statistical evaluation of cholinesterase inhibition. RChe, PChe, and BChe from animals exposed to fenthion, a known cholinesterase inhibitor, were determined at 8 different laboratories with experience in cholinesterase determination. Seven different instruments and 5 different assay procedures were employed. Marked differences in both the magnitude of inhibition measured and its designation as a statistically significant difference often occurred between laboratories using both the same as well as different methods of cholinesterase analysis. These findings illustrate the importance of considering not only the sensitivity of a given method of analysis, but also the influence of inter- and intra-laboratory variation on statistically responsive aspects of the data profile itself (i.e., precision, sample size, etc.) when establishing regulatory levels (i.e., Reference Doses (RfDs), Health Advisory Levels (HALs), etc.) on the basis of a cholinesterase no-observed- or lowest-observed-effect level (NOEL, LOEL).

Analysis of Variance↗

Structural analysis of oligosaccharides derivatized with 4-aminobenzoic acid 2-(diethylamino)ethyl ester by matrix-assisted laser desorption/ionization mass spectrometry.

Oligosaccharides derivatized with 4-aminobenzoic acid 2-(diethylamino) ethyl ester (ABDEAE) can be analyzed by ESI (Yoshino, K.; et al. Anal. Chem. 1995, 67, 4028-4031) and MALDI (Takao, T.; et al. Rapid Commun. Mass Spectrom. 1996, 10, 637-640) mass spectrometry. In this study, oligosaccharides derived from the enzymatic cleavage of the sugar chains of glycoproteins ribonuclease B, erythropoietin, and transferrin were subjected to ABDEAE derivatization, prior to analysis on a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (MALDI-TOF MS) for high-resolution mass measurement and a postsource decay (PSD) experiment. In the mass measurement of ABDEAE derivatives, quasi-molecular ion species have been observed in monoisotopic resolution using 2,5-dihydroxybenzoic acid as the matrix from spots that contain 50-200 fmol of sample; in the PSD analyses from the spots contained 500 fmol-1 pmol of sample, the predominant backbone ion series which covers the entire mass range for all the derivatives, the internal ion series which reflect the branched trimannosyl core structure of N-glycans, and the low m/z fingerprint ion of ABDEAE were consecutively observed, permitting structure elucidation of the oligosaccharides. Given the effectiveness of this derivatization in terms of its high sensitivity and resolution with respect to MALDI-TOF MS, current methodology is clearly applicable to the sensitive detection and accurate structural analysis of N-glycans.

Carbohydrate Sequence↗

Caregiver discourse: perceptions of illness-related dialogue.

Interacting with terminally-ill patients is significantly stressful for caregiving families. To date, few studies have examined how caregivers perceive their communication with dying family members. As such, the present investigation was undertaken. A sample of 10 family caregivers was utilized for the study; informants had to be the spouse or child of the patient, having provided the majority of care during the illness period. Semi-structured interviews were employed by the investigator to collect data on the communicative experiences of these caregivers; they were asked to describe their thoughts and interactional experiences with specific reference to the following: (1) the inevitability of the patient's death, (2) the patient's preferred courses of action, (3) levels of family interaction, (4) patient denial, (5) previous patterns of discourse, and (6) bereavement. All interviews were audio-recorded, transcribed verbatim, and analyzed using a two-tier system incorporating aspects of content analysis methodology. Results indicate that caregivers experience difficulty communicating with their patients and with other family members. Suggestions for developing effective, appropriate, and sensitive communication training programs for terminally-ill patients and their caregiving families are provided.

Aged↗

Involving patients to improve service quality in primary care.

A sample of 92 UK patients volunteered to take part in focus groups to discuss what elements of local primary care provision were important to them. Issues raised were prioritised by the patients and then fashioned into 18 quality indicators which nine local practices were invited to assess themselves against. At the assessment meeting three months later over 40 changes in service provision were noted in the nine participating practices. A patient questionnaire carried out in each practice, however, indicated a tendency for practices to overestimate the services they felt they provided. Patients rated the experience of generating standards as very worthwhile and enjoyed being asked. Further research needs to be carried out to assess the effectiveness of this methodology in different settings.

England↗

Are anaerobic pleuropulmonary infections uncommon or commonly undetected in Britain?

Despite marked and increasing awareness of the clinical significance of pathogenic anaerobes, the role of anaerobes in pleuropulmonary infections is still largely unrecognised in Britain. A considerable literature testifies that this is not so in America. The reasons for this paradox are explored. British anaerobic methodology is briefly reviewed, with special reference to the range of recognised respiratory pathogens and the anaerobes that can be cultured in simple anaerobic jars. The limitations of sampling and transport procedures are considered. Differences in approach are discussed. The technological problems of the isolation and culture of "difficult" pathogenic anaerobes have been largely solved at the laboratory level; effective approaches to sampling and transit of specimens require more positive consideration and the results might influence our choice of specific antimicrobial therapy. If these points are taken and an increased awareness of the role of the anaerobes in certain pathological conditions of the lower respiratory tract is generated, we might hope either to produce a meaningful parallel to the experience of our American colleagues--or to structure a more valid defence to explain our lack of experience of these infections in the lower respiratory tract.

Bacterial Infections↗

Shadows of culture in psychosis in south India: a methodological exploration and illustration.

Transcultural studies suggest a possible influence of culture on the course and outcome of schizophrenia. However, the notion of culture remains ill-defined in these studies; most often, hypotheses regarding protective factors seem to derive more from stereotyped visions of cultural differences than be empirically based. Explorative studies conducted in south India consider subjective experience as a key mediating variable between culture and course and outcome in schizophrenia. They explore patients and relatives experience and its evolution and aim at identifying the explicit and implicit references to culture throughout the narratives. Ethnographically oriented data collected through an open-ended Turning Point/Period Interview systematically reconstructs the perceived evolution of signs, coping, explanations, reactions and help-seeking from different perspectives. This paper examines the degree of convergence and divergence between narratives collected from a small sample of female schizophrenic patients and one of their relatives. A high degree of convergence at the level of symptoms and differences in their narrative construction are observed.

Adaptation, Psychological↗

Designing nursing research: the qualitative-quantitative debate.

Nursing research has not evolved with immunity from the qualitative-quantitative debate which has surrounded the behavioural and social sciences. The outcome of this debate should be better nursing science since researchers are forced to face and address the controversial issues. Attaining this goal requires researchers to debate the issues with a knowledge of epistemology and methodology and not blind devotion to the tradition of the hard sciences. This paper addresses the issues of epistemology, methodology, and ethics for two prototypes of the qualitative-quantitative continuum. Grounded theory explains the issues of qualitative research: the search for meaning, the inclusion of environmental factors, the depth of data, and the treatment of participants as subjects. The true experiment, the epitomy of the quantitative approach, seeks to identify existing truths by isolating the significant variables and controlling for contaminating factors. Based on these arguments, recommendations are made for nursing research which rely on both approaches.

Cognition↗

Internal migration, earnings, and the importance of self-selection.

This paper analyzes the impact of internal migration on earnings within the human capital model framework. Since migrants constitute a non-random sample of population, the endogenous nature of migration decision warrants necessary correction for the selectivity bias in their earnings function. The Mincer-type earnings model is thus augmented to determine the extent of this bias. Besides estimating the standard Mincerian earnings model, the paper also attempts to verify the learn-as-you-go proposition by introducing migration duration variables in the earnings model. Based on the household level Population, Labor Force, and Migration (1979-80) survey data, the analysis yields the following important conclusions: (i) the data allowed a meaningful estimation of Mincerian earnings function for migrants and non-migrants; (ii) the level of schooling was one of the important determinants of the distribution of income both for migrants and nonmigrants--the four categorical variables of education were in general statistically significant with expected signs, implying that the hypothesis of a positive relationship between income and education was accepted; (iii) the rates of return to education improved systematically with higher levels of education, thus confirming the notion that education serves as a signalling device; (iv) the age-income profile was almost linear for migrants but showed concavity for nonmigrants; (v) the presence of sample-selection was observed for migrants; and (vi) even after controlling for the influence of personal characteristics, i.e., education and experience, the long-standing migrants earned relatively more at the destination than the more recent migrants.

Age Factors↗

Double- and zero-quantum NMR relaxation dispersion experiments sampling millisecond time scale dynamics in proteins.

TROSY-based NMR relaxation dispersion experiments that measure the decay of double- and zero-quantum (1)H-(15)N coherences as a function of applied (1)H and (15)N radio frequency (rf) fields are presented for studying millisecond dynamic processes in proteins. These experiments are complementary to existing approaches that measure dispersions of single-quantum (15)N and (1)H magnetization. When combined, data from all four coherences provide a more quantitative picture of dynamics, making it possible to distinguish, for example, between two-site and more complex exchange processes. In addition, a TROSY-based pulse scheme is described for measuring the relaxation of amide (1)H single-quantum magnetization, obtained by a simple modification of the multiple-quantum experiments. The new methodology is applied to a point mutant of the Fyn SH3 domain that exchanges between folded and unfolded states at 25 degrees C.

Nuclear Magnetic Resonance, Biomolecular↗

Social support and adolescent cancer survivors: A review of the literature.

With survival rates increasing dramatically in pediatric cancer, concern has increasingly focused on the psychosocial aspects of the cancer experience. Clearly, the experience of a cancer diagnosis and treatment of cancer places high demands on the coping of adolescents. Research has shown social support to be effective in decreasing stress and enhancing coping in adolescents facing such demands. A review and critical analysis of studies of social support in adolescent cancer survivors was conducted. The seventeen studies were mainly descriptive and exploratory in nature with social support examined for a number of outcome variables in eight of the studies. Findings from this review indicate that support from parents (especially the mother) and friends were extremely important and that the adolescents were satisfied with family support. Support from friends was described as less satisfactory. Methodological concerns of the reviewed studies include small samples and a lack of consistency in the instruments used to assess social support. Future studies of social support for adolescent cancer survivors should include larger samples to determine gender, age group, and ethnic differences and to allow the examination of social support theoretical models specific to the developmental and chronic illness situation of these adolescents.

Adaptation, Psychological↗

Quantitative PCR analysis reveals novel expression of prothrombin mRNA and regulation of its levels in developing mouse muscle.

Precise determination of mRNA levels is an essential element in any investigation of complex regulatory systems. Classical methodologies such as Northern hybridization suffer from requirements for significant samples of material and also a degree of nonspecificity. Recently, quantitative techniques involving PCR amplification have been devised. We have developed and applied such procedures to the determination of prothrombin messages in skeletal muscle cells during development. In addition to its role in the blood coagulation cascade, the serine protease thrombin has been shown to participate in several signaling events in the neuromuscular system. The inactive precursor, prothrombin, primarily produced in the liver, has also been shown to be synthesized and developmentally-regulated in the brain. In skeletal muscle, thrombin is a mediator of activity-dependent polyneuronal synapse elimination (ADPSE) which occurs in early postnatal development. Recent experiments showing that thrombin is released from myotubes in culture under the influence of acetylcholine suggest that locally-synthesized prothrombin may be the source of this Hebbian synaptic interaction. We have determined that prothrombin is expressed in skeletal muscle, as the likely source of thrombin involved in ADPSE, and the current results show the quantitative expression of muscle prothrombin during this time of intense synapse remodeling.

Animals↗

30 years later--a new approach to Sol Spiegelman's and Leslie Orgel's in vitro evolutionary studies. Dedicated to Leslie Orgel on the occasion of his 70th birthday.

The conditions necessary for evolution are amplification, mutagenesis and selection. Here we describe the evolutionary response of an in vitro replicating system to the selection pressure for fast growth and show what happens to the amplified molecules within this replication system. Our emphasis is on methodology, on the monitoring and the automation of experiments in molecular evolution. In order to perform in vitro studies on the evolution of RNA molecules, a modified self-sustained sequence replication (3SR) method was used. In the first step of the 3SR reaction, the RNA template is reversely transcribed by HIV-1 reverse transcriptase, followed by a second strand synthesis and the transcription of the resulting dsDNA by T7 RNA polymerase. The selection pressure (fast growth) was achieved by applying the principle of serial transfer pioneered in the laboratories of Sol Spiegelman and Leslie Orgel. At the end of the exponential growth phase of the 3SR reaction, an aliquot of the reaction mixture is transferred into a new sample containing only buffer, nucleotides and enzymes while RNA template molecules are provided by the transfer. The conditions in the exponential growth phase allow the RNA molecules to be amplified in a constant environment; all enzymes (HIV-1 reverse transcriptase and T7 RNA polymerase) and nucleotides are present in large excess. Therefore, transferring reproducibly within the exponential growth phase is equivalent to selecting for fast growth; those molecules which can replicate faster will displace others after several transfers. The experiments were performed using a serial transfer apparatus (STA) which allows the nucleic acid concentration to be monitored on-line by measuring the laser-induced fluorescence caused by intercalation of thiazole orange monomers into the RNA/DNA amplification products. The serial transfer experiments were carried out with an RNA template (220b RNA) that represents a 220-base segment of the HIV-1 genome and comprises the in vivo primer binding site (PBS) for the HIV-1 reverse transcriptase. It could be shown that after only two serial transfers two RNA species (EP1 and EP2) emerged that were much shorter. EP1 (48b) and EP2 (54b) were formed by deletion mutations within the original 220b RNA template in the very beginning of the serial transfer experiment; due to their higher replication rate (calculated from the growth curves derived on-line) these two deletion mutants displaced the original 220b RNA template in the course of the following thirty transfers. We assume that these two RNA species evolved independently of each other. Their formation was probably induced by a strand-transfer reaction of HIV-1 reverse transcriptase. Sequence analyses of these two evolution products seem to confirm such a presented pathway. 30 years after Spiegelman's experiment, the study described here is another answer to the question he posed: 'How do molecules evolve if the only demand is the biblical injunction: multiply?'. The answer, derived from a modified 3SR amplification system (mimicking a part of the HIV-1 replication cycle in vitro), is the same as thirty years ago: The RNA molecules adapt to the new conditions by throwing away any ballast not needed for fast replication. Clearly, this is only one aspect of molecular evolution; however, it shows that we should be careful in designating unidentified genetic material as 'junk DNA'.

Bacteriophage T7↗

The effect of physician solicitation approaches on ability to identify patient concerns.

CONTEXT: Studies showing that physicians often interrupt the patient's opening statement assume that this compromises data collection. OBJECTIVE: To explore the association between such interruptions and physician accuracy in identifying patient concerns. DESIGN: This study replicates the Beckman-Frankel methodology and adds exit interviews to assess physician understanding. The authors audiotaped a convenience sample of 70 encounters and surveyed both parties following the visit. SETTING: A community-based ambulatory clinic. PARTICIPANTS: Internal medicine residents (77%) and attending physicians and their adult, English-speaking patients who were primarily low income and ethnic minority. OUTCOME MEASURE: The Index of Understanding measures patient-physician problem list concordance. It is the percentage of patient problems, obtained on exit, that the physician correctly identifies. RESULTS: In 26% of the visits, patients were allowed to complete their agenda without interruption; in 37% the physicians interrupted; and in 37% no inquiry about agenda was made in the first 5 minutes. Neither physician experience nor their assessment of time pressure or medical difficulty was associated with these rates. Exit interviews showed no significant difference in Index of Understanding between those involving completion of agenda (84.6%) and those involving patient interruption (82.4%) (P=.83). But when the physician did not solicit an agenda, the concordance was 59.2%, significantly lower than either the completion (P=.014) or the interruption group (P=.013). CONCLUSION: Interruption as defined by Beckman-Frankel does not curtail ability to identify patient concerns, but failure to ask for the patient's agenda associates with a 24% reduction in physician understanding.

Adult↗

Acquisition and display of radiation dose distributions using microcomputer technology.

In the commissioning or quality assurance of a medical linear accelerator or a computerized radiotherapy planning system, the traditional approach usually consists of acquiring and comparing one-dimensional dose profiles. This methodology is tedious and incomplete since only a portion of the radiation field can realistically be sampled. We have developed an automated measurement system which allows efficient measurement and display of complete two-dimensional dose distributions. The general purpose microcomputer used (IBM PC/XT compatible) can be interfaced economically to any water phantom dosimetry system equipped with a three axis scan controller, and can also communicate data to the treatment planning system. This allows for direct comparison of measured with computed dose distributions, thus revealing discrepancies in the dose computation algorithms used. In this paper, we describe the interface between the microcomputer, a conventional water dosimetry system (Therados RFA-3), and a treatment planning computer. We report our early experience with acquiring dose distributions and show sample comparisons with computed results for megavoltage electron beams incident on homogeneous and heterogeneous systems.

Humans↗

Enhancing detection of polygenic adaptation: a comparative study of machine learning and statistical approaches using simulated evolve-and-resequence data.

BACKGROUND: Detecting signals of polygenic adaptation remains a significant challenge in population genomics, as traditional methods often struggle to identify the associated subtle, multi-locus allele-frequency shifts. Here, we introduced and tested several novel approaches combining machine learning techniques with traditional statistical tests to detect polygenic adaptation patterns in time-series of allele frequency changes from whole genome data. We implemented a Naive Bayesian Classifier (NBC) and One-Class Support Vector Machines (OCSVM), and compared their performance against the classical Fisher's Exact Test (FET). Furthermore, we combined machine learning and statistical models (OCSVM-FET and NBC-FET), resulting in 5 competing approaches. The framework is mainly designed and validated for evolve-and-resequence (EaR) experimental designs, where defined selection pressures and temporal sampling are feasible, but might be applicable for certain natural experiments as well. RESULTS: Using a simulated dataset based on empirical C. riparius Pool-Seq data, we evaluated methods across evolutionary scenarios varying in generation, selection strength, and number of loci under selection. Our results demonstrate that the combined OCSVM-FET approach consistently outperformed competing methods, achieving the lowest false positive rate, highest area under the curve, and high accuracy. The performance peak aligned with what we term the 'late dynamic phase' of adaptation - the period after initial selection has occurred but before fixation - highlighting the method's sensitivity to ongoing selective processes. CONCLUSIONS: Furthermore, we emphasize the critical role of parameter tuning, balancing biological assumptions with methodological rigor. While broader applicability remains an important direction for future work, the present benchmarking is intentionally scoped to EaR experimental contexts.

Machine Learning↗

Cell microarray for screening feeder cells for differentiation of embryonic stem cells.

Microarrays are currently recognized as one of major tools in the assessment of gene expression via cDNA or RNA analysis and are now accepted as a powerful experimental tool for high-throughput screening of a large number of samples, such as cDNA and siRNAs. In this study, we examined the potential of the microarray methodology for high-throughput screening of candidate cells as feeder cells which effectively differentiate embryonic stem (ES) cells to the specific lineage. Cell arrays were prepared by applying three kinds of cells, PA6, human umbilical vein endothelial, and COS-1 cells, to circular spots, 2 mm in diameter, on a glass plate, followed by the application of mouse ES cells to the cell microarray. After 8 d in culture, TuJ1 (neuron-specific class III beta-tubulin) immunocytochemical staining clearly demonstrated that only PA6 cell spots had the capability to induce ES cells to neuronal differentiation. Although this is a model experiment, these findings clearly indicate that the cell microarray will become a powerful tool for high-throughput screening large numbers of candidate feeder cells for specific differentiation.

Animals↗