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PubMed1992

The postoperative pain experience: a description based on the McGill Pain Questionnaire.

In surgical nursing practice, postoperative pain is of particular concern because of its documented effect on recovery and behaviors associated with recovery. Yet, little is known about the nature of this pain, other than its intensity. In this study, a description of the nature of the postoperative pain experience was generated from analysis of patient responses to the McGill Pain Questionnaire in four nursing intervention studies. The combined sample included 246 adult cholecystectomy patients. Patient descriptions of pain on the third postoperative day suggest a circumscribed sensory experience of moderate intensity. Sensory descriptors selected reflect two levels of noxious stimulation, one at the deeper somatic level (e.g., throbbing, stabbing, cramping, pulling, and burning) and one at a more superficial level (e.g., pricking, sharp, pinching, itching, sore, and tender). Descriptors of deeper pain tended to reflect greater intensity. The overall experience was characterized by 16 descriptors, selected by more than 30% of the sample and reflecting sensory, affective, and evaluative dimensions of the pain experience. Comparison of the findings from this combined sample drawn from hospitals in the northeastern United States were remarkably similar to those reported by Taenzer in Canada. The descriptors selected support, extend, and validate the kind of "sensation information" needed in preoperative instruction used in nursing practice and for abdominal surgery and can be useful in the assessment and management of postoperative pain.

Adult↗
PubMed2003

[Experiencing motherhood in early adolescence].

OBJECTIVE: Although still scarcely studied in Brazil, motherhood in early adolescence among girls aged 10 to 14 years is mostly unwanted and it is an important public health issue. Most investigations are based on biomedical paradigms and few take into consideration the adolescent's point of view. This study aimed to explore the different patterns of experiencing early motherhood from the adolescent's own point of view. METHODS: William Stephenson's Q methodology was applied. The study population was selected from 2 public mother and child health units in Rio de Janeiro, Brazil, and comprised 20 adolescents who became pregnant at the age of 10 to 14 years and were followed up for a period of 6 to 24 months after giving birth. Q-sorts underwent factor analysis and then the factors were interpreted. RESULTS: Four qualitatively and statistically (p<0.01) perception patterns were found. Two factors were well defined: Factor I - Satisfied with motherhood/ Dependent on the child's affection: motherhood is a positive and rich experience; and Factor II - Depressed/ Stressed out: motherhood is a negative and stressful experience. Other two potential factors need confirmation in further studies with a larger sample size. CONCLUSIONS: It was observed that motherhood's experience is distinct and heterogeneous. For some adolescents, motherhood could be a rewarding experience

Adolescent↗
PubMed2004

A mixed-model approach for the analysis of cDNA microarray gene expression data from extreme-performing pigs after infection with Actinobacillus pleuropneumoniae.

We proposed a novel statistical approach for the analysis of cDNA experiments based on mixed-model methodology combined with mixtures of distributions. Our objective was to detect genes that may be involved in conferring heritable differences in susceptibility to common infections in intensive pig production. We employed a microarray expression profiling strategy and a mixed-model approach to the analysis of the expression data. A cDNA microarray of pig with 6,420 probes from immune tissues and cells was used to compare gene expression in peripheral blood leukocytes of two pigs showing extreme performance in their response to infection with Actinobacillus pleuropneumoniae. Principal components analyses were used to identify the two most extreme-performing pigs after infection (i.e., pigs whose measured responses to infection fell at the extremes). Blood samples and expression profiles from 0 to 24 h after infection were compared using a bivariate, mixed-model approach, in which the effect gene x immunological status interaction was treated as a random effect. Bayesian model-based clustering via mixtures of normal distributions of the resulting BLUP of the random interaction was approached and resulted in a list of 307 differentially expressed genes, of which 179 were down-regulated in the susceptible pig. The majority of the differentially expressed genes were derived from a cDNA library of leukocytes of A. pleuropneumoniae-challenged pigs that were subtracted against leukocytes before the challenge. These results provide evidence that the proposed statistical approach was useful in enhancing the knowledge of the mechanisms involved in the genetics of the immune response.

Actinobacillus Infections↗
PubMedDate not supplied

B- and T-cell gene rearrangement test: an overview of application and methodology.

OBJECTIVE: To examine the use of the B- and T-cell rearrangement test in the diagnosis of lymphoid neoplasms. DATA SOURCES: Recent texts, professional journals, and authors' experiences. STUDY SELECTION: Not specified. DATA EXTRACTION: Not specified. DATA SYNTHESIS: The B- and T-cell rearrangement test can detect a monoclonal population of B- and T-cells, strongly indicative of neoplasia. This is accomplished through the use of DNA probes. The presence of a unique band on the Southern blot signifies a monoclonal gene rearrangement, which can make or confirm a diagnosis of a lymphoproliferative disorder and classify the lineage as B- or T-cell. T-cell neoplasms generally behave more aggressively than B-cell neoplasms, which can have important implications for prognosis and therapy. The unique gene rearrangement "signature" can be followed during and after therapy to document remission or recurrence. The most commonly examined samples are from the blood, bone marrow, and lymph nodes, but any tissue or fluid suspected of harboring a lymphoid neoplasm can be examined. CONCLUSION: The test is an important diagnostic indicator in the evaluation and follow-up of patients with lymphoma or lymphoid leukemia. It is most helpful when it can be correlated to the clinical condition of the patient and other ancillary studies.

Blotting, Southern↗
PubMed1986

Coitally active university students: sexual behaviors, concerns, and challenges.

The past fifteen years, in particular, have seen a major increase in the extent to which both adolescents and young adults are engaging in sexual intercourse. While several studies call attention to the increasing incidence among college/university students, the concomitant shifts in the sociopsychological realms of sexuality are also important dimensions which impact upon sexual concerns of youth. Hence, the purposes of this study are to examine the behaviors, attitudes, and concerns of students who have engaged in coitus, as well as any changes they seek in their sex lives. The sample consisted of 123 never-married male and 205 never-married female undergraduate students from a state university. The data were obtained by utilizing an anonymous questionnaire administered to volunteers during regular university classes. Among the coitally active, 67.4% of males were psychologically satisfied after their first sexual experience, but only 28.3% of females. In contrast, 80.9% of males and 28.3% of females reported current psychological satisfaction with their sexual experiences. Significant differences between genders focused on male dissatisfaction with infrequent opportunities for sexual intercourse, lack of variety of sex partners, and insufficient oral-genital stimulation, whereas females expressed concerns relating to lack of stimulation to their breasts, painful sexual intercourse, lack of orgasm during sexual intercourse, and feelings of guilt and fear. An increasing awareness of current sexual behaviors, attitudes, and concerns of university students can help family life educators to meet student needs as they react to changes in interpersonal relationships, families, and society.

Adolescent↗
PubMed1997

Clustered binary logistic regression in teratology data using a finite mixture distribution.

The beta-binomial distribution introduced by Skellam has been applied in many teratology problems for modelling the litter effect. Recently, Morel and Nagaraj proposed a new distribution for modelling cluster multinomial data when the clustering is believed to be caused by clumped sampling. It turns out that the distribution is a mixture of two binomial distributions and accommodates the estimation of an additional parameter to account for intra-litter effect. The new distribution arises from a cluster mechanism in which some individuals within a cluster exhibit the same behaviour while the remaining individuals from the cluster react independently of each other. Such a mechanism is a natural model in teratology problems, where typically a genetic trait is passed with a certain probability to the foetuses of the same litter. In this article, we use the new distribution to model binary responses with logistic regression. We analyse data from a teratology experiment to demonstrate that the new model provides a useful addition to current methodology. The experiment investigates the synergistic effect of the anticonvulsant phenytoin and trichloropopene oxide on the prenatal development of inbred mice. In a simulation study we investigate the type I error rate and the power of the maximum likelihood ratio test when the data follow a finite mixture distribution.

Animals↗
PubMed2005

The use of a safety harness does not affect body sway during quiet standing.

BACKGROUND: Postural sway during quiet standing reduces when somatosensorial information is provided by an active or passive "light touch" of different body parts with a surface. The contact of the safety harness with the body could induce a similar effect, leading to an undesirable side effect in the balance evaluation. METHODS: This study investigated if a safety harness system, commonly used in balance studies, affects body sway during the balance evaluation. Healthy adults stood as quietly as possible for 60s in a comfortable position on a force plate. First, we performed an experiment on the light-touch effect with 10 subjects to determine the necessary sample size for the main investigation. Then, 60 subjects completed four tasks where the use of the safety harness and the visual information were manipulated. Area, root-mean square, speed, and frequency of the center of pressure displacement were analyzed. FINDINGS: A light touch decreased postural sway on both visual conditions but there was no effect of the use of a safety harness on sway when quietly standing, independent of the visual information. Postural sway increased on both somatosensorial conditions when the visual information was not provided. INTERPRETATION: This result shows that the safety harness does not interfere with the evaluation what is of major importance to methodological aspects of balance evaluation.

Adult↗
PubMed2000

Researching limiting long-term illness.

Needs assessment has become one of the cornerstones for commissioning health care in the UK but, as yet, no agreed methodological framework exists. This study attempts to build on a number of different approaches used in needs assessment in order to formulate a more complex and integrated model. We have taken limiting long-term illness (LLI) as a starting point and examined its prevalence within the primary care setting in an area of North Staffordshire. This was followed by the application of a health status measure on two sub-samples (those reporting LLI and those not reporting LLI). The diagnostic assessments of the GP was placed alongside the results of the health status measure in order to compare self-assessment with the professional perspective. Finally, in-depth interviews with people with LLI were carried out examining their own experience of ill-health. We argue that this detailed and complex needs assessment allows for a more targeted approach to commissioning and service development.

Chronic Disease↗
PubMed1990

Effect of two rating formats in multi-disease ROC study of chest images.

ROC methodology has been expanded in recent years to include multi-disease experiments. To accommodate these changes, different rating formats, general or disease specific, can be used. No experimental data are available concerning the possible effects of the rating format on the results of these studies. We performed a multi-observer, multi-disease study in which 196 chest images were rated using a format where each disease was evaluated individually and one in which the cases were evaluated without scoring a specific disease. The results indicate that for our data set, the overall assessment of accuracy was not significantly affected by the study format used. Thus, in spite of the difficulties in selecting appropriate controls and the necessity of reassessing sample size considerations, the disease-specific format appears to produce an assessment of accuracy equivalent to that produced by the general format. This equivalence permits the use of the disease-specific approach since it more closely simulates the readers' true environment and is more appropriate for comparing imaging systems that may have a relative accuracy that is disease specific.

Diagnosis, Differential↗
PubMedDate not supplied

Correlates of physical activity in chronic obstructive pulmonary disease.

BACKGROUND: Physical activity is a key dimension of functional status in people with chronic obstructive pulmonary disease (COPD), and the central target of interventions in this group. OBJECTIVES: To determine the relationships among functional performance measured as physical activity, functional capacity, symptom experiences, and health-related quality of life in people with COPD. METHOD: Cross-sectional, descriptive study. Convenience sample of 63 outpatients with COPD studied prior to entry into a pulmonary rehabilitation program. RESULTS: Daily physical activity, as measured by an accelerometer, was strongly associated with maximal distance walked during a 6-minute walk test (r = .60, p < .00), level of airway obstruction (r = .37, p < .01), walking self-efficacy (r = .27, p < .05), and physical health status (r = .40, p < .01). Physical activity was not correlated with self-report of functional status. The only predictor of physical activity was the 6-minute walk test. CONCLUSIONS: Accelerometer measurement of functional performance was most significantly related to walking abilities. This methodology represents a novel approach to measuring an important dimension of functional status not previously well quantified.

Activities of Daily Living↗
PubMed1995

Defining the concentration-effect relationship of volatile anesthetics in vessels using an in vitro nonsteady-state technique.

We compared traditional steady-state experiments with nonsteady-state experiments in defining the vasodilating potency of isoflurane in isolated cerebral vessels. The effects of volatile anesthetics on isolated arterial vessel wall tension are typically examined by means of steady-state methodology. This requires the prolonged administration of the agent under study until a stable wall tension is achieved. An alternative, non-steady-state approach to such experiments is proposed as an adjunct technique to help simplify and in some cases evaluate more fully vascular response. Cylindrical segments of the rabbit basilar artery were placed into a perfused tissue bath, stretched to a resting tension of approximately 2000 dynes and then constricted with 30 nM K+. Thirty minutes later, 2.0 MAC of isoflurane was introduced into the fluid reservoir supplying the chamber. This administration was continued for 10 min, at which time isoflurane was discontinued and vessel tension was monitored for another 10 min. During this 20-min washin-washout period, samples of bath fluid were obtained q 1 min and isoflurane concentrations were subsequently determined by gas chromatography. After completion of these "nonsteady-state" measurements, another 30-min waiting period was allowed, after which vessels were exposed to stable concentrations of 0.5, 1.0, 1.5 and 2.0 MAC of isoflurane in varied order. Each exposure was for 15 min, with a 30-min agent-free rest period between exposures. An effect compartment model was selected for analysis of the nonsteady-state data. Ke0, a first order rate constant linking the concentrations in the bath to a theoretical effect compartment, was estimated by using a hysteresis minimization technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Development of a conceptual model of quality of life.

Quality of life is a critically important concept for health care that has been developed predominantly in the past three decades. Conceptual clarity is extremely important, because differences in meaning can lead to profound differences in outcomes for research, clinical practice, and allocation of health care resources. This paper describes the development of the Ferrans conceptual model of quality of life. The model was developed based on the adoption of an individualistic ideology, which recognizes that quality of life depends on the unique experience of life for each person. Individuals are the only proper judge of their quality of life, because people differ in what they value. Consistent with this ideology, quality of life was defined in terms of satisfaction with the aspects of life that are important to the individual. The model was developed using qualitative methodology. Factor analysis of patient data was used to cluster related elements into domains of quality of life. The resulting model identifies four domains of quality of life: health and functioning, psychological/spiritual, social and economic, and family. Subsequent cross-cultural work with African Americans and Mexican Americans has provided evidence that the elements of the model appropriately reflect quality of life for segments of the population not sampled in the original work. The Ferrans and Powers Quality of Life Index was developed based on this model.

Concept Formation↗
PubMed2006

Determination of strength and deformation behavior of human cartilage for the definition of significant parameters.

In reconstructive surgery, an artificial supporting scaffold made from autogenous cartilage from the rib, the ear concha, or the nasal septum is used as a substitute for the destroyed endogenous tissue in the ear concha, the nose, the trachea, and in parts of the facial skeleton. For the successful use of polymer materials in reconstructive surgery, an exact knowledge of the material properties of the natural tissues is required. The applicability of conventional material test methods was examined with regard to the suitability of the test methodology. Materials properties are to be assessed for different specimen sizes and geometries. Human cartilage specimens from the septum, rib, and ear were subsected to the following test methods: (1) tension, (2) bending, (3) compression, and (4) micro-hardness measuring. Specimen geometry was evaluated for each experimental method by taking into account the dimensions of samples used in plastics testing as well as the appropriate model of miniaturization. Elastic properties determined using test methods (1), (2), and (3) are Et-sep=(7.2+/-3.4) MPa, Ef-rib=(8.8+/-2.9) MPa, and Ec-rib=(103+/-30) MPa. The micro-hardness values hpl fluctuate for septum from 1 to 4 N/mm2 and for the rib from 0.5 to 1.3 N/mm2. The experiments have shown that, beside the sex- and age-specific values recorded, the standard values and their variation are particularly influenced by preparation technique and by the conditions of storage. As a result of these first investigations, characteristic values for strength and deformation were determined under quasistatic and dynamic load conditions. The aim of this study was not the determination of statistically firmed properties, but the examination of the applicability of mechanical test methods of the polymer testing for these materials.

Cartilage↗
PubMed2005

Comparison of the method of diffusive gels in thin films with conventional extraction techniques for evaluating zinc accumulation in plants and isopods.

The measurement of diffusive gels in thin films (DGT) has recently been developed to assess metal bioavailability in soils. The DGT-method is based on diffusion in a porous matrix. To test the predictive capabilities of the method with regard to metal bioavailability, a study was set up with 28 soils having a variety of textures and amounts of zinc salts added. Correlation and regression analyses were performed to compare DGT-extracted zinc levels to zinc concentrations obtained by extraction with 0.01 M CaCl(2) and 0.43 M HNO(3), digestion with aqua regia and the zinc concentration in pore water. The amount of zinc extracted with CaCl(2) correlated well with DGT-extracted zinc levels in all soils spiked with different amounts of ZnCl(2). A similar correlation was not found for zinc concentrations in soil samples collected in the field. Experiments were performed to compare zinc content in organisms and in soils. The organisms tested were plants (grass, lettuce and lupine) and the hard bodied soil dwelling isopod Oniscus asellus. Good correlations were found between zinc accumulation in grass and lettuce and the C(E) (effective concentration) measured by a DGT-device, CaCl(2) extracted zinc and the zinc content in the pore water of all soils. The correlation with C(E) was not significant for lupine, neither for spiked soils, nor for field soils (p< or =0.001). Zinc levels in the isopods were not significantly related to any set of zinc measurements. From a synthesis of all results obtained it is concluded that the DGT-methodology does not have an additional value in predicting bioavailability of zinc in terrestrial ecosystems as compared to conventional extraction methods.

Biological Availability↗
PubMed2005

D-optimal experimental designs to test for departure from additivity in a fixed-ratio mixture ray.

Traditional factorial designs for evaluating interactions among chemicals in a mixture may be prohibitive when the number of chemicals is large. Using a mixture of chemicals with a fixed ratio (mixture ray) results in an economical design that allows estimation of additivity or nonadditive interaction for a mixture of interest. This methodology is extended easily to a mixture with a large number of chemicals. Optimal experimental conditions can be chosen that result in increased power to detect departures from additivity. Although these designs are used widely for linear models, optimal designs for nonlinear threshold models are less well known. In the present work, the use of D-optimal designs is demonstrated for nonlinear threshold models applied to a fixed-ratio mixture ray. For a fixed sample size, this design criterion selects the experimental doses and number of subjects per dose level that result in minimum variance of the model parameters and thus increased power to detect departures from additivity. An optimal design is illustrated for a 2:1 ratio (chlorpyrifos:carbaryl) mixture experiment. For this example, and in general, the optimal designs for the nonlinear threshold model depend on prior specification of the slope and dose threshold parameters. Use of a D-optimal criterion produces experimental designs with increased power, whereas standard nonoptimal designs with equally spaced dose groups may result in low power if the active range or threshold is missed.

Animals↗
PubMed2002

Alcohol use and risky sexual behavior among college students and youth: evaluating the evidence.

OBJECTIVE: To evaluate the empirical associations between alcohol use and risky sex at two levels of analysis. Global associations test whether individuals who engage in one behavior are more likely to engage in the other, whereas event-specific associations test whether the likelihood of engaging in one behavior on a given occasion varies as a function of engaging in the other on that same occasion. METHOD: Studies examining the association between drinking and risky sex in samples of college students and youth were reviewed. Those published in the past 10 years and using event-level methodology or random sampling were emphasized. RESULTS: Findings were generally consistent across levels of analysis, but differed across types of risky behaviors. Drinking was strongly related to the decision to have sex and to indiscriminate forms of risky sex (e.g., having multiple or casual sex partners), but was inconsistently related to protective behaviors (e.g., condom use). Moreover, the links among alcohol use, the decision to have sex and indiscriminate behaviors were found in both between-persons and within-persons analyses, suggesting that these relationships cannot be adequately explained by stable individual differences between people who do and do not drink. Analysis of event characteristics showed that drinking was more strongly associated with decreased protective behaviors among younger individuals, on first intercourse experiences and for events that occurred on average longer ago. CONCLUSIONS: Future efforts aimed at reducing alcohol use in potentially sexual situations may decrease some forms of risky sex, but are less likely to affect protective behaviors directly.

Adolescent↗
PubMed1999

Dysphoric mood and preference for immediate versus delayed monetary reinforcement.

It has been proposed that depression is the product of deficits in self-management skills: self-monitoring, self-evaluation, and self-reinforcement. While interventions based on this theory have shown promise, some of the basic tenets upon which the theory is based lack empirical support. The present experiment tested one such tenet--the claim that depressed individuals select smaller more immediate reinforcers (an impulsive choice) at the expense of larger more delayed reinforcers (a self-control choice). Currently, empirical support for this notion is sparse and contradictory. This study addressed several methodological problems in earlier studies by creating divergent groups based on Beck Depression Inventory scores, employing a task requiring multiple responses and applying a quantitative model to determine reinforcer value. Analyses indicated no systematic difference between participants in the dysphoric and nondysphoric groups in ability to delay reinforcement. Thus, the current results provide no support for the hypothesis that the 36 dysphoric individuals were unable to delay reinforcement relative to the 21 nondysphoric individuals. Because respondents across the sample as a whole showed a self-control preference, however, the data are consistent with findings in the experimental study of choice responding with adult human subjects. Interpretations in terms of sensitivity and pseudosensitivity to the experimental contingencies are explored.

Adolescent↗