SEARCH · PubMed Health

Results for “interpretive description”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,261 records · Page 70Linked to original sources

PubMed1980

[Sternal locations of Hodgkins disease. A report on two cases (author's transl)].

Two cases of sternal lesions of Hodgkin's disease are reported. Location of the disease process in the sternum is rarely encountered but may occur at any stage of the affection. They are isolated and initially presenting lesions in exceptional cases only. Diagnosis is therefore difficult in these cases, as illustrated by the description of the first patient. Clinical and radiological signs are not specific and histological findings not easy to interpret. The bone lesions, which are of the lytic or mixed type, are associated with swelling of the anterior and posterior sternal soft tissue. This latter observation strongly suggests that these lesions are caused by spread from existing anterior mediastinal adenopathies.

Adult↗

PubMedDate not supplied

Uncovering the knowledge embedded in clinical nurse manager practice.

To redesign effective nurse manager roles, data-based descriptions of their skilled performance and developmental learning are essential. This article is the first report of an interpretive, phenomenologic study to identify the skills and expertise embedded in the practice of nurse managers. The data describe how nurse managers operationalize institution values for patient care, and conversely, the impact of organization values on nurse managers' everyday behavior.

Adult↗

PubMed1993

[Birth of an illness, exemplified by Menière disease].

Martin Luther's history and a case report by Grapengiesser in 1801 demonstrate that there were typical clinical manifestations of Menière's disease long before Menière's description. Luther suspected Satanic inflictions as cause of his disease; later on clinical pictures of this kind were interpreted as cerebral apoplectiform congestions, or as symptoms of a psychosis. It is Menière's merit to have shown that lesions of the inner ear can cause deafness, tinnitus and vertigo without involving the middle ear, the acoustic nerve or the brain. The biography of Prosper Menière (1799-1862) is briefly outlined. He made his pioneering observation between 1834 and 1838 when he had to attend to a young lady who after catching a cold presented with vertigo and deafness on both ears, and died 5 days later. He reported on this case in an annotation to his translation of W. Kramer's textbook on otology in 1848, but did not mention the vertigo. It was only in 1861 that he described the complete syndrome he had discovered, referring in detail to the case and the post mortem findings of 25 years ago to prove his hypothesis that lesions in the inner ear can cause such symptoms. Following his presentation a controversy prevailed for many decades about the question whether there is an idiopathic Menière's disease or not. This is highlighted by quotations from the literature. The first audiogram-like picture of the hearing loss involving all frequencies was presented by Gradenigo in 1892.(ABSTRACT TRUNCATED AT 250 WORDS)

Europe↗

PubMedDate not supplied

Analyzing jobs for redesign decisions.

Job analysis, the collection and interpretation of information that describes job behaviors and activities performed by occupants of jobs, can provide nurse administrators with valuable information for redesigning effective and efficient systems of care.

Data Collection↗

PubMed1997

Patterns of caregiving following the institutionalization of elderly husbands.

The purpose of this study was to examine the caregiving career of older women following the institutionalization of their husbands. Informed by the interpretive perspective in sociology and Hughes's (1971) concept of career, the study employed a longitudinal, prospective, and descriptive design and combined the quantitative and qualitative approaches. The data used in the analysis were drawn from a larger study designed to explore the transition to quasi-widowhood and wives' responses to their husbands' institutionalization. The caregiving career of wives was seen as a pattern of frequent visiting and increasing involvement in the provision of care. Over the nine-month period of the study, two caregiving patterns emerged that were distinguished by a variety of circumstances and interactions. Wives who relinquished aspects of caregiving were more likely to be caring for husbands who were, in large measure, cognitively impaired. These wives reported good morale, few symptoms of depression, change in marital closeness, and satisfaction with aspects of institutional care. Wives who continued to be heavily involved in caregiving were more likely to have husbands who were physically impaired. They had depression scores indicative of moderate to severe depression, reported no change in marital closeness, and were dissatisfied with aspects of institutional care.

Aged↗

PubMed1994

Case report: asymmetrical development of the gyri recti presenting as a suprasellar mass: case report and description of six further cases.

Asymmetrical appearances of normal anatomical structures can sometimes mimic pathology. We present a case where asymmetry of the gyri recti was interpreted as a suprasellar mass on axial CT scanning. The true nature of the apparent abnormality was revealed by coronal magnetic resonance imaging (MRI). We also present six further cases where asymmetrical gyri recti were noted as incidental findings on coronal MRI scans. This is a common, but important, normal anatomical variant, which should not be mistaken for pathology.

Adult↗

PubMed2003

Non-parasitic chyluria: an interesting case of uncertain interpretation.

Chyluria occurs as a result of communication between the lymphatics and the urinary system. It is a common problem in developing countries. Since its original description by Hippocrates, chyluria has been mentioned frequently in the literature and has remained puzzling in many reports. As a rare occurrence, chyluria may present many diagnostic and therapeutic problems. A man with an interesting history of non-parasitic chyluria and an unusual radiological finding is described herein. The etiology and various treatments of chyluria are discussed.

Adult↗

PubMed1990

Structure of the glomerular mesangium: a biomechanical interpretation.

This paper summarizes our current knowledge of the structural details and probable functional significance of the system of contractile filaments in the glomerular mesangium. The description is based mainly on studies of superficial glomeruli of the rat kidney. The contractile apparatus of mesangial cells consists of microfilament bundles located predominantly within mesangial cell processes. The thickest microfilament bundles occur in the juxtacapillary mesangial cell processes, which directly abut the glomerular capillaries. The effector structure of mesangial cell contractility is the GBM. Mesangial cell processes are connected to the GBM either directly or through the interposition of extracellular microfibrils. In general, the contractile system of the mesangium interconnects opposing parts of the GBM. This arrangement is particularly obvious in the juxtacapillary processes, which underlie a mechanical connection between the GBM at the two opposing mesangial angles of a single capillary. The geometry and structural composition of the contractile apparatus of the mesangium indeed suggest a static rather than a dynamic function. In conjunction with the GBM, the mesangial contractile apparatus seems capable of supporting sufficient wall tension to counteract the distending forces acting across the capillary walls; the apparatus also seems capable of directly balancing the distending forces on the perimesangial walls. Assuming that mesangial cells are capable of isotonic contractions, the effect of such a contraction on capillary diameter and, consequently, on filtration area would be small.

Actin Cytoskeleton↗

PubMed1980

[Measurements of aphasic disorders. A brief description of the SAN-battery].

A Dutch test series for the measurement of aphasic disturbances is introduced. Factor analyses demonstrate three factors that can be interpreted clearly as spontaneous speech, production and comprehension of speech. This structure is very stable during a follow-up of one year. The tests and the production, comprehension and severity scores derived from them have high indices of reliability. Norms based on 147 cerebrovascular aphasics and 179 normal controls have been calculated.

Aphasia↗

PubMed2005

An investigation of job satisfaction, organizational commitment and role conflict and ambiguity in a sample of Chinese undergraduate nursing students.

This study aimed to explore the relationships between job satisfaction and organizational commitment, role conflict and ambiguity, and demographic variables associated with retention of nurses within the Chinese healthcare workforce. A hypothetical model derived from a review of research studies investigating relationships between these variables was tested in a cross-sectional questionnaire survey of all the final year nursing students in a medical university in China. Seventy-one out of the total sample of 75 final year nursing students completed the questionnaire, producing a response rate of 95%. Descriptive and inferential statistical analysis of the data revealed a positive relationship between job satisfaction and organizational commitment, and a negative relationship between job satisfaction and role conflict and ambiguity. These results largely support the hypothesised associations between variables found in research studies derived mainly from samples of Western qualified nurses. However, contrary to previous studies, the findings suggest that aspirations to work in a clinical post are associated with high job satisfaction, and degree level student nurses have relatively high job satisfaction. The main implications for nursing education and practice are that educators and clinical mentors should work collaboratively to reduce the gap between theory and practice, specifically to improve the quality of student nurses' clinical experience in China and elsewhere. Positive clinical placement experience is related to high job satisfaction, and so, potentially, to improved retention. Future studies are needed which investigate changes in job satisfaction and other related variables over time, which have student nurse samples that are sufficient to enable the predictive value of these variables on retention in the healthcare workforce to be investigated.

Adult↗

PubMed1999

MR contrast media in neuroimaging: a critical review of the literature.

BACKGROUND AND PURPOSE: MR contrast media are commonly used but do not have evidence-based guidelines for their application. This investigation seeks to define specific methodological problems in the MR contrast media literature and to suggest guidelines for an improved study design. METHODS: To evaluate the reported clinical efficacy of MR contrast media in neuroimaging, we performed a critical review of the literature. From 728 clinical studies retrieved via MEDLINE, we identified 108 articles that evaluated contrast media efficacy for a minimum of 20 patients per study. The articles were randomly assigned to four readers (a fifth reader reviewed all of the articles) who were blinded to article titles, authors, institutions, and journals of publication. The readers applied objective, well-established methodological criteria to assign each article a rating of A, B, C, or D. RESULTS: One hundred one of 108 articles received a D rating, six received a C rating, and one received a B rating. In general, the Methods sections of the evaluated articles did not contain details that would allow the reader to calculate reliable measures of diagnostic accuracy, such as sensitivity and specificity. Specifically, a common problem was failure to establish and uniformly apply an acceptable standard of reference. In addition, images were not always interpreted independently from the reference standard. Radiologists and clinicians need to determine the applicability of any published study to their own practices. Unfortunately, the studies we reviewed commonly lacked clear descriptions of patient demographics, the spectrum of symptomatology, and the procedure for assembling the study cohort. Finally, small sample sizes with inadequate controls were presented in almost all of the articles. CONCLUSION: Although MR contrast media are widely used and play an essential role in lesion detection and confidence of interpretation, no rigorous studies exist to establish valid sensitivity and specificity estimates for their application. On the basis of this review, we herein describe basic methods to document improvements in technology. Such studies are essential to devise measures of diagnostic accuracy, which can form the basis for further studies that will assess diagnostic and therapeutic impact and, ultimately, patient outcomes.

Cohort Studies↗

PubMedDate not supplied

Suspected pulmonary embolism and lung scan interpretation: trial of a Bayesian reporting method.

OBJECTIVE: To determine whether a Bayesian method of lung scan (LS) reporting could influence the management of patients with suspected pulmonary embolism (PE). DESIGN: 1) A descriptive study of the diagnostic process for suspected PE using the new reporting method; 2) a non-experimental evaluation of the reporting method comparing prospective patients and historical controls; and 3) a survey of physicians' reactions to the reporting innovation. SETTING: University of Virginia Hospital. PATIENTS: Of 148 consecutive patients enrolled at the time of LS, 129 were completely evaluated; 75 patients scanned the previous year served as controls. INTERVENTION: The LS results of patients with suspected PE were reported as posttest probabilities of PE calculated from physician-provided pretest probabilities and the likelihood ratios for PE of LS interpretations. RESULTS: Despite the Bayesian intervention, the confirmation or exclusion of PE was often based on inconclusive evidence. PE was considered by the clinician to be ruled out in 98% of patients with posttest probabilities less than 25% and ruled in for 95% of patients with posttest probabilities greater than 75%. Prospective patients and historical controls were similar in terms of tests ordered after the LS (e.g., pulmonary angiography). Patients with intermediate or indeterminate lung scan results had the highest proportion of subsequent testing. Most physicians (80%) found the reporting innovation to be helpful, either because it confirmed clinical judgement (94 cases) or because it led to additional testing (7 cases). CONCLUSIONS: Despite the probabilistic guidance provided by the study, the diagnosis of PE was often neither clearly established nor excluded. While physicians appreciated the innovation and were not confused by the terminology, their clinical decision making was not clearly enhanced.

Adult↗

PubMed1992

Descriptive ventilatory mechanics from noninvasive analog display of ribcage and abdominal flow.

A rapidly responding analog display of ventilatory flow at the mouth, ribcage and abdomen allows interpretation of the relative activity of the diaphragm, accessory inspiratory muscles and abdominal expiratory muscles. These relative movements are exaggerated by having volunteers perform the ventilatory maneuvers of sniff, rapid exhalation and cough. Activity and regional lung flow can change in time periods in the tens of milliseconds. These rapid (within an inspiratory or expiratory time) relational changes in respiratory muscle activity and regional lung flow have not previously been demonstrated with a simple noninvasive measurement.

Abdomen↗

PubMed1995

Headache classification and the Bible: Was St Paul's thorn in the flesh migraine?

The conversion of Saul to Paul was a major event in the history of Western culture. Compared with its impact, any medical comments may seem redundant, but they have kept their place in the literature for many centuries. The flashing light that caused Saul to fall is often explained as solar retinopathy or keratitis, a seizure, or even a hysterical fit. These interpretations propose either a trivial injury or disease that would interfere with mental health. Neither version is quite compatible with the dramatic dimension of the event and with Paul's later achievements and sufferings. In later years, Paul became a great manager, preacher and writer who was able to carry on under any kind of duress, though not without very painful reactions. He was suffering from bouts of unilateral headache, and also from a chronic eye condition which gave great trouble to his followers but did not cause lasting damage; the descriptions fulfil the criteria for migraine without aura of the 1988 Headache Classification. If the flashing light that caused Paul to fall down is interpreted as a visual migraine aura, with the additional symptoms of "not seeing" or photophobia and anorexia, it falls into place with his later history of migraine.

Bible↗

PubMed2007

Lessons learned in the implementation of an innovative consultation and liaison service for children of cancer patients in various hospital settings.

OBJECTIVE: To evaluate the process of implementing a family-oriented consultation and liaison service in various hospital-based settings, with special regard to problems and obstacles encountered. METHOD: Qualitative content analysis using categorization and sequential, phenomenological analysis of descriptive progress notes during the implementation period. The team members of the liaison service were defined as participant observers. Interpretations of the material were derived in previously defined, sequential steps in team discussions. RESULTS: Despite a consistent concept behind the new service, the degree to which it was able to be integrated into different medical settings varied to a remarkable degree. Obstacles encountered were often linked to a lack of consideration being given to divergent concepts of care. It was necessary to give special attention to providing physicians with practical evidence of the value of the intervention. The new service was most readily utilized by families when physicians personally communicated the referrals as a standard procedure to their patients and when the referrals were not made too quickly after the parent's initial diagnosis. CONCLUSIONS: Hospital-based services for cancer patients with children under the age of 18 should carefully address patients' fears of psychiatric stigmatization. Furthermore, they should include modules for acute crisis intervention. Implications for future implementation activities in this field are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Comparing proportional hazards and accelerated failure time models: an application in influenza.

The proportional hazards (PH) model is routinely employed for the analysis of time-to-event data in medical research when it is required to assess the effect of an intervention in the presence of covariates. The assumption of PH required for the PH approach may not hold, especially in circumstances where the effect of the intervention is to delay or accelerate the onset of an event rather than to reduce or increase the overall proportion of subjects who observe the event through time. If the assumption of PH is violated, the results from a PH model will be difficult to generalize to situations where the length of follow-up is different to that used in the analysis. It is also difficult to translate the results into the effect upon the expected median duration of illness for a patient in a clinical setting. The accelerated failure time (AFT) approach is an alternative strategy for the analysis of time-to-event data and can be suitable even when hazards are not proportional and this family of models contains a certain form of PH as a special case. The framework can allow for different forms of the hazard function and may provide a closer description of the data in certain circumstances. In addition, the results of the AFT model may be easier to interpret and more relevant to clinicians, as they can be directly translated into expected reduction or prolongation of the median time to event, unlike the hazard ratio. We recommend that consideration is given to an AFT modelling approach in the analysis of time-to-event data in medical research.

Adolescent↗

PubMed1989

ANABEL: intelligent blood-gas analysis in the intensive care unit.

ANABEL (ANalysis of Acid-Base status by Evaluating Lisp) is a prototype medical intelligent decision-support system aiming to assist clinicians in an Intensive Care Unit environment with the interpretation of blood-gas measurements. Its architecture is based on the merging of representations for declarative (domain-descriptive) and procedural (problem-solving) medical knowledge. The system performs diagnosis in two stages (tentative and differential) by first evaluating elementary computational units of procedural knowledge (procedures) and then abstracting their symbolic outputs in generating text. Thus, a 'semantic trace' is built which reflects the system's line of reasoning in reaching its conclusion. This paper describes the design aspects, development and clinical validation of ANABEL.

Acid-Base Imbalance↗

PubMed2004

Comparison of M-FISH and conventional cytogenetic analysis in accelerated and acute phases of CML.

FISH and multicolor FISH (M-FISH) techniques have greatly enhanced the resolution of conventional cytogenetic analysis, thus enabling the identification of novel regions of rearrangement in hematological malignancies. We report on the analysis of cells from 24 chronic myelogenous leukemia (CML) patients, in either accelerated phase (14 cases) or blast crisis (10 cases) aimed at searching for previously unidentified additional abnormalities related to disease evolution. Indeed, in 6 of 24 cases (25%) M-FISH allowed a more precise description of chromosomal aberrations, the finding of cryptic rearrangements, characterization of markers, identification of additional material and a better interpretation of complex aberrations. However, new recurrent aberration did not emerge from M-FISH analysis.

Adult↗