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PubMed1994

Delusional beliefs in first admitters. A clinical description.

Delusional beliefs in first admitters with no organic disorder are studied. The study sample of 88 patients provides a representation of delusional beliefs in first admitters. A scale for dimensions of delusional beliefs is proposed and applied to the patient group. The scale includes dimensions of conviction, extension, systematization, probability, pressure and global state. Adequate interobserver agreement is achieved. The patients are distributed according to ICD-10 and DSM-III-R with schizophrenia as the most frequent diagnostic category. More than half of the patients are, however, diagnosed differently. It is obvious that many patients with schizophrenia and persistent delusional disorder are seriously dysfunctioning at their entry into hospital. In contrast patients with affective disorder and acute and transient psychotic disorder are, on the average, functioning reasonably well. Identical delusional themes appear in different diagnostic categories while the dimensional severity of delusional beliefs varies from one category to another. When assessed at admission patients with a discharge diagnosis of schizophrenia have delusional beliefs with a high degree of dimensional severity in contrast to patients with affective disorder. Delusional beliefs in patients with persistent delusional disorder seem more systematized and probable than those diagnosed differently. In interpreting the findings one has to remember that the presence and theme of delusional beliefs are in no way independent aspects of diagnostic category. Description of delusional dimensions may, however, be important for the conceptualization of delusional beliefs and a method to study psychotic decompensation and resolution. Later on the patients were followed in search of the predictive significance of a qualified assessment of delusional beliefs in contrast to syndromes when defined according to new classification systems.

Adult↗

PubMed2005

Chemical variance, a useful tool for the interpretation and analysis of two-dimensional chromatograms.

A new method is presented for the analysis of comprehensive two-dimensional data. The approach complements existing chemometric methods for analysing these kinds of data (e.g. multivariate-curve-resolution methods, MCR), and is especially suited for the analysis of families of compounds. The method is based on finding a new pair of axes (replacing the retention time axes) to represent the data. A drop in the matrix rank is observed when one of the axes collects all the variance for a certain family of compounds. This is achieved by introducing retention models (in both chromatographic dimensions) that describe the behaviour of a family of compounds as a function of the property that varies between the members. After this transformation, a single family of compounds gives rise to a single source of variance. This suggests the application of MCR techniques in a second step to separate the contributions of different (overlapped) families of compounds. For the latter application, more research has to be performed. The approach is illustrated using the separation of families of functional poly(methyl-methacrylate) polymers with different numbers of hydroxyl end groups and degrees of polymerisation or, equivalently, with the molecular weight as the key descriptive property within one family.

Algorithms↗

PubMedDate not supplied

Impact of uncertainty, social support, and prenatal coping on the psychological well-being of high-risk pregnant women.

BACKGROUND: The effects of uncertainty and social support on the psychological well-being of high-risk pregnant women may be influenced by their prenatal coping strategies. OBJECTIVE: The purpose of this study was to investigate whether prenatal coping strategies (preparation for motherhood, avoidance, positive interpretation of events, and prayer) mediate the effects of uncertainty and social support on the psychological well-being of high-risk pregnant women. METHODS: A cross-sectional, descriptive, correlational design was used. The convenience sample consisted of 105 high-risk pregnant women 18-34 years of age and at 24-36 weeks gestation. The main measures were Mishel Uncertainty in Illness Scale, Medical Outcomes Study Social Support Survey, Prenatal Coping Inventory, and Psychological General Well-Being Index. Data analysis included descriptive statistics, correlational techniques, and path analyses. RESULTS: The women reported low levels of uncertainty, moderate levels of distress, and high levels of social support. Prayer was the most frequently used prenatal coping strategy, whereas avoidance was used least often. Women who reported higher levels of uncertainty also reported less social support (r = -.45, p < .01), less psychological well-being (r = -.48, p < .01), less positive interpretation (r = -.30, p < .01), and more use of avoidance (r = .43, p < .01). The modified path analysis showed good fit with the data. Avoidance significantly mediated the effects of uncertainty on psychological well-being (z = -2.74, p < .01). Social support had a significant direct effect on preparation for motherhood (beta = .43, z = 3.94, p < .001). DISCUSSION: Avoidance mediated the effect of uncertainty on psychological well-being for the high-risk pregnant women in this sample. The results of the study may help perinatal nurses to better understand how high-risk pregnancy affects these women.

Adaptation, Psychological↗

PubMed2000

Satellites, space, time and the African trypanosomiases.

The human and animal trypanosomiases of Africa provide unique challenges to epidemiologists because of the spatial and temporal scales over which variation in transmission takes place. This chapter describes how our descriptions of the different components of transmission, from the parasites to the affected hosts, eventually developed to include geographical dimensions. It then briefly mentions two key analytical techniques used in the application of multi-temporal remotely sensed imagery to the interpretation of field data; temporal Fourier analysis for data reduction, and a variety of discriminant analytical techniques to describe the distribution and abundance of vectors and diseases. Satellite data may be used both for biological, process-based models and for statistical descriptions of vector populations and disease transmission. Examples are given of models for the tsetse Glossina morsitans in the Yankari Game Reserve, Nigeria, and in The Gambia. In both sites the satellite derived index of Land Surface Temperature (LST) is the best correlate of monthly mortality rates and is used to drive tsetse population models. The Gambia model is then supplemented with a disease transmission component; the mean infection rates of the vectors and of local cattle are satisfactorily described by the model, as are the seasonal variations of infection in the cattle. High and low spatial resolution satellite data have been used in a number of statistical studies of land cover types and tsetse habitats. In addition multi-temporal data may be related to both the incidence and prevalence of trypanosomiasis. Analysis of past and recent animal and human trypanosomiasis data from south-east Uganda supports the suggestion of the importance of cattle as a reservoir of the human disease in this area; mean infection prevalences in both human and animal hosts rise and fall in a similar fashion over the same range of increasing vegetation index values. Monthly sleeping sickness case data from the districts and counties of south-east Uganda are analysed and often show significant correlations with local LST. Case numbers increase with LST in areas that are relatively cooler than average for this part of Uganda, but decrease with LST in areas that are on average warmer. This indicates different seasonal cycles of risk across the region, and may be related to the differing vectorial roles of the two local tsetse, G. fuscipes and G. pallidipes. Finally, the increasing pace of change, and the likelihood of new or reemerging vector-borne diseases, highlight the need for accurate and timely information on habitat changes and the impacts these will have on disease transmission. The next generation of satellites will have significantly more spectral and spatial resolution than the current satellites, and will enable us to refine both statistical and biological predictions of trypanosomiasis and other vector-borne diseases within disease early warning systems.

Africa↗

PubMed2003

Aging dynamics in globular proteins: summary and analysis of experimental results and simulation by a modified trap model.

Recent results of spectral diffusion experiments by spectral hole-burning techniques carried out at cryogenic temperatures on various monomeric heme proteins unequivocally show interesting new features of conformational dynamics of globular proteins that were not emphasized in the literature until now. These new aspects of the protein dynamics are anomalous diffusion and the aging effect. Here, using the similarities between proteins and glassy systems, we present a model which can interpret the line broadening and-through this effect-the aging phenomenon as well. Leaving untouched the widely accepted energy landscape (EL) concept for the general description of protein dynamics, we concentrate on the bottom of the funnel-like EL, because this part corresponds to the native state(s) at low temperature. We suggest that the overall shape of the EL at the lowest energy range is rather smooth, but on a finer scale it consists of traps. The dynamics is defined by sequential jumps among these traps and the process is described by a Master equation, where the hopping rate only depends on the parameters of the starting state. This model was adapted to interpret the common results of spectral diffusion experiments. We tested our model in the simplest case by computer simulation, and it shows excellent agreement with the experimental data. To our knowledge this is the first work where a theoretical interpretation of the aging dynamics of proteins is directly and quantitatively related to the experimental observations. We also show that the model, after the generalization that the traps are hierarchically organized, is in accordance with the concept of other well-known EL models.

Biophysical Phenomena↗

PubMed2003

The study of things I have never seen.

Tinbergen defined structure as the momentary condition of an organism. Inference, interpretation, and theory were reserved for answering the "why" questions. Mason, however, observed that the study of behavior is incorrigibly mentalistic. Description seems barren compared to the richness supplied by creative intelligence. Exciting intervening variables such as learning, intention, and selective pressures can only be examined using inference, logic, and powerful deductive theories. For more than 100 years people have argued the two extremes: should science be restricted to the directly observable, or expanded to include what professional judgment could provide? I have devoted my life to the study of aggression and dominance, yet I have directly observed neither. I point to some behavior as an example of aggression, but I cannot provide an operational definition of what I mean. I will never know if another intends harm. I will never know if another is aware of the functions that behavior serves, and the outcomes that I confuse with past selective pressures and motivation. In a world where our subjects face extinction, perhaps it is wise to use computer simulations, to ask colleagues to rate their impressions, and to use logic to deduce behavior. The new "data" may be very useful. Still, I will miss actually watching what animals really do, even if I always describe it in terms of what I infer.

Aggression↗

PubMed2002

How rehabilitation therapists gather, evaluate, and implement new knowledge.

INTRODUCTION: Rehabilitation therapists are strongly encouraged to apply research to their practices, but relatively little is known about the processes therapists use for continuing their education. This study examines the strategies used by a sample of therapists to gather new knowledge, evaluate its appropriateness to their clinical problems, and implement new learning into their practices. METHODS: Twenty-four randomly selected occupational therapists and physical therapists from a large metropolitan area participated in in-depth interviews. Descriptive codes within interview transcripts described participants' individual approaches to continuing education (CE). Themes derived from comparative analysis across interviews were interpreted, building on prior understandings and suggesting strategies for CE research and programs. RESULTS: Participants valued formal CE highly and expressed frustration concerning its limited availability. Most participants relied on informal consultations with peers as their first educational resource. Peers also supported participants' evaluation and implementation of new knowledge. Although seven participants reported use of systematic methods to access, evaluate, and implement new knowledge, others described more haphazard approaches toward evaluation and application of their learning. Participants identified economic, administrative, and interprofessional barriers to integration of new knowledge into their practices. DISCUSSION: There is a need to develop and incorporate guidelines for evaluating and implementing learning within formal and informal CE programs. The appeal of formal CE suggests that more efficient strategies for continuing rehabilitation are required. Therapists' heavy reliance on peers suggests that educationally influential therapists may be effective media for informal CE interventions. CE targeted to policy makers should focus on promoting organizational change to enhance therapists' translation of research into practice.

Canada↗

PubMed1993

Fine-needle aspiration biopsy of subcutaneous fat necrosis of the newborn.

This report provides the first description of the fine-needle aspiration biopsy findings in a case of subcutaneous fat necrosis of the newborn. While initial interpretation of the aspirate smears was suspicious for a neoplastic process, subsequent incisional biopsy confirmed the benign nature of the lesion. Review of the cytologic material revealed rare, negatively stained, needle-shaped crystals within histiocytes and multinucleate giant cells. In the appropriate clinical setting, and given a mixture of lymphocytes, histiocytes, and multinucleate giant cells in the aspirate smears, we believe the finding of negatively stained needle-shaped crystals can strongly suggest the diagnosis of subcutaneous fat necrosis of the newborn.

Adipose Tissue↗

PubMed2000

Mg(2+) binding to tRNA revisited: the nonlinear Poisson-Boltzmann model.

Our current understanding of Mg(2+) binding to RNA, in both thermodynamic and structural terms, is largely based on classical studies of transfer RNAs. Based on these studies, it is clear that magnesium ions are crucial for stabilizing the folded structure of tRNA. We present here a rigorous theoretical model based on the nonlinear Poisson-Boltzmann (NLPB) equation for understanding Mg(2+) binding to yeast tRNA(Phe). We use this model to interpret a variety of experimental Mg(2+) binding data. In particular, we find that the NLPB equation provides a remarkably accurate description of both the overall stoichiometry and the free energy of Mg(2+) binding to yeast tRNA(Phe) without any fitted parameters. In addition, the model accurately describes the interaction of Mg(2+) with localized regions of the RNA as determined by the pK(a) shift of differently bound fluorophores. In each case, we find that the model also reproduces the univalent salt-dependence and the anticooperativity of Mg(2+) binding. Our results lead us to a thermodynamic description of Mg(2+) binding to yeast tRNA(Phe) based on the NLPB equation. In this model, Mg(2+) binding is simply explained by an ensemble of ions distributed according to a Boltzmann weighted average of the mean electrostatic potential around the RNA. It appears that the entire ensemble of electrostatically bound ions superficially mimics a few strongly coordinated ions. In this regard, we find that Mg(2+) stabilizes the tertiary structure of yeast tRNA(Phe) in part by accumulating in regions of high negative electrostatic potential. These regions of Mg(2+) localization correspond to bound ions that are observed in the X-ray crystallographic structures of yeast tRNA(Phe). Based on our results and the available thermodynamic data, there is no evidence that specifically coordinated Mg ions have a significant role in stabilizing the native tertiary structure of yeast tRNA(Phe) in solution.

Binding Sites↗

PubMed1978

Paul Schilder and group psychotherapy: the development of psychoanalytic group psychotherapy.

Group Psychotherapy began in 1905 with Pratt who assembled tuberculosis patients for a class treatment. Application of psychoanalytic concepts to group psychotherapy varied from Pratt's rejection of Freud and psychoanalysis to Louis Wender's descriptive and educational use of psychoanalysis in his group psychotherapy in 1936. At about the same time (1936) Paul Schilder actually interpreted the resistance, transferences, and dreams in his group psychotherapy sessions. Accordingly, Schilder would have to be recognized as the first to conduct a psychoanalytic group psychotherapy. Schilder's many contributions to group psychotherapy appeared in a few papers written before 1941. Precursors of current mainstream group psychotherapy can be found in them and they are still used as references.

History, 20th Century↗

PubMed1981

The effect of electronic fetal monitoring on the incidence of cesarean section.

In an attempt to elucidate the effect of electronic fetal monitoring on cesarean section rates, a review was made of the experience before and that during the 7 years after the initiation of fetal monitoring at Vanderbilt University Hospital. When a comparison was made of the cesarean section rates in the 3 years prior to fetal monitoring with those over the subsequent 2 years, no change was observed, thus indicating that, in experienced hands, a liberal use of fetal monitoring in low-risk and high-risk patients does not necessarily cause a rise in the overall incidence of cesarean sections. During this time, the neonatal mortality rate fell approximately fourfold. On the basis of this study, the belief is that a liberal attitude toward delivery by cesarean section for patients with breech presentations and other high-risk conditions contributed more to the rise in cesarean sections at Vanderbilt University Hospital than did electronic fetal monitoring. With proper education of the clinician and correct interpretation of the findings, electronic fetal monitoring need not increase cesarean section rates, but rather should allow for a more accurate description of intrapartum life.

Cesarean Section↗

PubMed1992

Male-mediated teratogenesis and other reproductive effects: biologic and epidemiologic findings and a plea for clinical research.

This paper reviews biologic and epidemiologic evidence that prefertilization and perifertilization exposures to fathers influence a variety of reproductive outcomes, including fertilization, miscarriage, low birth weight, congenital anomalies, cancer, and neurodevelopmental and other childhood health problems. Males and females bring an equal number of chromosomes to their progeny, but their genomes may affect different aspects of reproduction. While the key male role principally ends at fertilization, there is growing experimental and human evidence that factors relating both to prefertilization and perifertilization exposure also play a role post fertilization. Some negative human epidemiologic findings reflect the fact that routinely gathered information usually generates detailed descriptions of maternal exposures and does not collect records regarding prefertilization paternal exposures. The absence of extensive human evidence should be interpreted as a deficiency in research rather than an absence of male-mediated adverse reproductive outcomes. More than 60 different compounds or industrial processes have been identified as increasing defects in human sperm and possibly increasing the risk to offspring from male-mediated exposures. Further research needs to include better characterizations of both maternal and paternal prefertilization and perifertilization exposures, in order to assess more accurately their relative effects. Pediatricians confronted with adverse pregnancy and antenatal health outcomes should obtain detailed information on relevant prefertilization exposures of both parents.

Abnormalities, Drug-Induced↗

PubMed2006

An interplay between protein disorder and structure confers the Ca2+ regulation of striated muscle.

The troponin (Tn) complex regulates the thin filament of striated muscle by transducing [Ca2+] fluctuations into conformational changes. These changes propagate to tropomyosin (Tm), which then assumes a new disposition with respect to actin, reversibly exposing actin's binding sites for the thick filament motor-ATPase (myosin). To date, the structural biology of thin filament regulation has been studied in the context of two equilibrium states corresponding to high (contraction-activated) and low (contraction-inhibited) sarcomeric [Ca2+]. New electron micrographic reconstructions of the thin filament have resolved Tn, actin, and Tm in high and low [Ca2+] states, integrating high-resolution structures of the Tn core, actin, and Tm. The resultant picture of thin filament regulation does not resolve all of the functionally significant portions of troponin I (TnI) or troponin C (TnC). Those regions of Tn have been shown (using NMR relaxation spectroscopy) to undergo conformational fluctuations, rationalizing the absence of these regions from micrograph-based reconstructions. The disordered portions of Tn are, to date, being interpreted within a canonical structure-activity paradigm. Here we present a new mechanism for the regulation of Tn having explicit descriptions of the kinetic pathways of activation and inhibition. Our thesis is that the intrinsic disorder of TnI is mechanistically significant. As the coupling of folding to binding has been shown to confer an inherent kinetic advantage (known as flycasting activity), our thesis accounts for TnI's conformational heterogeneity and known structure-activity relationships in a parsimonious fashion. We integrate recent NMR structures of the C-terminus of TnI and NMR observations of the conformational dynamics of the Tn complex into high-resolution models of the thin filament. Ways of evaluating the mechanism are discussed. The novel conceptual framework presented here prompts new hypotheses regarding the mechanism of pH sensitivity and of pathogenic mutations in troponin.

Calcium↗

PubMed2002

Five-year-olds' handling of reference and description in the domains of language and mental representation.

Children's concurrent success on false belief tasks and their handling of two labels for one object (e.g., bunny/rabbit) has been interpreted as demonstrating understanding about the essential features of representation. Three experiments reveal the limitations in 5-year-olds' understanding for both mental and linguistic representations. We report relatively poor performance on a task involving two labels for one object (e.g., dice/eraser) which required children to treat another's knowledge as representing only some of the feature of its real referent: Dice but not eraser. Five year olds who made errors also had difficulty handling the fact that a written word 'dice' referring to such a dice/eraser, can also be applied to a standard dice but not to a standard eraser. These children lacked metalinguistic awareness of words as entities that both refer and describe.

Analysis of Variance↗

PubMed2003

Pelvic ring disruptions in emergency radiology.

Pelvic ring disruptions are a result of high-energy trauma and are a significant cause of morbidity and mortality in major trauma patients. The initial pelvic radiograph, in combination with computed tomographic imaging in selected patients, provides a quick and accurate method of diagnosing pelvic fractures. Pelvic fracture classification schemes have evolved over the past few decades, and include description of the mechanism of injury and assessment of pelvic stability. Understanding these classifications is important in developing an approach to interpretation of pelvic imaging and prediction of associated injuries. Armed with these tools, the emergency radiologist can detect pelvic fractures early and guide subsequent imaging and therapy.

Emergency Service, Hospital↗

PubMed2002

Imaging of sequelae of head trauma.

The imaging of head trauma has been one of the fundamental cornerstones of neuroradiology. As the practice of neuroimaging has matured, great strides have been made in the diagnostic as well as prognostic armamentarium available to physicians. Given the vast diversity of trauma mechanisms and clinical pathways, new advanced imaging technologies have had a lasting impact on the detection, description, and depiction of head trauma. Furthermore, these new tools are allowing the imaging specialist to function not only as an interpreter of what is seen but as a 21st century radiographic oracle. We present a comprehensive review of the imaging findings of sequlae of traumatic brain injury and the growing correlation of new neuroimaging techniques and neurotraumatic outcomes.

Arachnoid Cysts↗

PubMed2002

Bioreporters in microbial ecology.

Bioreporters are effective research tools for gaining an understanding of a microbe's perception of the world. Fitted with a fusion of an environmentally responsive promoter to a suitable reporter gene, a bacterial or fungal bioreporter is able to communicate its metabolic or transcriptional behavior in a habitat, and furnish us with information on the chemical, physical or biological properties of its immediate surroundings. This review details recent developments in the use of such bioreporters in microbial ecology. Emphasis is placed on reporter genes that allow detection in individual microbial cells, as they provide a high-resolution description of the habitat under investigation. In an outlook on the future of bioreporter technology, this review stresses the need to interpret the activity of a bioreporter within the context of its biology.

Bacteria↗

PubMed1979

Interactions in contingency tables: a brief discussion of alternative definitions.

The purpose of this note is to indicate how the disagreement between Tennant & Bebbington and Brown & Harris has arisen. The difference between the 2 pairs of authors is due, at least in part, to their use of different models for the analysis of the data in question. There can be no final answer as to which model is correct - the data are simply open to more than one interpretation. Nevertheless, it is interesting that the use of a multiplicative model, seemingly ignored by Brown & Harris, leads to a simple description of the data in which the 'vulnerability factor' and the 'provoking agent' may be considered to act independently on the response. Consequently, in stating that their data contain an interaction so obvious that it can be detected by 'visual inspection', Brown & Harris may have been somewhat rash.

Adjustment Disorders↗