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PubMed2000

The role of corpus cavernosum electromyography.

Although corpus cavernosum electromyography presents great theoretical appeal as a possible direct clinical measure of penile neurogenic function, it has still not been adopted as a routine diagnostic test in the evaluation of patients with erectile dysfunction. This is because of the considerable technical and interpretative problems associated with the method. This review covers some of the more important research and clinical papers published since its first description in 1989, with a special focus on recent advances in this field.

Animals↗
PubMed2004

Reflection in preregistration nursing curricula.

BACKGROUND: The concepts of reflection and reflective practice are increasingly popular themes in the nursing literature. Reflective practice has been advocated as a method for overcoming the divergence between nursing theory and practice, and as a means of articulating and developing knowledge embedded in practice. However, these claims are based more on theoretical debate than research evidence. In common with other regulatory bodies, the Irish regulatory nursing body advocates the need for reflective nurses, and curricula are being adapted to reflect this. These changes are taking place when there is still little guidance on the teaching or assessment of reflective practice. Given the lack of research on the topic and the need for evidence on which to base the teaching of reflective practice, a descriptive exploratory study was undertaken. AIM: The aim of this paper is to report how a group of nurse teachers perceived and interpreted reflective practice in preregistration nursing curricula in schools of nursing in The Republic of Ireland. METHODS: Data were collected using a postal questionnaire distributed to all schools of nursing involved in the preregistration diploma in nursing (n = 40). RESULTS: The results indicate variation between institutions in the number of hours allocated to the subject and where reflective practice was included in the curriculum. Emphasis was placed on theoretical models of reflection as opposed to the process or the skills required to become a reflective practitioner. Lecture and group discussion were the dominant teaching methods. Additionally, a number of teachers expressed dissatisfaction with the preparation they had received to teach the subject, and identified some of the challenges they experience when teaching reflective practice. CONCLUSIONS: The results provide a focus for further debate amongst nurse educators involved in implementing reflective practice in the curriculum. The results are limited by a response rate of 50% and by the geographic setting. Further research is needed to substantiate the findings of the study. However, there results do suggest that there is a need to clarify curricular content in relation to reflective practice and prepare nurse tutors for their role in teaching this subject more effectively.

Attitude of Health Personnel↗
PubMed1984

Measurement of dental caries experience--modification of the DMFT index.

The DMFT index is one of the simplest and most commonly used indices in epidemiologic surveys of dental caries. It quantifies dental health status based on the number of carious, missing and filled teeth. The index, however, does not provide an accurate description of previous dental care. Nor does it provide information regarding the severity of the carious attack or the indicated treatment. Thus, a revision of the DMFT index was developed. This involved a division of the "D" component into four separate categories. With the addition of these categories, the index remains simple, and yet provides a description of one's previous dental experience. It further shows the extent of dental services needed by the population, which can be interpreted in terms of treatment hours and costs. This modified index has been successfully utilized in a dental epidemiologic survey of 1672 schoolchildren, 14-16 yr of age. It was apparent that the additional components provided significant data for treatment planning as well as dental health status.

Adolescent↗
PubMed2002

Parents' accounts of wheeze and asthma related symptoms: a qualitative study.

AIMS: To examine parents' accounts of how they recognise and judge respiratory symptoms in children, and to investigate their interpretations of respiratory survey questions about wheeze, shortness of breath, and cough. METHODS: Qualitative study using semistructured interviews. Data were analysed using the constant comparative method. Nineteen parents of children aged under 6 years were recruited from a cohort of parents who had responded to an earlier respiratory symptom survey and from one general practice. RESULTS: Parents judged respiratory symptoms using a range of cues, including changes in the sound of breathing and changes in appearance and behaviour. Experiential resources and contextual factors played an important role in parents' judgements. Interpretations of questions about respiratory symptoms were varied, particularly in relation to the terms "attacks of wheeze" and "shortness of breath". Parents' descriptions of wheeze differed from descriptions of the sound of wheeze used in some survey questionnaires. Parents drew fine distinctions between different "types" of cough and identified a distinct "asthma" cough. CONCLUSIONS: Attention needs to be given to the complexity of reporting respiratory symptoms in children and to the importance of contextual factors in parents' judgements. We suggest that questions which require parents to report on children's internal feelings or states be avoided. Consideration should be given to providing parents with explicit direction on what cues to attend to or ignore in reporting symptoms, and to clarifying some questions that are currently used in clinical practice and in surveys.

Asthma↗
PubMed2003

The management of affect storms in the psychoanalytic psychotherapy of borderline patients.

Affect storms are a frequent complication in the psychoanalytic approach to borderline patients. The descriptive, psychodynamic, and structural characteristics of these storms are explored, and the verbal, nonverbal, and countertransference manifestations that permit the formulation of interpretations under such conditions are described, as are the interventions required to maintain the treatment frame as a precondition for an analytic approach. The principal theoretical formulations regarding the affect pathology of borderline patients are reviewed and related to a proposed interpretive approach. An apparently opposite development, the utter absence of emotional developments in the sessions, is examined, and its defensive function of avoiding affect storms is explored. Clinical case material illustrates the proposed approach to these storms, and clinical evidence is given to support the approach, which centers on systematic analysis of the primitive internalized object relations of these patients in the transference, the use of countertransference analysis without countertransference communication to the patient, and the repeated restoration of technical neutrality in the service of protecting the treatment frame.

Acute Disease↗
PubMed1988

Lay theories of schizophrenia.

Subjects completed two brief questionnaires, one concerning the description of, and attitudes towards schizophrenia and schizophrenics and the second on the possible cause of schizophrenia. Both questionnaires yielded a clearly interpretable factor structure and the relationship between the cause and 'symptoms' was examined. The results are discussed in terms of the range, determinants and structure of lay beliefs in mental illness, particularly schizophrenia.

Adult↗
PubMed1979

Variability in interpretation of pulmonary function tests.

We asked 26 pulmonary physicians to interpret results of ten consecutive pulmonary function tests from one laboratory. There was frequent disagreement in their assessment of respiratory impairment. This is likely due to the variety of criteria for grading the severity of obstructive and restrictive defects. Since the narrative interpretation of pulmonary function data may influence patient care, physicians should consider the numerical magnitude of the derangements, as well as the descriptive terms applied.

Humans↗
PubMed2004

[A report of St. Bonaventura in the mirror of the history of neurology].

Ancient and medieval literature contain few case reports of specific syndromes. But there is no lack of such accounts in theological literature, with its long tradition of gathering and documenting individual case studies involving miracle cures--a practice which stretches from the ancient sanctuaries of Asclepius to today's places of pilgrimage. Among the many miracles attributed to St. Francis, complied around 1260 by his biographer, St. Bonaventura, is the case of a young monk afflicted by a sudden hemiplegia accompanied by aphasia and mental confusion. According to legend, he was miraculously and completely healed by the appearance of St. Francis. The report can be interpreted from a number of different approaches: medical, theological, literary or even autobiographical. Neurologists may treat this "case history" as an early description of a "prolonged ischaemic neurological deficit" (PRIND).

Aphasia↗
PubMed2006

Implicit memory and early unrepressed unconscious: their role in the therapeutic process (how the neurosciences can contribute to psychoanalysis).

The author discusses memory from the point of view of the neurosciences and molecular biology, proposing an integration with the psychoanalytic theory of the unconscious. The discovery of the implicit memory has extended the concept of the unconscious and supports the hypothesis that this is where the emotional and affective--sometimes traumatic--presymbolic and preverbal experiences of the primary mother-infant relations are stored. They could form the ground structure of an early unrepressed unconscious nucleus of the self. Identifying the unconscious with the memory leads to a theory about its morpho-functional organization. The unrepressed unconscious can be brought to the surface in analysis through the 'musical dimension' of the transference, characterized by the voice (its intonation and rhythm) and the prosody of the language. Dreams can symbolically transform pre-symbolic and preverbal experiences, so that they can be put into words and thought about even without their recollection. Dreams can also create images to fi ll the gap of the absence of representation which characterize the unrepressed unconscious. The description of a segment of analysis of a patient suffering from death anxiety provides a clinical illustration of the theories discussed. The interpretation of her voice and of the prosody of her language, besides the work on dreams, reproduced the emotional essence of the analysand's traumatic childhood experiences. This reconstruction enabled her to speak and think about them even without the actual recollection.

Adult↗
PubMed1979

Some recent results of the quantitative characterization of heart muscle cells.

The present situation of the quantitative characterization of the heart muscle may be summarized as follows: 1. There exists a great collection of quantitative data of the heart at the macroscopical, microscopical, and ultrastructural levels. 2. These data allow for the explanation of several life processes and of the pathogenesis of various diseases. 3. Correlations between cellular structures and biochemical processes can be realized by quantitative data, especially volume, number, and surface. 4. At present it is necessary to standardize the methods in order to obtain a better comparability of the results. 5. Moreover, the three levels should be correlated because only then numerous results may interpreted correctly. 6. All existing quantitative results show significantly that the isolated recording of quantitative data is an insufficient as is the description of qualitative results. The combination of quantitative and qualitative findings leads, however, to completely new results of higher scientific value which form--in combination with biochemical findings--the basis of the knowledge of normal and disturbed life processes.

Aging↗
PubMed1993

Parathyroid hormone, ionised calcium, and potentially interacting variables in plasma of an Old World primate.

Bone turnover and calcium homeostasis in man can only be modelled validly in Old World nonhuman primates. In order to interpret the models it is necessary to establish endocrine and biochemical parameters of bone mineral metabolism. This report is probably the first description of acute phase parathyroid responses to manipulations of blood ionised calcium, and of reference values for potentially interacting variables, in vervet monkeys. Plasma parathyroid hormone concentrations were measured in vervets under defined conditions, and ranges reported as normal for other nonhuman primates and man are summarised.

Animals↗
PubMed1993

Biological effects of saffron.

This review examines the literature data concerning the biological activities of saffron extract. Numerous studies have revealed that this substance possesses cytotoxic, anticarcinogenic and antitumor properties. A brief description of the other biological effects as well as chemical composition of the saffron extract is also included. Finally, these findings are interpreted and the possible mechanism of the antitumor effects of saffron extract are discussed.

Animals↗
PubMed1988

Association of cytogenetic abnormalities in a neuroblastoma and fragile sites expression.

A 15 month old boy with a stage IV right suprarenal gland neuroblastoma showed a number of raised biochemical parameters, whilst catecholamines and skeletal survey were normal. Treatment with peptichemio failed to give a clinical response. Histological evidence of neuroblastoma infiltration in the bone marrow aspirate was absent. Immunofluorescence on sedimented cells was negative using antibody UJ223.8, PI153/3 and H11; only UJ308 and to a lesser extent UJ13A gave positive results. After 21 days, however, the same cells in culture showed highly differentiated dendritic processes. Thirty-seven percent metaphases from bone marrow aspirate showed the following karyotype 45XY, del (1) (p32), and two markers. Mar1 = der (2) t (2; 2) (2qter----2q14::2p24----2qter). Mar2 = der (15) t (15; 2) (15qter----15p11::2p11----2pter). Treatment with methotrexate reduced the aberrant mitoses rate to 2%. N-myc in situ hybridisation showed significant signal on both markers confirming the cytogenetic interpretation. Peripheral blood lymphocytes at 72 h showed a higher level of breaks per cell than control. After treatment with aphidicolin (APC) or methotrexate (MTX) for the last 24 h, to induce fragile sites, the incidence of breaks per cells was increased. Moreover 11.4% of APC-induced breaks were in 1p31-32 (mean of normal controls = 2.3%). The mother presented an increased sensitivity to the inducibility of fragile sites, while the father's lymphocytes showed values within the control range. The genetic changes produced by the abnormalities on chromosomes 1 and 2 might be related to tumour progression. Furthermore this is the first description of correlation between a high frequency of fragile site 1p31-32 induced by APC in the patient's lymphocytes and deletion of 1p32 in tumour cells. The interpretation of these findings and of other similar correlations needs further study.

Adrenal Gland Neoplasms↗
PubMed1977

Nerve excitability: transition from descriptive phenomenology to chemical analysis of mechanisms.

The electrical activity by which impulses are conducted along nerve and muscle fibers, is carried by Na-and K-ions moving across the excitable membranes due to increased ion permeability. -- A biochemical approach, initiated to elucidate the mechanism of the permeability changes, centered around the analysis of the properties and functions of the proteins, including enzymes, directly associated with the role of AcCh, in the excitable membrane. The results necessitated a fundamentally reformed concept of the role of AcCh. The four proteins specifically associated with the function of AcCh form a cycle which controls the rapid ion permeability changes of the membrane and permits the ion fluxes through dynamic gateways. A model has been elaborated that integrates biochemical, biophysical, and thermodynamic data; it permits the interpretation of many electrophysiological data in molecular terms. AcCh has basically the same function in conducting and synaptic parts of excitable membranes. The new concept has replaced the purely descriptive phenomenology of nerve impulse propagation by the analysis of the chemical mechanisms of nerve excitability and bioelectricity.

Acetylcholine↗
PubMed1991

A decade of progress in statistical methodology for clinical trials.

Clinical trials played a dominant and expanding role in the evaluation of new treatments during the decade of the 1980s. There were major improvements in the quality of clinical trials in many medical fields. There were also important developments in the methodology of designing, monitoring, conducting, analysing, reporting and interpreting clinical trials. This paper attempts to review some of these developments. A comprehensive review is beyond the abilities of any one individual. Consequently, this paper attempts to offer a broad stroke description of this area and to highlight specific topics of importance based on my particular experience. An extensive, but non-comprehensive bibliography is included to provide entry points to the literature of methodologic developments for clinical trials in the 1980s.

Clinical Trials as Topic↗
PubMed1997

Feature extraction and modeling of the variability of performance in terms of biomechanical motion patterns during MMH tasks.

In investigating manual material handling (MMH) jobs, such as lifting, the quantification of the various kinematic and kinetic parameters of the lift is an important step towards functional assessment and evaluation. Experimental data collection generates a large quantity of data for the different kinetic, kinematic, and electromyographic parameters over the various lifting cycles. In order to efficiently manage and interpret the data, it is important to use appropriate tools which would reduce the dimension of the original data set without sacrificing any important features. Furthermore, the generated parameters are often expressed as a function of the lifting cycle resulting in complex waveforms as the unit of analysis. Appropriate statistical analysis of these waveforms or motion profiles should reflect their vectorial constitution as a function of the lifting cycle rather than the usual method of using traditional descriptive statistics based on collapsing the data over the cycle.

Adult↗