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PubMed1992

The construction of health knowledge in middle class families.

This paper examines some of the complexities involved in the relationship between knowledge, both 'lay' and 'scientific', and everyday health relevant behaviour. It is based on a multi-interview qualitative study of middle class family groups. The study explored the ways in which images of health, the socio-cultural context of behaviour and the constraints of daily life provided the background to health-relevant behaviour. The sample comprised a randomly selected group of home-owning, middle class couples, each with two children. Three rounds of semi-structured interviews were carried out with spouses during an 18 month fieldwork period. Their children, age range 4-12, were also interviewed. The main focus of the study was on the development of health-relevant beliefs and behaviours in the context of everyday life, particularly domestic life. In this paper some characteristics of how respondents perceived, interpreted and evaluated health knowledge are described. Illustrations are given of the differences between respondents' initial accounts of their 'usual' behaviours and the detailed descriptions of their daily lives obtained in later interviews. It is concluded that knowledge about health was not necessarily translated into behavioural practices, even in a supposedly health promoting environment. Qualitative examination of the socio-cultural context of daily behaviour may add to our understanding of the gaps between knowledge, attitudes and practices.

Adult↗

PubMed1985

"Fish-eye sign" in scintigraphy of benign thyroid nodule.

An unusual scintigraphic appearance of a benign adenomatous nodule in the thyroid is described which showed a central core of functional tissue surrounded by a rim of nonfunctioning tissue and degenerative changes. The descriptive term "fish-eye sign" is proposed. The characterization of tissue by scintigraphy prior to fine needle aspiration may be helpful in its interpretation.

Adult↗

PubMedDate not supplied

Role of the geneticist in testing and counseling for inherited thrombophilia.

Within the past decade, the identification of two mutations that are relatively prevalent among the white population (the factor V Leiden and prothrombin G20210A gene mutations) has paved the way for a number of large cohort studies that have greatly advanced our understanding of the pathogenesis of venous thromboembolism (VTE). VTE is clearly a multigenic disorder, with well-characterized examples of gene-gene and gene-environment interactions underlying its pathogenesis. Increasing numbers of patients are being referred for testing, and many more diagnoses of inherited thrombophilia are being made. The purpose of this article is to discuss the practical applications of both diagnostic testing and genetic counseling for the major inherited thrombophilias: inherited resistance to activated protein C/factor V Leiden, prothrombin G20210A mutation, protein C deficiency, protein S deficiency, and antithrombin deficiency. A description of each entity is included along with a discussion of the indications for testing, selection of the most appropriate screening test, and proper interpretation of test results. Informed consent for testing, screening of asymptomatic individuals in special circumstances (such as during pregnancy or before initiation of estrogen therapy), screening of family members, and posttest education are also addressed. This article emphasizes that these polymorphisms should be regarded as risk factors for thrombosis whose clinical expression generally depends on the coexistence of additional thrombophilic mutations or environmental conditions that provoke the development of VTE.

Environment↗

PubMed2004

Role of clustering and gridlike ordering in epidemic spreading.

The spreading of an epidemic is determined by the connectivity patterns which underlie the population. While it has been noted that a virus spreads more easily on a network in which global distances are small, it remains a great challenge to find approaches that unravel the precise role of local interconnectedness. Such topological properties enter very naturally in the framework of our two-time-step description, also providing an approach to track a probabilistic system. The method is elaborated for SIS-type epidemic processes, leading to a quantitative interpretation of the role of loops up to length 4 in the onset of an epidemic.

Cluster Analysis↗

PubMed1985

Creative nursing: processive care and more?

The authors describe a crisis point which led them from considering a reorientation of the present BSc (Nursing) curriculum at the University of Cape Town, South Africa to undertaking a radical revision of the degree programme. While examining final year students they realized that the nurses' excellent personal qualities apparent in everyday relationships, were not being used in their professional practice on hospital wards. It is suggested that this is due partly to an educational programme which neglected what the students already had (common sense and logic) and what they already knew from life experience and from instinct and intuition. It is also supposed that when hospital wards are their first clinical learning areas, nurses divorce patients and disease from the 'real' world, from the essentials of daily living and from the components of an individualized lifestyle. A staged process of learning experience, to include looking after healthy, elderly and disabled individuals in homes and institutions--with minimal nurse supervision--before exposure to hospital life, is advocated. In its present form the nursing process is seen as limiting the creativity of nursing practice and the authors suggest that further development of this approach is necessary if nursing science is to be interpreted as an art. Finally, the authors outline an experimental curriculum which takes cognisance of their experiences and syllogistic reasoning, together with a brief description of the first few months of its implementation at the University of Cape Town.

Creativity↗

PubMed2006

Support of fathers of infants by the child health nurse.

The child health nurse is considered to be able to support fathers in the transition to parenthood, through utilizing the fathers' inherent resources for the best development of the child. The aim of present study was to identify what expectations fathers of infants have of the child health care, including the nurse: whether they feel that they have received support in this role and how they think the nurse can support new fathers. A qualitative descriptive design was used with an inductive approach using grounded theory, which was suitable to obtain knowledge and understanding of how fathers perceived and interpreted their interaction with their child health nurse. Twenty fathers of infants gave their informed consent to participate. They were interviewed and data were systematically analysed on three levels by constant comparative method. From the analysis, the core category trustful relationship was discovered, comprising the categories involvement, faith and support. Nurses ought to reflect on that a father of an infant may feel slighted at the child health clinic if, as traditionally, the nurse turns only to the mother. Many fathers of today want to share the infant care and they want more communication with the nurse. It is suggested that in the long run, support in early fatherhood may be of benefit for the child and for the family. If the father has a trustful relationship with the nurse, his involvement in child health care is presumed to increase, as is the possibility of having faith in the nurse, as well as receiving support in his role as father. The findings are discussed in relation to literature in the field.

Adult↗

PubMed1998

Ultrafast solvation dynamics explored by femtosecond photon echo spectroscopies.

Chemical reaction and optical dynamics in the liquid phase are strongly affected by specific solute-solvent interactions. The dynamical part of this coupling leads to energy fluctuations. The associated energy gap dynamics can be probed by using various nonlinear optical spectroscopies. We discuss various forms of photon echo--time-integrated, time-gated, and heterodyne-detected photon echo--as well as Fourier transform spectral interferometry. It is shown that for solutions of the dye molecule DTTCI, a system-bath correlation function can be acquired that provides a quantitative description of all (non)linear spectroscopic experiments. The deduced correlation function is projected onto the multimode Brownian oscillator model, which allows for a physical interpretation of the multiple-time correlation function and a determination of the spectral density relevant to the solvation process. The following applications of photon echo to condensed phase dynamics are discussed: enhanced vibrational mode suppression, Liouville pathways interference, and dynamical Stokes shift. Recent results of echo-peak shift experiments on the hydrated electron are also presented. The review concludes that photon echo should be useful as a novel tool to explore transition state dynamics.

Journal Article↗

PubMed1978

Analysis of postcapillary pH changes in blood in vivo after gas exchange.

A quantitative description of the reaction and transport processes that take place in blood during and after gas exchange in capillaries is developed and used to interpret recently reported experimental results. Included in the computation are 1) CO2-H2CO3 hydration-dehydration reactions in plasma and erythrocytes, 2) CO2 reactions with hemoglobin, 3) O2 binding to hemoglobin, 4) buffering of H+ intra- and extracellularly, 5) HCO3- Cl- exchange across the red cell membrane, 6) diffusion of gases between alveolar gas and blood, and 7) transcellular movement of water. Ion and water fluxes are described assuming passive diffusion down their electrochemical potential gradients. Recent data on the magnitude of the Bohr and Haldane shifts and on carbamate formation in the presence of 2,3-diphosphoglycerate are used. The analysis is used to examine the direction, magnitude, and time course of plasma pH changes in blood leaving the pulmonary capillaries and is shown to preduct results that agree very closely with recently reported experimental measurements in vivo. The time computed for plasma pH equilibration after gas exchange when carbonic anhydrase activity is absent from plasma is so great that blood may never be in complete electrochemical equilibrium as it travels around the circulation in normal man.

Bicarbonates↗

PubMed2003

Change in psychoanalysis: getting from A to B.

The change that occurred during an analytic hour with a seven-year-old girl is explored by means of videotape observation and aspects of developmental theory drawn from the field of infant research. Detailed review of the videotape and transcript of twelve minutes of the analytic hour revealed significant change in the girl's attitude toward the loss represented by a cancelled session. The moment-to-moment process between two points, A and B--identified as representing the beginning and end of the change in the girl's ability to deal with loss in the analytic relationship--is studied and described in two forms: written transcript for the verbal material, and narrative description for the nonverbal material. The methodology is based on observed behaviors but also relies on the clinical experience of the analyst in the interpretation of affects and the recognition of intentions in both participants. The results suggest that, taken as a whole, many such small transitional episodes during the course of a treatment play an important role in the process of therapeutic change.

Child↗

PubMed2003

Tool development for measuring caller satisfaction and outcome with telephone advice nursing.

Caller descriptions and evaluations of their experiences with telephone advice services provide unique information that correlates highly with objective measures of quality and can help interpret data from other sources. An author-developed questionnaire assessed caller outcomes of telephone nursing advice in Phase I an iterative, purposive sample of 40 callers was interviewed by phone. An emergent design was used to develop questions, analyze constructs of interest, and test questions for a draft caller questionnaire, which was tested in Phase II. Responses to the questionnaire provided information about caller characteristics, advice call characteristics, and nurse practice behaviors that caused the authors to further revise the questionnaire. The resulting tool provides feedback to advice nurses about the outcomes of their practice and information to design orientation and development programs and support fund allocation decisions.

Counseling↗

PubMed2006

Analysis with respect to instrumental variables for the exploration of microarray data structures.

BACKGROUND: Evaluating the importance of the different sources of variations is essential in microarray data experiments. Complex experimental designs generally include various factors structuring the data which should be taken into account. The objective of these experiments is the exploration of some given factors while controlling other factors. RESULTS: We present here a family of methods, the analyses with respect to instrumental variables, which can be easily applied to the particular case of microarray data. An illustrative example of analysis with instrumental variables is given in the case of microarray data investigating the effect of beverage intake on peripheral blood gene expression. This approach is compared to an ANOVA-based gene-by-gene statistical method. CONCLUSION: Instrumental variables analyses provide a simple way to control several sources of variation in a multivariate analysis of microarray data. Due to their flexibility, these methods can be associated with a large range of ordination techniques combined with one or several qualitative and/or quantitative descriptive variables.

Algorithms↗

PubMed2002

Assessment training in clinical psychology doctoral programs: what should we teach? What do we teach?

All clinical psychology doctoral programs accredited by the American Psychological Association provide training in psychological assessment. However, what the programs teach and how they teach it vary widely. So, also, do beliefs about what should be taught. In this study, program descriptive materials and course syllabi from 84 programs were analyzed. Findings highlight commonalities in basic course content and supervised practice in administering, scoring, and interpreting assessment instruments as well as differences in coverage of psychometric and other assessment-related topics and in the extent to which lectures, labs, and practica are integrated.

Curriculum↗

PubMed2005

Light-induced relaxation of photolyzed carbonmonoxy myoglobin: a temperature-dependent x-ray absorption near-edge structure (XANES) study.

X-ray absorption near-edge structure (XANES) spectra at the Fe K-edge have been measured and compared on solution samples of horse carbonmonoxy-myoglobin and its photoproducts, prepared by two different photolysis protocols: 1), extended illumination at low temperature (15 K) by white light; and 2), slow-cool from 140 to 10 K at a rate of 0.5 K/min while illuminating the sample with a 532-nm continuous-wave laser source. CO recombination has been followed while increasing the temperature at a rate of 1.2 K/min. After extended illumination at 15 K, a single process is observed, corresponding to CO recombination from a completely photolyzed species with CO bound to the primary docking site (formally B-state, in agreement with previous x-ray diffraction studies). The temperature peak for this single process is approximately 50 K. Using slow-cool illumination, data show a two-state recombination curve, the two temperature peaks being roughly assigned to 50 K and 110 K. These results are in good agreement with previous FTIR studies using temperature-derivative spectroscopy. The XANES spectroscopic markers probe structural differences between the photoproduct induced by extended illumination at 15 K and the photoproduct induced by slow-cool illumination. These differences in the XANES data have been interpreted as due to light-induced Fe-heme relaxation that does not involve CO migration from the B-state. A quantitative description of the unrelaxed and relaxed B-states, including the measurements of the Fe-N(p), Fe-N(His), and Fe-CO distances, and the out-of-plane Fe displacement, has been obtained via a procedure (MXAN) recently developed by us. This work shows that XANES, being able to extract both kinetic and structural parameters in a single experiment, is a powerful tool for structural dynamic studies of proteins.

Animals↗

PubMed2000

Public health advocacy: process and product.

OBJECTIVES: In this article the author describes public health advocacy and proposes a conceptual framework for understanding how it works. METHODS: The proposed framework incorporates the image of an assembly line. The public health advocacy assembly line produces changes in societal resource allocation that are necessary for optimizing public health. The framework involves 3 main stages: information, strategy, and action. These stages are conceptually sequential but, in practice, simultaneous. The work at each stage is continually adjusted according to circumstances at the other stages. RESULTS: The framework has practical implications; for example, public health advocacy teams need members with complementary skills in distinct roles. Potential applications are illustrated via two public health advocacy efforts. CONCLUSIONS: The framework may be useful in assessing staffing and funding needs for public health advocacy endeavors, explaining common problems in these endeavors and suggesting solutions, and guiding decisions concerning effort allocation. Application of the framework to a variety of public health advocacy endeavors will clarify its strengths and weaknesses.

Accidents, Traffic↗

PubMed1985

Hypertrophic foci of pancreatic acinar cells in rats.

A morphologically distinctive type of pancreatic acinar cell foci, different from hyperplastic nodules and adenomas, in rats has been recognized for two decades. The lesions have been observed to occur spontaneously and to be induced experimentally. They consist of enlarged acinar cells with abundant cytoplasm of altered staining characteristics and prominent nuclei. There is, however, a wide divergence of opinion among investigators regarding the nature of the lesions. As a result of different interpretations and classifications, many terms have been given to them. Based on morphologic characteristics, the author has designated the lesions as hypertrophic foci, a descriptive morphological term. The biologic significance with particular reference to age and the relationship with acinar cell neoplasia is discussed. Also included in the review are similar lesions in other rodent species.

2-Acetylaminofluorene↗

PubMed2001

Invited review: Integrating quantitative findings from multiple studies using mixed model methodology.

In animal agriculture, the need to understand complex biological, environmental, and management relationships is increasing. In addition, as knowledge increases and profit margins shrink, our ability and desire to predict responses to various management decisions also increases. Therefore, the purpose of this review is to help show how improved mathematical and statistical tools and computer technology can help us gain more accurate information from published studies and improve future research. Researchers, in several recent reviews, have gathered data from multiple published studies and attempted to formulate a quantitative model that best explains the observations. In statistics, this process has been labeled meta-analysis. Generally, there are large differences between studies: e. g., different physiological status of the experimental units, different experimental design, different measurement methods, and laboratory technicians. From a statistical standpoint, studies are blocks and their effects must be considered random because the inference being sought is to future, unknown studies. Meta-analyses in the animal sciences have generally ignored the Study effect. Because data gathered across studies are unbalanced with respect to predictor variables, ignoring the Study effect has as a consequence that the estimation of parameters (slopes and intercept) of regression models can be severely biased. Additionally, variance estimates are biased upward, resulting in large type II errors when testing the effect of independent variables. Historically, the Study effect has been considered a fixed effect not because of a strong argument that such effect is indeed fixed but because of our prior inability to efficiently solve even modest-sized mixed models (those containing both fixed and random effects). Modern statistical software has, however, overcome this limitation. Consequently, meta-analyses should now incorporate the Study effect and its interaction effects as random components of a mixed model. This would result in better prediction equations of biological systems and a more accurate description of their prediction errors.

Analysis of Variance↗

PubMed2000

Maintaining updated DNA-based HLA assignments in the National Marrow Donor Program Bone Marrow Registry.

The National Marrow Donor Program (NMDP) has instituted an approach to address the impact of new alleles on the DNA-based HLA assignments obtained during volunteer donor typing. This approach was applied to the DRB typing results from 371,187 donors received from 14 laboratories in 1999. Samples were tested with a standardized set of sequence specific oligonucleotide reagents and the positive and negative hybridization results transmitted electronically to the NMDP. A software program interpreted the primary data into HLA assignments and rejected assignments which did not produce a result at the specified level of resolution. Comparison of the HLA assignments derived by the NMDP software to the assignments made by the laboratories using several local software prograins showed 90.5% of the assignments to be identical. Differences in assignments were explained by varying levels of typing resolution, variation in the inclusion of the second expressed DRB loci, disparity arising when alternative assignments were summarized, and failure to submit correct information. When the primary data collected in 1999 were interpreted into HLA assignments using the set of alleles defined in July 2000, 74% of the HLA-DRB assignments were altered by the description of new alleles, justifying the development of this software.

Base Sequence↗

PubMed2003

An overview of the methods and data used in the CCORT Canadian Cardiovascular Atlas project.

The Canadian Cardiovascular Atlas project, an initiative of the Canadian Cardiovascular Outcomes Research Team (CCORT), will be published as a series of 20 articles in future issues of the Canadian Journal of Cardiology. Through a wide range of data sources and analyses from a number of collaborators across Canada, the CCORT Atlas will provide a comprehensive overview of the current state of cardiac care and disease in Canada. Administrative data, clinical registries and community survey data will be analyzed at the provincial and health region levels. The purposes of this article are to 1) provide an overview of the data types and sources used in the Atlas project, 2) give a general description of the methods and analyses used to report Atlas data and 3) describe how Atlas maps were created and how they can be interpreted.

Canada↗