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PubMed2005

Response surface methodology in the development of a stacking-sensitive capillary electrophoresis method for the analysis of tricyclic antidepressants in human serum.

Stacking methods are very important in overcoming the poor detection limits in capillary electrophoresis (CE). In this paper, the separation and determination of several tricyclic antidepressants by a stacking method is described. The inclusion of acetonitrile (ACN) in the sample causes stacking (transient pseudoisotachophoresis) especially in presence of sodium chloride. An experimental design (central composite design) together with the response surface methodology has been used to find the optimum composition of the separation buffer and the optimal stacking conditions in few experiments. The response functions used are the product of the total resolution by the number of peaks, for the optimization of the separation buffer, and the product of the total resolution by the mean of the peak heights, for the optimization of the stacking conditions. About 28% of the capillary volume is loaded with sample. The calibration curves are linear over the working range (50-300 ng/mL). With a bubble capillary, the limits of detection (LODs) are in the order of 5 ng/mL. For the analysis of serum samples, enrichment with sodium chloride and the protein precipitation with ACN are enough to avoid interferences and to get stacking. Recoveries between 91.6 and 104% and RSD between 0.6 and 12% are obtained in the analysis of samples of lyophilized human serum and non-lyophilized human serum, spiked with the drugs.

Acetonitriles↗
PubMed2026

Associations between smart infusion pump-electronic health record interoperability and healthcare outcomes: A systematic review.

OBJECTIVE: This study synthesized available evidence on the associations between smart infusion pump-electronic health record (EHR) interoperability and healthcare outcomes. METHODS: A systematic review of PubMed, CINAHL, Embase, and Scopus databases identified 901 records, which were imported into Rayyan® for duplicate removal, independent screening by three reviewers, and resolution of discrepancies. Eligible studies were peer-reviewed, data-driven, and reported associations between smart infusion pump-EHR interoperability and healthcare outcomes. Studies focused solely on technical validation or interoperability prototypes were excluded. A backward citation search identified additional studies. Two reviewers independently extracted and cross-validated study characteristics using standardized templates. Methodological quality was assessed with the Joanna Briggs Institute Critical Appraisal Tools. RESULTS: Twenty records of 14 full-text studies and 6 conference proceedings were included. Most records reported positive associations between smart infusion pump-EHR interoperability and outcomes related to safety (e.g., medication administration errors, safety-reported events, pump alerts, and compliance with interoperability and drug library), operational efficiency (e.g., programming and documentation time and technical issues), financial performance (e.g., charges captured, and cost avoided), and user experience domains. Most studies used observational designs, reflecting real-world interoperability implementations, where controlling confounding factors is challenging. Limited reporting of baseline characteristics, pump type, and sample sizes limited comparability across studies. CONCLUSIONS: Smart infusion pump-EHR interoperability was associated with improvements in patient safety, efficiency, charge capture, and user experience, with variable findings across studies. Future research should use rigorous methodologies and standardized measures, examine relationships across outcome domains, assess limitations of pump-EHR interoperability, and evaluate underexplored outcomes, including team communication, cognitive workload, and AI-enabled pumps. IMPLICATIONS FOR CLINICAL PRACTICE: Interoperability should be viewed as a component of a broader sociotechnical system, in which technology, user, workflow, clinical content, and organizational practices collectively determine overall effectiveness.

Humans↗
PubMed1975

Serum ionized calcium by electrodes: new technology and methodology.

We report experience measuring serum ionized calcium (Ca2+) with new solid-state, specific calcium ion dip electrodes in a commercially available system for automated electrode measurments which permits stable measurements on thirty samples with up to six different electrodes simultaneously. The system provides electrostatic shielding, temperature regulation at 37degreeC, and adjustment of serum pH with CO2 gas, thereby making practical the use of serum standards and routine measurements on sera. When the electrodes are used with the rest of the measuring system and with serum standards, the system provides serum Ca2+ measurements with high precision (C.V. of 0.7%) and the calcium electrodes maintain good slopes for 50 to 150 hours of cumulative wet immersion. Response to new calcium activity is rapid, and wide variations in serum Ca2+ are readily measured.

Autoanalysis↗
PubMed1987

Validation of assay methodology used in pharmacokinetic studies.

Statistical methods for validating assays used in pharmacokinetic studies are discussed. Methods for assessing linearity, variability, and sensitivity are derived. It is proposed that a calibration experiment, in which samples are replicated at three different concentrations, will provide the necessary information to validate an assay prior to commencement of a pharmacokinetic study and during its routine use. A two-stage weighted least squares regression is used to analyze the calibration data. High performance liquid chromatography calibration data are used to illustrate the principles and techniques involved.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

[Utilization of complex technologies of molecular genetics for forensic expert identification of unidentified remains of victims of terrorist acts in Moscow in 1999].

This paper presents the first experience gained in Russia in expert identification practice with complex utilization of technologies of molecular genetic individualization of biological objects for solving identification tasks requiring the maximum complete armory of mutually supplementing means. This is particularly important for forensic expert personality identification in cases with many deaths, when indirect identification has to be resorted to, consisting in the use of biological samples from relatives of the victims as the identifying objects. Methodological approaches and concepts of expert studies, used for identification of the remains of people who died in terroristic acts committed in Moscow in September, 1999, are discussed. The results of this study and methodological experience notably extend the potentialities of expert evaluation as regards forensic medical identification of victims of overall disasters, terroristic acts, and war conflicts.

Cadaver↗
PubMed2004

Allele-frequency determination of BsmI and FokI polymorphisms of the VDR gene by quantitative real-time PCR (QRT-PCR) in pooled genomic DNA samples.

The vdr gene is a candidate for osteoporosis susceptibility, with conflicting results in association studies. We have designed and optimized an individual allele-specific and DNA pooling PCR-based methodology to quantitate BsmI and FokI polymorphisms of the vdr gene and studied single-nucleotide polymorphisms (SNPs) from pooled DNA samples. The allele frequency in DNA pooling experiments has been analyzed by kinetic PCR: quantitative real-time PCR (QRT-PCR). A Spanish cohort of 225 healthy postmenopausal women was studied. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA) and quantitative ultrasound calcaneous densitometry. Allele-specific PCR amplification of BsmI and FokI genes showed full concordance with the PCR-RFLP approach. The prevalence of the three BsmI VDR genotypes was 19.1, 44.9 and 36.0% for BB, Bb and bb, respectively. In the case of the FokI locus, the prevalence of genotypes was 40.4, 48.0 and 11.6% for FF, Ff and ff, respectively. No positive correlation was found between polymorphism and BMD. The DNA pooling procedure was validated. No differences were found in allele frequencies and T-score data obtained using the high throughput DNA pooling approach, as compared to known individual frequencies. In our hands, this is a very useful approach to study quantitative (thus polygenic) traits like osteoporosis susceptibility.

Absorptiometry, Photon↗
PubMed2000

Childhood maltreatment and malevolence: quantitative research findings.

This article examines the quantitative research literature that focuses on the object relations sequelae of childhood maltreatment. A review of 12 studies indicates strong support for a relationship between childhood maltreatment and a malevolent object world. This relationship holds despite variations in methodology across studies, including differences in sampling and measurement techniques. This paper defines the construct of malevolence, and proposes that malevolent representations are a central feature of the experience of childhood maltreatment. Implications for diagnosis and treatment are considered, and directions for future research are outlined.

Child↗
PubMed2004

Nurse-patient communication: an exploration of patients' experiences.

BACKGROUND: Patient-centred communication is a basic component of nursing and facilitates the development of a positive nurse-patient relationship which, along with other organizational factors, results in the delivery of quality nursing care. Nurses are frequently described in the literature as poor communicators, however, very few studies have examined patients' experiences of how nurses communicate. AIMS AND OBJECTIVES: The aim of the study was to explore and produce statements relating to patients' experiences of how nurses communicate. DESIGN: A qualitative perspective using an hermeneutic phenomenological approach was considered to be the most appropriate methodology for this study. METHODS: Using purposeful sampling, eight patients in a general teaching hospital in the Republic of Ireland were interviewed. Data were collected using unstructured interviews. Data analysis was a reflective process and the findings were presented through the description and interpretation of themes and sub-themes. RESULTS: Following data analysis four themes emerged. These were, 'lack of communication', 'attending', empathy' and 'friendly nurses'. CONCLUSIONS: The findings of this study indicate that, in contrast to the literature that suggests that nurses are not good at communicating with patients, nurses can communicate well with patients when they use a patient-centred approach. However, health care organizations do not appear to value or recognize the importance of nurses using a patient-centred approach when communicating with patients to ensure the delivery of quality patient care. RELEVANCE TO CLINICAL PRACTICE: The implication of these findings for clinical practice is that the task-centred approach to patient care that is associated with nursing in the past, appears to be alive and well. If health care management want to ensure that patients receive quality nursing care, they will need to consider patient-centred communication to be essential to encourage and support nurses to communicate in this manner.

Adult↗
PubMed2000

Specific detection of plasmid bearing Yersinia isolates by PCR.

A total of 210 isolates belonging to 9 different species of the genus Yersinia (Y.) was investigated with three different PCR assays targeting two plasmoidal genes, the Yersinia adhesin gene (yadA) and the V-antigen gene. The yadA PCR assay described in 1995 by Blais and Phillipe, targeting a Y. enterocolitica specific gene region and a newly designed assay targeting the gene region functionally responsible for autoagglutination, were compared. Both assays identified the same Y. enterocolitica strains. To exclude the possibility that false negative results were obtained due to mutations that had occurred in parallel in both gene regions, a third PCR assay by Neubauer et al. (2000) targeting a conserved region of the V-antigen gene was used as control. Again, DNA of the same Y. enterocolitica strains was amplified. In contrast to the yadA PCR assay described by Blais and Phillipe, the newly established yadA and the V-antigen PCR assays amplified DNA from Y. pseudotuberculosis strains. Therefore, by using the PCR technique as a molecular tool spontaneous mutations could be excluded as the cause of anomalous reactions in PCR assays targeting genes of the Yersinia virulence plasmid. Based on these results, it can be assumed that all presumptive pathogenic Yersinia isolates can be identified on the basis of PCR analysis. These molecular assays may also produce fewer false positive reactions in comparison to phenotypic tests such as the autoagglutination test which depend heavily on the handler's experience. It has to be stressed that the PCR assays used in this study have not been evaluated for routine use. Therefore, standardization of the PCR methodology including sample preparation, primer target sequences and PCR reagents is needed for the reliable and safe diagnosis of pathogenic Yersinia spp. in future.

Adhesins, Bacterial↗
PubMed1989

A qualitative review of psychosocial treatments for bulimia.

This review covers 32 individual and group therapy studies of the psychosocial treatment of bulimia published between 1976 and 1986. Using 14 criteria to assess the quality of experimental methodology, three studies were rated as high, 17 as medium, and 12 as low. Common methodological problems included the failure to use a control group or to specify the experience level of the therapist, overreliance on self-report outcome measures, and small sample sizes. Great variability was found among studies in inclusion criteria, treatment length, and length of follow-up. Thirty-eight percent of patients in group therapy and 41.5% of those in individual therapy were totally abstinent from bingeing and purging at follow-up. Although most studies used behavioral or cognitive-behavioral strategies, no modality of treatment has shown clear superiority. The results are discussed in terms of their implications for treatment, training, and future research.

Behavior Therapy↗
PubMed1992

The use of microdialysis for studying the regional effects of pharmacological manipulation on extracellular levels of amino acids--some methodological aspects.

The purpose of this study was to examine and validate the use of microdialysis for sampling and pharmacologically manipulating extracellular amino acids in the brain. Repeated use of microdialysis probes in acute intracerebral experiments did not significantly alter the relative recovery in vitro for the amino acids quantitated (GABA, aspartate, glutamate, glycine, taurine, and alanine). Regional differences in basal levels of some of the amino acids were detected in dialysates collected from the dorsomedial hypothalamus, striatum, and frontal cortex. The percent in vitro recoveries for the amino acids from the probes used in the three regions were not significantly different suggesting that the regional differences in basal levels of amino acids were functionally derived and not a consequence of variations in probe recovery. Perfusion with nipecotic acid, an inhibitor of GABA uptake, resulted in selective elevations in extracellular GABA in the three regions studied. Conversely, perfusion with high-potassium, a depolarizing agent, resulted in significant elevations in not only extracellular GABA but also aspartate, glutamate, and taurine. Thus, microdialysis is a method which can be employed to assess and to pharmacologically manipulate extracellular amino acids in the rat brain.

Amino Acids↗
PubMed1997

A small exploratory study of the reaction of older people to an episode of delirium.

Delirium or an acute confusional state, occurs as a result of disease or physiological imbalance secondary to impaired brain function. One of its main clinical features is widespread cognitive impairment, which causes patients to become disconnected from their immediate surroundings and misinterpret reality. It has a sudden onset and its duration is relatively brief. Some authors take the view that delirium might be interpreted as a precursor to dementia. The aim of the study was to retrospectively explore older peoples' experience of an episode of delirium. In particular, whether they knew what had caused and cured it; and whether it had left them with any unresolved feelings of anxiety. A cross sectional design using grounded theory methodology was chosen, as being the most appropriate method for exploring this issue. A sample of 19 patients was selected using predetermined criteria, and engaged in a semi-structured interview with the researcher, in the ward environment. The interviews were audiotaped, transcribed, and analysed using the constant comparison method. Those interviewees who had illusions and hallucinations, were often able to describe their experiences in detail. They ranged from being pleasant and entertaining, to horrible and frightening. They were also able to remember short verbal commands from nurses during the episode of altered perception. Others remembered, or chose not to remember, very little. Few interviewees appeared to know exactly what had caused and cured the delirium, although some were able to tentatively connect the experience to their present medical condition. There also appeared to be little evidence of therapeutic communication with nursing staff once the episode of delirium had resolved. Although no one connected the experience with dementia, there did seem to be some evidence of mildly disturbed feelings, on reflecting back over the episode. As interviewees were generally willing to discuss their experiences with the researcher, it suggests that it would be helpful for nurses to provide opportunities to do so. Nevertheless, interviewees appeared to regard the episode simply as a transitory event in the overall context of illness, admission to hospital and their future welfare. The latter was of prime concern; yet again it appeared that they did not always receive the information they required to maintain control over their personal destinies.

Adaptation, Psychological↗
PubMed2006

The dentinal caries experience of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys. AIMS: This paper reports the survey-derived estimates of dentinal caries experience of children aged five, eight, 12 and 15 years, considering the trends over recent decades and the position in 2003 following changes in disease presentation and the use of additional criteria. METHODOLOGY: A representative UK sample of children in the four specified age groups were invited to participate in a clinical dental examination in school. A total of 12,698 children were sampled and 10,381 were examined (82%). Examinations were undertaken in school by trained and calibrated examining teams using reclining chairs and portable lights, the criteria were visual, limited to dentine caries and no diagnostic aids were employed. In order to compare trend data with 1993 and earlier surveys the criteria allowed the re-classification of the full 2003a results (those including cavities and visual dentine caries - D(3cv)MFT/d(3cv)mft) according to the previous criteria to produce results labelled 2003b (those restricted to dentinal cavities--D(3c)MFT/d(3c)mft). RESULTS AND CONCLUSIONS: The experience of obvious dentinal caries in children within the UK has continued to change over the last decade and patterns are different for the two dentitions. While continuing overall improvements are evident for permanent teeth across the UK (D(3c) for 15-year-old children falling from 42% in 1983, via 30% in 1993 to 13% in 2003 for example), trends amongst those experiencing dentinal caries are more concerning and there have been no statistically significant improvements for primary teeth (the mean number of teeth with obvious dentine decay (d(3c)) at age five years being 1.3 in 1983 and 1.4 in both 1993 and 2003). The inclusion in the criteria of visual dentinal caries resulted in higher estimates of mean caries and mean caries experience in the permanent dentition (at age 15 years D(3) increasing from 0.2 to 0.8, D(3)MFT increasing from 1.6 to 2.0 for example) but not the primary dentition (where the estimates for % d(3)mft at age five years were identical at 43%). Geographic variations also persist across the UK (% with D(3cv)MFT at 12 years being 41% for England, 54% Wales, 73% Northern Ireland and 43% for the UK; % with d(3cv)mft at age 5 years: 41% for England, 52% Wales, 61% Northern Ireland and 43% for the UK). These survey results have implications for planning and for daily practice, but must be interpreted carefully acknowledging the specific survey conditions and diagnostic criteria employed.

Adolescent↗
PubMed2002

Methodological issues in Web-based research.

PURPOSE: To examine methodological issues associated with using the Internet and World Wide Web for scientific research, namely, issues related to the nature of the sample, the testing environment and environmental factors, privacy, and confidentiality, and response rates. METHODS: Reviews of literature and personal observation and experience. FINDINGS: Web-based research provides many advantages such as access to specific, sometimes difficult-to-find populations, speed of data access, and decreased costs for data collection and data entry. Such benefits are likely to increase as more nurse scientists use the Web for research purposes. CONCLUSIONS: Nurse researchers who use this technology must consider the methodological problems associated with Web-based methods. The research potential exists, but the methodological issues discussed in this paper are real and, if not addressed, they can seriously affect the validity of study findings.

Internet↗
PubMed2006

Menstrual cycle phase effects on nicotine withdrawal and cigarette craving: a review.

Evidence suggests that women are less likely to quit smoking than are men. This may reflect differences in nicotine dependence and, more specifically perhaps, nicotine withdrawal and craving. However, there is conflicting research on gender differences on the experience of withdrawal and craving. Menstrual cycle effects may moderate this relationship. Given hormonal changes during the menstrual cycle, abstinence-related symptoms such as withdrawal and craving may vary as a function of menstrual phase as well. This qualitative review summarizes the modest but expanding body of research in this area. One of the challenges inherent in interpreting this literature is the difficulty in distinguishing withdrawal symptomatology from premenstrual symptomatology. Methodological variation, including limited sample size and possible selection bias, in which several studies finding null effects excluded women with severe premenstrual dysphoric disorder, may explain some of the inconsistent findings across studies. Nonetheless, some of the 13 studies included in this review found heightened experiences of withdrawal or craving within the latter days of the menstrual cycle (i.e., the luteal phase). Further research is necessary to replicate these findings, but they may suggest the need for focused cessation treatment during the luteal phase or quit attempts that are well timed relative to specific menstrual phases.

Female↗
PubMed2004

Online consumer surveys as a methodology for assessing the quality of the United States health care system.

BACKGROUND: Interest in monitoring the quality of health care in the United States has increased in recent years. However, the policy objectives associated with collecting this information are constrained by the limited availability of timely and relevant data at a reasonable cost. Online data-collection technologies hold the promise of gathering data directly and inexpensively from large, representative samples of patients and consumers. These new information technologies also permit efficient, real-time assessment in such areas as health status, access to care, and other aspects of the care experience that impact health outcomes. OBJECTIVE: This study investigates the feasibility, validity, and generalizability of consumer online surveys to measure key aspects of health care quality in the United States. METHODS: Surveys about the health and health care experiences of a general adult population and of adults with diabetes were administered online and by telephone. The online survey drew from a sample frame of nearly 1 million consumers and used a single e-mail notification. The random-digit-dial methodology included 6 follow-up calls. Results from the online sample were compared to the telephone sample and to national benchmark data. RESULTS: Survey responses about quality of care collected using online and telephone methods were commensurate once they were weighted to represent the demographic distribution of the 2000 United States Census. Expected variations in health and health care quality across demographic and socioeconomic groups were largely observed, as were hypothesized associations among quality indicators and other variables. Fewer individuals were required to be contacted to achieve target sample sizes using online versus telephone methods. Neither method yielded representative cohorts of nonwhite individuals. CONCLUSIONS: Conclusions about the level and variations in health care quality in the United States are similar using data collected in this study compared to data collected using other telephone-based survey methods. As is typical for national telephone surveys conducted by the National Center for Health Statistics, stratified sampling and weighting of survey responses is necessary for results to be generalizable. Online methods are more appropriate for understanding health care quality than for conducting epidemiologic assessments of health in the United States.

Adolescent↗
PubMed2006

Improvement of technical and analytical performance in DNA sequencing by external quality assessment-based molecular training.

BACKGROUND: From 2003 to 2005, the European Union supported the EQUAL-initiative to develop methodological external quality assessment (EQA) schemes for genotyping (EQUALqual), quantitative PCR (EQUALquant), and sequencing (EQUALseq). As a relevant part of the EQUALseq program, a training course was held subsequent to the first EQA Program (EQAP1). The success of this course was reassessed in a 2nd EQUALseq round (EQAP2). METHODS: In September 2005, a 3-day training course took place. We invited 8 laboratories with below-average performance in EQAP1 to improve their methodological and analytical/proficiency skills by lectures and practical work. To compare the results of the pretraining and posttraining EQUALseq rounds, we distributed 2 samples used in the first EQUAL round, but this time we provided different oligonucleotide sets. We evaluated the results by means of a previously described scoring system. RESULTS: In EQAP2, 6 laboratories returned complete data sets, corresponding to an overall 14% of the 43 laboratories that had finished EQAP1. The scoring results for samples A (P=0.0025) and B (P=0.0125) demonstrated a significant improvement in EQAP2. Overall, a substantial improvement of technical and interpretative skills was demonstrated (P=0.0051). In general, the workshop experience was highly rated by the participants. CONCLUSIONS: Methodologic EQAPs in DNA sequencing are appropriate tools to uncover strengths and weaknesses in both technique and proficiency, emphasizing the need for mandatory EQAPs. Training courses, together with 2nd-round reiterations, should be implemented into methodological EQAPs in molecular diagnostics to improve technical performance and proficiency in genetic testing.

European Union↗
PubMed2003

Inner strength in older Hispanic women with chronic illness.

The phenomenon of inner strength has been studied in women with various chronic illnesses (Dingley, 1997; Dingley, Bush, & Roux, 2001; Koob, Roux, & Bush, 2002; Roux, Bush, & Dingley, 2001), demonstrating commonalities in the experiences that bridge the boundaries created by disease taxonomy or individual circumstance. Despite the richness of previous qualitative studies, the current state of the science reflects the interpreted reality of inner strength from the perspective of primarily middle class Caucasian women. Therefore, the purpose of this qualitative descriptive study was to explore the experience of inner strength in older Hispanic women living with chronic illness. The primary research question was: How do older Hispanic women experience inner strength as they live with chronic illness? The purposive sample consisted of women who met the criteria for the term "Hispanic", were 60 years of age or older, and had been diagnosed with a chronic illness. Data generation methods included observation and semi-structured interviews. Data analysis was based on qualitative methodology informed by grounded theory and the constant comparative method. Findings from the current study suggested the experience of inner strength in older Hispanic women involved the following interrelated dimensions: (a) Drawing Strength from the Past, (b) Focusing on Possibilities, (c) Being supported by Others, (d) Knowing One's Purpose, and (e) Nurturing the Spirit. The current study contributes to a cumulative program of research on the phenomenon of inner strength, furthering theory generation, cultural awareness, and future intervention studies.

Adaptation, Psychological↗