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PubMed2006

Discourse analysis: theoretical and historical overview and review of papers in the Journal of Advanced Nursing 1996-2004.

AIM: The aim of the paper is (1) to offer an overview of different theoretical approaches to discourse analysis and (2) to review papers published in the Journal of Advanced Nursing from 1996-2004 in which discourse analysis is identified as a method of data analysis. BACKGROUND: Discourse analysis offers rigorous approaches to analysing naturally occurring talk and texts. Forms of discourse analysis have developed across broad theoretical bases. Such development has created challenges for researchers wishing to adopt this methodology and readers wishing to evaluate the quality of discourse analytic work. METHODS: First, key documents which describe the theoretical range of discourse analysis are used to provide (i) a comprehensive overview of the approach, (ii) the identification of categories of discourse analysis and (iii) minimum criteria for determining if an individual paper can realistically claim to be adopting discourse analysis. Secondly, an electronic search followed by hand search of the Journal of Advanced Nursing full-contents between 1996 and 2004 was undertaken. The papers were grouped into the types of approach identified in i, and evaluated to see whether they met the 'minimum criteria' also identified in i. FINDINGS: The search of Journal of Advanced Nursing revealed 24 papers where the authors stated that discourse analysis was among the methods or was the sole method of data analysis. The majority of the papers cluster around critical approaches to discourse analysis. Only a few approach discourse analysis primarily as analysis of conversation. Some papers are excellent, while others offer analysis that bears little resemblance to any form of discourse analysis. CONCLUSIONS: A strategy for improvement could include more rigorous attention on the part of those practising discourse analysis to methodology and the key features that differentiate the different approaches to discourse analysis from other qualitative methods. Authors should include sufficient detail of their approach.

Concept Formation↗
PubMed2006

Relational conversation as method for creating partnerships: pilot study.

AIM: This paper reports a pilot study testing the intervention, Self-Care TALK, whose aim was to describe communication skills used by an advanced practice nurse to create partnerships with caregivers. The communication process and examples of skills used in creating partnerships are described. BACKGROUND: Decades of exploring nurse-client relationships provide a knowledge base for describing a structure and process for building partnerships. Self-Care TALK functions as a vehicle for an education and support partnership. Self-Care TALK, a theory-derived intervention, is based on the Self-Care for Health Promotion in Aging model. Implementation of the intervention was evaluated in a pilot study in 2003, with older spouse caregivers of persons with early dementia. METHODS: Pilot testing of Self-Care TALK followed Lichstein's criteria of tracking three phases of intervention: delivery, receipt and enactment. Henson's communication elements for establishing partnership relationships provided a guide for advanced practice nurse communication. Self-Care TALK was delivered during six phone conversations with caregivers for a total of 36 phone conversations. All phone conversations were audiotape recorded. Field notes were taken during each conversation. Data analysis followed a qualitative descriptive process of comparative analysis in which communication skills were compared across conversations. Categories of skills were named based on communication elements that dominated the category. Communication skills were compared to literature addressing communication and nurse-client partnerships. FINDINGS: Communication examples described the structure for interaction (Self-Care TALK protocol), process of interaction (relational conversation) and caregiver identified outcomes (intentions to enact self-care). CONCLUSION: Conversations to create partnerships depended on one theme: language that supported relational conversation. Four communication skills illustrated the how of relational conversation: listening with intent, affirming emotions, creating relational images, and planning enactment.

Adaptation, Psychological↗
PubMed1998

Recombinant phytochrome of the moss Ceratodon purpureus: heterologous expression and kinetic analysis of Pr-->Pfr conversion.

The phytochrome-encoding gene Cerpu;PHY;2 (CP2) of the moss Ceratodon purpureus was heterologously expressed in Saccharomyces cerevisiae as a polyhistidine-tagged apoprotein and assembled with phytochromobilin (P phi B) and phycocyanobilin (PCB). Nickel-affinity chromatography yielded a protein fraction containing approximately 80% phytochrome. The holoproteins showed photoreversibility with both chromophores. Difference spectra gave maxima at 644/716 nm (red-absorbing phytochrome [Pr]/far-red-absorbing phytochrome [Pfr]) for the PCB adduct, and 659/724 nm for the P phi B-adduct, the latter in close agreement with values for phytochrome extracted from Ceratodon itself, implying that P phi B is the native chromophore in this moss species. Immunoblots stained with the antiphytochrome antibody APC1 showed that the recombinant phytochrome had the same molecular size as phytochrome from Ceratodon extracts. Further, the mobility of recombinant CP2 holophytochrome on native size-exclusion chromatography was similar to that of native oat phytochrome, implying that CP2 forms a dimer. Kinetics of absorbance changes during the Pr-->Pfr photoconversion of the PCB adduct, monitored between 620 and 740 nm in the microsecond range, revealed the rapid formation of a red-shifted intermediate (I700), decaying with a time constant of approximately 110 microseconds. This is similar to the behavior of phytochromes from higher plants when assembled with the same chromophore. When following the formation of the Pfr state, two major processes were identified (with time constants of 3 and 18 ms) that are followed by slow reactions in the range of 166 ms and 8 s, respectively, albeit with very small amplitudes.

Avena↗
PubMed2004

Kinetic analysis of the oxidative conversion of the [4Fe-4S]2+ cluster of FNR to a [2Fe-2S]2+ Cluster.

The ability of FNR to sense and respond to cellular O(2) levels depends on its [4Fe-4S](2+) cluster. In the presence of O(2), the [4Fe-4S](2+) cluster is converted to a [2Fe-2S](2+) cluster, which inactivates FNR as a transcriptional regulator. In this study, we demonstrate that approximately 2 Fe(2+) ions are released from the reaction of O(2) with the [4Fe-4S](2+) cluster. Fe(2+) release was then used as an assay of reaction progress to investigate the rate of [4Fe-4S](2+) to [2Fe-2S](2+) cluster conversion in vitro. We also found that there was no detectable difference in the rate of O(2)-induced cluster conversion for FNR free in solution compared to its DNA-bound form. In addition, the rate of FNR inactivation was monitored in vivo by measuring the rate at which transcriptional regulation by FNR is lost upon the exposure of cells to O(2); a comparison of the in vitro and in vivo rates of conversion suggests that O(2)-induced cluster conversion is sufficient to explain FNR inactivation in cells. FNR protein levels were also compared for cells grown under aerobic and anaerobic conditions.

DNA↗
PubMed2005

[Comprehensive analysis of up-conversion luminescence saturation phenomena of ErYb:oxyfluoride vitroceramics].

The saturation phenomenon of the up-conversion luminescence of erbium ytterbium co-doped oxyfluoride vitroceramics (ErYb:FOV), when excited by a 966 nm diode-laser, was investigated comprehensively in the present article. A new kind of "characteristic saturation phenomenon", which results from energy diffusion, was found, i. e. the slope of logI-logP curve, the double logarithmic variation of up-conversion luminescence intensity I upon laser power P, is increased evidently toward regular multi-photon relation with the increase of laser facula. The "typical saturation phenomenon" resulting from ground state population's exhaustion has huge influence as well, which causes these logI-logP curves to bend gradually with the increase in laser power. Interestingly, this "typical saturation phenomenon" can be decreased obviously and even vanishes when the pumping laser power density is decreased enough.

Absorption↗
PubMed1998

[Preoperative interviewing: the possibility of a nurse anesthetist to provide emotional support to patient concerning surgery].

This study illustrates conversation strategies that a nurse anaesthetist uses to promote feelings of comfort among patients. The study concentrates on strategies that encourage patients to talk about their anxiety and fears and to ask for information about an impending surgery. In this article one videotaped nurse-patient preoperative interviewing session in a hospital was transcribed verbatim. Interview of the nurse conducted by the investigator after their conversation was also transcribed. The data coding and analysis were completed using adapted conversation analysis and reported as a case study. The conversation strategies the nurse used were: inviting opening of the interview, tactful probing for patient's fears and knowledge of the impeding surgery and building up a positive future image for the patient, which can also be seen realising the mental health perspective of health education. The study shows us how to provide patients with information they need and help them deal with anxiety caused by the surgery. The findings indicate that it is possible to carry out preoperative interviewing as a conversation with patient actively participating.

Anxiety↗
PubMedDate not supplied

Tacrolimus conversion in kidney transplant recipients: analysis of 107 patients.

Early results of an alteration in immunosuppressive protocol of tacrolimus conversion at a mean follow-up of 16 (range 1 to 36) months are presented with a mean time after transplantation of 34 +/- 1.4 months (range 1 to 158 months). Chronic allograft nephropathy in 16 (17%) patients, nephrotoxicity related to cyclosporine in 27(23%) patients and steroids resistant acute rejection in 64 (58%) represented the indications for tacrolimus conversion. Before starting tacrolimus there were 1 acute rejection episode in 37 patients, 2 in 17 patients, and 3 in 10 patients. After the drug conversion, 1 acute rejection occurred in 18 and 2 acute rejection in 4 patients. Graft loss was seen in 16 (16%) patients after drug conversion. Tacrolimus was withdrawn due to diabetes mellitus (n = 9), epilepsy (n = 4), and severe Nocardia sepsis, lymphoma and Kaposi sarcoma (each in one patient). Decreases in serum creatinine and increases in blood glucose levels were significantly associated with the tacrolimus doses (P = 0.0004 and P = 0.0400, respectively). The increase in creatinine clearance values were closely related to higher tacrolimus levels. The target range with maximum efficacy and minimum toxicity seemed to be 10 to 15 ng/mL. Tacrolimus conversion can be successful in cases of rejection and nephrotoxicity, but dose-dependent blood glucose elevations require close observation in these patients.

Adolescent↗
PubMed1996

Corneal changes in schoolchildren.

Videokeratography (TMS-1) data from the right eyes of 788 children between the ages of 6 and 14 years, examined in 1994 as part of the Orinda Longitudinal Study of Myopia, were analyzed using the Fast Fourier Transform (FFT) to quantify corneal power, toricity, and toricity axis. Cross-sectional analysis showed no statistically significant age trend for these parameters. Conversely, longitudinal analysis of data for 387 of these children, first measured in 1991, showed a statistically significant decrease in corneal power. Corneal toricity did not change significantly over this 3-year period, although there was a minute but statistically significant clockwise axis shift. From this we conclude that in the elementary and junior high school years-during which period axial length is known to increase-corneal flattening continues, but corneal toricity is stable.

Adolescent↗
PubMed2004

The natural history of recurrent optic neuritis.

BACKGROUND: Optic neuritis (ON) may occur in isolation or may herald multiple sclerosis (MS) or neuromyelitis optica (NMO). Occasionally, ON may recur many times without intervening evidence of dissemination in space. OBJECTIVE: To define the clinical course and prognosis of patients with recurrent ON. DESIGN: Retrospective medical record review and telephone follow-up survey. SETTING: Clinic-based practice in a large tertiary referral institution. MAIN OUTCOME MEASURES: Survival analysis of conversion to MS and NMO and final visual impairment. We studied the association of clinical and demographic factors, the presence of brain lesions on magnetic resonance images, and the use of corticosteroid treatment at the time of the first ON occurrence with conversion to MS and NMO. RESULTS: We identified 1274 patients with ON between 1994 and 2000 and selected 72 (5.7%) with recurrent ON without intervening symptoms of a disseminated demyelinating condition for further analysis. The 5-year conversion rate to NMO was 12.5% and to MS, 14.4%. Among 5 patients with 2 or more lesions consistent with MS on brain magnetic resonance images, 2 (40.0%) converted to MS and none to NMO, while among 11 patients without such lesions, none converted to MS and 2 (18.2%) converted to NMO (P =.16). Conversion to MS occurred in 7 (19.4%) of 36 individuals treated for their first ON episode with corticosteroids vs 4 (44.4%) of 9 untreated individuals (P =.19). There was no difference in the conversion rate to MS between those treated with intravenous steroids (4 [16.7%] of 24) vs oral steroids (3 [25.0%] of 12) (P =.33). Conversion to NMO occurred earlier than conversion to MS (2.3 +/- 1.6 vs 5.3 +/- 4.3 years, respectively; P =.01). Women tended to convert to NMO more frequently than men (female-male ratio for NMO converters, 7:1; MS converters, 2:1; nonconverters, 2:1; P =.56), as did those with a higher annual frequency of ON episodes (NMO converters, 2.0 +/- 1.3; MS converters, 1.0 +/- 1.0; nonconverters, 0.6 +/- 0.5; P =.04). The number of ON events in the first 2 years following the first ON episode was higher in the NMO group (NMO converters, 2.4 +/- 0.9; MS converters, 1.9 +/- 1.1; nonconverters, 1.7 +/- 0.7; P =.04). The final visual impairment was greatest in the NMO group (P =.02). CONCLUSIONS: Patients with rapid succession of severe ON events are more likely to develop a generalized demyelinating disease. Patients with NMO had a worse visual outcome.

Administration, Oral↗
PubMed2005

Effects of receptive listening on the congruence of speakers' response latencies in dialogues.

The present study investigated the receptiveness of speakers toward conversational partners in dialogues by comparing duration of response latencies in both Compromise and Debate conditions. 12 dyads of speakers holding opposing opinions participated in a 15-min. dialogue. Six dyads in the Compromise condition reached a conclusion through discussion and consideration of the partner's opinion. The six dyads in the Debate condition imposed their opinion on the conversational partner. Analysis indicated that in compromise dialogues, the response latencies of the conversational partners become similar over the time course, while in debate diaogues, the response latency does not become similar, suggesting that speakers having a receptive attitude adjust their response latencies to match the partner's. The role of congruence of response latencies in dyadic communication was discussed.

Adolescent↗
PubMed1996

Conversion of laparoscopic to open cholecystectomy. An analysis of risk factors.

BACKGROUND: Identifying patients who are at risk for conversion from laparoscopic (LC) to open cholecystectomy (OC) has proven to be difficult. The purpose of this review was to identify factors that may be predictive of cases which will require conversion to laparotomy for completion of cholecystectomy. METHODS: We reviewed 581 LCs initiated between July 1990 and August 1993 at a university medical center and recorded reasons for conversion to OC. Statistical analysis was then performed to identify factors predictive of increased risk for conversion. RESULTS: Of the 581 LC initiated, 45 (8%) required OC for completion. Reasons for conversion included technical and mandatory reasons and equipment failure. By multivariate analysis, statistically significant risk factors for conversion included increasing age, acute cholecystitis, a history of previous upper abdominal surgery, and being a patient at the Veterans Affairs Medical Center (VAMC). Factors not increasing risk of conversion included gender and operating surgeon. CONCLUSIONS: We conclude that no factor alone can reliably predict unsuccessful LC, but that combinations of increasing age, acute cholecystitis, previous upper abdominal surgery, and VAMC patient result in high conversion rates. Patients with the defined risk factors may be counseled on the increased likelihood of conversion. However, LC can be safely initiated for gallbladder removal with no excess morbidity or mortality should conversion be required.

Adolescent↗
PubMed2000

Characterization of energy conversion based on metabolic flux analysis in mixotrophic liverwort cells, Marchantia polymorpha.

In order to characterize the contributions of respiratory and photosynthetic actions to energy conversions, the mixotrophic cells of Marchantia polymorpha were cultivated in the medium containing 10kg/m(3) glucose as an organic carbon source. The cultures were conducted with the supply of ordinary air (0.03% CO(2)) at constant incident light intensities of 50 and 180W/m(2). From the results of metabolic analysis, it was found that the cell yield based on ATP synthesis was estimated to be 6.3x10(-3)kg-dry cells/mol-ATP in these cultures. Under the examined conditions, energy conversion efficiency through respiration was larger than that through photosynthesis, and efficiency of overall energy conversion to ATP was maximized when the sum of energies from glucose and light captured by the cells was approximately 7.2x10(5)J/(hkg-dry cells). Taking into account the efficiency of overall energy conversion, a batch culture of M. polymorpha in a bioreactor was carried out by regulating incident light intensity ranging from 9 to 58W/m(2). In the culture with light regulation, the cell yield of 6.2x10(-9)kg-dry cells/J was achieved on the basis of energy provided to the system throughout the culture, and this value was 2.3 and 9.3 times as large as those obtained in the cultures under constant incident light intensities of 50 and 180W/m(2), respectively.

Journal Article↗
PubMed1987

Conversations with autistic children: contingent relationships between features of adult input and children's response adequacy.

The relationship between certain features of adult speech and autistic children's response adequacy was examined within the context of unstructured, dyadic conversations. On separate sessions, four verbal, nonecholalic children were observed talking with their mothers and teachers. Analysis of conversational turns showed that as the number of facilitating features contained in adults' eliciting utterances increased, the proportion of adequate replies from the children increased. In this analysis, facilitating features included the use of Yes/No questions, questions that were conceptually simple, and questions that were semantically contingent on the child's topic. In a further analysis, it was found that adults tended to modify their use of these features in response to child feedback, although this tendency was relatively small and observed only in a minority of the sequences evaluated. The findings are discussed in terms of pragmatic deficits associated with autism and implications for intervention with this population.

Autistic Disorder↗
PubMed1978

A minicomputer system for display and rate analysis in vectorcardiography.

A system has been constructed for recording vectorcardiographic signal with a FM taperecorder. Off-line AD-conversion and analysis of rates and magnitudes of partial vectors are made with a minicomputer. The reason for studying particularly initial vectorrates is that according to our hypothesis these contain valuable information for classification of certain cardiac arrythmias according to supraventricular or ventricular impulse focus. Preliminary results confirm the hypothesis. In vectorcardiography one difficulty is to give an easily comprehensible presentation of the vectorloop. In this study a method for '3-dimensional' display has been developed, using a graphic display processor and varying intensities of the beam. The system is to a high degree man-machine interactive.

Arrhythmias, Cardiac↗
PubMed2000

Green up-conversion emission in Er3+:BaTiO3 sol-gel powders.

Bright green emissions at 549 and 526 nm have been observed from sol-gel derived Er3+:BaTiO3 powders upon excitations at two near infrared (NIR) wavelengths of 973 and 816 nm. The decay characteristics were measured and studied. It was found that the predominant emission at 549 nm has very different lifetimes upon excitation at 973 and 816 nm, which was explained by the mechanisms of excited state absorption (ESA) of individual Er3+ ion and cooperative energy transfer (CET) between two near Er3+ ions for the up-conversion emission. Analysis also showed that 973-nm excitation is more effective for the green up-conversion emission.

Barium Compounds↗
PubMed2002

Risk of tuberculin skin test conversion among health care workers: occupational versus community exposure and infection.

A prospective observational cohort study to assess rates of and risk factors for tuberculin skin test (TST) conversion among health care workers (HCWs) was conducted at an urban hospital located in a high tuberculosis-incidence area in 1994-1998. All hospital employees undergoing required testing every 6 months were included. A total of 69 (1.2%) of 5773 susceptible employees had a documented TST conversion (overall rate, 0.38 per 100 person-years worked). No significant difference existed in conversion rates among employees with frequent, limited, or no patient contact. HCWs with a TST conversion lived in zip codes with higher tuberculosis case rates (P< or =.05). In multivariate analysis, TST conversion was associated with history of bacille Calmette-Guérin vaccination (relative risk [RR], 11.63), annual salary <$20,000 (RR, 3.67), and increasing age. In the setting of an effective tuberculosis infection-control program, TST conversion rates were low, and risk of conversion among HCWs was associated most strongly with nonoccupational factors.

Adult↗