New look at the "egg shell skull" principle.
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This study presents a quantitative description of temporomandibular joint (TMJ) sounds provided by a rule-based classification system based on sound classification by three dentists, who listened to and classified the sound recordings as no sound, click, coarse crepitus and fine crepitus. The sounds were recorded with microphones in the ear canal from 126 subjects during vertical opening, digitized at 15 000 Hz, and replayed using a computer sound card and speakers. The dentists' classification of a test set resulted in intra- and inter-tester j values ranging from 0.71 to 0.81 and 0.61-0.73, respectively. Pooled j values for the dentists and the dentists plus the rules were 0.67 and 0.58, respectively, which were not significantly different in terms of the sound features on which the rules were based (P = 0.13). Linear discriminant analysis showed the four TMJ sound types were significantly different (P < 0.001). The performance of the rules was equivalent to the dentists and marginally better than the linear discriminant functions (P = 0.08), establishing the validity of the quantitative descriptions they provide. The recording and rebroadcast methodology produced sounds very similar to those observed in the clinic and could be used to train clinicians in classifying TMJ sounds.
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This study describes the experiences of nursing students with disabilities through interviews, observations, and document analysis. The sample included 10 current students and graduate nurses with physical or auditory impairments and 61 nursing faculty members, staff members, patients, and fellow students. The Colaizzi method of data analysis was modified to include additional information from interviews, observations, and documents. The findings reveal important concerns related to potentially unsafe nursing practices. The findings should assist nursing faculty with admission and retention decisions and development of reasonable accommodations. Recommendations for nursing programs to develop enforceable guidelines for admission are included.