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PubMed1996

Concept development: exploring undocumentedness.

Concept development involves multiple processes, one of which is concept exploration. The purpose of this paper is to present the process of concept exploration as exemplified in the case of undocumentedness. This particular exploration of undocumentedness was grounded in the discipline of nursing and approached from a feminist perspective. The exploratory process of the concept included personal reflexivity, the construction of definitions, examination of the historical, social, political, and legislative context of undocumented immigration in the United States, exploration of the meanings and implications of the concept, discussion of the relationship of undocumentedness to nursing and health, and identification of the needs for research to further develop the concept of undocumentedness for nursing.

Concept Formation↗
PubMedDate not supplied

The quality of self-concept in old age.

Self-concept in old age was investigated. The goal of the work was to reveal the contents of self-concept, that is, what is included in the sphere of self-assessment, and also to analyze the traditional parameters of self-assessment: its height, stability, adequacy. Specific features of self-concept in old age were found. They concern the contents of self-concept and are characterized by retrospective direction of self-analysis. Total lowering of the level of self-assessment and modification of its structure including real, ideal, attainable positions were found. As compared with previous periods of the life-cycle, self-concept becomes less stable and adequate. Besides the general peculiarities, old people's self-concept is characterized by wide individual variations and sex differences.

Adaptation, Psychological↗
PubMed1997

Adolescent self-concept among Han, Mongolian, and Korean Chinese.

Studies of self-concept have suffered from a lack of both a solid theoretical base and a clear definition of the term. It is not clear whether self-concept is a construct from the cognitive sciences, an active part of personality or of the ego and unconscious, or a physiological process as indicated from neurological research. Nor is it clear whether the psychological construct of self is related to other concepts, such as personal identity, self-esteem, and the ego, as sometimes these refer to the whole person or a structure or element within a person. What is evident is that the majority of researchers continue to assume that self-concept, however defined in theory, is primarily governed by environmental determinants despite abundant evidence from the neurosciences of the strong influence of its genetic heritability. This study assumed a genetic hypothesis, that self-concept is developmental and that adolescent perception of personal, relational, and academic self-identity occurs uniformly across cultures and environmental circumstances. Data were collected using a validated survey instrument, translated into Chinese, from majority and minority adolescents in the People's Republic of China. High similarity was found between the majority and minority adolescents, suggesting developmental propensities in the formation of self-concept.

Adolescent↗
PubMed1998

On developing self-concepts: a controlled study of children and adolescents with autism.

This study employed the self-understanding interview of Damon and Hart (1988) to assess the self-concepts of two groups of children and adolescents: a group of individuals with autism and a group of nonautistic mentally retarded individuals who were matched for age and for verbal ability. On the basis of an hypothesis concerning the interpersonal origins of social and psychological self-concepts (Hobson, 1990; Neisser, 1988), it was predicted that the participants with autism would show a relative dearth of such concepts in their talk about themselves. In accordance with our predictions, there was a significant group difference in the number and quality of statements that fell into the social category of self-concept; contrary to our predictions, however, there was no group difference in the number of statements that fell into the psychological category. In addition, although there were not significant group differences in the overall production of verbally expressed concepts concerning self-attributes of a physical, active, or psychological kind, even within these categories individuals with autism made fewer references to social interactions or qualities. These results are discussed with regard to theories of self-concept development in typically developing as well as autistic and mentally retarded individuals, and with reference to the limitations of interpersonal understanding ("theory of mind") in people with autism.

Adolescent↗
PubMed1986

How families manage chronic conditions: an analysis of the concept of normalization.

Concept analysis entails the systematic examination of the attributes or characteristics of a given concept for the purpose of clarifying the meaning of that concept. The term "normalization" appears frequently in reports of how families respond to the illness or disability of a member. While most authors agree that families who have an ill or disabled member attempt to normalize their family life, definitions and applications of the concept vary considerably across investigators. Following guidelines for concept analysis proposed by Chinn and Jacobs (1983), the origin and development of the concept normalization are traced and criteria are presented for distinguishing between normalization and other responses families make to a member's illness or disability. Three case examples are presented: a model (normalization) case, a contrary (disassociation) case, and a related (denial) case.

Adaptation, Psychological↗
PubMed2006

De novo chromosomal abnormalities and month of conception.

OBJECTIVES: We set out to study the possible relationship between the occurrence of chromosomal abnormalities and the month of conception using data from 7 years of prenatal diagnosis. METHODS: The sample included 7439 cytogenetic analyses from amniocentesis performed for conceptions between 1997 and 2003. The monthly prevalence of all de novo chromosomal abnormalities, trisomies, including trisomy 21, and Robertsonian translocations was investigated. RESULTS: Two hundred and four de novo numerical and structural chromosomal abnormalities (2.7%) were detected. A significant decrease in the frequencies of all de novo chromosomal abnormalities for June conceptions, as well as lower summer occurrences of trisomy 21, were found. In addition, de novo Robertsonian translocations were unexpectedly detected only among December conceptions. CONCLUSIONS: The relationship between chromosomal abnormalities and the month of conception could turn out to be useful in estimating the actual risk in pregnancy, if confirmed by other studies. The observed June lowest rate might indicate an association between chromosomal abnormalities and the maximum number of daylight hours throughout the year (summer solstice). We cannot explain the unusual findings concerning Robertsonian translocations that were only found for conceptions in December. This may be related to the annual minimum daylight hours (winter solstice) as opposed to the summer solstice.

Amniocentesis↗
PubMed1997

Effects of Three Types of Elaboration on Learning Concepts from Text

Two experiments were performed to evaluate the effects of three different elaborative activities on concept learning. Experiment 1 consisted of 60 undergraduates, while Experiment 2 consisted of 54 undergraduates. In both experiments, subjects studied a passage which asked them to create personal examples of the target concepts, contrast the target concepts, or expand on the effects of the target concepts. Subjects took a criterion test which consisted of recall of concept definitions and teaching examples, classification of novel examples, and problem solving scenarios. In both experiments, the condition which asked subjects to contrast the target concepts produced significantly better performance than the other two conditions. Possible explanations focus on: (1) the degree to which the different elaborative activities influence the richness and/or distinctiveness of the encoded information, and (2) the relation among the focus of the elaborative activity, the experimental text, and the measured criterion outcomes.

Journal Article↗
PubMed1996

Object-oriented development of a concept learning system for time-centered clinical data.

A concept learning system is expected to be a powerful tool for filtering and analyzing a large amount of data in a variety of scientific fields. A simple application of it to clinical data, however, fails to mine medical information and knowledge. One of the major obstacles in mining a clinical database is time, which is a very important concept in clinical medicine. To be successful in data mining in clinical medicine, an efficient model of clinical data with time and a flexible concept learning system augmented to handle the model are both necessary. Herein we modeled clinical data to easily express and manipulate time and extended a concept learning system to utilize a time-centered clinical data model. The modified concept learning system is based on the message-value method rather than the traditional attribute-value method. The object-oriented technology was of great help in modeling time-centered clinical data and in developing a modified concept learning system.

Algorithms↗
PubMed2002

[Innovative training for enhancing patient safety. Safety culture and integrated concepts].

INTRODUCTION: Patient safety is determined by the performance safety of the medical team. Errors in medicine are amongst the leading causes of death of hospitalized patients. These numbers call for action. Backgrounds, methods and new forms of training are introduced in this article. METHOD: Concepts from safety research are transformed to the field of emergency medical treatment. Strategies from realistic patient simulator training sessions and innovative training concepts are discussed. RESULTS: The reasons for the high numbers of errors in medicine are not due to a lack of medical knowledge, but due to human factors and organisational circumstances. A first step towards an improved patient safety is to accept this. We always need to be prepared that errors will occur. A next step would be to separate "error" from guilt (culture of blame) allowing for a real analysis of accidents and establishment of meaningful incident reporting systems. Concepts with a good success record from aviation like "crew resource management" (CRM) training have been adapted my medicine and are ready to use. These concepts require theoretical education as well as practical training. Innovative team training sessions using realistic patient simulator systems with video taping (for self reflexion) and interactive debriefing following the sessions are very promising. CONCLUSION: As the need to reduce error rates in medicine is very high and the reasons, methods and training concepts are known, we are urged to implement these new training concepts widely and consequently. To err is human - not to counteract it is not.

Clinical Competence↗
PubMed2005

Efficacy of novel-concept pedicle screw fixation augmented with calcium phosphate cement in the osteoporotic spine.

Pedicle screw instrumentation has become increasingly popular for rigid internal stabilization of the thoracolumbar spine. However, when pedicle screws are used in elderly osteoporotic patients, the screw-bone interface is stripped easily. Therefore, the risk of screw loosening and backing-out after surgery has increased. The purpose of this study was to evaluate the efficacy of the novel-concept pedicle screw fixation augmented with calcium phosphate cement (CPC) in the osteoporotic spine. The novel-concept screw has the same shape as the ordinary screw, but it is hollow and fabricated with 20 small holes (1.3 mm in diameter) leading to the hollow part on the bottom of the thread. Fifteen embalmed cadaveric lumbar vertebrae were instrumented with two types of pedicle screw (the ordinary screw and the novel-concept screw) in each pedicle. Only the novel-concept screws were augmented with CPC after insertion. Seven days later, axial pull-out testing was performed at a crosshead speed of 10 mm/min. The mean maximal pull-out strength of the ordinary screws was 258 N, and that of the novel concept screws was 637 N. These results suggest that the novel-concept screw augmented with CPC can be useful for pedicle screw fixation of the osteoporotic spine.

Aged↗
PubMed2006

Health care students' differing conceptions of expertise: a challenge for inter-professional care.

The aim of the study was to examine do health care students, who study at different programs, value similar expert qualities. To investigate this issue, a questionnaire was administered among health care students in a Finnish polytechnic (two cohorts, total n = 466), consisting of a scale for rating the importance of different expert qualities. The questionnaire resulted in the following dimensions of the conceptions of expertise: (1) social skills, (2) scientific skills, (3) innovativeness, (4) continuing self-development, and (5) problem-solving skills. Also the Inventory of General Study Orientations (IGSO) was applied to analyse possible motivational explanations for different conceptions of expertise. In addition to the scales, an open-ended writing task was used to explore in depth students' conceptions of expertise. It appeared that study orientations were a minor factor in the study, while study environment (study programs) clearly differentiated students' conceptions of expertise. Thus, the study argues that health care students' conceptions of expertise are constituted mainly on domain-specific bases and that students who graduate from different programs may possess very diverse ideas about their profession. Consequently, different conceptions captured during the education form a major challenge for inter-professional care later in work-life. This phenomenon should be taken into account when organising health care education.

Analysis of Variance↗
PubMed2005

Likelihood of natural conception following treatment by IVF.

PURPOSE: To predict the ongoing likelihood of natural conception, when a couple has ceased to try to conceive by assisted conception. METHODS: A postal questionnaire survey obtained information on further attempts to conceive and have a baby, either without treatment or by treatment elsewhere. RESULTS: From a response rate of 44%, there were 116 couples who fulfilled the study criteria. The data presented are based on this group. The overall likelihood of conception was 18%. Cumulative results were analysed up to 3 years following treatment. Univariate analysis showed that likelihood of conception was affected by infertility diagnosis (p = 0.024), woman's age (> 38 years; p < 0.005) (negatively) and duration of infertility (< 3 years; p < 0.005) (positively), while primary infertility did not. Effects of diagnosis and infertility duration were confirmed by multivariable analysis, controlling for age and primary infertility. These latter variables had no independent effect. CONCLUSION: The likelihood of natural conception following IVF treatment was determined by duration of infertility and diagnosis; tubal disease in particular was associated with a very poor likelihood of natural conception.

Female↗
PubMed1986

Intraverbal acquisition of semantic concepts by preschoolers.

Intraverbal learning is a process through which semantic knowledge is acquired from purely linguistic information. The concern of this study is to investigate the role of intraverbal learning in the preschool-aged child's acquisition of semantic concepts. Three- and 4-year-old children were either shown pictures illustrating novel concepts or they were told verbal definitions of novel concepts, the definitions containing information about key physical and functional properties. An additional manipulation consisted of including or omitting information about the superordinate category membership of the concept. Concept acquisition was assessed via a battery of comprehension tasks; these tasks assessed both referential and formal knowledge of the concepts. Results indicate a correspondence between the type of information received and the type of knowledge acquired, with intraverbal information resulting in broader knowledge than pictorial information. Purely pictorial information was associated with referential knowledge only, while intraverbal information enhanced both referential and formal knowledge.

Child, Preschool↗
PubMed1996

Goethe's Archetype and the romantic concept of the self.

This paper attempts to illuminate Goethe's concept of an archetype by setting it alongside the concept of the self that was being articulated at the same time, also by writers of the Romantic movement. The Romantic concept of the self expresses a new concept of the self as a 'core' plus an expression of the core: and it is the same 'core plus expression' idea that is embodied in the Goethean archetype. Goethe's archetype is not simply a 'plan'. It is a kind of agent at the heart of a thing, striving for self expression, and to this end driving the thing's development. Both Romantic self and archetype reflect the wider attempt to reinstate the concept of action in our understanding of things and happenings in general. The root idea of there being at the heart of a living thing an agent pursuing a goal remains in the modern concept of the organism.

Biology↗
PubMed1985

The concept of culture-bound syndromes: anorexia nervosa and brain-fag.

The concept culture-bound syndrome' (CBS) is elusive. In this paper an attempt has been made to tie the concept down more firmly by proposing a strict definition, examining the appropriateness of this definition in determining the CBS status of two new syndromes (anorexia nervosa and brain-fag) and analysing the usefulness or not of the basic CBS concept. A CBS is defined as a collection of signs and symptoms of disease (not including notions of cause as recently proposed in the anthropological literature) which is restricted to a limited number of cultures by reason of certain of their psychosocial features. Anorexia nervosa appears to fit the definition but further empirical evidence is required to assure that the illness is restricted to Western cultures or cultures strongly influenced by them. The question of the CBS status of brain-fag demonstrates the need to clearly differentiate such disease features as symptom clusters, labels for those clusters, and notions of etiology. Failure to keep such features distinct has led to considerable controversy, but if the proposed definition is strictly adhered to, brain-fag does qualify for the CBS designation. As regards the usefulness of the CBS concept, it is proposed that the question hinges upon whether CBS's signal a difference that makes a difference. It is demonstrated that the CBS concept is useful for medical anthropologists or transcultural psychiatrists who are concerned about relationships between symptom patterns and cultural processes. It is also useful to epidemiologists who, for example, may be interested in estimating the prevalence of depression; it is important to know that they must count some cases of CBS's along with cases of depression with a more typically Western symptomatology. The concept may be redundant for psychopharmacologists who find that they successfully treat many different culture bound syndromes with the same drugs.

Adolescent↗
PubMed1989

Concepts about infant health, growth, and weaning: a comparison between nutritional scientists and Madurese mothers.

Nutrition education is a critical component of programs designed to improve nutritional status, yet it often fails because of differences in the concepts underlying the educational message and those motivating mothers' behavior. To illustrate this discrepancy in the context of infant feeding we compare the views of nutritional scientists' and mothers in Madura, Indonesia on (a) health and disease and (b) the relationship of foods to the concepts of state-of-health, infancy and growth. The relationship of these concepts to mothers' practices and nutritional scientists' recommendations are also explored. Views of the nutritional scientist were drawn from the published literature and those for the Madurese mothers' from ethnographic and survey data gathered between February 1983 and June 1984. While mothers and nutritional scientists both seek to give a diet appropriate for a stage of infancy, their definitions of key concepts differed. Nutritional scientists recommend feeding infants high quality clean foods in amounts sufficient for maintenance, activity and growth. Underlying these recommendations are the concepts of disease as a deviation from the norm, food as a source of pathogens as well as nutrients, infancy as a period of physiological growth, and poor growth as an indicator of disease. All infants have the same type of nutrient requirements. Madurese mothers perceive health and its components as a process of balance. Balance is partly attained either by feeding rice soon after birth or by withholding rice until after one year of age. This concept results in two distinct but coexisting types of requirement and weaning patterns for infants. The important development during an infant's first year of life is 'growth' from a vulnerable state in the 'neonatal' period (40 days) to a state of independence and reason (akal) in late infancy (greater than 7 months). To foster 'growth' in rice-fed infants, mothers force-feed increasing amounts of quality foods. Once akal is achieved, mothers no longer feed quality foods or increase amounts of food, and the infant, not the mother, initiates feeding. These comparisons suggest how nutritional scientists can help improve the process of communication in nutrition programs. First they can describe and analyze the mother's as well as their own conceptual framework to arrive at approaches and messages that blend together points of views. Second, by studying the consequence on infants of mother's behavior, nutritional scientists may gain further insight into the biological processes leading to good nutrition and refine messages and interventions accordingly.

Attitude to Health↗
PubMed1986

Alcoholism as an addiction: the disease concept reconsidered.

The concept of alcoholism as a disease is compared to the concept of addiction in regard to individual intentionality, the resultant social and legal accountability and especially the total phenomenology of the addictive process. It is held that alcoholism is essentially an addiction like any other that if active, can culminate in various diseases and in death but that its most significant and characteristic volitional disorder: starting to drink when sober, is not explained by the disease concept. The concept of alcoholism as a disease is basically due to a reversal of the perception of cause and effect and has thereby impoverished full understanding and treatment of the entire process of addictive emotionality, addictive relationships and the addictive way of life. The disease concept can contribute best by inclusion to describe the results of active alcoholism but not as an explanation. This means we must turn to the concept of addiction to provide more accurate guidance in the development of adequate domestic and societal responses to alcoholism and especially for more adequate management methods for the physician confronted with the many overt and hidden forms of alcoholism in daily practice.

Alcoholism↗
PubMed2005

Use of various contraceptive methods and time of conception in a community-based population.

AIMS: To investigate the association between method of contraception and time to conception in a normal community-based population. DESIGN: Prospective, cross-sectional, survey. SETTING: Large comprehensive ambulatory women's health center. PATIENTS AND METHODS: One thousand pregnant women at their first prenatal obstetrics visit were asked to complete a self-report questionnaire. The return to fertility was analyzed by type of contraceptive method, duration of use, and other sociodemographic variables. RESULTS: Response rate was 80% (n=798). Mean age of the patients was 29.9+/-5 years. Seventy-five percent had used a contraceptive before trying to conceive: 80% oral contraceptives, 8% intrauterine device, and 7% barrier methods. Eighty-six percent conceived spontaneously. Contraceptive users had a significantly higher conception rate than nonusers in the first 3 months from their first attempt at pregnancy. Type of contraception was significantly correlated with time to conception. Pregnancy rates within 6 months of the first attempt was 60% for oral contraceptive users compared to 70 and 81% for the intrauterine device and barrier method groups, respectively. There was no correlation between time to conception and parity or duration of contraceptive use. Other factors found to be significantly related to time to conception were older age of both partners and higher body mass index. CONCLUSIONS: Contraception use before a planned pregnancy does not appear to affect ease of conception. Type of method used, although not duration of use, may influence the time required to conceive.

Adult↗