Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Acceptance Process”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2005

Clinical holistic medicine: chronic pain in internal organs.

Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free) state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are "holding" or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are "love" and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain.

Abdominal Pain↗
PubMed2000

Dissociating automatic and intentional processes in children's eyewitness memory.

Two experiments investigated the contribution of automatic and intentional memory processes to 5- and 8-year-old children's acceptance of misinformation. Children were presented with a picture story followed by misleading postevent details that either were read to participants or were self-generated in response to semantic and perceptual hints. Children were then given a recognition test under 2 instructional conditions. In the inclusion condition children reported whether they remembered items from either of the previous phases. In the exclusion condition children were instructed to exclude postevent suggestions. Children were more likely to accept misled-generate items compared to misled-read items in the inclusion condition, but the opposite was the case under exclusion instructions. Both automaticity and recollection (cf. L. L. Jacoby, 1991) influenced misinformation acceptance, but the role of automatic processes declined with age.

Age Factors↗
PubMed1997

Ethical issues relating to reproduction control and women's health.

There are many ethical aspects which derive from the application of reproduction control in women's health. Women's health can be enhanced if women are given the opportunity to make their own reproduction choices about sex, contraception, abortion and application of reproductive technologies. The main issues that raise ethical dilemmas following the development of assisted reproduction techniques are: the right to procreate or reproduce; the process of in vitro fertilization itself-is it morally acceptable to interfere in the reproduction process?; the moral status of the embryo; the involvement of a third party in the reproductive process by genetic material donation; the practice of surrogacy, cryopreservation of pre-embryos; genetic manipulation; experiments on pre-embryos, etc. Induced abortion raises ethical issues related to the rights of the woman versus the rights of the fetus. For those who consider life to begin at conception abortion always equals murder and is therefore forbidden. Those who believe in the absolute autonomy of the woman over her body take the other extreme approach. The discussion surrounding abortion usually centers on whether it should be legal or illegal. Access to safe abortion is critical to the health of women and to their autonomy. The development of new effective contraceptive methods has a profound impact on women's lives. By the use of contraception it is possible to lessen maternal, infant and child mortality and to reduce the prevalence of sexually transmitted diseases. Research and development of new effective reversible contraceptives for women and men is needed. Dissemination of information about the safety and effectiveness of contraceptive methods is of great importance. Female genital mutilation is still practiced worldwide due to customs and tradition among various ethnic groups. The procedure is considered to be medically detrimental to the physical and mental health of women and girls, and is considered by many as oppression of women. The practice has to be stopped. Recognition of the fetus as a 'patient' has a potential effect on women's right for autonomy; they have no legal obligation to undergo invasive procedures and to risk their health for the sake of their fetuses. The woman carries ethical obligations toward her fetus. This obligation should not be enforced by the law. At present women bear most of the burden of reproductive health. All of them have a right of access to fertility regulation. Governments and society must ensure the women's equal rights to health care just as men have in the regulation of their fertility.

Abortion, Induced↗
PubMed1994

The biology of the artery wall in atherogenesis.

A great deal of progress has been made in the past few years in our understanding of the processes involved in atherogenesis and in mechanisms by which commonly accepted risk factors may affect these processes. These insights have allowed us to understand how various interventions may retard atherogenesis and decrease clinical events by improving plaque stability. The identification of new risk factors, such as lipoprotein(a), and of particular molecules that can be identified in atherosclerotic tissue, such as adhesion molecules, growth factors, cytokines, and proteins that regulate cholesterol uptake and removal, have identified several potential new targets for therapeutic intervention. Advances in molecular biologic techniques, including transgenic techniques, have markedly increased the types of potential interventions available. A major challenge for the future will be to determine which among this plethora of therapeutic possibilities holds the most promise for decreasing the morbidity and mortality associated with this disease.

Animals↗
PubMed1994

[A harmonious and hierarchic order].

As is well known, biologists in Darwin's own life-time were sceptical to the mechanism he proposed as the driving force behind evolution. In this essay it is argued that one reason for this scepticism was the idealistic structure of 19th century thought. Scientists in the 19th century saw perfection as the ultimate goal for history, society and mankind. A concept of evolution that emphasized random selection of individuals was unacceptable as long as there were other theories that could support the scientist's idealism. It is argued that the embryological concept of evolution was such a theory. By studying evolution on the model of the stages of the embryo's growth to maturity, life's history on earth described an evolution with an ultimate goal. From the anatomist Anders Retzius (1796-1860) to the zoologist Vilhelm Leche (1850-1927) it is shown how different scientists in Sweden were studying this growth process and how their idealistic frame of mind made the embryological conception of evolution an acceptable alternative to the mechanical process described by Darwin.

Biological Evolution↗
PubMed2003

Novel consent process for research in dying patients unable to give consent.

OBJECTIVES: To develop a process of advance consent to enable research to be undertaken in patients in the terminal phase. DESIGN: Feasibility study of an advance consent process to support a randomised controlled trial of two antimuscarinic drugs (hyoscine hydrobromide and glycopyrronium bromide) in the management of noisy respirations associated with retained secretions ("death rattle"). SETTING: Palliative care wards in a major cancer centre. PARTICIPANTS: Patients admitted to a palliative care ward who may develop "death rattle" and thus be eligible for randomisation. MAIN OUTCOME MEASURES: Patient accrual; acceptability of the consent process. RESULTS: Of the 107 patients approached, 58 patients gave advance consent to participate in the study. Of these, 15 patients developed death rattle and were randomised to receive either hyoscine or glycopyrronium; 16 patients died elsewhere; 15 patients died on the palliative care wards but were not randomised; 12 patients are still alive. CONCLUSIONS: Initial assessment suggests that this is a workable consent process allowing research to be undertaken in patients who are unable to give consent at the time of randomisation. Patient accrual rates to date are lower than needed to recruit adequate numbers in the time allotted to answer the research question.

Advance Directives↗
PubMed2004

Assessment of individual quality of life using the SEIQoL-DW in older medical patients.

BACKGROUND: Many hospital admissions aim to optimize quality of life (QoL). However, the standard medical clerking does not systematically record QoL items. AIM: To examine whether the current disease-based clerking could be supplemented in older people with QoL information. DESIGN: Survey of non-elective admissions aged > or = 65 years. METHODS: Participants (n = 60) were interviewed on day 3-5 of their admission. QoL was measured using the SEIQoL-DW and the SF36 (version 2). Cognitive and physical function were also assessed. Aspects of feasibility and acceptability were explored, and the potential clinical benefits of the information investigated. RESULTS: Mean patient age was 81 years; 36 (60%) were female. Forty-five completed the SEIQoL-DW, (mean time 37.7 min), of whom 17 experienced practical difficulties drawing the cue levels, and 25 had difficulty manipulating the direct weighting device of the SEIQoL-DW. However, the assessment process was judged as acceptable, and elicited more subjective information than was recorded in medical and nursing notes. Doctors considered the individual QoL information potentially useful for planning discharge and follow-up. DISCUSSION: The SEIQoL-DW is probably too time-consuming for standard medical clerking. However, as it was judged acceptable by patients, and according to medical staff, gives potentially valuable information, there may be circumstances in which its use is worthwhile.

Aged↗
PubMedDate not supplied

Modifying blood bank processes for efficiency and effectiveness: a case study.

Among the lessons to be learned in the case study is that the use of quality tools provides the opportunity for success. It will take longer than the group intends to implement change effectively. However, it is better to take smaller steps and be successful than to take giant steps and struggle or fail. Failure to communicate is often the reason that change is difficult. When staff are asked to make changes, the rationale for the change is often essential to acceptance. The quality improvement process requires documentation of goals, decision steps, implementation procedures, and monitoring outcomes. Success breeds success. Sharing the information with everyone from hospital support staff in the laboratory and maintenance department to direct patient care givers at the clinic site or the patient bedside makes everyone a part of the success.

Blood Banks↗
PubMed2006

Attention rehabilitation following stroke and traumatic brain injury. A review.

UNLABELLED: Attentional capacities, which are frequently impaired following brain injury, have also been found to be amenable to rehabilitation. This review discusses various approaches to attention rehabilitation in adult clients following stroke and traumatic brain injury. Attention process training has been accepted by many as a practice standard in postacute clients, however, its ability to generalize to new situations and to functional capacities is unclear. There is evidence for the use of psychostimulant medication, which may be most helpful when prescribed in combination with attention training. Biofeedback is a new avenue for intervention and is beginning to show some promising RESULTS: Rather than train underlying processes, another approach which shows promising results in a few small studies is training clients on specific functional skills, such as driving or vocational duties. Finally, modifications to the environment, implementation of strategies, provision of emotional support, and introduction of external supports/aids are important parts of a rehabilitation program, especially as the client returns to their home environment.

Attention↗
PubMed2001

[Tomographic studies of myocardial perfusion normality with 99m Tc-Tetrofosmin. Spanish multicenter study].

As a first phase in a nationwide multicenter study to obtain myocardial perfusion normality patterns, this work presents the study design and quality control methodology used to guarantee that the gammacameras fulfilled some minimum quality requirements. The following aspects were considered in the study design in order to guarantee the homogeneity and interchangeability of the results: creation and structure of the work group, data interchange system, data selection and acquisition, centralized archiving and processing, assessment system, study acceptance criteria and distribution of the results. To carry out the instrumental quality control, three phantom studies were established, one to control the rotation center, another to verify tomographic uniformity and a third to simulate the shape and orientation of the left ventricle. The three phantoms circulated through all of the 18 participating centers in this project, which corresponded to 19 gammacameras. Very strict guidelines had to be followed in the acquisition and processing of these phantom studies. If any camera and/or center did not fulfill the criteria established, it was advised of the problem detected in order to correct it. Once the defect was repaired, all the phantoms were sent again for verification. Uniformity of the rotation center was quantified by means of the eccentricity of a 360 degrees orbit, admitting up to a maximum of 10%. Tomographic uniformity was visually assessed, taking in account the number of slices with rings and their contrast and finally no artifacts could be present in the reconstructed study of the ventricle. The center of rotation was within limits in all the cameras except one case while the tomographic uniformity was incorrect in 6 cases. All the departments, except one, corrected the defects detected, and passed the acceptance test. The results made it possible to guarantee adequate homogeneity and instrumental quality in this multicenter study.

Coronary Circulation↗
PubMed2005

IEC 61511 and the capital project process--a protective management system approach.

This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.

Accident Prevention↗
PubMed1991

Recent developments in the multistage modeling of cohort data for carcinogenic risk assessment.

The modeling of cohort data based on the Armitage-Doll multistage model of the carcinogenic process has gained popular acceptance as a methodology for quantitative risk assessment for estimating the dose-related relationships between different occupational and environmental carcinogenic exposures and cancer mortality. The multistage model can be used for extrapolation to low doses relevant for setting environmental standards and also provides information regarding whether more than one stage is dose-related, which assists in determining whether different carcinogens affect different stages of the cancer process. This paper summarizes recent developments in the multistage modeling of cohort data and emphasizes practical issues such as handling data arising from large epidemiologic follow-up studies, the time-dependent nature of exposures and statistical issues such as multicollinearity in time-related variables, robustness of parameter estimates, validating of the fitted models, and routine inferential procedures. Problems related to uncertainties of risk estimates are discussed also. Computer programs for fitting multistage models with one or two dose-related stages to cohort data incorporating time-dependent exposure patterns; constructing confidence regions for model parameters; and predicting lifetime risks of dying from cancer adjusting for competing causes of death are detailed. Illustrations are provided using lung cancer mortality in a cohort of nonwhite male coke oven workers exposed to coal tar pitch volatiles.

Carcinogens, Environmental↗
PubMed1983

Enzyme-Linked Immunosorbent Assay for Quantitative Detection of Bacillus thuringiensis Crystal Protein.

Accurate measurement of the toxic protein crystal produced during deep-tank fermentation of Bacillus thuringiensis is critical for optimum process yield. The currently accepted method is a bioassay that requires more time to generate data than to complete the fermentation itself. A noncompetitive enzyme-linked immunosorbent assay has been developed with purified B. thuringiensis crystals to generate rabbit antiserum. This technique gives a quantitative crystal protein value with a colorimetric endpoint for either liquids or powders within 4 h of sampling. Reproducibility of this enzyme-linked immunosorbent assay satisfies criteria for use in a commercial process.

Journal Article↗
PubMed2004

Promoting evidence-based practice: an internship for staff nurses.

Implementing evidence-based practice is a complex but valued process that requires support for nurses to make it a reality in care delivery. To address this, an Evidence-Based Practice Staff Nurse Internship was developed at the University of Iowa Hospitals and Clinics in the United States. PROGRAM OVERVIEW: The objective of this internship is to promote use of evidence by staff nurses to improve patient outcomes. Through a competitive application process, six nurses are accepted in each cohort. The program provides didactic content and dedicated work time on topics interns select (e.g., family pet visitation, sedation management, bowel sounds assessment, guided imagery, family transition to pediatric floor). Interns receive paid clinical release time for participating. ROLES AND RESPONSIBILITIES: Teams include the staff nurse, the nurse manager, and an advanced practice nurse. Responsibilities for each step are assigned to the person with the appropriate expertise. EVALUATION: Interns report understanding the process, appreciate the opportunity for professional growth, and report their objectives are being met. Participants evaluated the program very positively and also provided recommendations for revision (e.g., revising class content). The program resulted in improved quality of care such as increased patient and family satisfaction, decreased length of stay, and cost savings. IMPLICATIONS: Programs that support practitioners through the evidence-based practice process are needed for use in a variety of settings internationally. This unique program supports staff nurses in making evidence-based practice a reality for their work and patients and might be transferable across settings.

Attitude of Health Personnel↗
PubMedDate not supplied

[The treatment of superficial burns of the hands under controlled microclimate conditions].

In the treatment of the superficial burns of the hands, since October 1996, we have used exclusively the method of the controlled microclimate, verified in different variants starting early sixties. At the end of the usual primary wound treatment, the hand covered with the chosen topic is an ordinary new polyethylene bag. The bags are not pre-sterilized but the test showed no pathogen germs. The patient uses the hands for the daily activities--eating, reading. He/she is encouraged to perform active exercises (light gymnastics). We change the bags daily or whenever necessary, after a careful of the wound. We evaluated the healing time, the epithelial quality, secretions, mobility, patient's and medical personnel's acceptability, and the economic aspect. Though we couldn't notice a shorter period of healing, the epithelium showed a better quality in the early period of regeneration. The range of mobility was faster restored but long term results were the same as with usual dressings. We consider the method is appropriate for standardization in superficial hand burns in inpatients or outpatients for at least 4 reasons: comfort for the patient, his active and conscious participation in the process of healing, high acceptability among medical personnel, the semnificative economic advantage.

Burns↗
PubMed2003

[Calcifications in temporal arteries -- their morphogenesis in comparison to physiological osteogenesis].

OBJECTIVE: Vascular calcification, traditionally regarded as a dystrophic process, has recently been interpreted as a bone-like biologically regulated phenomenon. Because temporal arteries which also contain calcifications are easily available from biopsies of older individuals with suspected giant cell arteritis, we studied the morphogenesis of this calcification in comparison with the development of fetal bone. MATERIAL AND METHODS: Formaldehyde fixed arteries were processed in paraffin sections and investigated by light-, transmission-, and scanning electron microscopy. The atomic composition of the calcifications was estimated by X-ray microanalysis. Fetal bone, also fixed with formaldehyde, was investigated using identical methods. RESULTS: Early calcifications are often present as focal or diffuse granular mediacalcinosis. With increasing age, calcified granules appear in association with the internal elastic membranes and progress to sheet-like calcifications. Ultrastructurally calcospherites, not rarely exhibiting the Liesegang phenomenon, are the hallmark of early calcifications. In advanced sheet-like calcification calcospherites could be detected as components of the calcified lumps. Calcospherites also appear in endochondral calcification, but are absent in calcified osteoid. The ultrastructure of calcospherites in provisional endochondral ossification differs from that in vascular calcification. Instead of corpuscles as with the Liesegang phenomenon, radial clusters of needle-like crystals resembling apatite are present. While calcospherites of the tunica media often contain a high amount of magnesium, calcified sheets as well as bone exhibited in contrast a low magnesium content. CONCLUSIONS: It is concluded that, comparable to granular mediacalcinosis of the aorta, development of calcified arteriosclerotic plaques, and Mönckeberg's disease, calcification of small muscular temporal arteries is also initially a calcospherite-dependent process. It is generally accepted that these calcified corpuscles represent remnants of calcified necrotic or apoptotic cells. In the phase of confluence with the appearance of sheet-like calcification, a low bone-like magnesium content that differs from the high amount in the isolated medial calcospherites was measured. This finding, together with the observation that calcified sheets contain calcospherites, supports the hypothesis that vascular calcification in general is different from bone formation and has to be regarded as a biphasic process initiated by the appearance of calcospherites and followed by a secondary calcifying phase with the formation of bone-like apatite that leads to rock hard lumps of calcified vessels.

Adult↗
PubMed2002

New life in an old idea: the synaptic plasticity and memory hypothesis revisited.

The notion that changes in synaptic efficacy underlie learning and memory processes is now widely accepted, although definitive proof of the synaptic plasticity and memory hypothesis is still lacking. This article reviews recent evidence relevant to the hypothesis, with particular emphasis on studies of experience-dependent plasticity in the neocortex and hippocampus. In our view, there is now compelling evidence that changes in synaptic strength occur as a consequence of certain forms of learning. A major challenge will be to determine whether such changes constitute the memory trace itself or play a less specific supporting role in the information processing that accompanies memory formation.

Animals↗
PubMed2002

Audit of turnaround times for processing Mycobacterium tuberculosis specimens in a district general hospital.

Automated liquid culture systems, coupled with molecular techniques, have decreased the time required for culture, identification and antibiotic susceptibility testing of Mycobacterium tuberculosis. This audit assessed the turnaround times of a district general hospital (DGH), assisted by the reference laboratory, for processing samples for Mycobacterium tuberculosis. A liquid culture system was in use. The hospital serves an area with a high prevalence of tuberculosis. Request forms and reference laboratory reports were examined for every new laboratory diagnosis of tuberculosis in 2000. Time to result was taken as time from receipt of specimen in the laboratory to date of reporting by reference laboratory. Seventy-two new cases of tuberculosis were culture positive in 2000. Median time to identification was 21.5 days and to antibiotic susceptibility results was 35 days. With liquid culture systems, acceptable turnaround times for processing mycobacteria are achievable, but in many DGHs this equipment is not available.

Cell Culture Techniques↗