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PubMed1980

Planning an initial expressive sign lexicon for persons with severe communication impairment.

Selecting an initial sign lexicon for an individual requires far more than simply making a list of useful words or translating a spoken lexicon into signs through use of a sign dictionary. It requires knowledge of child language acquisition, knowledge of manual signs and linguistic constraints on their use, and knowledge of the needs and desires of the individual for whom the lexicon is intended. Suggestions of writers such as Holland (1975) and Lahey and Bloom (1977) are studied in terms of their appropriateness for visual-manual communication and are applied to approximately 50 signs most frequently taught to retarded and autistic persons (Fristoe and Lloyd, 1979a) to aid in lexicon planning. Additional signs are proposed for extending this basic list. The resulting sample lexicon is evaluated against the suggestions of Holland and of Lahey and Bloom. Rationales given for determining these selections, deletions, and additions can be applied to modify this initial lexicon to make it better suited for a specific individual.

Autistic Disorder↗
PubMed1983

Amer-Ind transparency.

Objective and reliable transparency comprehension results have been obtained on the citation form of the 193 Amer-Ind signals as presented in the original Amerind Video Dictionary. Transparency ratings, as determined by three different scoring criteria, as well as the most common errors, are presented. While transparency (42-50%) was considerably less than what has been suggested in previous reports (80-88%) it was, nevertheless, well above what has been reported for signs from American Sign Language. Transparency of repetitive signals was significantly higher than that reported for kinetic and static signals. The implications for clinical practice are discussed.

Adult↗
PubMed1975

A comparative computer content analysis of the verbal behavior of institutionalized and noninstitutionalized retarded children.

Previous studies have indicated structural language differences favoring the noninstitutionalized retarded when compared to matched institutionalized retarded children. In this study, a sociological and psychological deficit hypothesis for institutional retardates was explored by using a verbal content analysis system. Unstructured speech samples from 20 institutionalized and 20 noninstitutionalized retarded children were employed using the computerized General Inquirer System and the Harvard III Psychosociological Dictionary. Differences were found between the groups but all except two were negated or attenuated by additional extended manual analysis treatments. The findings of this study do not support a psychological or sociological deficit hypothesis for institutionalized educable retardates as measured by this content analysis system.

Adaptation, Psychological↗
PubMed1977

Auditory/vibratory perception of syllabic structure in words by profoundly hearing-impaired children.

Sixty monosyllabic, disyllabic, and trisyllabic words were recorded and presented at different times through earphones and vibrators to 20 normal-hearing adults and to 20 profoundly hearing-impaired children to evaluate their perception of number of syllables. Vibratory perception by the profoundly hearing-impaired and normal-hearing subjects and auditory perception by the profoundly hearing-impaired subjects all were similar. Their responses could be predicted by counting the number of prominent energy bursts displayed on the screen of a storage oscilloscope. The subjects' responses obtained under these conditions differed considerably from normal auditory perception, which could be predicted by "dictionary criteria" for syllabification. These findings suggest the need for a special perceptual viewpoint in teaching stress or prosody to profoundly hearing-impaired children.

Acoustic Stimulation↗
PubMed1995

Qualitative developments in the content and form of children's definitions.

This research examined qualitative developments in school-age children's (N = 96) expressible knowledge of a sample of 434 words selected to represent the contents of a large unabridged dictionary. Definitions were classified according to the quality of both semantic content and syntactic form. Analyses revealed developmental increases in the proportions of known words and in the relative proportions of definitions credited for high-quality content and/or form. Children generally were more successful in expressing precise semantic content than in using conventional syntactic form. The work characteristics of part of speech and morphological composition also affected definitional quality, with coordination of high-quality content and form achieved earlier for root and compound nouns than for inflected and derived nouns for verbs and adjectives of all morphological types. Both lexical organization and differential experience may support the earlier use of conventional definitional form for root and compound nouns than for other word types. The results provide a more complete picture of the development of definitional skills.

Child↗
PubMed1999

Defining abstract entities: development in pre-adolescents, adolescents, and young adults.

Students ages 12, 15, 18, and 23 (n = 60 per group) wrote definitions for 16 abstract nouns (e.g., pride, courage, realization). Responses were analyzed for the Aristotelian style, a type of definition that mentions both the superordinate category term and one or more characteristics of the word (e.g., "Pride is a sense of delight about a possession or accomplishment"). This response type was of interest because it is a sophisticated and literate defining style that is modeled in classrooms, textbooks, and dictionaries-a style that is informative, concise, and efficient. The results indicated that a number of important changes occur in the ability to provide Aristotelian definitions for abstract nouns during the developmental period from late childhood to early adulthood. Specifically, there was an increasing tendency for students to mention the appropriate category to which a word belongs, core features of the word, and subtle aspects of meaning. The study contributes to the knowledge base concerning the nature of language development in pre-adolescents, adolescents, and young adults.

Adolescent↗
PubMed1993

Development and testing of the autobiographical memory coding tool.

Development and testing of the autobiographical memory coding tool (AMCT) is detailed. The tool uses quantitative content analysis procedures to code interpretations of autobiographical memories as validating or lamenting. Development of a system of measuring autobiographical memories from transcribed reminiscence interviews involved defining the units of analysis, defining the categories and themes, constructing a codebook, assessing content validity, assessing reliability and making revisions. Thirty-nine transcripts of reminiscence interviews were used for tool development and testing. The AMCT contains a series of step-by-step guidelines for conducting the analysis and includes an autobiographical memory thematic dictionary and descriptions of range and variations in each theme to assist with coding data. Intercoder reliability estimates were 0.93, 0.93 and 0.95. Test-retest reliability was 1.00.

Abstracting and Indexing↗
PubMed2001

Intuition: an important tool in the practice of nursing.

AIM: The aim of the study reported here was to evaluate the role of intuition, to examine nurses' understanding of intuition and their perceptions of their use of intuition, and to assess the impact of intuition on nursing practice. BACKGROUND: When we read the dictionary definition of intuition, we have a sense of the meaning but there is also a sense of something still not quite defined. Yet we instinctively know what intuition is. That is, of course, an example of intuition in itself: an understanding of the concept based on our feelings, knowledge and experience. Intuition is a concept neither clearly articulated nor adequately theorized in nursing. There is evidence to suggest that practising nurses use intuition and that its use can change outcomes for patients. Because of its influence on patient well being, it needs to be recognized as an important tool in the practice of nursing. The very nature of intuition determines that there will be little agreement on a precise definition and little empirical evidence to support its existence or worth. Neither of these issues detracts from the fact that intuition is an important part of nursing. METHODS: Grounded theory was used as the overarching theoretical and methodological framework for this study. Using focus group interviews and the Delphi survey technique, data were collected from 262 Registered Nurses who volunteered to take part in the study. FINDINGS: The theory that emerged from this study provides nurses with a way of articulating their understanding of intuition and their perceptions of its use in nursing practice. CONCLUSIONS: Intuition is not some mystical power that appears from nowhere, with no rational explanation or basis. The findings from this study show that it is a product of the synergy that occurs as a result of the interaction of a number of factors.

Attitude of Health Personnel↗
PubMed2002

Towards clarification of the meaning of spirituality.

BACKGROUND: Rhetoric about spirituality and nursing has greatly increased, as scientific-based approaches are not fully able to address many human problems, such as persistent pain. Despite the renewed interest and growing literature on spirituality, there is no consensus on a definition of this concept. There is also ambiguity on how this concept is incorporated into nursing practice, research, and education. AIM: This paper aims to contribute toward clarification of the meaning of spirituality in relevance to health and nursing today through a conceptual analysis process. METHODS: Information was obtained through dictionary definitions and electronic database searches of literature on spirituality spanning the past 30 years. The criteria for selection included scholarly articles and books with a definition of spirituality, and research studies that investigated the meaning of spirituality to individuals' health. A total of 76 articles and 19 books were retrieved for this analysis. FINDINGS: Spirituality is an inherent component of being human, and is subjective, intangible, and multidimensional. Spirituality and religion are often used interchangeably, but the two concepts are different. Spirituality involves humans' search for meaning in life, while religion involves an organized entity with rituals and practices about a higher power or God. Spirituality may be related to religion for certain individuals, but for others, such as an atheist, it may not be. CONCLUSION: In order to provide clarity and enhance understanding of this concept, this analysis delineates antecedents, attributes, constructed case examples, empirical referents, and consequences of spirituality. A proposed definition of spirituality emerged from this process, which may be applied broadly. Implications for nursing practice, education, and research are discussed.

Holistic Nursing↗
PubMed2000

National breast surgery audit.

BACKGROUND: Surgical audit is routinely conducted throughout the surgical community in order to examine practice in a peer-review environment. A national audit for breast cancer surgery has been implemented in Australia and New Zealand. It aims to standardize the way in which surgical activities are recorded. The present paper describes the development and implementation of the audit project. METHODS: An audit kit including instruction manual, data dictionary and choice of two data collection instruments (paper or database) were distributed among participants. Surgeons record their patients prospectively, submit data to central office and provide feedback. RESULTS: Information on 3000 breast cancer patients has been collected within the first 6 months. CONCLUSION: The project has been successfully implemented and is continuing to develop. Many surgeons have incorporated the patient record forms in their routine case management activities. Comments and other submissions have been reviewed and changes incorporated into the second and subsequent releases of the kit.

Breast Neoplasms↗
PubMed2000

The pharmacovigilance of tamsulosin: event data on 12484 patients.

OBJECTIVE: To determine drug effectiveness and adverse effects in a noninterventional observational cohort study of over 10 000 patients treated with tamsulosin in general medical practice. METHODS: Using prescription-event monitoring, data were collected of all prescriptions for tamsulosin issued nationally during June 1996 to January 1998. For each patient entered into the cohort a computerized longitudinal record of exposure was constructed. The outcome data, patient information and an opinion about the effectiveness of the drug were provided by the prescriber, using a standard questionnaire sent 6 months after the initial prescription for tamsulosin. The incidence of each of almost 2000 events listed in the Drug Safety Research Unit computerized dictionary was calculated and scrutinized by medical assessors for possible adverse reactions, and any difference determined between the incidence of each event in the first month and subsequent months of exposure. All deaths were followed up to detect possibly drug-related causes. RESULTS: Event data were obtained on 12484 patients, from the 52.9% of questionnaires returned and that contained valid event data. Tamsulosin was reported to have been effective in 7428 (78.3%) of the 9487 patients in whom the general practitioners expressed an opinion about effectiveness. Suspected adverse drug reactions were reported in only 171 (1.4%) of the cohort. Dizziness, headache, malaise and hypotension were common to the reported adverse reactions, reasons for stopping the drug and events of greatest incidence density. None of the 282 deaths that occurred in this elderly cohort were attributed to the drug. CONCLUSION: This study suggests that tamsulosin has a highly acceptable benefit-to-risk ratio. No untoward features not already mentioned in the prescribing guidance were identified.

Adolescent↗
PubMed2001

Finasteride and tamsulosin used in benign prostatic hypertrophy: a review of the prescription-event monitoring data.

OBJECTIVE: To review the results of non-interventional observational cohort studies of 14 772 patients treated with finasteride and 12 484 patients treated with tamsulosin, both studies being of national proportions and undertaken in general medical practice in England. METHODS: Both studies were undertaken by prescription-event monitoring (PEM), whereby the exposure data are derived from information provided in strict confidence by the Prescription Pricing Authority of the National Health Service. The outcome data are derived from 'green form' questionnaires completed by the prescribing general practitioners (GPs). Additional data are obtained by medical follow-up with the attending practitioners. Adverse experience was measured in three ways; as reports of events which the doctors considered to represent adverse drug reactions; as reports of reasons for stopping the drug; and by studying the incidence density of each reported event. For these purposes a computerized dictionary containing 1430 higher level terms was used. The duration of exposure in the finasteride study was approximately 1 year and was approximately 6 months in the tamsulosin study. RESULTS: The outcome data on the 14 772 and 12 484 patients treated in the finasteride and tamsulosin studies were derived from the 63% and 57.4% of the green forms sent out and returned, respectively. The finasteride cohort included two women and the tamsulosin cohort 70 women. The mean (SD) age of the men in the two cohorts was, respectively, 69.0 (9.2) and 66.2 (11.7) years. Both drugs were well tolerated on long-term therapy and 69.6% (10 274 patients) of the total finasteride and 62.0% (7739 patients) of the total tamsulosin cohort were still receiving the drug at the end of 6 months. In the finasteride study, impotence or ejaculatory failure was reported in 2.0% of the patients still receiving the drug; there were reports of decreased libido in 1.0% and gynaecomastia was reported whilst the drug was still being prescribed in 39 patients (0.3% of the cohort). With tamsulosin, uncommon cases of dizziness, headache, malaise and hypotension (89 reports in 12 484 patients, i.e. 0.7% of the cohort) were common to the findings of reported adverse reactions, reasons for stopping the drug and events of highest incidence density. None of the deaths which occurred in either of these large cohorts was attributed by either the reporting GPs or the PEM medical staff to the drugs examined. Conclusion The GPs rated the drugs effective in most patients; tolerance and adverse experience was consistent with the known pharmacology of the two drugs. No serious, unexpected adverse effects were identified.

Adrenergic alpha-Antagonists↗
PubMed2002

Central nervous system-active medications and risk for falls in older women.

OBJECTIVES: To determine whether current use of central nervous system (CNS)-active medications, including benzodiazepines, antidepressants, anticonvulsants, and narcotics, increases the risk for subsequent falls. DESIGN: Prospective cohort study. SETTING: Four clinical centers in Baltimore, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania. PARTICIPANTS: Eight thousand one hundred twenty-seven women aged 65 and older participating in the fourth examination of the Study of Osteoporotic Fractures between 1992 and 1994. MEASUREMENTS: Current use of CNS-active medications was assessed with an interviewer-administered questionnaire with verification of use from medication containers. A computerized dictionary was used to categorize type of medication from product brand and generic names. Incident falls were reported every 4 months for 1 year after the fourth examination. RESULTS: During an average follow-up of 12 months, 2,241 women (28%) reported falling at least once, including 917 women (11%) who experienced two or more (frequent) falls. Compared with nonusers, women using benzodiazepines (multivariate odds ratio (MOR) = 1.51, 95% confidence interval (CI) = 1.14-2.01), those taking antidepressants (MOR = 1.54, 95% CI = 1.14-2.07), and those using anticonvulsants (MOR = 2.56, 95% CI = 1.49-4.41) were at increased risk of experiencing frequent falls during the subsequent year. We found no evidence of an independent association between narcotic use and falls (MOR = 0.99 for frequent falling, 95% CI = 0.68-1.43). Among benzodiazepine users, both women using short-acting benzodiazepines (MOR = 1.42, 95% CI = 0.98-2.04) and those using long-acting benzodiazepines (MOR = 1.56, 95% CI = 1.00-2.43) appeared to be at greater risk of frequent falls than nonusers, although the CIs overlapped 1.0. We found no evidence to suggest that women using selective serotonin-reuptake inhibitors (MOR = 3.45, 95% CI = 1.89-6.30) had a lower risk of frequent falls than those using tricyclic antidepressants (MOR 1.28, 95% CI = 0.90-1.84). CONCLUSIONS: Community-dwelling older women taking CNS-active medications, including those taking benzodiazepines, antidepressants, and anticonvulsants, are at increased risk of frequent falls. Minimizing use of these CNS-active medications may decrease risk of future falls. Our results suggest that fall risk in women taking benzodiazepines is at best marginally decreased by use of short-acting preparations. Similarly, our findings indicate that preferential use of selective serotonin-reuptake inhibitors is unlikely to reduce fall risk in older women taking antidepressants.

Accidental Falls↗
PubMed2001

[The measurement of anxiety through computerized content analysis--automation of the Gottschalk-Gleser Test].

The Gottschalk-Gleser Content analysis for the measurement of anxiety and hostility has proven to be a valid and reliable content analytic method for the quantification of affects in many studies. It was used world-wide, German scales have been available since 1980. Especially in the field of psychosomatic medicine a lot of research was done. The certain use of this method, however, needs an extensive training and the application takes an enormous amount of time. For these reasons a computer program for the Gottschalk-Gleser analysis was developed in English language, whereas for German texts such a program has not been available up to this date. This report describes the development of a computer based anxiety measurement method in German--the Dresden Anxiety Dictionary (Dresdner Angstwörterbuch, DAW). The DAW is designed as a category system for use with different content analytic software. The test of reliability and validity, using 160 clinical texts, shows that the DAW is a reliable and valid method that can be used in different fields.

Anxiety↗
PubMed1991

[Placebos: aspects in medical history and approaches to definition].

The historic roots of the term placebo, its development from religious to secular use and finally its establishment as a medical terminus at the end of the 18th century are described. After the first and rare placebo publications in the 30ties and 40ties a sudden increase in the number of published placebo articles took place since 1950. In the following decades the progress in experimental placebo investigations was overwhelming and placebo phenomena more and more became a subject of scientific inquiry in its own. An overview of the experimental results of this period concerning the efficacy and toxicity of placebo interventions is given. Existing attitudes and prejudices to placebos are confronted with hard data from empirical studies. In particular the 'myth of the non-specificity of placebos' will be critical reviewed and reconsidered. Finally, after a short retrospective view to placebo definitions in medical dictionaries since the 19th century the actual controversy between pharmacological and general placebo definitions is outlined. Two modern definitory propositions of Shapiro and Morris, 1978, and Brody, 1980, are presented and discussed in detail.

Germany↗
PubMed2003

29. Immunization.

The medical dictionary defines immunization as the "protection of susceptible individuals from communicable diseases by the administration of a living modified agent, a suspension of killed organisms, or an inactivated toxin." This elegant description can be expanded to include twenty-first century approaches to immunization that include recombinant technology, reassortment virus techniques, live vectors, DNA vaccines, and the expansion of the field to encompass noncommunicable diseases such as Alzheimer's disease, autoimmunity, and tumor immunogenetics. Integral to the success of immunization is our knowledge of the immune system's memory of antigens, yet our understanding of this fundamental feature remains limited. On a global scale, communicable diseases remain the number-one cause of morbidity and mortality; hence Jenner's pioneering work with its birth in 1796 still has a challenging and exciting future.

Adjuvants, Immunologic↗
PubMed2003

Electrostatic complementarity in an aldose reductase complex from ultra-high-resolution crystallography and first-principles calculations.

The electron density and electrostatic potential in an aldose reductase holoenzyme complex have been studied by density functional theory (DFT) and diffraction methods. Aldose reductase is involved in the reduction of glucose in the polyol pathway by using NADPH as a cofactor. The ultra-high resolution of the diffraction data and the low thermal-displacement parameters of the structure allow accurate atomic positions and an experimental charge density analysis. Based on the x-ray structural data, order-N DFT calculations have been performed on subsets of up to 711 atoms in the active site of the molecule. The charge density refinement of the protein was performed with the program MOPRO by using the transferability principle and our database of charge density parameters built from crystallographic analyses of peptides and amino acids. Electrostatic potentials calculated from the charge density database, the preliminary experimental electron density analysis, DFT computations, and atomic charges taken from the amber software dictionary are compared. The electrostatic complementarity between the cofactor NADP+ and the active site shows up clearly. The anchoring of the inhibitor is due mainly to hydrophobic forces and to only two polar interaction sites within the enzyme cavity. The potentials calculated by x-ray and DFT techniques agree reasonably well. At the present stage of the refinement, the potentials obtained directly from the database are in excellent agreement with the experimental ones. In addition, these results demonstrate the significant contribution of electron lone pairs and of atomic polarization effects to the host and guest mechanism.

Aldehyde Reductase↗
PubMed2003

Reevaluation of human cytomegalovirus coding potential.

The Bio-Dictionary-based Gene Finder was used to reassess the coding potential of the AD169 laboratory strain of human cytomegalovirus and sequences in the Toledo strain that are missing in the laboratory strain of the virus. The gene-finder algorithm assesses the potential of an ORF to encode a protein based on matches to a database of amino acid patterns derived from a large collection of proteins. The algorithm was used to score all human cytomegalovirus ORFs with the potential to encode polypeptides >/=50 aa in length. As a further test for functionality, the genomes of the chimpanzee, rhesus, and murine cytomegaloviruses were searched for orthologues of the predicted human cytomegalovirus ORFs. The analysis indicates that 37 previously annotated ORFs ought to be discarded, and at least nine previously unrecognized ORFs with relatively strong coding potential should be added. Thus, the human cytomegalovirus genome appears to contain approximately 192 unique ORFs with the potential to encode a protein. Support for several of the predictions of our in silico analysis was obtained by sequencing several domains within a clinical isolate of human cytomegalovirus.

Algorithms↗