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PubMed1994

[Body image and the experience of illness--experience of women with breast cancer].

UNLABELLED: This phenomenological study aimed at problematizing the living body as experienced by American women who suffered from breast cancer and underwent chemotherapy. Forty-eight interviews were collected from 18 women over a period of six months for another study. A secondary analysis was performed. It centered on the following three questions: 1. How do bodily changes impact on the women's embodied self-understanding? 2. How does bodily subjection to medical treatments illuminate professional and self's relationships to the body? and 3. What kind of knowledge about the body and the illness do the women express? RESULTS: 1. Central in the patients' accounts were experiences of "I cannot" (any more) or "I can" (again). 2. Illness and bodily subjection to medical interventions influenced the women's relationship with their body. Five different patterns of "I"-body-relationships are described. They varied between "I"-body-oneness and "I"-body distance. 3. The women expressed varying levels of knowledge as they talked about bodily experiences and the illness. Vernacular concepts, medical concepts and complex medical knowledge were expressed. The paper emphasizes the existential importance of "I can" or "I cannot" experiences.

Body Image↗
PubMed1998

[Fenestration of diaphragm for management of persistent postoperative pleural effusion: clinical experience and experiment in rabbits].

UNLABELLED: The management of persistent postoperative pleural effusion is still considered difficult. We report here our experience with such a case, successfully managed with fenestration of the diaphragm-the first of it's kind. Clinical Experience: A two-year-old boy with double outlet right ventricle, underwent right heart bypass procedure. Due to low output and high venous pressure, he was on ventilator until the 26th postoperative day. The pericardial and right pleural effusion persisted till the 60th postoperative day. Right phrenic nerve palsy and atelectasis of right lower lobe were suspected to contribute to it. We performed a plication of the right diaphragm and fenestration of the pericardium and right diaphragm. A T-shaped incision was made on the right diaphragm and the edges were trimmed and strengthened with non-absorbable suture into a circular shaped defect of 1.5 cm diameter. The defect was closed with a Dacron mesh allowing passage of fluid across. Pleural effusion decreased immediately and he was discharged a month after the procedure. Experimental Study: The above procedure was experimented in rabbits in whom a contrast medium injected into the pleural cavity could easily drain into the peritoneum through the fenestation, proved by fluoroscopy. CONCLUSION: Fenestration of the diaphragm is an effective procedure to manage persistent pleural effusion.

Animals↗
PubMed1998

Coherence selection and excitation sculpting using RF-gradients in selective 1D experiments and nonselective 2D experiments

The B0 gradient pulses can be replaced with long high-power pulses (RF-gradients) in z-rotation composite sandwiches. By doing this, practically all B0 gradient-based pulse sequences can be performed with instruments lacking a field gradient accessory. We have implemented RF-gradients into selective 1D and nonselective 2D TOCSY and NOESY experiments. The spectral quality obtained with the RF-gradient method was comparable to that of the B0 method for small- to medium-sized molecules. There are also some advantages in using RF-gradients instead of B0 gradients. There is practically no shift or coupling evolution during RF-gradient pulses. This may be significant in some experiments. Copyright 1998 Academic Press.

Journal Article↗
PubMed1988

Psi experiments: do the best parapsychological experiments justify the claims for psi?

Since the founding of the Society of Psychical Research in 1982, psychical researchers have, in each generation, generated research reports which they believed justified the existence of paranormal phenomena. Throughout this period the scientific establishment has either rejected or ignored such claims. The parapsychologists, with some justification, complained that their claims were being rejected without the benefit of a fair hearing. This paper asks the question of how well the best contemporary evidence for psi--the term used to designate ESP and psychokinetic phenomena--stands up to fair and unbiased appraisal. The results of the scrutiny of the three most widely heralded programs of research--the remote viewing experiments, the psi ganzfeld research, and the work with random number generators--indicates that parapsychological research falls short of the professed standards of the field. In particular, the available reports indicate that randomization is often inadequate, multiple statistical testing without adjustment for significance levels is prevalent, possibilities for sensory leakage are not uniformly prevented, errors in use of statistical tests are much too common, and documentation is typically inadequate. Although the responsible critic cannot argue that these observed departures from optimal experimental procedures have been the sole cause of the reported findings, it is reasonable to demand that the parapsychologists produce consistently significant findings from experiments that are methodologically adequate before their claims are taken seriously.

Evaluation Studies as Topic↗
PubMed1984

Laser myoplasty for hypertrophic cardiomyopathy. In vitro experience in human postmortem hearts and in vivo experience in a canine model (transarterial) and human patient (intraoperative).

The feasibility of performing a myotomy/myectomy for hypertrophic cardiomyopathy (HC) by means of laser phototherapy was evaluated experimentally in vitro and in vivo, and the procedure then applied to a patient intraoperatively. In vitro experience revealed that the beam of an argon laser, delivered directly or via an optical fiber, could both cut and vaporize myocardium, producing a myotomy/myectomy morphologically similar to that produced by the conventional blade technique. In vivo experiments, in which the beam of an argon laser was delivered via an optical fiber to the ventricular septum of a canine heart, confirmed that a laser myoplasty could be achieved in 4 of 5 dogs by a transarterial approach. Finally, laser myoplasty was performed intraoperatively in a patient with HC, using a 200-mu fiber interfaced with an argon laser. Measured laser power was 1.5 W; cumulative exposure was less than 4 minutes; the myoplasty was 4 X 1 X 0.5 cm. These investigations establish the feasibility of using laser therapy to create a myoplasty trough that is similar in appearance to that typically achieved by the conventional blade technique. Illumination of the intraventricular operative field and precise modeling of the myoplasty trough constitute the principal advantages of laser myoplasty for HC.

Adult↗
PubMed1983

Tritiated thymidine experiments in the cat: a description of techniques and experiments to define the time-course of radioactive thymidine availability.

Tritiated thymidine [(3H]thymidine) autoradiographic techniques have been used to define birthdates for cells in a variety of animals. In an effort to include [3H]thymidine experiments in our ongoing studies of visual system development, we have used an intrauterine injection procedure that affords [3H]thymidine labeling of dividing nerve cells in the cat. This report contains a detailed description of the injection procedures used, as well as the results of experiments undertaken to define the period of time during which the exogenous [3H]thymidine introduced by such injections remains available for uptake.

Animals↗
PubMed2004

Confined compression experiments on bovine nucleus pulposus and annulus fibrosus: sensitivity of the experiment in the determination of compressive modulus and hydraulic permeability.

The biphasic material properties for nucleus pulposus tissue in confined compression have not been reported previously, and are required for a better understanding of intervertebral disc function and to provide material properties for use in finite-element models. The aims of this study were to determine linear and non-linear material properties for nucleus pulposus and annulus fibrosus tissues in confined compression, to define the influence of swelling conditions on these properties, and to determine the changes in the compressive modulus and hydraulic permeability induced by the repetition of the stress-relaxation experiment after a return to swelling pressure equilibrium. Specimens from caudal bovine nucleus and annulus were tested in confined compression stress-relaxation experiments and analyzed to quantify the compressive modulus and hydraulic permeability using linear and non-linear biphasic models. Our results suggested the use of confined swelling pre-test condition and non-linear biphasic model, which provided the material parameters with lowest relative variance and water content most representative of physiological conditions. Smaller compressive modulus and higher hydraulic permeability were obtained for the nucleus (H(A0)=0.31+/-0.04 MPa, k(0)=0.67+/-0.09 x 10(-15)m(4)/Ns) than for the annulus (H(A0)=0.74+/-0.13 MPa, k(0)=0.23+/-0.19 x 10(-15)m(4)/Ns), with relatively weak non-linearities. Strains up to 20% resulted in material properties that were significantly altered upon retesting. These altered material properties are an effort to quantify non-recoverable damage that occurs in disc tissue and suggest that in vivo exposure of disc tissues to low strain-rate and high-deformation loading conditions which outpace biological repair may result in altered mechanical behaviors.

Animals↗
PubMed2004

Information versus experience: a comparison of an information leaflet on antidepressants with lay experience of treatment.

The quality of patient information leaflets has been criticised for being too medico centred. Written information produced by a patient organisation should be tailored to members' expressed needs, and based on their experience and therefore useful in helping patients to self-manage their condition. Views expressed in semi-structured interviews with 30 members of a self help group for depression were compared with the content of an antidepressant leaflet produced by the parent organisation. The information leaflet used six frequently asked questions to deliver a biomedical discourse on antidepressants. Members of the group had questions not included in the leaflet around self help, stigma and sense of self, and more complex answers to the six questions. It cannot be assumed that information leaflets written by lay led organisations are patient centred and promote self help. To assist in facilitating concordance between patient and prescriber medicine information leaflets should draw on patient experience of the condition and treatment for it.

Antidepressive Agents↗
PubMed2003

Main results and experience obtained on Mir space station and experiment program for Russian segment of ISS.

This article presents main scientific and practical results obtained in course of scientific and applied research and experiments on Mir space station. Based on Mir experience, processes of research program formation for the Russian Segment of the ISS are briefly described. The major trends of activities planned in the frames of these programs as well as preliminary results of increment research programs implementation in the ISS' first missions are also presented.

Aerospace Medicine↗
PubMed2000

Database of patients' experiences (DIPEx): a multi-media approach to sharing experiences and information.

The Database of Individual Patients' Experience of illness (DIPEx) is a multimedia website and CD-ROM that links patients' experiences with evidence-based information about treatments and the illness itself and with a range of other resources that may be useful, including support groups and links to other websites. DIPEx aims to identify the questions that matter to people when they are ill and it has potential for informing patients, educating healthcare professionals, and providing a patient-centred perspective to researchers and those who manage health services.

Algorithms↗
PubMed2003

Ten year experience with Aspire (Tissuemed) porcine bioprosthesis: single centre experience.

BACKGROUND: Aspire (Tissuemed) bioprosthesis is a third generation porcine bioprosthesis. 10-year outcome of this bioprosthesis is unknown. METHODS: We report our experience of 139 consecutive prosthesis implanted between 1990-1998. The clinical outcome was reviewed retrospectively. RESULTS: 126 patients (67 males and 59 females), mean age 68.4+/-8.4 years underwent 139 valve replacements. Sites of valve implantation included the aortic in 77 patients (61%); mitral in 35 patients (27%); aortic+mitral in 13 patients (10%) and tricuspid in 1 patient (0.8%). 32/126 patients (25%) also underwent concomitant coronary artery bypass grafting (CABG). 30-day mortality for the whole group was 8.7% (11/126) with no valve related deaths. Follow up was 98.4% complete with a mean follow up of 6.1+/-3.3 years (766 patient-years, range 0-10.2 years). Overall 10-year actuarial survival was 41+/-7% (AVR 49+/-10%, MVR 29+/-11%) and this was influenced by pre-operative poor left ventricular function (EF<30%) (p=0.007) and pre-operative NYHA class III/IV (p=0.001). Overall estimated 10-year actuarial freedom from valve related events (Kaplan-Meier) and valve related events expressed as linearised rates (%/patient-year) were: freedom from structural valve failure 97+/-2% (0.26%/patient-year); non-structural dysfunction 98+/-1% (0.13%/patient-year); freedom from prosthetic valve endocarditis 94+/-3% (0.39%/patient-year); freedom from significant haemorrhagic event 82+/-6% (1.33%/patient-year); freedom from thrombo-embolism 90+/-3% (0.91%/patient-year) and freedom from re-operation was 93+/-3% (0.52%/patient-year). CONCLUSION: In our experience Aspire (Tissuemed) porcine bioprosthesis functions satisfactorily at 10-years with low valve related complications. Further follow-up will determine its long-term durability.

Adult↗
PubMed2001

Surgical correction of scaphocephaly: experiences with a new procedure and follow-up investigations.

Introduction: Simple resection of the sagittal suture and the use of alloplastic material or extensive skull resections have long been proven to be unsatisfactory in the treatment of sagittal synostosis. In contrast to these experiences, the immediate correction of skull shape seems to yield the best results without significant morbidity. Patients: Thirty-six scaphocephalic infants with an average age of 6.5 (3.5-14) months underwent operation by our craniofacial team since 1994. Methods: Wide resection of the sagittal suture was used in combination with a bone-strip resection along the coronal and lambdoid sutures. Occasionally partial resection and reshaping of the frontal or occipital bone was necessary to correct an extremely bulging skull. The cranial growth and shape was monitored by anthropometric skull measurements in the last 20 patients. Results: Except in two cases, in which the dura mater was minimally injured intraoperatively, no complications occurred in any patient. Craniofacial oedema always occurred but disappeared after 72 h. The immediate correction of the skull shape was successful in all cases and was completed within 6 months postoperatively. There was no iatrogenic bone defect one year after surgery. Postoperative skull shape and growth was normal. Conclusion: These procedures seem to be effective in the treatment of scaphocephalus. Further normalization of skull shape is achieved by unrestricted postoperative brain growth. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed2004

Exploring the service needs and experiences of persons with TBI and their families: the South Carolina experience.

PRIMARY OBJECTIVE: This article presents the results of four focus groups with persons with traumatic brain injury (TBI) and their families living in South Carolina. The objective was to learn what participants perceive their service needs to be and where they experience service gaps in the existing system of TBI services. METHODS AND PROCEDURES: Four focus groups were conducted. In each group, a convenience sample of persons < 5 years post-injury and family members responded to 10 semi-structured questions. MAIN OUTCOMES: Qualitative content analysis revealed overwhelming consensus regarding the need for (1) early, continuous, comprehensive service delivery; (2) information/education; (3) formal/informal advocacy; (4) empowerment of persons with TBI/families; and (5) human connectedness/social belonging. CONCLUSIONS: Persons with TBI and families in South Carolina experience the service system as unorganized, uneducated, unresponsive and uncaring. Effective strategies are needed that link services into an ongoing continuum of TBI care, increase TBI-specific education and awareness and foster social re-integration.

Adult↗
PubMed2005

The out-of-body experience and body image: differences between experiments and nonexperiments.

The present study sought to examine various aspects of body image for persons reporting a previous out-of-body experience (OBE). A total of 64 people took part in the study, 34 of whom had had an OBE. Participants reporting a previous OBE were found to score significantly higher on measures of body dissatisfaction, social physique anxiety, and somatoform dissociation, and lower on a measure of physical self-presentation. OBE experiments also reported lower levels of body awareness during use of an immersive virtual reality system than nonexperiments.

Adult↗
PubMed2005

Patient choice cesarean--the Maine experience.

BACKGROUND: Patient choice cesarean refers to elective primary cesarean in the absence of a medical or obstetrical indication. The purpose of this study was to determine obstetricians' attitudes and practices with respect to patient choice cesarean in Maine, United States. METHODS: A questionnaire was sent to all Maine Fellows of the American College of Obstetricians and Gynecologists actively practicing obstetrics, after receiving institutional review exemption. Data were analyzed using descriptive statistics, Fisher exact, or chi-square tests. RESULTS: Seventy-eight of 110 (70.9%) obstetricians responded. Of these, 60 of 71 (84.5%) respondents performed or were willing to perform patient choice cesarean. However, 15 of 71 (21.1%) preferred a cesarean delivery for themselves (women) or partners (men). Indications included urinary continence (53.3%), adverse previous birth experience (41.7%), anal continence (35.0%), concern for fetal death or injury (33.3%), and fear of childbirth, preservation of sexual function, or pelvic organ prolapse (26.7% each). Less frequent were pain (11.7%), convenience (8.3%), and provider availability (10.0%). In addition, 82.1 percent believed medical evidence and 85.9 percent believed ethical issues sometimes or always supported patient choice cesarean. Responses were similar by gender, age, and time interval from training completion with two exceptions. Women under age 35 years were more likely to opt for a cesarean delivery themselves (p = 0.04), and 42.9 percent of respondents under age 35 years interpreted the medical literature as supporting cesarean in all cases versus 4.2 percent of older colleagues (p = 0.008). Sixty-four of 78 (82.1%) respondents would find a randomized trial of planned vaginal versus planned cesarean delivery helpful in addressing the issue of patient choice cesarean. CONCLUSIONS: Although Maine obstetricians were willing to perform patient choice cesarean, few preferred this delivery mode for themselves or their partners. A randomized trial of planned vaginal versus planned cesarean delivery is highly desired.

Adult↗
PubMed1997

Comparison of simulation and experiments of different closed-loop strategies for functional electrical stimulation: experiments in paraplegics.

Open-loop and closed-loop stimulation of the knee extensors for the control of the knee joint angle and torque were tested as a potential basis for more complex functional electrical stimulation (FES) systems to be used in human locomotion. The output of the biomechanical simulation model described previously was compared with stimulation experiments in patients with complete thoracic spinal cord injury. Good correspondence between simulation and experiments was obtained under both isometric conditions and conditions with a freely swinging shank. For closed-loop control, a simple proportional integral derivative (PID) controller yielded sufficient performance only under isometric conditions, especially if combined with (linear) feedforward. Because of additional nonlinearities of musculotendon and body segmental dynamics, more complex strategies have to be applied to the control of unconstrained movements. To compensate for these nonlinearities, an inverse model was derived from the direct biomechanical model. This inverse model had satisfactory agreement between the measured knee angle and the desired trajectory already under open-loop conditions. A combination of the inverse model in the feedforward part of the control loop and a PID controller provided robust and precise control of the knee angle. Further improvement may be achieved by including elements of spasticity into the simulation model and by controlling both agonistic and antagonistic muscles.

Biomechanical Phenomena↗
PubMed2003

An arresting experiment: domestic violence victim experiences and perceptions.

This study looks at the experiences and perceptions that domestic violence victims reported with Mills's power model. The victims' partners were the primary research participants in an arrest experiment. The following were empirically examined: the occurrence of violence following suspect arrest, victim perceptions of personal and legal power, victim satisfaction with the police, and victim perceptions of safety following legal intervention. Race and two victim resource measures (i.e., employment status and income advantage) explained variance in perceptions of independence. A police empowerment scale was used to measure legal power. It was found that arrest affected the probability of re-occurring domestic violence. Suspect arrest and the victim's perceptions of legal power were related to perceptions of safety following police intervention. The study concludes with some implications for domestic violence research, programs, and perspectives.

Adult↗
PubMed2002

Modulation and experience of external stimuli: toward a science of experience and interoception.

The concept of interoception can be found in various writing over the past 100 or more years dating back to Sherrington, James and Lange. Professor György Adám that made American scientists increasingly aware of the importance of interoception with his 1967 book Interoception and Behavior. In this article we want to discuss two areas of research from out laboratory that have been influenced from this perspective. First, we will focus on electrocortical correlates of error detection during visuo-motor task and examine the manner in which an individual becomes aware of making an error as well as the way in which this awareness directs behavior on an ongoing basis. Second, we will examine hypnotic modulation of the pain experience and describe the manner in which electrocortical processes reflect the modulation and experience of pain. In this discussion, we suggest the importance of the anterior cingulate in not only modulating these processes in particular but also in its more general role as an interface between the limbic system and the neocortex and the integration of cognitive with emotional stimuli.

Electroencephalography↗