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Subjective Nature (subjective + nature)
Selected AbstractsAdvances in the treatment of root dentine sensitivity: mechanisms and treatment principlesENDODONTIC TOPICS, Issue 1 2006D.G. GILLAM There are limited studies specifically on the prevalence of root dentine hypersensitivity or root sensitivity per se; most of the published information relates to the prevalence of dentine hypersensitivity (DH). Several investigators have suggested that there may be some justification on the basis of differing pathologies of distinguishing between those individuals complaining of DH who have relatively healthy mouths with those who complain of DH as a result of periodontal disease and/or its treatment. It is generally recognized that those individuals diagnosed with periodontal disease and having periodontal therapy including scaling procedures may have a higher prevalence than those who present with healthy mouths and evidence of gingival recession. The availability of a vast array of treatments, however, would indicate either that there is no one effective desensitizing agent for completely resolving the discomfort or that the condition, due to its highly subjective nature, is difficult to treat irrespective of the available treatment options. The importance of implementing preventative strategies in identifying and eliminating predisposing factors in particularly erosive factors (e.g. dietary acids) cannot be ignored if the practitioner is going to treat this troublesome clinical condition successfully. This paper will review the published literature and provide information as to the prevalence of the condition, its etiology and causal factors, as well as recommendations for the clinical management of the problem. [source] Barriers to Satisfactory Migraine Outcomes.HEADACHE, Issue 7 2009What Have We Learned, Where Do We Stand? Barriers to optimal migraine care have traditionally been divided into a number of categories: under-recognition and underconsultation by migraine sufferers; underdiagnosis and undertreatment by health care professionals; lack of follow-up and treatment optimization. These "traditional" barriers have been recognized and addressed for at least 15 years. Epidemiologic studies suggest that consultation, diagnosis, and treatment rates for migraine have improved although many migraine sufferers still do not get optimal treatment. Herein, we revisit the problem, review areas of progress, and expand the discussion of barriers to migraine care. We hypothesize that the subjective nature of pain and difficulty in communicating it contributes to clinical and societal barriers to care. We then revisit some of the traditional barriers to care, contrasting rates of recognition, diagnosis, and treatment over the past 15 years. We follow by addressing new barriers to migraine care that have emerged as a function of the knowledge gained in this process. [source] Workplace performance: a comparison of subjective and objective measures in the 2004 Workplace Employment Relations SurveyINDUSTRIAL RELATIONS JOURNAL, Issue 2 2008John Forth ABSTRACT Understanding what determines workplace performance is important for a variety of reasons. In the first place, it can inform the debate about the UK's low productivity growth. It also enables researchers to determine the efficacy of different organisational practices, policies and payment systems. In this article, we examine not the determinants of performance but how it is measured. Specifically, we assess the alternative measures of productivity and profitability that are available in the 2004 Workplace Employment Relations Survey (WERS). Previous WERS have been an important source of data in research into workplace performance. However, the subjective nature of the performance measures available in WERS prior to 2004 has attracted criticism. In the 2004 WERS, data were again collected on the subjective measure but, in addition, objective data on profitability and productivity were also collected. This allows a comparison to be made between the two types of measures. A number of validity tests are undertaken and the main conclusion is that subjective and objective measures of performance are weakly equivalent but that differences are also evident. Our findings suggest that it would be prudent to give most weight to results supported by both types of measure. [source] Cognitive leisure activities and their role in preventing dementia: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2010Cindy Stern BHSc(Hons) Abstract Background, Dementia inflicts a tremendous burden on the healthcare system. Identifying protective factors or effective prevention strategies may lead to considerable benefits. One possible strategy mentioned in the literature relates to participation in cognitive leisure activities. Aim, To determine the effectiveness of cognitive leisure activities in preventing Alzheimer's and other dementias among older adults. Inclusion criteria Types of participants.,Adults aged at least 60 years of age with or without a clinical diagnosis of dementia that resided in the community or care setting. Types of interventions.,Cognitive leisure activities, defined as activities that required a mental response from the individual taking part in the activity (e.g. reading). Types of outcomes.,The presence or absence of dementia was the outcome of interest. Types of studies.,Any randomised controlled trials, other experimental studies, as well as cohort, case,control and cross-sectional studies were considered for inclusion. Search strategy.,A search for published and unpublished studies in the English language was undertaken with no publication date restriction. Methodological quality, Each study was appraised independently by two reviewers using the standard Joanna Briggs Institute instruments. Data collection and analysis, Information was extracted from studies meeting quality criteria using the standard Joanna Briggs Institute tools. Because of the heterogeneity of populations and interventions, meta-analyses were not possible and results are presented in narrative form. Results, There were no randomised controlled trials located that met inclusion criteria. Thirteen observational studies were included in the review; the majority were cohort design. Because of the heterogeneity of interventions, the study design, the way in which they were grouped and the different stages of life they were measured at, statistical pooling was not appropriate. Studies were grouped by stage of adult life participation when interventions were undertaken, that is, early adulthood, middle adulthood and late life. Five out of six studies showed a positive association between participating in activities and a reduced risk of developing Alzheimer's disease and other dementias when interventions were undertaken in middle adulthood and six out of seven studies produced a positive association for late life participation. Results indicated that some activities might be more beneficial than others; however, results should be interpreted with caution because of the subjective nature of activity inclusion. Conclusion ,,Actively participating in cognitive leisure activities during mid- or late life may be beneficial in preventing the risk of Alzheimer's disease and other dementias in the elderly; however, the evidence is currently not strong enough to infer a direct causal relationship. ,,Participating in selected cognitive leisure activities may be more favourable than others but currently there is no strong evidence to recommend one over the other. [source] The Credibility of Voluntary Disclosure and Insider Stock TransactionsJOURNAL OF ACCOUNTING RESEARCH, Issue 4 2007FENG GU ABSTRACT We examine stock price reaction to voluntary disclosure of innovation strategy by high-tech firms and its relation with insider stock transactions before the disclosure. We find that, despite the qualitative and subjective nature of strategy-related disclosure, there is positive stock price reaction to the disclosure. The evidence suggests that investors view the disclosure as credible good news. We also find that the disclosure is associated with more positive stock price reaction when it is preceded by insider purchase transactions. This evidence is consistent with insider purchase enhancing the credibility of the disclosure. The credibility-enhancing effect is found to be stronger for firms with higher degrees of information asymmetry (younger firms, firms with lower analyst following, loss firms, and firms with higher research and development (R&D) intensity). Our evidence also indicates that predisclosure insider purchase is associated with greater future abnormal returns, suggesting that managers are privy to good news shortly before the disclosure. [source] Supporting user-subjective categorization with self-organizing maps and learning vector quantizationJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 4 2005Dina Goren-Bar Today, most document categorization in organizations is done manually. We save at work hundreds of files and e-mail messages in folders every day. While automatic document categorization has been widely studied, much challenging research still remains to support user-subjective categorization. This study evaluates and compares the application of self-organizing maps (SOMs) and learning vector quantization (LVQ) with automatic document classification, using a set of documents from an organization, in a specific domain, manually classified by a domain expert. After running the SOM and LVQ we requested the user to reclassify documents that were misclassified by the system. Results show that despite the subjective nature of human categorization, automatic document categorization methods correlate well with subjective, personal categorization, and the LVQ method outperforms the SOM. The reclassification process revealed an interesting pattern: About 40% of the documents were classified according to their original categorization, about 35% according to the system's categorization (the users changed the original categorization), and the remainder received a different (new) categorization. Based on these results we conclude that automatic support for subjective categorization is feasible; however, an exact match is probably impossible due to the users' changing categorization behavior. [source] Stratified resampling of phytosociological databases: some strategies for obtaining more representative data sets for classification studiesJOURNAL OF VEGETATION SCIENCE, Issue 4 2005Ilona Knollová Abstract Question: The heterogeneous origin of the data in large phytosociological databases may seriously influence the results of their analysis. Therefore we propose some strategies for stratified resampling of such databases, which may improve the representativeness of the data. We also explore the effects of different resampling options on vegetation classification. Methods: We used 6050 plot samples (relevés) of mesic grasslands from the Czech Republic. We stratified this database using (1) geographical stratification in a grid; (2) habitat stratification created by an overlay of digital maps in GIS; (3) habitat stratification with strata defined by traditional phytosociological associations; (4) habitat stratification by numerical classification and (5) habitat stratification by Ellenberg indicator values. Each time we resampled the database, taking equal numbers of relevés per stratum. We then carried out cluster analyses for the resampled data sets and compared the resulting classifications using a newly developed procedure. Results: Random resampling of the initial data set and geographically stratified resampling resulted in similar classifications. By contrast, classifications of the resampled data sets that were based on habitat stratifications (2,5) differed from each other and from the initial data set. Stratification 2 resulted in classifications that strongly reflected environmental factors with a coarse grain of spatial heterogeneity (e.g. macroclimate), whereas stratification 5 resulted in classifications emphasizing fine-grained factors (e.g. soil nutrient status). Stratification 3 led to the most deviating results, possibly due to the subjective nature of the traditional phytosociological classifications. Conclusions: Stratified resampling may increase the representativeness of phytosociological data sets, but different types of stratification may result in different classifications. No single resampling strategy is optimal or superior: the appropriate stratification method must be selected according to the objectives of specific studies. [source] Multimodal Analgesia for Chronic Pain: Rationale and Future DirectionsPAIN MEDICINE, Issue S2 2009Charles E. Argoff MD ABSTRACT Chronic pain is a multifaceted disease requiring multimodal treatment. Clinicians routinely employ various combinations of pharmacologic, interventional, cognitive,behavioral, rehabilitative, and other nonmedical therapies despite the paucity of robust evidence in support of such an approach. Therapies are selected consistent with the biopsychosocial model of chronic pain, reflecting the subjective nature of the pain complaint, and the myriad stressors that shape it. Elucidating mechanisms that govern normal sensation in the periphery has provided insights into the biochemical, molecular, and neuroanatomic correlates of chronic pain, an understanding of which is leading increasingly to mechanism-specific multidrug therapies. Peripheral and central neuroplastic reorganization underlying the disease of chronic pain is influenced by patient-specific emotions, cognition, and memories, further impairing function and idiosyncratically defining the illness of chronic pain. Clinical perceptions of these and related subjective elements associated with the suffering of chronic pain drive psychosocial treatments, including, among other options, relaxation therapies, coping skills development, and cognitive,behavioral therapy. Treatment selection is thus guided by comprehensive assessment of the phenomenology and inferred pathophysiology of the pain syndrome; patient goals, preferences, and expectations; behavioral, cognitive, and physical function; and level of risk. Experiential, practice-based evidence may be necessary for improving patient care, but it is insufficient; certainly, well-designed studies are needed to support therapeutic decision making. This review will discuss the biochemical basis of pain, factors that govern its severity and chronicity, and foundational elements for current and emerging multimodal treatment strategies. [source] Trust in development: some implications of knowing in indigenous knowledgeTHE JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE, Issue 1 2010Paul Sillitoe The indigenous knowledge (IK) initiative in development has met with limited success. The cultural relativity of knowledge , i.e. what qualifies as justified belief , may partly explain why. Drawing on New Guinea Highlands' ethnography, I explore the implications for dominant capitalist development discourse of constituting and verifying knowledge differently. Trust emerges as a central issue. Highlanders' approach to knowing attends to the subjective nature of understanding and potential for disagreement. The grammar of language , such as that spoken by the Wola of the Southern Highlands Province , reflects these concerns, notably attention to the source/reliability of any professed knowledge. This evidential interest relates to oral traditions, enskilled knowing, and individual knowledge variability, in addition to the trust to be put on any expressed knowledge. It relates also to how stateless political contexts preclude the imposition of views, such as what comprises economic development; albeit what shape an alternative ,acephalous development' might take is currently unclear. Résumé L'initiative sur les savoirs autochtones (indigenous knowledge (IK)) dans le développement n'a connu qu'un succès mitigé. Ce résultat médiocre peut s'expliquer par la relativité culturelle des savoirs, autrement dit de ce qui peut être considéré comme une croyance justifiée. À partir de l'ethnographie des Hautes Terres de Nouvelle-Guinée, l'auteur explore les implications pour le discours capitaliste dominant en matière de développement d'une nouvelle manière de constituer et de valider les connaissances. La confiance s'avère une question centrale dans cette optique. L'approche du savoir par les habitants des Hautes Terres tient compte de la nature subjective de la compréhension et de la possibilité de désaccords. La grammaire de la langue, par exemple de celle des Wolas de la province des Hautes Terres du Sud, reflète ces préoccupations, et notamment l'attention portée à la source et à la fiabilité des connaissances déclarées. Outre la confiance que l'on peut accorder à tout savoir exprimé, cet intérêt pour les preuves est liéà la tradition orale, aux connaissances acquises et à la variabilité des connaissances individuelles. Il est donc aussi corréléà la manière dont des contextes politiques non étatiques empêchent l'imposition d'opinions, telles que celles qui ont trait à ce en quoi consiste le développement économique. Pour autant, la forme que pourrait prendre un mode différent de « développement acéphale » n'est pas nette pour l'instant. [source] Monitoring sedation in the critically ill childANAESTHESIA, Issue 5 2010A. Lamas Summary Sedation is an essential part of the management of the critically ill child, and its monitoring must be individualised and continuous in order to adjust drug doses according to the clinical state. There is no ideal method for evaluating sedation in the critically ill child. Haemodynamic variables have not been found to be useful. Clinical scales are useful when sedation is moderate, but are limited by their subjective nature, the use of stimuli, and the impossibility of evaluating profoundly sedated patients or those receiving neuromuscular blocking drugs; in addition, many of these scales have not been evaluated in children. The COMFORT scale is the most appropriate, as it was designed and validated for critically ill children requiring mechanical ventilation. Electroencephalography-derived methods permit continuous monitoring, provide an early indication of changes in the level of sedation, and facilitate a rapid adjustment of medication. However, these methods were designed and validated for patients under anaesthesia and their results cannot be fully extrapolated to the critically ill patient; in addition, some of them have not been validated in small children and there is still little experience in critically ill children. The main indications for the use of these methods are in patients with deep sedation and/or neuromuscular blockade. The bispectral index is the most widely used method at the present time. Analysis and comparison of the efficacy of the different methods for evaluating sedation in the critically ill child is required. [source] Tadalafil and vardenafil vs sildenafil: a review of patient-preference studiesBJU INTERNATIONAL, Issue 9 2009Vincenzo Mirone The immediate objective of phosphodiesterase type 5 (PDE5) inhibitor treatment is to restore the ability of a man to achieve and/or maintain an erection adequate for sexual intercourse. As erectile dysfunction (ED) generally develops in the second half of life, the ultimate objective generally is not procreation, but quality of sexual life. Indeed, ED is known to impair quality of life considerably; two-thirds of men report that ED has impaired their self-esteem and nearly a third claim that it has damaged the relationship with their partner. It follows that the therapeutic success of PDE5 inhibition has an important subjective component, which is compounded by the subjective nature and complexity of sexual life in humans. This makes it very difficult for physicians to be certain that they have selected the optimal therapy for a couple, even after a thorough evaluation. The 2007 European Association of Urology Guidelines stress the importance of educating the patient and claim that ,the patient will choose the final drug after his own experience'. However, PDE5 inhibitors are typically used twice a week, so a patient would have to spend ,3 months trying the various compounds and dosages to achieve adequate exposure to all three PDE5 inhibitors; this would seem an unrealistic strategy in normal clinical practice. The acknowledgement that the patient has an important role in therapeutic decisions for ED has fuelled interest in the concept of patient preference. It has been established that patient preference depends on three factors, i.e. personal characteristics, e.g. age, duration of ED, frequency and dynamics of sexual relations, and the characteristics of their partners, e.g. age, menopausal status and level of interest in sexual activity and medication profile. Medication features of interest include efficacy in terms of quality of erection, consistency of effects, rapid onset of action, long duration of action, side-effect profile and route of administration; drug costs must also be considered if the medicinal product is not reimbursed. [source] Pruritus measurement and treatmentCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 3 2009M. D. Langner Summary Pruritus measurement is problematic, because of its subjective nature and poor localization. Ratio scales enhance the usefulness of the visual analogue scale (VAS) by reducing variation; other scales such as the generalized labelled magnitude scale may also be useful. Pruritus neuroanatomy includes peripheral receptors, peripheral and central nerves, ascending and descending spinal pathways, and several brain regions. Pruritus receptors include Merkel discs and free nerve endings, and itch receptors have fast or slow adaptation. In this review, we discuss the pathophysiology of pruritus in atopic dermatitis, psoriasis and scabies. Pruritus treatment is reviewed for topical agents and antihistamines. Future research directions are suggested. [source] | |||||||||||||