Wahrgenommene Effekte spirituellen Heilens: Ergebnisse einer prospektiven Fallserie

Background: The aims of this pilot study were to observe perceived outcomes of spiritual healing in Germany. Patients and Methods: In this prospective case study, we performed qualitative interviews with clients and healers about perceived outcomes of spiritual healing treatments. A directed qualitative content analysis was used. In addition, we applied questionnaires (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, intensity of complaints on visual analogue scale) at baseline and after week 1, month 2 and month 6 which were analysed descriptively. Results: Seven healers and 7 clients participated, 42 interviews were analysed. In the interviews, the clients described positive body sensations, greater relaxation and well-being as short-term effects of healing treatments. Perceived longer-term effects were related to making significant life changes, creating new meanings, activating resources and improving social relationships. Patients in pain described a reduction of pain intensity. In the questionnaires, the clients reported improvements in quality of life and self-efficacy, to a smaller extent improvements of intensity of complaints and sense of coherence. Conclusion: The results from this pilot study could be useful to choose outcomes of future prospective studies with a larger sample: qualitative assessments combined with global and broad quantitative outcomes such as quality of life, self-efficacy and intensity of complaints could be applied.Hintergrund: Ziel dieser Pilotstudie war es, subjektiv wahrgenommene Effekte des spirituellen Heilens quali­tativ und quantitativ zu erfassen. Patienten und Metho­den: In dieser prospektiven Pilotstudie wurden über 6 Monate qualitative Interviews mit Klienten und Heilern über wahrgenommene Effekte spiritueller Heilbehandlungen geführt und auf Basis einer qualitativen Inhaltsanalyse ausgewertet. Ergebnisse wurden zusätzlich mit Fragebögen (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, Beschwerdeintensität auf visueller Analogskala) zu Studienbeginn und nach der Woche 1, Monat 2 und Monat 6 erfasst. Ergebnisse: Sieben Heiler und 7 Klienten nahmen an dieser Studie teil, 42 ­Interviews wurden analysiert. Klienten beschrieben als kurzfristige Effekte der Heilbehandlungen positive Körperempfindungen, mehr Entspannung und Wohlbefinden. Die längerfristig wahrgenommenen Effekte standen im Zusammenhang mit signifikanten Veränderungen des Lebens, neuen Deutungen, Ressourcenaktivierung und der Verbesserung sozialer Beziehungen durch die Klien­ten. Klienten mit Schmerzen beschrieben eine Verringe­rung der Schmerzintensität. In den Fragebögen zeigten sich Verbesserungen der Lebensqualität und der Selbstwirksamkeit, zu einem geringeren Ausmaß Verbesserungen der Beschwerdeintensität und des Kohärenzgefühls. Schlussfolgerung: Die Ergebnisse dieser Pilotstudie könnten nützlich sein, um Endpunkte für künftige pros­pektive Studien mit einem größeren Stichprobenumfang zu wählen: qualitative Analysen in Kombination mit Fragebögen, die globale und umfassende Aspekte wie Lebensqualität, Selbstwirksamkeit und Intensität der ­Beschwerden erfassen, sind unserer Ansicht nach am besten geeignet

Perceived outcomes of spiritual healing: results from a prospective case series

BACKGROUND: The aims of this pilot study were to observe perceived outcomes of spiritual healing in Germany. PATIENTS AND METHODS: In this prospective case study, we performed qualitative interviews with clients and healers about perceived outcomes of spiritual healing treatments. A directed qualitative content analysis was used. In addition, we applied questionnaires (WHOQOL-BREF, General Self-Efficacy Scale, Sense of Coherence 13, SpREUK-15, intensity of complaints on visual analogue scale) at baseline and after week 1, month 2 and month 6 which were analysed descriptively. RESULTS: Seven healers and 7 clients participated, 42 interviews were analysed. In the interviews, the clients described positive body sensations, greater relaxation and well-being as short-term effects of healing treatments. Perceived longer-term effects were related to making significant life changes, creating new meanings, activating resources and improving social relationships. Patients in pain described a reduction of pain intensity. In the questionnaires, the clients reported improvements in quality of life and self-efficacy, to a smaller extent improvements of intensity of complaints and sense of coherence. CONCLUSION: The results from this pilot study could be useful to choose outcomes of future prospective studies with a larger sample: qualitative assessments combined with global and broad quantitative outcomes such as quality of life, self-efficacy and intensity of complaints could be applied

The Therapeutic Process in Spiritual Healing: Qualitative Results of a Prospective Case Series

Introduction: The aim of this study was to explore the therapeutic process between contemporary spiritual healers and their clients in Germany. Methods: This prospective observational case study was supported by questionnaires and semi-structured interviews with clients and healers from the first encounter through a period of 6 months. The qualitative analysis is based on a directed content analysis with focus in this article on the results relating to the therapeutic process. Results: Seven healers and seven clients were included, and 22 interviews with healers and 20 interviews with clients were conducted. The first treatment session was perceived as laying a foundation for the therapeutic process and the relationship, which was seen as crucial for healing to take place. Healers perceived the therapeutic process as highly individualized and multi-layered, with the perceived effects of spiritual healing sessions layered upon each other. The capacities to connect and to trust were seen as key elements of the healing process. Trust and connection operate multidimensionally: to oneself, to others, and to a transcendent or spiritual source. Clients’ spiritual attitudes were regarded as fundamental resources. Conclusion: The therapeutic process between spiritual healers and their clients was understood as a dynamic and individual activity, building up on a trustful relationship from the first encounter

Extraocular Surgical Approach for Placement of Subretinal Implants in Blind Patients: Lessons from Cochlear-Implants

In hereditary retinal diseases photoreceptors progressively degenerate, often causing blindness without therapy being available. Newly developed subretinal implants can substitute functions of photoreceptors. Retina implant extraocular surgical technique relies strongly on cochlear-implant know-how. However, a completely new surgical approach providing safe handling of the photosensor array had to be developed. The Retina Implant Alpha IMS consisting of a subretinal microphotodiode array and cable linked to a cochlear-implant-like ceramic housing was introduced via a retroauricular incision through a subperiosteal tunnel above the zygoma into the orbit using a specially designed trocar. Implant housing was fixed in a bony bed within a tight subperiosteal pocket in all patients. Primary outcomes were patient short term safety as well as effectiveness. Nine patients participated in the first part of the multicenter trial and received the subretinal visual implant in one eye. In all cases microphotodiode array pull-through procedure and stable positioning were possible without affecting the device function. No intraoperative complications were encountered. The minimally invasive suprazygomatic tunneling technique for the sensor unit as well as a subperiosteal pocket fixation of the implant housing provides a safe extraocular implantation approach of a subretinal device with a transcutaneous extracorporeal power supply

JetViP 1.1: Calculating One- and Two-Jet Cross Sections with Virtual Photons in NLO QCD

JetViP is a computer program for the calculation of inclusive single- and dijet cross sections in eP- and e-gamma-scattering in NLO QCD. The virtuality of the photon, radiated by the incoming electron, can be chosen in a continuous range, reaching from photoproduction into deep inelastic scattering. The various contributions to the full jet cross section, including the resolved photon contributions, are implemented. The calculation is based on the phase-space-slicing method.Comment: 31 pages, LaTeX, 3 eps figure

Interim Results of a Multicenter Trial with the New Electronic Subretinal Implant Alpha AMS in 15 Patients Blind from Inherited Retinal Degenerations

Purpose: We assessed the safety and efficacy of a technically advanced subretinal electronic implant, RETINA IMPLANT Alpha AMS, in end stage retinal degeneration in an interim analysis of two ongoing prospective clinical trials. The purpose of this article is to describe the interim functional results (efficacy). Methods: The subretinal visual prosthesis RETINA IMPLANT Alpha AMS (Retina Implant AG, Reutlingen, Germany) was implanted in 15 blind patients with hereditary retinal degenerations at four study sites with a follow-up period of 12 months (www.clinicaltrials.gov NCT01024803 and NCT02720640). Functional outcome measures included (1) screen-based standardized 2- or 4-alternative forced-choice (AFC) tests of light perception, light localization, grating detection (basic grating acuity (BaGA) test), and Landolt C-rings; (2) gray level discrimination; (3) performance during activities of daily living (ADL-table tasks). Results: Implant-mediated light perception was observed in 13/15 patients. During the observation period implant mediated localization of visual targets was possible in 13/15 patients. Correct grating detection was achieved for spatial frequencies of 0.1 cpd (cycles per degree) in 4/15; 0.33 cpd in 3/15; 0.66 cpd in 2/15; 1.0 cpd in 2/15 and 3.3 cpd in 1/15 patients. In two patients visual acuity (VA) assessed with Landolt C- rings was 20/546 and 20/1111. Of 6 possible gray levels on average 4.6 ± 0.8 (mean ± SD, n = 10) were discerned. Improvements (power ON vs. OFF) of ADL table tasks were measured in 13/15 patients. Overall, results were stable during the observation period. Serious adverse events (SAEs) were reported in 4 patients: 2 movements of the implant, readjusted in a second surgery; 4 conjunctival erosion/dehiscence, successfully treated; 1 pain event around the coil, successfully treated; 1 partial reduction of silicone oil tamponade leading to distorted vision (silicon oil successfully refilled). The majority of adverse events (AEs) were transient and mostly of mild to moderate intensity. Conclusions: Psychophysical and subjective data show that RETINA IMPLANT Alpha AMS is reliable, well tolerated and can restore limited visual functions in blind patients with degenerations of the outer retina. Compared with the previous implant Alpha IMS, longevity of the new implant Alpha AMS has been considerably improved. Alpha AMS has meanwhile been certified as a commercially available medical device, reimbursed in Germany by the public health system

Subretinal electronic chips allow blind patients to read letters and combine them to words

A light-sensitive, externally powered microchip was surgically implanted subretinally near the macular region of volunteers blind from hereditary retinal dystrophy. The implant contains an array of 1500 active microphotodiodes (‘chip’), each with its own amplifier and local stimulation electrode. At the implant's tip, another array of 16 wire-connected electrodes allows light-independent direct stimulation and testing of the neuron–electrode interface. Visual scenes are projected naturally through the eye's lens onto the chip under the transparent retina. The chip generates a corresponding pattern of 38 × 40 pixels, each releasing light-intensity-dependent electric stimulation pulses. Subsequently, three previously blind persons could locate bright objects on a dark table, two of whom could discern grating patterns. One of these patients was able to correctly describe and name objects like a fork or knife on a table, geometric patterns, different kinds of fruit and discern shades of grey with only 15 per cent contrast. Without a training period, the regained visual functions enabled him to localize and approach persons in a room freely and to read large letters as complete words after several years of blindness. These results demonstrate for the first time that subretinal micro-electrode arrays with 1500 photodiodes can create detailed meaningful visual perception in previously blind individuals

Heavy Flavour Hadro-Production from Fixed-Target to Collider Energies

We review the hadro-production data presently available on open charm and beauty absolute production cross-sections, collected by experiments at CERN, DESY and Fermilab. The published charm production cross-section values are updated, in particular for the "time evolution" of the branching ratios. These measurements are compared to LO pQCD calculations, as a function of the collision energy, using recent parametrisations of the parton distribution functions. We then estimate, including nuclear effects of the parton densities, the charm and beauty production cross-sections relevant for measurements at SPS and RHIC energies, in proton-proton, proton-nucleus and nucleus-nucleus collisions. The calculations are also compared with measurements of single D and B kinematical distributions, and DDbar pair correlations. We finish with two brief comments, concerning the importance of beauty production as a feed-down source of J/psi production, and open charm measurements performed using leptonic decays

Heavy-Quark Production in the Target Fragmentation Region

Fixed-target experiments permit the study of hadron production in the target fragmentation region. It is expected that the tagging of specific particles in the target fragments can be employed to introduce a bias in the hard scattering process towards a specific flavour content. The case of hadrons containing a heavy quark is particularly attractive because of the clear experimental signatures and the applicability of perturbative QCD. The standard approach to one-particle inclusive processes based on fragmentation functions is valid in the current fragmentation region and for large transverse momenta $p_T$ in the target fragmentation region, but it fails for particle production at small $p_T$ in the target fragmentation region. A collinear singularity, which cannot be absorbed in the standard way into the phenomenological distribution functions, prohibits the application of this procedure. This situation is remedied by the introduction of a new set of distribution functions, the target fragmentation functions. They describe particle production in the target fragmentation region, and can be viewed as correlated distribution functions in the momentum fractions of the observed particle and of the parton initiating the hard scattering process. It is shown in a next-to-leading-order calculation for the case of deeply inelastic lepton-nucleon scattering that the additional singularity can be consistently absorbed into the renormalized target fragmentation functions on the one-loop level. The formalism is derived in detail and is applied to the production of heavy quarks. The renormalization group equation of the target fragmentation functions for the perturbative contribution is solved numerically, and the results of a case study for deeply inelastic lepton-nucleon scattering at DESY (H1 and ZEUS at HERA), at CERN (NA47) and at Fermilab (E665) are discussed. We also comment briefly on the case of an intrinsic heavy-quark content of the proton.Comment: Habilitationsschrift, Universitaet Hamburg, submitted in April 1996. 118 pages (LATEX); figures are included via epsfig; The AMSTEX fonts are required. See also http://wwwcn.cern.ch/~graudenz/publications.html for a complete (compressed) postscript fil

Tibetan Medicine Off the Roads : Modernizing the Work of the Amchi in Spiti

The central theme of this dissertation is an anthropological analysis of modernization processes of Tibetan medicine in the remote Spiti valley in the north-western Indian Himalayas. The investigation of the politico-economical and socio-cultural change of the daily practices of the physicians of Tibetan medicine (called amchi) refers to Max Weber’s notion of rationalization. The activities of the amchi in modernizing their conditions of work, are therefore especially examined in view of a rational "Zweckorientierung" as well as an increasing bureaucratization (organizational structures, accountancy, control, efficiency). This is framed into a detailed ethnography of the main aspects of amchi medicine – diagnosis, medicine production and administering, and religious practices –, as well as the social and economic aspects of their work. This amchi practice currently observed in Spiti is further confronted with extracts from the Rgyud bzhi, the most important classical text of Tibetan medicine, representations of Tibetan medicine in English literature and interviews with Spiti amchi. The thesis discusses the development of Tibetan medicine in context of the conditions of Spiti valley, that must be understood in medical and political terms, historically as well as contemporarily, as a marginal frontier area. The rapid changes of the social and politico-economic environment, especially the introduction of the capitalist market economy with cash crop-production, wage-labor and commoditization, have led to a depersonalization and individualization of the local society. The social "disembedding" (Giddens) is especially visible in the breakdown of mutual reciprocity (gift exchange) between villagers and amchi, that was earlier the socio-economic basis of the medical work. This has led in combination with further factors, as there are state supported biomedicine, school and college education and the merging of time and space (through road connections to the Indian plains), to a rapid decline of the medical tradition of Spiti valley within the last two decades. To oppose this development the amchi started a process of professionalization (set up of an association and a local clinic) in the late 1990s. Despite the continuing exclusion from public health care, the Indian state supported this process financially and forced a bureaucratization within the association and the clinic, as well as a monetarization of Tibetan medicine. Weber has argued that modernization entails a loss of values, norms and religious practices – a process that has been observed in the rationalization and secularization of Tibetan medicine in its centers in Lhasa and Dharamshala (Adams, Cantwell, Janes, Samuel). In contrast to that, emphasize the Spiti amchi today the local transmission of medical and religious practices in their amchi lineages and substantiate thereby their specific tradition – to be differentiated from other, institutionalized educations – and therefore an explicit, local identity