259 research outputs found
Artifact Biography: A Variable Colour Mixer
Among the artifacts representing early research in experimental psychology at the University of Toronto is a precisely machined steel instrument of German manufacture. The provenance of this variable colour mixer opens onto a largely-forgotten history of research into colour perception that depended heavily on mechanical instruments of the spinning-wheel type. Like the broader practices and principles of experimental psychology, these instruments were widely disseminated during a period in which the German research-based model of university education was widely admired. For most of its early history at the University of Toronto, the experimental laboratory was run by a German, August Kirschmann (1860-1932), who led investigations into the psychological basis for aesthetic judgement, especially as it concerned colour perception. Kirschmann’s hostility to existing art criticism reflected his belief that experimental psychology could provide a coherent foundation to the language of aesthetics
Quality profiling at the TCM Hospital Bad Kötzting - examples from an ongoing systematic patient documentation
BACKGROUND Quality profiling is practiced at the TCM hospital Bad Kötzting since its establishment 25 years ago. The profiling comprises assessment of treatment effectiveness andsafety, structural features, staff qualification as well as diagnostic and therapeutic processes. Findings regarding patients, intervention and outcome profiles are presented by appropriate examples. METHODS Data of each in-patient were systematically collected by physicians and via self-reports at admission, discharge and follow-up. Over the years the system was adjusted several times resulting in a data pool of about 19,000 in-patients by end of 2014. RESULTS Patients are 52 years old on average, 70% are female, and suffering from the main complaint since 7 years (median). The diagnostic spectrum changed over the years according to the development towards a psychosomatic focus. For TCM acupuncture therapy 222 different acupoints were used in 7.7 different localisations on average per individual treatment. The mean intensity of the main complaint decreased clinically relevant (Cohen's d = 1.11 at discharge and 0.93 at follow-up). After the hospital stay the number of days of sick leave declined from 51.3 days by 40% per patient and year. Depressive disorders as most common mental illness decreased significantly decreased significantly at discharge (ICD symptom rating; Cohen's d = -1.01). 29.8% of patients met the criteria for a metabolic syndrome diagnosis according to the International Diabetes Federation (IDF). In this group of cases, triglycerides, cholesterol and blood glucose improved markedly at discharge. DISCUSSION The presented quality control measures clearly contribute to an enhanced transparency in terms of a comprehensive quality profile. The findings from various outcome parameters indicate that patients benefit from the treatment
Beobachtungsstudien im Rahmen eines naturheilkundlichen Klinikverbunds :Teil IV: Methodische Aspekte, Diskussion und Empfehlungen
Objective: Empirical investigation of the influence of patient self-selection during follow-up in a prospective observational study in 4 in-patient facilities for complementary medicine and discussion of further methodological problems. Methods: 2662 patients treated in the 4 hospitals and included in a prospective observational study had been sent follow-up questionnaires 2, 6, and 12 months after admission. Characteristics and therapeutic success at discharge were compared in patients responding and those not responding. Results: Patients not responding to the follow-up questionnaires tended to be older and to assess the benefit of the treatment less positive than patients who responded (hospital one: 56.2% of patients with a follow-up reported a good or very good response to therapy at discharge compared to 37.7% of the patients without a follow-up: hospital two: 63.7% vs. 54.6%; hospital three: 71.1% vs. 65.8%; hospital four: 78,3% vs. 70,9%). Interpretation: When interpreting the results of the observational study a certain degree of bias induced by selection during follow-up has to be taken into account. Discussion: Other methodological problems discussed narratively include spontaneous improvements, reliability of baseline measures, influence of effective cointerventions, side-effects, outcome measures, feasibility, and efficiency. Finally, recommendations for quality management programs in in-patient facilities for complementary medicine are provided
Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background
Background:
Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section. In this study of a predominantly socially deprived population we have sought to prospectively examine the association between antenatal maternal anxiety and socioeconomic background and the development of persistent pain of all sources after caesarean section.
Methods:
Demographic details and an anxiety questionnaire were completed by 205 women before elective caesarean section. On the first postoperative day, pain scores were recorded, and at four months patients were asked to complete a Brief Pain Inventory and an Edinburgh Postnatal Depression Score.
Results:
Of 205 parturients recruited, 186 records were complete at the hospital admission phase and 98 (52.7%) were complete at the four-month follow-up phase. At recruitment, 15.1% reported pain. At four months 41.8% (95% CI 32.1 to 51.6%) reported pain, of whom pain was a new finding in 35.7% (95% CI 26.2 to 45.2%). Antenatal anxiety was not a significant predictor of severity of new pain at four months (P=0.43 for state anxiety, P=0.52 for trait anxiety). However, four-month pain severity did correlate with social deprivation (P=0.011), postnatal depression (P<0.001) and pain at 24 h (P=0.018).
Conclusion:
Persistent pain from a variety of sources after caesarean section is common. Our findings do not support the use of antenatal anxiety scoring to predict persistent pain in this setting, but suggest that persistent pain is influenced by acute pain, postnatal depression and socioeconomic deprivation
Beobachtungsstudien im Rahmen eines naturheilkundlichen Klinikverbunds :Teil III: Zwischenergebnisse der diagnosespezifischen Dokumentation Migräne in der Klinik für TraditionelleChinesische Medizin Kötzting
Objective: To evaluate the course of symtoms and quality of life of migraine patients after treatment with traditional Chinese medicine. Design: Prospective observational study with 12 months follow-up. Patients: 138 consecutive patients diagnosed by a neurologist to have migraine headaches. Intervention: Complex in-patient treatment with traditional Chinese medicine including acupuncture and Chinese drug therapy. Outcomes: Number of days with headaches per month, number, intensity and duration of migraine attacks, concomitant symptoms, quality of life, global assessment and days off work. Results: The number of days with headaches per month decreased from 9 (median) at baseline to 4 at discharge and was 3 at 12 months. Also, for the other outcomes a clear improvement was seen with a slight wash-out tendency in follow-up. Conclusion: The observed patients with long-lasting migraines had a marked benefit from an in-patient treatment with traditional Chinese medicine
A Unit-level Quantile Nested Error Regression Model for Domain Prediction with Continuous and Discrete Outcomes
In this paper we will present recent work on a new unit-level small area
methodology that can be used with continuous and discrete outcomes. The
proposed method is based on constructing a model-based estimator of the
distribution function by using a nested-error regression model for the
quantiles of the target outcome. A general set of domain-specific parameters
that extends beyond averages is then estimated by sampling from the estimated
distribution function. For fitting the model we exploit the link between the
Asymmetric Laplace Distribution and maximum likelihood estimation for quantile
regression. The specification of the distribution of the random effects is
considered in some detail by exploring the use of parametric and non-
parametric alternatives. The use of the proposed methodology with discrete
(count) outcomes requires appropriate transformations, in particular
jittering. For the case of discrete outcomes the methodology relaxes the
restrictive assumptions of the Poisson generalised linear mixed model and
allows for what is potentially a more flexible mean-variance relationship.
Mean Squared Error estimation is discussed. Extensive model-based simulations
are used for comparing the proposed methodology to alternative unit-level
methodologies for estimating a broad range of complex parameters
Tri-snRNP-associated proteins interact with subunits of the TRAMP and nuclear exosome complexes, linking RNA decay and pre-mRNA splicing
Nuclear RNA decay factors are involved in many different pathways including rRNA processing, snRNA and snoRNA biogenesis, pre-mRNA processing, and the rapid decay of cryptic intergenic transcripts. In contrast to its yeast counterpart, the mammalian nuclear decay machinery is largely uncharacterized. Here we report interactions of several putative components of the human nuclear RNA decay machinery, including the TRAMP complex protein Mtr4 and the nuclear exosome constituents PM/Scl-100 and PM/Scl-75, with components of the U4/U6.U5 tri-snRNP complex required for pre-mRNA splicing. The tri-snRNP component Prp31 interacts indirectly with Mtr4 and PM/Scl-100 in a manner that is dependent on the phosphorylation sites in the middle of the protein, while Prp3 and Prp4 interact with the nuclear decay complex independent of Prp31. Together our results suggest recruitment of the nuclear decay machinery to the spliceosome to ensure production of properly spliced mRNA
Beobachtungsstudien im Rahmen eines naturheilkundlichen Klinikverbunds :Teil II: Detaillierte Ergebnisse der Klinik für Traditionelle ChinesischeMedizin Kötzting
Objective: To collect information on patients, interventions and outcomes in a hospital for traditional Chinese medicine in Germany. Design: Prospective observational study with 12 months followup. Patients: All 667 consecutive patients admitted for in-patient treatment in the hospital between December 1994 and July 1995 were documented. The follow-up rate after 12 months was 65.8%. Outcome Measures: Sociodemographic data, diagnoses, duration of complaints, type and frequency of diagnostic and therapeutic interventions, intensity of complaints, assessment of the therapeutic success and quality of life. Results: About two thirds of the patients suffered from chronic pain syndromes (the most frequent single diagnoses were migraine, lumbago, and neck pain/headaches). 72.3% of the patients were female; the median duration since the onset of the disease was 7 years. Almost all patients received acupuncture and treatment with traditional Chinese drugs. 50.3% assessed the therapeutic success as good or very good at discharge; after 12 months this rate was 55.6%. Both intensity of main complaints and psychic and physical aspects of quality of life improved after treatment. After 12 months the improvement was less distinct but still significant. Conclusions: The in-patient treatment provided a clear benefit to the patients. Without a valid comparison with an alternative treatment little can be concluded about comparative effectiveness and efficiency of a treatment in the hospital for traditional Chinese medicine
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