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Psychologische und genetische Risikofaktoren und Konsequenzen postoperativer Schmerzen
No full textKumulative Dissertation, Otto-Friedrich-Universität Bamberg, 2016Zusammenfassung
Die vorliegende publikationsbasierte Dissertation umfasst eine Literaturübersicht und zwei klinische Studien, die in drei unabhängigen Publikationen veröffentlicht wurden. Die Publikationen werden zu Beginn des jeweiligen Kapitels zitiert, der die Inhalte der entsprechenden Publikation darstellt. Die vorliegende Dissertation befasst sich mit den wechselseitigen Beziehungen zwischen psychologischen und geneti-schen Risikofaktoren und dem postoperativen Schmerz. Das Ziel dieser Arbeit ist die Ermittlung klinisch relevanter Aussagen zur Verbesserung der Identifikation von Patienten mit erhöhtem Risiko für die Entwicklung chronischer Schmerzen infolge eines chirurgischen Eingriffs. Als Modell für postoperative Schmerzen wurde in den klinischen Studien die kosmetische Korrektur einer angeborenen Deformität des Brustkorbs, bekannt als Trichterbrust, verwendet. Diese Patienten sind jung und weisen präoperativ keine schwerwiegende Schmerzerfahrung auf. Aus diesem Grund bot dieses Operationsmodell herausragende Bedingungen für die Untersuchung des Übergangs zum chronischen Schmerz.
Aus der Literaturübersicht erwies sich das Auftreten chronischer Schmerzen nach Operationen als ein häufiges Phänomen mit einer Abhängigkeit der Epidemiologie von der Art des chirurgischen Eingriffs. Depressivität, sowie schmerzspezifische psychologische Faktoren zeigten eine starke Aussagekraft als Risikofaktoren. Die selbstberichtete Hypervigilanz im Sinne eines Monitoring des Schmerzes schien ein Risikofaktor für die langfristige schmerzassoziierte Beeinträchtigung darzustellen [Dimova, V. & Lautenbacher, S. (2010). Chronische Schmerzen nach Operationen. Epidemiologie unter besonderer Berücksichtigung psychologischer Risikofaktoren. AINS 45, 488-494]. In Studie 1 lieferten ausgewählte schmerz-assoziierte genetische Polymorphismen einen schwachen Beitrag für die Erklärung des Verlaufs postopera-tiven Outcomes bis zu 1 Jahr nach der Trichterbrustoperation. Im Vergleich konnte die selbstberichtete Vigilanz für Schmerz die längerfristig verbleibende Beeinträchti-gung durch den postoperativen Schmerz erklären [Dimova, V., Lötsch, J., Hühne, K., Winterpacht, A., Heesen, M., Parthum, A., Weber, P. G., Carbon, R., Griessinger, N., Sittl, R. & Lautenbacher, S. (2015). Associations of genetic and psychological factors with persistent pain after cosmetic thoracic surgery, Journal of Pain Research, 8, 829-844]. In Studie 2 trug der akute postoperative Schmerz als Konsequenz zur einen unmittelbaren kurzfristigen psychologischen Sensibilisierung in der Patientenpopulation bei. Dieser Befund weist auf die generelle Implikation hin, dass ein ein-maliges intensives Schmerzereignis zur Veränderung kognitiv-emotionaler Prozesse führen kann [Dimova, V., Horn, C., Parthum, A., Kunz, M., Schöfer, D., Carbon, R., Griessinger, N., Sittl, R. & Lautenbacher, S. (2013). Does severe acute pain provoke lasting changes in attentional and emotional mechanisms of pain-related processing? A longitudinal study. PAIN, 154 (12), 2737-2744].
Zusammenfassend hebt die vorliegenden Dissertation folgende drei wissenschaftli-che Befunde hervor: Schmerzspezifische psychologische Risikofaktoren stellen potente Prädiktoren für postoperative Schmerzen dar. Ihr Erklärungswert kann den schmerzassoziierter genetischer Marker übersteigen, wie es für die selbstberichtete Schmerzvigilanz gezeigt wurde. Eine einmalige intensive Schmerzepisode beeinflusst negativ die kognitiv-emotionale Schmerzverarbeitung.Abstract
In the present dissertation, the results of a literature survey and two clinical studies published as three separate scientific publications are reported. The publication corresponding to the respective study is cited at the beginning of the particular chapter describing this study. The aim of the studies was to investigate the relationships between psychological as well as genetic factors and postoperative pain with the purpose to identify patients at risk of developing chronic pain conditions after surgery, in the particular example of thoracic surgery for funnel chest correction. The cosmetic correction of congenital chest malformation known as funnel chest was used as a model for postoperative pain because the patients are usually young and without severe pain experience prior to surgery. These conditions allowed for investigating the relationships between postoperative pain and its risk factors without confounding effects of preoperatively existing pain.
The review of available studies suggested that an alarmingly high proportion of patients undergoing surgery develop chronic pain. The rates depend on the type of surgical manipulation. Mood as well as pain-related cognitive-emotional mechanisms seem to be potential risk factors for the development of chronic pain [Dimova, V. & Lautenbacher, S. (2010). Chronische Schmerzen nach Operationen. Epidemiologie unter besonderer Berücksichtigung psychologischer Risikofaktoren. AINS, 45, 488-494]. In study 1, genetic variants functionally related to pain showed no meaningful impact on the time course of pain intensity and disability up to one year after surgery. They exerted also only small effects on final postoperative outcome. In contrast, a higher level of self-reported pain vigilance was a risk factor for long-lasting pain disability [Dimova, V., Lötsch, J., Hühne, K., Winterpacht, A., Heesen, M., Parthum, A., Weber, P. G., Carbon, R., Griessinger, N., Sittl, R. & Lautenbacher, S. (2015). Associations of genetic and psychological factors with persistent pain after cosmetic thoracic surgery, Journal of Pain Research, 8, 829-844]. In study 2, the acute postoperative pain, representing in this clinical sample a singular major pain episode, provoked in turn changes in cognitive and emotional mechanisms of pain processing that could not outlast the acute postoperative phase. Even if such changes were short-lived, they may act as risk factors that adversely affect the patient’s postoperative recovery [Dimova, V., Horn, C., Parthum, A., Kunz, M., Schöfer, D., Carbon, R., Griessinger, N., Sittl, R. & Lautenbacher, S. (2013). Does severe acute pain provoke lasting changes in attentional and emotional mechanisms of pain-related processing? A longitudinal study. PAIN, 154 (12), 2737-2744].
Summarized, the present dissertation highlights the following aspects: Pain-related psychological risk factors seem to be powerful predictors of postoperative outcome. Their effects on long-term postoperative outcome may even exceed the effects of pain-related genetic markers as shown for the pain vigilance. An intense pain episode such as postoperative pain acts negatively on cognitive-emotional processing
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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