383 research outputs found
Collegii medici hoc tempore decanus Rudolfus Guilielmus Crausius, phil. + med. D. prax. + chim. profess. publ. collegii laudati senior, lectori benevolo S. D. P.
No full textElektronische Reproduktion von: Collegii Medici hoc tempore Decanus Rvdolfvs Gvilielmvs Cravsivs, Phil. + Med. D. Prax. + Chim. Profess. Publ. Collegii laudati Senior, Lectori benevolo S. D. P.
- [1713]. - [Jena] : Literis Krebsianis. - 8 Seiten. -
Standort: Universität Marburg, Universitätsbibliothek. -
Signatur: VIII B 331 db, 22. -
Fingerprint: e.i- u-r- u-ut n-a- C 1713Q. -
Werktitel: Collegii medici hoc tempore decanus Rudolfus Guilielmus Crausius, phil. + med. D. prax. + chim. profess. publ. collegii laudati senior, lectori benevolo S. D. P. -
Anmerkung: Einladungsschrift zur Disputation des Johann Ludwig Schmid. -
Erscheinungsjahr nach Datierung am Textende: "Anno M DC CXIII. d. 9. April." . -
(Hassiaca)
Digitalisiert 202
Transfer of manualized CBT for social phobia into clinical practice (SOPHO-PRAX) : a study protocol for a cluster-randomized controlled trial
No full textBackground: Cognitive-behavioral therapy (CBT) is generally known to be efficacious in the treatment of social phobia when applied in RCT's, namely when the treatment manual is based on the Clark-Wells approach. However, little is known about the efficacy of manualized treatments in routine clinical practice (Phase IV of psychotherapy research). The present study (SOPHO-PRAX) is a continuation of a large multi-centre randomized clinical trial (SOPHO-NET) and analyses the extent to which additional training practitioners in manualized procedures enhances treatment effect.
Methods: N = 36 private practitioners will be included in three treatment centres and randomly designated to either training in manualized CBT or no specific training. The treatment effects of the therapies conducted by both groups of therapists will be compared. A total of 162 patients (N = 116 completers; N = 58 per condition) will be enrolled. Liebowitz Social Anxiety Scale (LSAS) will serve as primary outcome measure. Remission from social phobia is defined as LSAS total [less than or equal to] 30 points. Data will be collected at treatment begin, after 8, 15, and 25 sessions (50 mins. each), at treatment completion, as well at 6 and 12 months post-treatment.
Discussion: The present CBT trial combines elements of randomized-controlled trials and naturalistic studies in an innovative way. It will directly inform about the incremental effects of procedures established in a controlled trial into clinical practice. Study results are relevant to health care decisions and policy. They may serve to improve quality of treatment, and shorten the timeframe between the development and widespread dissemination of effective methods, thereby reducing health cost expenditures. The results of this study will not only inform about the degree to which the new methods lead to an improvement of treatment course and outcome, but also about whether the effects of routine psychotherapeutic treatment are comparable to those of the controlled, strictly manualized treatments of the SOPHO-NET study. Trial Registration: ClinicalTrials.gov identifier: NCT01388231. This study was funded by the German Federal Ministry of Education and Research (SOPHO-NET: BMBF 01GV0607; SOPHO-PRAX: BMBF 01GV1001)
Do different subjective evaluation criteria reflect distinct constructs?
No full textThis is not the published version. Published version available from: http://journals.lww.com/jonmd/pages/default.asp
Potential risk factors for adverse drug reactions in elderly patients : contribution to safer drug prescribing
No full textBecause of demographic aging the proportion of elderly persons in the population is
increasing, especially in industrialized countries. Increasing age is associated with a
higher prevalence of comorbidities possibly necessitating pharmacotherapy. Elderly
persons are not only treated with more drugs than younger ones, but they are also
more vulnerable to adverse drug reactions (ADRs). The aim of the thesis was to
elucidate potential risk factors that increase the risk for ADRs in the elderly with the
purpose to improve safety of medical treatment. First, the literature was reviewed in
order to get an overview on the potential risk factors already known. It has been
shown that not only physiological changes that affect pharmacokinetic and/or
pharmacodynamic effects of drugs, but also specific drugs and drug classes may
increase the risk for ADRs. Two studies were then performed to evaluate specific
aspects of drug prescribing, which may enhance the risk for ADRs.
In the first study age-specific differences in the prevalence of clinically relevant
potential drug-drug interactions (pDDIs) in ambulatory dyslipidemic patients treated
with a statin were evaluated. Practitioners from different parts of Switzerland
collected data for a total of 2’742 patients treated with a statin which attended their
practice. Medical treatment was screened for clinically relevant pDDIs, defined as a
DDI that could have had a potential serious outcome, using an interactive electronic
drug interaction program. The prevalence of clinically relevant pDDIs was
significantly higher in patients aged ³75 years than in patients aged £54 years
(18.4% versus 7.9%; p < 0.001). This was ascribed to a higher number of diseases
(3.5 versus 2.8; p < 0.001) and pharmacologically active substances prescribed (5.8
versus 3.8; p < 0.001). Beside polypharmacy, also heart failure and arrhythmia have
been identified as risk factors for pDDIs in elderly patients. The more frequent
prescription of cardiovascular drugs with a high potential for drug interactions (e.g.
amiodarone and digoxin) was mainly responsible for the observed increase in statin
and non statin pDDIs.
The aim of the second study was to retrospectively evaluate and compare the
prevalence of potentially inappropriate medication (PIM) use and prescription of
drugs with strong anticholinergic properties in 800 elderly patients hospitalized on
general medical or geriatric wards throughout hospital stay. PIMs as defined by the
Beers criteria and anticholinergic drugs have been associated with a higher risk for
ADRs in patients aged ³65 years. At hospital discharge, geriatric patients had a lower
prevalence of use of PIMs that should generally be avoided than at admission
(15.9% versus 22.1%; p < 0.05), whereas no difference was observed in medical
patients. Overall, the three most prevalent inappropriate drugs/drug classes were
amiodarone, long-acting benzodiazepines and anticholinergic antispasmodics. On
the other hand, geriatric patients were discharged with a higher prevalence of use of
PIMs that should be avoided in the presence of specific underlying diseases
compared to medical patients (23.7% versus 11.7%; p < 0.001). The main reason
was the higher prescription rate of benzodiazepines to patients with a history of falls
and syncope. There was neither a difference in the prevalence of patients with
anticholinergic drugs at admission nor at discharge between medical and geriatric
patients. Compared with internists, geriatricians appeared to be more aware of PIMs
that should generally be avoided. However, the results of this study should be
interpreted with caution, because some of the drugs identified as potentially
inappropriate may in fact be beneficial when the patient’s individual clinical condition
is taken into consideration.
Finally, a patient with lithium intoxication as a result of a drug-drug interaction (DDI)
with rofecoxib is presented. This 68-year-old woman had several risk factors that
finally resulted in the clinical manifestation of the DDI, illustrating well the problems of
pharmacotherapy in the elderly. The already impaired renal function (calculated
creatinine clearance 40 mL/min) deteriorated after the addition of rofecoxib, a
selective cyclooxygenase 2 (COX-2) inhibitor. As a consequence, renal clearance of
lithium was impaired, leading to an accumulation of the drug and symptoms of lithium
intoxication such as vomiting, hypokinesia and tremor. Selective COX-2 inhibitors
seem therefore not to be safer than conventional nonsteroidal anti-inflammatory
drugs concerning their effect on renal function, especially in patients with renal
insufficiency.
Depending on the underlying disease, medical treatment with drugs associated with
a high potential for DDIs and/or ADRs may not always be avoided. Knowledge of the
potential risk can help to take appropriate measures to lower the probability for an
adverse outcome, e.g. close monitoring of the patient, dose adjustment or selection
of an alternative drug
Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?
No full text© 2015 Mundt et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.BackgroundThroughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.Methods150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.ResultsA vast majority of 99 prisoners (66%; 95% CI: 58¿73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45¿61) in inpatient treatment, 62 (41%; 95 CI: 34¿49) in outpatient treatment and 42 (29%; 21¿39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho¿=¿0.27; p¿<¿0.01). Inpatient treatment was described as successfully completed by 56% (N¿=¿41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.ConclusionThe data do not support the notion of a general `mental health treatment gap¿ in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed
Myslenie a konanie, filozofia a životná prax (Thinking and Acting, Philosophy and Life Practice)
No full textThe author of the article is concerned with metaphilosophical problem of defining philosophy in the context of life practice. He investigates terms “thinking” and “acting” in ordinary language. He is pointing out that dichotomy of thinking and acting, or rather philosophy and life practice, is not strictly and clearly defined. The content of this dichotomy is in fact bound to intent, which determines its formulation
Avaliação clínica da fluorescência de dentes naturais
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Florianópolis, 2006.Esta pesquisa teve como objetivo avaliar clinicamente a fluorescência presente nos dentes naturais e a sua relação com a faixa etária. 40 voluntários foram selecionados de acordo com critérios pré-estabelecidos e divididos de acordo com sua faixa etária em 4 grupos (n=10): Grupo 1; de 06 à 14 anos; Grupo 2; de 15 à 29 anos; Grupo 3; de 30 à 44 anos e Grupo 4; de 45 à 59 anos. A refletância espectral e as coordenadas de cor foram mensuradas de acordo com a escala de cor CIELAB da Comissão internacional de Luminosidade (CIE) relativa ao iluminante padrão D65. Foi utilizada a geometria de medição D/8°, com iluminação difusa a 10°, comprimento de onda de 360 a 740nm, com a componente especular exclusa e com a luz ultravioleta excluída e incluída. A fluorescência foi calculada pela diferença na reflectância pela exclusão e inclusão da luz ultra-violeta. A intensidade da fluorescência não foi influenciada pela faixa etária (p>0,05). Apesar do grupo 1 ter apresentado valores de luminosidade estatisticamente maiores (p=0,005), não foi observada relação entre a cor dos dentes e a intensidade de emissão fluorescente. Concluímos que, quando avaliada clinicamente, a fluorescência dos dentes naturais não foi afetada pela idade dos pacientes.The objective of this study was to analyze the fluorescence of natural teeth and its relation with age. 40 volunteers were selected in view of pre- established criteria, and divided in 4 groups according to their age (n=10): Group 1; from 06 to 14 years; Group 2; from 15 to 29 years; Group 3; from 30 to 44 years and Group 4; from 45 to 59 years. Spectral reflectance and color coordinates were measured according to the Commission Internationale de l'Eclairage (CIE) CIELAB color scale relative to the standard illuminant D65. The measurement geometry used was D/8°, with 10° diffuse illumination, 360 to 740nm wavelengths, specular component excluded and ultraviolet light excluded or included. Fluorescence was calculated from the subtraction of the reflectance values by the inclusion and exclusion of the ultraviolet component. The fluorescence intensity was not influenced by the age (p>0.05). Even tough group 1 presented luminosity values statistically higher (p=0.005), no relation was observed between teeth color and intensity of fluorescent emission. We conclude that, when measured in a clinical environment, the fluorescence of natural teeth was not related with patients' age
Genotyping of Cryptosporidium spp. isolated from human stool samples in Switzerland
No full textIn a study to estimate the frequency of Cryptosporidium infections in Switzerland, stool samples from patients found to be positive for Cryptosporidium spp. by modified Ziehl-Neelson staining and fluorescence microscopy were used for genotyping experiments. With 9 of 12 samples, DNA extraction and subsequent genotyping was successful. All Cryptosporidium-isolates belonged to the bovine genotype. In one stool sample, two strains of Cryptosporidium were demonstrated, suggesting a mixed infection. In comparison with reference strains from calves, one of the isolates showed a full sequence identity and the other a similarity of 97.5%. The fact that only bovine genotypes were detected suggests, that cryptosporidiosis must primarily be considered as a zoonotic disease in Switzerland. This is in contrast to other countries, where the human genotype of C. parvum was shown to dominate the epidemiological situation. The results of our study are supported by the previous finding, that two of the analysed strains originated from patients who used to consume raw milk or raw cream, a known risk factor for cryptosporidiosis
Evaluation of rehabilitation impact on hydraulic and environmental performance of sewer systems (WP3 CARE-S Project)
No full text- …
