152 research outputs found
Circular instead of hierarchical: methodological principles for the evaluation of complex interventions
Get PDFBackground
The reasoning behind evaluating medical interventions is that a hierarchy of methods exists which successively produce improved and therefore more rigorous evidence based medicine upon which to make clinical decisions. At the foundation of this hierarchy are case studies, retrospective and prospective case series, followed by cohort studies with historical and concomitant non-randomized controls. Open-label randomized controlled studies (RCTs), and finally blinded, placebo-controlled RCTs, which offer most internal validity are considered the most reliable evidence. Rigorous RCTs remove bias. Evidence from RCTs forms the basis of meta-analyses and systematic reviews. This hierarchy, founded on a pharmacological model of therapy, is generalized to other interventions which may be complex and non-pharmacological (healing, acupuncture and surgery).Discussion
The hierarchical model is valid for limited questions of efficacy, for instance for regulatory purposes and newly devised products and pharmacological preparations. It is inadequate for the evaluation of complex interventions such as physiotherapy, surgery and complementary and alternative medicine (CAM). This has to do with the essential tension between internal validity (rigor and the removal of bias) and external validity (generalizability).Summary
Instead of an Evidence Hierarchy, we propose a Circular Model. This would imply a multiplicity of methods, using different designs, counterbalancing their individual strengths and weaknesses to arrive at pragmatic but equally rigorous evidence which would provide significant assistance in clinical and health systems innovation. Such evidence would better inform national health care technology assessment agencies and promote evidence based health reform
First person – Lauren Falkenberg
No full textFirst Person is a series of interviews with the first authors of a selection of papers published in Disease Models & Mechanisms, helping early-career researchers promote themselves alongside their papers. Lauren Falkenberg is first author on ‘
Ccdc103 promotes myeloid cell proliferation and migration independent of motile cilia’, published in DMM. Lauren is a MD/PhD student in the lab of Joshua S. Waxman at Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA, investigating the intersection of rare disease biology, human genetics and immunology
EU FP7 project 'CAMbrella' to build European research network for complementary and alternative medicine
Get PDFBackground: The status of complementary and alternative medicine (CAM) within the EU needs clarification. The definition and terminology of CAM is heterogeneous. The therapies, legal status, regulations and approaches used vary from country to country but there is widespread use by EU citizens. A coordination project funded by the EU has been launched to improve the knowledge about CAM in Europe. Objectives and Methods: The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to establish an EU network involving centres of research excellence for collaborative projects, to develop consensus-based terminology to describe CAM interventions, to create a knowledge base that facilitates the understanding of patient demand for CAM and its prevalence, to review the current legal status and policies governing CAM provision, and to explore the needs and attitudes of EU citizens with respect to CAM. Based on this information a roadmap will be created that will enable sustainable and prioritised future European research in CAM. CAMbrella encompasses 16 academic research groups from 12 European countries and will run for 36 months starting from January 2010. The project will be delivered in 9 work packages coordinated by a Management Board and directed by a Scientific Steering Committee with support of an Advisory Board. Output: The outcomes generated will be disseminated through the project’s website, peer review open access publications and a final conference, with emphasis on current and future EU policies, addressing different target audiences
The problem of prostitution in the medieval Cracow. Iudicium de aedificandis domis pro meretricibus by John Falkenberg
No full textThe author focuses on the question of prostitution in the medieval Cracow in the light of edited-by- himself treaty by John Falkenberg Iudicium de aedificandis domis pro meretricibus. Writing his treaty Falkenberg was trying, at the request of the Municipal Council, answer the following questions: do laws established by people allow the existence of prostitutes, and: can the ruler of the city or councillors build brothels, put prostitutes there and then profit from such business. The text contains a short review of the problem of prostitution in Cracow of that time as well as the explanati of a context in which Falkenberg’s work was written. In the last part of the article, the author presents a two-part edition of the treaty
Servants of the devil or protectors of Christianity and apostles among pagans? Shaping the image of Poland and Poles in the context of steps taken by Wladyslaw II Jagiello’s diplomacy against ‘Satira’ by John Falkenberg
No full textThe author analyses the legal action of the Polish delegation against the Satira by Dominican friar John Falkenberg, which appeared at the Council of Constance (1414–1418). In his work, Falkenberg called for the extermination of the Polish nation as well as the king Wladyslaw Jagiello. He announced that those who would achieve this aim would attain salvation. The Polish delegation, especially Paul Włodkowic and archbishop Nicolas Trąba, made efforts aimed at the recognition of the Dominican’s work as heretical. Falkenberg was arrested and his work was condemned by the Commission of Faith, however it was not recognized as heretical. The new pope Martin V, in turn, did not want the verdict of the commission to become a resolution of the Council. In response, Poles, despite the threat of anathema, at the last session of the Council, appealed against the Satira to the next council, which undermined the authority of the pope. In the article, the author shows the factors which prevented Poles from achieving complete success in the Falkenberg case. He addresses the question whether the determination of the Polish envoys in the defence of honour of their ruler and state in the final days of the council brought positive results in the years after the council. The author gives consideration to the question whether the actions of Polish diplomacy against ‘Satira’ combined with other steps on the international forum contributed to a certain extent to creating Jagiello’s image as the last apostle of the barbarian Europe
Stagmatoptera supplicaria
No full textStagmatoptera supplicaria (Burmeister, 1838) (Fig. 149) Mantis (Acontistes) supplicaria Burmeister, 1838: 542. = Mantis flavipennis Audinet-Serville, 1838: 128. Type locality. Unknown (Rodrigues & Cancello 2016). Records. MUSM: ♂, 230 m, lux, 27.IX.2016, leg. M. Falkenberg, M. Schlemm & R. Mörtter (ex. SMNK); 2 ♂♂, 230 m, lux, 28.IX.2016, leg. M. Falkenberg, M. Schlemm & R. Mörtter (ex. SMNK); 2 ♂♂, 230 m, lux, 02.X.2016, leg. M. Falkenberg, M. Schlemm & R. Mörtter (ex. SMNK); 2 ♂♂, 230 m, lux, 07.X.2016, leg. M. Falkenberg, M. Schlemm & R. Mörtter (ex. SMNK); ♂, 230 m, lux, 09.X.2016, leg. M. Falkenberg, M. Schlemm & R. Mörtter (ex. SMNK). NMB: ♂, 230 m, lux, leg. E.-G. Burmeister, 20. IX.–09.X.2007 (QR-NMB-Mant 1569, ex. ZSM). SMNK: ♂, 230 m, lux, 17.II.1984, leg. M. Verhaagh (SMNK-Mant 09690); ♂, 230 m, 26.IX.2014, leg. R. Mörtter (SMNK-Mant 12800); ♂, 230 m, lux, 28.IX.2014, leg. M. Falkenberg (SMNK-Mant 12548); ♂, 260 m, lux, 07.X.2016, leg. R. Mörtter (SMNK-Mant 12873); 4 ♂♂, 230 m, lux, 16.IV.2018, leg. M. Falkenberg (SMNK-Mant 12793–12796); 3 ♂♂, 230 m, lux, 17.IV.2018, leg. M. Falkenberg (SMNK-Mant 12797–12799); 3 ♂♂, 230 m, 14.IV.2018, leg. R. Mörtter (SMNK-Mant 12801–12803). ZSM: ♂, 230 m, lux, 20.IX.–09.X.2007, leg. E.-G. Burmeister, E. Diller, O. Gruler, M. Breitsameter & T. Kothe (genitalia preparation Rodrigues #GM0070); ♂, 230 m, lux, 20.IX.–09.X.2007, leg. E.-G. Burmeister; 4 ♂♂, 230 m, lux, 02.–18.X.2009, leg. E.-G. Burmeister; ♂, 230 m, lux, V.2013, leg. E. Diller. CSC: ♂, 230 m, lux, 17.IV.2018, leg. M. Falkenberg (ex. SMNK); ♂, 230 m, 20.IX.–06.X.2013, leg. E. Diller (ex. ZSM). Distribution. Bolivia, Brazil, Colombia, Ecuador, French Guiana, Peru, Suriname, Trinidad & Tobago, Venezuela (Rodrigues & Cancello 2016). Remarks. As pointed out by Rodrigues & Cancello (2016), Burmeister (1838) has to be credited as the author of the species, not Stoll (1813). While a female of St. supplicaria is figured in both Stoll (1787) and the 1813 reprint, it is misidentified as St. precaria (Linnaeus, 1758). Very common at the study site.Published as part of Schwarz, Christian J., Ehrmann, Reinhard, Stiewe, Martin B. D., Mörtter, Rolf & Falkenberg, Michael, 2020, Mantodea of Panguana (Insecta: Dictyoptera), pp. 1-66 in Zootaxa 4824 (1) on pages 43-44, DOI: 10.11646/zootaxa.4824.1.1, http://zenodo.org/record/440199
Integrativ hälso- och sjukvård i ett globalt perspektiv
Get PDFHälso- och sjukvården ställs idag inför utmaningar med en åldrande befolkning, kroniska multifaktoriella sjukdomar och mental ohälsa, där vi idag saknar god kunskap om hur vi på bästa sätt behandlar och resurssätter samhället för att klara dessa utmaningar. Världshälsoorganisationen (WHO) menar i sin Traditional Medicine Strategy 2014-2023 att världens länder behöver mobilisera alla goda krafter i samverkan och pekar på den potentialitet som den informella hälso- och sjukvårdssektorn utgör. Den kända placeboforskaren vid Harvard, Ted Kaptchuk menar att det är dags att “move beyond the distinctions of conventional and complementary health care as models opposite to each other” och istället anamma en pluralistisk modell där olika hälsoprofessioner samexisterar och samarbetar, och tillerkänner och accepterar varandras skillnader, fördelar och tillkortakommanden. Motion, kost, massage, akupunktur och mindfulness-baserad kognitiv terapi är några exempel som seglat upp på senare år som möjliga inslag i behandlingen av vissa kroniska sjukdomstillstånd. Sådana komplement är ofta relativt biverkningsfria och kan bidra till en ökad ekonomisk och social hållbarhet, och en sådan ambition, med det bästa från två världar utgör grunden för området integrativ hälso- och sjukvård, som självklart skall vara säker och effektiv och där pragmatiska kliniska prövningar kan bidra till evidensinformerat beslutsfattande
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