Jokumsenquinn0869

The complex correlation structure induced by repeated finite risk set sampling makes the standard resampling procedure for variance estimation fail. We propose a perturbation resampling procedure that provides valid interval estimation for the proposed estimators. Simulation studies show that the proposed method performs well in finite samples. We apply the proposed method to the Nurses' Health Study II to develop and evaluate prediction models using clinical biomarkers for cardiovascular risk.A functional hypersalivation reduces patient's quality of life by the need of repeated changes of cloths, skin damage around the mouth and reduced personal contacts. The indication to treat hypersalivation is justified furthermore when respiratory infections by saliva aspiration occur. Transnasal swallowing endoscopy allows to evaluate sufficiently dysphagia with limited risks. With this method therapy options can be judged for effectiveness. There are other additional radiologic assessments to complete diagnostic. Swallowing therapy should be initiated as first-line approach for hypersalivation and offers several treatment concepts to overcome the syndrome. Glycopyrrolate bromid received approval for children and adolescents as it reduces saliva flow relevantly with limited risk. Other anticholinergic drugs are restricted in use because of their side effects and off-label-use situation. Ultrasound guided injections of botulinum toxine in salivary glands are an established treatment option since decades. Meanwhile, the evidence for this method has improved, so Incobotulinum toxine is an approved therapy for chronic hypersalivation in adults, whereby new injections are needed about every four months. In the light of effective medical options, surgical approaches such as salivary duct relocation are recommended less often today because of invasiveness and failure. Radiotherapy is reserved mainly for neurodegenerative diseases and shows good response, but the cancer induction risks need to be discussed. A close follow-up regime is necessary to establish compliance not only by the patient, but also by his family and caregivers. By this, treatment effects can be optimized and therapies can be adjusted individually.An altered interoception is a central correlate of anorexia nervosa (AN) and addressing this issue offers a promising approach in the treatment of AN. First results have shown the effectiveness of yoga as a body-focused intervention in the treatment of AN. However, to date there is a lack of empirical evidence regarding the question how yoga strategies and yoga elements (postures, relaxation, breath, meditation) should be applied. Against this background, we conducted a qualitative pilot study with n=6 female patients with AN undergoing treatment in a specialist unit supporting re-insertion subsequent to a preceding inpatient AN treatment. Study participants received a weekly one-hour hatha-yoga intervention over at least 12 weeks. Sulbactam pivoxil After the yoga intervention, semi-structured interviews (1/2 to 1 hour) were conducted to assess the experiences of the study participants during the yoga intervention. The data were analyzed using Grounded Theory. At the upper level of analysis, four categories were differentiated information regarding 1) study participants' symptoms, 2) aspects of the setting experienced to be beneficial, 3) yoga strategies perceived to be beneficial and 4) perceived consequences of yoga strategies. With regard to the yoga strategies perceived to be beneficial, analyses revealed 4 subcategories features of 1) postures and movements, 2) breath and meditation exercises, 3) relaxation exercises and 4) general information about the setting. The results give first indications regarding the conceptualization of yoga in the treatment of AN and potential mechanisms. Further qualitative and quantitative studies are needed, e.g., with regard to effectiveness, contraindications, mediators or moderators to better evaluate the potential of yoga in the treatment of AN.

The aim of the study was to show the frequency, localisation, intensity, quality and degree of chronic pain in people with thalidomide-induced congenital defects (thalidomide embryopathy) and to investigate the association with biopsychosocial factors more closely.

A group of 202 people from North Rhine-Westphalia with thalidomide embryopathy were studied for the first time both physically for the pattern of the original damage and also psychiatrically in a structured diagnostic interview (SCID I & SCID II). The results were combined with a standardized pain interview (MPSS) and questionnaires on further pain-related (SF-36, painDETECT) and sociodemographic variables and analysed. In the analysis 167 completed datasets were included.

The prevalence of pain in the sample population was 94%. The majority (107, 54.0%) already showed an advanced stage of chronicity in the MPSS 63 subjects with Stage II (37.7%) and 44 with Stage III (26.3%). In 74 subjects (44.3%) the PainDetect score showed a possible or neuropathic pain component. The factors that most reliably influenced the chronicity of pain proved to be hip pain (p<0.001) and also mental health disorders (p=0.001), above major depression (p<0.001) and also somatic symptom disorders and substance-related disorders (p=0.001 in each case). Social variables proved non-significant here (p=0.094 for living alone, p=0.122 for unemployment, p=0.167 for lack of college education), as did the care situation (p=0.191 for care dependency) and the underlying pattern of organ damage (p=0.229 for damage to hearing, p=0.764 for dysmelia).

People with thalidomide defects frequently suffer from a separate pain disorder which can be seen as secondary thalidomide-induced damage and which requires specialized and personalized multimodal pain management.

People with thalidomide defects frequently suffer from a separate pain disorder which can be seen as secondary thalidomide-induced damage and which requires specialized and personalized multimodal pain management.The transdiagnostic concept of personality structure plays a key role in psychodynamic nosology, since many mental and psychosocial disorders are considered mainfestations of structural vulnerabilities and deficits. Therefore, structural diagnostics is of particular importance, especially with respect to the planning of tailor-made psychotherapeutic interventions. Because changes in personality structure are increasingly being considered as a relevant therapeutic goal, any measures employed towards achieving this goal should be sensitive enough to capture these changes appropriately. Although the short form of the OPD Structure Questionnaire (OPD-SQS) can easily be administered and is therefore frequently used in clinical and research settings, its sensitivity to change has not yet been analyzed. Two large, independent and diagnostically heterogeneous samples of inpatient psychotherapy patients (n=1183 and n=967, respectively) completed the OPD-SQS both at admission and before discharge. Standardized Effect Size (SES), Standardized Response Mean (SRM) and Smallest Real Difference (SRD) were computed as indicators of the measure's ability to capture change.