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Institute
Objective
The aim of this study was to assess the influence of cranio-cervical posture on the maximal mouth opening (MMO) and pressure pain threshold (PPT) in patients with myofascial temporomandibular pain disorders.
Materials and Methods
A total of 29 patients (19 females and 10 males) with myofascial temporomandibular pain disorders, aged 19 to 59 years participated in the study (mean years±SD; 34.69±10.83 y). MMO and the PPT (on the right side) of patients in neutral, retracted, and forward head postures were measured. A 1-way repeated measures analysis of variance followed by 3 pair-wise comparisons were used to determine differences.
Results
Comparisons indicated significant differences in PPT at 3 points within the trigeminal innervated musculature [masseter (M1 and M2) and anterior temporalis (T1)] among the 3 head postures [M1 (F=117.78; P<0.001), M2 (F=129.04; P<0.001), and T1 (F=195.44; P<0.001)]. There were also significant differences in MMO among the 3 head postures (F=208.06; P<0.001). The intrarater reliability on a given day-to-day basis was good with the interclass correlation coefficient ranging from 0.89 to 0.94 and 0.92 to 0.94 for PPT and MMO, respectively, among the different head postures.
Conclusions
The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.
Characteristics of German Hospitals Adopting Health IT Systems : Results from an Empirical Study
(2011)
Hospital characteristics that facilitate IT adoption have been described by the literature extensively, however with controversial results. The aim of this study therefore is to draw a set of the most important variables from previous studies and include them in a combined analysis for testing their contribution as single factors and their interactions. Total number of IT systems installed and number of clinical IT systems in the hospital were used as criterion variables. Data from a national survey of German hospitals served as basis. Based on a stepwise multiple regression analysis four variables were identified to significantly explain the degree of IT adoption (60% explained variance): 1) hospital size, 2) IT department, 3) reference customer and 4) ownership (private vs. public). Our results replicate previous findings with regard to hospital size and ownership. In addition our study emphasizes the importance of a reliable internal structure for IT projects (existence of an IT department) and the culture of testing and installing most recent IT products (being a reference customer). None of the interactions between factors was significant.
The well-documented social gradient in health in the developed world will not just disappear on its own. Tackling health inequalities by introducing a universal coverage healthcare system recently became an important notion in the U.S. Using cross-sectional data from Germany which has maintained its compulsory egalitarian healthcare system for more than 50 years now, we apply logistic and negative binomial regression to uncover utilisation behaviour patterns under universal coverage. We find that lower education and unemployment raise the risks for all diseases under consideration. Unemployment increases the chance of contacting a physician, while income and education do not apparently affect the healthcare utilisation behaviour. Those diseases concentrated among unemployed and less educated, however, are associated with intensified healthcare utilisation. We conclude that universal coverage may make access to health care easier for those facing the worst health; the unemployed and lower educated.
This study examined the relation between employees' perceived extent of change and adaptive performance, focusing on the roles of expressive suppression (i.e. the habit of suppressing overt expressions of emotion) at work and perceived strain. Analysing survey data of 153 employees in Germany with different occupational backgrounds via bootstrapping, the conceptual moderated indirect effect scheme was supported. As hypothesized, greater changes were associated with higher strain. Strain, in turn, was negatively related to adaptive performance. Although extent of change did not directly affect adaptive performance, the data supported the expected indirect relationship via strain. Finally, expressive suppression at work acted as a buffer of this indirect effect: extent of change was only negatively related to strain for employees low in suppression. In line with newer evidence, our results indicate that the suppression of overt emotional expressions at work can have positive effects under certain circumstances.