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Restricted Versus Unrestricted Search Space : Experience from Mining a Large Japanese Database
(2015)
The aim of this study was to investigate whether standard Big Data mining methods lead to clinically useful results. An association analysis was performed using the apriori algorithm to discover associations among co-morbidities of diabetes patients. Selected data were further analyzed by using k-means clustering with age, long-term blood sugar and cholesterol values. The association analysis led to a multitude of trivial rules. Cluster analysis detected clusters of well and badly managed diabetes patients both belonging to different age groups. The study suggests the usage of cluster analysis on a restricted space to come to meaningful results.
BACKGROUND:
There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease.
OBJECTIVES:
To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain.METHODS: A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events.
RESULTS:
Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS.
CONCLUSIONS:
Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long-term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS.
Background:
Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain.
Methods:
The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3–10 years old) with recurrent pain to find robust predictors.We used multiple logistic regressions to investigate age, gender, socio-economic status(SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain.
Results:
Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life anmental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants
are needed until the results stabilize.
Conclusions:
Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably
identify predictors of health care utilization.
The assessment of somatosensory function is a cornerstone of research and clinical practice in neurology. Recent initiatives have developed novel protocols for quantitative sensory testing (QST). Application of these methods led to intriguing findings, such as the presence lower pain-thresholds in healthy children compared to healthy adolescents. In this article, we (re-) introduce the basic concepts of signal detection theory (SDT) as a method to investigate such differences in somatosensory function in detail. SDT describes participants’ responses according to two parameters, sensitivity and response-bias. Sensitivity refers to individuals’ ability to discriminate between painful and non-painful stimulations. Response-bias refers to individuals’ criterion for giving a “painful” response. We describe how multilevel models can be used to estimate these parameters and to overcome central critiques of these methods. To provide an example we apply these methods to data from the mechanical pain sensitivity test of the QST protocol. The results show that adolescents are more sensitive to mechanical pain and contradict the idea that younger children simply use more lenient criteria to report pain. Overall, we hope that the wider use of multilevel modeling to describe somatosensory functioning may advance neurology research and practice.
Einleitung: Aktuelle Erkenntnisse der Faszienforschung zeigen, dass Faszien weitaus mehr Einfluss auf den menschlichen Bewegungsapparat haben, als bisher angenommen. Besonders die Fascia Thoracolumbalis (FTL) stellt eine große Faszie dar, deren patholo-gische Veränderungen zu Beschwerden im Bereich des unteren Rückens führen können. Auf der Grundlage dieser Erkenntnisse wurde die Behandlungsmethode mit der Foam Roll entwickelt, um Muskeln und Faszien gezielt zu behandeln und Beschwerden vorzubeugen. Beobachtungen zeigen, dass das Foam Rolling die Dehnfähigkeit der Muskulatur verbes-sert. Jedoch wurde bisher nicht untersucht, wie sich Übungen mit der Foam Roll auf die Beweglichkeit der Faszien auswirken. Ziel dieser Studie ist es daher, aufzuzeigen, ob das Foam Rolling Einfluss auf die Beweglichkeit der FTL hat. Zu diesem Zweck wurden sowohl die kurzfristigen, als auch die langfristigen Auswirkungen untersucht.
Methode: Es nahmen 38 Probanden an der Studie teil. Diese wurden in eine Foam Roll Gruppe, eine Placebo- und eine Kontrollgruppe eingeteilt. Das Bewegungsausmaß einer Rumpfflexion von 30° wurde mit Videos eines Ultraschallgerätes, als Grundlage der Unter-suchungen über die Beweglichkeit der FTL, aufgezeichnet. Anschließend erfolgte die Ana-lyse mit der Cross Correlation Software nach Dr. Andrew Dilley. Hierdurch konnte das Bewegungsausmaß der Faszie ermittelt werden. Neben der Faszienbeweglichkeit wurden Messungen bezüglich der lumbalen, sowie thoracolumbalen Flexion und der Mechanosen-sivität einzelner Muskeln durchgeführt. Zur Ermittlung der Werte gab es eine Messung vorab und zehn Minuten nach der Intervention. Die Messwerte wurden sowohl in einen Vorher-Nachher-Vergleich gestellt, sowie in einem Vergleich zwischen den drei Gruppen. Zusätzlich nahmen zwei Probanden an einer Fallstudie teil, deren Ziel es war die langfristi-gen Wirkungen auf die Beweglichkeit der Faszie zu analysieren.
Ergebnisse: Nach der Behandlung mit der Foam Roll verbesserte sich die Beweglichkeit der FTL durchschnittlich um 1,7915 mm (p<0,001). Dagegen konnte in der Placebogruppe (p=0,397) und in der Kontrollgruppe (p=0,861) keine signifikante Verbesserung der Beweg-lichkeit verzeichnet werden. Messungen mit weiteren Messinstrumenten zeigten keine Verbesserungen. Bei den zwei Probanden der Fallstudie konnte, über einen Zeitraum von vier Wochen, eine Verbesserung der Beweglichkeit der FTL festgestellt werden.
Schlussfolgerung: Durch die Anwendung der Foam Roll konnte die Beweglichkeit der Fascia Thoracolumbalis signifikant verbessert werden.
Schlüsselwörter: Fascia Thoracolumbalis, Ultraschall, Foam Roll, Faszienbeweglichkeit
Usability is a core construct of website evaluation and inherently defined as interactive. Yet, when analysing first impressions of websites, expected usability, i.e., before use, is of interest. Here we investigate to what extend ratings of expected usability are related to (a) experienced usability, i.e., ratings after use, and (b) objective usability measures, i.e., task performance. Furthermore, we try to elucidate how ratings of expected usability are correlated to aesthetic judgments. In an experiment, 57 participants submitted expected usability ratings after the presentation of website screenshots in three viewing-time conditions (50, 500, and 10,000 ms) and after an interactive task (experienced usability). Additionally, objective usability measures (task completion and duration) and subjective aesthetics evaluations were recorded for each website. The results at both the group and individual level show that expected usability ratings are not significantly related either to experienced usability or objective usability measures. Instead, they are highly correlated with aesthetics ratings. Taken together, our results highlight the need for interaction in empirical website usability testing, even when exploring very early usability impressions. In our study, user ratings of expected usability were no valid proxy neither for objective usability nor for experienced website usability.
Although national eHealth strategies have existed now for more than a decade in many countries, they have been implemented with varying success. In Germany, the eHealth strategy so far has resulted in a roll out of electronic health cards for all citizens in the statutory health insurance, but in no clinically meaningful IT-applications. The aim of this study was to test the technical and organisation feasibility, usability, and utility of an eDischarge application embedded into a laboratory Health Telematics Infrastructure (TI). The tests embraced the exchange of eDischarge summaries based on the multiprofessional HL7 eNursing Summary standard between a municipal hospital and a nursing home. All in all, 36 transmissions of electronic discharge documents took place. They demonstrated the technical-organisation feasibility and resulted in moderate usability ratings. A comparison between eDischarge and paper-based summaries hinted at higher ratings of utility and information completeness for eDischarges. Despite problems with handling the electronic health card, the proof-of-concept for the first clinically meaningful IT-application in the German Health TI could be regarded as successful.