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Search Results: 1 - 10 of 401429 matches for " M. Esch "
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Patient satisfaction with primary care: an observational study comparing anthroposophic and conventional care
Barbara M Esch, Florica Marian, André Busato, Peter Heusser
Health and Quality of Life Outcomes , 2008, DOI: 10.1186/1477-7525-6-74
Abstract: We collected baseline data on structural characteristics of the physicians and their practices and health status and demographics of the patients. Four weeks later patients assessed their satisfaction with the received treatment (five items, four point rating scale) and evaluated the praxis care (validated 23-item questionnaire, five point rating scale). 1946 adult patients of 71 CON and 32 AM primary care physicians participated.1. Baseline characteristics: AM patients were more likely female (75.6% vs. 59.0%, p < 0.001) and had higher education (38.6% vs. 24.7%, p < 0.001). They suffered more often from chronic illnesses (52.8% vs. 46.2%, p = 0.015) and cancer (7.4% vs. 1.1%). AM consultations lasted on average 23,3 minutes (CON: 16,8 minutes, p < 0.001).2. Satisfaction: More AM patients expressed a general treatment satisfaction (56.1% vs. 43.4%, p < 0.001) and saw their expectations completely fulfilled at follow-up (38.7% vs. 32.6%, p < 0.001). AM patients reported significantly fewer adverse side effects (9.3% vs. 15.4%, p = 0.003), and more other positive effects from treatment (31.7% vs. 17.1%, p < 0.001).Europep: AM patients appreciated that their physicians listened to them (80.0% vs. 67.1%, p < 0.001), spent more time (76.5% vs. 61.7%, p < 0.001), had more interest in their personal situation (74.6% vs. 60.3%, p < 0.001), involved them more in decisions about their medical care (67.8% vs. 58.4%, p = 0.022), and made it easy to tell the physician about their problems (71.6% vs. 62.9%, p = 0.023). AM patients gave significantly better rating as to information and support (in 3 of 4 items p [less than or equal to] 0.044) and for thoroughness (70.4% vs. 56.5%, p < 0.001).AM patients were significantly more satisfied and rated their physicians as valuable partners in the treatment. This suggests that subject to certain limitations, AM therapy may be beneficial in primary care. To confirm this, more detailed qualitative studies would be necessary.The modern vie
The evolution of the global aerosol system in a transient climate simulation from 1860 to 2100
P. Stier, J. Feichter, E. Roeckner, S. Kloster,M. Esch
Atmospheric Chemistry and Physics (ACP) & Discussions (ACPD) , 2006,
Abstract: The evolution of the global aerosol system from 1860 to 2100 is investigated through a transient atmosphere-ocean General Circulation Model climate simulation with interactively coupled atmospheric aerosol and oceanic biogeochemistry modules. The microphysical aerosol module HAM incorporates the major global aerosol cycles with prognostic treatment of their composition, size distribution, and mixing state. Based on an SRES A1B emission scenario, the global mean sulfate burden is projected to peak in 2020 while black carbon and particulate organic matter show a lagged peak around 2070. From present day to future conditions the anthropogenic aerosol burden shifts generally from the northern high-latitudes to the developing low-latitude source regions with impacts on regional climate. Atmospheric residence- and aging-times show significant alterations under varying climatic and pollution conditions. Concurrently, the aerosol mixing state changes with an increasing aerosol mass fraction residing in the internally mixed accumulation mode. The associated increase in black carbon causes a more than threefold increase of its co-single scattering albedo from 1860 to 2100. Mid-visible aerosol optical depth increases from pre-industrial times, predominantly from the aerosol fine fraction, peaks at 0.26 around the sulfate peak in 2020 and maintains a high level thereafter, due to the continuing increase in carbonaceous aerosols. The global mean anthropogenic top of the atmosphere clear-sky short-wave direct aerosol radiative perturbation intensifies to 1.1 W m 2 around 2020 and weakens after 2050 to 0.6 W m 2, owing to an increase in atmospheric absorption. The demonstrated modifications in the aerosol residence- and aging-times, the microphysical state, and radiative properties challenge simplistic approaches to estimate the aerosol radiative effects from emission projections.
Risk of overweight and obesity among migrants in Switzerland  [PDF]
Thomas Volken, Peter Rüesch
Health (Health) , 2012, DOI: 10.4236/health.2012.48082
Abstract: We assessed the risk of overweight and obesity for six large migrant groups in Switzerland. We used population-based survey data form the Swiss Migrant Health Survey 2010 and the Swiss Health Survey 2007. The sample comprised permanent residents aged 17 - 64 years (n = 14,637). Multivariate logistic regressions have been used to estimate odds ratios (OR). Compared with Swiss nationals, the odds of being obese were 1.97 times higher for Turkish nationals (CI-95 1.26, 3.07), 1.73 times higher for Kosovan nationals (CI-95 1.09, 2.74) and 3.42 times higher for Serbs (CI-95 2.28, 5.12). The chance of being obese was not statistically different between Swiss nationals and those from Portugal, Italy, and Germany. The chance of being overweight or obese (BMI ≥ 25) was higher for migrants than for Swiss nationals. The respective odds were 1.54 times higher for nationals from Portugal (CI-95 1.13, 2.11), 2.05 times higher for those from Turkey (CI-95 1.50, 2.78), 2.67 times higher for those from Serbia (CI-95 1.93, 3.68), 2.68 times higher for those from Kosovo (CI-95 2.01, 3.56), and 2.16 times higher for nationals from Italy (CI-95 1.54, 3.02). We suggest that preventive initiatives should take into account the specific needs of migrants as well as the needs of persons with low education from all nationalities.
Health Status Inequality among Immigrants in Switzerland  [PDF]
Thomas Volken, Peter Rüesch
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.46054
Abstract:

Objective: To assess self-rated health and impairments for six large immigrant groups (Germany, Italy, Kosovo, Portugal, Serbia, Turkey) in Switzerland. Methods: We used population-based survey data from the Swiss Migrant Health Survey 2010 and the Swiss Health Survey 2007. The sample comprised permanent residents aged 17 - 64 years (n = 14,637). Multivariate logistic regressions have been used to estimate odds ratios (OR). Results: Ill health and activities of daily living (ADL) impairments were associated with older age in all groups. However, nationals from Turkey and nationals from Kosovo were substantially more likely than Swiss to report ill health (OR = 1.05; CI = 1.02 - 1.09; P = 0.001 and OR = 1.05; CI = 1.01 - 1.10; P = 0.016) and ADL impairments (OR = 1.06; CI = 1.03 - 1.09; P = 0.000 and OR = 1.04; CI = 1.01 - 1.07; P = 0.004) with increasing age. Furthermore, Portuguese women were more likely (OR = 2.65; CI = 1.40 - 5.03; P = 0.003) to report ill health than Swiss women. Conclusions: Immigrant-specific preventive and health promotion initiatives should target vulnerable immigrants from Turkey, Portugal, and Kosovo. Furthermore, groups with few economic and psychosocial resources in the general population of Switzerland should be more involved in interventions to reduce health risk.

Aging and Osteoarthritis: An Inevitable Encounter?
Thomas Hügle,Jeroen Geurts,Corina Nüesch,Magdalena Müller-Gerbl,Victor Valderrabano
Journal of Aging Research , 2012, DOI: 10.1155/2012/950192
Abstract: Osteoarthritis (OA) is a major health burden of our time. Age is the most prominent risk factor for the development and progression of OA. The mechanistic influence of aging on OA has different facets. On a molecular level, matrix proteins such as collagen or proteoglycans are modified, which alters cartilage function. Collagen cross-linking within the bone results in impaired plasticity and increased stiffness. Synovial or fat tissue, menisci but also ligaments and muscles play an important role in the pathogenesis of OA. In the elderly, sarcopenia or other causes of muscle atrophy are frequently encountered, leading to a decreased stability of the joint. Inflammation in form of cellular infiltration of synovial tissue or subchondral bone and expression of inflammatory cytokines is more and more recognized as trigger of OA. It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms. Therefore physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass. A reduced stem cell capacity in the elderly is likely associated with a decrease of repair mechanisms of the musculoskeletal system. New treatment strategies, for example with mesenchymal stem cells (MSC) are investigated, despite clear evidence for their efficacy is lacking. 1. Introduction Half of all persons aged over 65 suffer from osteoarthritis (OA) [1]. As a matter of fact, age is the most prominent risk factor for the initiation and progression of OA. The common explanation for this is the cumulative effect of mechanical load over the years, resulting clinically in “wear and tear” and pathologically in cartilage breakdown [2]. Therefore, OA has been regarded as a naturally occurring, irreversible disorder, rather than a specific, potentially treatable disease. During the last decade, however, it became clearer that OA is not a purely mechanical problem. Inflammatory and metabolic processes are substantially involved in the pathogenesis and progression of OA. Not only cartilage, but also subchondral bone, menisci, muscles as well as fat, and synovial tissues play an important role, notably in the early phase of OA (Figure 1). Therefore, OA has been referred to as a “whole joint disease.” Despite a higher complexity, this concept has not only improved our understanding of the disease but also indicates potentially new treatment strategies. Figure 1: Osteoarthritis as a whole joint disease in the elderly. To understand why aging predisposes to the development of OA, a link between aging processes and the pathological
Can the Future EnMAP Mission Contribute to Urban Applications? A Literature Survey
Wieke Heldens,Uta Heiden,Thomas Esch,Enrico Stein,Andreas Müller
Remote Sensing , 2011, DOI: 10.3390/rs3091817
Abstract: With urban populations and their footprints growing globally, the need to assess the dynamics of the urban environment increases. Remote sensing is one approach that can analyze these developments quantitatively with respect to spatially and temporally large scale changes. With the 2015 launch of the spaceborne EnMAP mission, a new hyperspectral sensor with high signal-to-noise ratio at medium spatial resolution, and a 21 day global revisit capability will become available. This paper presents the results of a literature survey on existing applications and image analysis techniques in the context of urban remote sensing in order to identify and outline potential contributions of the future EnMAP mission. Regarding urban applications, four frequently addressed topics have been identified: urban development and planning, urban growth assessment, risk and vulnerability assessment and urban climate. The requirements of four application fields and associated image processing techniques used to retrieve desired parameters and create geo-information products have been reviewed. As a result, we identified promising research directions enabling the use of EnMAP for urban studies. First and foremost, research is required to analyze the spectral information content of an EnMAP pixel used to support material-based land cover mapping approaches. This information can subsequently be used to improve urban indicators, such as imperviousness. Second, we identified the global monitoring of urban areas as a promising field of investigation taking advantage of EnMAP’s spatial coverage and revisit capability. However, owing to the limitations of EnMAPs spatial resolution for urban applications, research should also focus on hyperspectral resolution enhancement to enable retrieving material information on sub-pixel level.
Functional Characterization Improves Associations between Rare Non-Synonymous Variants in CHRNB4 and Smoking Behavior
Gabe Haller, Ping Li, Caroline Esch, Simon Hsu, Alison M. Goate, Joe Henry Steinbach
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096753
Abstract: Smoking is the leading cause of preventable death worldwide. Accordingly, effort has been devoted to determining the genetic variants that contribute to smoking risk. Genome-wide association studies have identified several variants in nicotinic acetylcholine receptor genes that contribute to nicotine dependence risk. We previously undertook pooled sequencing of the coding regions and flanking sequence of the CHRNA5, CHRNA3, CHRNB4, CHRNA6 and CHRNB3 genes and found that rare missense variants at conserved residues in CHRNB4 are associated with reduced risk of nicotine dependence among African Americans. We identified 10 low frequency (<5%) non-synonymous variants in CHRNB4 and investigated functional effects by co-expression with normal α3 or α4 subunits in human embryonic kidney cells. Voltage-clamp was used to obtain acetylcholine and nicotine concentration–response curves and qRT-PCR, western blots and cell-surface ELISAs were performed to assess expression levels. These results were used to functionally weight genetic variants in a gene-based association test. We find that there is a highly significant correlation between carrier status weighted by either acetylcholine EC50 (β = ?0.67, r2 = 0.017, P = 2×10?4) or by response to low nicotine (β = ?0.29, r2 = 0.02, P = 6×10?5) when variants are expressed with the α3 subunit. In contrast, there is no significant association when carrier status is unweighted (β = ?0.04, r2 = 0.0009, P = 0.54). These results highlight the value of functional analysis of variants and the advantages to integrating such data into genetic studies. They also suggest that an increased sensitivity to low concentrations of nicotine is protective from the risk of developing nicotine dependence.
Evaluation of a Seven-Week Web-Based Happiness Training to Improve Psychological Well-Being, Reduce Stress, and Enhance Mindfulness and Flourishing: A Randomized Controlled Occupational Health Study
T. Feicht,M. Wittmann,G. Jose,A. Mock,E. von Hirschhausen,T. Esch
Evidence-Based Complementary and Alternative Medicine , 2013, DOI: 10.1155/2013/676953
Abstract: Background. As distress in society increases, including work environments, individual capacities to compete with stress have to be strengthened. Objective. We examined the impact of a web-based happiness training on psychological and physiological parameters, by self-report and objective means, in an occupational health setting. Methods. Randomized controlled trial with 147 employees. Participants were divided into intervention (happiness training) and control groups (waiting list). The intervention consisted of a seven-week online training. Questionnaires were administered before, after, and four weeks after training. The following scales were included: VAS (happiness and satisfaction), WHO-5 Well-being Index, Stress Warning Signals, Freiburg Mindfulness Inventory, Recovery Experience Questionnaire, and Flourishing Scale. Subgroup samples for saliva cortisol and alpha-amylase determinations were taken, indicating stress, and Attention Network Testing for effects on attention regulation. Results. Happiness ( ; ), satisfaction ( ; ), and quality of life ( ; ) improved; perceived stress was reduced ( ; ); mindfulness ( ; ), flourishing ( ; ), and recovery experience ( ; ) also increased significantly. No significant differences in the Attention Network Tests and saliva results occurred (intergroup), except for one saliva value. Conclusions. The web-based training can be a useful tool for stabilizing health/psychological well-being and work/life balance. 1. Introduction 1.1. Background Psychology has long been primarily concerned with perception of disorders and negative feelings, but current scientific attention on happiness and the recognition of positive mental states is at an “all-time” high [1, 2]. Reasons for this development are rising levels of psychological pressure and stress at work [3–5], which results in a reduced ability to work due to psychological illnesses. This development is noticeable in Germany. Compared to 1994, the index for days of work missed due to illness increased by 121.1% in 2011 [6]. Since the last decade, researchers increasingly search for answers to the questions of what makes us feel good and how to generate psychological stability and health despite higher work-related demands. Studies showing a link between happiness and vocational success make this a topic of interest for companies and the economy in general as well as for individuals [7]. The investigation of subjective well-being and happiness and the question of whether it is possible to foster positive emotions through training are among the prime topics of
Are Demographic Diversity Effects Spurious?
Stephan Nüesch
Economic Analysis and Policy , 2009,
Abstract: The substantial literature on the relationship between demographic diversity and team performance yields weak and/or inconsistent results. Using match-level data of all games played in the German soccer league Bundesliga over six seasons, this paper analyzes age, race and tenure diversity of the fielded team under different model specifications to test the robustness of demographic diversity effects. The empirical results reveal that the correlations between demographic diversity and the outcome of the game are confounded by mean values of the demographic attributes and contextual covariates.
On the Everett programme and the Born rule
Patrick Van Esch
Physics , 2005,
Abstract: Proponents of the Everett interpretation of Quantum Theory have made efforts to show that to an observer in a branch, everything happens as if the projection postulate were true without postulating it. In this paper, we will indicate that it is only possible to deduce this rule if one introduces another postulate that is logically equivalent to introducing the projection postulate as an extra assumption. We do this by examining the consequences of changing the projection postulate into an alternative one, while keeping the unitary part of quantum theory, and indicate that this is a consistent (although strange) physical theory.
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