Biomedical subjects

Thorsten Meyer

Publications and source records attributed to Thorsten Meyer.

8 recordsLinked to original sources

PubMed2006

Missing data due to a 'checklist misconception-effect'.

OBJECTIVES: To analyze the extent and relevance of a postulated "checklist misconception-effect" (a specific response pattern characterized by symptom-free persons not checking the "not at all"-category). METHODS: Our data is derived from a survey of blue collar workers (n = 228) who previously had filed in applications for medical rehabilitation benefits. We defined the "checklist misconception-effect" by the following response pattern: (1) at least one missing value and (2) at least one valid item response and (3) no 'not at all' responses. RESULTS: 75% of the responders had complete data, 16.2% a postulated 'checklist misconception-effect'. Substantial co-variations with socio-demographic characteristics or health status indicators could not be found. Additional imputation of missing values under the assumption of a "checklist misconception-effect" led to a reduction of missing data in the somatisation-subscale score from 12.3% to 0.4% compared to a simple manual-based calculation. Correlation with various external criteria (general health perception, level of functioning, depression) remained unchanged. CONCLUSIONS: Ignoring the "checklist misconception-effect" would overestimate symptom load. However, the validity of this effect has still to be proven in methodological studies.

Adult↗

PubMed2006

[Concepts of quality of life in patients with schizophrenia. The relationship to their quantitative evaluation of quality of life].

OBJECTIVE: It is analysed whether the personal concept of what constitutes one's quality-of-life (QoL) is related to subjective QoL ratings in schizophrenic persons. METHODS: In a cross-sectional study, statements of specific QoL-aspects in an open-ended interview with n=255 schizophrenic persons were correlated with subjective QoL ratings (Munich Quality of Life Dimensions List) and analysed for their predictive value by means of linear regression analysis. RESULTS: Stating the family and oral needs were positive, stating aspects of illness and negative well-being were negative predictors of subjective QoL, independent of age and gender. Substantial contributions to subjective QoL ratings were found when persons generally negated positive or, independently, generally negated negative aspects of QoL. CONCLUSIONS: The importance of a primary social network (family), of the illness and well-being for subjective QoL ratings could be replicated. It could be shown that "oral needs" are related to subjective QoL ratings. Moreover, there is further evidence for a resigning attitude towards life in schizophrenic persons and their impact on QoL ratings.

Adaptation, Psychological↗

PubMed2005

Medical practitioners in outpatient care: who is interested in participating in EBM courses? Results of a representative postal survey in Germany.

We surveyed the attitudes of medical practitioners towards evidence-based medicine (EBM) and characterized those with an interest in participating in EBM courses. A random sample of 900 outpatient care doctors stratified by level and field of specialization was surveyed by means of a postal questionnaire. Importance of knowledge on information management, a positive attitude towards EBM and not yet doing critical appraisal were significant predictors of interest in participating in EBM courses. Low participation rates of outpatient care doctors in EBM courses are not due to attitudinal or general motivational problems. Although possible predictors of interest in participation could be specified, further factors contributing to actual participation need to be identified.

Adult↗

PubMed2004

[Evidence-based medicine from the office-based physicians' point of view: a representative survey on its acceptance and demand for continuous medical education].

In 2002 a curriculum on evidence-based medicine (EbM) has been developed and published in Germany on behalf of the national statutory health care administrations. Planning and guiding medical education in EbM requires an empirically-based knowledge of the level of awareness and acceptance of EbM as well as specific educational needs and organisational preferences. In Germany, there is no such systematic knowledge, particularly in regard to general practitioners. A random sample of 900 office-based physicians in the German state of Schleswig-Holstein, stratified by medical specialties, was surveyed by means of a postal questionnaire. After two reminders the response rate was 65.6%. Respondents mainly welcomed EbM, in terms of their own daily work, for the benefit of the patient and the healthcare system as a whole. Integrating EbM into their daily practice and possible restrictions to therapeutic freedom were considered the most serious problems of EbM. 46.8% of the respondents were interested in EbM training. They preferred a rather low-cost 2-day weekend seminar. Office-based physicians were found to be sufficiently motivated to participate in EbM courses, which is in marked contrast to the actual participation rate being rather low in Schleswig-Holstein. The training should primarily focus on integrating EbM into daily routines. In public presentations efforts should be directed towards promoting the way in which EbM enhances professional autonomy and therapeutic freedom.

Curriculum↗

PubMed2002

Unified route to the palmarumycin and preussomerin natural products. Enantioselective synthesis of (-)-preussomerin G.

The total syntheses of eight members of the palmarumycin family have been achieved, with identification of the absolute stereochemistry for three of these natural products. In addition, the ras-farnesyl transferase inhibitor (-)-preussomerin G has been synthesized, achieving the first enantioselective route for accessing this family of natural products. Highlights of the synthetic work include an asymmetric epoxidation of a cyclic enone in excellent yield and enantiomeric excess and a potentially biomimetic oxidative spirocyclization for the introduction of the bis-spiroketal array unique to the preussomerin natural products.

Biological Products↗

PubMed2002

[Schizophrenic patients, who still live in psychiatric hospitals despite decades of deinstitutionalization. Part 1 of the Hessian Deinstitutionalisation Study].

Deinstitutionalization (DI) of most of the chronic long-stay patients has taken place in the last decades in Germany. However, a "residual" group of patients often remains in psychiatric hospitals, with an ongoing controversy on an appropriate type of their care (community based vs. hospital). Clinical, functional and social characteristics of such schizophrenic patients still residing in the long-stay wards in the German state of Hesse after decades of DI are presented. The n = 266 patients investigated displayed a marked degree of negative symptoms and moderate positive symptoms but, however, severe social disabilities. In addition, the patients were very dependent in daily living, had an extremely impoverished social network and leisure activities. The findings contribute to the research on "difficult-to-place" patients described in the literature.

Activities of Daily Living↗

PubMed2002

[Subgroups and Prognosis of "Difficult-to-Place" Schizophrenic Long-Stay Patients: Distinguishing "Hard Core" Patients].

Long-standing processes of deinstitutionalization often display processes of selection that result in groups of patients with marked disability profiles left in hospital. According to the literature socially deviant and unacceptable behaviour are a main obstacle to living in the community. Therefore, a group of "remnant" chronic schizophrenic patients was analysed by means of a latent class analysis with indicators of social behaviour and compliance. Three different subgroups were found, one of which had an extremely poor level of adaptation. However, prognosis of staff with regard to patients' ability to live outside the psychiatric hospital, and the rates of patients being moved into the community in the course of subsequent deinstitutionalization were not different among the three groups. Characteristics of "most-difficult-to-place patients' " as discussed in the literature are called into question on the basis of the results of this study.

Adult↗

PubMed2002

[Subjective quality of life in severely disabled long-stay schizophrenic patients].

In the controversy about severely chronic mental patients, who still reside in the psychiatric hospital after decades of deinstitutionalization, their quality of life (QoL) has become a main topic. On the basis of a critique of the dominant, mere standardized approach to QoL this method is compared with a qualitative approach in such a schizophrenic "residual" patient group (n = 144). While in the standardized approach a high level of subjective QoL could be found that correlated positively with the duration of hospitalisation, the open interviews yielded specific experiences of deficiencies. The appraisal of the quality of life especially of chronic or hospitalized patients is reconsidered.

Adult↗