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1.
ACS Energy Lett ; 9(4): 1331-1338, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38633991

ABSTRACT

Hydrogen peroxide (H2O2) is a widely used green oxidant. Until now, research has focused on the development of efficient catalysts for the two-electron oxygen reduction reaction (2e- ORR). However, electrolyte effects on the 2e- ORR have remained little understood. We report a significant effect of alkali metal cations (AMCs) on carbons in acidic environments. The presence of AMCs at a glassy carbon electrode shifts the half wave potential from -0.48 to -0.22 VRHE. This cation-induced enhancement effect exhibits a uniquely sensitive on/off switching behavior depending on the voltammetric protocol. Voltammetric and in situ X-ray photoemission spectroscopic evidence is presented, supporting a controlling role of the potential of zero charge of the catalytic enhancement. Density functional theory calculations associate the enhancement with stabilization of the *OOH key intermediate as a result of locally induced field effects from the AMCs. Finally, we developed a refined reaction mechanism for the H2O2 production in the presence of AMCs.

2.
J Cancer Res Clin Oncol ; 149(11): 8393-8402, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37079052

ABSTRACT

PURPOSE: For patients with a cancer diagnosis, coping abilities are of high importance. Cancer patients with a high sense of coherence may cope better. The purpose of this study is to learn more about the correlation of sense of coherence and different aspects, such as demographics, psychological factors, lifestyle, complementary and alternative medicine (CAM) and lay aetiology. METHODS: A prospective cross-sectional study was performed in ten cancer centres in Germany. The questionnaire consisted of ten sub-items, collecting information about sense of coherence, demographics, general life satisfaction, resilience, spirituality, self-efficacy, physical activity and sports, nutrition, CAM methods and cancer causes. RESULTS: As many as 349 participants were evaluable. The mean sense of coherence score was M = 47.30. Significant associations were shown for sense of coherence and financial situation (r = 0.230, p < 0.001), level of education (r = 0.187, p < 0.001), marital status (η = 0.177, p = 0.026) and time interval since diagnosis (r = - 0.109, p = 0.045). Sense of coherence and resilience correlated on a high level, as well as spirituality, self-efficacy and general life satisfaction (r = 0.563, r = 0.432, r = 0.461, r = 0.306, p's < 0.001). CONCLUSION: Several aspects, such as demographics and psychological factors, have a great influence on the sense of coherence. To help patients to cope better, physicians should try to strengthen sense of coherence, resilience and self-efficacy and, at the same time, consider patients' individual background such as level of education, financial capacity and emotional support by family members.


Subject(s)
Complementary Therapies , Sense of Coherence , Humans , Cross-Sectional Studies , Prospective Studies , Quality of Life/psychology , Life Style , Surveys and Questionnaires
3.
Support Care Cancer ; 31(4): 235, 2023 Mar 27.
Article in English | MEDLINE | ID: mdl-36971861

ABSTRACT

PURPOSE: Chemotherapy-related polyneuropathy (CIPN) is a very common, often dose-limiting side effect that affects the patients' quality of life. Treatment usually consists of a combination of medicinal, medical, and individualized treatment approaches, although the effectiveness of these therapies is insufficient for many patients. The aim of this article is to review and evaluate the impact of CIPN on patients' daily lives and possible effective treatment approaches. METHODS: A standardized questionnaire was developed based on ten anonymous telephone interviews with CIPN patients. The content of the questionnaire was divided into 5 categories: demographics, clinical presentation, everyday symptoms, treatment of CIPN symptoms, and medical care. Mostly closed questions were used but multiple choice and individual additions by free text answers were possible. RESULTS: CIPN limits patients' quality of life over a long period of time. In addition to diurnal and situational fluctuations, the emotional burden negatively affects patients' daily lives in many ways. From the patients' point of view, the individually implemented therapy measures were most effective in treating their complaints. But even the combination of different therapy methods insufficiently alleviates the symptoms of the patients. CONCLUSION: It is important and necessary to comprehensively inform patients about CIPN as a possible side effect, to point out prevention strategies, and to critically examine and evaluate different therapy approaches. In this way, misunderstandings of the doctor-patient relationship can be avoided. In addition, patient satisfaction and quality of life can be increased in the long term.


Subject(s)
Antineoplastic Agents , Drug-Related Side Effects and Adverse Reactions , Neoplasms , Peripheral Nervous System Diseases , Polyneuropathies , Humans , Antineoplastic Agents/adverse effects , Quality of Life , Physician-Patient Relations , Peripheral Nervous System Diseases/chemically induced , Polyneuropathies/therapy , Polyneuropathies/drug therapy , Drug-Related Side Effects and Adverse Reactions/drug therapy , Neoplasms/drug therapy
4.
Inn Med (Heidelb) ; 64(1): 3-9, 2023 Jan.
Article in German | MEDLINE | ID: mdl-36594968

ABSTRACT

BACKGROUND: Approximately half of all cancer patients use complementary or alternative medicine. AIM: The results of the German S3 guidelines on complementary oncology are presented and placed into the context of patient consultation. MATERIAL AND METHODS: The core recommendations of the S3 guidelines are summarized including an overview of the evidence. RESULTS: Selected methods of complementary medicine can be used with the aim of improving the quality of life and reducing side effects. Comprehensive data are available for physical activity with respect to survival, quality of life and supportive therapy. For most other methods the evidence is relatively low. Therefore, weighing up the benefits and risks more frequently resulted in negative recommendations in the guidelines, especially for methods based on substances. Exceptions to this are three micronutrients (vitamins B12, D and selenium), as even in the case of a well-balanced diet, deficiency symptoms are possible. Therefore, routine measurement of the blood levels of these micronutrients is recommended. CONCLUSION: The questions from patients on what they can do by themselves should be answered respectfully and based on evidence. The benefits and risks of complementary methods must be carefully considered. To do this, regular questioning of patients on the interest in complementary methods is recommended. The decisive benefit of complementary medicine is the chance for patients to become active themselves. Therefore, all recommendations refer to the discussion with the patient, which do not formulate a therapy but are consultation recommendations: should be recommended instead of should be done.


Subject(s)
Complementary Therapies , Neoplasms , Humans , Quality of Life , Complementary Therapies/adverse effects , Medical Oncology , Neoplasms/therapy , Micronutrients
5.
Nutr Cancer ; 75(1): 33-47, 2023.
Article in English | MEDLINE | ID: mdl-35819060

ABSTRACT

B-vitamins act as enzymatic co-factors in immune functions, therefore they are considered to reduce chemotherapy-induced side effects in cancer patients. We conducted a systematic search, screening five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies on the effectiveness and potential harm of B-vitamin therapy on cancer patients. Out of the 7465 search results, 11 RCTs about vitamin B6, B12 and B-vitamins in combination were included in this systematic review. A total of 1546 patients with diverse types of cancer were evaluated. Overall, most studies were of acceptable quality and reported consistent results. Studies examining the effectiveness of vitamin B6 reported that there is no significant impact on decreasing the incidence and severity of chemotherapy-induced side effects (e.g., hand-foot syndrome), the necessity of chemotherapy dose-modifications or improving patients' quality of life, tumor response/progression, and overall survival. Two studies reported that vitamin B12 could be effective in the alleviation of symptoms resulting from chemotherapy; it might decrease motor, sensory and pain symptoms of peripheral neuropathy. However, a combination of B vitamins may not reduce the incidence of chemotherapy-induced peripheral neuropathy. All in all, the evidence on B-vitamins in cancer patients is low and supplementation cannot be recommended.


Subject(s)
Antineoplastic Agents , Neoplasms , Peripheral Nervous System Diseases , Vitamin B Complex , Humans , Vitamin B Complex/therapeutic use , Quality of Life , Dietary Supplements , Vitamin B 6/therapeutic use , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects
6.
Qual Life Res ; 32(5): 1427-1446, 2023 May.
Article in English | MEDLINE | ID: mdl-36441383

ABSTRACT

BACKGROUND: Clinical data on the modern topic fasting among cancer patients are rare. This review aimed to summarise published clinical data on fasting and its effects on patients undergoing chemotherapy and therefore to give some directions in advising patients with the desire to fast. METHOD: A systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of fasting during therapy on cancer patients. The main endpoints were quality of life, side effects and toxicities of the fasting intervention. RESULTS: The search results totaled 3983 hits. After systematic sorting according to standardised pre-defined criteria, nine publications which covered eight studies with 379 patients were included in this systematic review. The majority of the patients included were diagnosed with breast- and gynaecological cancers. Fasting duration and timepoints ranged significantly (24-140 h before, and on the day of, chemotherapy to 56 h after chemotherapy). In one study patients were fasting before cancer surgery. The studies were mostly low to moderate quality and reported heterogeneous results. Overall, the studies were insufficiently powered to detect significant effects on the predefined endpoints. CONCLUSION: Fasting for short periods does not have any beneficial effect on the quality of life of cancer patients during treatment. Evidence on fasting regimes reducing side effects and toxicities of chemotherapy is missing. In contrast, as the negative effects of unintentional weight loss are known to impact clinical outcomes severely, fasting is not indicated in this context.


Subject(s)
Neoplasms , Quality of Life , Humans , Quality of Life/psychology , Neoplasms/drug therapy , Fasting
7.
J Cancer Res Clin Oncol ; 149(6): 2607-2619, 2023 Jun.
Article in English | MEDLINE | ID: mdl-36166091

ABSTRACT

PURPOSE: Bioenergy therapies are among the popular alternative treatment options for many diseases, including cancer. Many studies deal with the advantages and disadvantages of bioenergy therapies as an addition to established treatments such as chemotherapy, surgery, and radiation in the treatment of cancer. However, a systematic overview of this evidence is thus far lacking. For this reason, the available evidence should be reviewed and critically examined to determine what benefits the treatments have for patients. METHODS: In June 2022, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of bioenergy therapies including Reiki, Therapeutic Touch, Healing Touch and Polarity Therapy on cancer patients. RESULTS: From all 2477 search results, 21 publications with 1375 patients were included in this systematic review. The patients treated with bioenergy therapies were mainly diagnosed with breast cancer. The main outcomes measured were anxiety, depression, mood, fatigue, quality of life (QoL), comfort, well-being, neurotoxicity, pain, and nausea. The studies were predominantly of moderate quality and for the most part found no effect. In terms of QoL, pain and nausea, there were improved short-term effects of the interventions, but no long-term differences were detectable. The risk of side effects from bioenergy therapies appears to be relatively small. CONCLUSION: Considering the methodical limitations of the included studies, studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.


Subject(s)
Breast Neoplasms , Quality of Life , Humans , Female , Breast Neoplasms/therapy , Mind-Body Therapies , Pain , Nausea
9.
Complement Ther Clin Pract ; 44: 101389, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33932731

ABSTRACT

INTRODUCTION: The interest in CAM among cancer patients is constantly growing and about 50% already used CAM alongside cancer therapy. Little is known on the factors influencing patients' choice of type of CAM used. METHODS: A questionnaire consisting of two validated instruments (the ASKU (Allgemeine Selbstwirksamkeit Kurzskala), the PAM 13-D (Patient Activation Measure) and the structured AKKOM questionnaire on CAM usage was distributed at a German university hospital. RESULTS: 639 patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% had used CAM in the last 3 months (biological 73%, holistic 63%, mind-body-methods 62%). Participants up to 30 years preferred biologically (p = 0.001), while women with gynecological cancer favored holistic based methods (p < 0.0001). There was no association between patients' beliefs on cancer causes and the chosen CAM method. CONCLUSION: Improving knowledge in patients on cancer etiology and treatments could facilitate the understanding of additional complementary treatments.


Subject(s)
Complementary Therapies , Neoplasms , Female , Humans , Male , Neoplasms/therapy , Surveys and Questionnaires
10.
Phys Rev Lett ; 126(13): 137402, 2021 Apr 02.
Article in English | MEDLINE | ID: mdl-33861119

ABSTRACT

We measure the spin-lattice relaxation of donor bound electrons in ultrapure, isotopically enriched, phosphorus-doped ^{28}Si:P. The optical pump-probe experiments reveal at low temperatures extremely long spin relaxation times which exceed 20 h. The ^{28}Si:P spin relaxation rate increases linearly with temperature in the regime below 1 K and shows a distinct transition to a T^{9} dependence which dominates the spin relaxation between 2 and 4 K at low magnetic fields. The T^{7} dependence reported for natural silicon is absent. At high magnetic fields, the spin relaxation is dominated by the magnetic field dependent single phonon spin relaxation process. This process is well documented for natural silicon at finite temperatures but the ^{28}Si:P measurements validate additionally that the bosonic phonon distribution leads at very low temperatures to a deviation from the linear temperature dependence of Γ as predicted by theory.

11.
Med Oncol ; 38(2): 15, 2021 Jan 28.
Article in English | MEDLINE | ID: mdl-33507443

ABSTRACT

Physical activity has a high importance for cancer patients. The present study aimed to evaluate the influence of ballroom dancing on fatigue, body image, self-efficacy, and functional exercise capacity for patients with cancer. We collected data among participants of a regular dance training program for cancer patients with a questionnaire including the Body Image Scale (BIS), Brief Fatigue inventory (BFI), Short Scale for Measuring General Self-efficacy Beliefs (ASKU), and the 6-min walking test (6-MWT). 66 participants took part in the study, and among them, 39 participants also engaged in the 6-MWT: dance experience and the weeks of dance training were significantly associated with a higher walking distance in the 6-MWT. Participants with dance experience showed higher self-efficacy scores than participants without. Participants rated the influence of dancing on partnership positively. However, the dance training had no significant effects on fatigue or body image. Ballroom dancing may improve functional exercise capacity, and dance experience may be associated with a high self-efficacy and active lifestyle, which can be beneficial for cancer patients during and after treatment. Further studies are needed to assess the influence of ballroom dancing more deeply on physical activity and fitness and to learn more on impact on the partnership. As ballroom dancing seems to improve physical activity and wellbeing and can promote intimacy between partners, this intervention has the potential to support cancer survivors in various levels.


Subject(s)
Body Image , Dancing , Fatigue/psychology , Neoplasms/psychology , Self Efficacy , Adult , Aged , Aged, 80 and over , Exercise , Female , Humans , Male , Middle Aged , Physical Endurance , Walking
12.
HNO ; 69(11): 878-885, 2021 Nov.
Article in German | MEDLINE | ID: mdl-33052423

ABSTRACT

BACKGROUND AND OBJECTIVE: Laryngectomy is usually associated with olfactory dysfunction. How do laryngectomees personally experience and feel about this change? MATERIALS AND METHODS: In cooperation with the Bundesverband der Kehlkopfoperierten (German Association of Throat Cancer Patients) and together with laryngectomized patients, a new questionnaire was created and distributed via the regional offices according to the population sizes of the federal states (n = 293) for the first time in spring 2018. The questionnaire covers patient characteristics and daily life without a larynx, as well as the specific areas of smell and taste, albeit without differentiation between ortho- and retronasal olfaction. The items were designed to be answered using patient-friendly visual rating scales, multiple-choice answers, and free text. RESULTS: Return rate was 198/293 (67.6%). Median age of all participants was 69 years (48-88). Overall life situation was rated by 99/198 (50%) participants as "good" or "very good." The primary subjective impairment for the patients was loss of voice (137/198, 69.1%) and loss of olfaction (113/198, 59.1%). Adaption to life without a larynx has been completed within a maximum of 3 years for 161/198 (81.3%) patients. Principally, 127/198 (64.1%) affirmed being able to smell and 176 of 198 (88.9%) being able to taste; however, only 29/198 (14.6%) rated their sense of smell and 109/198 (55.1%) their sense of taste as "good" or "very good." Most frequently detected smell sensations were perfume (141), smoke (126), and feces (99). Univariate analysis showed a significant (p < 0.05) correlation between adaptation time <1 year and current subjective smell and taste. CONCLUSION: Subjective loss of smell and taste after laryngectomy is a daily problem for patients in Germany, which should be focused on promptly and included in early rehabilitation strategies.


Subject(s)
Larynx , Olfaction Disorders , Aged , Aged, 80 and over , Humans , Laryngectomy , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Smell , Surveys and Questionnaires
14.
Urologe A ; 59(6): 695-699, 2020 Jun.
Article in German | MEDLINE | ID: mdl-32270244

ABSTRACT

Modern concepts such as patient empowerment stand for the selection of appropriate concomitant treatment procedures from a scientific point of view and for placing these in the hands of the patient, thereby demanding and encouraging personal responsibility. It is important to distinguish between the terms complementary and/or alternative medicine. If we look at the motivation of patients to use complementary and/or alternative procedures, this is divided into the desire to do something directly against the tumor and on the other hand to strengthen the body's own resources, support the immune system, and reduce side effects in a concrete manner. The crux of modern oncology is that many specialists no longer have sufficient time for detailed patient information talks and multiple good physician-patient talks. The importance of complementary medicine in addition to nutrition and exercise lies above all in its targeted use as a concomitant supportive therapy. Complementary medicine primarily offers the chance to meet the desire of those affected to actively participate in their treatment.


Subject(s)
Complementary Therapies/methods , Urogenital Neoplasms/therapy , Humans , Medical Oncology/trends , Patient Participation , Physician-Patient Relations
15.
HNO ; 68(7): 492-497, 2020 Jul.
Article in German | MEDLINE | ID: mdl-32161976

ABSTRACT

BACKGROUND: A cancer diagnosis is always associated with a threat to life and therefore demands a great deal of the decision maker. For patients, this means making decisions under high emotional stress. On the other hand, medical facts can limit freedom of choice. For interactions with the patient in medical practice, this often means a balancing act between honesty and hope. OBJECTIVE: This article aims to present factors that influence medical decisions in the area of conflict between ethical and moral obligations towards the patient and the daily routine of oncological care. MATERIALS AND METHODS: The current study is a narrative review. RESULTS: There are different decision models and decision principles, all of which are influenced by the physician-patient relationship. In oncology, informing patents with regard to lifetime and quality of life is particularly demanding. Sometimes a balancing act between honesty and hope must be made. CONCLUSION: In every treatment situation but particularly in the palliative situation, open and honest communication is absolutely necessary. It must be ensured that the patient receives all the necessary information, understands it, and includes it in the decision-making process. An emphatic but clear naming of the medical facts allows the patient to maintain his autonomy and dignity.


Subject(s)
Decision Making , Medical Oncology , Quality of Life , Communication , Humans , Physician-Patient Relations
16.
Sci Rep ; 10(1): 658, 2020 Jan 20.
Article in English | MEDLINE | ID: mdl-31959783

ABSTRACT

By applying an interdigitated back contacted solar cell concept with poly-Si on oxide passivating contacts an efficiency of 26.1% was achieved recently. In this paper the impact of the implemented initially intrinsic poly-Si region between p-type poly-Si and n-type poly-Si regions is investigated. Two recombination paths are identified: The recombination at the interface between the initially intrinsic poly-Si and the wafer as well as the recombination across the resulting p(i)n diode on the rear side which is aimed to be reduced by introducing an initially intrinsic region. By using test structures, it is demonstrated that the width of the initially intrinsic region ((i) poly-Si region) has a strong influence on the recombination current through the p(i)n diode and that this initially intrinsic region needs to be about 30 µm wide to sufficiently reduce the recombination across the p(i)n diode. Lateral and depth-resolved time of flight secondary ion mass spectrometry analysis shows that the high-temperature annealing step causes a strong lateral inter-diffusion of donor and acceptor atoms into the initially intrinsic region. This diffusion has a positive impact on the passivation quality at the c-Si/SiOx/i poly-Si interface and is thus essential for achieving an independently confirmed efficiency of 26.1% with 30 µm-wide initially intrinsic poly-Si regions.

17.
Cancer Invest ; 37(4-5): 216-226, 2019.
Article in English | MEDLINE | ID: mdl-31204520

ABSTRACT

This survey aimed at getting a first insight into diverse side effects and their association with satisfaction with life as well as the use of complementary and alternative medicine (CAM) in cancer patients. A total of 100 patients in a German University Hospital were included. General side effects like fatigue, fever, headache, limb pain and sleep disorders had a significant influence on the patients' satisfaction with life (p = .034 and p = .032, respectively). Concerning CAM, we could not detect any association between the frequency of side effects and the use of CAM. Improving the treatment of side effects may have a strong impact on patients' satisfaction with life.


Subject(s)
Complementary Therapies/statistics & numerical data , Neoplasms/therapy , Patient Satisfaction , Quality of Life , Adult , Aged , Complementary Therapies/methods , Female , Germany , Humans , Male , Middle Aged , Neoplasms/psychology , Patient-Centered Care/methods , Pilot Projects , Surveys and Questionnaires/statistics & numerical data , Treatment Outcome
18.
Br J Cancer ; 116(2): 253-259, 2017 Jan 17.
Article in English | MEDLINE | ID: mdl-27898656

ABSTRACT

BACKGROUND: The rate of interval cancers is an established indicator for the performance of a cancer-screening programme. METHODS: We examined the incidence, tumour characteristics and risk factors of melanoma interval cancers that occurred in participants of the SCREEN project, which was carried out 2003/2004 in Schleswig-Holstein, Germany. Data from 350 306 SCREEN participants, who had been screened negative for melanoma, were linked to data of the state cancer registry. Melanoma interval cancers were defined as melanomas diagnosed within 4-24 months after SCREEN examination. Results were compared with melanomas of the pre-SCREEN era (1999-2002), extracted from the cancer registry. RESULTS: The overall relative incidence of melanoma interval cancers in terms of observed/expected ratio was 0.93 (95% CI: 0.82-1.05; in situ: 1.61 (1.32-1.95), invasive: 0.71 (0.60-0.84)). Compared with melanomas of the pre-SCREEN era, the interval melanomas were thinner and had a slightly greater proportion of lentigo maligna melanomas whereas nodular melanomas were less frequent. INTERPRETATION: The results indicate a moderate performance of the SCREEN intervention with an excess of in situ melanomas. In part, the findings might be due to specifics of the SCREEN project, in particular a short-term follow-up of patients at high risk for melanoma.


Subject(s)
Mass Screening , Melanoma , Skin Neoplasms , Adult , Aged , Aged, 80 and over , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Female , Germany/epidemiology , Humans , Incidence , Male , Mass Screening/methods , Mass Screening/standards , Melanoma/diagnosis , Melanoma/epidemiology , Melanoma/pathology , Middle Aged , Registries , Risk Factors , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/pathology , Time Factors , Young Adult
19.
Dtsch Med Wochenschr ; 141(12): e106-14, 2016 Jun.
Article in German | MEDLINE | ID: mdl-27305310

ABSTRACT

INTRODUCTION: Patients are looking for information regarding palliative care in different sources. Goal of this study is the analysis of the most important online forum for cancer patients, Cancer Compass, concerning palliative care. METHODOLOGY: On the chosen date, 3.02.2012, all threads on the various topics (cancer types, cancer treatment, specific user groups, general topics, advice and addresses, countries and regions, Über den Krebs-Kompass & Vermischtes) were systematically analyzed. All entries relating to palliative care were recorded and subsequently analyzed and summarized. RESULTS: From 231 threads relating to palliative care, 163 were relevant.The general practitioner is the main source of information, but the internet is gaining importance. The forum users often offer good explanations of cancer and palliative care and also refer to web pages with exact definitions. Reliability of web pages is a one issue discussed in the forum.Patients are afraid of pain and dying. Relatives fear for the patient, are overwhelmed and experience existential problems. Both groups use the Cancer Compass to share experiences and get psychological support. Thus Cancer Compass offers a possibility to discuss options for improving quality of life.Especially in the initial phase of care, many users are uncertain what palliative care means. The treatment of pain represents the main concern of patients and their families. Whereas dedicated palliative care wards are rated positively, users speak less positively about pain treatment in general wards in home care.In general, inpatient palliative care was rated positively. However information regarding outpatient care is lacking. Family care is mostly not possible on account of geographical distance. One point of criticism is the discrepancy between urban and rural areas. Patients place more trust in their general practitioner than in hospital doctors. CONCLUSION: Cancer Compass is an important medium for patients and their families to share information, i. a. on palliative care. In order to improve the reliability of information from the internet, a certification of websites would be helpful. In web forums moderators may improve the quality of information.


Subject(s)
Information Seeking Behavior , Neoplasms/psychology , Palliative Care/psychology , Patient Education as Topic , Social Media , Attitude to Death , Caregivers/psychology , General Practitioners , Germany , Health Literacy , Hospice Care/psychology , Humans , Internet , Neoplasms/therapy , Pain/psychology , Physician-Patient Relations , Quality of Life/psychology , Sick Role , Social Support
20.
Z Geburtshilfe Neonatol ; 219(2): 73-80, 2015 Apr.
Article in German | MEDLINE | ID: mdl-25901868

ABSTRACT

BACKGROUND: The decline in the incidence of stillbirths in Germany has remained static in recent years. This study aims to analyse the current situation of data documentation and examination of stillbirths. Furthermore, possible stillbirth prevention strategies should be developed. METHODS: Searches in the international peer-reviewed literature, retrospective data collection of 168 stillbirths in 8 hospitals, (in the area of Bonn) with subsequent statistical evaluation (descriptive statistics, t-test and binominal test) were undertaken. RESULTS: This study shows considerable deficits in data documentation, interdisciplinary communication and postmortal examination. Only in 51.8% (87/168) of the cases was a certain or uncertain cause of death found (42.3% placental, 1.2% foetal, 3.6% chromosomal, 4.8% umbilical cord abnormalities). Severe foetal growth restriction (<5(th) percentile) was observed in 29.2%; 44.9% (22/49) of them died at the age of ≥36+0 weeks of gestation. CONCLUSION: The first step to reduce the rate of stillbirths in Germany is to increase the identified causes of foetal death: Therefore, an interdisciplinary case report form was compiled to improve data collection and interdisciplinary collaboration. To standardise and complete postmortal management, an algorithm was created. The long-term aim is the development of a central data register for statistical analysis, to identify goals of research and to organise conferences with interdisciplinary reports of diagnostic findings.


Subject(s)
Fetal Growth Retardation/mortality , Stillbirth/epidemiology , Cohort Studies , Female , Germany/epidemiology , Humans , Incidence , Male , Retrospective Studies , Risk Factors , Survival Rate
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