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Background: Although infantile fever is harmless in most cases, many parents feel insecure when having to deal with it because important information is often missing. For educational purposes, an information video on fever in children was developed, which is also intended to serve as an onboarding element of a health app. The aim of the present work was to record the attitude of parents and adults on the topic of fever before and after the presentation of the information video, as well as its evaluation. Methods: Between May and November 2020, a total of 123 adults from three groups with different backgrounds (students, parents and educators) were interviewed using a questionnaire that was completed before and after the one-time presentation of an educational information video clip. Results: Several significant outcomes were recorded in attitude change toward managing fever, with no significant difference between groups. After viewing the informational video clip, 74% of participants would take body temperature rectally more often. In the after-questionnaire, 83% of participants agreed that they would now be more cautious about using fever-reducing medications. Before the video clip, 75% of the participants thought fever was “rather useful”; after, 93%. The level of temperature played a minor role as a reason for fever reduction. The information content and quality of the video were rated positively. Discussion: This study shows that a short information video is capable of bringing about a subjectively perceived intentional change in the attitude to dealing with fever, motivating a change in behavior, and reducing uncertainty in dealing with fever. Since the change in attitude was measured immediately after viewing the video clip, no statement can be made about the medium to long-term effect. Conclusion: The information video clip can be classified as a short-term fever education tool for which at least short-term effective is demonstrated. Long-term and possible synergistic effects when integrated into a health app with further information still needs to be investigated., Hintergrund: Obwohl kindliches Fieber in den meisten Fällen harmlos ist, fühlen sich viele Eltern im Umgang damit unsicher, weil oft wichtige Informationen fehlen. Zu Aufklärungszwecken wurde ein Informationsvideo über Fieber bei Kindern entwickelt, das auch als Onboarding-Element einer Gesundheits-App dienen soll. Ziel der vorliegenden Arbeit war es, die Einstellung von Eltern und Erwachsenen zum Thema Fieber vor und nach der Präsentation des Informationsvideos sowie dessen Evaluation zu erfassen. Methoden: Zwischen Mai und November 2020 wurden insgesamt 123 Erwachsene in drei Gruppen mit unterschiedlichem Hintergrund (Studenten, Eltern und Pädagogen) mittels eines Fragebogens befragt, der vor und nach der einmaligen Präsentation eines Aufklärungsvideos ausgefüllt wurde. Ergebnisse: Es wurden mehrere signifikante Ergebnisse in Bezug auf die Veränderung der Einstellung zum Umgang mit Fieber festgestellt, wobei es keine signifikanten Unterschiede zwischen den Gruppen gab. Nach der Vorführung des Informationsvideoclips würden 74 % der Teilnehmer die Körpertemperatur häufiger rektal messen. In der Nachbefragung stimmten 83% der Teilnehmer zu, dass sie nun vorsichtiger mit fiebersenkenden Medikamenten umgehen würden. Vor dem Videoclip hielten 75% der Teilnehmer Fieber für „eher nützlich“, danach waren es 93%. Die Höhe der Temperatur spielte als Grund für die Fiebersenkung eine untergeordnete Rolle. Der Informationsgehalt und die Qualität des Videos wurden positiv bewertet. Diskussion: Diese Studie zeigt, dass ein kurzes Informationsvideo in der Lage ist, eine subjektiv wahrgenommene intentionale Veränderung der Einstellung zum Umgang mit Fieber herbeizuführen, zu einer Verhaltensänderung zu motivieren und die Unsicherheit im Umgang mit Fieber zu verringern. Da die Einstellungsänderung unmittelbar nach dem Betrachten des Videoclips gemessen wurde, kann keine Aussage über die mittel- bis langfristige Wirkung getroffen werden. Schlussfolgerung: Der Informationsvideoclip kann als kurzfristiges Fieberaufklärungsinstrument eingestuft werden, für das zumindest eine kurzfristige Wirksamkeit nachgewiesen ist. Langfristige und mögliche synergetische Effekte bei Integration in eine Gesundheits-App mit weiteren Informationen müssen noch untersucht werden.

Background: Religiosity and/or spirituality (R/S) of physicians have been reported to inform behavior regarding religiosity and spirituality in clinical practice (R/S-B). Our aim was to study this association. Methods: Building upon a large international data pool of physician values we performed network and systematic literature searches using Google Scholar, Web of Science, Embase, Medline, and PsycInfo. Measures for R/S and R/S-B were selected for comparability with existing research. We performed a two-stage IPDMA using R/S coefficients from sample-wise multiple regression analyses as summary measures. We controlled for age, gender, and medical specialty. An additional sub-analysis compared psychiatrists to non-psychiatrists. Results: We found 11 eligible surveys from 8 countries (n = 3159). We found a positive association between R/S and R/S-B with an overall R/S coefficient of 0.65 (0.48–0.83). All samples revealed a positive association between R/S and R/S-B. Only 2 out of the 11 samples differed from the overall confidence interval. Psychiatrists had a higher degree of R/S-B, but associations with R/S did not differ compared to non-psychiatrists. Conclusions: We confirmed a significant association between R/S and R/S-B in this study. Despite large cultural differences between samples, coefficients remained almost constant when controlling for confounders, indicating a cultural independent effect of R/S on R/S-B, which to our knowledge has not been documented before. Such interaction can constitute both facilitators and barriers for high quality health care and should be considered in all aspects of patient and relationship-centered medicine.

Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians' right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care. Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians’ right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.

Supplemental Digital Content is available in the text, Background: Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design. Methods: Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale “Religiosity of Health Professionals”; and a dichotomized value of the question “My religious beliefs influence my practice of medicine.” Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders. Results: Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96–9.96]) compared with the Asian samples India (10.46 [9.82–10.21]) and Indonesia (12.52 [12.19–12.84]), whereas Brazil (9.76 [9.54–9.99]) and USA (10.02 [9.82–10.21]) were placed in between. The proportion of the European physicians who agreed to the statement “My religious beliefs influence my practice of medicine” (95% CI) was 42% (26%–59%) compared with Brazil (36% [29%–43%]), USA (57% [54%–60%]), India (58% [52%–63%]), and Indonesia (91% [84%–95%]). Conclusions: Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.

SPIRIT 2013 Checklist: recommended items to address in a clinical trial protocol and related documents. (DOC 122 kb)

Hintergrund und Fragestellung: Den Medizinstudierenden kommt im Praktischen Jahr (PJ) häufig eine passive Rolle zu, die sich auf eine Unterstützung der behandelnden Stationsärzte konzentriert [ref:1]. Für den beruflichen Kompetenzerwerb ist jedoch eine aktive Mitwirkung[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ)

Introduction & question: Active student participation (ASP) in Clinical Education Wards (CEW) integrates students actively in interprofessional health care teams. By this manner of workplace based learning (WBL) students acquire practical skills and different qualities of professionalism. Previous[for full text, please go to the a.m. URL], 5th International Conference for Research in Medical Education (RIME 2017)

Questionnaire: Cool Down Index. (PDF 266 kb)

Zusammenfassung Das Schlagwort »Spiritualitat« taucht in den letzten Jahrzehnten vermehrt als Forschungsgegenstand in unterschiedlichen Bereichen der Medizin auf. Vermehrt ist dieses Thema dabei auch in der Komplementarmedizin anzutreffen, wobei der Eindruck entsteht, dass dies oftmals ohne eine Klarung der benutzten Begrifflichkeiten geschieht. Auf Basis einer Literaturrecherche gibt diese Arbeit eine Ubersicht daruber, welche Konzepte und Definitionen von »Spiritualitat « derzeit diskutiert werden, welche Messverfahren und Konstrukte zur Spiritualitat etabliert sind und wie Studienergebnisse zum Verhaltnis von Spiritualitat und Gesundheit in diesem Zusammenhang bewertet werden konnen.

Este artículo presenta una síntesis de un estudio sobre los posicionamientos egocéntricos en la adolescencia realizado en tres contextos escolares diferentes. El análisis permitió determinar que el posicionamiento egocéntrico puede ser mejor determinado a través de dos predictores: el sentido del propio bienestar (eudemonismo) y la convicción de que "la lástima ajena previene tomar iniciativas propias". Estos dos factores fueron correlacionados con la satisfacción del contexto escolar específico, la orientación espiritual y la idea de ayudar a otros. Los posicionamientos y los ideales éticos difieren entre los estudiantes de los tres contextos escolares: colegios Waldorf, colegios cristianos y colegios estatales. Los resultados confirman que la tendencia egocéntrica fue significativamente inferior en el grupo femenino de adolescentes. Este artículo invita a reflexionar sobre el papel que juega el contexto escolar en el proceso de desarrollo de la etapa adolescente a la adulta de los estudiantes. Este artigo apresenta uma síntese de um estudo sobre os posicionamentos egocêntricos na adolescência realizado em três contextos escolares diferentes. A análise permitiu determinar que o posicionamento egocêntrico está relacionado a dois fatores: o sentido do próprio bem-estar (eudemonismo) e a convicção de que "a compaixão evita a busca por iniciativas próprias". Estes fatores foram correlacionados com a satisfação no contexto escolar específico, a orientação espiritual e a ideia de ajudar os outros. Os posicionamentos e os ideais éticos diferem entre os estudantes dos três contextos escolares: escolas Waldorf, escolas cristãs e escolas públicas. Os resultados confirmam que a tendência egocêntrica foi significativamente inferior no grupo feminino de adolescentes. Este artigo convida à reflexão acerca do papel do contexto escolar no processo de desenvolvimento da etapa adolescente à adulta dos estudantes. This article presents a summary of a study on egocentric positionings in adolescents conducted in three different school contexts. The analysis reveals that egocentric positioning can be better determined through two predictors: a sense of personal well-being (eudemonism) and a conviction that "shame experienced on behalf of another person prevents oneself to take personal initiatives". These two factors correlate to satisfaction within the school context, spiritual orientation and the idea of helping others. The positionings and the ethical ideas differ from the students of the three school contexts: Waldorf, Christian, and State schools. The results confirm that the egocentric tendency was significantly inferior in the female group of adolescents. This article invites readers to reflect upon the role that the school context plays in the process of development of the students from adolescence to adultness.

Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1) why do people turn to prayer in times of illness?, (2) what are the main topics of their prayers?, and (3) how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1) participants in the study were patients dealing with an illness, (2) the study examined the use of private rather than intercessory prayer, and (3) the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1) disease-centered prayer, (2) assurance-centered prayer, (3) God-centered prayer, (4) others-centered prayer, and (5) lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness.

Background: Feelings of gratitude and awe facilitate perceptions and cognitions that go beyond the focus of illness and include positive aspects of one's personal and interpersonal reality, even in the face of disease. We intended to measure feelings of gratitude, awe, and experiences of beauty in life among patients with multiple sclerosis and psychiatric disorders, particularly with respect to their engagement in specific spiritual/religious practices and their life satisfaction. Methods: We conducted a cross-sectional survey with standardized questionnaires to measure engagement in various spiritual practices (SpREUK-P) and their relation to experiences of Gratitude, Awe and Beauty in Life and life satisfaction (BMLSS-10). In total, 461 individuals (41 +/- 13 years; 68% women) with multiple sclerosis (46%) and depressive (22%) or other psychiatric disorders (32%) participated. Results: Among participants, 23% never, 43% rarely, 24% often, and 10% frequently experienced Gratitude. In contrast, 41% never, 37% rarely, 17% often, and 6% frequently experienced Awe. Beauty in Life was never experienced by 8% of the sample, and 28% rarely, 46% often, and 18% frequently experienced it. Gratitude (F = 9.2; p = .003) and Beauty in Life (F = 6.0; p = .015) were experienced significantly more often by women than men. However, the experience of Awe did not differ between women and men (F = 2.2; n.s.). In contrast to our hypothesis, Gratitude/Awe cannot explain any relevant variance in patients' life satisfaction (R2 = .04). Regression analyses (R2 = .42) revealed that Gratitude/Awe can be predicted best by a person's engagement in religious practices, followed by other forms of spiritual practices and life satisfaction. Female gender was a weak predictor and underlying disease showed no effect. Conclusions: Gratitude/Awe could be regarded as a life orientation towards noticing and appreciating the positive in life - despite the symptoms of disease. Positive spirituality/religiosity seems to be a source of gratitude and appreciation in life, whereas patients with neither spiritual nor religious sentiments (R-S-) seem to have a lower awareness for these feelings.

Claims of benefits of aromatherapy for cancer patients include reduced anxiety levels and relief of emotional stress, pain, muscular tension and fatigue. The objective of this paper is to provide an updated descriptive, systematic review of evidence from pre-clinical and clinical trials assessing the benefits and safety of aromatherapy for cancer patients. Literature databases such as Medline (via Ovid), the Cochrane database of systematic reviews, Cochrane Central were searched from their inception until October 2010. Only studies on cancer cells or cancer patients were included. There is no long lasting effect of aromatherapy massage, while short term improvements were reported for general well being, anxiety and depression up to 8 weeks after treatment. The reviewed studies indicate short-term effects of aromatherapy on depression, anxiety and overall wellbeing. Specifically, some clinical trials found an increase in patient-identified symptom relief, psychological wellbeing and improved sleep. Furthermore, some found a short-term improvement (up to 2 weeks after treatment) in anxiety and depression scores and better pain control. Although essential oils have generally shown minimal adverse effects, potential risks include ingesting large amounts (intentional misuse); local skin irritation, especially with prolonged skin contact; allergic contact dermatitis; and phototoxicity from reaction to sunlight (some oils). Repeated topical administration of lavender and tea tree oil was associated with reversible prepubertal gynecomastia.

This report summarizes the current evidence on the effects of yoga interventions on various components of mental and physical health, by focussing on the evidence described in review articles. Collectively, these reviews suggest a number of areas where yoga may well be beneficial, but more research is required for virtually all of them to firmly establish such benefits. The heterogeneity among interventions and conditions studied has hampered the use of meta-analysis as an appropriate tool for summarizing the current literature. Nevertheless, there are some meta-analyses which indicate beneficial effects of yoga interventions, and there are several randomized clinical trials (RCT’s) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health. Yoga may well be effective as a supportive adjunct to mitigate some medical conditions, but not yet a proven stand-alone, curative treatment. Larger-scale and more rigorous research with higher methodological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective, may be practiced at least in part as a self-care behavioral treatment, provides a life-long behavioural skill, enhances self-efficacy and self-confidence and is often associated with additional positive side effects.

Background. Researchers aimed at systematically reviewing and meta-analyzing the effectiveness of yoga interventions for fatigue. Methods. PubMed/Medline was searched until January 2012 for controlled clinical studies. Two reviewers independently extracted the data. The methodological quality of the studies was assessed. A meta-analysis was performed. Results. Nineteen clinical studies (total 𝑛 = 9 4 8 ) were included in this review. Investigated yoga styles included Hatha, Iyengar, Asanas, Patanjali, Sahaja, and Tibetan yoga. Participants were suffering from cancer, multiple sclerosis, dialysis, chronic pancreatitis, fibromyalgia, asthma, or were healthy. Yoga had a small positive effect on fatigue (SMD = 0.27, 59% CI = 0.23–0.31). Seven studies received 4 points on the Jadad score. There were baseline differences in at least 5 studies. Conclusion. Overall, the effects of yoga interventions on fatigue were only small, particularly in cancer patients. Although yoga is generally a safe therapeutic intervention and effective to attenuate other health-related symptoms, this meta-analysis was not able to define the powerful effect of yoga on patients suffering from fatigue. Treatment effects of yoga could be improved in well-designed future studies. According to the GRADE recommendations assessing the overall quality of evidence, there is a moderate effect of the confidence placed in the estimates of the effects discussed here.

DNA - stabilisierende wirkungen von Viscum album L. - Sind mistelextrakte als adjuvans wärend der koventionellen chemotherapie indiziert?