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Background This study presents a concept for training general practitioners (GPs) in taking a spiritual history. In the same workshop, medical assistants (MAs) were trained in counselling elderly, chronically ill patients on social activities and home remedies. After the training, GPs and MAs will apply the acquired skills in their practices within the scope of the HoPES3 intervention study, which aims at raising patients’ self-efficacy. Methods Sixteen GPs and 18 MAs were trained in a 5-hour workshop and completed an evaluation questionnaire. Results All participants reported great satisfaction. In particular, 85% of GPs (n=11) affirmed increased capacity to address patients’ spiritual needs. About 88% (n=15) of MAs were satisfied with the training, yet expressed difficulties in integrating theoretical knowledge into daily professional routine. Discussion While the evaluation of the workshop is promising, the results of the randomized-controlled trial evaluating the effectiveness of the complete HoPES3 intervention have to be awaited. Conclusion To our knowledge, this is the first interdisciplinary, holistic care training in primary care in Germany. It fosters GPs’ and MAs’ competency in providing a proactive support in spirituality, social activities, and home remedies to their patients. If the concept proves to be effective, it could be integrated into existing care models and curriculums and provide clear guidance on how to consider elderly patients’ spiritual needs and strengthen their self-efficacy in primary care settings., Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/hcz-CKYOk8s

The aim of this study was to give an early snapshot of primary care strategies that were implemented to cope with the early period of the COVID-19 pandemic in Baden-Wuerttemberg (Germany).In June 2020, all 271 outpatient SARS-CoV-2 contact points, established by the National Association of Statutory Health Insurance Physicians (16 centers for testing, 204 specialized family practices, 51 Outpatients Corona Centers), and a randomly generated sample of 400 primary care practices of Baden-Wuerttemberg were invited to take part in a paper-based questionnaire. The data were gathered anonymously and analysed descriptively.Out of those invited, n=63 (15.8%) primary care practices and n=92 (33.9%) SARS-CoV-2 contact points participated; 78.7% of the primary care practices cooperated with SARS-CoV-2 contact points (n=48). In all, 92.1% had implemented a compulsory registration by phone for patients with (suspected) COVID-19 (n=58) and 81% offered consultation exclusively by phone or video in case of a mild courses (n=51). The new outpatient SARS-CoV-2 contact points were established in collaboration with several stakeholders, mainly led by primary care physicians (n=76, 82.6%) and almost 50% of these were established in March 2020 (n=42, 48.3%). The most commonly reported method of registration was regulated mainly by primary care practices (n=88, 95.7%) and public health departments (n=74, 80.4%). In 92.4% (n=85) of cases, it was possible to register by phone. The consultation response was most commonly given in the form of oral information to the patient (n=65, 77.4%). Less then 50% of the SARS-CoV-2 contact points used standardized sheets for registration, documentation and consultation. The assessment of future primary care structures for (suspected) COVID-19 patients were heterogeneous.Effort, improvisation and collaboration were required for a successful and rapid implementation of measures for primary care during the initial period of the COVID-19 pandemic. Impulses for ongoing development of primary care strategies during a pandemic can be derived out of these results.Das Ziel der Arbeit war eine deskriptive frühzeitige Momentaufnahme von Einleitung und Umsetzung ambulanter Strategien im primärärztlichen Setting zur Bewältigung der frühen Phase der COVID-19- Pandemie in Baden-Württemberg (Deutschland).Im Juni 2020 erhielten alle 271 Corona-Anlaufstellen unter Trägerschaft der Kassenärztlichen Vereinigung (16 Abstrichstellen, 204 Corona-Schwerpunktpraxen, 51 Zentrale Fieberambulanzen) sowie eine zufällig generierte Stichprobe von 400 Hausarztpraxen aus Baden-Württemberg einen papierbasierten Fragebogen. Die Daten wurden anonym erhoben und deskriptiv ausgewertet.Insgesamt nahmen n=63 (15,8%) Hausarztpraxen und n=92 (33,9%) Corona-Anlaufstellen teil. 78,7% der Hausarztpraxen nutzten Corona-Anlaufstellen (n=48). 92,1% hatten eine verpflichtende telefonische Anmeldung für PatientInnen mit (vermuteter) COVID-19-Erkrankung (n=58) implementiert. 81% boten bei leichtem Verlauf eine rein telefonische oder videokonsultatorische Versorgung an (n=51). Parallel dazu wurden die neuen ambulanten Corona-Anlaufstellen vorwiegend unter hausärztlicher Leitung (n=76, 82,6%) in Zusammenarbeit mit weiteren Akteuren, in fast der Hälfte der Fälle bereits im März aufgebaut (n=42, 48,3%). Die am häufigsten genannten Anmeldepfade waren gesteuert und konnten vorwiegend über HausärztInnen (n=88, 95,7%) und Gesundheitsamt (n=74, 80,4%), aber auch durch weitere Akteure erfolgen. In 92,4% (n=85) konnte eine telefonische Anmeldung erfolgen. Die mündliche Rückmeldung an die PatientInnen (n=65, 77,4%) war der am häufigsten genannte Rückmeldeweg. In weniger als der Hälfte der Corona-Anlaufstellen lagen standardisierte Anmelde-, Dokumentations- und Rückmeldebögen vor. Die Einschätzung der zukünftigen Versorgungsstrukturen von PatientInnen mit (vermuteter) COVID-19-Erkrankung waren heterogen.In einem gemeinsamen Kraftakt, mit Improvisation und Zusammenarbeit gelang eine rasche Implementierung von Maßnahmen zur Patientenversorgung während der Anfangsphase der Pandemie im primärärztlichen Setting. Aus den Ergebnissen können Impulse für die primärärztliche Versorgung in einer Pandemie abgeleitet werden.

To screen for infection with Chlamydia trachomatis in semen samples from asymptomatic men in couples consulting for infertility and to determine the relationship of seminal chlamydial antibodies with clinically relevant parameters of male fertility, 197 randomly chosen patients were enrolled in a prospective study. The median duration of infertility was 4 years (range 1-18). Screening for C. trachomatis and chlamydial antibodies of the immunoglobulin (Ig) A and IgG classes were performed in ejaculates and, in parallel, endocervical material from the partners of the patients and serum samples from both partners were evaluated. A comprehensive examination of semen quality included sperm analyses, semen cultures, local antisperm antibody (ASA) testing, the determination of potential infection markers, and sperm-cervical mucus interaction testing in vitro (SCMPT) and in vivo (post-coital testing). Chlamydial IgA antibodies were found in the semen samples of 18.8% (37/197) of the patients, while chlamydial IgG antibodies were found in 8.1% (16/197) of the patients. Screening for C. trachomatis was negative in all semen and cervical specimens. Only 5.5% of men remembered a past genital infection. Chlamydia antibodies (IgA/Ig/G) in semen were significantly correlated with chlamydia IgG antibodies in serum samples (P < 0.001). No marked relationship was found between the presence of seminal chlamydial antibodies and the major parameters of sperm analysis, semen cultures, local ASA and sperm penetration testing as an indicator of functional capacity. Seminal chlamydial antibodies were not significantly associated with potential infection or inflammation markers in aliquots of the same ejaculates. However, a significant relationship of chlamydial antibodies in patients' semen with past genital infections of their female partners was found with clinical relevance for a tubal infertility factor. The results indicate that in asymptomatic patients the presence of chlamydial antibody IgA or IgG in semen is not associated with reduced semen quality, potential seminal infection markers or impaired functional capacity as important determinants of male fertility; however, seminal chlamydial antibodies suggesting a previous sexually transmitted disease are significantly related to a tubal infertility factor of female partners.