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Self-management interventions for adult haemodialysis patients: a scoping review of randomized controlled trials
No full textBackgroundEffective self-management is crucial for individuals undergoing haemodialysis to prevent complications, which can lead to morbidity and mortality. However, among this population self-management behaviours are often inadequate. To improve patient outcomes interventions that promote and enhance self-management behaviours are essential.ObjectiveThis study aimed to provide an overview of the current body of evidence from randomized controlled trials (RCTs) on self-management interventions for haemodialysis patients. First, we aimed to present the outcomes investigated, their corresponding measurement tools and the significant results of each study. Second, we examined the presence of various self-management components and activities within the interventions. We aimed to identify new, underrepresented, and absent self-management components and activities found in the interventions.MethodsFollowing the scoping review process, a systematic literature search was conducted across six databases (MedLine All, Emcare, CINAHL, PsycINFO, Web of Science, Cochrane) to identify relevant studies. The search focused on RCTs involving adult haemodialysis patients. The review utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statements for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) approach. The included studies were required to address either self-management theories or self-management support interventions. Data were synthesized using a tabular format. The findings were analysed using content analysis based on the self-management concept.ResultsOverall, fourteen articles from eight countries were included. The findings illustrate the broad thematic scope of self-management interventions. Most frequent intervention outcomes were ‘quality of life’, ‘self-management’ and ‘self-efficacy’. The most used instrument was ‘Strategies used by people to promote health’ for measuring self-care self-efficacy. All authors of the included studies reported significant results of the intervention. The content analysis identified commonly employed self-management components and activities for haemodialysis patients, such as ‘emotion regulation’, ‘medication adherence’, and ‘diet management’. It revealed underrepresented (infection control), absent (smoking cessation), and new (stress management) self-management dimensions.ConclusionThis innovative scoping review represents the first comprehensive overview of self-management intervention outcomes, their measurements, and significant results while simultaneously highlighting the complex self-management components and activities that haemodialysis patients must navigate on a daily basis. The identified gaps and opportunities underscore important areas for future intervention development
Social–ecological traps in agroforestry and the role of law
No full textAgroforestry is an example of a social–ecological system that was once common across Europe, but has largely disappeared with the intensification of agriculture. Although agroforestry law has been shown to be an obstacle to the adoption of agroforestry by farmers, little is known about the implementation of agroforestry law at the local level and its interaction with other social–ecological feedback processes. In targeting this research gap, we conducted semi-structured interviews with farmers, non-governmental organisations and administration in three case study regions across Germany. To understand the interaction of agroforestry law with other social–ecological feedback processes, we adopted the perspective of social–ecological traps (SET). We find that (1) agriculture in Germany is currently at a crossroad, where farmers are playing the role of pioneers and adopting agroforestry as a new farming practice to escape prevailing path-dependent processes. Moreover, we show that (2) agroforestry law is closely intertwined with other social–ecological feedback processes and plays a dual role in promoting and hindering agroforestry in the case study regions. Our study may inform the further revision of the European and national laws and highlights the need to take a holistic approach to the law
Ukrainian linguistic creativity and decolonial resistance: a Twitter analysis
No full textIn this study, I conduct an analysis of Ukrainian-language tweets from 2022, the year of Russia’s full-scale invasion, using the statistical software R. After a brief overview of the linguistic history of Ukraine and how it has been shaped by Russia, resulting in widespread Ukrainian-Russian bilingualism, I discuss the challenges of working with Ukrainian Twitter data and compiling a Twitter corpus concerned with Russia’s war in Ukraine. Subsequently, I conduct the analysis and visualize the results. The analysis reveals that, since Russia’s invasion on February 24, 2022, Ukrainians have employed various means, such as nicknames and slurs for members of the aggressor state, decapitalization of proper nouns, the creative use of prepositions, and creative orthography and ‘Mock Russian.’ Sentiment analysis suggests that Ukrainian Twitter users respond positively to certain war-related events, demonstrating confidence and the will to resist the aggressor. Furthermore, the study demonstrates that linguistic questions are relevant for Ukrainian society at war, showing that the analysis of linguistic behavior on social media helps to shed light on how Ukrainians cope with Russia’s war of aggression and how they use social media as a tool for decolonial resistance
Correction: Cancer care in German centers of excellence during the first 2 years of the COVID-19 pandemic
No full textPersonalized radiation therapy planning for primary prostate cancer: comparative analysis between multiparametric MRI and PSMA PET/CT for focal dose escalation and linking clinical parameters with radiosensitivity
No full textPCa is the second leading cause of cancer-related death among men in Germany. This study aims to advance personalized RT for primary PCa by tailoring treatment to individual tumor characteristics. The primary objective is to compare the efficacy of imaging for precise tumor localization and delineation. Additionally, the potential for intensifying RT by optimizing radiation doses based on the tumor's unique sensitivity is explored.In the clinical study, 93 patients from two German university hospitals underwent pre-therapeutic 3T mpMRI and [18F] PSMA-1007 PET/CT (Freiburg) or [18F] PSMA-1007 PET/MRI (Dresden). The study included GTV delineation and T-staging using both imaging methods. A subgroup analysis of 20 patients undergoing prostatectomy assessed tumor laterality. Sensitivity and specificity were calculatedusing a quadrant-based approach. Another cohort of 16 patients scheduled for HDR-BT underwent pretherapeutic imaging. Tissue samples were irradiated and analyzed using specific staining techniques. The study categorized patients into radio-sensitive and radio-resistant groups, exploring correlations between radio response and different parameters.The results showed that PSMA PET outperformed mpMRI in identifying intraprostatic tumor lesions and classifying cT2c and cT3b stages. Concordance rates between PET and MRI were observed, with PET exhibiting significantly higher concordance with surgery specimens. In a subgroup of 20 patients, GTV-PET demonstrated higher sensitivity than GTV-MRI, while GTV-MRI showed higher specificity. The distribution of residual γH2AX foci after ex-vivo irradiation was observed. Patients were categorized into radio-resistant and radio-sensitive groups based on median normalized γH2AX foci values. Significant differences were observed in PSA, SUV-max, SUV-mean, and ADC-mean values between the two groups. Unirradiated samples from nine patients underwent NGS, revealing detectable mutations in four patients, including variants in ATM, BRCA1, and PMS2 genes. One patient had a novel NBN gene frameshift mutation. ALDH1A1-positive tumor areas in three patients exhibited significantly smaller γH2AX foci values than ALDH1A1-negative fields.This study aimed to improve personalized RT for PCa by comparing [18F] PSMA-1007 PET/CT with mpMRI in two patient cohorts. Results indicated superior tumor detection and larger volumes with PSMA PET, showing higher concordance with surgical specimens and increased sensitivity. The findings underline the necessity for both imaging methods in treatment planning, considering the intrinsic radiosensitivity's impact on RT response and recognizing the need for personalized approaches in PCa treatment.PCa ist eine der häufigsten malignen Erkrankungen und die zweithäufigste Krebstodesursache bei Männern in Deutschland. Ziel dieser Studie ist es, die personalisierte Strahlentherapie des primären PCadurch die Anpassung der Behandlung an die individuellen Tumoreigenschaften voranzutreiben. DieWirksamkeit von bildgebender Verfahren zur genauen Abgrenzung von Tumoren wird untersucht, sowie das Potenzial zur Intensivierung der Strahlentherapie durch die Optimierung der Strahlendosis in Abhängigkeit von der individuellen Tumorsensitivität.In die klinische Studie wurden 93 Patienten aus zwei deutschen Universitätskliniken eingeschlossen. Die Patienten erhielten vor der Therapie entweder 3T-mpMRI und [18F] PSMA-1007 PET/CT (Freiburg) oder [18F] PSMA-1007 PET/MRT (Dresden). Die Studie umfasste die Abgrenzung des GTV und die Bestimmung der T-Stadien. Eine Analyse von 20 Patienten, die eine Prostatektomie erhielten, diente zur Beurteilung der Tumor-Lateralität und Bestimmung von Sensitivität und Spezifität. Eine weitere Kohorte von 16 Patienten, die für eine HDR-BT vorgesehen waren, wurde analysiert. Die entnommenen Gewebeproben wurden bestrahlt und gefärbt. Die Studie kategorisierte die Patienten in strahlenempfindliche und strahlenresistente Gruppen und untersuchte Zusammenhänge zwischen die Antwort auf Bestrahlung und verschiedene Parametern.Die Ergebnisse zeigten eine Überlegenheit der PSMA PET gegenüber mpMRI bei der Identifizierung von GTVs und der Klassifikation von cT2c- und cT3b-Stadien. Es wurden Übereinstimmungen zwischen PET und MRT beobachtet, wobei PET eine signifikant höhere Übereinstimmung mit den Operationspräparaten zeigte. In der Untergruppe zeigte GTV-PET eine höhere Sensitivität als GTVMRT, während GTV-MRT eine höhere Spezifität aufwies. In der zweiten Kohorte wurden die Patientenanhand der medianen normalisierten γH2AX-Werte in strahlesensitive und strahlenresistente Gruppen eingeteilt. Signifikante Unterschiede wurden in PSA-, SUV-max-, SUV-mean- und ADC-mean-Werten beobachtet. Nicht bestrahlte Proben wurden einer NGS unterzogen. Von denen zeigten vier Patienten nachweisbare Mutationen, darunter Varianten in den Genen ATM, BRCA1 und PMS2 und eine NBNGen-Shift-Mutation. ALDH1A1-positiven Tumorareale bei drei Patienten wiesen signifikant kleinere γH2AX-Werte auf als ALDH1A1-negative Areale.Diese Studie hatte das Ziel, die personalisierte RT für PCa zu verbessern, indem [18F] PSMA-1007 PET/CT mit mpMRI verglichen wurde und potenziele prediktive Faktoren für RT analysiert wurden. Die Befunde unterstreichen die Notwendigkeit beider Bildgebungsverfahren in der Behandlungsplanung und erkennen den Bedarf an personalisierten Ansätzen in der Prostatakrebsbehandlung a
The RRM domain–containing protein Rbp3 interacts with ribosomes and the 3’ ends of mRNAs encoding photosynthesis proteins
No full text
oDigital pathology biomarkers for guiding radiotherapy-based treatment concepts in prostate cancer - a systematic review and expert consensus
No full textEntwicklung eines Kommunikationskonzepts zur Föderung der Gesundheitsbildung im Rahmen eines Volkshochschulkurses über Klimaanpassung. Identifikation der Kommunikationsmöglichkeiten in Rastatt anhand qualitativer Interviews
No full textTeaching neonatal emergency umbilical venous access to untrained medical staff: a pilot study using video instruction and real umbilical cords
No full textBackground: Establishing intravenous access in newborns in an emergency situation is a challenge even for well-trained neonatologists. As not all hospitals have a neonatology department, other specialists such as anaesthesiologists and obstetricians must also be able to quickly establishing venous access. Consequently, there is a need for teaching strategies that can be used for a large group of people.Aim: To evaluate the applicability and the acceptance of a teaching method for umbilical venous access that can be implemented in hospitals with obstetric departments following the principles of simulation-based learning.Methods: Single-center cross-over pilot-study with video-based teaching of medical students using a model with fresh umbilical cords. The volunteers performed three techniques: standard umbilical cord cut - umbilical button cannula (S-EUC), lateral incision - umbilical button cannula (L-EUC) and standard umbilical cord cut - umbilical catheter (S-UC). Participants’ acceptance of the teaching method was evaluated using Likert-scale.Results: The video teaching was considered as easy to learn and understand for all three techniques. After practicing on the model, most participants believed that they could successfully apply at least one of the techniques if faced with a real emergency situation. Subjects were able to perform the techniques in similar timescales to those published in the literature for the standard technique (S-UC).Conclusion: The teaching method combining video learning and practical training on real umbilical cords, is suitable for teaching venous access in newborns even for untrained personnel. The model can be replicated using materials every obstetrics department has at hand