The meaning of continuity of care from the perspective of older people with complex care needs-A scoping review.

People aged 65 years or older with complex care needs are at risk of fragmented care. This may jeopardise patient safety. Complex care needs are defined as care needs that require the performance of time-consuming processes such as reviewing medical history, providing counselling, and prescribing medications.

Influence of Heterogeneity on the Ultrafast Photoisomerization Dynamics of Pfr in Cph1 Phytochrome.

Photoisomerization of a protein-bound chromophore is the basis of light sensing and signaling in many photoreceptors. Phytochrome photoreceptors can be photoconverted reversibly between the Pr and Pfr states through photoisomerization of the methine bridge between rings C and D. Ground-state heterogeneity of the chromophore has been reported for both Pr and Pfr.

[Institutional handling of sexual abuse: experiences, evaluations, and desires of nonabusing parents of sexually abused children].

This article describes experiences of parents of sexual abused children and their evaluations of institutional interventions on sexual child abuse. Results are presented of a study investigating 'individual and institutional reactions on sexual child abuse'. The number of contacted institutions, personnel experiences with these institutions and resulting requirements are described.

[Institutional handling of criminal measures in sexual abuse. Results of a survey of experts].

A broad spectrum of very different institutions is confronted with the problem of sexual child abuse. So far, only a few systematic descriptions of institutional interventions and their impact on sexually abused children exist. In this article, first results are presented of a study investigating "individual and institutional reactions on sexual child abuse'.

Acceleration-sensitivity threshold of Physarum.

Free-living cells show distinct gravisensitivities and often use the gravity ('g') vector for their spatial orientation. The rhythmic contractions of the ameboid Myxomycete (acellular slime mold) Physarum polycephalum are a sensitive parameter which can be modified by external stimuli. Space experiments and ground-based 0 x g simulation studies established that the contraction period transiently decreases after a transition from 1 x g to 0 x g with a back-regulating process starting after 30 min.

Gravity perception and signal transduction in single cells.

Cellular signal processing in multi-, as well as in unicellular organisms, has to rely on fundamentally similar mechanisms. Free-living single cells often use the gravity vector for their spatial orientation (gravitaxis) and show distinct gravisensitivities. In this investigation the gravisensitive giant ameboid cell Physarum polycephalum (Myxomycetes, acellular slime molds) is used.

Gravitational response of the slime mold Physarum.

The acellular slime mold Physarum polycephalum is used as a model system to investigate the graviresponse of single cells which possess no receptors specialized for the perception of gravity. To obtain insights into the gravity-signal transduction mechanism the light response of the cell is used: Macroplasmodia of the slime mold show clear geo- and phototaxes. Gravity increases and white light decreases transiently the contraction frequency of plasmodial strands whereby both responses follow the same time pattern.

Histopathologic analysis of suspected amiodarone hepatotoxicity.

This analysis of the morphology of suspected amiodarone (AD) liver disease is based on a study of liver specimens from 17 individuals. Changes similar to alcoholic liver injury were commonly seen. Steatosis, both macrovesicular and microvesicular, was the most frequent histopathologic feature.

6-Mercaptopurine in the management of inflammatory bowel disease: short- and long-term toxicity.

We assess toxicity related to 6-mercaptopurine in the treatment of inflammatory bowel disease by reporting our experience with 396 patients (120 patients with ulcerative colitis, 276 with Crohn disease) observed over 18 years. Follow-up data for a mean period of 60.3 months were obtained for 90% of the patients.

Fecal alpha 1-antitrypsin measurement: an indicator of Crohn's disease activity.

Random fecal alpha 1-antitrypsin levels were determined in 34 patients, 24 with Crohn's disease, and 10 "controls" having diarrheal illnesses not associated with intestinal protein loss, in an effort to evaluate its usefulness as a measure of Crohn's disease intestinal activity. In the control group, all alpha 1-antitrypsin levels were less than 2 mg/g dry wt of stool. The mean fecal level among those with Crohn's disease was 52.

Role of plasmapheresis in primary biliary cirrhosis.

Five patients with primary biliary cirrhosis and prolonged cholestasis underwent intensive plasmapheresis. The indications for plasmapheresis included intractable pruritus or hypercholesterolemia and xanthomatous neuropathy. Patients noted a rapid improvement of pruritus and fatigue which was sustained as long as plasmapheresis was continued.

The clinical effectiveness and safety of chronic plasmapheresis in patients with primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is a chronic nonsuppurative, destructive cholangitis, whose etiology is unknown. Morbidity arises early from pruritus and later from hypercholesterolemia with xanthoma formation. Therapy is supportive and directed at the complications of cholestasis.

Mycobacterium avium-intracellulare-associated colitis in a patient with the acquired immunodeficiency syndrome.

A 40-year-old bisexual man with the acquired immunodeficiency syndrome developed abdominal pain and bloody diarrhea. At sigmoidoscopy, the mucosa of the rectum and sigmoid colon was edematous, erythematous, and friable, with multiple linear and oval erosions. Histologic examination of rectal biopsies demonstrated innumerable acid-fast bacilli free and within macrophages of the lamina propria.

Malignancy in primary biliary cirrhosis. High incidence of breast cancer in affected women.

Primary biliary cirrhosis is characterized by abnormalities in both cellular and humoral immunity. It is associated with presumably autoimmune diseases such as Sjögren's syndrome, rheumatoid arthritis, and scleroderma. Sjögren's syndrome and scleroderma have been noted to have an increased frequency of malignancy.