Utilization and quality of primary and specialized palliative homecare in nursing home residents vs. community dwellers: a claims data analysis.

Background: There are hardly any data on the extent to which nursing home residents are provided with palliative homecare. We want to add evidence by comparing nursing home residents (who had been living in a nursing home for at least one year) and nursing-care-dependent community dwellers in terms of utilization and quality of palliative homecare.

Methods: We conducted a population-based study with nationwide claims data from deceased beneficiaries of a large German health insurance provider.

Cost-effectiveness of a multicomponent intervention against cognitive decline.

Introduction: The societal costs of dementia and cognitive decline are substantial and likely to increase during the next decades due to the increasing number of people in older age groups. The aim of this multicenter cluster-randomized controlled trial was to assess the cost-effectiveness of a multi-domain intervention to prevent cognitive decline in older people who are at risk for dementia.

Methods: We used data from a multi-centric, two-armed, cluster-randomized controlled trial ( trial, ID: DRKS00013555).

Care for post-COVID-19 condition in Germany from the perspectives of patients, informal caregivers and general practitioners: Study protocol for a mixed methods study.

Background: A large number of individuals suffer from post-COVID-19 condition (PCC), characterised by persistent symptoms following a SARS-CoV-2 infection with an impact on daily personal and professional activities. This study aims at examining which (health) care services are used by PCC patients in the German federal state of Lower Saxony, and how these patients manage their condition. The perspectives of patients, informal caregivers and general practitioners (GPs) will be considered.

Mixed-methods process evaluation of a proactive approach to healthcare in Parkinson's disease-ParkProReakt: a protocol of a hybrid efficacy-implementation study.

Introduction: People with Parkinson's disease (PwPD) experience a wide range of motor and non-motor symptoms that have a significant impact on their health and quality of life. Effective care management for PwPD involves monitoring symptoms at home, involving specialised multidisciplinary care providers and enhancing self-management skills. This study protocol describes the process evaluation within a randomised clinical trial to assess the implementation and its impact on patient health outcomes of ParkProReakt-a proactive, multidisciplinary, digitally supported care model for community-dwelling PwPD.

Effects of timely case conferencing between general practitioners and specialist palliative care services on symptom burden in patients with advanced chronic disease: results of the cluster-randomised controlled KOPAL trial.

Background: Patients with advanced chronic non-malignant conditions often experience significant symptom burden. Therefore, overcoming barriers to interprofessional collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams is essential to facilitate the timely integration of palliative care elements. The KOPAL trial aimed to examine the impact of case conferences between GPs and SPHC teams on symptom burden and pain in patients with advanced chronic heart failure, chronic obstructive pulmonary disease, and dementia.

Report from the Fourth International Last Aid Conference: Last Aid and networks in community palliative care.

The Fourth International Last Aid Conference was held from 4th to 6th September 2024 in Cologne, Germany. Seventy-three participants from 16 different countries and nationalities participated in the Fourth International Last Aid conference in the Mildred Scheel Academy and the Department of Palliative Medicine at the University Hospital of Cologne, Germany. The main topics of the conference were experiences with Last Aid Courses, research on public palliative care education (PPCE) and networks in community palliative care from different countries.

Social participation and cognitive activities as explanation factor for the association between income and self-rated health for older adults.

Introduction: Health disparities pose a considerable challenge for older adults individuals, particularly those with a heightened risk of developing dementia. Discrepancies in health status among various income brackets are only partially attributable to structural factors such as working and living conditions or the quality of food. The aim of this study was therefore to explore whether and to what extent various health-promoting behaviors can explain the association between household income and self-rated health among older people at risk of dementia.

Provision of hospice and palliative care and implementation of advance care planning for residents in German nursing homes - a cross-sectional study.

Background: Demographic changes are leading to a rise in the demand for care services, with nursing homes (NHs) playing an increasingly important role in end-of-life care. Evidence suggests that NH residents at the end of life significantly benefit from hospice and palliative care and the implementation of advance care planning (ACP). In 2018, Germany passed a law to promote the implementation of ACP in NHs and to enable the refinancing of ACP services by the statutory health insurance funds.

Challenges of regional hospice and palliative care networks: A group discussion study with coordinators and network experts.

Background: Within hospice and palliative care, professionals from various disciplines collaborate to deliver comprehensive care to terminal patients and their relatives. Regional hospice and palliative care networks exist in various countries, aimed at facilitating cooperation among health care providers at a local level. To date, little is known about the challenges faced by these networks.

Alzheimer's disease-specific transcriptomic and epigenomic changes in the tryptophan catabolic pathway.

Background: Neurodegenerative disorders, including Alzheimer's disease (AD), have been linked to alterations in tryptophan (TRP) metabolism. However, no studies to date have systematically explored changes in the TRP pathway at both transcriptional and epigenetic levels. This study aimed to investigate transcriptomic, DNA methylomic (5mC) and hydroxymethylomic (5hmC) changes within genes involved in the TRP and nicotinamide adenine dinucleotide (NAD) pathways in AD, using three independent cohorts.

Who Changes Indwelling Urinary Catheters in Male Nursing Home Residents and Where? Results from a Nationwide Cross-Sectional Survey in Germany.

Introduction: We examined the practice and variability of indwelling urinary catheter changes in male nursing home residents.

Methods: Cross-sectional data from a nationwide survey conducted in a representative sample of German nursing homes in 2023 were analyzed. The professions conducting most transurethral/suprapubic catheter changes in men were identified, and proportions for whom respective catheters are changed in nursing homes were determined.

The Doctors, Their Patients, and the Symptom Checker App: Qualitative Interview Study With General Practitioners in Germany.

Background: Symptom checkers are designed for laypeople and promise to provide a preliminary diagnosis, a sense of urgency, and a suggested course of action.

Objective: We used the international symptom checker app (SCA) Ada App as an example to answer the following question: How do general practitioners (GPs) experience the SCA in relation to the macro, meso, and micro level of their daily work, and how does this interact with work-related psychosocial resources and demands?

Methods: We conducted 8 semistructured interviews with GPs in Germany between December 2020 and February 2022. We analyzed the data using the integrative basic method, an interpretative-reconstructive method, to identify core themes and modes of thematization.

Effects of yoga on stress in stressed adults: a systematic review and meta-analysis.

Background: With the increasing prevalence of stress, stress reduction is getting more and more important. Yoga is being considered as a non-pharmacological treatment option for stress.

Objective: Investigation of the effects of yoga on stress in stressed adults from the general population.

Enhancing patient activation: a controlled implementation study of an interprofessional evidence-based counseling program for complementary and integrative healthcare in cancer patients ('CCC-Integrativ').

Complementary and integrative healthcare (CIH) is increasingly recognized as a valuable approach to empowering and activating cancer patients. Studies have shown that higher patient activation is positively associated with improved health outcomes and reduced healthcare costs. The CCC-Integrativ study aimed to assess the implementation of an evidence-based counseling service on CIH at four Comprehensive Cancer Centers (CCC) in Germany.

Recommendations for Psychosocial Support for Long-Distance Caregivers of Terminally Ill Patients.

Context: The provision of appropriate psychosocial support has a significant impact on quality of life for informal caregivers of terminally ill patients. Long-distance caregivers have specific wishes and needs for psychosocial support.

Objectives: To date, no formal support measures for long-distance caregivers of terminally ill patients have been developed in Germany.

Does voluntary practice improve the outcome of an OSCE in undergraduate medical studies? A Propensity Score Matching approach.

In Objective Structured Clinical Examinations (OSCE), students have to demonstrate proficiency in a wide array of medical knowledge and different skills, ranging from physical examinations to medical-practical skills and doctor-patient interactions. In this study, we empirically test the concept 'assessment drives learning' and investigate whether an OSCE motivates extracurricular, voluntary free practice (FP) of specific skills in a Skills Lab, and whether this has positive treatment effects on exam success in the respective parts of the OSCE. To explore causal inference with observational data, we used Propensity Score Matching (PSM) to generate a control and a treatment group that only differed in their practice behavior.

Experiences of patients with advanced chronic diseases and their associates with a structured palliative care nurse visit followed by an interprofessional case conference in primary care - a deductive-inductive content analysis based on qualitative interviews (KOPAL-Study).

Background: Chronic, non-malignant diseases (CNMD) like chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and dementia in advanced stages are very burdensome for patients. Timely palliative care with strong collaboration between general practitioners (GPs) and specialist palliative home care (SPHC) teams can reduce symptom burden, hospitalization rates, hospitalization costs and overall healthcare costs. The KOPAL-study on strengthening interprofessional collaboration for patients with palliative care needs tested the effect of an intervention comprising of a SPHC nurse assessment and an interprofessional case conference.

How does the role of complementary and alternative medicine in general practice differ between countries? Interviews with doctors who have worked both in Germany and elsewhere in Europe.

Background: Available data suggest that general practitioners (GPs) in Germany use complementary and alternative medicine (CAM) modalities more frequently than GPs in many other countries. We investigated the country differences perceived by general practitioners who have worked in Germany and in one of four other European countries with regard to the role of complementary and alternative treatments in primary care.

Methods: In this qualitative study we conducted semi-structured interviews with 12 GPs who had worked both in Germany and Italy, the Netherlands, Norway or the United Kingdom (UK; n = 3 for each of the four countries).

Profiles of Met and Unmet Care Needs in the Oldest Old Primary Care Patients with Cognitive Disorders and Dementia: Results of the AgeCoDe and AgeQualiDe Study.

Introduction: The prevalence of mild cognitive impairment (MCI) and dementia is increasing as the oldest old population grows, requiring a nuanced understanding of their care needs. Few studies have examined need profiles of oldest old patients with MCI or dementia. Therefore, this study aimed to identify patients' need profiles.

Prevalence of undetected chronic kidney disease in high-risk middle-aged patients in primary care: a cross-sectional study.

Introduction: The global health burden of chronic kidney disease (CKD) results from both the disease itself and the numerous health problems associated with it. The aim of this study was to estimate the prevalence of previously undetected CKD in middle-aged patients with risk factors for CKD. Identified patients were included in the Styrian nephrology awareness program "kidney.