Somatoform Disorders in Primary Care-An Exploratory Mixed-Methods Study on Experiences, Challenges and Coping Strategies of General Practitioners in the Federal Republic of Germany.

Somatoform symptoms are widely spread in outpatient care. For treating physicians, it can be challenging to establish a relationship that is conducive to compliance and to take stabilising action when dealing with affected patients. As primary care providers, GPs are usually the first point of contact for patients with somatoform disorders; they set the course for stabilisation and further care.

A QALY is [still] a QALY is [still] a QALY? : Evaluating proportional shortfall as the answer to the problem of equity in healthcare allocations.

Despite clinical evidence of drug superiority, therapeutic modalities, like combination immunotherapy, are mostly considered cost-ineffective due to their high costs per life year(s) gained. This paper, taking an ethical stand, reevaluates the standard cost-effectiveness analysis with that of the more recent justice-enhanced methods and concludes by pointing out the shortcomings of the current methodologies.

Primary care involvement in clinical research - prerequisites, motivators, and barriers: results from a study series.

Background: Long-term reinforcement in the role of primary care and improvement the healthcare system as a whole requires the involvement of GPs in clinical research processes. However, many clinical studies fail due to failure to achieve sample population targets amongst GPs and their patients. This issue has been identified and discussed, but effective strategies to overcome it are still lacking.

What requirements do primary care physicians have with regard to dementia diagnostics and dementia care? - a survey study among general practitioners in Germany 2022/2023.

Background: General practice offers good conditions to detect and provide care for dementia-related diseases. Nonetheless, the effectiveness of dementia care in general practice is repeatedly criticised. To date, few studies have attempted to form a comprehensive picture of the status quo of dementia care in general practice that focuses on GP perspectives of experience and action.

Online enquiries and health concerns - a survey of German general practitioners regarding experiences and strategies in patient care.

Aim: Increasingly at GP practices, patients appear who are extremely worried as a result of health information researched online and consequently affected by doubts and concerns. The study highlights GP attitudes and experiences with regard to this patient group. Moreover, it identifies strategies adopted by GPs to respond appropriately to worried or scared patients.

How to conceive the dignity of the dead? A dispositional account.

In dealing with human corpses, notions of dignity play a decisive role, especially within legal texts that regulate a corpse's handling. However, it is quite unclear how the claim "Treat human corpses with dignity!" should be understood and justified. Drawing upon examples and problems from forensic medicine, this paper explores three possible lines of interpreting such demands: (a) positions that closely link the dignity of the human corpse to the dignity of the former living persons and (b) accounts that derive the dignity of the dead from consequentialist considerations.

Promotion of Exercise and Health for Older People in Primary Care: A Qualitative Study on the Potential, Experiences and Strategies of General Practitioners in Germany.

In advanced age, physical activity becomes an important element in maintaining one's individual health. GPs are considered to be well suited for advising and attending to older patients according to the principles of (preventive) healthcare. The subject was examined in the context of a study that determined options for action, experiences and strategies relating to the physical activation of older patients by GPs.

Attitudes and experiences of registered diabetes specialists in using health apps for managing type 2 diabetes: results from a mixed-methods study in Germany 2021/2022.

Background: Hardly any area of application for health apps is seen to be as promising as health and lifestyle support in type 2 diabetes mellitus. Research has emphasised the benefits of such mHealth apps for disease prevention, monitoring, and management, but there is still a lack of empirical data on the role that health apps play in actual type 2 diabetes care. The aim of the present study was to gain an overview of the attitudes and experiences of physicians specialising in diabetes with regard to the benefits of health apps for type 2 diabetes prevention and management.

Attitudes, attributions, and usage patterns of primary care patients with regard to over-the-counter drugs-a survey in Germany.

Studies show that over-the-counter drugs are widely used by consumers. Moreover, there is a huge selection available and they are prominently featured in advertising. To date, there exist only a few studies that shed light on the attitudes, attributions, and usage patterns of patients with regard to use of over-the-counter drugs.

Eating disorder psychopathology: The role of attachment anxiety, attachment avoidance, and personality functioning.

Objective: Although the relationship between insecure attachment patterns and eating disorder (ED) psychopathology has repeatedly been demonstrated, the underlying mechanisms of this association are not fully understood. Therefore, the current study aimed to examine personality functioning, defined as an impairment in self and interpersonal functioning, as a mediator between attachment insecurity and ED psychopathology.

Methods: In a representative population-based sample (N = 2508; age range 14-92 years) ED symptomatology, personality functioning, and attachment insecurity (anxiety and avoidance) were assessed.

Experiences with Innovation Fund healthcare models in primary care: a qualitative study amongst German general practitioners.

The Innovation Fund was set up in 2015 with the aim of improving medical care in the German statutory health insurance system. Primary care needs to be involved in testing interventions and new forms of care for effectiveness and inclusion in standard care. There has so far been hardly any research on how far Innovation Fund models accommodate the primary care setting, or on the experience general practitioners have had with these models.

Evaluation of elevated liver values in primary care - a series of studies on the status quo of care in Germany with special reference to alcoholic liver disease.

Background: In primary care, elevated liver values often appear as incidental findings. As well considering the presenting symptoms, key factors in effective diagnosis are which liver values to include as indicators and when to refer patients for further diagnostics. It is also important that there is coordinated collaboration between GPs and specialists.

Prerequisites for providing effective support to family caregivers within the primary care setting - results of a study series in Germany.

Background: General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs.

The COPE-Trial-Communicating prognosis to parents in the neonatal ICU: Optimistic vs. PEssimistic: study protocol for a randomized controlled crossover trial using two different scripted video vignettes to explore communication preferences of parents of preterm infants.

Background: One of the numerous challenges preterm birth poses for parents and physicians is prognostic disclosure. Prognoses are based on scientific evidence and medical experience. They are subject to individual assessment and will generally remain uncertain with regard to the individual.

Collective agency and the concept of 'public' in public involvement: A practice-oriented analysis.

Background: Public involvement activities are promoted as measures for ensuring good governance in challenging fields, such as biomedical research and innovation. Proponents of public involvement activities include individual researchers as well as non-governmental and governmental organizations. However, the concept of 'public' in public involvement deserves more attention by researchers because it is not purely theoretical: it has important practical functions in the guidance, evaluation and translation of public involvement activities.

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"Staining is the Best Policy". Visualization in the work of Paul Ehrlich. For nearly all of his life, the biomedical scientist Paul Ehrlich dedicated himself to work on dyes and staining at the interface between so-called color-chemistry and histopathology.

Tales of healthy men: male reproductive bodies in biomedicine from 'Lebensborn' to sperm banks.

Using the example of 'sperm tales', borne out of the biomedical technologies that went hand in hand with the establishment of the 'science of man' (andrology), the article engages with the epistemic evolution of interrelated biomedical theories and concepts of what constitutes a 'healthy' reproductive male body. The article asks: how has the normative ideal male body been either perpetuated or interrogated through these tales of male reproduction at the interface between scientific and medical technologies? And how were changes to the normalization of male bodies central to clinical practices and cultural understandings of health and illness? With many aspects of the medical history of male reproduction in the 20th century still unexplored, this article will focus on the growing intervention of biomedicine to 'treat' male infertility by way of the classification, standardization and normalization of male corporeality, focusing in particular on the representation and construction of men and the male body, as reflected in medical science and practice from the second half of the 20th century onwards in Germany. The article analyses the rise in importance of sperm in biomedical investigation, including a consideration of the construction of infertility as the defining force behind concepts of 'healthy men', and examines the related conceptualization of male reproductive bodies at the crossroad between 'healthy' and 'normal'.

How to make sense of broadly applied medical classification systems: introducing epistemic hubs.

What are medical classification systems good for? Taking this question as a starting point, this paper argues that different answers have to be given depending on the scope of application of the classification system. While the use of restricted and specialised classification systems can be described rather well with the existing scientific taxonomy account, this account falls short to make sense of the function that systems play that are heterogeneous and imprecise but broadly applied, such as the International Statistical Classification of Diseases and Health-Related Problems (ICD). Given that the causal complexity and inter-individual heterogeneity of disease manifestation and progression challenge obtaining unambiguous, universally applicable definitions of the units of classification, this paper aims to introduce a pluralist account that relies on the concept of "epistemic hubs.

How reproductive and regenerative medicine meet in a Chinese fertility clinic. Interviews with women about the donation of embryos to stem cell research.

The social interface between reproductive medicine and embryonic stem cell research has been investigated in a pilot study at a large IVF clinic in central China. Methods included observation, interviews with hospital personnel, and five in-depth qualitative interviews with women who underwent IVF and who were asked for their consent to the donation of embryos for use in medical (in fact human embryonic stem cell) research. This paper reports, and discusses from an ethical perspective, the results of an analysis of these interviews.

Ethical aspects of human embryonic stem cell research in the islamic world: positions and reflections.

Rapid technological developments in human embryonic stem cell research are holding promises of future new medical treatment for a range of currently incurable chronic diseases. At the same time, stem cell research using human embryos raises radically new, previously unimaginable ethical issues posing a dramatic challenge to humankind. By analysing the discourses on these ethical issues we can show that the cultural values and religious convictions of all stakeholders involved play a decisive role in formulating ethical positions.

A 'little world of your own': stigma, gender and narratives of venereal disease contact tracing.

As in other countries, in order to protect the public from venereal disease (syphilis and gonorrhoea), contact tracing in New Zealand has been a public health strategy since the mid-20th century. So far, scholars have predominantly focused on the aspect of control of the cases traced. Based on a rare interview with a female contact tracer, together with a range of archival material, this article aims to expand the scholarship by focusing on the tracer instead of the patient.