[The potentials of patient surveys for quality assurance in medical care]. / Die Potenziale von Patientenbefragungen für die Qualitätssicherung in der medizinischen Versorgung.

What constitutes "quality" in medical care and the means by which it is controlled, secured, or (re-)established has largely been assigned to the joint self-administration of service providers and health insurers in Germany. The current implementation uses an understanding of quality that does not sufficiently take into account important patient-centered quality dimensions. One of the reasons for this might be that patient surveys are not yet recognized as an equivalent data source for quality assessment in the German healthcare context and are not yet established nationwide. Where patient survey instruments are used, they are often reduced to the survey of so-called patient satisfaction. In the future, survey instruments must be viewed and used in a much more differentiated manner.Indication-specific patient surveys on treatment results (patient-reported outcome measures; PROMs) can provide information on the success of treatment in certain diseases. With the targeted collection of patient experiences (patient-reported experience measures; PREMs), the process quality can also be determined. The routine use of corresponding patient surveys is provided according to §§ 136 ff. and § 299 Social Security Code Book V (SGB V) for the purposes of legally binding external quality assurance. Their use is intended to support the alignment of the health system towards value and benefit for patients. To this extent, there is an urgent need for implementation and considerable further development.

Crop nitrogen monitoring: Recent progress and principal developments in the context of imaging spectroscopy missions.

Nitrogen (N) is considered as one of the most important plant macronutrients and proper management of N therefore is a pre-requisite for modern agriculture. Continuous satellite-based monitoring of this key plant trait would help to understand individual crop N use efficiency and thus would enable site-specific N management. Since hyperspectral imaging sensors could provide detailed measurements of spectral signatures corresponding to the optical activity of chemical constituents, they have a theoretical advantage over multi-spectral sensing for the detection of crop N. The current study aims to provide a state-of-the-art overview of crop N retrieval methods from hyperspectral data in the agricultural sector and in the context of future satellite imaging spectroscopy missions. Over 400 studies were reviewed for this purpose, identifying those estimating mass-based N (N concentration, N%) and area-based N (N content, Narea) using hyperspectral remote sensing data. Retrieval methods of the 125 studies selected in this review can be grouped into: (1) parametric regression methods, (2) linear nonparametric regression methods or chemometrics, (3) nonlinear nonparametric regression methods or machine learning regression algorithms, (4) physically-based or radiative transfer models (RTM), (5) use of alternative data sources (sun-induced fluorescence, SIF) and (6) hybrid or combined techniques. Whereas in the last decades methods for estimation of Narea and N% from hyperspectral data have been mainly based on simple parametric regression algorithms, such as narrowband vegetation indices, there is an increasing trend of using machine learning, RTM and hybrid techniques. Within plants, N is invested in proteins and chlorophylls stored in the leaf cells, with the proteins being the major nitrogen-containing biochemical constituent. However, in most studies, the relationship between N and chlorophyll content was used to estimate crop N, focusing on the visible-near infrared (VNIR) spectral domains, and thus neglecting protein-related N and reallocation of nitrogen to non-photosynthetic compartments. Therefore, we recommend exploiting the estimation of nitrogen via the proxy of proteins using hyperspectral data and in particular the short-wave infrared (SWIR) spectral domain. We further strongly encourage a standardization of nitrogen terminology, distinguishing between N% and Narea. Moreover, the exploitation of physically-based approaches is highly recommended combined with machine learning regression algorithms, which represents an interesting perspective for future research in view of new spaceborne imaging spectroscopy sensors.

[DNVF Memorandum Health Literacy (Part 1) - Background, Relevance, Research Topics and Questions in Health Services Research]. / DNVF Memorandum Gesundheitskompetenz (Teil 1) ­ Hintergrund, Relevanz, Gegenstand und Fragestellungen in der Versorgungsforschung.

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. The DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings. The relevance of health literacy research is worked out in different phases of life, for different target groups and in different healthcare contexts. Central research topics and future research desiderata are derived.

[DNVF Memorandum Health Literacy (Part 1) - Background, Relevance, Research Topics and Questions in Health Services Research: Short Version]. / DNVF Memorandum Gesundheitskompetenz (Teil 1) ­ Hintergrund, Relevanz, Gegenstand und Fragestellungen in der Versorgungsforschung: Kurzfassung.

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. This short version of the DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings. Central research topics and future research desiderata are derived.

[Patient involvement: challenges for organized self-help and joint self-government]. / Patientenbeteiligung: Herausforderungen für die verbandliche Selbsthilfe und die Gemeinsame Selbstverwaltung.

The involvement of the patient perspective in decision-making processes in the healthcare system is commonly welcome, especially in Germany, with self-help organizations currently providing the vast majority of patient representatives in the various committees. The central plank of organized self-help is the mutual support of chronically diseased and disabled people as well as their relatives in self-help groups.Patient involvement, however, seems to lead organized self-help to an insoluble dilemma. Either organized self-help must give up their traditional working principles in order to be capable of acting as a professional player in the discourse of the joint self-government of doctors and healthcare funds, or they will simply be unable to cope with patient involvement if they remain true to their original way of mutual exchange and communication. But if organized self-help and joint self-government are considered as social systems, it becomes clear that though patient involvement relates these systems to each other, it does not give rise to a relation of dominance and subordination. Organized self-help may have to handle the requirements and inputs of self-government as well as of the systems of science and law, but also has to be considered a challenge to and an opportunity for the self-government to help them achieve their system-related goals.

[Therapiesteuerung in der Hämatologie und Onkologie].

Die diesjährige Frühjahrstagung der DGHO (Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie e. V.) stand unter der Überschrift «Herausforderungen in der Onkologie - personalisierte Therapiesteuerung¼. Über drei Themenkomplexe hinweg wurden aktuelle Möglichkeiten und Perspektiven der Therapiesteuerung in der Onkologie hinsichtlich «Methoden¼, gelungenen «Beispielen¼ sowie der «Umsetzung in der Versorgung¼ diskutiert.

A Self-Adhesive Elastomeric Wound Scaffold for Sensitive Adhesion to Tissue.

Pressure sensitive adhesives based on silicone materials are used particularly for skin adhesion, e.g., the fixation of electrocardiogram (ECG) electrodes or wound dressings. However, adhesion to sensitive tissue structures is not sufficiently addressed due to the risk of damage or rupture. We propose an approach in which a poly-(dimethylsiloxane) (PDMS)-based soft skin adhesive (SSA) acts as cellular scaffold for wound healing. Due to the intrinsically low surface free energy of silicone elastomers, functionalization strategies are needed to promote the attachment and spreading of eukaryotic cells. In the present work, the effect of physical adsorption of three different proteins on the adhesive properties of the soft skin adhesive was investigated. Fibronectin adsorption slightly affects adhesion but significantly improves the cellular interaction of L929 murine fibroblasts with the polymeric surface. Composite films were successfully attached to explanted tympanic membranes. This demonstrates the potential of protein functionalized SSA to act as an adhesive scaffold in delicate biomedical applications.

[Kick-off article: Patients first in health care: Status quo]. / Impulsbeitrag: Patient First in der Gesundheitsversorgung: Status quo.

"Putting patients first in health care" seems to be a rhetorical statement. But is it really the case that patients always come first? And where exactly do we stand with patient involvement and patient orientation in Germany? What participation options are currently available? Is the patient involvement and patient orientation we have so far achieved sufficient? What needs to be done? These questions will be addressed in the following discussion. Patient self-help organizations, patient interest groups, patient representatives as well as the industrial and political decision-making bodies agree that the patient perspective should be more strongly integrated into health care and health care delivery decisions. The relevant information and sources of evidence, however, are yet insufficiently provided and used. Patients are experts for their own cause. There is consensus that patient participation is and must be an integral part of all levels of health care. Patient representation has made enormous progress in the last decade. This article outlines the current state of affairs of patient representation, patient involvement, their legal legitimacy and possible future scenarios. The transformation from of a paternalistically oriented health care system towards a patient-oriented system is far advanced, but much remains to be done. (As supplied by guesteditors).