[Systematic analysis of the readability of patient information on websites of German nonuniversity ENT hospitals]. / Systematische Analyse der Lesbarkeit von Patienteninformationstexten auf Internetseiten deutscher nichtuniversitärer HNO-Kliniken.

BACKGROUND: Besides their function as one of the main contact points, websites of hospitals serve as medical information portals. All patients should be able to understand medical information texts; regardless of their literacy skills and educational level. Online texts should thus have an appropriate structure to ease their comprehension. MATERIALS AND METHODS: Patient information texts on every German nonuniversity ENT hospital website (n = 125) were systematically analysed. For ten different ENT topics a representative medical information text was extracted from each website. Using objective text parameters and five established readability indices, the texts were analysed in terms of their readability and structure. Furthermore, we stratified the analysis in relation to the hospital organisation system and geographical region in Germany. RESULTS: Texts from 142 internet sites could be used for the definite analysis. On average, texts consisted of 15 sentences and 237 words. Readability indices congruously showed that the analysed texts could generally only be understood by a well-educated or even academic reader. CONCLUSION: The majority of patient information texts on German hospital websites are difficult to understand for most patients. In order to fulfil their goal of adequately informing the general population about disease, therapeutic options and the particular focal points of the clinic, a revision of most medical texts on the websites of German ENT hospitals is recommended.

Normative data collection of the Marburg Concentration Test for Pre-school Children (German: MKVK).

OBJECTIVE: The objective of this study was the standardization of the Marburg Concentration Test for Pre-school Children (German: MKVK) for 3- to 6-year-old children as an instrument for the early diagnosis of lack of concentration in connection with language development disorders. PATIENTS AND METHODS: We conducted the MKVK on 309 children in 15 day-care centres. The MKVK is a matter of a simple sorting task of 80 cards according to pictures. The ascertainment of the concentration performance is conducted using the criteria processing time and error count. The results are analysed in seven age groups. RESULTS: An age dependence is seen in the execution time and a tendency in the amount of errors. Three-year-olds require more time and make more errors than 4.5- and 5-year-olds. Two groups become apparent in the 3-year-olds: children with whom the test is easy to take and children who are still overwhelmed with the instructions and processing. CONCLUSION: The MKVK is easy to conduct and shows children's ability to concentrate at pre-school ages. It proves to be of particular value for the 4- and 5-year-olds. The study gives hints on different work methods of the children. Indications for a differentiated facilitation could be deduced from that.

The 200-MeV proton therapy project at the Paul Scherrer Institute: conceptual design and practical realization.

The new proton therapy facility is being assembled at the Paul Scherrer Institute (PSI). The beam delivered by the PSI sector cyclotron can be split and brought into a new hall where it is degraded from 590 MeV down to an energy in the range of 85-270 MeV. A new beam line following the degrader is used to clean the low-energetic beam in phase space and momentum band. The analyzed beam is then injected into a compact isocentric gantry, where it is applied to the patient using a new dynamic treatment modality, the so-called spot-scanning technique. This technique will permit full three-dimensional conformation of the dose to the target volume to be realized in a routine way without the need for individualized patient hardware like collimators and compensators. By combining the scanning of the focused pencil beam within the beam optics of the gantry and by mounting the patient table eccentrically on the gantry, the diameter of the rotating structure has been reduced to only 4 m. In the article the degrees of freedom available on the gantry to apply the beam to the patient (with two rotations for head treatments) are also discussed. The devices for the positioning of the patient on the gantry (x rays and proton radiography) and outside the treatment room (the patient transporter system and the modified mechanics of the computer tomograph unit) are briefly presented. The status of the facility and first experimental results are introduced for later reference.

[Management and treatment of elderly psychiatric patients by the general practitioner]. / Betreuung und Behandlung alterspsychiatrischer Patienten durch den Praktiker.

About one third of all elderly people suffer from psychosocial disturbances reducing their well-being, ability or independence. Those disturbances can be mitigated more often than expected by medical treatment, psychotherapy or other therapies. In this field it is above all the general practitioner who has to be engaged as gate keeper and case manager.

Pharmacological treatment strategies of residential primary care providers in dementia diseases--results of a representative survey in western Austria.

OBJECTIVE: The goal of this study was to investigate pharmacological treatment strategies used by residential primary care providers for patients with dementia. METHODS: A postal questionnaire survey was sent to all residential primary care providers, internists, neurologists and psychiatrists (n = 689) in the western region of Austria. RESULTS: The response rate (53 %) was similar in all four physician groups. Acetylcholinesterase inhibitors are considered to have a higher efficacy (p < 0.0005) compared to nootropic drugs. However, the vast majority of primary care providers (95 %) prescribe nootropic drugs. Two thirds (64 %) of the primary care providers prescribe acetylcholinesterase inhibitors. The dementia subtype influences the prescription frequency of acetylcholinesterase inhibitors, but not the specific choice of nootropic compound. Half of the primary care providers (52 %) combine antidementia drugs. Nearly two-thirds (62 %) of all primary care providers frequently prescribe antidepressants. Specific serotonin reuptake inhibitors are applied by the majority of primary care providers (96 %). About one-third (39 %) of primary care providers and internists (29 %) prescribe tricyclic antidepressants. Antipsychotics are applied frequently by around a quarter (29 %) of all physicians. More than half of primary care providers (62 %) and internists (58 %) treat patients with typical antipsychotics. Psychiatrists and neurologists are significantly more reluctant to prescribe tricyclic antidepressants and typical antipsychotics. CONCLUSIONS: Despite the lack of scientific evidence, residential primary care providers combine antidementia drugs very frequently. Therefore, controlled studies on combination therapies are urgently needed; in contrast to neurologists and psychiatrists, primary care providers and internists frequently prescribe tricyclic antidepressants and typical antipsychotics. The reasons for this should be clarified in further studies.

[Problems of the cytological diagnosis in carcinoma of the corpus uteri]. / Die Problematik der zytologischen Erfassung des Korpuskarzinoms.

The accuracy of cytology and the cytological possibilities in the detection of the carcinoma of the corpus of the uterus are discussed on the basis of a ten year's experience of the gynaecological material of the 1st University Hospital for ob. gyn., Vienna, Austria. In particular, the various clinical and laboratory sources of mistakes are pointed out. The various possibilities of taking the smear are under discussion in order to improve the cytological diagnosis of the carcinoma of the corpus of the uterus. All these procedures, however, do not relieve the gynaecologist of the necessity to perform a fractioned d. and c. in all cases of irregular bleeding.