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1.
Lung Cancer ; 175: 131-140, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36529115

ABSTRACT

Lung cancer is the leading cause of cancer death worldwide due to its late-stage detection. Lung cancer screening, including low-dose computed tomography (low-dose CT), provides an initial clinical solution. Nevertheless, further innovations and refinements would help to alleviate remaining limitations. The non-invasive, gentle, and fast nature of breath analysis (BA) makes this technology highly attractive to supplement low-dose CT for an improved screening algorithm. However, BA has not taken hold in everyday clinical practice. One reason might be the heterogeneity and variety of BA methods. This scoping review is a comprehensive summary of study designs, breath analytical methods, and suggested biomarkers in lung cancer. Furthermore, this synthesis provides a framework with core outcomes for future studies in lung cancer BA. This work supports future research for evidence synthesis, meta-analysis, and translation into clinical routine workflows.


Subject(s)
Lung Neoplasms , Humans , Lung Neoplasms/diagnosis , Early Detection of Cancer/methods , Tomography, X-Ray Computed , Biomarkers
2.
Acta Paediatr ; 110(7): 2074-2081, 2021 07.
Article in English | MEDLINE | ID: mdl-33657661

ABSTRACT

AIM: Due to scarce available national data, this study assessed current attitudes of neonatal caregivers regarding decisions on life-sustaining interventions, and their views on parents' aptitude to express their infant's best interest in shared decision-making. METHODS: Self-administered web-based quantitative empirical survey. All 552 experienced neonatal physicians and nurses from all Swiss NICUs were eligible. RESULTS: There was a high degree of agreement between physicians and nurses (response rates 79% and 70%, respectively) that the ability for social interactions was a minimal criterion for an acceptable quality of life. A majority stated that the parents' interests are as important as the child's best interest in shared decision-making. Only a minority considered the parents as the best judges of what is their child's best interest. Significant differences in attitudes and values emerged between neonatal physicians and nurses. The language area was very strongly associated with the attitudes of neonatal caregivers. CONCLUSION: Despite clear legal requirements and societal expectations for shared decision-making, survey respondents demonstrated a gap between their expressed commitment to shared decision-making and their view on parental aptitude to formulate their infant's best interest. National guidelines need to address these barriers to shared decision-making to promote a more uniform nationwide practice.


Subject(s)
Caregivers , Infant, Extremely Premature , Child , Decision Making , Humans , Infant , Infant, Newborn , Parents , Quality of Life , Switzerland
3.
J Altern Complement Med ; 27(1): 45-57, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33121261

ABSTRACT

Objectives: In parts I and II of our review of physicochemical research performed on homeopathic preparations, we identified relevant publications and analyzed the data in terms of individual experiments, looking for the most promising techniques that were used in the past. In this third part, we analyze the results of the experiments seeking to extract information about the possible modes of action underpinning homeopathic preparations. Methods: We summarized the results from the 11 experimental areas previously introduced, extracting the general findings and trends. We also summarized the results in terms of specific research topics: aging, medium used for potentization, sample volume, temperature, material of potentization vessel, and, finally, the use of molecules to probe homeopathic samples. Results: We identified a number of effects that appear consistently throughout the data: Differences to controls seem to increase with: time, moderate temperature, small samples volume, and in ionic medium, whereas high temperatures seem to abolish differences to controls. Based on the present analysis, there is no consistent evidence to date for the nanoparticle hypothesis to explain specific homeopathic treatment effects. However, the quantum coherence domain hypothesis, the dynamic water cluster hypothesis, and the weak quantum theory are still contenders and need to be further assessed experimentally. Conclusions: The field requires further targeted experimentation to validate past findings reporting differences between homeopathic dilutions and controls, and to expand these findings by specifically testing the three main working hypotheses that are currently at hand.


Subject(s)
Bibliometrics , Homeopathy , Materia Medica , Chemical Phenomena , Chemistry Techniques, Analytical , Humans , Materia Medica/analysis , Materia Medica/chemistry , Nanoparticles , Quantum Theory , Research Design
4.
Front Pediatr ; 8: 449, 2020.
Article in English | MEDLINE | ID: mdl-32850558

ABSTRACT

Aim: To investigate whether the early administration of Euphrasia eye drops® in preterm neonates presenting with ocular discharge fosters the resolution of the ocular discharge and reduces the need for topical antibiotic therapy, as compared to placebo. Methods: We conducted a randomized double-blind placebo-controlled trial at the University Children's Hospital Bern, Switzerland. Preterm neonates with white, yellow, or green ocular discharge were included. Infants were randomly assigned (1:1) to the Euphrasia arm (Euphrasia eye drops®, Weleda AG, Arlesheim) or the placebo arm (NaCl 0.9%). Euphrasia or placebo was administrated at a dose of one drop in each eye four times a day over a period of 96 h. The primary outcome was the treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. Results: A total of 114 neonates were screened and 84 were randomized. Among neonates in the Euphrasia arm, 22 (55.0%) achieved our primary outcome compared to 21 (51.2%) in the placebo arm (p = 0.85). In the Euphrasia arm, time to resolution of reddening tended to fall within the shorter bracket of 24 to 48 h (24 (92.3%) vs. 12 (80.0%) in the placebo arm, p = 0.34) and relapse or first signs of reddening during the 96-h intervention tended to be lower [3 (7.9%) eyes vs. 8 (18.2%) eyes in the placebo arm, p = 0.17]. Tearing at 96 h tended to be lower in the Euphrasia arm [5 (12.8%) eyes in the Euphrasia arm vs. 12 (27.3%) eyes in the placebo arm, p = 0.10]. Discussion: Euphrasia did not significantly improve treatment success, defined as no ocular discharge at 96 h and no use of topical antibiotic therapy during the 96-h intervention. However, results suggest that Euphrasia may be of benefit for symptoms such as reddening and tearing, and thus improve the comfort of patients. Trial Registration: The trial is registered at the US National Institutes of Health (ClinicalTrials.gov) NCT04122300 and at the portal for human research in Switzerland SNCTP000003490.

5.
BMC Pediatr ; 20(1): 47, 2020 Jan 31.
Article in English | MEDLINE | ID: mdl-32005110

ABSTRACT

After publication of our article [1] it was brought to our attention that we did not have permission to reproduce the questionnaire in Additional File 1.

6.
Health Info Libr J ; 36(4): 372-377, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31829503

ABSTRACT

The feature is a part of the series about medical library services in various countries. It gives an overview of medical library services to support research, education and clinical practice in Switzerland. Data were collected by means of an online survey and set in the wider context of the Swiss healthcare system. Key findings are that library services, including support by academic librarians, are provided to health care staff in hospitals - both university and others, while there is no information service infrastructure to serve the large number of GPs and specialists who mostly run their own practice. The authors recommend that - if the health authorities take EBM seriously - information services should be introduced for these small practices. J.M.


Subject(s)
Evidence-Based Medicine/trends , Health Personnel , Libraries, Medical/organization & administration , Library Services , Education, Medical , Humans , Librarians , Students, Medical , Surveys and Questionnaires , Switzerland
7.
J Altern Complement Med ; 25(9): 890-901, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31290681

ABSTRACT

Objectives: In Part 1 of the review of physicochemical research performed on homeopathic preparations the authors identified relevant publications of sufficient reporting quality for further in-depth analysis. In this article, the authors analyze these publications to identify any empirical evidence for specific physicochemical properties of homeopathic preparations and to identify most promising experimental techniques for future studies. Methods: After an update of the literature search up to 2018, the authors analyzed all publications in terms of individual experiments. They extracted information regarding methodological criteria such as blinding, randomization, statistics, controls, sample preparation, and replications, as well as regarding experimental design and measurement methods applied. Scores were developed to identify experimental techniques with most reliable outcomes. Results: The publications analyzed described 203 experiments. Less than 25% used blinding and/or randomization, and about one third used adequate controls to identify specific effects of homeopathic preparations. The most promising techniques used so far are nuclear magnetic resonance (NMR) relaxation, optical spectroscopy, and electrical impedance measurements. In these three areas, several sets of replicated high-quality experiments provide evidence for specific physicochemical properties of homeopathic preparations. Conclusions: The authors uncovered a number of promising experimental techniques that warrant replication to assess the reported physicochemical properties of homeopathic preparations compared with controls. They further discuss a range of experimental aspects that highlight the many factors that need to be taken into consideration when performing basic research into homeopathic potentization. For future experiments, the authors generally recommend using succussed (vigorously shaken) controls, or comparing different homeopathic preparations with each other to reliably identify any specific physicochemical properties.


Subject(s)
Materia Medica , Bibliometrics , Homeopathy , Materia Medica/analysis , Materia Medica/chemistry , Materia Medica/classification
8.
BMC Pediatr ; 18(1): 226, 2018 07 09.
Article in English | MEDLINE | ID: mdl-29986696

ABSTRACT

After publication of the original article [1], the corresponding author noticed the given names and family names of the members included in the Swiss Neonatal End-of-Life Study Group were incorrectly reverted.

9.
Front Physiol ; 9: 623, 2018.
Article in English | MEDLINE | ID: mdl-29896113

ABSTRACT

An increasing cancer incidence affecting any age and social class is putting serious strain on populations and health care systems around the world. This systematic literature search aims (i) to examine the correlation of heart rate variability (HRV) and cancer patients' prognosis, (ii) to examine the relationship of HRV and clinicopathological features, and (iii) to compare HRV between different patient groups, and between patient and control groups. We conducted a systematic literature review following the PRISMA Statement. We searched the PubMed and EMBASE databases for publications released by December 2017. The search terms were: "cancer" AND "heart rate variability" AND "human" NOT "animal" NOT "review." A total of 19 studies were finally included in this review. Most publications were high-quality observational studies. The studies showed that higher HRV correlated positively with patients' progression of disease and outcome. Thus, we conclude that individuals with higher HRV and advanced coping mechanisms seem to have a better prognosis in cancer progression. HRV appears to be a useful aspect to access the general health status of cancer patients.

10.
Trials ; 19(1): 333, 2018 Jun 25.
Article in English | MEDLINE | ID: mdl-29941003

ABSTRACT

BACKGROUND: Breathing retraining techniques have received increased attention in the management of asthma, because there is growing evidence of the usefulness of such methods in improving quality of life, reducing symptoms and reducing bronchodilator use. Our study investigated the effect of anthroposophic therapeutic speech (ATS), which uses sounds and syllabic rhythm to improve articulation, breathing and cardiorespiratory interaction, in patients with asthma in a real-life outpatient setting. METHODS: In a randomised controlled crossover trial, patients with asthma in three centres in Switzerland and Germany were randomised to either receive 11 ATS sessions or to wait. Subsequently, patients changed either to wait or to receive ATS. Primary outcomes were changes from the beginning to the end of each phase in the Asthma Quality of Life Questionnaire (AQLQ) and spirometry parameters. Secondary outcomes were changes in inhaled glucocorticoids, the Asthma Control Test (ACT), peak flow and asthma exacerbations. RESULTS: Altogether, 63 patients were randomised, of which 56 were enrolled and 49 completed the study. Statistically significant differences between the ATS groups and waiting control groups were found for the overall AQLQ score (d = 0.86, p = 0.001) and the domain scores for symptoms, activity limitation and emotional function as well as ACT score (d = 0.53, p = 0.048). No significant differences were observed in spirometry parameters, inhaled glucocorticoids, peak flow and days without asthma exacerbation per week. No serious adverse events occurred during ATS sessions. CONCLUSIONS: ATS significantly improves asthma control and quality of life in patients with asthma. Whether ATS may improve lung function remains to be shown. TRIAL REGISTRATION: ClinicalTrials.gov NCT02501824 . Retrospectively registered on 8 July 2015.


Subject(s)
Ambulatory Care , Anthroposophy , Asthma/therapy , Breathing Exercises/methods , Lung/physiopathology , Respiration , Speech Therapy/methods , Speech , Adult , Asthma/diagnosis , Asthma/physiopathology , Cross-Over Studies , Female , Germany , Humans , Male , Middle Aged , Quality of Life , Recovery of Function , Switzerland , Time Factors , Treatment Outcome
11.
BMC Pediatr ; 18(1): 81, 2018 02 22.
Article in English | MEDLINE | ID: mdl-29471821

ABSTRACT

BACKGROUND: In the last 20 years, the chances for intact survival for extremely preterm infants have increased in high income countries. Decisions about withholding or withdrawing intensive care remain a major challenge in infants born at the limits of viability. Shared decision-making regarding these fragile infants between health care professionals and parents has become the preferred model today. However, there is an ongoing ethical debate on how decisions regarding life-sustaining treatment should be reached and who should have the final word when health care professionals and parents do not agree. We designed a survey among neonatologists and neonatal nurses to analyze practices, difficulties and parental involvement in end-of-life decisions for extremely preterm infants. METHODS: All 552 physicians and nurses with at least 12 months work experience in level III neonatal intensive care units (NICU) in Switzerland were invited to participate in an online survey with 50 questions. Differences between neonatologists and NICU nurses and between language regions were explored. RESULTS: Ninety six of 121 (79%) physicians and 302 of 431(70%) nurses completed the online questionnaire. The following difficulties with end-of-life decision-making were reported more frequently by nurses than physicians: insufficient time for decision-making, legal constraints and lack of consistent unit policies. Nurses also mentioned a lack of solidarity in our society and shortage of services for disabled more often than physicians. In the context of limiting intensive care in selected circumstances, nurses considered withholding tube feedings and respiratory support less acceptable than physicians. Nurses were more reluctant to give parents full authority to decide on the course of action for their infant. In contrast to professional category (nurse or physician), language region, professional experience and religion had little influence if any on the answers given. CONCLUSIONS: Physicians and nurses differ in many aspects of how and by whom end-of-life decisions should be made in extremely preterm infants. The divergencies between nurses and physicians may be due to differences in ethics education, varying focus in patient care and direct exposure to the patients. Acknowledging these differences is important to avoid potential conflicts within the neonatal team but also with parents in the process of end-of-life decision-making in preterm infants born at the limits of viability.


Subject(s)
Attitude of Health Personnel , Clinical Decision-Making/ethics , Decision Making/ethics , Fetal Viability , Neonatologists/psychology , Nurses, Neonatal/psychology , Withholding Treatment/ethics , Adult , Clinical Decision-Making/methods , Dissent and Disputes , Female , Humans , Intensive Care, Neonatal/ethics , Male , Middle Aged , Professional-Family Relations/ethics , Qualitative Research , Surveys and Questionnaires , Switzerland , Terminal Care/ethics
12.
J Altern Complement Med ; 24(5): 409-421, 2018 May.
Article in English | MEDLINE | ID: mdl-29377709

ABSTRACT

OBJECTIVES: The last systematic review of physicochemical research performed on homeopathic preparations was published in 2003. The aim of the study is to update and expand the current state of knowledge in the area of physicochemical properties of homeopathic preparations. In part 1 of the study, we aim to present an overview of the literature with respect to publication quality and methods used. In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations. METHODS: A two-step procedure was adopted: (1) an extensive literature search, followed by a bibliometric and quality analysis on the level of publications and (2) a thorough qualitative analysis of the individual physicochemical investigations found. In this publication, we report on step (1). We searched major scientific databases to find publications reporting physicochemical investigations of homeopathy from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted. RESULTS: We identified 183 publications (compared to 44 in the last review), 122 of which had an MIS ≥5. The rate of publication in the field was ∼2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. The quality of publications was seen to increase sharply from 2000 onward, whereas before 2000, only 12 (13%) publications were rated as "high quality" (MIS ≥7.5); 44 (48%) publications were rated as "high quality" from 2000 onward. Countries with most publications were Germany (n = 42, 23%), France (n = 29, 16%), India (n = 27, 15%), and Italy (n = 26, 14%). Techniques most frequently used were electrical impedance (26%), analytical methods (20%), spectroscopy (20%), and nuclear magnetic resonance (19%). CONCLUSIONS: Physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications.


Subject(s)
Bibliometrics , Homeopathy , Materia Medica , Materia Medica/analysis , Materia Medica/chemistry
13.
Rev. homeopatia (São Paulo) ; 81(1/2): 29-54, 2018.
Article in Portuguese | LILACS, HomeoIndex Homeopathy | ID: hom-12226

ABSTRACT

Objetivo: A última revisão sistemática das pesquisas físico-químicas sobre preparações homeopáticas foi publicada em 2003. O objetivo do presente estudo foi atualizar e ampliar o estado atual dos conhecimentos na área das propriedades físico-químicas das preparações homeopáticas. Na parte 1 do estudo objetivamos apresentar um panorama da literatura quanto à qualidade e métodos utilizados nas publicações. Na parte 2 objetivamos identificar as técnicas experimentais mais interessantes. Desta maneira, esperamos estar na posição de gerar hipóteses significativas quanto ao possível modo de ação das preparações homeopáticas. Métodos: Foi adotado um procedimento com 2 etapas: 1) pesquisa ampla da literatura, seguida de análise bibliométrica e da qualidade das publicações e, 2) análise qualitativa minuciosa das pesquisas físico-químicas individuais localizadas. Na presente publicação relatamos a etapa 1). Realizamos uma busca nas principais bases científicas de dados de publicações relatando pesquisas físico-químicas da homeopatia desde a sua origem até o final de 2015. As publicações foram avaliadas através de um sistema de pontuação, o Manuscript Information Score (MIS). Foram coletadas informações sobre o país de origem dos estudos e as técnicas experimentais utilizadas. Resultados: Localizamos 183 publicações (versus 44 na revisão anterior), 122 delas com MIS ≥ 5. A taxa de publicações na área foi ˜2 por ano entre as década de 1970 e 2000. Depois aumentou para mais de 5,5 publicações por ano. [...] Conclusões: As pesquisas físico-químicas sobre as preparações homeopáticas está aumentando tanto na quantidade e na qualidade das publicações. (AU)


Objectives: The last systematic review of physicochemical research performed on homeopathic preparations was published in 2003. The aim of the study is to update and expand the current state of knowledge in the area of physicochemical properties of homeopathic preparations. In part 1 of the study, we aim to present an overview of the literature with respect to publication quality and methods used. In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations. Methods: A two-step procedure was adopted: (1) an extensive literature search, followed by a bibliometric and quality analysis on the level of publications and (2) a thorough qualitative analysis of the individual physicochemical investigations found. In this publication, we report on step (1). We searched major scientific databases to find publications reporting physicochemical investigations of homeopathy from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted. Results: We identified 183 publications (compared to 44 in the last review), 122 of which had an MIS ‡5. The rate of publication in the field was *2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. [...]Conclusions: Physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications. (AU)


Subject(s)
Homeopathy , High Potencies , Homeopathic Pharmacy Techniques , Dynamization
14.
Rev. homeopatia (Säo Paulo) ; 81(1/2): 29-54, 2018.
Article in Portuguese | LILACS, HomeoIndex Homeopathy | ID: biblio-908632

ABSTRACT

Objetivo: A última revisão sistemática das pesquisas físico-químicas sobre preparações homeopáticas foi publicada em 2003. O objetivo do presente estudo foi atualizar e ampliar o estado atual dos conhecimentos na área das propriedades físico-químicas das preparações homeopáticas. Na parte 1 do estudo objetivamos apresentar um panorama da literatura quanto à qualidade e métodos utilizados nas publicações. Na parte 2 objetivamos identificar as técnicas experimentais mais interessantes. Desta maneira, esperamos estar na posição de gerar hipóteses significativas quanto ao possível modo de ação das preparações homeopáticas. Métodos: Foi adotado um procedimento com 2 etapas: 1) pesquisa ampla da literatura, seguida de análise bibliométrica e da qualidade das publicações e, 2) análise qualitativa minuciosa das pesquisas físico-químicas individuais localizadas. Na presente publicação relatamos a etapa 1). Realizamos uma busca nas principais bases científicas de dados de publicações relatando pesquisas físico-químicas da homeopatia desde a sua origem até o final de 2015. As publicações foram avaliadas através de um sistema de pontuação, o Manuscript Information Score (MIS). Foram coletadas informações sobre o país de origem dos estudos e as técnicas experimentais utilizadas. Resultados: Localizamos 183 publicações (versus 44 na revisão anterior), 122 delas com MIS ≥ 5. A taxa de publicações na área foi ˜2 por ano entre as década de 1970 e 2000. Depois aumentou para mais de 5,5 publicações por ano. [...] Conclusões: As pesquisas físico-químicas sobre as preparações homeopáticas está aumentando tanto na quantidade e na qualidade das publicações. (AU)


Objectives: The last systematic review of physicochemical research performed on homeopathic preparations was published in 2003. The aim of the study is to update and expand the current state of knowledge in the area of physicochemical properties of homeopathic preparations. In part 1 of the study, we aim to present an overview of the literature with respect to publication quality and methods used. In part 2, we aim to identify the most interesting experimental techniques. With this, we aim to be in a position to generate meaningful hypotheses regarding a possible mode of action of homeopathic preparations. Methods: A two-step procedure was adopted: (1) an extensive literature search, followed by a bibliometric and quality analysis on the level of publications and (2) a thorough qualitative analysis of the individual physicochemical investigations found. In this publication, we report on step (1). We searched major scientific databases to find publications reporting physicochemical investigations of homeopathy from its origin to the end of 2015. Publications were assessed using a scoring scheme, the Manuscript Information Score (MIS). Information regarding country of origin of the research and experimental techniques used was extracted. Results: We identified 183 publications (compared to 44 in the last review), 122 of which had an MIS ‡5. The rate of publication in the field was *2 per year from the 1970s until 2000. Afterward, it increased to over 5.5 publications per year. [...]Conclusions: Physicochemical research into homeopathic preparations is increasing both in terms of quantity and quality of the publications. (AU)


Subject(s)
Dynamization , High Potencies , Homeopathic Pharmacy Techniques , Homeopathy
15.
Swiss Med Wkly ; 147: w14477, 2017.
Article in English | MEDLINE | ID: mdl-28804867

ABSTRACT

BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants. Of these 140 questions, 12 questions related to sources of distress and 10 to burnout. All physicians and nurses (n = 552) working in the nine NICUs in Switzerland were invited to participate. RESULTS: The response rate was 72% (398). The aspects of work most commonly identified as sources of distress were: lack of regular staff meetings, lack of time for routine discussion of difficult cases, lack of psychological support for the NICU staff and families, and missing transmission of important information within the caregiver team. Differences between physicians' and nurses' perceptions became apparent: for example, nurses were more dissatisfied with the quality of the decision-making process. Different perceptions were also noted between staff in the German- and French- speaking parts of Switzerland: for example, respondents from the French part rated lack of regular staff meetings as being more problematic. On the other hand, personnel in the French part were more satisfied with their accomplishments in the job. On average, low levels of burnout symptoms were revealed, and only 6% of respondents answered that the work-related burden often affected their private life. CONCLUSIONS: Perceived sources of distress in Swiss NICUs were similar to those in ICU studies. Despite rare symptoms of burnout, communication measures such as regular staff meetings and psychological support to prevent distress were clearly requested.


Subject(s)
Burnout, Professional/prevention & control , Intensive Care Units, Neonatal , Nursing Staff, Hospital/psychology , Physicians/psychology , Stress, Psychological/psychology , Adult , Attitude of Health Personnel , Humans , Infant, Newborn , Job Satisfaction , Surveys and Questionnaires , Switzerland
16.
Swiss Med Wkly ; 147: w14418, 2017.
Article in English | MEDLINE | ID: mdl-28322431

ABSTRACT

QUESTION: Extreme prematurity can result in long-term disabilities. Its impact on society is often not taken into account and deemed controversial. Our study examined attitudes of the Swiss population regarding extreme prematurity and people's perspectives regarding the question of solidarity with disabled people. METHODS: We conducted a nationwide representative anonymous telephone survey with 1210 Swiss residents aged 18 years or older. We asked how people estimate their own personal solidarity, the solidarity of their social environment and the solidarity across the country with disabled persons. Spearman's correlation calculations were used to assess if a correlation exists between solidarity and setting financial limits to intensive care and between solidarity and withholding neonatal intensive care. RESULTS: According to 36.0% of the respondents intensive medical care should not be withheld from extremely preterm infants, even if their chances for an acceptable quality of life were poor. For 28.8%, intensive care should be withheld from these infants, and 26.9% held an intermediate position depending on the situation. A total of 31.5% were against setting a financial limit to treatment of extremely preterm newborns with an uncertain future quality of life, 34.2% were in favour and 26.9% were deliberating. A majority (88.8%) considered their solidarity toward disabled people as substantial; the solidarity of their personal environment and of the society at large was estimated as high by 79.1% and 48.6%, respectively. CONCLUSIONS: The Swiss population expressed a high level of solidarity which may alleviate some pressure on parents and health care providers in the decision-making process in neonatal intensive care units. In addition, there was no relationship between solidarity and people's willingness to pay for the care or withholding treatment of extremely preterm babies.


Subject(s)
Decision Making , Infant, Extremely Premature , Intensive Care Units, Neonatal/economics , Intensive Care Units, Neonatal/statistics & numerical data , Adult , Attitude of Health Personnel , Attitude to Death , Disabled Children/psychology , Female , Humans , Infant, Newborn , Male , Middle Aged , Parents/psychology , Physicians/psychology , Quality of Life/psychology , Surveys and Questionnaires , Switzerland , Withholding Treatment
17.
Acta Paediatr ; 106(3): 423-429, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27880025

ABSTRACT

AIM: Studies have provided insights into the different attitudes and values of healthcare professionals and parents towards extreme prematurity. This study explored societal attitudes and values in Switzerland with regard to this patient group. METHODS: A nationwide trilingual telephone survey was conducted in the French-, German- and Italian-speaking regions of Switzerland to explore the general population's attitudes and values with regard to extreme prematurity. Swiss residents of 18 years or older were recruited from the official telephone registry using quota sampling and a logistic regression model assessed the influence of socio-demographic factors on end-of-life decision-making. RESULTS: Of the 5112 people contacted, 1210 (23.7%) participated. Of these 5% were the parents of a premature infant and 26% knew parents with a premature infant. Most participants (77.8%) highlighted their strong preference for shared decision-making, and 64.6% said that if there was dissent then the parents should have the final word. Overall, our logistic regression model showed that regional differences were the most significant factors influencing decision-making. CONCLUSION: The majority of the Swiss population clearly favoured shared decision-making. The context of sociocultural demographics, especially the linguistic region in which the decision-making took place, strongly influenced attitudes towards extreme prematurity and decision-making.


Subject(s)
Health Knowledge, Attitudes, Practice , Infant, Extremely Premature , Adult , Aged , Female , Humans , Infant, Newborn , Language , Male , Middle Aged , Quality of Life , Surveys and Questionnaires , Switzerland
18.
Complement Ther Med ; 24: 111-7, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26860812

ABSTRACT

OBJECTIVE: Homeopathic globules are commonly used in clinical practice, while research focuses on liquid potencies. Sequential dilution and succussion in their production process has been proposed to change the physico-chemical properties of the solvent(s). It has been reported that aqueous potencies of various starting materials showed significant differences in ultraviolet light transmission compared to controls and between different dilution levels. The aim of the present study was to repeat and expand these experiments to homeopathic globules. METHODS: Globules were specially produced for this study by Spagyros AG (Gümligen, Switzerland) from 6 starting materials (Aconitum napellus, Atropa belladonna, phosphorus, sulfur, Apis mellifica, quartz) and for 6 dilution levels (6x, 12x, 30c, 200c, 200CF (centesimal discontinuous fluxion), 10,000CF). Native globules and globules impregnated with solvents were used as controls. Globules were dissolved in ultrapure water, and absorbance in the ultraviolet range was measured. The average absorbance from 200 to 340nm was calculated and corrected for differences between measurement days and instrumental drift. RESULTS: Statistically significant differences were found for A. napellus, sulfur, and A. mellifica when normalized average absorbance of the various dilution levels from the same starting material (including control and solvent control globules) was compared. Additionally, absorbance within dilution levels was compared among the various starting materials. Statistically significant differences were found among 30c, 200c and 200CF dilutions. CONCLUSION: This study has expanded previous findings from aqueous potencies to globules and may indicate that characteristics of aqueous high dilutions may be preserved and detectable in dissolved globules.


Subject(s)
Homeopathy/methods , Materia Medica/analysis , Materia Medica/chemistry , Spectrophotometry, Ultraviolet/methods , Aconitum , Animals , Atropa belladonna , Bees , Phosphorus , Quartz , Sulfur
19.
PLoS One ; 10(12): e0144676, 2015.
Article in English | MEDLINE | ID: mdl-26650080

ABSTRACT

[This corrects the article DOI: 10.1371/journal.pone.0141985.].

20.
PLoS One ; 10(10): e0141985, 2015.
Article in English | MEDLINE | ID: mdl-26513370

ABSTRACT

BACKGROUND: Complementary medicine (CM) is popular in Switzerland. Several CM methods (traditional Chinese medicine/acupuncture, homeopathy, anthroposophic medicine, neural therapy, and herbal medicine) are currently covered by the mandatory basic health insurance when performed by a certified physician. Treatments by non-medical therapists are partially covered by a supplemental and optional health insurance. In this study, we investigated the frequency of CM use including the evolvement over time, the most popular methods, and the user profile. METHODS: Data of the Swiss Health Surveys 2007 and 2012 were used. In 2007 and 2012, a population of 14,432 and 18,357, respectively, aged 15 years or older answered the written questionnaire. A set of questions queried about the frequency of use of various CM methods within the last 12 months before the survey. Proportions of usage and 95% confidence intervals were calculated for these methods and CM in general. Users and non-users of CM were compared using logistic regression models. RESULTS: The most popular methods in 2012 were homeopathy, naturopathy, osteopathy, herbal medicine, and acupuncture. The average number of treatments within the 12 months preceding the survey ranged from 3 for homeopathy to 6 for acupuncture. 25.0% of the population at the age of 15 and older had used at least one CM method in the previous 12 months. People with a chronic illness or a poor self-perceived health status were more likely to use CM. Similar to other countries, women, people of middle age, and those with higher education were more likely to use CM. 59.9% of the adult population had a supplemental health insurance that partly covered CM treatments. CONCLUSIONS: Usage of CM in Switzerland remained unchanged between 2007 and 2012. The user profile in Switzerland was similar to other countries, such as Germany, United Kingdom, United States or Australia.


Subject(s)
Complementary Therapies , Patient Acceptance of Health Care/statistics & numerical data , Acupuncture Therapy , Complementary Therapies/methods , Female , Health Surveys , Homeopathy , Humans , Male , Medicine, Chinese Traditional , Socioeconomic Factors , Switzerland
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