Position statement on the role of nurses in therapeutic patient education in atopic dermatitis.

In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased disease severity and improved quality of life in AD patients. Various healthcare professionals (dermatologists, nurses, psychologists, dieticians) have been involved. TPE performed by trained dermatology nurses are highly efficient and improve various health-related outcomes. The aim of this position paper is to analyse the aims, modalities and efficacy of TPE in AD, to identify specific roles of dermatology nurses, to assess qualification requirements, and to propose practical recommendations. Potential activities of nurses in ongoing and future TPE programmes for AD patients will be discussed.

Weight loss and reduced body mass index: a critical issue in children with multiorgan chronic graft-versus-host disease.

Weight loss and malnutrition are major problems in patients with chronic graft-versus-host disease (GVHD). In adults, low body mass index (BMI) is a predictor for mortality; however, weight loss and BMI have not been studied in pediatric chronic GVHD. A retrospective study on 18 children with extensive chronic GVHD was completed. Median age at SCT was 12.3 (range 0.6-23) years; age at chronic GVHD diagnosis was 12.5 (1-23) years. Patients with multiorgan involvement had a mean maximal decrease in BMI of 20.9% and most dropped below 10th percentile in expected weight-for-age. This change in BMI not only indicates a significant decrease in weight but often a plateau in stature. In contrast, patients with one organ system involved had a mean maximal decrease in BMI of 5% and did not fall below 10th percentile. All patients with multiorgan involvement required salvage therapy beyond steroids and CSA. Three patients died due to complications of chronic GVHD. Weight loss and malnutrition (as reflected by a decrease in BMI) are clinically significant issues in children with multisystem chronic GVHD. Weight loss is likely another systemic manifestation of the disease and may contribute, along with other factors such as increased immunosuppression and infection, to increased mortality in this group.

Orf5/SolR: a transcriptional repressor of the sol operon of Clostridium acetobutylicum?

The gene of Orf5 (SolR) of Clostridium acetobutylicum DSM 792 was subcloned and overexpressed in Escherichia coli. The protein was purified with Ni-NTA agarose and used for DNA binding assays. No DNA binding of Orf5 to regions upstream of the sol operon from C. acetobutylicum was observed. Overexpression of Orf5 in C. acetobutylicum led to a change in the organism's pattern of glycosylated exoproteins. The Orf5 protein was localized in the cell membrane fraction and to a small extent in the supernatant medium. Based on these results Orf5 (SolR) appears not to act as a transcriptional repressor in C. acetobutylicum, but instead may be an enzyme involved in glycosylation or deglycosylation.

Why managed care has gone too far.

Managed care has not solved employers' problems with rising health care costs; instead, it has created another set of problems, this author maintains. She suggests steps that employers can take to enhance the quality of health care for their employees and prevent further damage from the excesses of managed care.

[Premature uterine contraction from the psychosomatic viewpoint. A critical literature review of methods]. / Vorzeitige Wehentätigkeit unter psychosomatischem Aspekt. Ein methodenkritischer Literaturüberblick.

Premature labor is often followed by premature delivery. This is to be prevented because of the increased perinatal mortality and morbidity. Etiology of premature uterine activity has not been elucidated up to now neither medically nor psycho-socio-somatically. There are many contradictory findings examining imminent premature labor with view to psychosomatics. In this review they are listed tabularly and investigated critically with regard to methodological structure. It is evident, that conflicting results are caused by disregard of fundamental principles of planning experiments and data analysis. The procedure should be thought over newly and exact research aspired including interdisciplinary knowledge.

[Usefulness of the S-S-G, a questionnaire for measuring attitude to pregnancy, sexuality and birth]. / Zur Verwendbarkeit des S-S-G, Fragebogen zur Messung von Einstellungen zu Schwangerschaft, Sexualität und Geburt.

As a part of a larger research-project a questionnaire to measure attitudes towards pregnancy, sexuality and birth was used. The questionnaire, S-S-G, was developed by Lukesch and Lukesch. It is designed to measure attitudes which are believed to be very important for the processes of pregnancy, birth and eventually to the fetal development, as well. Our findings do not support the relevance and significance of this questionnaire. The further use of the S-S-G cannot be recommended because: 1. The standardization is not valid according to our and other random samples. 2. The authors' proofs of validity are not sufficient and cannot be replicated with the exception of one statement. 3. Other correlations postulated cannot be confirmed with our sample. 4. The questionnaire is both in substance and method insufficient. 5. The questionnaire is recommended by the authors for uses which have not been tested by them.

[The dream of love and the reality of contraception. Current adolescent sexual behaviour and contraceptive methods (author's transl)]. / Von Liebe träumen - an Verhütung denken Jugendsexualität und Kontrazeption heute.

PIP: The sexual behavior of young people and questions of contraceptive methods cannot be understood outside the context of the psychosocial and psychodynamic backgrounds in society. In spite of sexual liberation and the improvement of contraceptive methods during the last decades, there are still important external and internal factors which prevent taking advantage of the progress which has already been made. In addition, the doctor receives recommendations on how to behave with young people seeking advice concerning contraception. (author's)^ieng