Importance of music in biographies of people with dementia.

Recent research on music and music-based interventions for people with dementia (PwD) is focused on changes of psychological and cognitive functions. Little is known about the role of biography in the importance of music to PwD. A qualitative study was conducted to identify the phases of their life in which PwD were influenced by music. 20 semi-structured interviews with PwD from nursing homes and PwD cared for at home were conducted. Additionally, their relatives were interviewed separately. The results were analysed relating to four categories divided into past and present with the aim of identifying the changes in daily routine and challenges for everyday care. First access to music and education mostly were built in the family setting. Social participation e.g. music activities, listening to music and playing instruments changed dramatically with the onset of dementia. Moreover, PwD generally needed assistance in participating in those activities. The dependency on their caregivers and inability to express their needs leads to a daily routine without music. There is a need of trained professionals motivating and assisting PwD to attend musical activities. In addition, care homes should offer more music activities and music therapy for PwD with various stages of dementia. Moreover, care institutions should implement music questionnaire in the patient's file regarding musical preferences.

[App-based self-monitoring in type 2 diabetes]. / App-basiertes Selbstmonitoring bei Typ-2-Diabetes.

BACKGROUND: The success of self-monitoring in the treatment of type 2 diabetes mellitus has already been verified in several studies. To date there are a multitude of smartphone apps which support diabetic patients in systematically recording and analyzing relevant health data; however, most of these smartphone apps are primarily developed for a young target group. OBJECTIVE: As part of this study we examined to what extent a smartphone app for self-monitoring is used by older diabetic patients. METHODS: In this study 36 adults with type 2 diabetes mellitus older than 60 years were included. After a comprehensive training course the participants used the application for 3 months. Reminders for medication, physical activity and diet could be set and recorded health data, such as weight or blood sugar, could be entered into the app. After 3 months the data were analyzed concerning usage behavior and impact on overall health. RESULTS: Data analysis revealed intensive usage of the smartphone app (90 % on a daily basis). Furthermore, according to the patients, after the study period significant improvements in medication adherence and psychological well-being were recorded [t[35] = -2.24, p < 0.05). Additional motivational elements did not influence the usage behavior by older adults. CONCLUSION: Until now only a small proportion of older adults used smartphone health apps, despite the ubiquitous availability. These apps have to be tailored to the requirements of older adults so that the market will be opened up to them. Using self-monitoring apps can help older adults to structure their daily routine despite their disease.

SmartSenior@home: Acceptance of an integrated ambient assisted living system. Results of a clinical field trial in 35 households.

AIMS: The primary objective of the SmartSenior@home study was to examine the acceptance of the SmartSenior system by older adults. METHODS: Twenty-eight partners from industry and research, including the health care sector, worked collaboratively to implement services aiming to maximize independence in old age. The prospective cohort study was conducted in Potsdam, Germany, with n = 35 older adults between 55 and 88 years of age in their apartments. All participants underwent extensive pre- and post-study visits with in-home interviews, functional assessments for cognition, fine motor skills, and mobility as well as responding to questionnaires on user acceptance and quality of life. RESULTS: The results indicate moderate-to-high user acceptance for the SmartSenior system. In particular, the services for general assistance and health, such as audio/video communication, blood pressure monitoring, and communication with a health professional, were rated as very attractive. Less used and less accepted services were those promoting social interaction and reminder services. CONCLUSION: Besides reliable functioning of the SmartSenior system, the availability of a confidant seems to be the most significant acceptance factor. As one conclusion of this trial, it is possible to develop, integrate, and test an infrastructure for ambient assisted living services in real life.

[The efficacy of therapy using 89Sr-strontium chloride in 200 patients with bone metastases of a prostatic cancer]. / Wirksamkeit der Therapie mit 89Sr-Strontiumchlorid bei 200 Patienten mit Skelettmetastasen eines Prostatakarzinoms.

Since 1976 200 patients with multiple skeletal metastases from prostatic cancer were treated with 89Sr. In the present study the results were evaluated in order to confirm the efficacy of this therapy. Following the application of 3 injections each of 0 (n = 21), 37 (n = 65), 75 (n = 72), 100 (n = 25) or 150 (n = 17) MBq 89Sr subjective pain relief, scintigraphic follow-up observations, survival times and haematological complications were recorded. In comparison to the results of placebo administration the effects of 89Sr on pain were: in the placebo group deterioration 11%, no change 55%, improvement 17% and full pain relief 17% whereas in the Sr groups combined the corresponding figures were 3, 38, 26 and 33%. Pain relief correlated with the activity administered. A dose relationship to scintigraphic regression is probable, the latter correlating with pain relief. Due to a decrease of early deaths the survival rate increased during the first months after start of treatment but later on returned to the level observed in untreated patients. Pain relief and regressive scintigraphic findings were combined with increased marrow involvement which, however, did not by itself influence survival rates. 89Sr therapy is an effective additional treatment of patients with multiple skeletal metastases from prostatic cancer.

[Prognosis of acute dialysis dependent renal failure]. / Prognose bei akutem dialysepflichtigem Nierenversagen.

In a retrospective study of 116 patients with acute renal failure treated by hemodialysis the prognostic value of various clinical data was evaluated by discriminant analysis. With a letality of 73.6% the patient survival was dependent on the frequency of associated organ disorders. The following order was prognostical important: respiratory insufficiency, age, cardio-vascular complications and infection or sepsis. Other problems like gastrointestinal complications, coagulation disorders and hepatic failure were without significant value.