Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study.

BACKGROUND: Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. METHODS: The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). DISCUSSION: This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03855735; date of registration: February 27, 2019

‘The Rest is Silence’:Psychogeography, Soundscape and Nostalgia in Pat Collins’ Silence

Guy Debord defines the term psychogeography as 'the study of the precise laws and specific effects of the geographical environment, consciously organised or not, on the emotions and behaviour of individuals' (Debord 1955: 23). Similar to the belief of psychogeographers that the geography of an environment has a psychological effect on the human mind, proponents of acoustic ecology such as R. Murray Schafer hold that humans are affected by the sound of the environment in which they find themselves. Further to this, they examine the extent to which soundscapes can be shaped by human behaviour. Recently a body of Irish films has emerged that directly engages with the Irish soundscape and landscape on a psychogeographical level. Rather than using landscape as a physical space for the locus of action, these representations of the Irish landscape allow for an engagement with the aesthetic effects of the geographical landscape as a reflection of the psychological states of the protagonists. Bearing this in mind, this article examines how Silence (Collins 2012) arguably demonstrates the most overt and conscious incursion into this area to date. It specifically interrogates how the filmic representation of the psychogeography and soundscape of the Irish rural landscape can serve to express emotion, alienation and nostalgia, thus confronting both the Irish landscape and the weight of its associated history

Polymorphisms of genes coding for ghrelin and its receptor in relation to colorectal cancer risk: a two-step gene-wide case-control study

<p>Abstract</p> <p>Background</p> <p>Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHSR), has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also indicates a role of ghrelin in cancer development.</p> <p>Methods</p> <p>We conducted a case-control study to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with colorectal cancer risk. Pairwise tagging was used to select the 11 polymorphisms included in the study. The selected polymorphisms were genotyped in 680 cases and 593 controls from the Czech Republic.</p> <p>Results</p> <p>We found two SNPs associated with lower risk of colorectal cancer, namely SNPs rs27647 and rs35683. We replicated the two hits, in additional 569 cases and 726 controls from Germany.</p> <p>Conclusion</p> <p>A joint analysis of the two populations indicated that the T allele of rs27647 SNP exerted a protective borderline effect (P_trend= 0.004).</p

Synthetische Alkyllysophospholipide als Antitumormittel - Strukturverwandte des „Platelet Activating Factors”

Synthetische Alkyllysophospholipide (ALP) sind Strukturverwandte des biologisch wichtigen „platelet activating factors” (PAF). ALP und davon abgeleitete Strukturen (Hexadecylphosphocholin) zeigen in Zellkulturen und im Tierexperiment antineoplastische Aktivität. Hexadecylphosphocholin wird zur Zeit in einer klinischen Phase I Studie als Antitumormittel getestet. Der Artikel beschreibt die Substrateigenschaften des PAF und der ALP gegenüber Phospholipid-metabolisierenden Enzymen. Es wird gezeigt, wie anhand von Metabolismus- Studien neu, biologisch wirksame Phospholipide mit potentiellen antitumoralen Eigenschaften entwickelt werden können