Case-based learning in der Thoraxchirurgie

Hintergrund In der modernen medizinischen Lehre wird der klassische Frontalunterricht zunehmend durch innovative Lehrmethoden, wie z. B. „case-based learning“ oder E‑Learning (Electronic-Learning), ergänzt. Ziel der Arbeit Konzipierung und Evaluation eines neuen Kurskonzeptes in der Thoraxchirurgie, um Studierende zu motivieren und zugleich Möglichkeiten zu finden, das ärztliche Personal in seiner Lehrtätigkeit zu entlasten. Material und Methoden Alle Studierenden des jeweils 3. klinischen Semesters der Universität Regensburg absolvierten im Sommersemester 2016 und Wintersemester 2016/17 im Rahmen des Blockpraktikums Chirurgie ein Seminar nach dem Prinzip des fallbasierten Lernens zum Thema „Pulmonaler Rundherd“. Dabei wurde bei einer Gruppe von Studierenden ein moderiertes Präsenzseminar, bei der anderen eine reine Onlineveranstaltung abgehalten. Der Wissensgewinn und die subjektive Bewertung des Kurses durch die Studierenden wurden über Fragebögen ermittelt. Ergebnisse Insgesamt nahmen 190 Studierende an den Seminaren teil, davon 88 am Präsenz- und 102 am Onlinekurs. Obwohl beide Gruppen einen deutlichen Wissenszuwachs durch die Kursintervention verzeichneten, zeigten die Studierenden des Präsenzkurses eine deutlich höhere subjektive Zufriedenheit im Vergleich zu ihren KommilitonInnen im Onlinekurs. Diskussion Das fallbasierte Lernen erwies sich als Erfolg versprechendes Konzept in der thoraxchirurgischen Lehre, wobei sich die Etablierung von Onlinelernverfahren deutlich schwieriger gestaltete als bei präsenzbasiertem Unterricht

Fallbasiertes Lernen in der Thoraxchirurgie - Ein Vergleich zwischen online- und präsenzbasiertem Unterricht

Hintergrund: In der modernen medizinischen Lehre wird der klassische Frontalunterricht zunehmend von innovativen Lehrmethoden, wie zum Beispiel dem Case-Based-Learning oder E-Learning ergänzt. Ziel der Arbeit: Konzipierung und Evaluation eines neuen Kurskonzeptes in der Thoraxchirurgie, um Studierende zu motivieren und zugleich Möglichkeiten zu finden, das ärztliche Personal in seiner Lehrtätigkeit zu entlasten. Material und Methoden: Alle Studierenden des jeweils 3. klinischen Semesters der Universität Regensburg absolvierten im Sommersemester 2016 und Wintersemester 2016/17 im Rahmen des Blockpraktikums Chirurgie ein Seminar nach dem Prinzip des fallbasierten Lernens zum Thema „Pulmonaler Rundherd“. Dabei wurde bei einer Gruppe von Studierenden ein moderiertes Präsenz-Seminar, bei der anderen eine reine Online-Veranstaltung abgehalten. Der Wissensgewinn und die subjektive Bewertung des Kurses durch die Studierenden wurden über Fragebögen ermittelt. Ergebnisse: Insgesamt nahmen 190 Studierende an den Seminaren teil, davon 88 am Präsenz- und 102 am Online-Kurs. Obwohl beide Gruppen einen deutlichen Wissenszuwachs durch die Kursintervention verzeichneten, zeigten die Studierenden des Präsenzkurses eine deutlich höhere subjektive Zufriedenheit im Vergleich zu ihren Kommilitonen im Online-Kurs. Diskussion: Das fallbasierte Lernen erwies sich als erfolgsversprechendes Konzept in der thoraxchirurgischen Lehre, wobei sich die Etablierung von online-Lernverfahren deutlich schwieriger gestaltete als bei präsenzbasiertem Unterricht

SARS-CoV-2 in pregnancy and possible transfer of immunity: assessment of peripartal maternal and neonatal antibody levels and a longitudinal follow-up

Objectives: In the current Severe Acute Respiratory Distress Coronavirus 2 (SARS-CoV-2) pandemic there is still great uncertainty about the effects of an infection in pregnancy especially regarding a possible fetal transmission of antibodies to SARS-CoV-2 and the longevity of this immunity. Methods: Sixteen women who were infected with SARS-CoV-2 during pregnancy and their offspring were included. The antibody response to SARS-CoV-2 was measured in mother and umbilical cord blood peripartum and in a follow-up examination 6-11 weeks after birth. Medical history, symptoms regarding SARS-CoV-2, obstetric and neonatal information were queried following recommendations by the WHO. Results: A total of 73% of the women and one third of the infants developed antibodies to SARS-CoV-2 spike (S) protein receptor binding domain (RBD), with a long interval between infection and birth proving favorable for a transplacentar transfer of antibodies to the neonates. All infants showed declining or vanishing antibody-titers in the follow-up examination, while the titers of their mothers were stable or even increased. Conclusions: Our results demonstrate that transplacental transfer of SARS-CoV-2-specific antibodies is possible, but also indicate that the immunity that may be gained as a result might decrease in newborns postpartum. This provides important evidence that could be useful for further studies covering vaccination during pregnancy

Single-institution cross-sectional study to evaluate need for information and need for referral to psychooncology care in association with depression in brain tumor patients and their family caregivers

Background The prognosis of patients with brain tumors is widely varying. Psychooncologic need and depression are high among these patients and their family caregivers. However, the need for counselling and need for referral to psychooncology care is often underestimated. Methods We performed a single-institution cross-sectional study to evaluate psychooncologic need, depression and information need in both patients and their family caregivers. The Hornheider Screening Instrument (HSI) and the Patient Health Questionnaire (PHQ-9) were used to evaluate psychooncologic need and depression, and a study-specific questionnaire was developed to evaluate information need. Multivariable analyses were performed to detect correlations. Results A total of 444 patients and their family caregivers were approached to participate, with a survey completion rate of 35.4%. More than half of the patients and family caregivers were in need for referral to psychooncology care and 31.9% of patients suffered from clinically relevant depression. In multivariable analysis, psychooncologic need were positively associated with mild (odds ratio, OR, 7.077; 95% confidence interval, CI, 2.263–22.137; p = 0.001) or moderate to severe (OR 149.27, 95% CI 26.690–737.20; p <  0.001) depression. Patient information need was associated with depression (OR 3.007, 95% CI 1.175–7.695; p = 0.022). Conclusions Unmet counselling need in brain tumor patients and their family caregivers associate to high psychooncologic need and depression. Adequate information may decrease the need for referral to psychooncology care and treatment of depression in these patients. Future studies should further explore these relations to promote development of supportive structures

Information needs and requirements in patients with brain tumours and their relatives

Patients with brain tumours face a number of medical and social challenges. Previous studies have shown that these patients and their relatives need a high level of patient-oriented information and counselling. However, these needs are often underestimated. In this single-centre cross-sectional study, we evaluated, for the first time, the information needs of patients with brain tumours and their relatives depending on diagnosis, age and level of education. The participants were interviewed using pre-specified questionnaires. Answers were evaluated descriptively using standard statistical methods. A total of 888 questionnaires were sent out. The return rate was 50.7%. The majority of patients (nP = 103; 59.9%) and a higher proportion of relatives (nR = 103; 72.5%; p = 0.019) wished to receive a maximum of information. The majority (79.7% of patients; 83.1% of relatives) also stated that they preferred a personal, face-to-face meeting as primary source of information. The need for information increased with education (p = 0.015), and decreased with tumour grade (p = 0.025) and age (p = 0.118). Our data indicate that patients with brain tumours and their relatives have high information needs throughout their disease and continuously require information and counselling. Optimal provision of information is based on personal preferences, which needs to be evaluated appropriately. Patient-oriented information and counselling are parts of a successful communication strategy that can improve cancer care significantly

Pregnant and postpartum women requiring intensive care treatment for COVID-19 — first data from the CRONOS-registry

(1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30–36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28–35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome