Burn out – slow down?

The article focuses on multitasking and virtual mobility in young people’s everyday life. The author demonstrates how paradoxes of a digital high speed society massively influence both the educational sphere and young people’s leisure time and encourage thinking about strategies concerning the work-life balance and burnout prevention in young target groups.     

Determinants of acceptance of end-of-life interventions: a comparison between withdrawing life-prolonging treatment and euthanasia in Austria

Background

End-of-life decisions remain a hotly debated issue in many European countries and the acceptance in the general population can act as an important anchor point in these discussions. Previous studies on determinants of the acceptance of end-of-life interventions in the general population have not systematically assessed whether determinants differ between withdrawal of life-prolonging treatment (WLPT) and euthanasia (EUT).

Methods

A large, representative survey of the Austrian adult population conducted in 2014 (n?=?1,971) included items on WLPT and EUT. We constructed the following categorical outcome: (1) rejection of both WLPT and EUT, (2) approval of WLPT but rejection of EUT, and (3) approval of both WLPT and EUT. The influence of socio-demographics, personal experiences, and religious and socio-cultural orientations on the three levels of approval were assessed via multinomial logistic regression analysis.

Results

Higher education and stronger socio-cultural liberal orientations increased the likelihood of approving both WLPT and EUT; personal experience with end-of-life care increased only the likelihood of approval of WLPT; and religiosity decreased approval of EUT only.

Conclusion

This study found evidence for both shared (education, liberalism) and different (religiosity, care experiences) determinants for the acceptance of WLPT and EUT.

     

Environmental Isolates of Azole-Resistant Aspergillus fumigatus in Germany

Azole antifungal drug resistance in Aspergillus fumigatus is an emerging problem in several parts of the world. Here we investigated the distribution of such strains in soils from Germany. At a general positivity rate of 12%, most prevalently, we found strains with the TR₃₄/L98H and TR₄₆/Y121F/T289A alleles, dispersed along a corridor across northern Germany. Comparison of the distributions of resistance alleles and genotypes between environment and clinical samples suggests the presence of local clinical clusters.     

Short length of stay and the discharge process: Preparing breast cancer patients appropriately

ObjectiveBreast cancer is the most common cancer among women worldwide, increasing the relevance of an efficient and successful care process. As length of stay (LOS) in the hospital decreases, patients’ satisfaction with the LOS varies. We hypothesize that successful discharge planning can improve this evaluation.MethodsData of 4,390 female breast cancer patients from a cross-sectional survey was analyzed. The data was collected in 2017 in 86 German hospitals. Logistic regressions were used to test hypotheses.ResultsThe majority of included patients rated their LOS as appropriate. However, patients who felt better prepared for discharge were less likely to rate their stay as too short. A longer stay in the hospital further decreased this likelihood. The effect of LOS was moderated by patient experiences with preparation for discharge.ConclusionAs hospital LOS decreases, one challenge in allowing patients to feel sufficiently informed and ready to go home is the reduced time for face-to-face consultations. Our results indicate, however, that a strong and thorough discharge planning makes the actual number of days for LOS irrelevant for patient’s rating of LOS.Practice ImplicationsThe study results underscore the importance of ensuring the quality and thoroughness of the discharge process.     

Behandlung der kindlichen Unterarmschaftfraktur

All forearm fractures with no or only minimal dislocation should still be treated by immobilization with an upper arm plaster cast. In cases of severe dislocation primary operative repositioning including elastic stable intramedullary nailing (ESIN) osteosynthesis is the best form of treatment for children with excellent functional results. In addition, greenstick fractures which need repositioning during general anesthesia should also undergo primary ESIN osteosynthesis.