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The timely integration of palliative medicine is an important component in the treatment of various advanced diseases. While a German S‑3-guideline on palliative medicine exists for patients with incurable cancer, a recommendation for non-oncological patients and especially for palliative patients presenting in the emergency department or intensive care unit is missing to date. Based on the present consensus paper, the palliative care aspects of the respective medical disciplines are addressed. The timely integration of palliative care aims to improve quality of life and symptom control in clinical acute and emergency medicine as well as intensive care. [ABSTRACT FROM AUTHOR]

Efficient swallowing without functional and structural limitations is indispensable for adequate oral intake of food and fluids. Regardless of food consistencies, food forms, or tablet forms, the act of swallowing is an extremely complex movement pattern involving the participation of up to 100 muscles. Impaired swallowing can occur in many neurological disorders, with stroke and neurodegenerative diseases being the most common. With advancing age, various changes occur in the body that also affect swallowing function and physiology in healthy older individuals, a condition known as presbyphagia. This process becomes visible as early as the age of 65, with its intensity and prevalence increasing with age and potentially progressing into a clinically relevant swallowing disorder called dysphagia. Despite its clinical relevance, swallowing disorders in older adults are underestimated by primary care providers as well as by seniors themselves. This paper highlights the key elements of diagnosis and therapy of swallowing disorders in the elderly, which will gain importance in outpatient primary care and in the primary care of the aging population. Consistent and structured swallowing diagnostics and therapy are crucial to efficiently prevent aspiration pneumonia with significant health economic consequences, such as frequent rehospitalizations. In addition, intact swallowing is essential for efficient oral medication intake and their effectiveness, as medications that are not swallowed cannot exert their effects or their pharmacokinetics may be compromised. [ABSTRACT FROM AUTHOR]

It is an accepted idea that poverty is much more than low incomes. Consequently, the multidimensional approach has become an alternative way to understand that question. The aim of this paper is to propose an alternative estimation of multidimensional poverty in Colombia. The methodology uses unconventional dimensions, continuous and pseudo-continuous variables; it will estimate dimensional gaps and apply Bourguignon and Chakravarty's methodology. Although, there has been a noticeable reduction of headcount poverty, the multidimensional poverty gap and its severity have not shown the same trend. In addition, there are huge regional differences, and dimensions with high deprivation. [ABSTRACT FROM AUTHOR]

Microscopic colitis (MC) is still an underestimated cause of chronic, non-bloody watery diarrhea. It is typically manifested in elderly patients with a female predominance. The incidence of microscopic colitis has been increasing. The aetiology and pathophysiology remain unclear. Conditions associated with it include autoimmune diseases. There may be a genetic predisposition, as familial cases have been described. As implicated by the name microscopic colitis, the diagnosis is found by histological examination. There are mainly two subtypes, the lymphocytic colitis (LC) and the collagenous colitis (CC). Even if the condition's long-term course is benign, a chronic recurrent course of the symptoms is frequent. Due to the symptoms, there is an impairment of patient's health-related quality of life. A correct diagnosis and therapy is therefore mandatory. The aim of this paper is to create awareness for microscopic colitis. [ABSTRACT FROM AUTHOR]

Effectiveness of rehabilitation services according German Social Act XII for persons with substance use disorders Abstract. Background: Rehabilitation services according to German Social Act XII (SGB XII) for persons with substance use disorders provided by mainly inpatient facilities in the greater Hamburg area are an important pillar of social and health care policy. Objective: The study analyzed the effectiveness of these interventions for new clients entering rehabilitation services with regard to the achievement of objectives in the areas of addiction and social integration which are determined in an agreement between client and rehabilitation staff on a regular basis at treatment onset. Methods: In a prospective pre-post-analysis both clients and rehabilitation staff were interviewed by means of a paper-pencil-survey. The interviews were conducted at treatment onset and after 6 months or, in case treatment was ended prior to the end of month 6, at an earlier date. Results: In total 255 clients were included in the study. The majority of clients either largely or fully met the agreed objectives in the areas of addiction and social integration. An improvement of the clients’ situation regarding substance use could be found in more than two thirds of all cases. Impairments according to ICF have decreased; psychological distress (BSI-18) and health-related quality of life (SF-12) have improved. A longer duration of interventions and a greater intensity of care show positive effects as to these improvements. Conclusion: The study is the first external evaluation of rehabilitation services according to German Social Act XII to show that the defined objectives are being fully met in a large part of clients. However, due to its single-arm study design the validity of this analysis is limited, further studies are required. Rehabilitation services according to German Social Act XII are an important supplement to the treatment system for persons with substance use disorders who are beyond the reach of regular health care measures and rehabilitation services. [ABSTRACT FROM AUTHOR]