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Aim: The aim of the study is to look at the specific contribution of outpatient cancer counselling centers (OCCC) from the perspective of both the person seeking advice and the referring health care professionals., Methods: Qualitative design by means of guideline-based face-to-face interviews with cancer patients/relatives and individual telephone interviews with referring health care professionals., Results: A total of 43 persons seeking advice and 30 referring health care professionals were interviewed. With regard to the contents of counselling, psycho-oncological support and help for self-help in combination with social-legal information about additional support services are perceived as central features. In the group of referring physicians, however, there seems to be some uncertainty about what OCCCs (can) provide., Conclusion: On the one hand, the results point to a specific core of the services offered by OCCCs, and on the other hand to ambiguous perceptions on the part of the respondents. They may contribute to further sharpening the profile of OCCC and to clarifying their place in the health care system., Competing Interests: Susanne Singer erhielt Vortrags- bzw. Juryhonorare von Pfizer, Lilly, Boehringer-Ingelheim und BMS, alle außerhalb der hier vorgestellten Studie. Andreas Ihrig, Evelyn Flohr-Schmitt, Markus Besseler, Gudrun Bruns, Norbert Gelse und Alexander Wünsch sind selbst Mitarbeiter/innen einer Krebsberatungsstelle. Alle anderen Autor/innen (Margret Xyländer, Oliver Bayer, Melanie Schranz, Thorsten Meyer) geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Aim: The aim of the present survey was to describe and evaluate experiences of German psychosocial cancer counselling centers with user surveys as a quality management measure., Methods: Representatives of various psychosocial cancer counselling centers were asked to prepare an experience report on user surveys. Nine field reports were presented and discussed in summary by the working group "Cancer Counselling Centers" of the Working Group Psychooncology of the German Cancer Society (PSO). Special attention was paid to the short questionnaire KBS-N (Cancer Counselling Centre Questionnaire) recommended by the working group., Results: All psychosocial cancer counselling centers reported positive experiences with user surveys, which, however, represent an effort in terms of personnel and logistics. In addition to the KBS-N, more detailed questionnaires were also used. The surveys were conducted either continuously or on a random basis over a limited period of time. Those seeking advice were usually asked at a defined time directly after the initial interviews or after the end of the counselling sequence. The response rate was higher (85-95%) when the questionnaire was handed out personally after the initial consultation than for postal delivery and return (47-89%). All counselling centers reported positive feedback on the counselling services provided. Isolated points of criticism were related in particular to organizational framework conditions., Conclusion: After weighing up the costs and benefits, an active follow-up survey of those seeking advice using the short questionnaire KBS-N appears to be a practicable quality assurance measure, at least over a limited period of time. More detailed user surveys require more effort and are therefore more suitable for use in research that go beyond quality assurance., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

During the last years two studies for the investigation of the etiology of porcine ear necrosis were carried out at the Clinic for Swine of the University of Veterinary Medicine Vienna. In study 1, parameters, which are discussed in this context, were collected by veterinary practitioners by completing specially designed questionnaires in farms with symptoms of the porcine ear necrosis syndrome. In study 2, samples of piglets and feed were collected for laboratory analysis of the most important infectious agents as well as mycotoxins. In the present manuscript, the results of both projects were compared. Even if the selection criteria of both studies differed, the affected age class was comparable (5.5 to ten weeks of life in study 1 and six to ten weeks of life in study 2). The herd-specific prevalence of the porcine ear necrosis syndrome varied considerably with percentages between 2 and 10, respectively, to 100%. The evaluation of questionnaires in study 1 showed that 51% of the farms had problems with cannibalism. Particles of plant material, which were frequently seen on the histologic slides of study 2, could have got into the tissue by chewing the ears of the pen mates or cannibalism. Whereas in study 1 the negative effect of parameters as high pig density, suboptimal climate, missing enrichment material and bad quality of feed and water were considered, in study 2 all these factors were checked at sample collection and ruled out as precursor for cannibalism. In both studies bacterial agents proved to be a crucial co-factor for the expansion of the necroses to deeper tissue layers, whereas viral pathogens were classified less important. In both projects it was not possible to estimate the direct impact of infectious agents and mycotoxins as direct trigger of the necroses as well as their participation as co-factors or precursor in the sense of an immunosuppression or previous damage of blood vessels or tissue.

This essay on prognosis in tumor diagnosis pathology resp. tumor etiology, cancerogenesis and molecular oncology is the authors personal opinion. Generally tumor diagnosis improves with progress in histo- and cytological methods for example in tumors of the APUD-system and precancerous lesions especially of the breast. Fundamental principle of developed tumor diagnosis is the knowledge of malignant transformation. Its profits favours the etiology in cancerogenesis and e.g. non Hodgkin lymphomas (Burkitt lymphoma, adult T-cell lymphoma) and to result from new methods in molecular biology and viral genetics (DNS-hybridizing, -recombination and gene technology). With the beginning century a stepwise fitted diagnosis of malignant lymphomas is evident up to monoclonal dedifferentiated lymphoid cells and their multifarious phenotypical markers. This concept may be of general significance in tumor diagnosis already indicated in prelymphomas. Finally the present prognosis of tumor diagnosis is evaluated by contents, tasks and strategies of its corresponding research lines in clinical and experimental tumor pathology resp. its organization.

Concentration-effectivity curves of Triton X-100 activity on ascitic cells of mouse leukemia 1210 and Zajdela-Hepatoma in rats have been plotted by electronic determination of cell numbers, indicating only one part of cytolysis which follows a sudden decrease of cell volumes. A better characterization of the whole cytolysis can be realised by volumetricall particle counter analysis. It first displays an increase in cell volumes for several concentrations in connection with microscopically observed increase in cells staining relatively weak by eosin. Staining and swelling nearly simultaneosly reach their maximum. Furthermore a sudden diminution of the cells follows with a shift of cell volumes distribution curves to the left, determined by particle counter depending on temperature, e. g. a strong delay at 0 degrees C.

The author describes a psychoanalytical liaison service conducted over a period of two years on behalf of a psychiatric ward for acutely demented patients. About one-sixth of the psychiatric patients admitted during this time were subjected to psychoanalytical examination. Psychiatric inpatient treatment was suggested for about one-tenth of them, i.e. two per cent of all referrals to the ward. Due to the introduction of a psychodynamic mode of viewing the cases, together with a patient-centered interpretation of interaction patterns, the general atmosphere in the ward changed gradually. The article concludes with general considerations as to the use of the psychoanalytical approach in psychiatry.

Three psychiatric hospital types regularly involved in psychiatric inpatient care, state mental hospitals, psychiatric departments of general hospitals and psychiatric departments of universities are compared based on statistical data. The main results are: general and university departments are functioning very similarly; they show a low number of beds, a low ratio of beds per 1,000 residents, a short length of stay, a low rate of compulsory hospitalizations and a high level of hospitalizations altogether. For all these data state hospitals exhibit the opposite tendency, though they have reached many improvements from 1972 to 1985.

In the recent century research in cancer metastasis has greatly improved; nowadays it is a superior topic in cancer literature. Most of its problems result from alternate assumptions: The functional seed and soil and the hemomechanic hypothesis, after all putting two questions on account of metastasis being either a permanent likewise passive or a cascade phenomenon. In regard of metastasizing bronchial-, breast- and prostate carcinomas or multifocal tumors and most of rodent neoplasms a passive tumor cell transport might be a single effect, but the characteristic feature rather a step by step metastasizing cascade, implicating special organ localizations, and the fact, that metastasis distribution correlates with tumor biology, localization of the first metastasis and in manifold metastasizing tumors with typical organ patterns. From introduction of recent in vitro and cloning-techniques the metastasizing potency of tumors now becoming able to be defined by function of its genetic heterogeneity, developing metastasizing phenotypes respective neoplastic evolution by mutation, gene amplification, and epigenetic factors. On the other side having an unique xenobiotic metabolism metastasizing tumor cells are in accordance with the conception of their inherent "commonality".