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Background: Impact of the COVID-19 outbreak on cancer patients may be high in terms of anxiety, fear and psychological distress;however, this topic remains under-addressed We aim to describe cancer patient experiences related to the COVID-19 pandemic in Switzerland Information gained through in-depths interviews will be triangulated with the level of distress and resilience Methods: Purposive sampling will be used to recruit four patient subgroups diagnosed with melanoma, breast, lung, or colon cancer (i) under adjuvant treatment;(ii) under anti-cancer treatment with palliative intent;(iii) being consulted at institutes for complementary and integrative medicine (ICIM);(iv) being consulted by clinical nurse specialists (CNS) Interview guides were developed based on qualitative analysis of public online cancer patients’ forums from four different countries We selected main posts related to COVID-19 Semantic and inductive thematic analysis approaches were used to identify meaningful patterns and themes The level of distress and resilience will be measured by the NCCN Distress Thermometer and the 2-item Connor-Davidson-Resilience Scale We aim to include 120 patients (10 participants per subgroup in each language region) Recruitment will start in September 2020 Results: The design of the study as well as preliminary data regarding themes and subthemes identified in the patient’s forum analysis will be presented Conclusions: To the best of our knowledge, no patient experience study with a qualitative design is conducted or planned with cancer patients during COVID-19 pandemic in Europe The study will serve to identify concerns, unmet information and clinical needs and potential positive experiences of patients with cancer in relation to the COVID-19 pandemic Newly developed patient reported measures should be based on qualitative data The identification of topics considered important to patients will thus support the development of patient reported experience measures for the current or future epidemics/pandemics Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: S Colomer-Lahiguera: Travel/Accommodation/Expenses: Vifor pharma M Eicher: Travel/Accommodation/Expenses: Vifor pharma;Honoraria (institution): Vifor pharma;Honoraria (institution), Research grant/Funding (institution): BMS;Honoraria (institution), Research grant/Funding (institution): Roche;Research grant/Funding (institution): Kaiku Health All other authors have declared no conflicts of interest

The value of qigong in the treatment of chronic low back pain is unclear. In a randomized controlled trial, we evaluated whether qigong is non-inferior to exercise therapy in patients with chronic low back pain.German outpatients (aged 46.7 ± 10.4) with chronic low back pain [mean visual analogue scale (VAS), 53.9 ± 12.5 mm] were enrolled and randomly allocated in a 1:1 ratio to receive either qigong (64 patients, 12 sessions with 1 × 90 min/week over 3 months) or exercise therapy (63 patients, 12 sessions 1 × 60 min/week). The primary outcome measure was the average pain intensity over the last 7 days on a VAS (0-100 mm, 0 = no pain, 100 = worst imaginable pain, non-inferiority margin = 5 mm) after 3 months. Follow-up was measured after 6 and 12 months.The mean adjusted low back pain intensity after 3 months was 34.8 mm [95% confidence interval (CI) 29.5; 40.2] in the qigong group and 33.1 mm (95% CI 27.7; 38.4) in the exercise group. Non-inferiority of the qigong group compared with the exercise group failed to show statistical significance (p = 0.204). In both groups, 10 patients reported suspected adverse reactions (e.g., muscle soreness, dizziness, pain) the total number was comparable in both groups (qigong n = 40, exercise n = 44).Qigong was not proven to be non-inferior to exercise therapy in the treatment of chronic low back pain. Its role in the prevention of chronic low back pain might be addressed in further studies.

Patients' expectations of acupuncture treatment have widely been investigated; however, little focus has been on the physicians' expectations. We aimed to investigate (1) which patient characteristics lead to different expectations of physicians, and (2) whether physicians' expectations predict pain reduction and physical functioning in acupuncture and usual care treatment for chronic pain.In four large multi-centre, randomized trials patients with chronic pain were randomized to receive usual care alone or 10 additional acupuncture treatments. Data were pooled. Baseline characteristics of the three expectation groups were compared, and the physicians' expectation and its interaction with the treatment group were included in two linear regression models predicting pain reduction and change in physical functioning. Other patient characteristics were included for adjustment.9900 patients treated by 2781 physicians were analysed. Age, education and disease-related variables differed in the expectation groups. There was no interaction between treatment group and expectation. Patients, for whom the physicians had expected substantial improvement, showed more pain reduction (p0.001) and better physical functioning (p0.001) than patients for whom moderate improvement was expected. No significant differences were found between expected moderate and expected lack of success. However, the proportion of explained variance that was due to physicians' expectations was small considering total explained variance.Physicians' high expectations at baseline predict better outcome, independent of the treatment. Since we adjusted for several patient variables including duration and severity of disease, this cannot be explained by prognostic factors only. Other explanations are discussed and recommended for future research.

To investigate the effects of stimulated and non-stimulated manual acupuncture at ST36 and PC6 on gastric myoelectrical activity and autonomic function.A total of 65 healthy volunteers were randomly assigned to a 1: 1: 2 ratio to receive either 15 min of verum acupuncture (VA) with stimulation followed by 15 min of VA without stimulation (nsVA), or 15 min of nsVA followed by 15 min of VA with stimulation (sVA), or 30 min of sham acupuncture (SA). Measures of autonomic function included electrogastrogram, electrocardiogram, impedance cardiography and assessment of blood pressure, breathing frequency, and electrodermal activity. Outcome parameters were compared between VA and SA, and between sVA and nsVA. The percentage of regular gastric slow waves (normogastria) was defined as the primary outcome.The percentage of normogastria was not significantly different between VA and SA. Differences in secondary outcomes such as power spectrum of gastric slow waves and heart rate variability parameters were pronounced in the comparison of sVA and nsVA. During sVA, the percentage of normogastria was lower (P = 0.005), the percentage of bradygastria was higher (P = 0.003) and power ratio was higher (P0.001), systolic blood pressure was lower (P = 0.039) and RMSSD was higher (P0.001) as compared with nsVA.Our study suggests that manual stimulation of acupuncture needles at ST36 and PC6 affects gastric myoelectrical as well as cardiac activities in healthy volunteers. The effect of stimulation in acupuncture deserves further investigation.

In Germany, acupuncture is one of the most frequently used complementary and alternative therapies. In the year 2000, we initiated three large projects in co-operation with statutory health insurance companies to assess the effectiveness, safety and costs of acupuncture in patients with chronic headache, low back pain and pain due to osteoarthritis. Our findings showed that acupuncture was more effective than conventional standard treatment, treatment without acupuncture or a waiting list control. A significant difference between acupuncture and sham acupuncture was only seen for arthritis of the knee; for the other diagnoses, both forms of acupuncture showed similar effects. Whether the effects of acupuncture are due primarily to specific or unspecific mechanisms appears to depend on the diagnosis and should be investigated in further studies.

Die Erwartungen von Patienten spielen beim Plazeboeffekt eine entscheidende Rolle und korrelieren z. B. bei Akupunktur aber auch mit dem Behandlungsergebnis. Witt et al. uberpruften, ob Entsprechendes ebenfalls fur die Erwartungen der Arzte gilt, wie es fur konventionelle Schmerzbehandlung bereits gezeigt wurde.

1. Voltage-dependent properties of isolated guinea pig outer hair cells (OHCs) were investigated using whole-cell recording. An inward current was detected in approximately 10% of the cells. This inward current was identified as belonging to the voltage-activated sodium current family on the basis of its high sensitivity to tetrodotoxin and the effect of substitution of impermeant ions. Although this is the first report of a sodium current in the mammalian cochlea, it differs from the classical neuronal sodium current by having a variable magnitude from cell to cell and an inactivation that is shifted to hyperpolarized potentials. The sensory processing role of hair cells in general and outer hair cells in particular could be disrupted by the presence of a regenerative voltage-dependent current. The functional role of the OHC sodium channels is puzzling, particularly as they may be silent in vivo.

To compare anthroposophic treatment (eurythmy, rhythmical massage or art therapy; counselling, anthroposophic medication) and conventional treatment for low back pain (LBP) under routine conditions.62 consecutive outpatients from 38 medical practices in Germany, consulting an anthroposophic (A-) or conventional (C-) physician with LBP ofor= 6 weeks duration participated in a prospective non-randomised comparative study. Main outcomes were Hanover Functional Ability Questionnaire (HFAQ), LBP Rating Scale Pain Score (LBPRS), Symptom Score, and SF-36 after 6 and 12 months.At baseline, LBP duration was6 months in 85% (29/34) of A-patients and 54% (15/28) of C-patients (p = 0.004). Unadjusted analysis showed significant improvements in both groups of HFAQ, LBPRS, Symptom Score, SF-36 Physical Component Summary, and three SF-36 scales (Physical Function, Pain, Vitality), and improvements in A-patients of three further SF-36 scales (Role Physical, General Health, Mental Health). After adjustment for age, gender, LBP duration, and education, improvements were still significant in both groups for Symptom Score (p = 0.030), SF-36 Physical Component Summary (p = 0.004), and three SF-36-scales (Physical Function, p = 0.025; Role Physical, p = 0.014; Pain, p = 0.003), and in A-patients for SF-36-Vitality (p = 0.032). Compared to C-patients, A-patients had significantly more pronounced improvements of three SF-36 scales (Mental Health: p = 0.045; General Health: p = 0.006; Vitality: p = 0.005); other improvements did not differ significantly between the two groups.Compared to conventional therapy, anthroposophic therapy for chronic LBP was associated with at least comparable improvements.