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Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder of unknown pathological origin that is associated with psychological distress and reduced health‐related quality of life (HRQoL). We investigated the effects of stress‐management for adults with IBS on typical symptoms, HRQoL and mental health. With predefined criteria (patients: adults with IBS; intervention: stress‐management; control: care as usual or waitlist; outcome: patient‐relevant; study‐type: controlled trials), we registered the study with PROSPERO (168030) and searched the main medical databases. Two researchers independently reviewed the publications and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network checklist. We performed meta‐analysis with homogeneous trials of acceptable quality. After screening 6656 publications, ten suitable randomized trials of acceptable (n = 5) or low methodological quality (n = 5) involving 587 patients were identified. Our meta‐analysis showed no effect of stress‐management on IBS severity 1–2 months after the intervention (Hedges' g = −0.23, 95%‐CI = −0.84 to −0.38, I2 = 86.1%), and after 3–12 months (Hedges' g = −0.77, 95%‐CI = −1.77 to −0.23, I2 = 93.3%). One trial found a short‐term reduction of symptoms, and one trial found symptom relief in the long‐term (at 6 months). One of two studies that examined HRQoL found an improvement (after 2 months). One of two studies that examined depression and anxiety found a reduction of these symptoms (after 3 weeks). Stress‐management may be beneficial for patients with IBS regarding the short‐term reduction of bowel and mental health symptoms, whereas long‐term benefits are unclear. Good quality RCTs with more than 6 months follow‐up are needed. [ABSTRACT FROM AUTHOR]

Background: Control strategies in Tanzania focus on school children by mass drug administration (MDA) using praziquantel. High risk adults are left untreated although potentially infected. Objective: To understand the prevalence of S. mansoni among the adult population and to find whether Testing and treatment campaign, intensive information campaign and engaging the community improves praziquantel uptake during MDA among high-risk adults in Ilemela and Nyamagana municipality, Mwanza Tanzania. Methods: For three consecutive years (January 2018, January 2019, and November 2019), we implemented three cross sectional prevalence surveys through a test and treatment approach involving adult individuals aged ≥15 years. Participants' age, sex, and history of participating in the study were recorded by using a questionnaire. A single urine sample were collected from each participant and screened for S. mansoni infection using PO-CCA test. Participants who tested positive were treated with praziquantel 40mg/kg bwt. Prior to the implementation of MDA, there was an intensive information campaign and community engagement. MDA were done among adult individuals about one month after each testing and treating campaign. Results: A total of 2,148 (38.3% females), 2,070 (32.8% females) and 2,141 (36.6% female) adult individuals participated in the testing and treatment campaign in January 2018, January 2019, and November 2019, respectively. The respective overall prevalence of S.mansoni based on PO-CCA was 81.7% (95%CI: 79.9- 83.2), 70.9% (95%CI: 68.9-72.8) and 74.1% (CI: 72.2 -75.9); indicating a clear decline in prevalence of S. mansoni infection between the baseline and the two consecutive follow-up testing and treatment rounds. The number of participants of PZQ uptake increased from 18,252(67.6%) in the 1st round in February 2018 to 22,581 (83.6%) in July 2019 and 22,583 (83.6%) in December 2019 during the 2ndand 3rd treatment rounds respectively, of the 27,000 adult individuals aimed to be treated in every treatment round. In all three MDA rounds, male had higher participation rate than female and more than half of the participants were youth aged 15-35 years. Conclusion: There was high prevalence of S. mansoni among adults along shore of the Lake Victoria in Mwanza city, however following testing campaign, engaging the community and intensive information campaign there was a significant increase in praziquantel uptake and improvement in the treatment coverage of MDA. The findings demonstrate the role of multi- strategic approaches on praziquantel uptake when implementing along with treatment and test campaign in high-risk adult population. [ABSTRACT FROM AUTHOR]

Background: The connections between climate, environment, and health as well as the concept of planetary health need to be integrated into the education of health professionals, as is increasingly demanded both internationally and nationally. Planetary health education should also aim to foster transformative action for climate protection and sustainability. In recent years, innovative teaching formats and objective catalogues have emerged internationally. In Germany, these topics have not yet been integrated into medical education everywhere. Since 2021, the Faculty of Medicine in Würzburg has offered an elective course as a first step of a longitudinal curriculum currently in development. The design, content, structure, and results of the evaluation are discussed in this article and will be used for quality assurance as well as the (further) development of this kind of educational interventions elsewhere., Methodology: We developed an elective course for students in their second to tenth semester with 30 onsite and online face-to-face teaching units and an additional project phase. We used an innovative mix of didactic methods with online simulations, training in climate-sensitive health counselling, and interdisciplinary climate communication as well as local sustainability projects in small groups, with a large amount of peer-teaching. A quantitative and qualitative evaluation was done immediately after the teaching units through feedback rounds and online with the evaluation software Evasys®, using closed and open-ended questions exploring learning progress (summer semester) and achievement of learning objectives (winter semester), motivation to participate, acceptance of teaching methods, attitudes, relevance, and further interest. The evaluation questionnaire was slightly modified for the winter semester., Results: In the summer and winter semester of 2021/2022, a total of 34 students (17 per semester) participated in the elective course; of these, 33 participated in the written evaluation. The evaluation in the summer semester (n = 17) showed a significant increase in self-assessed learning gain, the evaluation in the winter semester (n = 16) indicated a substantial achievement of learning objectives (mean = 3.96 of a 5-point Likert scale). Participants of both semesters (n = 33) regarded peer-teaching as a suitable method (mean = 4.2) and well-implemented (mean = 4.3). The topics were considered highly relevant but not adequately integrated into the main curriculum. There was a high level of interest in local impacts of climate and environmental changes and local measures for climate protection and sustainability. The specific projects in small groups may serve as examples of how transformative action can be promoted in education., Discussion: In the current dynamic development of the widely demanded integration of planetary health education into curricula, this elective course shows a possible and well-accepted example with a combination of various innovative didactic methods aiming at the levels of knowledge, attitudes, skills, and self-efficacy (or confidence) alike. The positive evaluation by the students and the high interest in local sustainability projects show the potential for future integration into the main curriculum., Conclusion: The elective can serve as an inspiration to tackle the challenge of taking the steps from knowledge to action in planetary health education. While an elective cannot replace the integration of all relevant aspects of planetary health into the main curriculum, it can serve as a space for piloting of future curricular educational interventions and offer opportunities for developing transformative competencies., (Copyright © 2024. Published by Elsevier GmbH.)

Background and Objectives: The first wave of the COVID-19 pandemic (Mar-Apr 2020) posed significant challenges for primary care. The goal of this study was to analyse the burden of the crisis situation as experienced by the general practitioners (GPs) at its beginning and over the course of the pandemic and to identify factors predictive of the sense of being overburdened., Methods: In this cross-sectional study, a total of 6300 randomly selected GPs in four federal states of Germany were contacted per post in order to survey changes in health care they provided and their psychological burden in the context of the pandemic between August and October 2020., Results: The response rate was 23%; 46% of the participants were female. At the beginning of the pandemic, 40% of the participants experienced a high or a very high level of being overburdened; later on, it was only 10%. With increasing numbers of COVID patients, the sense of being overburdened increased, as also their perceived capability to care for COVID patients. Predictors of a sense of being overburdened were, among others, a high level of psychological stress, excessive organising efforts, poor capability to care for COVID patients, and scarce supply of protective equipment., Conclusion: Despite a sense of being overburdened initially, GPs felt increasingly capable of caring for COVID patients. To help GPs in future crisis situations like this pandemic, organization of care should be simplified to the extent possible so that they can focus on patient care., Competing Interests: Die Autoren/Autorinnen geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder of unknown pathological origin that is associated with psychological distress and reduced health-related quality of life (HRQoL). We investigated the effects of stress-management for adults with IBS on typical symptoms, HRQoL and mental health. With predefined criteria (patients: adults with IBS; intervention: stress-management; control: care as usual or waitlist; outcome: patient-relevant; study-type: controlled trials), we registered the study with PROSPERO (168030) and searched the main medical databases. Two researchers independently reviewed the publications and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network checklist. We performed meta-analysis with homogeneous trials of acceptable quality. After screening 6656 publications, ten suitable randomized trials of acceptable (n = 5) or low methodological quality (n = 5) involving 587 patients were identified. Our meta-analysis showed no effect of stress-management on IBS severity 1-2 months after the intervention (Hedges' g = -0.23, 95%-CI = -0.84 to -0.38, I 2  = 86.1%), and after 3-12 months (Hedges' g = -0.77, 95%-CI = -1.77 to -0.23, I 2  = 93.3%). One trial found a short-term reduction of symptoms, and one trial found symptom relief in the long-term (at 6 months). One of two studies that examined HRQoL found an improvement (after 2 months). One of two studies that examined depression and anxiety found a reduction of these symptoms (after 3 weeks). Stress-management may be beneficial for patients with IBS regarding the short-term reduction of bowel and mental health symptoms, whereas long-term benefits are unclear. Good quality RCTs with more than 6 months follow-up are needed., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)