Robert Bosch Stiftung

Abstract: OBJECTIVE: to review systematically the range of case definitions and methods used to measure falls in randomised controlled trials. Design/methods: a Cochrane review of fall prevention interventions was used to identify fall definitions in published trials. Secondary searches of various databases were used to identify additional methodological or theoretical papers. Two independent reviewers undertook data extraction, with adjudication by a third reviewer in cases of disagreement. Settings: community-dwelling and institutionalised older persons. RESULTS: 90 publications met the predefined inclusion criteria. Of these, 44 provided no definition of the term fall. In the remainder, there were substantial variations in the definition and methods of measuring falls. Reporting periods ranged from 1 week to 4 years with only 41% using prospective data collection methods. CONCLUSION: the standard of reporting falls in published trials is poor and significantly impedes comparison between studies. The review has been used to inform an international consensus exercise to make recommendations for a core set of outcome measures for fall prevention trials.

Abstract: Vorgestellt wird die deutsche Version der Falls Efficacy Scale-International Version (FES-I). Dieser Fragebogen zur Erfassung sturzassoziierter Selbstwirksamkeit bei alteren Menschen wurde im Rahmen eines Experten- Netzwerks zur Sturzpravention (Prevention of Falls Network Europe ProFaNE) entwickelt. Die FES-I stellt eine Erweiterung der Falls Efficacy Scale (FES) dar, in der zum einen komplexere funktionelle Aktivitaten und zum anderen soziale Aspekte der Selbstwirksamkeit zusatzlich aufgenommen wurden. Die FES-I zeigt sowohl eine hohe interne Konsistenz (Cronbachs α = 0,96) als auch eine hohe Retest-Reliabilitat (r = 0,96). Die Item-Interkorrelation betrug im Mittel r = 0,55 (Range r = 0,29– 0,79). Ergebnisse von Validierungsstudien bei zu Hause lebenden Alteren aus unterschiedlichen europaischen Landern und von geriatrischen Patienten mit kognitiver Schadigung werden in Kurze publiziert.

Abstract: Eighteenth century literature contains critiques of physicians' behavior, as for example in Goethe's Faust. These critiques aim at the physicians' therapeutical incapacity which they try to compensate with a behavioral code called "savoir faire". This paper compares the critiques with the advices of medical authors given to their younger colleagues in the "savoir faire" literature. These sources often discuss, how to hide doubts, how to maintain the authority over the patients or to prevent complaints of malpractice. Obviously, physicians often didn't trust in their therapeutical proficiency and tried to bind their patients by inspiring a behavior of confidence, independent of the question of the real effectiveness of their treatments.

Abstract: Purpose The aim was to present current knowledge about pain assessment in people with dementia and to discuss special challenges and possible solutions.

Abstract: Introduction: We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age = 15 years (ORhet = 0.84, 95% CI 0.75, 0.94; ORhom = 0.81, 95% CI 0.51, 1.30; P-trend = 0.002) but not for those who had their menarche age <= 11 years (ORhet = 1.06, 95% CI 0.95, 1.19, ORhom = 1.07, 95% CI 0.67, 1.72; P-trend = 0.29). Conclusions: To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels.