Der Anaesthesist
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The diagnostics of pain in older people with cognitive impairments should always consist of a subjective self-report of pain and a structured observation of pain behavior. It is important to note that the subjective self-report of pain becomes less valid with increasing cognitive decline (starting with a moderate degree of dementia). ⋯ Moreover, the patient should be observed for at least 3 min. Online forms of training have recently been developed and are freely available for training in external observation.
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Transparency in healthcare has been demanded and promoted for years. The aim of such transparency is disclosure of relationships and interests, so that patients can draw their own conclusions regarding the economic relations of their treating physician. ⋯ Overall, transparency should keep healthcare free from non-medical considerations, which may stand in contrast to the patient's wellbeing. Part of this strategy is the legislation aimed at fighting corruption in healthcare passed 13 April 2016, the so-called Anticorruption Act.
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Multidrug-resistant pathogens often lead to treatment failure of antimicrobial regimens. After a period of imbalance between the occurrence/spread of resistance mechanisms and the development of new substances, some new substances have meanwhile been approved and many more are currently undergoing clinical testing. They are particularly effective against specific resistance mechanisms/pathogens and should be preserved for definitive treatment of an isolated pathogen. ⋯ They are again used in special infection scenarios and clinically tested in combination with new substances. Despite the introduction and development of new substances the building of resistance will at some time also render these (at least partially) ineffective. Therefore, their implementation must be carried out according to the antibiotic or infectious diseases stewardship.