Information provision and information needs in adult survivors of childhood cancer

BACKGROUND Knowledge about their past medical history is central for childhood cancer survivors to ensure informed decisions in their health management. Knowledge about information provision and information needs in this population is still scarce. We thus aimed to assess: (1) the information survivors reported to have received on disease, treatment, follow-up, and late effects; (2) their information needs in these four domains and the format in which they would like it provided; (3) the association with psychological distress and quality of life (QoL). PROCEDURE As part of the Follow-up survey of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all survivors (≥18 years) who previously participated to the baseline survey, were diagnosed with cancer after 1990 at an age of <16 years. RESULTS Most survivors had received oral information only (on illness: oral: 82%, written: 38%, treatment: oral: 79%, written: 36%; follow-up: oral: 77%, written: 23%; late effects: oral: 68%, written: 14%). Most survivors who had not previously received any information rated it as important, especially information on late effects (71%). A large proportion of survivors reported current information needs and would like to receive personalized information especially on late effects (44%). Survivors with higher information needs reported higher psychological distress and lower QoL. CONCLUSIONS Survivors want to be more informed especially on possible late effects, and want to receive personalized information. Improving information provision, both qualitatively and quantitatively, will allow survivors to have better control of their health and to become better decision makers. Pediatr Blood Cancer 2014;61:312-318. © 2013 Wiley Periodicals, Inc.

Umstrukturierung von kollektiven Kapitalanlagen

The issuance of the Swiss Federal Act on Collective Investment Schemes (CISA) in the year 2007 and the revision thereof in 2013 expanded the possibilities for restructuring of collective investment schemes and simplified the procedures. For instance, in article 95 the CISA contains a provision that deals in a non-conclusive way with the restructuring of open-ended collective investment schemes. As a novelty regulation, this provision allows for mergers not only of contractual funds but also of investment companies with variable capital (SICAV). Additionally, the transformation of an open-ended collective investment into another CISA legal form was also included into the catalogue of possible restructuring processes. Further, a SICAV still maintains the possibility for asset transfer according to article 69 ff. of the Federal Act on Merger, Demerger, Transformation and Transfer of Assets (MerA). However, not all open questions have been clarified. As long as the CISA does not contain restructuring provisions, as is the case with closed-ended collective investment schemes, generally the MerA and/or the Swiss Code of Obligations (CO) apply. The interplay of diverse, partly overlapping legislative bases leads to the emergence of unwanted gaps. Moreover, the partial revision of the CISA was not completely implemented at the ordinance level. Among others, the following issues have not been conclusively or clearly regulated: the permitted combinations of mergers, the merger procedure of the SICAV, the permitted restructurings, the transformation procedure as well as the application scope of the asset transfer for collective investment schemes according to the relevant merger regulations. Although these questions will be clarified in the following article through a systematic and teleological analysis of the relevant regulations, it is to be hoped that the gaps will be closed within the next CISA revision in order to guarantee comprehensive legal certainty.

Perinatal mental health service provision in Switzerland and in the UK.

QUESTIONS UNDER STUDY The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. METHODS Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. RESULTS Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. CONCLUSIONS The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.