Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer

Purpose This study investigated satisfaction with treatment decision (SWTD), decision-making preferences (DMP), and main treatment goals, as well as evaluated factors that predict SWTD, in patients receiving palliative cancer treatment at a Swiss oncology network. Patients and methods Patients receiving a new line of palliative treatment completed a questionnaire 4–6 weeks after the treatment decision. Patient questionnaires were used to collect data on sociodemographics, SWTD (primary outcome measure), main treatment goal, DMP, health locus of control (HLoC), and several quality of life (QoL) domains. Predictors of SWTD (6 = worst; 30 = best) were evaluated by uni- and multivariate regression models. Results Of 480 participating patients in eight hospitals and two private practices, 445 completed all questions regarding the primary outcome measure. Forty-five percent of patients preferred shared, while 44 % preferred doctor-directed, decision-making. Median duration of consultation was 30 (range: 10–200) minutes. Overall, 73 % of patients reported high SWTD (≥24 points). In the univariate analyses, global and physical QoL, performance status, treatment goal, HLoC, prognosis, and duration of consultation were significant predictors of SWTD. In the multivariate analysis, the only significant predictor of SWTD was duration of consultation (p = 0.01). Most patients indicated hope for improvement (46 %), followed by hope for longer life (26 %) and better quality of life (23 %), as their main treatment goal. Conclusion Our results indicate that high SWTD can be achieved in most patients with a 30-min consultation. Determining the patient’s main treatment goal and DMP adds important information that should be considered before discussing a new line of palliative treatment.

Alpine lacustrine varved record reveals summer temperature as main control of glacier fluctuations over the past 2250 years

Glacier fluctuations are a key indicator of changing climate. Their reconstruction beyond historical times unravels glacier variability and its forcing factors on long time scales, which can considerably improve our understanding of the climate–glacier relationship. Here, we present a 2250-year-long reconstruction of particle-mass accumulation rates recorded in the lacustrine sediments of Lake Trüebsee (Central Swiss Alps) that are directly related to glacier extent, thus reflecting a continuous record of fluctuations of the upstream-located Titlis Glacier. Mass accumulation rate values show strong centennial to multi-centennial fluctuations and reveal 12 well-pronounced periods of enhanced values corresponding to times of maximum extent of the neighboring Lower Grindelwald Glacier. This result supports previous studies of proglacial lake sediments that documented high mass accumulation rate values during glacier advances. The strong variability in the Lake Trüebsee mass accumulation rate record thus represents a highly sensitive paleoclimatic archive, which mirrors rapid and pronounced feedbacks of Titlis Glacier to climatic changes over the past 2250years. The comparison of our data with independent paleo-temperature reconstructions from tree rings suggests that variations in mean summer temperature were the primary driving factor of fluctuations of Titlis Glacier. Also, advances of Titlis Glacier occurred during the grand solar minima (Dalton, Maunder, Spörer, Wolf) of the last millennium. This relation of glacier extent with summer temperature reveals strong evidence that the mass balance of this Alpine glacier is primarily controlled by the intensity of glacier melting during summer.

Die israelitische Gemeinde Bürgel am Main

von C. Lammert

Die israelitische Gemeinde Gross-Krotzenburg am Main

von J. Berberich

Die Entwicklung des Krankenkassenwesens in der israelitischen Gemeinde zu Offenbach am Main

von [Siegfried] Guggenheim

Aus der Vergangenheit der israelitischen Gemeinde zu Offenbach am Main : zur Einweihung der neuen Synagoge

hrsg. von [Siegfried] Guggenheim

Divrê šālôm we-emet=Worte des Friedens und der Wahrheit : Ansprache des israelitischen Gemeindevorstandes zu Offenbach am Main an seine Gemeindeglieder über dessen Anordnungen und Einrichtungen seit 1821 bis auf die Gegenwart

[Vorr.: Guggenheim]

Die Polen in Offenbach am Main : historische Erzählung aus den 80er Jahren des vorigen Jahrhunderts bis 1817

hrsg. von A. G. Schenck-Rinck

Für die Opfer der drei Lemberger Blutnächte : aus der Leidensgeschichte der Lemberger Juden ; Aktion Hermann Wronker und Maler Wilh. Taubert, Frankfurt am Main

gesammelt und Bild von W. Taubert