Gesundheitsdienst

Zusammenfassung: Die rasante Entwicklung von Künstlicher Intelligenz (KI) verändert zunehmend die Bildungslandschaft (Gottschling et al., 2024). Sprachmodelle wie ChatGPT werden unreflektiert angewendet und führen zu fehlerhaften Ergebnissen (Krüger et al., 2023). Während bisherige Studien das Nutzungsverhalten bei Studierenden untersuchten, nahm die vorliegende Arbeit Pflegeauszubildende in den Fokus.

Patient-reported outcome measures (PROMs) are becoming increasingly important for patient-centered assessment of treatment success in healthcare. In recent decades, alarge number of instruments have been developed that allow for differentiated recording of symptoms, everyday functions, and various aspects of quality of life. PROMs are now used in nearly 50% of all clinical studies to compare treatments in terms of their benefits for patients. In addition, PROMs are used in quality assurance to compare the treatment success of various healthcare providers. In individual treatment, PROMs can be used to screen for psychological burden or mental health condition.The use of PROMs as an intervention in themselves is relatively new. Systematic symptom assessment in oncology allows side effects to be better controlled and regularly shows positive effects on patients' quality of life.Nevertheless, PROMs have been little used in routine clinical practice to date. For clinicians, the benefits for their daily work rarely outweigh the additional effort involved. The prerequisites for successful implementation in clinical processes currently appear to be, on the one hand, intersectoral harmonization of measurements and, on the other hand, better integration into electronic health records. In Germany and Europe, various initiatives have emerged in recent years, including as part of the Medical Informatics Initiative, which address both issues. It seems inconceivable that empirically oriented medicine will in the long term dispense recording one of the central therapeutic goals-how the patient is doing.

Schon der Begriff „Künstliche Intelligenz (KI)“ ist irreführend. Intelligenz setzt Bewusstsein auf der Basis eines Bewusstseinsmodells voraus, was aber eine KI nicht hat. Eine KI ist primär eine stochastische Maschine, die auf Befehle (Prompts) reagiert. Als mehr sollte KI auch nicht gesehen werden. Jede Form von Persönlichkeitszuschreibung ist eine kognitive Falle. Dennoch ist KI in der Wissenschaft ein Mittel zur exponentiellen Potenzierung der menschlichen Leistung. Damit und mit praktischen Konsequenzen im Bereich des Urheberrechts setzt sich der nachstehende Beitrag auseinander.

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

This study aims to examine the use of dexmedetomidine (DEX) combined with propofol in hip fracture surgery and its effect on postoperative pain and hemodynamics. One hundred forty patients undergoing hip fracture surgery were divided into a treatment group (receiving DEX combined with propofol anesthesia) and a control group (receiving propofol anesthesia). The Ramsay Sedation Scale was used to evaluate the sedative effect 24 hours postoperatively, while the Visual Analog Scale was used to assess the analgesic effect 24 hours after surgery. The Montreal Cognitive Assessment (MoCA) scale was used to evaluate cognitive function before and 24 hours after surgery. Heart rate (HR) and mean arterial pressure (MAP) were recorded at different stages of anesthesia, and the incidence of postoperative adverse reactions was also recorded. Compared with the control group, at 24 hours postoperatively, patients in the treatment group had higher Ramsay sedation scores and lower Visual Analog Scale scores ( P < 0.05). Before surgery, the MoCA scores of both groups showed no significant difference ( P > 0.05), but the treatment group had higher MoCA scores 24 hours after surgery compared with the control group ( P < 0.05). No difference was observed in HR and MAP levels before anesthesia between the two groups ( P > 0.05), while the treatment group performed lower MAP and HR levels than the control group at skin incision and at the end of surgery ( P < 0.05). In addition, the incidence of postoperative adverse reactions was lower in the treatment group than in the control group ( P < 0.05). DEX combined with propofol for composite anesthesia in hip fracture surgery effectively meets the requirements for surgical anesthesia, maintains hemodynamic stability, and exhibits good postoperative analgesic and sedative effects.

The aim of this study was to evaluate the effects of a herd-specific vaccine against Mycoplasmopsis bovis (M. bovis; the genus name is similar to Mycoplasma;) on the health status of calves in Swiss fattening farms. In the run-up to this study, some farmers reported that they had significantly less problems with calf diseases on their farm since the use of a herd-specific vaccine than before. In order to test this statement in detail, six fattening farms were selected. There, the vaccination was given twice, 4 weeks apart, starting the first week after arrival, usually at an age of 4 weeks. Retrospectively, the treatment journals for one year before the use of the vaccine until one year after the use of the vaccine were evaluated and the disease incidences were calculated. The data were collected between March 2019 and November 2022. The monthly incidence of respiratory diseases in the chi-square test dropped significantly dependent on vaccination against M. bovis (p=0,034), varied between farms (p=0,001) and was found to be lower in summer compared to winter (p=0,006). The monthly incidence of otitis revealed no significant difference with regard to the use of the vaccine (p>0,05). The incidence of omphalitis was significantly different between farms (p=0,048), decreased with vaccination (p=0,022) and tended to be lower in summer compared to winter (p=0,058). Diarrhea showed a statistical tendency to be dependent from the farm (p=0,06). The monthly incidence of the sum of all diseases (otitis, pneumonia, omphalitis and diarrhea) was significantly dependent on vaccination against M. bovis (p=0,021). The results indicate that M. bovis is more important for calf health than currently assumed. M. bovis should therefore be considered more in diagnostics in order to perform an adequate therapy. The herd-specific vaccination against M. bovis improved general calf health potentially also due to a non-pathogen-specific immune response.