Satellite Symposia / European Journal of Integrative Medicine 2 (2010) 165–172 169 From a biochemical perspective, optimal nutrition implies an adequate supply of nutrients and energy to all tissues as required by the prevailing metabolic situation. From a psychological point of view nutrition involves the sensations of choosing, preparing, eating and digesting foods. From a sociological per- spective nutrition involves social bonding while talking about food and while eating. These different areas of individual need should be recognized and put into the focus of nutritional screen- ing, assessment and care. Several simple but valid screening tools for detecting indi- viduals with impending or active malnutrition are established and screening should be used in all oncological patients. Objec- tive assessment of basic nutritional parameters should best be performed once in all and repeatedly in at-risk patients; this includes at least the usual and the current body weight, height, recent changes in body weight, energy intake, appetite score, performance index and the level of an acute phase protein to estimate systemic inflammatory activation. Psychological and social problems related to nutritional status or functions prob- ably are best detected during a structured interview by an experienced nutritionist. Requirements of energy, fluids, macro- and micronutri- ents should be known and deficits should be minimized by avoiding and treating nausea, anorexia and gastrointestinal dysfunctions. Attention should be paid to metabolic derange- ments like metabolic syndrome, systemic inflammation and treatment-induced hyperglycemia. Chronic pain and psycho- logical problems should be relieved carefully and as much as possible. It should be attempted to stabilize or reorganize social contacts and communications that may be deranged by nutri- tional defects and deficits. doi:10.1016/j.eujim.2010.09.222 Science for Students The patient–health professional-relationship in conventional versus complementary and alternative medicine S. Länger, J. Ernst ∗ , E. Brähler University of Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany Background: Patient involvement gains more importance in medical decision-making. The traditional paternalistic decision- making model is replaced by a bilateral concept known as Shared Decision Making (SDM). This process implicates an interaction wherein patient and health professional act as equal partners in terms of diagnostic and therapeutic decisions. By incorpo- rating patients’ concerns, preferences and perspectives SDM has been advocated to be a decisive factor for a more faith- ful patient–health professional-relationship, for greater patient confidence and higher efficiency in health care. Objective: The focal idea of this study was: How does the different concept of medicine, conventional versus complemen- tary and alternative medicine, influence the relationship between patient and health professional, particularly the arrangement of a consultation and patient involvement in the decision-making process. The different concept of medicine could imply a differ- ent approach to knowledge and implementation of SDM by the health professionals resulting in different levels of occupational satisfaction. Methods: The study design was a qualitative analysis of guideline-based interviews which were performed with 30 gen- eral and nonmedical practitioners in the Leipzig area between January and April 2008. On this behalf, participants were divided into three groups: conventional general practitioners (COM), general practitioners with mainly complementary and alternative practice (CAM) and nonmedical practitioners (HP). Ten partici- pants of each group were randomly chosen for the interview. The interviews enclosed questions concerning (1) attitude towards and implementation of patient involvement in medical decision- making, (2) basic and political conditions as well as feasibility of SDM, (3) patient as well as physician and practitioner factors promoting and restraining SDM, (4) occupational satisfaction especially in respect of a sufficient patient-health professional- relationship, (5) differences in decision-making in conventional medicine and complementary and alternative medicine. Results and conclusions: Are expected by November 2010. doi:10.1016/j.eujim.2010.09.223 Treatment of knee osteoarthritis utilising hirudo medicinalis—Effects on clinical pain and mechanical sensory thresholds M. Müller a,b,∗ , R. Lauche c , H. Schleenbecker a , R. Lüdtke d , F. Musial c , G. Dobos c , M. Lengsfeld b a Rheumazentrum Mittelhessen, Bad Endbach, Germany b University of Marburg, Department of Orthopaedics and Rheumatology, Marburg, Germany c Kliniken Essen-Mitte, Academic Teaching Hospital, Depart- ment of Internal and Integrative Medicine, Essen, Germany d Karl and Veronica Carstens Foundation, Essen, Germany Osteoarthritis of the knee is one of the most common chronic diseases in the western world. The most prominent afflictions are pain followed by con- strained movement up to immobility and a corresponding reduction in quality of life. Previous randomized studies have shown a significant pain reduction using leaches for the treat- ment of knee osteoarthritis compared to placebo or standard therapy (topical diclofenac regimen). Based on the results of previous studies, the objective of this pilot study designed as a case series was to explore psy- chophysical measures of local pain perception at the knee in order to evaluate the effectiveness of leeches in the treat- ment of knee osteoarthritis. The measures are subtests obtained from the QST (Quantitative sensory testing) protocol, namely the measurement of the MDT (mechanical detection thresh- old), the VDT (vibration detection threshold) and the PPT (pain pressure threshold). Furthermore the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was obtained before and seven days after therapy in addition to pain