Zeitgemäß oder anachronistisch? Zwangseinweisungspraxis in Frankfurt am Main

Background: The evaluation of local mental health care remains difficult. For this reason systematic development of appropriate services is barely possible. Methods: We examined involuntary hospitalization in the city of Frankfurt/Main with regard to diagnoses, socio-demographic data, complementary psychosocial outpatient care, and circumstances of hospitalization. There are four psychiatric clinics, each serving a catchment area of more than 165.000 inhabitants. These clinics are responsible for all psychiatric in-patient treatments regardless of the admission modus. During a one year period, 677 patients were involuntarily hospitalized. Statistical analyses were performed subsequent to pooling the data. Results: During a period of one year, 103 out of 100.000 inhabitants of Frankfurt/Main were admitted involuntarily. The rate of involuntary admissions related to all admissions was 10.98 percent. Any complementary psychosocial care was missing in more than 70 percent of patients admitted involuntarily. Only about 10 percent of patients were examined by a physician before reaching the hospital and in disappointing 1.3 percent the municipal mental health service had been consulted prior to involuntarily admission. Conclusion: Our results show that a systematic improvement of precautionary complementary psychosocial care for risk patients is needed as well as the obligation of psychiatric emergency consultation before involuntary hospitalization.Anliegen: In der gemeindepsychiatrischen Versorgung ist eine systematische Datenerhebung bislang unzureichend etabliert. Daher ist eine planvolle Entwicklung von Versorgungsstrukturen kaum möglich. Zur weiteren Qualitätsverbesserung der gemeindepsychiatrischen Struktur soll eine verlässliche Datenbasis geschaffen werden. Methode: Das durch den Sozialpsychiatrischen Dienst initiierte Projekt PISA untersuchte 677 Zwangseinweisungen in die Versorgungskliniken der Stadt Frankfurt/Main. Ergebnisse: Bei über 70 % der Patienten fehlte eine komplementäre psychosoziale Versorgung, nur 10 % wurden außerhalb der Klinik vor der Einweisung ärztlich untersucht, nur 1,3 % durch den Sozialpsychiatrischen Dienst. Schlussfolgerungen: Eine gezielte Ausweitung ambulanter Hilfesysteme und die Hinzuziehung fachärztlicher Kompetenz vor einer Zwangseinweisung erscheinen dringend erforderlich

Involuntary hospitalizations in Frankfurt/Main, Germany

Background: The evaluation of local mental health care remains difficult. For this reason systematic development of appropriate services is barely possible. Methods: We examined involuntary hospitalization in the city of Frankfurt/Main with regard to diagnoses, socio-demographic data, complementary psychosocial outpatient care, and circumstances of hospitalization. There are four psychiatric clinics, each serving a catchment area of more than 165.000 inhabitants. These clinics are responsible for all psychiatric in-patient treatments regardless of the admission modus. During a one year period, 677 patients were involuntarily hospitalized. Statistical analyses were performed subsequent to pooling the data. Results: During a period of one year, 103 out of 100.000 inhabitants of Frankfurt/Main were admitted involuntarily. The rate of involuntary admissions related to all admissions was 10.98 percent. Any complementary psychosocial care was missing in more than 70 percent of patients admitted involuntarily. Only about 10 percent of patients were examined by a physician before reaching the hospital and in disappointing 1.3 percent the municipal mental health service had been consulted prior to involuntarily admission. Conclusion: Our results show that a systematic improvement of precautionary complementary psychosocial care for risk patients is needed as well as the obligation of psychiatric emergency consultation before involuntary hospitalization.Anliegen: In der gemeindepsychiatrischen Versorgung ist eine systematische Datenerhebung bislang unzureichend etabliert. Daher ist eine planvolle Entwicklung von Versorgungsstrukturen kaum möglich. Zur weiteren Qualitätsverbesserung der gemeindepsychiatrischen Struktur soll eine verlässliche Datenbasis geschaffen werden. Methode: Das durch den Sozialpsychiatrischen Dienst initiierte Projekt PISA untersuchte 677 Zwangseinweisungen in die Versorgungskliniken der Stadt Frankfurt/Main. Ergebnisse: Bei über 70 % der Patienten fehlte eine komplementäre psychosoziale Versorgung, nur 10 % wurden außerhalb der Klinik vor der Einweisung ärztlich untersucht, nur 1,3 % durch den Sozialpsychiatrischen Dienst. Schlussfolgerungen: Eine gezielte Ausweitung ambulanter Hilfesysteme und die Hinzuziehung fachärztlicher Kompetenz vor einer Zwangseinweisung erscheinen dringend erforderlich

Theory of Umklapp-assisted recombination of bound excitons in Si:P

We present the calculations for the oscillator strength of the recombination of excitons bound to phosphorous donors in silicon. We show that the direct recombination of the bound exciton cannot account for the experimentally measured oscillator strength of the no-phonon line. Instead, the recombination process is assisted by an umklapp process of the donor electron state. We make use of the empirical pseudopotential method to evaluate the Umklapp-assisted recombination matrix element in second-order perturbation theory. Our result is in excellent agreement with the experiment. We also present two methods to improve the optical resolution of the optical detection of the spin state of a single nucleus in silicon.Comment: 9 pages, 6 EPS figures, Revtex

Influence of Differences in Exercise-intensity and Kilograms/Set on Energy Expenditure During and After Maximally Explosive Resistance Exercise

With resistance exercise, greater intensity typically elicits increased energy expenditure, but heavier loads require that the lifter perform more sets of fewer repetitions, which alters the kilograms lifted per set. Thus, the effect of exercise-intensity on energy expenditure has yielded varying results, especially with explosive resistance exercise. This study was designed to examine the effect of exercise-intensity and kilograms/set on energy expenditure during explosive resistance exercise. Ten resistance-trained men (22±3.6 years; 84±6.4 kg, 180±5.1 cm, and 13±3.8 %fat) performed squat and bench press protocols once/week using different exercise-intensities including 48% (LIGHT-48), 60% (MODERATE-60), and 72% of 1-repetition-maximum (1-RM) (HEAVY-72), plus a no-exercise protocol (CONTROL). To examine the effects of kilograms/set, an additional protocol using 72% of 1-RM was performed (HEAVY-72MATCHED) with kilograms/set matched with LIGHT-48 and MODERATE-60. LIGHT-48 was 4 sets of 10 repetitions (4x10); MODERATE-60 4x8; HEAVY-72 5x5; and HEAVY-72MATCHED 4x6.5. Eccentric and concentric repetition speeds, ranges-of-motion, rest-intervals, and total kilograms were identical between protocols. Expired air was collected continuously throughout each protocol using a metabolic cart, [Blood lactate] using a portable analyzer, and bench press peak power were measured. Rates of energy expenditure were significantly greater (p≤0.05) with LIGHT-48 and HEAVY-72MATCHED than HEAVY-72 during squat (7.3±0.7; 6.9±0.6 \u3e 6.1±0.7 kcal/min), bench press (4.8±0.3; 4.7±0.3 \u3e 4.0±0.4 kcal/min), and +5min after (3.7±0.1; 3.7±0.2 \u3e 3.3±0.3 kcal/min), but there were no significant differences in total kcal among protocols. Therefore, exercise-intensity may not effect energy expenditure with explosive contractions, but light loads (~50% of 1-RM) may be preferred because of higher rates of energy expenditure, and since heavier loading requires more sets with lower kilograms/set

Heart Rate Reduction by Ivabradine Improves Aortic Compliance in Apolipoprotein E-Deficient Mice

Background: Impaired vascular compliance is associated with cardiovascular mortality. The effects of heart rate on vascular compliance are unclear. Therefore, we characterized effects of heart rate reduction (HRR) by I(f) current inhibition on aortic compliance and underlying molecular mechanisms in apolipoprotein E-deficient (ApoE–/–) mice. Methods: ApoE–/– mice fed a high-cholesterol diet and wild-type (WT) mice were treated with ivabradine (20 mg/kg/d) or vehicle for 6 weeks. Compliance of the ascending aorta was evaluated by MRI. Results: Ivabradine reduced heart rate by 113 ± 31 bpm (∼19%) in WT mice and by 133 ± 6 bpm (∼23%) in ApoE–/– mice. Compared to WT controls, ApoE–/– mice exhibited reduced distensibility and circumferential strain. HRR by ivabradine increased distensibility and circumferential strain in ApoE–/– mice but did not affect both parameters in WT mice. Ivabradine reduced aortic protein and mRNA expression of the angiotensin II type 1 (AT1) receptor and reduced rac1-GTPase activity in ApoE–/– mice. Moreover, membrane translocation of p47phox was inhibited. In ApoE–/– mice, HRR induced anti-inflammatory effects by reduction of aortic mRNA expression of IL-6, TNF-alpha and TGF-beta. Conclusion: HRR by ivabradine improves vascular compliance in ApoE–/– mice. Contributing mechanisms include downregulation of the AT1 receptor, attenuation of oxidative stress and modulation of inflammatory cytokine expression

A direct PCR approach with low-biomass insert opens new horizons for molecular sciences on cryptogam communities

Molecular sequence data have transformed research on cryptogams (e.g., lichens, microalgae, fungi, and symbionts thereof) but methods are still strongly hampered by the small size and intermingled growth of the target organisms, poor cultivability and detrimental effects of their secondary metabolites. Here, we aim to showcase examples on which a modified direct PCR approach for diverse aspects of molecular work on environmental samples concerning biocrusts, biofilms, and cryptogams gives new options for the research community. Unlike traditional approaches, this methodology only requires biomass equivalent to colonies and fragments of 0.2 mm in diameter, which can be picked directly from the environmental sample, and includes a quick DNA lysis followed by a standardized PCR cycle that allows co-cycling of various organisms/target regions in the same run. We demonstrate that this modified method can (i) amplify the most widely used taxonomic gene regions and those used for applied and environmental sciences from single colonies and filaments of free-living cyanobacteria, bryophytes, fungi, and lichens, including their mycobionts, chlorobionts, and cyanobionts from both isolates and in situ material during co-cycling; (ii) act as a tool to confirm that the dominant lichen photobiont was isolated from the original sample; and (iii) optionally remove inhibitory secondary lichen substances. Our results represent examples which highlight the method’s potential for future applications covering mycology, phycology, biocrusts, and lichenology, in particular