Der Umgang mit Sexualität und Partnerschaft in der Arbeit mit erwachsenen Menschen mit intellektueller Behinderung in betreuten Wohngemeinschaften in Raum Wien

Die vorliegende Arbeit befasst sich mit dem Thema „Sexualassistenz“ bei erwachsenen Menschen mit intellektueller Behinderung in betreuten Wohnformen in Raum Wien. Unter dem Begriff „Sexualassistenz“ werden Handlungen verstanden, die von sexualpädagogischen Maßnahmen, einer Hilfestellung bei Selbstbefriedigung oder Geschlechtsverkehr bis hin zur Vermittlung von externen Personen für die Befriedigung sexueller Bedürfnisse der Klienten/innen reichen. Dabei sei angemerkt, dass in Österreich seit 2008 professionelle Sexualbegleiter/innen ausgebildet werden, um speziell Personen mit Behinderungen dabei zu helfen, ihre Sexualität entsprechend individueller Grenzen und Möglichkeiten auszuleben. In der vorliegenden Arbeit wird den Sichtweisen der Behindertenbetreuer/innen besondere Aufmerksamkeit geschenkt, da ihre Einstellungen und Handlungen Einfluss darauf nehmen, in welcher Art und Weise Sexualität thematisiert wird. In einschlägiger Literatur wird mehrfach darauf hingewiesen, dass sich die Mitarbeiter/innen der Betreuungseinrichtungen oftmals mit unterschiedlichsten Interessen konfrontiert sehen. Neben ihren individuellen Grenzen, müssen sie einerseits die sexuellen Bedürfnisse ihrer Klienten/innen beachten und andererseits die Einstellungen ihrer Leiter/innen, Kollegen/innen und gegebenenfalls der Angehörigen und gesetzlichen Vertreter/innen bei ihren Entscheidungen berücksichtigen. Zudem sind nach österreichischer Rechtslage die Durchführung sexueller Handlungen an -, sowie die Vermittlung von Prostituierten oder Sexualbegleiter/innen für intellektuell beeinträchtigte Personen strafbar. So stellt sich die Frage, welche sexuellen Assistenzleistungen durch Betreuer/innen umgesetzt werden können. Es wird davon ausgegangen, dass vor allem eine Schulung der Mitarbeiter/innen, eine kontinuierliche Kommunikation innerhalb des Teams sowie die Gestaltung der institutionellen Rahmenbedingungen ausschlaggebend dafür sind, in welcher Art und Weise die Bewohner/innen ihre Sexualität ausleben können. Die qualitative Untersuchung erfolgt durch problemzentrierte Interviews mit Behindertenbetreuer/innen und einem Experteninterview mit einer professionellen Sexualbegleiterin. Zusätzlich wird auf Leitungsebene verschiedenster Wohneinrichtungen eine Fragebogenerhebung durchgeführt und die institutionellen Rahmenbedingungen zu erheben. Durch die Studie soll vor allem ein Einblick darüber gewonnen werden, in welcher Art und Weise „Sexualassistenz“ thematisiert wird und wo diesbezüglich Grenzen bestehen, um Konsequenzen für pädagogische Arbeitsfelder formulieren zu können.The following paper deals with the „sexual assistance“ for adults with intellectual disability in residential care homes in the Vienna area. The expression “sexual assistance” explains acts in the field of sex education, assistance with masturbation or sexual intercourse, as well as negotiations between external people and the clients for the satisfaction of their sexual needs. It has to be pointed out, that since 2008 in Austria sexual escorts have been trained to be able to help people with disabilities realize their sexual needs within their individual possibilities and limits. In the following paper special focus lies on the point of view of the carers for disabled people, as their attitudes and actions influence the way in which sexuality is made subject of discussion. In relevant literature it is pointed out several times that the employees in these establishments are confronted with different interests. Besides their individual limits, in decision-making processes they have to be aware of their clients’ limits as well as the attitudes of employers, colleagues, relatives and even legal representatives. Furthermore, due to the legal position in Austria, carrying out any sexual acts or the negotiation between mentally disabled people and prostitutes or sexual escorts is liable to prosecution. This leads to the question which kind of sexual assistance can be put into practice by carers. It is assumed that in particular training of employees, a continuous communication within the team, as well as the organization of the institutional conditions are decisive for the way in which the clients in the facilities can live up to their sexual needs. The qualitative survey takes place through problem-focused interviews with carers of people with disabilities and an expert-interview with a professional sexual escort. In addition, on the level of management in several residential care homes, a survey through a questionnaire is carried out to find out about the institutional conditions. The aim of this survey is, in particular, to collect an insight on the ways in which “sexual assistance” is made subject and where boundaries are met in this respect, to be able to formulate consequences for pedagogical fields of work

Formal überqualifiziert? Eine Analyse der Verwertbarkeit der formalen Ausbildung am österreichischen Arbeitsmarkt

Warum eine Arbeitskraft auf einem Arbeitsplatz tätig ist, der nicht ihrer formalen Qualifikation entspricht, kann viele Gründe haben. In diesem Beitrag wird untersucht, in welchem Maße die Art der formalen Ausbildung - Allgemeinbildung versus Berufsbildung - das Risiko von Männern und Frauen beeinflusst, nicht entsprechend ihrer formalen Qualifikation im Unternehmen eingesetzt zu werden. Kontrolliert wird dabei für Arbeitsplatzeigenschaften

Österreich 2025: Arbeitszeitverteilung in Österreich - Analyse und Optionen aus Sicht der Arbeitnehmerinnen und Arbeitnehmer

Die empirische Evidenz zur Verteilung der Arbeitszeit unselbstständig Beschäftigter in Österreich zeigt eine hohe Heterogenität, insbesondere zwischen Frauen und Männern (Gender-Time-Gap). Während Frauen durchschnittlich mehr Zeit pro Woche für unbezahlte Tätigkeiten aufwenden als Männer, sind Männer im Durchschnitt einen Vollzeit-Tag pro Woche (8,2 Stunden) länger in bezahlter Beschäftigung als Frauen. Der beträchtliche Unterschied in der durchschnittlichen Wochenerwerbsarbeitszeit (Männer 39,8 und Frauen 31,6 Stunden) geht primär darauf zurück, dass fast die Hälfte der Frauen (49,4%) teilzeitbeschäftigt ist und viele Männer Überstunden leisten. Grund dafür sind traditionelle Rollenbilder sowie die ungleiche Verteilung der Hausarbeit und der Betreuung von Kindern und Pflegebedürftigen. So dominiert in Paarhaushalten mit Kindern unter 15 Jahren das Zuverdienst-Modell: Der Mann ist in Vollzeit erwerbstätig, die Frau in Teilzeit. Gleichzeitig entspricht bei rund einem Viertel der unselbstständig Beschäftigten die tatsächlich geleistete Wochenerwerbsarbeitszeit nicht dem gewünschten Ausmaß: Frauen würden durchschnittlich gerne mehr Stunden pro Woche berufstätig sein, Männer weniger. Mit zunehmendem Alter wird der Abstand zwischen gewünschter und realisierter Arbeitszeit größer. Die Studie zeigt arbeitszeitbezogene Ansatzpunkte zur Förderung einer ausgeglichenen Verteilung der Erwerbsarbeitszeit von Frauen und Männern über ihr Erwerbsleben ebenso wie Maßnahmen für spezifische Lebensphasen, die eine Anpassung der individuellen Erwerbsarbeitszeit zur Vereinbarkeit von Beruf und außerberuflichen Verpflichtungen bzw. Interessen ermöglichen.The empirical evidence for the distribution of the working hours of dependent workers in Austria shows a high heterogeneity, especially between women and men (gender time gap). While women spend an average more time per week on unpaid activities than men, men are on average a full-time day per week (8.2 hours) longer in paid employment than women. The significant difference in average weekly working hours (men 39.8 and women 31.6 hours) is primarily due to the fact that almost half of women (49.4%) work part-time and many men work overtime. The reason for this is traditional gender roles, as well as the uneven distribution of domestic work and the care of children and dependent persons. For example, in couples with children under the age of 15, the modified breadwinner model dominates: the man is full-time working, the woman part-time. At the same time, about a quarter of the employed is unsatisfied with their actual weekly working hours: on average women prefer working more hours a week, men less. With increasing age, the distance between preferred and realized weekly working hours increases. The study shows working-time approaches to promote a balanced distribution of the working time of women and men over their working lives, as well as measures for specific life stages, which allow an adaptation of the individual working time to reconcile work and non-work commitments or interests

Mental health issues in unaccompanied refugee minors

Previous studies about unaccompanied refugee minors (URMs) showed that they are a highly vulnerable group who have greater psychiatric morbidity than the general population. This review focuses on mental health issues among URMs. Articles in databases PsycINFO, Medline and PubMed from 1998 to 2008 addressing this topic were reviewed. The literature had a considerable emphasis on the assessment of PTSD symptoms. Results revealed higher levels of PTSD symptoms in comparison to the norm populations and accompanied refugee minors. In several studies, age and female gender predicted or influenced PTSD symptoms. The existing literature only permits limited conclusions on this very hard to reach population. Future research should include the analysis of long-term outcomes, stress management and a more thorough analysis of the whole range of psychopathology. Additionally, the development of culturally sensitive norms and standardized measures for diverse ethnic groups is of great importance

Cross-sectional observational study of 208 patients with non-classical urea cycle disorders

Urea cycle disorders (UCDs) are inherited disorders of ammonia detoxification often regarded as mainly of relevance to pediatricians. Based on an increasing number of case studies it has become obvious that a significant number of UCD patients are affected by their disease in a non-classical way: presenting outside the newborn period, following a mild course, presenting with unusual clinical features, or asymptomatic patients with only biochemical signs of a UCD. These patients are surviving into adolescence and adulthood, rendering this group of diseases clinically relevant to adult physicians as well as pediatricians. In preparation for an international workshop we collected data on all patients with non-classical UCDs treated by the participants in 20 European metabolic centres. Information was collected on a cohort of 208 patients 50% of which were ≥ 16 years old. The largest subgroup (121 patients) had X-linked ornithine transcarbamylase deficiency (OTCD) of whom 83 were female and 29% of these were asymptomatic. In index patients, there was a mean delay from first symptoms to diagnosis of 1.6 years. Cognitive impairment was present in 36% of all patients including female OTCD patients (in 31%) and those 41 patients identified presymptomatically following positive newborn screening (in 12%). In conclusion, UCD patients with non-classical clinical presentations require the interest and care of adult physicians and have a high risk of neurological complications. To improve the outcome of UCDs, a greater awareness by health professionals of the importance of hyperammonemia and UCDs, and ultimately avoidance of the still long delay to correctly diagnose the patients, is crucial

A genome-wide association study of anorexia nervosa

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2,907 cases with AN from 14 countries (15 sites) and 14,860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery datasets. Seventy-six (72 independent) SNPs were taken forward for in silico (two datasets) or de novo (13 datasets) replication genotyping in 2,677 independent AN cases and 8,629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication datasets comprised 5,551 AN cases and 21,080 controls. AN subtype analyses (1,606 AN restricting; 1,445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01×10−7) in SOX2OT and rs17030795 (P=5.84×10−6) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76×10−6) between CUL3 and FAM124B and rs1886797 (P=8.05×10−6) near SPATA13. Comparing discovery to replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P= 4×10−6), strongly suggesting that true findings exist but that our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field

A genome-wide association study of anorexia nervosa suggests a risk locus implicated in dysregulated leptin signaling

J. Kaprio, A. Palotie, A. Raevuori-Helkamaa ja S. Ripatti ovat työryhmän Eating Disorders Working Group of the Psychiatric Genomics Consortium jäseniä. Erratum in: Sci Rep. 2017 Aug 21;7(1):8379, doi: 10.1038/s41598-017-06409-3We conducted a genome-wide association study (GWAS) of anorexia nervosa (AN) using a stringently defined phenotype. Analysis of phenotypic variability led to the identification of a specific genetic risk factor that approached genome-wide significance (rs929626 in EBF1 (Early B-Cell Factor 1); P = 2.04 x 10(-7); OR = 0.7; 95% confidence interval (CI) = 0.61-0.8) with independent replication (P = 0.04), suggesting a variant-mediated dysregulation of leptin signaling may play a role in AN. Multiple SNPs in LD with the variant support the nominal association. This demonstrates that although the clinical and etiologic heterogeneity of AN is universally recognized, further careful sub-typing of cases may provide more precise genomic signals. In this study, through a refinement of the phenotype spectrum of AN, we present a replicable GWAS signal that is nominally associated with AN, highlighting a potentially important candidate locus for further investigation.Peer reviewe

A genome-wide association study of anorexia nervosa.

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field

Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder.

A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.PEV was supported by the Medical Research Council (grant no. MR/K020706/1) and is a Fellow of MQ: Transforming Mental Health (MQF17_24)

Exploration of Shared Genetic Architecture Between Subcortical Brain Volumes and Anorexia Nervosa

In MRI scans of patients with anorexia nervosa (AN), reductions in brain volume are often apparent. However, it is unknown whether such brain abnormalities are influenced by genetic determinants that partially overlap with those underlying AN. Here, we used a battery of methods (LD score regression, genetic risk scores, sign test, SNP effect concordance analysis, and Mendelian randomization) to investigate the genetic covariation between subcortical brain volumes and risk for AN based on summary measures retrieved from genome-wide association studies of regional brain volumes (ENIGMA consortium, n = 13,170) and genetic risk for AN (PGC-ED consortium, n = 14,477). Genetic correlations ranged from − 0.10 to 0.23 (all p > 0.05). There were some signs of an inverse concordance between greater thalamus volume and risk for AN (permuted p = 0.009, 95% CI: [0.005, 0.017]). A genetic variant in the vicinity of ZW10, a gene involved in cell division, and neurotransmitter and immune system relevant genes, in particular DRD2, was significantly associated with AN only after conditioning on its association with caudate volume (pFDR = 0.025). Another genetic variant linked to LRRC4C, important in axonal and synaptic development, reached significance after conditioning on hippocampal volume (pFDR = 0.021). In this comprehensive set of analyses and based on the largest available sample sizes to date, there was weak evidence for associations between risk for AN and risk for abnormal subcortical brain volumes at a global level (that is, common variant genetic architecture), but suggestive evidence for effects of single genetic markers. Highly powered multimodal brain- and disorder-related genome-wide studies are needed to further dissect the shared genetic influences on brain structure and risk for AN