Psychiatrische Therapieempfehlungen bei Angststörungen, Delir und nach Suizidversuchen: Retrospektive Analyse aus dem psychiatrischen Konsiliardienst in einem Allgemeinkrankenhaus

Einleitung: Der psychiatrische Konsiliardienst spielt eine wichtige Rolle in der Versorgung psychisch komorbid erkrankter Patienten. Die vorliegenden Studien analysieren den konsiliarpsychiatrischen Dienst in einem Allgemeinkrankenhaus anhand von drei häufigen komorbiden psychiatrischen Krankheitsbildern: nach Suizidversuchen, bei Angststörungen und bei Delirien. Ziel der Arbeit war die Analyse von deskriptiven Daten zum Patientenkollektiv sowie die Auswertung von Therapieempfehlungen durch den konsiliarpsychiatrischen Dienst bei den unterschiedlichen Krankheitsbildern. Methodik: Bei allen drei Publikationen handelt es sich um retrospektive Datenauswertungen der psychiatrischen Konsilscheine der Charité - Universitätsmedizin Berlin – Campus Benjamin Franklin in einem Zeitraum von ein bzw. zwei Jahren. In der Publikation zu Delirien wurden vergleichend die Konsilscheine der Neurologie ausgewertet. Ergebnisse: Bei der Studie zu Suizidversuchen war die häufigste Diagnose die depressive Episode und die Therapieempfehlung zielte oftmals auf die Übernahme auf eine psychiatrische Station ab. Falls zu einer Psychopharmakotherapie geraten wurde, wurden meist Benzodiazepine verordnet. Bei Angststörungen war die verbreitetste Diagnose im Konsil die einer Panikstörung (inkl. Panikattacken). Verordnet wurden am häufigsten Benzodiazepine, als weitere Erstmaßnahme wurde am häufigsten eine Psychoedukation durchgeführt. Bei Delirien wurde bei Patienten mit einer neurologischen Vorerkrankung öfter der neurologische Konsiliardienst gerufen, bei einer psychiatrischen Vorerkrankung eher der psychiatrische Konsiliardienst. Die therapeutischen Empfehlungen reichten von konservativen Therapieoptionen bis zur akuten Psychopharmakotherapie, die signifikant häufiger durch den psychiatrischen Konsiliardienst angeraten wurde. Schlussfolgerungen: Die Studien belegen die essentielle Rolle des konsiliarpsychiatrischen Dienstes für die multimodale Betreuung psychisch komorbid erkrankter Patienten. Dabei spielen sowohl die diagnostischen Einschätzungen, unter anderem die Frage nach einer weiterhin beste- henden Suizidalität, als auch die Therapieempfehlungen des Facharztes für Psychiatrie und Psychotherapie (Verlegung auf eine psychiatrische Station, Beginn einer Pharmakotherapie) eine zentrale Rolle für die Weiterversorgung der komorbid psychisch erkrankten Patienten in einem Allgemeinkrankenhaus. (deutsch)Introduction: The psychiatric consultation-liaison service is of great importance in the care of patients with comorbid psychiatric illness. The present studies analyse the psychiatric consultation-liaison service in a general hospital with regard to three frequent comorbid psychiatric clinical pictures: after a suicide attempt and in regard to an anxiety disorder or a delirium. The objective was to analyse descriptive data on the patient population and assess the treatment recommendations made by the consulting psychiatrist with regard to the different clinical pictures. Methods: All three publications are based on retrospective data analyses of consultation sheets of the Charité Universitätsmedizin Berlin – Campus Benjamin Franklin in a one- or two-year-period. The study on delirium also involved the comparative evaluation of the neurological consultations. Results: Regarding suicide attempts, the most frequent diagnosis was a depressive disorder and treatment recommendations often entailed further treatment in a psychiatric ward. Where medication was advised, most patients received benzodiazepines. The largest group of patients with anxiety symptoms presented panic attacks and/or panic disorders. The treatment recommendation most often comprised benzodiazepines and acute psychoeducation. In the study on delirium, a neurological precondition resulted more often in a consultation by an attending neurologist, whereas a psychiatric precondition resulted more often in a consultation by an attending psychiatrist. Treatment recommendations ranged from conservative options to acute pharmacotherapy, the latter being more frequently recommended by the psychiatric consultation-liaison service. Conclusions: The studies highlight the essential role of the consultation-liaison psychiatry for the multimodal treatment of patients suffering from comorbid psychiatric illnesses. The diagnostic assessment, for instance the evaluation of remaining suicidality, as well as the treatment recommendation (i.e. further treatment on a psychiatric ward or pharmacotherapy) by the attending psychiatrist play a vital role for the care and treatment of patients with comorbid psychiatric illnesses in a general hospital. (englisch

Low thermal expansion glass-ceramics in the system BaO-Al2O3-B2O3: crystallisation and properties

Gläser im System BaO-Al2O3-B2O3 wurden im Hinblick auf ihr Kristallisationsverhalten und ihre Eigenschaften untersucht. Die Experimente wurden mit der stöchiometrischen Zusammensetzung BaO-Al2O3-B2O3 und geringfügig modifizierten Zusammensetzungen, sowie Gläsern mit TiO2-, TiO2/ZrO2-Zusatz und mit Platin dotierten Gläsern durchgeführt. Von diesen Gläsern und den dazugehörigen Glaskeramiken wurden die Dichte, der lineare thermische Ausdehnungskoeffizient, die hydrolytische Beständigkeit und die Glasübergangs- sowie Erweichungstemperatur bestimmt. Licht- und Rasterelektronenmikroskopie sowie IR-Spektroskopie wurden ebenfalls angewendet. Die elektrische Impedanz als Funktion der Temperatur wurde untersucht, um die spezifische Leitfähigkeit und nach deren Ableitung nach (-dln sigma klein/d(1/kT)) Kristallisations- und Schmelztemperatur und den Entmischungsbereich im System BaO-Al2O3-B2O3 zu bestimmen. Die Glaskeramiken im untersuchten System verfügen über einige herausragende Eigenschaften, wie einen negativen thermischen Ausdehnungskoeffizienten, eine niedrigere Dichte als das dazugehörige Glas und eine ausgeschiedene Kristallphase, BaAl2B2O7, die eine äußerst niedrige Aktivierungsenergie (der ionischen Leitfähigkeit) von 0,50 eV besitzt

The roles of emojis in mobile phone notifications

The texts in mobile messages are not always easy to decipher since tone and body language is removed from the context. Emojis offer an attractive way to express emotions to avoid misunderstandings of message tone. In this paper we shed the light on the roles of Emojis in phone notification, we conducted an in-situ study to gather phone notification data. We outline the relationship between Emojis and various social network applications including WhatsApp, Facebook and Twitter. Early results allow us to draw several conclusions in relation to number, position, type and sentimental value of Emojis. It turns out that most popular Emojis in one social app is not as popular in the others. Emojis sentimental polarity in Twitter is high and overall number of Emojis is less than Facebook. The sentimental value of Emojis is more meaningful when there are multiple Emoji in one notification

Service Design for sustainability: Finding best practices for culturally sustainable tourism in small and medium enterprises

The global tourism industry is steadily growing and increasingly affecting not only the physical, but also the cultural environments of the tourism destinations. The amalgamation of cultures happening as a result of globalisation is particularly threatening for small or remote cultures, that are often at the centre of the local tourism. Most tourism businesses are SMEs owned or managed by entrepreneurs with little formal management education. Finally, the opinions of tourism researchers and practitioners diverge on many key issues, which hinders fruitful cooperation, and the current research on sustainable tourism is mainly focused on ecological, rather than cultural sustainability. These factors converge to make cultural tourism a delicate business, the challenges of which SME entrepreneurs are rarely able to meet. It was the aim of this thesis to help fill the gap in the research on culturally sustainable tourism, and to contribute to a better cooperation between tourism professionals and researchers, by investigating the stated problems and presenting results and recommendations useful to both tourism entrepreneurs and academics. The research questions (What are best practices in culturally sustainable tourism for SMEs? How can service design be employed by entrepreneurs, to identify/implement and enhance these best practices in their businesses?) were answered using a qualitative survey and laboratory ethnography in the form of collaborative service design workshops, and analysing the results using the theoretical framework of the thematic literature review. While the research showed that environmental sustainability issues resulting from tourism are seen as more pressing than cultural ones, it also confirmed that types of sustainability such as economic, ecological, or cultural sustainability cannot be observed in isolation from each other. What is more, it was found that measures to promote ecological or economic sustainability can be adapted to support cultural sustainability. The research also yielded five areas of best practice in cultural sustainability for tourism SME owners to adopt in their businesses. Finally, this thesis proved that service design is suited both for identifying sustainable best practices, and for managing a tourism business sustainably

Bioinformatic approaches for genome finishing

Husemann P, Tauch A. Bioinformatic approaches for genome finishing. Bielefeld: Universitätsbibliothek Bielefeld; 2011

Measuring cascade effects in interdependent networks by using effective graph resistance

Understanding the correlation between the underlie network structure and overlay cascade effects in the interdependent networks is one of major challenges in complex network studies. There are some existing metrics that can be used to measure the cascades. However, different metrics such as average node degree interpret different characteristic of network topological structure, especially less metrics have been identified to effectively measure the cascading performance in interdependent networks. In this paper, we propose to use a combined Laplacian matrix to model the interdependent networks and their interconnectivity, and then use its effective resistance metric as an indicator to its cascading behavior. Moreover, we have conducted extensive comparative studies among different metrics such as average node degree, and the proposed effective resistance. We have found that the effective resistance metric can describe more accurate and finer characteristics on topological structure of the interdependent networks than average node degree which is widely adapted by the existing research studies for measuring the cascading performance in interdependent networks

Cascade effects of load shedding in coupled networks

Intricate webs of interlinked critical infrastructures such as electrical grid, telecommunication, and transportation are essential for the minimal functioning of contemporary societies and economies. Advances in Information and Communication Technology (ICT) underpin the increasing interconnectivity of these systems which created new vulnerabilities that can be seriously affected by hardware failure, link cut, human error, natural disaster, physical-attacks and cyber-attacks. Failure of a fraction on nodes may lead to failure of dependent nodes in the other networks. Therefore, the main objective of this paper is to investigate the cascades phenomena caused by load shedding between two interconnected networks using Bak-Tang-Wiesenfeld sandpile modeling. We have found that, large avalanche occurred when node degree and/interconnectivity link become dense. In addition, the coupled random-regular networks have been found to be more robust than the coupled Erdos-Renyi networks. However, coupled random-regular networks are vulnerable to random attack and coupled Erdos-Renyi networks are vulnerable to target attack due to the degree distribution

Effect of TiO2 , ZrO2 and ZnO addition on the hydrolytic durability, viscosity and crystallization behaviour of fibre glasses

Glasses of the System Na2O-K2O-MgO-CaO-BaO-AI2O3-SiO2-B2O3 with additions of TiO2, ZrO2 and ZnO were melted from the raw materials. The glasses were characterized with respect to their hydrolytic durabilities, the working ranges (difference of temperatures attributed to viscosities of 10^2 and 10^4 dPa s), the temperatures attributed to the working point (η = 10^3.5 dPa s), and the crystal growth velocities. In the most cases, the additions led to an increase in viscosity and to a slight decrease in the workability range. The crystal growth velocities decreased with the addition of Ti02 and/or Zr02, while they increased if adding ZnO. The addition of ZnO or of TiO2 and ZrO2 resulted in better chemical durability

Complete Genome Sequence of the Type Strain Corynebacterium Epidermidicanis DSM 45586, Isolated from the Skin of a Dog Suffering from Pruritus

The complete genome sequence of Corynebacterium epidermidicanis DSM 45586 comprises 2,692,072 bp with 58.06% G+C content. The annotation revealed 2,466 protein-coding regions, including genes for surface-anchored proteins with Cna B-type or bacterial Ig-like domains and for an adhesive SpaABC-type pilus with similarity to fimbrial subunits of Corynebacterium resistens DSM 45100