Pflanzenvergiftungen — psychiatrische Aspekte

Zusammenfassung: Seit der Antike sind Pflanzenvergiftungen dokumentiert, trotzdem werden Intoxikationen mit pflanzlichen Giften im psychiatrischen Schrifttum wenig beachtet, und die Gefahr durch Giftpflanzen wird gemeinhin verkannt. In diesem Artikel wird diese Problematik erörtert. Es werden weiterhin entsprechende Empfehlungen zur Vermeidung von Pflanzenvergiftungen und zum allgemeinen Umgang mit deren Folgen gegebe

Schwere Lithiumintoxikationen bei normalen Serumspiegeln

Anliegen Unser Ziel ist es, Faktoren zu identifizieren, die das Risiko einer Lithiumintoxikation trotz normaler Serumspiegel erhöhen. Methode Wir beschreiben zwei eigene Fälle und bewerten diese im Kontext der Literatur. Ergebnisse Alter, Begleiterkrankungen und psychopharmakologische Komedikation erhöhen das Risiko einer Lithiumintoxikation bei normalen Serumspiegeln. Diskussion Bei älteren, multimorbiden Patienten sollte eine engmaschige klinische Kontrolle inklusive Spiegelbestimmung und EEG erfolgen, bei klinischen Anzeichen der Intoxikation sollte auch bei unauffälligen Spiegeln ein Absetzen erwogen werden

From research to practice: Implementing an experimental home treatment model into routine mental health care

Background In line with previous findings, in a recent randomized controlled trial (RCT), we found that home treatment (HT) for acute mental health care can reduce (substitute) hospital use among severely ill patients in crises. This study examined whether the findings of the RCT generalize to HT services provided under routine care conditions. Methods We compared patients who received HT during the RCT study phase with patients who received the same HT service after it had become part of routine mental health services in the same catchment area. Sociodemographic and clinical characteristics as well as service use (HT and hospital bed days) were compared between the RCT and the subsequent routine care study period. Results Compared to patients who received HT during the RCT, routine care HT patients were more often living with others, less often admitted compulsorily, more often diagnosed with anxiety and stress-related disorders (ICD-10 F4) and less often diagnosed with schizophrenia spectrum disorders (F2). When compared to patients who were exclusively treated on hospital wards, involvement of the HT team in patients’ care was associated with a clear-cut reduction of hospital bed days both during the RCT and under routine care conditions. However, unlike during the RCT study period, involvement of HT was associated with longer overall treatment episodes (inpatient + HT days) under routine care conditions. Conclusions HT seems to reduce the use of hospital bed days even under routine care conditions but is at risk of producing longer overall acute treatment episodes

Анализ современной распределенной термометрии в процессе разработки месторождений Западной Сибири

Объектом исследования является технология распределенной оптоволоконной термометрии. Цель исследования – анализ применения распределенной оптоволоконной термометрии в процессе разработки на месторождениях Западной. В процессе исследования был проведен анализ возможностей современных систем мониторинга разработки месторождения на основе распределенных оптоволоконных. Рассмотрены технологии и используемых данным типом оборудования и возможности анализа данных поступающих при долговременном мониторинге. Учтены современные тренды, способствующие применению данной технологии в разработке месторождений.The object of research is the technology of distributed fiber optic thermometry. The purpose of the study is to analyze the use of distributed fiber optic thermometry in the development process at Western deposits. During the study, an analysis was made of the capabilities of modern field development monitoring systems based on distributed fiber optic systems. The technologies and the equipment used by this type of equipment and the possibilities of analyzing the data received during long-term monitoring are considered. Modern trends that contribute to the application of this technology in field development are taken into account

Social Phobia Is Associated with Delayed Onset of Chickenpox, Measles, and Mumps Infections.

Evidence showing that infectious diseases in childhood play an important role in the etiopathogenesis of neurodevelopmental and other mental disorders is growing. The aim of this study was to explore the timing of common childhood diseases in early-onset anxiety disorders. We analyzed data from PsyCoLaus, a large Swiss Population Cohort Study (N = 3720). In this study, we regressed overanxious disorder, separation anxiety disorder, social phobia, and specific phobias on the age of onset of several childhood diseases, always adjusting for the other anxiety disorders listed above and for sex. The timing of viral childhood diseases (chickenpox, measles, and mumps) was consistently delayed in social phobia, notably both in men and women. We found no evidence for a reversed sequence of onset of phobia symptoms before that of the infections included. Social phobia was the only early anxiety disorder to show an association with a delayed onset of common viral childhood diseases

Clinical decision making and outcome in the routine care of people with severe mental illness across Europe (CEDAR)

Aims. There is a lack of knowledge on clinical decision making and its relation to outcome in the routine treatment of people with severe mental illness. This study examined preferred and experienced clinical decision making from the perspectives of patients and staff, and how these affect treatment outcome. Methods. CEDAR (ISRCTN75841675) is a naturalistic prospective observational study with bimonthly assessments during a 12-month observation period. 588 adults with severe mental illness were consecutively recruited from caseloads of community mental health services at the six study sites (Germany, UK, Italy, Hungary, Denmark, and Switzerland). Clinical decision making was measured using two instruments (Clinical Decision Making Style Scale. CDMS;Clinical Decision Making Involvement and Satisfaction Scale, CDIS) from patient and staff perspectives. Outcomes assessed were unmet needs (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS). Mixed-effects multinomial regression was used to examine differences in involvement in and satisfaction with actual decision making. The effect of clinical decision making on outcome was examined using hierarchical linear modelling controlling for covariates. Results. Shared decision making was preferred by patients (2=135.08; p<0.001) and staff (2=368.17; p<0.001). Decision making style of staff significantly affected unmet needs over time, with unmet needs decreasing more in patients whose clinicians preferred active to passive (-0.406 unmet needs per two months, p=0.007) or shared (-0.303 unmet needs per two months, p=0.015) decision making. Conclusions. A shift from shared to active involvement of patients is indicated, including the development and rigorous test of targeted interventions

Computing the first eigenpair of the p-Laplacian via inverse iteration of sublinear supersolutions

We introduce an iterative method for computing the first eigenpair $(\lambda_{p},e_{p})$ for the $p$-Laplacian operator with homogeneous Dirichlet data as the limit of $(\mu_{q,}u_{q})$ as $q\rightarrow p^{-}$, where $u_{q}$ is the positive solution of the sublinear Lane-Emden equation $-\Delta_{p}u_{q}=\mu_{q}u_{q}^{q-1}$ with same boundary data. The method is shown to work for any smooth, bounded domain. Solutions to the Lane-Emden problem are obtained through inverse iteration of a super-solution which is derived from the solution to the torsional creep problem. Convergence of $u_{q}$ to $e_{p}$ is in the $C^{1}$-norm and the rate of convergence of $\mu_{q}$ to $\lambda_{p}$ is at least $O(p-q)$. Numerical evidence is presented.Comment: Section 5 was rewritten. Jed Brown was added as autho

Empowerment and satisfaction in a multinational study of routine clinical practice

Objective: Decision-making between mental health clinicians and patients is under-researched. We tested whether mental health patients are more satisfied with a decision made (i) using their preferred decision-making style and (ii) with a clinician with the same decision-making style preference. Method: As part of the CEDAR Study (ISRCTN75841675), a convenience sample of 445 patients with severe mental illness from six European countries were assessed for desired clinical decision-making style (rated by patients and paired clinicians), decision-specific experienced style and satisfaction. Results: Patients who experienced more involvement in decision-making than they desired rated higher satisfaction (OR = 2.47, P = 0.005, 95% CI 1.32–4.63). Decisions made with clinicians whose decision-making style preference was for more active involvement than the patient preference were rated with higher satisfaction (OR = 3.17, P = 0.003, 95% CI 1.48–6.82). Conclusion: More active involvement in decision-making than the patient stated as desired was associated with higher satisfaction. A clinical orientation towards empowering, rather than shared, decision-making may maximise satisfaction