[Legal Analysis of the Implementation Rules of Delegation of Home Visits by Family Doctors to Non-Physician Health Professionals: Is the Implementation in Accordance with the Intention of the Law?] / Juristische Analyse der Umsetzungsregelungen der Delegation vertragsärztlicher Hausbesuche an nicht-ärztliche Gesundheitsberufe ­ ist die Umsetzung in Einklang mit dem Willen des Gesetzgebers?

Objective: Triggered by the AGnES model project of the University Medicine Greifswald, the Code of Social Law V was changed by the German Lower and Upper House of Parliament (Bundestag and Bundesrat) in 2008 so that the delegation of GP's activities to non-physician colleagues was allowed under highly restricted preconditions. Delegated home visits should become an integral part of the standard care in Germany. In this study, the implementation of § 87 para 2b clause 5 SGB V, established in Annex 8 of the Federal Collective Agreement, was checked for its legality in terms of qualification. Methods: The problem was checked with the legal methods of interpretation in pursuance of the norm and the methods of systematic, historic and teleologic interpretation. Results: Even though the Parliament clearly required orientation to the AGnES model project (in order to assure safety and effective care of delegated home visits), self-management in the implementation of the law remained far behind these guidelines. The main outcome of the legal analysis was that the implementation arrangements of the Code of Social Law V are predominantly illegal. Conclusions: The parties of the Federal Collective Agreement have to change the arrangements to meet the requirements of the Parliament and to avoid risks of liability for delegating GPs.

Scopolamine inhibition of female sexual behavior in rhesus monkeys (Macaca mulatta).

Previous research supports the activational role of central cholinergic mechanisms in rodent female sexual behavior. This experiment examined if similar central cholinergic mechanisms facilitate female rhesus monkey (Macaca mulatta) sexual behavior. Eight ovariectomized female rhesus monkeys received daily estradiol benzoate priming (5 microg/kg, SC). After 13-16 days of estrogen priming, animals were injected intravenously with either the cholinergic antagonist, scopolamine (0.70 mg/kg), or saline vehicle (1 ml/kg). Results indicate that the female proceptive behaviors of noncontact presentations significantly decreased 1545 min after scopolamine injection. Scopolamine inhibition was sustained up to 75 min only after 15 days of estrogen priming. Scopolamine did not significantly reduce other female sexual behaviors. Additionally, significant decreases in the number of mounts and intromissions, but not hip touches, were displayed by males exposed to scopolamine-treated females. This research suggests the possibility of a central cholinergic mechanism regulating female sexual behavior in rhesus monkeys. However, the general nature and duration of the cholinergic regulation of primate female sexual behavior differs substantially when compared to rodent behavior.