Establishing a student-run free clinic in a major city in Northern Europe: a 1-year experience from Hamburg, Germany.

BACKGROUND: Student-Run Free Clinics (SRFCs) have been an integral part of US medical schools since the 1960s and provide health care to underserved populations. In 2018, we established an SRFC in Hamburg, Germany, a major city in Northern Europe. The aim of this study was to describe the central problems and to investigate the usefulness of an SRFC in a country with free access to medical care, such as Germany. METHODS: All consecutive patients treated at the SRFC Hamburg between February 2018 and March 2019 that consented to this study were analyzed regarding clinical characteristics, diagnosis, readmission rate and country of origin. RESULTS: Between February 2018 and March 2019, 229 patients were treated at the SRFC in Hamburg. The patients came from 33 different countries with a majority (n = 206, 90%) from countries inside the European Union. The most common reasons for visiting the SRFC were infections (23.2%), acute or chronic wounds (13.5%) and fractures (6.3%). CONCLUSION: Our multicultural patients suffer mainly from infections and traumatological and dermatological diseases. We find similarities to published Canadian SRFC patient cohorts but differences in diseases and treatment modalities compared to US SRFCs. Importantly, we demonstrate the relevance and necessity of the SRFC in a major city in Northern Europe.

Botulinum Toxin Therapy for Psychiatric Disorders in Clinical Practice: A Retrospective Case Study.

Inhibiting the facial expression of negative emotions via botulinum toxin A (BTX) has been shown to mitigate symptoms of clinical depression in randomized controlled trials. This retrospective case study sought to reproduce the beneficial effects of BTX in a naturalistic setting for major depressive disorder and collect casuistic data on its effect on other mental disorders. Moreover, we describe symptom development across multiple treatment cycles with BTX, and assess the implementation of additional injection targets in the lower face region. Participants were N = 51 adult psychiatric outpatients mainly seeking treatment for depression. Over 50% suffered from comorbid psychiatric conditions, predominantly generalized anxiety disorder (GAD) or borderline personality disorder (BPD). A pre-post case series design was adapted. All participants received BTX-injections in the glabellar region on at least one occasion. Some received additional injections in the mouth region and over multiple treatment cycles. Treatment response was followed up by self-rated scales at varying time intervals post treatment. The results showed that BTX may yield favorable outcomes across multiple and comorbid mental disorders, especially, however, for patients suffering from depression. It potentially prevents the recurrence of clinical symptoms if applied regularly. Adding additional regions of the face does not seem to be superior over applying it to the glabellar region alone. The results add to the growing evidence that BTX therapy is effective in alleviating symptoms of depression. Positive effects can be sustained and reinstated, when applied over multiple treatment cycles. Observed symptom reduction in other psychiatric disorders was less pronounced. Further research is needed to understand the mechanisms by which BTX therapy reduces psychiatric symptoms.

Visual selective attention is equally functional for individuals with low and high working memory capacity: evidence from accuracy and eye movements.

Selective attention and working memory capacity (WMC) are related constructs, but debate about the manner in which they are related remains active. One elegant explanation of variance in WMC is that the efficiency of filtering irrelevant information is the crucial determining factor, rather than differences in capacity per se. We examined this hypothesis by relating WMC (as measured by complex span tasks) to accuracy and eye movements during visual change detection tasks with different degrees of attentional filtering and allocation requirements. Our results did not indicate strong filtering differences between high- and low-WMC groups, and where differences were observed, they were counter to those predicted by the strongest attentional filtering hypothesis. Bayes factors indicated evidence favoring positive or null relationships between WMC and correct responses to unemphasized information, as well as between WMC and the time spent looking at unemphasized information. These findings are consistent with the hypothesis that individual differences in storage capacity, not only filtering efficiency, underlie individual differences in working memory.