[Outpatient Medical Rehabilitation Services: A New Socio-Law Perspective In Psychiatric Care]. / Ambulante Leistungen der medizinischen Rehabilitation: Eine neue sozialrechtliche Perspektive in der psychiatrischen Versorgung.

The equality of mentally ill people with somatically ill people and the provision of community care were central topics of the Psychiatry-Enquête. With regard to medical rehabilitation services, this goal has not been implemented to date. The amendments to the Ninth Book of the Social Code (SGB IX) made by the Federal Participation Act (BTHG) again open up the possibility of making outreach medical rehabilitation services accessible to people with severe mental illnesses.

Paving the way for systemic phenomenological psychiatry - the forgotten heritage of Wolfgang Blankenburg.

Phenomenological psychopathology focuses on the first-person experience of mental disorders. Although it is in principle descriptive, it also entails an explanatory dimension: single psychological symptoms are conceived as genetically arising from a holistic structure of personal experience, i.e., the patient's being-in-the-world - and of its dynamic unfolding over time. Yet both classical and current phenomenological approaches tend to identify the essential disorder or "trouble générateur" (Minkowski) of mental illness within the individual, thereby neglecting the relevance of the social context not only for the emergence of symptoms but also for their treatment. The work of Wolfgang Blankenburg on schizophrenia represents a noteworthy approach to overcome this individualistic tendency. He introduced the concept of "loss of common sense" as the structural core of schizophrenic experience and being-in-the-world and he considered the social and most importantly familial context for the emergence of schizophrenic experience. By accounting not only for personal experience but also for interactional structures of families and social milieus in which experience is embedded, Blankenburg thereby offered ways to combine phenomenological and systemic explanations of mental disorders. Beside his most renowned work on "the loss of common sense," in this paper we also present his family studies of young persons with schizophrenia, which have so far received little if no attention. We thus discuss the different ways in which Blankenburg expanded the phenomenological approach into a more systemic and social direction. We then link Blankenburg's work with current systemic explanatory models of schizophrenia and explore the clinical and scientific implications of this link. Finally, we call for further research on the synergy effects between the two.

[Implementation and evaluation of a telephone hotline for professional mental health first aid during the COVID-19 pandemic in Germany]. / Implementierung und Evaluation einer Telefonhotline zur professionellen Ersthilfe bei psychischen Belastungen durch die COVID-19-Pandemie in Baden-Württemberg.

BACKGROUND: The COVID-19 pandemic represents a significant psychological burden for many people; however, especially during the first wave of the pandemic in Germany, little acute professional help was available for people in need. OBJECTIVE: In southern Germany, a telephone hotline for psychological first aid for COVID-19-related burdens was set up under the lead of the Baden-Wuerttemberg Ministry of Social Affairs and Integration, opened to the entire population and evaluated in April 2020. MATERIAL AND METHODS: In the period from 22 April to 24 July 2020, 753 volunteer psychotherapeutically trained counselors from different professional groups answered a total of 8096 calls. RESULTS: Depression symptoms (36%), anxiety symptoms (18%) and psychotic symptoms (19%) were most frequently reported. Every second call was related to a previous mental illness. During the counseling sessions, which lasted 25 min on average, a variety of psychological acute interventions were conducted. In the presence of unclear symptoms, psychotic symptoms or severe personality disorder symptoms, the counselors were able to help significantly less compared to the remaining calls in which other clearly defined symptoms were present. CONCLUSION: The results point to both the benefits and limitations of hotline services. The major benefits relate to the fast availability and effective professional help for people with clearly characterized symptoms. In the case of unclear or complex symptoms, immediate help by telephone seems to be possible only to a limited extent, but it could initiate access to further help offers. Overall, the results of this study provide a first indication that hotline services for psychological first aid are feasible under pandemic conditions.

[Opportunities to Implement Guideline Recommendations on Psychosocial Therapies within the Federal Participation Act (BTHG)]. / Chancen zur Umsetzung der Leitlinienempfehlungen zu psychosozialen Therapien im Rahmen des Bundesteilhabegesetzes (BTHG).

The development of treatment guidelines alone does not improve patient care. The implementation of guidelines depends on various conditions, including structural conditions. The update of the S3 guideline "Psychosocial therapies for severe mental illnesses" systematically describes very different psychosocial therapies and reviews their effectiveness. The implementation of the resulting recommendations, which are coordinated in a complex consensus process, is hampered by the structured social legislation in Germany. The present article shows to what extent the recommendations of the update of the S3 Guideline Psychosocial Therapies follow the Federal Participation Act (BTHG).

Blood circulation in the ascidian tunicate Corella inflata (Corellidae).

The body of the ascidian tunicate Corella inflata is relatively transparent. Thus, the circulatory system can be visualized by injecting high molecular weight fluorescein labeled dextran into the heart or the large vessels at the ends of the heart without surgery to remove the body wall. In addition, after staining with neutral red, the movement of blood cells can be easily followed to further characterize the circulatory system. The heart is two gently curved concentric tubes extending across the width of the animal. The inner myocardial tube has a partial constriction approximately in the middle. As in other tunicates, the heart is peristaltic and periodically reverses direction. During the branchial phase blood leaves the anterior end of the heart by two asymmetric vessels that connect to the two sides of the branchial basket. Blood then flows in both transverse directions through a complex system of ducts in the basket into large ventral and dorsal vessels which carry blood back to the visceral organs in the posterior of the animal. During the visceral phase blood leaves the posterior end of the heart in two vessels that repeatedly bifurcate and fan into the stomach and gonads. Blood velocity, determined by following individual cells in video frames, is high and pulsatory near the heart. A double peak in velocity at the maximum may be due to the constriction in the middle of the heart tube. Blood velocity progressively decreases with distance from the heart. In peripheral regions with vessels of small diameter blood cells frequently collide with vessel walls and cell motion is erratic. The estimated volume of blood flow during each directional phase is greater than the total volume of the animal. Circulating blood cells are confined to vessels or ducts in the visible parts of the animal and retention of high molecular weight dextran in the vessels is comparable to that seen in vertebrates. These are characteristics of a closed circulatory system.

Development of an asymmetric synthesis of a chiral quaternary FLAP inhibitor.

A practical sequence involving a noncryogenic stereospecific boronate rearrangement followed by a robust formylation with an in situ generated DCM anion has been developed for the asymmetric construction of an all-carbon quaternary stereogenic center of a FLAP inhibitor. The key boronate rearrangement was rendered noncryogenic and robust by using LDA as the base and instituting an in situ trapping of the unstable lithiated benzylic carbamate with the boronic ester. A similar strategy was implemented for the DCM formylation reaction. It was found that the 1,2-boronate rearrangement for the formylation reaction could be temperature-controlled, thus preventing overaddition of the DCM anion and rendering the process reproducible. The robust stereospecific boronate rearrangement and formylation were utilized for the practical asymmetric synthesis of a chiral quaternary FLAP inhibitor.

Addressing the configuration stability of lithiated secondary benzylic carbamates for the development of a noncryogenic stereospecific boronate rearrangement.

A practical noncryogenic process for the Aggarwal stereospecific boronate rearrangement with chiral secondary benzylic carbamates has been developed. The use of LDA instead of sec-BuLi combined with an in situ trapping of the unstable lithiated carbamate was critical to success. Furthermore, this new process increased the substrate scope to include the versatile aryl iodide and bromide substrates. The methodology was applied to a diverse array of substrates and was demonstrated on multikilogram scale.

[Community care for former forensic patients in the local mental health care system--evaluation of the basic documentation in two regions]. / Die Versorgung ehemaliger forensischer Patienten im Gemeindepsychiatrischen Verbund--Auswertung einer Basisdokumentation aus zwei Landkreisen.

OBJECTIVE: This study analyzes, to which extent clients formerly detained in forensic psychiatric units can be integrated into the community and what kind of assistance they need. METHODS: Analysis of basic documentation in community mental health care in 2 regions. RESULTS: Integration into the community is feasible. Former forensic patients are more likely to show aggressive behaviour than clients without forensic history. These aggressive acts nevertheless can be handled. Aggressive acts decrease with the duration of integration. Crisis interventions are not more frequent in patients with forensic history. CONCLUSIONS: Integration of patients who are "difficult to place" into a community can be accomplished by community based services with obligation to provide assistance.