Four Winds Hospital

The Obsessive-Compulsive Inventory-Revised (OCI-R) is widely used to assess symptoms of Obsessive-Compulsive Disorder (OCD). Despite its consistent factor structure, criticism on its syndromal validity has been raised. With the recent update of the commonly used diagnostic manuals, hoarding symptoms are now better captured by the diagnosis "pathological hoarding". Furthermore, the neutralising scale suffers from relatively low psychometric properties. Consequently, a 12-item version of the scale (OCI-12), excluding hoarding and neutralising items was recently developed in English. The current study examined the psychometric properties of the German version of the OCI-12. The psychometric properties of the translated German version of the OCI-12 were investigated in a German-speaking sample, consisting of 102 participants with OCD, 69 participants with an anxiety-related disorder, and 248 non-clinical controls. The German version of the OCI-12 replicated the four-factor structure of the original English version, with a higher order factor of general OCD symptoms. In addition, similar to the original version, the German OCI-12 showed good internal consistency and test-retest reliability, moderate-to-good construct validity, and good-to-excellent diagnostic accuracy. The German version of the OCI-12 represents a syndromally valid and reliable inventory for assessing OCD symptoms. Psychometric properties are good-to-excellent and comparable to the original English version. The diagnostic sensitivity is good-to-excellent and further supports using the OCI-12 in clinical and research settings.

Definitive Field Care (DFC) is a medical strategy required when evacuation is impossible due to tactical, environmental, or political constraints. Unlike Prolonged Field Care (PFC) or Prolonged Casualty Care (PCC), which assume eventual evacuation, DFC places full responsibility for definitive treatment on the initial provider. Historical examples, such as the Yugoslavian Partisans in World War II and Afghan resistance fighters during the Soviet invasion, highlight the necessity of DFC in austere, high-risk environments. Key considerations include operational constraints, risk tolerance, and provider mindset. Without evacuation, medical priorities shift, requiring difficult decisions. Providers must adapt to scarce resources, hostile conditions, and the absence of Geneva Convention protections. The mindset required demands resilience, adaptability, and acceptance of non-Western medical standards. As irregular warfare becomes more prevalent, formally recognizing, studying, and integrating DFC into military and humanitarian medical planning is essential. Training personnel for DFC will enhance operational effectiveness and improve survival rates in extreme conditions.

Alveolar echinococcosis caused by Echinococcus multilocularis is common parasitic disease among humans and animals in the northern hemisphere. Dogs, foxes, and other wild canids are definitive hosts, whereas small rodents play the role of intermediate hosts. In rare cases, after incidental ingestion of tapeworm eggs, dogs can become an intermediate host. The study describes briefly two cases of alveolar echinococcosis in dogs in Poland, including clinical management, diagnostic, treatment and molecular confirmation. Diagnostic procedures included laparotomy, cytology, histopathology and molecular analysis. Obtained sequences data were 100% homologous to E. multilocularis dehydrogenase subunit 1 gene sequences in GenBank®. To the authors' knowledge, alveolar echinococcosis has not been reported previously in a dog in Poland.

Studies of community wellbeing have identified numerous contributing social, economic, environmental, and cultural factors. Yet despite this diversity of dimensions, in practice many community wellbeing interventions focus on providing material resources, infrastructure, and amenities. In this perspective article, we offer an alternative approach to community wellbeing practice, drawing on several years of applied community development research and practice, formulated as principles of purpose, place, and relation. Together, these principles foster greater connectivity and resilience, support the creation of safe, dignified, and collective places and spaces, and encourage reciprocal and empathetic relations amongst people and across generations. Research and practice using these principles emphasizes being and interacting in community. Our approach is rooted in the perspective that community wellbeing could benefit not only from improved resources and infrastructure, but also from processes that promote humans willing to build and connect with community.

An in-depth review of dynamic compression plate (DCP) fixation of propagating medial condyle fractures of the third metacarpus or metatarsus has not been previously reported. To describe the technique, evaluate short-term outcome and long-term race performance of racehorses that underwent DCP fixation for repair of propagating or spiralling medial condylar fractures of the third metacarpal (McIII) or metatarsal (MtIII) bone. Retrospective case series. The surgical case records of 30 horses with propagating fractures of the medial condyle of McIII or MtIII were reviewed. Medical information included: age, breed, sex, presentation, how injury occurred (racing or training), surgical treatment and post operative complications. Racing information included: starts, top 3 placing and career earnings. Long propagating fractures of the medial condyle of Mc/tIII were identified in 23 Thoroughbred (TB) and 7 Standardbred (STB) racehorses. The fracture spiralled proximally in 22 of 30 cases (73%). Standardbreds had a higher propensity for hindlimb involvement (71%), whereas TBs tended to have more front limb involvement (61%). Twelve of 30 (40%) horses raced post surgery. Career earnings were significantly lower for TB horses with medial condylar fractures; $34,916 when compared with the national average of $60,841 (P≤0.03). Overall, horses having DCP fixation for medial condylar fractures had less starts post surgery (3.1 TBs and 5.8 STBs) compared with the national average (7 TBs and 17.3 STBs) and decreased lifetime starts 13.4 (TBs) compared with 17.3 nationally. Propagating medial condyle fractures can be repaired with plate fixation to potentially lessen the risk of catastrophic fracture destabilisation and return to racing can be expected in 40% of horses. Further prospective studies are warranted comparing lag screw fixation with DCP fixation for repair of severe medial condylar fractures of the metacarpus/metatarsus.

There has been steady progress advancing life cycle assessment methods. However, application of LCA in business decision making has lagged. UNEP and SETAC are collaborating on development of a life cycle management capability maturity model to address this gap, particularly in small-to-medium sized enterprises (SME) with limited life cycle experience. The model provides a structured sequence of improvement actions that can speed organisational learning and deliver near- term business results. The framework also complements existing efforts to develop quantified sustainability performance measures by building the capacity of lower tier suppliers to make effective decisions based on their understanding of the local situation and according to their priorities. This should ensure the quality of the data provided as well as help further the development of sustainability indicators.

A call from the "cancer floor" sets a second-year psychiatric resident on a 42-year journey in treating patients with terminal illness. Far from being an unremittingly sad experience, working with patients who are approaching death helped refine a sense of focus on the importance of the day-to-day experience.