Reha-Zentrum Bad Frankenhausen

Dual rehabilitation (dR) of patients with physical and mental illnesses comprises equal care and cooperation between two specialist departments. As part of the multi-method project that aimed to evaluate dR in different indications (DUAL), we explored the acceptance from the rehabilitants' perspective.We conducted 36 semi-structured interviews with rehabilitants of different indications (psycho-gastroenterology, -dermatology, -orthopedics, -diabetology, -cardiology, -pneumology). Interviews were analyzed using qualitative content analysis. Knowledge and access, expectations, experiences, and subjective benefits were explored as indicators for acceptance.Rehabilitants reported appropriate expectations such as improvement of mental and physical complaints or open expectations. Cross-departmental aspects such as admission and ward rounds were experienced as beneficial if there was sufficient exchange and cooperation between specialist departments. In individual psychotherapeutic consultations and groups, an improved understanding of both disorders and contact with fellow patients were important which also had a positive effect outside therapies. The multimodality of the dR was perceived to be beneficial just as the therapists' behavior and offers for counseling on both diseases. Hindering experiences included a lack of interdisciplinarity/coordination between the specialist areas, a lack of individualization in therapy planning and structural aspects in almost all areas. Subjective benefits were improved self-management and symptoms of both illnesses, as well as occupational performance.Appropriate expectations, beneficial experiences with the multimodal therapy components, therapists, and fellow patients as well as perceived positive effects support rehabilitants' satisfaction and indicate a high level of acceptance. Hindering experiences and modification requests suggest ways for overcoming obstacles, for example, by increasing interdisciplinarity and cooperation between the specialist departments. Providing sufficient information and knowledge about dR available to practitioners and patients can further support acceptance and patient participation.

This paper derives the fundamental physical constants from a projection-based informational framework in which spacetime and its fields emerge from constraint-governed realization of identity structures defined in a non-metric domain, Ω. In this ontology, identity signatures \sigma\ \in\ \Omega are timeless latent configurations, and projection Π: Ω → M is governed by compatibility with constraint classes C ⊂ Ωⁿ. The projection process is characterized by intrinsic latency τ, curvature κ, and an impedance tensor Zμν, which together define the emergent geometry of observable physics. Constants such as Planck’s constant ℏ, Newton’s constant G, vacuum permittivity ε₀, permeability μ₀, elementary charge e, and the fine-structure constant α are shown to arise as invariant features of constraint-saturated projection. ℏ corresponds to minimal τ⋅κ coupling, G quantifies curvature response to projection strain, and ε₀, μ₀ represent electric and magnetic admittances of projection. The fine-structure constant emerges as a ratio of structural asymmetry to projection granularity. These results reinterpret fundamental constants as necessary consequences of the informational structure underlying spacetime and not as empirical parameters. The framework unifies dimensional and dimensionless constants within a single ontological model, suggesting that the laws of physics reflect structural limits of admissible identity realization rather than imposed dynamical axioms.

A temporary barrier separating scaffold zones seeded with different cell types prevents faster growing cells from overgrowing co-cultured cells within the same construct. This barrier should allow sufficient nutrient diffusion through the scaffold. The aim of this study was to test the effect of two variants of collagen-based barriers on macromolecule diffusion, viability, and the spreading efficiency of primary ligament cells on embroidered scaffolds. Two collagen barriers, a thread consisting of a twisted film tape and a sponge, were integrated into embroidered poly(lactic-co-caprolactone) and polypropylene scaffolds, which had the dimension of lapine anterior cruciate ligaments (ACL). A diffusion chamber system was designed and established to monitor nutrient diffusion using fluorescein isothiocyanate-labeled dextran of different molecular weights (20, 40, 150, 500 kDa). Vitality of primary lapine ACL cells was tested at days 7 and 14 after seeding using fluorescein diacetate and ethidium bromide staining. Cell spreading on the scaffold surface was measured using histomorphometry. Nuclei staining of the cross-sectioned scaffolds revealed the penetration of ligament cells through both barrier types. The diffusion chamber was suitable to characterize the diffusivity of dextran molecules through embroidered scaffolds with or without integrated collagen barriers. The diffusion coefficients were generally significantly lower in scaffolds with barriers compared to those without barriers. No significant differences between diffusion coefficients of both barrier types were detected. Both barriers were cyto-compatible and prevented most of the ACL cells from crossing the barrier, whereby the collagen thread was easier to handle and allowed a higher rate of cell spreading.

Zur Optimierung der psychosozialen Versorgung im Nachsorgebereich wurde im Rahmen eines von dem DRV-Bund geförderten Forschungsprojektes die Akzeptanz und Wirksamkeit einer internetgestützten Nachsorge durch Chatgruppen nach stationärer psychosomatischer Rehabilitation untersucht. An der randomisierten Studie nahmen 600 Rehabilitanden aus 2 psychosomatischen Kliniken teil. Die Interventionsgruppe (n=225) erhielt die internetgestützte Nachsorge, die Kontrollgruppe (n=225) erhielt keine Nachsorge und die Placebogruppe (n=150) erhielt eine Minimalaufgabe übers Internet. Unter anderem wurden die folgenden standardisierten Messinstrumente an 5 Messzeitpunkten bei der Aufnahme in und Entlassung aus der Klinik, sowie 4 (NU1), 8 (NU2)und 12 (NU3) Monate nach der Entlassung aus der Klinik eingesetzt: Brief Symptom Inventory (BSI), Beck-Depressions-Inventar (BDI), Gießener Beschwerdebogen (GBB–24) und Arbeitsbezogenes Verhaltens- und Erlebensmuster (AVEM). In Hinblick auf die psychische Symptombelastung (BSI) und die Depressivität (BDI) zeigen die Ergebnisse einen signifikanten Unterschied zwischen den Gruppen zugunsten der Interventionsgruppe. Bei körperlichen Beschwerden (GBB) gibt es unmittelbar nach der Nachsorge (NU1) keinen Unterschied zwischen den Gruppen. Bei NU2 sind die GBB-Werte der Interventionsgruppe jedoch signifikant niedriger als die Werte der Kontrollgruppe und bei NU3 signifikant niedriger als die Werte beider Kontroll- und Placebogruppen.

Orobanche PanciciiBeck, a New Species to the Flora of SloveniaWe describe localities and sites ofOrobanche pancicii, a new species of the Slovenian flora. It was recorded in the subalpine belt (1500 to 2000 m a.s.l.) on forest edges, clearings and on stony grasslands in the Julian Alps and the eastern Karavanke mountains, on the hostsKnautia drymeia, K. longifoliaandScabiosa lucida.

Translation and validation of the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI) for defining disease status in ankylosing spondylitis (AS) and related diseases. The German version BASDAI-D was translated with only a few modifications. It contains six 10 cm horizontal visual analog scales to measure severity of fatigue, spinal and peripheral joint pain, tenderness and morning stiffness. A total of 318 patients with AS and other spondarthropathies completed the instrument at the beginning and at the end of their medical rehabilitation. Psychometric evaluation was performed separately for patients with AS corresponding to the modified New York Criteria ( SPA-NY, N=211) and for a second group of patients, which fulfilled the early diagnostic criteria for AS or the ESSG criteria of spondylarthropathies (Fd/Spond., N=86). SPA-NY: Factor analysis yielded one factor explaining 54.8% of variance. The sum score with a standard deviation of 1.94 is nearly symmetrical distributed with mean of 4.7. Reliability analysis yielded high internal consistency (Cronbach's alpha=0.83). Corrected item-total correlations are also high and are large ranging from 0.48 to 0.71. Concerning concordant validity the BASDAI-D showed a substantial correlation with the scale bodily pain of the SF 36 (r = -0.72). There are no correlations with objective clinical parameters. Furthermore the assessment of disease activity by the physician correlates significantly, albeit low with the BASDAI-D. Sensitivity to change yields effect sizes up to 0.60. Fd/Spond.: The results for this group are almost identical with SPA-NY (one factor explaining 53.8% variance, mean 4.6+/-1.75; corrected item-total correlations from 0.50 to 0.75; correlation with the scale bodily pain r = -0.62). Analysis for subgroups showed higher scores for women in both groups SPA-NY and Fd/Spond. BASDAI-D ist applicable for patients with AS and likewise for patients fulfilling the early diagnostic criteria for AS or the ESSG criteria of spondylarthropathies. In summary, BASDAID is reliable and valid. Because of its good acceptance and usability BASDAI-D is easy to use in research as well as in clinical practice.