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The aim of this paper is to outline a current trend in inpatient medical rehabilitation in Germany, i.e. vocationally oriented medical rehabilitation (VOMR). Since employment-related demands and challenges pose a potential source of strain regarding employees' health and work ability, rehabilitative treatment in Germany is increasingly geared towards including work-related issues in diagnostics and therapy. To date, German rehabilitation research and practice have focussed primarily on the development of screening instruments for identifying vocational problems, interface management and inter-sectoral cooperation and the specification and standardisation of vocationally oriented interventions and programmes (e.g. work hardening, group interventions). Further developments in VOMR should examine the varying needs of patients for work-related interventions as well as the neglect of specific subgroups of patients (e.g. long-term unemployed) and topics (e.g. interference between work and other life domains).

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Key words • ▶ work-related medical rehabilitation • ▶ implementation • ▶ back pain • ▶ sick leave • ▶ formative evaluation Bibliografi e DOI http://dx. Zusammenfassung▼ Hintergrund: Das Anforderungsprofi l zur Durchführung der medizinisch-berufl ich orientierten Rehabilitation (MBOR) im Auftrag der Deutschen Rentenversicherung beschreibt Standards für berufsorientierte Kernmaßnahmen in der medizinischen Rehabilitation. Wir überprüften, wie die Umsetzung der Inhalte und des empfohlenen Leistungsumfangs gelang und welche Verände-rungseff ekte mit der Umsetzung assoziiert waren. Methoden: Die Umsetzung des Anforderungsprofi ls wurde in 7 stationären orthopädischen Rehabilitationseinrichtungen mittels schriftlicher Patientenbefragungen am Rehabilitationsbeginn und Rehabilitationsende sowie 3 Monate nach Abschluss der Rehabilitation untersucht. Zusätzlich wurden aus den ärztlichen Entlassungsberichten die durchgeführten therapeutischen Leistungen extrahiert. Ergebnisse: Der empfohlene Umfang der Sozialberatung und der berufsbezogenen Gruppen wurde erreicht. Diskrepanzen gab es zum empfohlenen Umfang des Arbeitsplatztrainings. Die standardisierte Mittelwertdiff erenz (SMD) der Arbeitsunfähigkeitsdauer vor und 3 Monate nach der Rehabilitation entsprach einer nahezu moderaten Verringerung (SMD = 0,47; 95 %-KI: 0,28-0,66). 5 zusätzliche Stunden berufsorientierter Therapien gingen mit einer Verringerung der Arbeitsunfähigkeitsdauer um 1,2 Wochen einher (95 %-KI: − 2,38 bis − 0,03). Schlussfolgerungen: Das Anforderungsprofi l wurde weitgehend erfolgreich umgesetzt und setzt wichtige Standards für den Ausbau der MBOR. Die fl ächendeckende Umsetzung des MBOR-Anforderungsprofi ls bedarf einer kontinuierlichen Qualitätssicherung, die zeitnahe Rückmeldungen über den erreichten Umsetzungsgrad ermöglicht. Abstract ▼ Background:The guideline for work-related medical rehabilitation (WMR) in responsibility of the German Pension Insurance describes standards of work-related measures in medical rehabilitation. We investigated if contents and recommended amount of treatment were successfully implemented and which improvements were associated with the implementation. Methods: Implementation of the WMR guideline was evaluated at 7 inpatient orthopaedic rehabilitation centres. Patients completed questionnaires at beginning of rehabilitation, at discharge and 3 months after discharge. Details regarding the treatments provided were extracted from the standardised discharge report. Results: The recommended amount of social counselling and work-related psychosocial therapy measures were appropriate. However, there were discrepancies regarding the recommended amount of functional capacity training. The standardised mean diff erence (SMD) between baseline and 3-month follow-up sick leave duration indicated an almost medium-sized eff ect (SMD = 0.47; 95 % CI: 0.28-0.66). An additional 5 h of work-related therapy was associated with a 1.2-week decrease in sick leave duration (95 % CI: − 2.38 to − 0.03). Conclusion: The guideline was for the most p...

We have characterized the effects of different short-chain fatty acids (SCFAs) on cell growth and differentiation as well as the phosphorylation state of ERK1 and 2 in the human colon adenocarcinoma cell line HT-29. Of the five SCFAs tested, only butyrate and propionate impaired cellular proliferation. Moreover, butyrate and propionate specifically resulted in a decrease in ERK1 and 2 phosphorylation at 3 and 6 hours post-treatment, suggesting a correlation between the ability of these SCFAs to inhibit cellular proliferation and decrease ERK phosphorylation. Notably, the decrease in ERK phosphorylation was observed prior to the induction of the differentiation markers alkaline phosphatase (AP) and carcinoembryonic antigen (CEA) by butyrate and propionate from days 6 to 18 post-treatment. In the case of butyrate- and propionate-induced differentiation, ERK phosphorylation is a marker and may play a role in the proliferation and/or differentiation states of this cell line.

BackgroundThe influence of personality on health-related quality of life in patients with multiple sclerosis has been the focus of previous studies showing that introversion and neuroticism were related with reduced health related quality of life. However, no data exist on the impact of temperament on quality of life in this patient group.MethodsBetween April 2014 and March 2016 139 multiple sclerosis patients were recruited from a specialized outpatient clinic of the general hospital of Vienna. Health-related quality of life was measured by “The Multiple Sclerosis International Quality of Life Questionnaire (MusiQol)”, temperament by “Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Questionnaire – Münster version” (briefTEMPS-M), and disability by the “Expanded disability status scale”. All patients underwent a diagnostic psychiatric semi-structured interview (MINI).ResultsKnown predictors (like disease duration, EDSS, psychiatric co-morbidities, immunomodulatory treatments) explain the proportion of variation in the outcome of MusiQol global index score in 30.9% in multi-variable linear regression analysis. It increased respectively to 40.3, 42.5, and 45.8% if adding the depressive, cyclothymic, or hyperthymic temperament to the list of variables. An increase of depressive and cyclothymic temperament scores significantly reduced global index score of MusiQol (p = 0.005, p = 0.002, respectively), while the hyperthymic temperament significantly raised it (p < 0.001).ConclusionIn MS patients, the depressive and cyclothymic temperament predict a lower and hyperthymic temperament an increased health-related quality of life, independent of current disability status, immunomodulatory treatments, and affective co-morbidities.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1719-6) contains supplementary material, which is available to authorized users.

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Vocational orientation in medical rehabilitation has become an important issue in rehabilitation science and practice in Germany. Although a variety of vocationally oriented interventions has been developed in recent years, there is still a lack of consensus with regard to the definition of specific types of interventions as well as relevant criteria (e. g., methods; instruments; duration/frequency; patient groups). Building on preliminary definitions, basic types of vocationally oriented measures/interventions were conceptually modified and refined in the context of a consensual process. 39 experts of various professions were contacted during a 2-stage Delphi survey to evaluate existing definitions of vocationally oriented interventions using key questions. Standardized descriptions of 5 vocationally oriented basic interventions were specified in cooperation with an interdisciplinary panel of experts. Descriptions were published in a workbook and a homepage for researchers and clinicians, which also contain information on the implementation of measures into rehabilitative care as well as good practice examples. The media developed in this project may contribute to the transfer of research results on vocationally oriented rehabilitation into health care practice.