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Background: Numerous traumatic experiences and post-migration living difficulties (PMLDs) increase the risk of developing symptoms of complex post-traumatic stress disorder (CPTSD) among Afghan refugees and asylum seekers, living in Austria. Research has repeatedly associated higher levels of CPTSD with higher levels of PMLDs. Summarizing PMLDs into empirically derived factors might facilitate a further understanding of their interaction with symptom presentation within distinct clusters of CPTSD., Objective: The current study aimed to investigate homogeneous subgroups of ICD-11 CPTSD and their association with demographic variables, traumatic experiences, and empirically derived factors of PMLDs., Method: Within a randomized controlled trail (RCT) CPTSD, PMLDs, and traumatic experiences were assessed in a sample of 93 treatment-seeking Afghan refugees and asylum seekers through a fully structured face-to-face and interpreter-assisted interview using the ITQ, the PMLDC, and a trauma checklist. Underlying clusters of CPTSD, superior factors of PMLDs, and their associations were investigated., Results: In total, 19.4% of the sample met the diagnostic criteria for PTSD and 49.5% for CPTSD. We identified a 2-cluster solution consisting of two distinct subgroups as best fitting: (1) a CPTSD cluster and (2) a PTSD cluster. The multitude of PMLDs was summarized into four superior factors. CPTSD cluster membership was associated with childhood potentially traumatic experience types, and one of four PMLD factors, namely 'language acquisition & barriers'., Conclusions: The results suggest that not PMLDs in general, but rather specific types of PMLDs, are associated with CPTSD. An assumed bidirectional relationship between these PMLD factors and CPTSD symptoms might lead to a downward spiral of increasing distress, and could be considered in treatment strategies., Competing Interests: The authors declare that they have no competing financial or personal interests., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Our study aimed to assess the change in the sleep patterns during the Coronavirus lockdown in five regions (Austria/Germany, Ukraine, Greece, Cuba and Brazil), using online surveys, translated in each language. Part of the cohort (age 25-65, well-educated) was collected directly during lockdown, to which retrospective cross-sectional data from and after lockdown (retrospective) questionnaires were added. We investigated sleep times and sleep quality changes from before to during lockdown and found that, during lockdown, participants had (i) worse perceived sleep quality if worried by COVID-19, (ii) a shift of bedtimes to later hours during workdays, and (iii) a sleep loss on free days (resulting from more overall sleep during workdays in non-system relevant jobs), leading to (iv) a marked reduction of social jetlag across all cultures. For further analyses we directly compared system relevant and system irrelevant jobs, because it was assumed that the nature of the lockdown's consequences is dependent upon system relevance. System relevant jobs were found to have earlier wake-up times as well as shorter total sleep times on workdays, leading to higher social jetlag for people in system relevant jobs. Cultural differences revealed a general effect that participants from Greece and Ukraine had later bedtimes (on both work and free days) and wake-up times (on workdays) than Cuba, Brazil and Austria, irrespective of COVID-19 lockdown restrictions., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

In recent years, Germany and Austria have been among the leading European receiving countries for asylum seekers and refugees (AS&R). The two countries have cultural and economic similarities, but differ, for example, in their health care systems, with AS&R having unrestricted access to health services upon arrival in Austria, but not in Germany. This study investigates the determinants of health among refugees in Austria and Germany, and how these determinants differ between the two countries. We analyze comparable and harmonized survey data from both countries for Syrian, Afghan, and Iraqi nationals aged 18 to 59 years who had immigrated between 2013 and 2016 (Germany: n = 2,854; Austria: n = 374). The study adopts a cross-sectional design, and uses propensity score matching to examine comparable AS&R in the two receiving countries. The results reveal that the AS&R in Germany (72%) were significantly less likely to report being in (very) good health than their peers in Austria (89%). Age and education had large impacts on health, whereas the effects of length of stay and length of asylum process were smaller. Compositional differences in terms of age, sex, nationality, education, and partnership situation explained the country differences only in part. After applying propensity score matching to adjust for structural differences and to assess non-confounded country effects, the probability of reporting (very) good health was still 12 percentage points lower in Germany than in Austria. We conclude that many of the determinants of health among AS&R correspond to those in the non-migrant population, and thus call for the implementation of similar health policies. The health disadvantage found among the AS&R in Germany suggests that removing their initially restricted access to health care may improve their health., Competing Interests: The authors have declared that no competing interests exist.

Background: The aim of this pilot study was to describe the acceptance and feasibility of an exercise intervention in breast cancer patients of Turkish origin in Austria by using a hand-held swinging-ring system. Methods: The inclusion period lasted 1 year (1 February 2016-31 January 2017). In a multicentre cooperation, Turkish female breast cancer patients were included by using face-to-face information, email, facebook ® , phone, and notice boards. The exercise program consisted of 1) supervised and 2) home-based exercise by using the smovey ® vibroswing system. Feasibility and acceptance were assessed by using the Austrian school grading system and a qualitative approach after 3 months. Furthermore, the six-minute walk test (6MWT), handgrip strength, body composition (BIA), and health-related quality of life (QOL) were assessed at baseline (T0) and after 3 months (T1). Results: Only 5 breast cancer patients could be included, from whom one dropped out due to breast cancer recurrence. The exercise intervention showed no side effects and was well accepted by all 4 patients. Furthermore, results of the 6MWT, handgrip strength, BIA, and QOL improved. Conclusion: These results indicate notable barriers towards regular physical activity in female Turkish breast cancer patients in Austria. Four out of five of those involved were comfortable with the intervention. Therefore, it seems to be essential to further address these barriers in order to plan and implement effective interventions.Implications for RehabilitationExercise is an effective means of improving health and quality of life experienced by female patients suffering from breast cancer.Although extensive efforts were taken only a minority of Turkish female patients attended a structured exercise program.It seems to be essential to further address barriers to exercise in order to plan and implement effective interventions.

The article deals with the demographic data of migration in Austria and with therapeutic advice concerning drug therapy and diabetes education for patients with migration background. In this context sociocultural specifics are discussed. These suggestions are seen complementary to the general treatment guidelines of the Austrian Diabetes Association.The fasting month Ramadan is widely practiced by the Muslim population worldwide. Ensuring the optimal care of the many people with diabetes who fast during Ramadan is crucial. The IDF-DAR Practical Guidelines (International Diabetes Federation - Diabetes and Ramadan International Alliance) provide healthcare professionals with relevant background information and practical recommendations to enable them to help patients with diabetes participate in fasting during Ramadan while minimizing the risk of complications.

Objective: Recent observations revealed substantial differences in smoking behaviour according to individuals' migration background. However, smoking cessation strategies are rarely tailored on the basis of a migration background. We aimed to determine whether smoking behaviour and preferences for smoking cessation programmes differ between Austrian migrant smokers and Austrian smokers without a migration background., Study Design: Cross-sectional study., Setting: Recruitment and interview were performed at public places in Vienna, Austria., Participants: The 420 smokers included: 140 Bosnian, 140 Turkish migrant smokers of the first or second generation, as well as 140 Austrian smokers without a migration background., Methods: We cross-sectionally assessed determinants of smoking behaviour and smoking cessation of every participant with a standardised questionnaire., Primary Outcome Measure: The Fagerström Test for Nicotine Dependence., Secondary Outcome Measures: Determinants of smoking behaviour, willingness to quit smoking and smoking cessation., Results: Nicotine addiction expressed via the Fagerström score was significantly higher in smokers with a migration background versus those without (Bosnian migrant smokers 4.7 ± 2.5, Turkish migrant smokers 4.0 ± 2.0, Austrian smokers without a migration background 3.4 ± 2.3, p<0.0001). Bosnian and Turkish migrant smokers described a greater willingness to quit, but have had more previous cessation trials than Austrian smokers without a migration background, indicating an increased demand for cessation strategies in these study groups. They also participated in counselling programmes less often than Austrian smokers without a migration background. Finally, we found significant differences in preferences regarding smoking cessation programmes (ie, preferred location, service offered in another language besides German, and group rather than single counselling)., Conclusions: We found significant differences in addictive behaviour and cessation patterns between smokers with and without a migration background. Our results indicate a strong demand for adjusting cessation programmes to the cultural background., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

The victories near Ulm and Elchingen, where the Napoleonic army took 60000 prisoners between 15th and 20th of October 1805, lead to the arrival at Troyes (county "Aube") of nearly 2000 Austrian soldiers to be held inside former monasteries among whose, mainly the Jacobinians casern where more than half of them stayed. At the beginning of 1806, the government sent the epidemics medical practitioner Dr Desgenettes on an inspection tour to control the state of health of the populations of places where foreign prisoners were held, which lead him through several counties of the North-eastern part of France, where he surveyed several diseases ranging from all kinds offevers up to dysentery, scabies or gangrenes. With the means of acid fumigations invented by the chemist Guyton Morveau from Dijon, the authorities took care of combating and preventing the epidemics in the caserns. As soon as October 1805, the epidemics medical practitioner Dr Pigeotte from Troyes wrote to the county governor his observations recommending a better diet, airing of the rooms and also calls to take some exercise. All these precepts showed an astonishing modernity.

We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population. Significant changes in mortality trends were identified by Joinpoint regression and annual percentage changes (APCs) were calculated for periods with uniform trends. Cancer mortality in Romania was among the lowest in Europe in 1986, but was higher than most countries by 2009. Despite the declining mortality (APC) in younger Romanians for all cancers combined (men-1.5% from 1997, women-1.2% 1997-2004 and -3.8% 2004-2009), male lung cancer (-2.8% from 1997), female breast (-3.5% from 1999) and cervical (-5.4% from 2004) cancers, mortality has increased in middle-aged and elderly patients for most cancers analysed. The exception was declining stomach cancer mortality in most Romanians, except elderly men. For most cancers analysed, mortality declined in the Baltic countries in young and middle-aged patients, and in western and northern countries for all ages. Lung cancer mortality in women increased in all countries except Latvia. We urge immediate steps to reverse the alarming increase in cancer mortality among middle-aged and elderly Romanians.

Background: In ethnobotanical research, the investigation into traditional knowledge of medicinal plants in the context of migration has been of increasing interest in recent decades since it is influenced and changed by new environmental and social conditions. It most likely undergoes transformation processes to match the different living circumstances in the new location. This study compares the traditional knowledge of medicinal plants held by Tyroleans - and their descendants - who emigrated to Australia, Brazil and Peru at different time scales. The study's findings allow a discussion of the complexities and dynamics that influence this knowledge within the context of long-distance migration., Methods: Information was obtained from 65 informants by free-listing, semi-structured interviews and non-participatory observation in Tyrol (Austria) and the migrants' countries: Australia, Brazil and Peru. The collected data was analysed using different quantitative approaches, including statistical tests, and compared between the countries of investigation., Results: All respondents in all four investigation areas claimed that they had knowledge and made use of medicinal plants to treat basic ailments in their day-to-day lives. Informants made 1,139 citations of medicinal plants in total in free lists, which correspond to 164 botanical taxa (genus or species level) in Tyrol, 87 in Australia, 84 in Brazil and 134 in Peru. Of all the botanical taxa listed, only five (1.1%) were listed in all four countries under investigation. Agreement among informants within free lists was highest in Tyrol (17%), followed by Peru (12.2%), Australia (11.9%) and Brazil (11.2%). The proportion of agreement differs significantly between informants in Australia and Tyrol (p = 0.001), Brazil and Tyrol (p = 0.001) and Peru and Tyrol (p = 0.001) and is similar between informants in the migrant countries, as indicated by statistical tests. We recorded 1,286 use citations according to 744 different uses (Tyrol: 552, Australia: 200, Brazil: 180, Peru: 357) belonging to 22 different categories of use. Use values are significantly different between Tyrol and Australia (p < 0.001) but not between Tyrol and Brazil (p = 0.127) and Tyrol and Peru (p = 0.853). The average informant agreement ratio (IAR) in Tyrol is significantly higher than in Australia (p = 0.089) and Brazil (p = 0.238), but not Peru (p = 0.019)., Conclusions: Changing ecological and social conditions have transformed and shaped traditional knowledge of medicinal plants through adaptation processes to match the new circumstances in the country of arrival. Continuation, substitution and replacement are strategies that have taken place at different rates depending on local circumstances in the research areas. Traditional knowledge of medicinal plants acquired in the home country is continuously diminishing, with its composition influenced by urbanisation and ongoing globalisation processes and challenged by shifts from traditional healing practices to modern healthcare facilities.

Objective: To identify risk factors for the development and progression of untreated persistent microalbuminuria in children and adolescents with type 1 diabetes., Design and Methods: A total number of 683 children and adolescents with type 1 diabetes recruited from the prospective nationwide German and Austrian diabetes survey (DPV) were included in the analysis. Inclusion criteria were onset of type 1 diabetes under the age of 11 years, diabetes duration of more than 1 year and continuous follow-up over 5 years with at least two documented urine analyses per year. Subjects treated with angiotensin-converting enzyme inhibitors were excluded. Risk factors such as sex, body mass index SDS, diabetes duration, HbA1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, systolic and diastolic blood pressure, and immigrant status were analysed by logistic regression., Results: At baseline (age 10.5 ± 0.1 years, diabetes duration 4.6 ± 2.4 years and HbA1c 7.4 ± 1.1%), 75.6% of children had normoalbuminuria, 15.7% had intermittent microalbuminuria, 8.6% had persistent microalbuminuria and 0.1% had macroalbuminuria. After a follow-up of 5 years, 59.4% of adolescents continued to have normoalbuminuria, 18.4% had progression, 15.2% had regression of microalbuminuria, and in 6.9% of the subjects, microalbuminuria remained unchanged. We found significant associations between persistent microalbuminuria at baseline and during each year of follow-up (P < 0.0001). Logistic regression analysis identified diabetes duration and immigrant status as significant factors for microalbuminuria (P = 0.009 and P = 0.009)., Conclusions: The survey in a real-world setting shows that diabetes duration and immigrant status are risk factors for the development and progression of untreated microalbuminuria in children and adolescents with type 1 diabetes.

Purpose: This cross-cultural study investigated the prevalence of suicidal behavior and attitudes towards suicide and reactions to suicidal individuals in 320 Austrian and 326 Turkish medical students., Methods: Data were collected using a self-report questionnaire consisting of sections on demographic information, suicidal behavior, current mood, religiosity, attitudes towards suicide, and reactions to suicidal individuals., Results: More Austrian (37.8%) than Turkish (27.3%) students reported life-time, past 12-month, or current suicidal ideation, while more Turkish (6.4%) than Austrian (2.2%) students reported life-time or past 12-month suicide attempts. Austrian students had more permissive and liberal attitudes towards suicide, while those of Turkish students were more rejecting. Conversely, attitudes of Turkish medical students towards an imagined suicidal close friend were more accepting than those of Austrian medical students. Comparisons of suicidal versus nonsuicidal students showed that those reporting suicidal ideation or suicide attempts generally were more accepting of suicide and viewed suicide as a solution to a greater extent than the nonsuicidal group., Conclusion: The findings suggest that cultural factors play a role in observed country differences in suicidal ideation and behavior and in attitudes towards suicide and reactions to suicidality among Austrian and Turkish medical students.

Adolescents with a migration background account for a substantial proportion of juveniles in custody. Psychosocial adversities pose a significant risk for criminal behaviour. So far, the nature of psychosocial adversities experienced by migrant youth is understudied. The aim of this study was to explore differences in psychosocial background in three ethnic groups (Turkish, former-Yugoslavian and Austrian) of detained juveniles in Austria. A semi-structured interview (Multidimensional Clinical Screening Inventory for delinquent juveniles, MCSI) was used to assess psychosocial background (e.g., trauma, family background, forensic and psychiatric family history, school history, psychiatric treatment received and criminal history) in juveniles entering an Austrian pre-trial detention facility. Of the 370 eligible participants, the final study sample consisted of 278 juveniles. The ethnic distribution was as follows: 55.4% Austrian (mean age 16.88 years, S.D.=1.52), 14% Turkish (mean age 16.28 years, S.D.=1.23), 30.6% former-Yugoslavian (mean age 16.47 years, S.D.=1.41). In the Austrian sample, family dysfunction was significantly more prevalent than in the Turkish or former-Yugoslavian samples. Mental health services were significantly less used by juveniles with migration background. Turkish juveniles had a significantly poorer school performance than Austrians. Juveniles from former-Yugoslavia had significantly less often attended schools offering secondary education. The results suggest that detained juveniles with migration background are poorly integrated into the educational and mental health system of the host society. Family systems, even if substantially dysfunctional, seem to be perceived as more stable by migrant youth than by Austrian youth., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Although written in vastly different cultural contexts and periods, Hermine Hug-Hellmuth's "Diary of a Young Girl" (1919) and Lei Feng's "The Diary of Lei Feng" (1963) both to a large extent were written as concept pieces, with the goal of illustrating specific theories of the self. In the case of Hug-Hellmuth, the underlying theory is the Freudian sexualized unconscious mind, whereas for Lei Feng, it is Maoist revolutionary optimism. Additionally, both diaries have unusually strong inauthentic or 'fake' aspects. Although Hug-Hellmuth never admitted to writing the diary, most critics believed it came from her pen. Lei Feng's diary was revised through his own attempts to present himself as politically progressive, by editors, and through successive political movements that focused on the person behind the diary and made him one of the most widely-recognized figures in China. As such, the diaries are excellent windows into powerful and long-lasting ideological constructs.

This article examines a group photograph of the Psychiatry and Neurology section of the 66th Meeting of the Society of German Natural Scientists and Doctors in Vienna, 24-30 September 1894 which Sigmund Freud attended. The society's origins in Naturphilosophie are indicated and a number of the participants are identified on the photo. They and the events at the conference are related to Sigmund Freud's work at the time and to his gradual abandonment of anatomy and of heredity and degeneration as significant aetiological factors in the neuroses. Philosophical problems, such as how phenomena should be described and how 'nature' is conceptualized, are also considered in the light of their implications for Freud's life and thought at that period.

This essay presents an overview of artists and writers who read Freud's work in Mexico between 1920 and 1968. The focus is on cultural readings of Freud: non-clinical interpretations of psychoanalysis that applied Freud's theory to literary, artistic, philosophical, or religious questions. The essay focuses on Salvador Novo, one of the poets associated with the Contemporáneos group, and his reading of the "Three Essays in the Theory of Sexuality;" Raúl Carrancá y Trujillo, a judge and criminologist who used psychoanalysis in his work, including the trial of Trotky's assassin; Octavio Paz, a poet and intellectual who wrote an essay on Mexican history, "The Labyrinth of Solitude," as a response to "Moses and Monotheism;" and Gregorio Lemercier, a Benedictine monk who placed his monastery in group analysis. These unorthodox readings of Freud opened the door for some of the most daring intellectual experiments in the 20th century.

This article provides a summary of the author’s research on human smuggling in Austria comparing migrants from Former Yugoslavia and the Russian Federation. The project’s primary intent was to collect more detailed information on migrants seeking asylum in Austria and their use of smuggling services to leave their home countries, including detailed information on demographics, force or threat of force by smugglers, routes and methods of transportation, costs of smuggling, payment methods, and deeper perceptual questions regarding the flight. Another central premise of the article discusses how current distinctions between human smuggling and human trafficking are arbitrary in many regards.

Objective: To compare service expectations between Arab and Austrian patients., Methods: We used a Kano model-based questionnaire with 20 service attributes of relevance to the dialysis patient. We analyzed 530, 172, 60, and 68 responses from Saudi, Austrian, Syrian, and UAE patients, respectively. We compared the customer satisfaction coefficient and the frequencies of response categories ("must be," "attractive," "one-dimensional," and "indifferent") for each of the 20 service attributes and in each of the 3 national groups of patients. We also investigated whether any differences seen were related to sex, age, literacy rate, or duration on dialysis., Results: We observed higher satisfaction coefficients and "one-directional" responses among Arab patients and higher dissatisfaction coefficients and "must be" and "attractive" responses among Austrian patients. These were not related to age or duration on dialysis but were related to literacy rate., Conclusion: We speculate that these discrepancies between Austrian and Arab patients might be related to underdeveloped sophistication in market competitive forces and to cultural influences.

Gender differences in body composition, the prevalence in overweight and obesity as well as in physical activity patterns were tested among 3003 children and adolescents aging between 6 and 18 years (x = 12.1 +/- 3.6) in Vienna and rural parts of Eastern Austria. As to be expected, the absolute and relative amount of body fat was significantly higher among girls of nearly all age groups, while boys exhibited a significantly higher amount of lean or fat free body mass. The prevalence of overweight and obesity was markedly higher among prepubertal girls, however significantly lower among younger and older adolescent girls aging 11 years and older in comparison to their male counterparts. This was however only true of adolescents originating from Austria. Considering adolescents with a background of migration originating from Turkey or the Near East, a significantly higher amount of overweight and/or obesity was found among girls. Therefore, biocultural factors have to be considered to explain gender differences in obesity during childhood and adolescence.

To investigate the frequency of mutations in the Leucine-Rich Repeat Kinase 2 gene (LRRK2) in a sample of Austrian Parkinson's disease (PD) patients, we sequenced the complete coding region in 16 patients with autosomal dominant PD. Furthermore, we sequenced exons 31, 35, and 41 additionally in 146 patients with idiopathic PD and 30 patients with dementia with Lewy bodies. Furthermore, all 192 patients were screened for 21 putative LRRK2 mutations. While the most common mutation G2019S and the risk variant G2385R were not found in our samples, we detected a novel missense mutation (S973N) in a patient with familial, late-onset and dopa-responsive PD., (Copyright (c) 2007 Movement Disorder Society.)

This article examines the role played by Ernest Jones in saving psychoanalysts from Germany and Austria during the 1930s, and , in particular, in the case of Drs Otto and Salomea Isakower from Vienna. Archives from the Library of Congress and the British Psychoanalytical Society are used to document how Jones navigated the considerable difficulties presented in both Europe and London as well as by colleagues and was able to help the Isakowers emigrate to Liverpool where they worked and began the "North of England" training group with others and emigrated to the USA in 1940. As President of the International Society, Jones had responsibilities with psychoanalyst refugees, which he performed with care, commitment and political competence. Although Jones did not succeed in saving psychoanalysis in Europe, he played a crucial role in saving psychoanalysts. He helped to spread the world-wide standing and influence of psychoanalysis.

This article presents a unique document, a hitherto unpublished diary of a patient analysis with Freud in 1921. Conclusions on how Freud worked with patients at that period, particularly insofar as transference is concerned, are drawn.

This paper examines Freud's approach to technology from two interrelated perspectives. First it discusses the way his theory presents technology solely in positive terms, as an instrument that expands human power over nature almost infinitely. Here the goal is to underscore a limitation of Freud's way of thinking about human creations, which comes to the fore in his somewhat myopic enthusiasm for technology. Then the essay elaborates on a void in Freud's writings, examining why he did not refer to railway accidents in his discussion of technology. It concludes with a choice of three possible answers: (a) that his theories allowed no conceptual room for accidents, (b) that his silence on accidents was conditioned by the emergence of his oedipal desire on the occasion of a railway journey from Leipzig to Vienna, (c) that his silence was caused by a fear of accidents that threatened to overwhelm him.

Decorations on the bodies of newborns indicate that they were probably important in their community. Several adult graves from the Stone Age (Upper Palaeolithic period) have been found but child burials seem to be rare, which has prompted discussion about whether this apparently different treatment of infants could be significant. Here we describe two recently discovered infant burials from this period at Krems-Wachtberg in Lower Austria, in which the bodies were covered with red ochre and decorated with ornaments and were therefore probably ritually buried. These findings indicate that even newborns were considered to be full members of these hunter-gatherer communities about 27,000 years ago.

This paper provides the historical, cultural, and clinical context for the relationship between Bruno Bettelheim (1903-1990) and Rudolf Ekstein (1912-2005). Both were Viennese-born and trained intellectuals who received doctorates in the human sciences from the University of Vienna in 1937. Both were deeply identified with lay analysis, emphasizing that for psychoanalysis to perpetuate itself it needed to promote serious and rigorous forms of research. Because Bettelheim was the better known of the two, this introduction focuses on Ekstein's family history, with special emphasis on his experience of loss and trauma and his capacity to recover from personal and educational obstacles. It argues that Ekstein was a representative product of Austro-Marxism in the period between the wars, embracing the ethical brand of democratic socialism and group solidarity that was integral to the theory and practice of Austrian Social Democracy. It discusses Ekstein's training with Moritz Schlick in philosophy and his immersion in the Vienna Circle of logical positivism. From Schlick, Ekstein evolved into a philosophical thinker who learned how to think his own thoughts. Ekstein joined the circle of psychoanalytic pedagogues who clustered around the Vienna Psychoanalytic Society, under the tutelage of Willi Hoffer, August Aichhorn and, above all, Anna Freud. The clinical component of psychoanalysis emanated from his commitment to understanding the inner world of the child. Bettelheim and Ekstein first became aware of each other from reading the analytic literature and finally met in America in the 1950s. They shared a professional interest in conducting research and doing clinical work on severely disturbed children and adolescents, including those with psychotic, borderline and autistic diagnoses. They debated the value of milieu therapy versus psychoanalytically oriented psychotherapy on such children. As their relationship evolved, the two collaborated and began a fascinating correspondence that gradually evolved into an intimate friendship. They both engaged in a polemic with Bernard Rimland, who was massively critical of their clinical work and a hostile critic of psychoanalytic approaches to the treatment of disturbed children. Rimland was an advocate of a neurological approach to mental illness, with an emphasis on biology and psychopharmacology. The 22 letters that constitute the Bettelheim-Ekstein exchange began with clinical concerns, including the varieties of solitude, isolation and countertransference disruptions that may trouble the psychoanalytic researcher and clinician in dealing with primitively disordered children. It moves to other issues, including mutual support during the Rimland Affair. As the two became more friendly, a pattern of good-natured competition and envy appeared. The two engaged in a heated exchange on the question of whether contemporary Vienna remained as anti-Semitic as it had been in their respective youths: Bettelheim, the concentration camp survivor, argued that nothing had changed and that most Austrians remained viscerally anti-Semitic; Ekstein, the Austro-Marxist, contended that one could not blame a generation born after World War II, holding that in his experience many Austrians had examined their consciences and held distinctly different options from their parents or grandparents. Toward the end of their correspondence, we encounter Ekstein's tender sensitivity to Bettelheim's descent into depression as a result of the death of his wife, Trude, leading eventually to recurrent episodes of suicidal ideation and plans for his own suicide. The letters testify to a unique friendship with a somewhat old-world quality.

A previously unknown photograph of the old Emanuel Freud with his youngest daughter Bertha inspires an attempt to salvage what can be rescued of these lost lives and reminds us that history is always incomplete. Emanuel's appearances in Freud's dreams exemplify the dream-like aspects of the photographic image, which momentarily highlights particular aspects of the sitter while neglecting others. Examining photographs for documentation involves a reappraisal of the language of historical evidence.

Purpose: Due to the widespread use of Free Functional Muscle Transplant (FFMT) around the world to reanimate the paralysed face, it is important to be aware of ethnic differences in facial movements., Methods and Material: Participants in this study were born in Taiwan (n=24) and Austria (n=24). Analyses were conducted applying the digitised three-dimensional video-analysis system. All 48 subjects have never undergone any treatments in the face nor did they have previous histories of craniofacial anomalies., Results: In general, Europeans were observed to have larger facial movements than Asians, from 0.4 mm (e.g. 5.7%) up to 3.9 mm (e.g. 30.3%), on average 1.3 mm+/-0.82 SD (e.g. 20.6%). Particularly the eyebrow, nose and mouth regions show statistically significant larger excursions on average 1.4 mm (e.g. 19.9%), 1.3 mm (e.g. 34.6%) and 3.0 mm (e.g. 30.3%). One exception is in the eye region, where Asians have a larger excursion (1.4 mm, e.g. 15.8%) of the eyelids, due to the larger distances between the upper and lower eyelids in the rest position., Conclusion: Europeans have generally larger facial movements than Asians. Particularly the eyebrow, nose and mouth regions show statistically significant larger excursions; exception must be made to the eye region, where Asians have a larger excursion of the eyelids. This is the first step to gather essential information about the ethnical differences in facial movements, a factor that should be considered as FFMT is becoming more popular worldwide.

Background: The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study, we examined the symptomatology of PCOS and the health-related quality of life among infertility patients suffering from PCOS with different socio-cultural and ethnic background., Methods: Symptomatology of PCOS, body composition characteristics as well as socio-economic factors were examined in 49 PCOS infertility patients of the University Clinic for Gynecology and Obstetrics, in Vienna, who originated from two socio-cultural subgroups, Austrian women and Moslem immigrant women. Additionally, the Cronins health-related quality of life questionnaire of women with PCOS was used in order to examine the impact of PCOS symptoms on the individual quality of life of the affected women., Results: In terms of the appearance of the symptoms, the typical heterogeneity of PCOS could be found in both subgroups with no differences. However, differences in the health-related quality of life were impressive. Health-related quality of life of women from an Islamic background was affected to a greater degree than that of Austrian women, although no differences in symptomatology were found. This was true of all five domains investigated (infertility, overweight, hirsutism, menstrual irregularities and emotional problems). First of all, infertility was a dramatic problem for immigrant women. Islamic women had very high reproductive pressure. The Moslem immigrant PCOS women suffer more from infertility than do Austrian women., Conclusions: Health professionals should be sensitive to the ethnicity, religious and cultural background of their patients to provide the best possible medical support.

In homocystinuria due to cystathionine beta-synthase (CBS) deficiency, vitamin B6 response has been linked to distinct mutations and ruled out for others. The splice site mutation c.1224-2A>C leading to the deletion of exon 12 is predominantly found in patients from Central Europe, where it has been found on in average 14% of mutant alleles. In this study we analyzed the clinical picture in 17 CBS deficient carriers of c.1224-2A>C. Homozygotes for c.1224-2A>C did not respond to vitamin B6, while in compound heterozygotes the response to vitamin B6 depended on the mutation on the second allele. Maximum likelihood analysis revealed one common haplotype of the c.1224-2A>C alleles. Additionally, we report the four novel CBS mutations c.451G>A (p.Gly151?), c.740&#95;769del (p.Lys247&#95;Gly256del), c.862G>C (p.Ala288Pro) and c.1135C>T (p.Arg379Trp). In summary, the data of this study suggest that the CBS c.1224-2A>C allele confers vitamin B6 nonresponsiveness and that this mutant allele came from a common ancestor., (Copyright 2004 Wiley-Liss, Inc.)

In 1922 Sigmund Freud wrote to fellow Viennese author and dramatist Arthur Schnitzler: "I believe I have avoided you out of a sort of fear of my double." Through a series of reflections on this imagined doubling and its reception, this paper demonstrates that the ambivalent desire for his literary other attested by Freud's confession goes to the heart of both theoretical and historical questions regarding the nature of psychoanalysis. Bringing Schnitzler's resistance to Freud into conversation with attempts by psychoanalytically oriented literary scholars to affirm the "Doppengängertum" of the two men, it argues that not only psychoanalytic theories and modernist literature but also the tendency to identify the two must be treated as historical phenomena. Furthermore, the paper contends, Schnitzler's work stands in a more critical relationship to its Viennese milieu than Freud's: his examination of the vicissitudes of feminine desire in "Fräulein Else" underlines the importance of what lies outside the oedipal narrative through which the case study of "Dora" comes to be centered on the uncanny nexus of identification with and anxious flight from the other.

Freud's path to the Oedipus complex reveals conceptual inconsistencies. These uncertainties concern fathers, brothers and sons, and the place of the oedipal triad within the family romance. Freud's uncovering of the Oedipus complex emerged, in large part, from his self-analysis of his childhood years in Freiberg. Freud's father was 20 years older than his third wife, and had two adult sons, all of whom lived in Freiberg. In 1897, when Freud announces the Oedipus complex, he stresses his love of his mother and jealousy of his father. Yet in 1924 Freud wrote that his adult brother, Philipp, had taken his father's place as the child's rival. The oedipal complex alters if there are four players rather than three. Freud's concept of an oedipal triangle does not adequately explain the psychological dynamics of his childhood. Fuller conceptual clarity would occur if the dynamics of the Oedipus complex were placed within the family context in which it unfolds.

Recently, a 342-kb deletion involving GJB6 was associated with autosomal-recessive non-syndromic hearing loss (NSHL) and in combination with a GJB2 mutation with digenic NSHL. This deletion was the second most common mutation causing prelingual NSHL in Spain, and was frequently observed in patients from France and Israel. We screened 393 patients with NSHL being negative or heterozygous for GJB2 mutations for this GJB6 deletion using a multiplex PCR. Most patients were of Austrian (84.2%), and the other patients were of Turkish, Serbian, and Bosnian origin. None of these patients was carrying the deletion in GJB6 indicating that the occurrence of this deletion is restricted to certain populations., (Copyright 2003 Wiley-Liss, Inc.)

Proceeding from Wittels' comment that Isidor Sadger's essay "The miracle of the thinking protein" (1897a) was the day residue for Freud's dream of the norekdal style, I suggest that the dream was dreamt between February/April 1897 and autumn 1897. I go on to consider which of Sadger's publications on Ibsen could have been the second day residue for Freud's dream. Against the background of Freud and Sadger's relationship in the 1890s, I examine what it was about Sadger's essay that could have precipitated the dream. Flechsig's basic conception of the connection between brain and mind and Sadger's pre-analytical view of psychic phenomena are outlined. Furthermore, a previously unpublished letter from Freud to Sadger in 1902 is presented and its possible context discussed. I show that Sadger probably already began carrying out analyses in 1898 and that, of Freud's immediate circle in Vienna, he was either the first or the second doctor to begin analytical work. In addition Sadger already made references to Freud in his publications in 1897. In summary, Isidor Sadger was probably the only one of Freud's disciples for whom the following combination was true: he became interested in Freud's approach before 1900, carried out analyses before 1900, publicly spoke out for Freud before 1900, became a member of the Wednesday group and stayed in Freud's vicinity for a long time (until 1933).

As a number of Sigmund Freud's patients and followers in the crucial formative years of psychoanalysis were from the German- and Austrian-Jewish educated class, and as the then prestigious humanistic tradition was considered essential for the formation of analysts, the paper gives a historical account of various discourses of "Bildung"so as to explain the particularity of the Freudian psychoanalyst. Amongst others, his humanistic aspirations are compared with Thomas Mann's re-examination of the tradition of "Bildung." It is argued that Freud's specific cultural milieu -- the German-Jewish assimilation -- conditioned the form his psychological knowledge adopted and the way the analyst was fashioned: the demand of breaking away from one's alienating individuality by the objectifying effect of a symbolic system. The Freudian ideals of purity and neutrality, the Freudian method of self-formation, and the Freudian expert subject thus produced were historically and culturally determined and thus subject to variation.

Ernst Brücke's great-grandson paid a visit to Freud on 27 September 1932. Previously unknown documents relating to this visit, which Freud mentioned in his "Shortest Chronicle" ("Kürzeste Chronik"), provide evidence that this was Franz Theodor Brücke, 24 years old at the time. During the conversation, there was mention of the biography of Ernst Brücke, written in 1928 by his grandson, Ernst Theodor, the father of Franz Theodor Brücke, of which Freud had no knowledge. After he received a copy of the book, Freud quickly responded with a previously unknown letter to Franz Theodor Brücke, in which he emphasized Brücke's "capacity for love" and corrected details in the biography, including the cause of the blow to Brücke's nose. The relationship of Freud and Brücke will be described in a review of known sources and it will be shown that Brücke functioned to a great extent and into old age as an ego ideal for Freud. He also represented Freud's high standards, while Ernst Fleischl, who is mentioned twice in the letter by Freud, epitomizes the danger of failure.

Based on sources that have so far partly been neglected, this paper examines the accusations of plagiarism that Fliess levelled against Weininger, Swoboda and Freud in 1906, trying to determine to what degree they can or cannot be justified. In the case of Weininger it seems clear that his theory of bisexuality was stimulated by an indirect communication of Freud which harked back to a Fliessian idea. But there is no evidence that he had heard anything about the specific version of this theory in which Fliess felt plagiarized. In the case of Swoboda any reproach of plagiarism was out of place because he explicitly utilized ideas (about periodicity) which had already been published. He did, however, veil the extent of his dependence on Fliess, while Fliess ignored the originality of Swoboda's psychological (rather than biological) approach. The fact that Fliess set the two cases in parallel and related them both to an indiscretion of Freud, confirms the paranoid pattern of his accusations. The paper concludes that the episode is not suitable to use as evidence for a hostile paradigm of studies of Freud.