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Copyright of Ergotherapie & Rehabilitation is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ergotherapie & Rehabilitation is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effects of mental diseases on the employment and working situation can be substantial. They are one of the main reasons for inability to work and reduced earning capacity. Against this background the question arises about suitable occupational reintegration measures for people with severe mental illnesses. In recent years, the principle of supported employment has been internationally shown to be increasingly more successful. In this context mentally ill people are primarily placed at a position of the first employment market and supported on-site by a job coach. This concept is inclusive, individual and evidence based. Despite proven effectiveness, it has so far been insufficiently implemented in German-speaking regions. In the future it will be a matter of considering the individual needs for assistance of mentally ill people more intensively than previously and to respond with functional and in a best-case scenario, multiprofessional and flexible offers., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

This paper sketches a new approach using Fuzzy Cognitive Maps (FCMs) to operably map and simulate digital transformation in architecture and urban planning. Today these processes are poorly understood. Many current studies on digital transformation are only treating questions of economic efficiency. Sustainability and social impact only play a minor role. Decisive definitions, concepts and terms stay unclear. Therefore this paper develops an open experimental testbed for sustainable and innovative environments (ETSIE) for three different digital transformation scenarios using FCMs. A traditional growth-oriented scenario, a COVID-19 scenario and an innovative and sustainable COVID-19 scenario are modeled and tested. All three scenarios have the same number of components, connections and the same driver components. Only the initial state vectors are different and the internal correlations are weighted differently. This allows for comparing all three scenarios on an equal basis. The Mental Modeler software is used. This paper presents one of the first applications of FCMs in the context of digital transformation. It is shown that the traditional growth-oriented scenario is structurally very similar to the current COVID-19 scenario. The current pandemic is able to accelerate digital transformation to a certain extent. But the pandemic does not guarantee for a distinct sustainable and innovative future development. Only by changing the initial state vectors and the weights of the connections an innovative and sustainable turnaround in a third scenario becomes possible., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Höhl W.)

Purpose of Review: Life expectancy of people with severe mental illness is considerably shortened and their risk for cardiovascular and metabolic disorders is increased. They spend more time in solitary and less time in structured activities than the general population.Engagement in healthy patterns of activity, including active, meaningful participation in the community can, therefore, be critical to recovery from severe mental illness. Occupational therapy is a profession that focuses on time use, activity patterns and occupational engagement, and the links to health and well-being. In this study, we review research evidence regarding approaches to occupational engagement, including behavioural activation, time use, and activity promotion. We also will review studies that specifically evaluate the impact of occupational therapy interventions., Recent Findings: There is a growing body of evidence regarding the value of interventions addressing occupational engagement of individuals with severe mental illness, including a range of activation strategies and approaches. There is a need, however, for documentation of theoretically informed approaches that are supported by fidelity measures to ensure standardization., Summary: Larger-scale studies are needed, including consistent outcome measures to document engagement and changes in activity patterns as well as health-related outcomes. High-quality randomized clinical trials are important to establish effectiveness. As occupational therapy interventions are complex and embedded within a range of multidisciplinary approaches, new models of pragmatic trials within the naturalistic context of psychiatric rehabilitation are also needed.

Objective: Unemployment rates are high in people with schizophrenia, so that considerable importance is attached to measures to improve their ability to work and their vocational integration., Methods: In a study of the German Research Network on Schizophrenia the long-term effects of four-week vocational and ergotherapeutic measures on in-patients were investigated. The target criteria were the vocational integration, level of general functioning (Global Assessment of Functioning Scale) and psychopathology (Positive and Negative Syndrome Scale). 227 patients were randomized and assigned either to a work-oriented vocational therapy group, or to a creativity-oriented ergotherapy group; 163 patients completed the study. Data was available for 89 patients at the last catamnesis point after two years., Results: No differences were seen between the effects of the two forms of therapy on the development of vocational integration or on general functioning level and psychopathology after two years. The number of patients in regular work declined over this period., Conclusions: It is assumed from this that short-lasting vocational and ergotherapeutic measures do not have any long-term influence on the vocational integration of patients with schizophrenia.

Objectives: In a previous study the effectiveness of vocational therapy was evaluated using the Osnabrück Profile of Working Abilities (O-AFP). No or only minor effects were detected. The goal of this reanalysis is to identify distinct responder groups., Methods: Hierarchical cluster analysis of O-AFP-scores before and after treatment, anovas, t-statistics as well as regression and discriminant analyses were applied to specify the clusters., Results: For each of the O-AFP-scales (Learning Ability, Social Communication Ability, Adaptation) three subgroups different in level and slope of abilities could be identified. Improvements with medium to high effect sizes were detected for Social Communication Ability (34 %) and Learning Ability (14 % of the patients), deterioration was found in 30 % of the patients for Adaptation. Subgroups could be described with the help of symptomatology. Further variables and subgroup membership could be predicted above chance by discriminant and regression analysis., Conclusion: Targeted and more appropriate design of vocational therapy seems necessary.

For some decades, vocational therapy approaches have been an integral part of inpatient psychiatric treatment of patients with schizophrenia. Like most sociotherapeutic measures, they are largely hypothesis-based. So far, their effectiveness has been subjected to very little scientific scrutiny. The results of a multicenter study in which five vocational therapy models were compared with creativity-oriented ergotherapy in a prospective, randomized control group design are presented. Target criteria were job-relevant skills, psychopathology, general level of functioning, quality of life, self-efficacy, and speed of cognitive performance. 227 patients were enrolled in the study, which was carried out within the framework of the German Research Network on Schizophrenia funded by the German Federal Ministry for Education and Research (BMBF). Multicenter analyses in a pre-post comparison revealed only minimum differences between the experimental and the control group over a four-week intervention period. Job-oriented approaches cannot currently be assumed to be superior to creativity-oriented ergotherapy.

NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase catalyzes the first step in the metabolism of prostaglandins which is usually associated with physiological inactivation. A highly purified homogenous enzyme preparation from human placenta was used to determine the molecular mass and lack of quaternary structure of the enzyme. Furthermore we have examined enzyme kinetics of the purified enzyme with (5Z,8E,10E,12S)-12-hydroxy-5,8,10-heptadecatrienoic acid (HHT) an equimolar coproduct of thromboxane biosynthesis. Using gel electrophoresis and gel filtration on FPLC, we could estimate a molecular mass of 28 +/- 1 kDa, indicating that the enzyme consists of one single protein chain. The exact molecular mass of the monomer was calculated by matrix-assisted laser desorption/ionization mass spectrometry to 28740 +/- 30 Da. (5Z,8E,10E)-12-oxo-5,8,10-heptadecatrienoic acid (oxo-HT) could be identified as the only product obtained from the enzymatic reaction with HHT. Quantification of this metabolite was achieved by gas chromatography/tandem mass spectrometry. The calculated enzyme kinetic constants for the formation of the metabolic product [Km (HHT) = 9.68 microM, Vi = 12.78 mU/micrograms] were in agreement with those determined for NADH formation (Km = 7.65 microM, Vi = 11.79 mU/micrograms). This demonstrates that HHT shows high affinity to the enzyme which is comparable to prostaglandin E2 (PGE2). As the product oxo-HT is a potent inhibitor of platelet aggregation, dehydrogenation of HHT might represent a biological activation step.