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Two forms of an acidic bromelain proteinase isolated from crude bromelain, an extract from pineapple stem, were found by a two-step FPLC purification procedure. The basic main components were removed by cation exchange chromatography and the breakthrough fraction was further resolved by anion exchange chromatography into 15 protein fractions, only two of which, called SBA/a and SBA/b, were proteolytically active. These components were characterized by electrospray mass spectroscopy (ESMS), isoelectric focusing, N-terminal amino acid sequence analysis, monosaccharide analysis, and enzymatic parameters. The molecular masses of SBA/a and SBA/b were determined by ESMS to be 23,550 and 23,560, respectively. The isoelectric points (pI) of the two bands of SBA/a were 4.8 and 4.9; SBA/b focused as a single band at pI = 4.8. Partial N-terminal amino acid sequences (11 residues) were identical to SBA/a and SBA/b and identical with those of stem bromelain, the basic main proteinase of the pineapple stem, and fruit bromelain, the acidic main proteinase of the pineapple fruit. Both components are highly glycosylated; hydrolysis of SBA/a yielded about twofold more monosaccharide per protein than SBA/b. The comparison of the catalytic properties of SBA/a with those of SBA/b revealed no relevant differences in the hydrolysis of three peptidyl-NH-Mec substrates and in the inhibition profiles using chicken cystatin and E-64, indicating that these components can be considered as two forms of a single enzyme. Both forms are scarcely inhibited by chicken cystatin and slowly inactivated by E-64, hence are nontypical cysteine proteinases of the papain superfamily.

Background: This study was carried out to assess the situation of and the demand for specific training in transcultural psychiatry as part of the residency program in Germany. Method: A semistructured questionnaire with 30 questions (28 structured, 2 open) was developed, for which the "Local Survey of Realities in Transcultural Psychiatry" of the World Psychiatric Association (APA) served as a model and was modified accordingly. This questionnaire was sent out to all directors of psychiatric training institutions in Germany (N = 450). The directors of official psychiatric training institutions are authorized for residency training by the state medical associations. The responses were not anonymous. Results: The return rate was 25.5% (N = 114). In 71.7% of the training institutions (81 out of 113 valid cases), specific training in transcultural psychiatry occurred only rarely or not at all. 83.3% of the directors of psychiatric training institutions (70 out of 84 valid cases) reported a demand for training in transcultural psychiatry in their training institutions; in 94.5% of the cases, the directors of psychiatric training institutions (69 out of 73 valid cases) reported a need for transcultural issues as part of the official curriculum of the psychiatric residency program in Germany. The most frequently reported aspects were teaching of general cultural competence and of culture-specific issues in mental disorders. Implications: Cultural aspects currently are not a mandatory part of the official training curriculum of the psychiatric residency training in Germany. With respect to the reported need for training in cultural issues of mental disorders, the implementation of transcultural psychiatry within the official curriculum of the psychiatric residency training in Germany should be discussed. Zielsetzung: Ziel der vorliegenden Studie ist die Erhebung des Status quo der Weiterbildungssituation in transkultureller Psychiatrie für den Facharzt in Psychiatrie und Psychotherapie in Deutschland. Methodik: Es wurde ein semistrukturierter Fragebogen mit 30 Fragen (davon 28 strukturiert, 2 mit Freitextangaben) entwickelt, der sich an den "Local Survey of Realities in Transcultural Psychiatry" der World Psychiatric Association (APA) anlehnt und für Deutschland modifiziert wurde. Dieser wurde an die Leiter aller psychiatrischen Weiterbildungsinstitutionen in Deutschland verschickt (n=450). Als psychiatrische Weiterbildungsinstitutionen wurden diejenigen klinischen Einrichtungen definiert, deren Leiter über eine Ermächtigung zur Facharztweiterbildung durch die Landesärztekammern verfügen. Der Rücklauf erfolgte nicht anonymisiert. Ergebnisse: Die Rücklaufquote betrug 25,5% (Gesamt-N=114). In 71,7% der Weiterbildungsinstitutionen (n=81/113 gültige Fälle) wurden in der klinikinternen Weiterbildung Themen aus dem Gebiet der transkulturellen Psychiatrie selten oder gar nicht angesprochen. 83,3% der Weiterbildungsleiter (n=70/84 gültige Fälle) formulierten Bedarf an Weiterbildung in transkultureller Psychiatrie für die jeweils eigene Institution, 94,5% (n=69/73 gültige Fälle) sahen den Bedarf grundsätzlich auch für das Curriculum der Facharztausbildung in Psychiatrie und Psychotherapie. Die am häufigsten genannten Themen betrafen eine allgemeine Schulung kultureller Kompetenz sowie kulturspezifische Aspekte seelischer Erkrankungen. Schlussfolgerungen: Im Rahmen der Weiterbildungsordnung zum Facharzt für Psychiatrie und Psychotherapie sind aktuell in keinem Bundesland entsprechende Inhalte aus dem Bereich der transkulturellen Psychiatrie verankert. Angesichts des formulierten Bedarfs muss die Implementierung eines entsprechenden Curriculums in die Weiterbildungsordnung zum Facharzt für Psychiatrie und Psychotherapie diskutiert werden.

Von 1998 bis 2001 führten das "Zentrum für Angewandte Gesundheitswis-senschaften" der Universität Lüneburg, die Psychiatrische Klinik Häcklingen in Lüneburg und die Abteilung Sozialpsychiatrie und Psychotherapie der Me-dizinischen Hochschule Hannover ein Forschungsprojekt durch, das sich mit der Verbreitung psychischer Störungen in den vollstationären Einrichtungen der Altenpflege im Landkreis Uelzen und verschiedenen Aspekte der Versor-gung der dort lebenden psychisch gestörten BewohnerInnen befasste. Dabei wurde eine Vollerhebung der Altenheimbewohnerschaft mithilfe eines stan-dardisierten Fragebogens durchgeführt. Es wurden demografische Merkma-le, Pflegebedürftigkeit und psychische Störungen sowie vor allem verschie-dene Aspekte der Betreuung und Pflege (im Hinblick auf psychische Störun-gen) erhoben. Von allen ca. 1100 BewohnerInnen konnten 925 erfasst wer-den. Die Ergebnisse zeigen, dass etwa ß der Bewohnerschaft ausgeprägte Anzeichen für verschiedenartige psychische Störungen aufweisen; knapp die Hälfte weist eine demenzielle Symptomatik auf. Die Versorgung, sowohl in der Pflege als auch in der Behandlung - Medikation und nichtmedikamentö-se therapeutische Maßnahmen -, weist deutliche Defizite auf. Eine an thera-peutischen Standards und bisherigen Leitlinien orientierte Versorgung ist kaum erkennbar; dies gilt insbesondere für die psychopharmakologische Therapie. Mit Ausnahme von einer Reihe von Modellprojekten (vor allem zur Versorgung Demenzkranker) dürften sich die hier gefundenen Verhältnisse von anderen Regionen der Bundesrepublik nicht wesentlich unterscheiden. From 1999 to 2001 the “Centre of Applied Health Sciences” (University of Lüneburg) carried out a research project in cooperation with the Psychiatric Hospital Häcklingen in Lüneburg and the department of social psychiatry and psychotherapy of the Hanover College of Medicine. The project covered the prevalence of mental disorders among the residents of nursing and geriatric homes in the district of Uelzen including different aspects of medical, psychiatric and nursing care. The research was based on a survey including all residents of these institutions. The response rate was 925 of a total of 1,100 residents. Results showed that three-quarters of the residents had considerable and different psychiatric symptoms and that almost half of the residents suffered from symptoms of dementia. The provision of health care as well as nursing care for these residents are considerably deficient. Care facilities are hardly of therapeutical standard and guidelines. This refers in particular to treatment with psychoactive drugs. The (few) comparable studies show that - with the exception of some pilot projects - the situation in the district of Uelzen may be similar to that in other regions of Germany.

Aim: To evaluate the effectiveness of the German model of community psychiatry at the Medical University of Hanover. Patients and Methods: Three hundred and thirteen (313) patients treated over a period of ten years (1987-1996) at the Social Psychiatry Department of the University of Hanover were anonymously grouped on basis of their score on a Psychosocial Risk Score (PSR). Those admitted to the study were between 18 and 60 and excluded addictions and psycho-organic disorders. Results: There was a highly significant correlation between psychosocial risks (indicators of the chronicity and severity of psychiatric disorder, the psychiatric first diagnosis, the age of onset of disease and duration since onset of disease) at the first therapeutic contact and future Long Stay Hospitalization (LSH). The highest coefficient was found for the criterion of the situation of employment, followed by primary income living situation, duration since onset of disease, type of initial diagnosis and age at onset of disease. Conclusion: The simple sum core (PRS) allows calculating the risk of LSH on the basis of a small number of characteristics drawn from usually registered psychiatric base data and can help psychiatric services to concentrate on high risk patients. Key Words: Community Psychiatry, German Model, Effectiveness. Journal of College of Medicine 2005: 9(2): 85-88