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Organ transplant patients who must undergo nontransplant surgical interventions can be challenging for the anesthesiologists in charge. On the one hand, it is important to carefully monitor the graft function in the perioperative period with respect to the occurrence of a possible rejection reaction. On the other hand, the ongoing immunosuppression may have to be adapted to the perioperative requirements in terms of the active substance and the route of administration, the resulting increased risk of infection and possible side effects (e.g., myelosuppression, nephrotoxicity and impairment of wound healing) must be included in the perioperative treatment concept. Furthermore, possible persistent comorbidities of the underlying disease and physiological peculiarities as a result of the organ transplantation must be taken into account. Support can be obtained from the expertise of the respective transplantation center., (© 2023. The Author(s).)

Background: Children diagnosed with cancer are at increased risk for the development of psychosocial problems. Currently, no qualitative and quantitative tests are available to measure their need for psychosocial follow-up care. The NPO-11 screening was developed to tackle this issue., Patients and Methods: 11 dichotomous items were generated to measure self- and parent-reported fear of progression, sadness, avolition, self-esteem problems, school and vocational problems, somatic complaints, emotional withdrawal, social disintegration, pseudo-maturity, parent-child conflicts, and parental conflicts. Data from N=101 parent-child dyads were obtained to validate the NPO-11., Results: Self- and parent-reported items showed few missing values and response frequencies without floor or ceiling effects. Inter-rater reliability was fair to moderate. Factor analysis confirmed a single-factor model and therefore an overall NPO-11 sum score. Self- and parent-reported sum scores had sufficient to good reliability and large correlations with health-related quality of life., Conclusion: The NPO-11 is a screening for psychosocial needs in pediatric follow-up care with good psychometric properties. It may help to plan diagnostics and interventions for patients transitioning from in-patient to out-patient treatment., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme. All rights reserved.)

Background: Although psychotherapy is an important pillar in the treatment of bipolar disorders, alongside pharmacotherapy, non-drug and complementary procedures, there is no up to date evidence synthesis for inpatient psychotherapeutic treatment and work with caregivers., Objective: To review and evaluate the current study situation on evidence-based inpatient psychotherapy for bipolar disorders., Material and Methods: 1.Summary of the evidence for inpatient psychotherapy in adolescents and adults with bipolar disorders from current review articles and guidelines (German S3 guidelines, Australian, Canadian, and British NICE guidelines). 2. Systematic literature search (PRISMA) in Cochrane trials and Medline (via PubMed). 2a. Identification of original articles using the following search term: "bipolar fft" OR "bipolar ipsrt" OR "bipolar cbt" OR "bipolar cognitive remediation" OR "bipolar psychotherapy inpatient". 2b. Screening of n = 942 publications on the following inclusion criteria: randomized controlled efficacy trials, inpatient treatment/recruitment in the inpatient setting, adolescent or adult patients with bipolar disorder or caregivers., Results: The guidelines recommend a combination of pharmacotherapy and psychotherapy for the treatment of patients with bipolar disorders (so far no evidence-based presentation of inpatient psychotherapy). The results from reviews and original papers are heterogeneous. Recently described evidence-based psychotherapeutic approaches for inpatient treatment are family focused therapy (FFT), interpersonal and social rhythm therapy (IPSRT) and psychoeducation., Conclusion: Although the current evidence is heterogeneous and further systematic studies are necessary, the results indicate that psychotherapy should be started or initiated in the inpatient setting with inclusion of caregivers., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Tyrol, a province of Austria with about 760,000 inhabitants, was one of the first regions in Europe, along with northern Italy, to be affected by the pandemic spread of the coronavirus in spring 2020. A lockdown with far-reaching restrictions in all areas of life occurred from 16 March 2020. Restrictions were imposed in the areas of gastronomy, trade and free mobility as well as in recreational sports. The ski resorts were closed and due to the strong winter tourism in Tyrol, this meant that about 340,000 people left the region. In the province of Tyrol comprehensive emergency medical care is provided by 13 ground-based emergency medical systems (NEF) in combination with air rescue (16 emergency medical helicopters, some of which are seasonal). Normally, this system provides emergency medical care for approx. 1 million people; however, in spring 2020 during the first lockdown, the number of people to be cared for was approx. 30% less. In order to protect the emergency medical teams as best as possible from infections and thus the system from failures, the Integrated Control Center Tyrol (Landesleitstelle Tirol GmbH) adapted the release order for emergency medical resources. The aim of the study is to describe the influence of the pandemic in spring 2020 on the emergency medical services in Tyrol in comparison to the three preceding years., Methods: A retrospective survey of all emergency helicopter missions and ground-based emergency physician missions in Tyrol in the period 15 March 2020-15 May 2020, as well as in the same period of the previous years 2017-2019, was conducted. Detailed figures on medical procedures and patient-related data were collected from 6 ÖAMTC helicopter bases. In addition, all ground-based emergency physician missions from all 13 physician systems including appeal mission diagnoses were collected in the same period., Results: The total number of emergency helicopter missions and ground-based emergency physician missions showed a significant decrease during the observational period (67.3% and 39.8%, respectively). In the area of ground-based emergency medical resources, there was a significant increase in respiratory and CNS diseases during the observational period. The range of emergency helicopter missions showed a significant shift from sports and leisure missions to internal medicine and neurological emergencies and the duration of missions was significantly longer. The NACA score was higher with a significant decrease in NACA 3 scores in favor of NACA 4 and 5. The circulatory status of patients during the observational period was significantly more often documented as unstable. Hypertension, impending shock and circulatory arrest occurred more frequently in the trend. Cardiac massage, oxygen administration, circulatory drugs and specific monitoring were used more frequently in 2020. Analgesics were administered less frequently. In air rescue, there was no infection of rescue workers in the field., Conclusion: The first pandemic wave in Tyrol and the consecutive lockdown from 16 March 2020 had a massive impact on emergency medical care in Tyrol, both quantitatively and in terms of the spectrum of operations and emergency medical interventions. The decline in patient numbers was highly relevant, especially in air rescue and can be explained in part by the discontinuation of tourism, the general exit restrictions and the restrictive disengagement order. This decline primarily affected patients in the NACA 3 category and the analgesic administration measure. The patients treated had a higher NACA score and the emergency procedures were more extensive during the observational period. The measures to protect the emergency helicopter team from infections were presumably successful as no infections occurred., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Evaluation of a Manualized Group Program for Siblings of Children with Diseases or Disabilities This study evaluates a manualized group program for siblings of children with life-threatening/life-limiting diseases or disabilities. The program aims to activate resources and to reduce emotional and behavioral problems, using cognitive-behavioral methods and experience-based interventions. In this multi-center study, 13 GeschwisterTREFFs were conducted by 11 study sites in Germany. Prior to and after the intervention 97 siblings aged 7 to 14 years and their parents were examined with standardized questionnaires. At baseline, the siblings of children with diseases or disabilities showed significant more emotional and behavioral problems compared to the respective norm samples. After the intervention, the siblings reported declined problem behavior scores that were mostly in the range of the particular norm values. Furthermore, the children indicated a significant improvement of self-esteem, self-efficacy, school competences and relations to their siblings. However, parents reported more problem behavior and less health-related quality of life of their children at both assessments. The present multi-center study showed the interventions' feasibility in different settings and confirmed expected improvements of target variables during the intervention period. Randomized-controlled trails are warranted to verify our results.

Objective: To examine the association of maternal social phobia with maternal bonding and infant attachment in a prospective-longitudinal study (MARI study, N = 306)., Method: A subsample of 46 women with and without lifetime social phobia (Composite International Diagnostic Interview for Women, CIDI-V) and their infants was investigated. Mothers reported antenatal and postnatal bonding (MAAS, MPAS). Infants’ attachment classifications/behavior were observed in the strange situation test at 16 months after delivery., Results: The rate of insecure attachment was higher in infants of mothers with social phobia (45.4 % vs. 33.3 %), and infants needed significantly more time to reconnect with their mothers during reunion in the strange situation (U = 160.0, p = .019). There were no group differences with regard to maternal bonding during pregnancy (t = -.151, p = .881) and after delivery (t = .408, p = .685) and resistant (U = 262.5, p = .969), avoidant (U = 311.5, p = .258) as well as contact-keeping behaviors (U = 224.0, p = .373) of the infant in the strange situation., Conclusions: Mothers with social phobia may transmit their inhibited behavioral disposition to their infants or fail to encourage their infants to interact with other people. Mothers with social phobia should be informed about the possible link of maternal avoidance behavior with adverse infant development and should be provided with information on treatment options.

Epidemiological studies indicate sex-specific differences in prevalence rates and the natural course of mental disorders. Affective, anxiety, somatoform and eating disorders are more prevalent in women than men, whereas substance use disorders occur more commonly in men, and some disorders are equally distributed in both sexes (e. g. psychotic disorders). The aim of this review is to depict the natural course of mental disorders during the reproductive stages (premenstrual phases, peripartum period, perimenopause) in women, including also neuroendocrine features associated with the menstrual cycle, pregnancy, puerperium and perimenopause. Recommendations for sex-specific diagnostic and therapeutic procedures are provided., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Fear of Progression (FoP), the fear of further disease progression, is one of the most common psychological strains of chronically ill patients and can also be found in healthy partners of cancer patients. Parents of children with cancer are also at risk of developing distinct fears that may persist after medical treatment. This study aimed to assess FoP in parents of children with cancer and to investigate relationships between FoP in parents of children with cancer and disease- and treatment-related issues, the child's current medical condition and parents' quality of life., Patients: In this study 76 parents (51 mothers, 25 fathers) whose children were in inpatient treatment or follow-up care were surveyed., Method: The short form of the FoP Questionnaire was adapted by rephrasing the items for the parental perspective (FoP-Q-SF/PR)., Results: The FoP-Q-SF/PR is a short questionnaire with adequate psychometric properties (e. g. Cronbach's α=0.90) and satisfying results in terms of construct validity. Significant correlations with FoP are found for the child's current medical condition (r=0.35), time since diagnosis (r=- 0.30), parents' capacity to cope with disease-related fears (r=- 0.45) and parents' quality of life (r=- 0.55). A cut-off value of 46 points is recommended., Conclusion: The FoP-Q-SF/PR offers a feasible and sensitive battery to assess disease-related fears. For clinicians, evaluation of individual results can provide insight into specific problem areas for parents of children with cancer. The questionnaire is thus well suited for use in psychosocial care of families within the field of paediatric oncology., (© Georg Thieme Verlag KG Stuttgart · New York.)