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Mental illnesses are among the most common diseases worldwide. Cases of inability to work caused by mental illness are frequent and the related economic burden is immense. A successful reintegration into their work environment of those patients who were on sick leave due to a mental illness is an important prognostic factor for the further course of the disease and helps reducing financial consequences. It was the aim of the present review to give an overview of the status quo of return-to-work interventions in the international literature.Main themes of interventions addressing return to work of persons with mental illnesses are the provision of psychotherapeutic support with or without combining these approaches with work directed interventions. Personal contact of employees, mental healthcare staff and supervisors may be helpful with regard to facilitating return to work.Current return to work interventions are mostly elaborate, extensive and expensive without convincing results regarding work related outcome parameters. A variety of reasons might be responsible for this finding, including heterogeneity of outcomes, a poor definition of return-to-work-interventions and the complexity of the issue (involving multiple stakeholders).

Zusammenfassung Ziel der Studie Erwerbstätige mit einer psychischen Erkrankung haben nach einer psychischen Krise oft massive Schwierigkeiten, ihre Arbeit wiederaufzunehmen. Im Mittelpunkt der Studie steht die Frage, wie Menschen den Übergang zwischen akutpsychiatrischer Klinik und Arbeitsplatz erleben. Methodik Der Studie liegt ein qualitatives Forschungsdesign (Grounded Theory) zugrunde. Zehn narrative Interviews mit erkrankten Arbeitnehmern sowie vier Gruppeninterviews mit professionellen „Rückkehr-Begleitern“ (Return-to-Work-Experten) wurden geführt. Ergebnisse Die vorliegende Analyse zeigt, dass das Zusammenspiel der beteiligten Akteure von enormer Bedeutung ist. Wesentlich ist, wie die Beteiligten den Rückkehrprozess deuten und welche Handlungsaufforderungen infolge dessen an die Beteiligten adressiert werden. Schlussfolgerungen Ein arbeitsplatzbezogenes Entlassmanagement sollte Unterstützungsangebote vorhalten, die an den Erwartungshaltungen der Beteiligten ansetzen und einen gemeinschaftlichen Deutungsprozess fördern bzw. in Gang setzen.

Zusammenfassung Hintergrund Psychische Erkrankungen sind inzwischen die zweithäufigste Ursache für Krankschreibungen und die häufigste Ursache für krankheitsbedingte Verrentungen. Um Jobverluste zu vermeiden sind besondere Interventionen zur Rückkehr an den Arbeitsplatz erforderlich. Ein erfolgreicher Rückkehrprozess kann eine erneute Krankschreibung sowie Erwerbsunfähigkeit verhindern. Zudem kann eine gelingende Rückkehr in den Berufsalltag positiv auf den Genesungsprozess zurückwirken. Internationale Erfahrungen zeigen, dass Return-to-Work-Programme eine wirksame Handlungsoption sind, um Patienten nach längerer Erkrankung nachhaltig wieder ins Arbeitsleben zurückzuführen. Return-to-Work-Programme bilden hinreichende Unterstützungsangebote, um mangelnde Ressourcen (z. B. fehlende Wertschätzung) und Belastungen (z. B. zu hohes Arbeitsvolumen) zu bewältigen. Methode Für die Studie RETURN wurde ein Return-to-Work Konzept für stationär-psychiatrisch behandelte Patienten entwickelt. Ergebnisse Die Intervention besteht aus dem Einsatz von Return-to-Work- Experten, die auf Basis eines Handbuches arbeiten. In klar definierten Modulen werden mit den Patienten während des stationären Aufenthaltes u. a. sozialrechtliche Grundlagen und Einzelheiten des Rückkehrprozesses besprochen sowie schwierige Situationen (z. B. Umgang mit der Offenlegung der Diagnose, Rückkehrgespräch) vorbereitet. Nach Entlassung erfolgt die Weiterbetreuung v. a. im Hinblick auf Erfahrungen am ersten Arbeitstag, Begleitung zu Gesprächen des BEM (Betriebliches Eingliederungsmanagement) und Unterstützung bei etwaigen Schwierigkeiten. Schlussfolgerung Die Ergebnisse der noch laufenden Studie werden zeigen, ob der gewählte methodische Ansatz zu einer Verbesserung der Rückkehr an den Arbeitsplatz führt.

Introduction Suicide notes are not only the last personal message from the suicide victim to the bereaved, but are also a valuable source for research in preventing suicides. However, not all suicide victims leave a suicide note and it is unclear whether note leavers are representative of the general population of suicide victims. Methods The aim of our study was to compare suicide victims who leave a suicide note compared to those who do not. Therefore, data from the Allgau Suicide Study, which comprised detailed information on N = 626 suicides, were analysed using multiple regression analyses. Results Of N = 612 cases with complete data, n = 255(42%) left a suicide note and n = 357 (58%) did not. Persons who wrote suicide notes before they killed themselves were more often female, less often married, found themselves more often in a financial or partnership crisis, and were more likely to suffer from a medical illness. They tended to poison themselves more often and were less likely to have a history of alcohol abuse disorder. Conclusion Suicide notes are one source to better understand the motives, which lie behind suicides and therefore may help to further develop and improve suicide prevention programs. Keeping in mind that suicide has heterogeneous reasons, the group of “note writers” might be one, which might especially have benefitted from psychosocial and psychotherapeutic interventions, as interpersonal relationships obviously played an important role even shortly before suicide.

Background: In recent years it could be shown that psychosocial working conditions and mental health of employees are closely correlated. One well-established instrument to measure psychosocial stress at work is the COPSOQ (Copenhagen Psychosocial Questionnaire, German Standard Version). It is an 84 item self-rating instrument addressing several domains of psychosocial working conditions and is generally used for risk assessments in companies. Aims: To examine associations between COPSOQ ratings with clinical features and symptoms of employees who currently suffer from an episode of a mental illness requiring inpatient treatment. Method: For 265 inpatients with mental disorders who participated in a cluster randomized trial (RETURN-study) COPSOQ-data were available as part of the baseline data acquisition. These data were compared with the German COPSOQ validation sample of the Freiburg research center for occupational sciences (FFAW; approximately 250,000 participants). For subdomains of the COPSOQ that showed major and significant differences between the two samples regression analyses were done to predict COPSOQ scores within the RETURN-sample. Results: Psychiatric inpatients did not assess their working conditions significantly different compared to the population based FFAW sample. However, with regard to the effects of working conditions (general health, burnout, presenteeism, and intention to leave the job) there were major differences between the two samples with the clinical sample expressing more negative views. In the RETURN sample these were predicted by a greater expression of depressive symptoms. Conclusions: The linkage between work and mental wellbeing is complex. Mental illness is not necessarily a result of poor working conditions, while good working conditions may not in every case prevent symptoms of bad health, even if such associations exist.

Patients with mental illnesses often face difficulties when returning to workplace after an episode of inpatient treatment. Available resources intended to support the return-to-work process are often not used. It was the aim of the present study to develop an intervention that facilitates the implementation of patient support at the interface of in- and outpatient care.We used a structured development process for the establishment of a return-to-work intervention for psychiatric inpatients.The intervention consisted of the use of return-to-work experts who worked on the basis of a manual. In clearly defined modules, patients were given information on social law basics and details of the return process. Difficult situations (e. g., dealing with the disclosure of the diagnosis, return interview) were discussed and rehearsed. After discharge, further care took place, above all with regard to experiences on the first working day, accompaniment to discussions with the employer and support with any other upcoming difficulties.The results of the ongoing study will show whether the chosen approach actually yields the expected results, namely an improvement of the return-to-work process.Psychische Erkrankungen sind inzwischen die zweithäufigste Ursache für Krankschreibungen und die häufigste Ursache für krankheitsbedingte Verrentungen. Um Jobverluste zu vermeiden sind besondere Interventionen zur Rückkehr an den Arbeitsplatz erforderlich. Ein erfolgreicher Rückkehrprozess kann eine erneute Krankschreibung sowie Erwerbsunfähigkeit verhindern. Zudem kann eine gelingende Rückkehr in den Berufsalltag positiv auf den Genesungsprozess zurückwirken. Internationale Erfahrungen zeigen, dass Return-to-Work-Programme eine wirksame Handlungsoption sind, um Patienten nach längerer Erkrankung nachhaltig wieder ins Arbeitsleben zurückzuführen. Return-to-Work-Programme bilden hinreichende Unterstützungsangebote, um mangelnde Ressourcen (z. B. fehlende Wertschätzung) und Belastungen (z. B. zu hohes Arbeitsvolumen) zu bewältigen.Für die Studie RETURN wurde ein Return-to-Work Konzept für stationär-psychiatrisch behandelte Patienten entwickelt.Die Intervention besteht aus dem Einsatz von Return-to-Work- Experten, die auf Basis eines Handbuches arbeiten. In klar definierten Modulen werden mit den Patienten während des stationären Aufenthaltes u. a. sozialrechtliche Grundlagen und Einzelheiten des Rückkehrprozesses besprochen sowie schwierige Situationen (z. B. Umgang mit der Offenlegung der Diagnose, Rückkehrgespräch) vorbereitet. Nach Entlassung erfolgt die Weiterbetreuung v. a. im Hinblick auf Erfahrungen am ersten Arbeitstag, Begleitung zu Gesprächen des BEM (Betriebliches Eingliederungsmanagement) und Unterstützung bei etwaigen Schwierigkeiten.Die Ergebnisse der noch laufenden Studie werden zeigen, ob der gewählte methodische Ansatz zu einer Verbesserung der Rückkehr an den Arbeitsplatz führt.

People with mental illness must often decide the extent to which they want to disclose their mental illness publicly. Especially in the context of work, this is a complex and individual decision. This Open Forum discusses the importance of well-reasoned disclosure management to increase the chances of successful workplace reintegration after a leave of absence due to a mental illness. The authors posit that despite the risks of stigma and discrimination, disclosing a mental illness to an employer can benefit employees. However, proper support is often essential in establishing how to best manage disclosure or nondisclosure.

Social interactions are a crucial part of human life. Understanding the neural underpinnings of social interactions is a challenging task that the hyperscanning method is trying to tackle in the last two decades. Here, we review the existing literature and evaluate the current state of the hyperscanning method. We review the type of methods (fMRI, M/EEG, fNIRS) that are used to measure brain activity from more than one participant simultaneously and their pros and cons for hyperscanning. Further, we discuss different types of analyses that are used to estimate between brain networks and synchronization. Lastly, we present results of hypercanning studies in the context of different cognitive functions and their relations to social interactions. All in all, we aim to comprehensively present methods, analyses, and results of the last twenty years of hyperscanning research.

Supplying modern water systems in smart cities requires the ability to monitor water quality in the production plants and the distribution network. Protection against accidental or intentional events is usually based on an Early Warning Detection System (EWDS) to minimize the impact of any contamination [1]. A major issue is positioning online sensors along the water distribution network to ensure the best protection at minimum cost. Several contributions for tackling such problem have been proposed during the last decade, including a scientific challenge comparing 14 methodologies [2] and two reviews of about 150 articles [3,4]. Currently there is no consensus about algorithms or design objectives to use, and such a problem is NP-hard [5,6]. In this paper, a greedy approach is proposed to near-optimally solve the sensor placement problem dealing with large-scale water systems. This methodology is designed to integrate both the specificity of the studied network (expert/prior knowledge) and flexibility related to the uncertainty of the nature, time, and duration of contamination injections. The method is illustrated to minimize the expected fraction of the exposed population on the largest network in France (about 100,000 nodes, 600,000 connections, above 8,000 km of pipes). Costly approaches in terms of computation time, such as MIP (Mixed-Integer Programming) and exhaustive search cannot scale to large networks. A sensitivity analysis is presented using the greedy approach on a sub-network which leads to choose the number of sufficient contamination simulations and the concentration threshold used to detect contaminations. The extensive experiments allow us to highlight the effectiveness and the rapidity of the proposed approach.

The use of mobile phone applications (mHealth) to provide health education and behavioral prompts is 1 of the 12 common mHealth functions identified by the World Health Organization as innovations to strengthen health systems. Among low-income pregnant and parenting women, health education is widely recognized as a way to improve maternal and infant health outcomes, but the efficacy of written health education materials to change knowledge and behavior for this population is questionable. mHealth prompts, in contrast, is a promising alternative.A team of researchers in medicine/epidemiology, anthropology/midwifery, computer science/sensors, and community-based case management created and pilot tested a mHealth application (mHealth app) for African-American women at high risk for adverse birth outcomes. We tested the acceptability and feasibility of the interactive application among women during the reproductive stages of early and late pregnancy, postpartum, and interconception.Interview data from 14 women in the various reproductive stages revealed that most women found the mHealth messages helpful. Also, 62 Ob-Gyn physicians and nurses and 19 Family Medicine residents provided feedback. Women's responses to specific messages trended down over time. Women in the postpartum phase had the highest response rate to particular text messages, followed by those in the pregnancy phase. Responses dropped off dramatically during the interconception period. About 21% of women lost their phones. Unexpected findings were that all participants already had smartphones, women wanted messages about depression, and clinicians wanted the app to link to case management for individualized medical care.Logistical challenges to app management were limitations but are useful for consideration before scale-up. This study corroborates findings in the health literacy literature that women most at risk for adverse birth outcomes need additional face-to-face support with mHealth applications.

OBJECTIVE To estimate the risk for stillbirth among three generally accepted obesity subtypes based on severity. METHODS We used the Missouri maternally linked cohort data containing births from 1978 to 1997. Using prepregnancy weight and height, mothers were classified on the basis of calculated body mass index (BMI) above 30 into three subsets: class I (30-34.9), class II (35-39.9), and extreme obesity (greater than or equal to 40). Using normal-weight, white women (18.5-24.9) as a reference, we applied Cox proportional hazard regression models to estimate risks for stillbirth. RESULTS The prevalence of obesity in pregnant women was 9.5% (12.8% among blacks and 8.9% among whites). Overall, obese mothers were about 40% more likely to experience stillbirth compared with nonobese gravidas (adjusted hazard ratio 1.4; 95% confidence interval [CI] 1.3-1.5). The risk for stillbirth increased in a dose-dependent fashion with increase in BMI: class I (adjusted hazard ratio 1.3; 95% CI 1.2-1.4); class II (adjusted hazard ratio 1.4; 95% CI 1.3-1.6) and extreme obesity (adjusted hazard ratio 1.9; 95% CI 1.6-2.1; P for trend

Die Entstehung der Kulturwissenschaften hat das Feld der Geistes- und Sozialwissenschaften in den letzten Jahren gehörig in Bewegung gebracht. Neue transdisziplinäre und zunehmend auch transkulturelle Wissensordnungen bilden sich heraus, eine Vielzahl neuer Studiengänge wurde ins Leben gerufen. Doch was ist eigentlich der Kern der »Kulturwissenschaften«? Mit diesem Nachschlagewerk liegt nun erstmals ein Kompendium vor, das nicht nur eine allgemeine Übersicht klassischer kulturwissenschaftlicher Schlüsselwerke bietet, sondern gleichzeitig auch neue Fragen und Perspektiven der Forschung aufwirft. Mit seiner interkulturellen Perspektive und stark objektbezogenen Herangehensweise trägt der Band dem kulturellen Pluralismus moderner Gesellschaften Rechnung, die unter den Bedingungen von Globalität in zunehmendem Maße kein ›Außen‹ mehr kennen. Die einzelnen Artikel stellen mit klarer Gliederung und in verständlicher Sprache die jeweiligen Werke vor und zeigen ihre Relevanz für die heutigen und zukünftigen Kulturwissenschaften. Ein unverzichtbares Hilfsmittel für Studium und Lehre in den Kulturwissenschaften.