Benefits and challenges in practice-oriented psychotherapy research in Germany: The TK and the QS-PSY-BAY projects of quality assurance in outpatient psychotherapy

Objective: Two patient-focused long-term research projects performed in the German outpatient psychotherapy system are focused on in this article. The TK (Techniker Krankenkasse) project is the first study to evaluate a quality assurance and feedback system with regard to its practical feasibility in German routine care. The other study (“Quality Assurance in Outpatient Psychotherapy in Bavaria”; QS-PSY-BAY) was designed to test a new approach for quality assurance in outpatient psychotherapy using electronic documentation of patient characteristics and outcome parameters. In addition this project provides the opportunity to analyze data on health-related costs for the patients undergoing outpatient psychotherapy. Method: Both projects and their results indicating high effect sizes are briefly described. Results: From the perspectives of the research teams, advisory boards and other stakeholders, the experiences with these projects are discussed focusing on obstacles, challenges, difficulties, and benefits in developing and implementing the studies. The triangle collaboration of therapists, researchers, and health insurance companies/health service institutions turned out to be fruitful in both studies. Conclusions: Despite some controversies between the partners the experiences indicate the importance of practiced-research collaborations to provide relevant information about the delivery of outpatient psychotherapy in the health system

Preliminary study on carprofen concentration measurements after transcutaneous treatment with Vetdrop® in a microfracture joint defect model in sheep.

BackgroundThe present preliminary study describes concentration time courses of the NSAID carprofen in the plasma and synovial fluid in a microfrature sheep model after transcutaneous treatments with a novel application device (Vetdrop®). To treat circumscribed inflammatory processes a transcutaneous application device could potentially be beneficial. After transcutaneous application normally lower systemic concentrations are measured which may reduce the incidence of side effects, whereas efficacy is still maintained.In this study carprofen was used based on its capacity to provide analgesia after orthopaedic procedures in sheep and it is considered that it may have a positive influence on the healing of cartilage in low concentrations.ResultsIn all transcutaneously treated animals, carprofen plasma concentrations exceeded those of synovial fluid, although plasma levels remained significantly reduced (300-fold) as compared to carprofen administered intravenously. Furthermore, in contrast to the intravenously treated animals, a modest accumulation of carprofen in plasma and synovial fluid was observed in the transcutaneously treated animals over the 6-week treatment period.ConclusionsThe transcutaneously administered carprofen using the Vetdrop® device penetrated the skin and both, plasma- and synovial concentrations could be measured repeatedly over time. This novel device may be considered a valuable transcutaneous drug delivery system.

Schiller und das Wiener Burgtheater. Don Karlos-Inszenierungen 1938 und 1955 als Beispiele

Der Beitrag untersucht anhand der Rezeption von zwei exemplarischen Don Karlos-Inszenierungen, die beide in politisch markanten Jahren der österreichischen Geschichte ihre Premiere erlebten, die Funktionalisierung der Institution Burgtheater in Verbindung mit der Funktionalisierung des Dramatikers Friedrich Schiller für eben diese Institution. Eine Neueinstudierung erfolgte 1938, dem Jahr von Österreichs ‚Anschluss’ an Nazi-Deutschland, die andere 1955, dem Jahr der Unterzeichnung des Österreichischen Staatsvertrages. Beide Don Karlos-Inszenierungen fanden als spezifische Festvorstellungen im Rahmen von Feierlichkeiten rund um die Institution Burgtheater statt. Diente 1938 Schillers Don Karlos dazu, als ‚Schlüsselstück’ der ‚nationalsozialistischen Revolution’ einen politisch-gesellschaftlichen Aufbruch zu markieren, so wurde 1955 die Inszenierung des Dramas zum Triumph einer Schauspielerelite, deren Können sich in die konstruierte Tradition eines k.k. ‚Schauspieleradels’ einreihte. Während 1938 der ‚nationale Dichter’ dem ‚heimgekehrten’ Nationaltheater zum ästhetischen ‚Anschluss’ verhalf, diente der ‚überzeitliche’ Klassiker 1955 dazu, eine ästhetische ‚Wiedergeburt’ zu behaupten, die dem restaurativen Kunst- und Kulturbegriff Nachkriegsösterreichs verpflichtet war.