[Psychotherapy for everyone? On the indications for psychotherapeutic treatment]. / Psychotherapie für alle? : Zur Indikation für psychotherapeutische Behandlungen.

BACKGROUND: The effectiveness of psychotherapy for the treatment of most mental disorders is empirically very convincingly documented; however, there are not enough therapists by far available globally to enable all people suffering from mental disorders to be adequately provided with psychotherapy. AIMS AND METHODS: Considerations are made regarding which illnesses, disorders and problems in general should be treated by means of psychotherapy, who should best conduct the treatment and in which way the dissemination of evidence-based psychotherapeutic approaches could be improved in spite of scarce resources. RESULTS: The more severely pronounced a health problem is, the greater is normally the therapeutic benefit of a given intervention. This applies to psychotherapy as well; however, to date severely ill people in particular are often not treated with effective psychotherapeutic interventions. One of the reasons is that there are only few validated treatment protocols for multimorbid patients with both mental and physical illnesses. Another reason is that treatment of such patients requires specific medical knowledge as well as other special skills and experiences that not all psychotherapists have at their command. CONCLUSION: The indications for psychotherapy should always be made with a sense of proportion, taking into consideration the currently available scientific evidence and clinical experience. In the future, the training of psychotherapists, scientific investigations of psychotherapies and clinical service provision should increasingly concentrate on patients with severe mental disorders and/or with psychological and physical comorbidities.

[Economic impact of Circovac® - vaccination in a PCV2 subclinically infected farm in Switzerland on performance parameters]. / Ökonomische Auswirkungen der CIRCOVAC® - Impfung in einem subklinisch mit PCV2 infizierten Zuchtbetrieb in der Schweiz auf die Mastleistungsparameter.

Vaccination of dams in a PCV2 subclinically infected farm 2 and 4 weeks before insemination, with a booster at 12 weeks of gestation did not influence fertility parameters of the dams. However, growth parameters of offspring of vaccinated sows improved significantly (+ 51 g/d), resulting in a shorter growing period of 9 days and a massively improved economy. Mortality of weaners and fattening pigs was not significantly influenced by dam vaccination. Nevertheless, compared to a period of 6 months before vaccination, the mortality rate declined in the weaning period by 0,3 % and in the fattening period by 5,5 %. The Return on Investment (ROI) was calculated with 1:9.5. Even, the historically low pork prices in 2011 led to a ROI of 1:7.

Vaccination of dams increases antibody titer and improves growth parameters in finisher pigs subclinically infected with porcine circovirus type 2.

Porcine circovirus type 2 (PCV2) is the obligate infectious agent in postweaning multisystemic wasting syndrome (PMWS) of pigs. To control PMWS, we vaccinated dams at 4 and 2 weeks before pregnancy and again in the 12th week of gestation with an inactivated PCV2 vaccine (Circovac). Two producer farms run under the control of Swiss Swine Health Organization were selected for the experiment. Previously, in one farm PMWS was diagnosed on pigs after weaning, whereas in the other farm, pigs wasted during the fattening period. For the experiments 113 dams were randomly vaccinated, and 111 dams were sham injected. Vaccination increased serum antibodies in dams 3- to 9-fold, accompanied by serum antibody titer increases in their offspring. In the sixth week of life, progeny from vaccinated dams had about the same IgG antibody titers as progeny of unvaccinated dams at the third day of life. In sera of vaccinated dams only low concentrations of PCV2 DNA were detected, and no progeny developed PMWS. Interestingly, at day 56 four progeny of unvaccinated dams tested positive for anti-PCV2 IgM antibodies, indicating a primary infection with PCV2. Of economic importance is the observation that progeny of vaccinated dams had a significantly higher daily weight gain in the fattening period (farm X, +51 g/day; farm Y, +30 g/day) and thus a shortened fattening period of about 6 days compared to progeny of controls. To our knowledge this is the first demonstration of subclinical circovirus infection and its effects on growth performance of fattening pigs by vaccination of dams.

[When the soul shatters]. / Wenn die Seele zerbricht.

Clinically relevant psychiatric disorders are very common in palliative medicine. Depending on severity, their influence on the patient's quality of life can be very unfavorable. Because of the fact that mental disorders usually have multifactor roots, an interdisciplinary approach to diagnostic and treatment procedures is necessary. In our daily clinical work we are often far away from realizing this approach. While treating these patients, the doctor is often left alone and feels powerless. The following remarks are meant as an aid to the doctor working in the field of palliative medicine, to enable him to recognize the psychiatric disorder and treat the illness accordingly. Besides the clinically relevant psychiatric disorders, many other psychological and social problems and also spiritual aspects are to be kept in mind when caring for these chronically ill patients. Due to lack of space it will not be possible to deal with all of these important issues in this paper.