Case Management in der ambulanten gerontopsychiatrischen Versorgung

In der vorliegenden Arbeit wird ein am Strengths-Modell orientiertes Case Management-Projekt zur Prozess- und Ergebnisoptimierung der bereits bestehenden ambulanten gerontopsychiatrischen Versorgungsstruktur untersucht. Dazu arbeitete eine Krankenpflegerin mit psychiatrischer Fachausbildung in einer Berliner Sozialstation auf Basis einer professionellen Beziehung für 4-6 Wochen bei Klientinnen mit gerontopsychiatrischen Problemlagen, erstellte ein Assessment, leistete notwendige Unterstützung zunächst selbst, vermittelte gestützt auf die eigenen Erfahrungen weiterführende Dienste, leitete diese Dienste an, zog sich dann aus dem direkten Kontakt mit den Klientinnen zurück und blieb beratend für die weiterführenden Dienste verfügbar. Zur Untersuchung des Projekts wurden qualitative und quantitative Verfahren eingesetzt. Zur Beschreibung der Inhalte wurden die für jede Klientin verfasste Dokumentation und die Ergebnisse von grob strukturierten Interviews mit der Case Managerin, angelehnt an eine reduzierte Form der Methode Grounded Theory, in einem iterativen Prozess analysiert. In einem zweiten Schritt wurde dann untersucht, inwieweit die einzelnen Arbeitsinhalte des Case Managements die sozial-räumlichdingliche Umweltanpassung und Proaktivität der Klientinnen unterstützten. Die Wirkungen des Projektes auf Kognition, Aktivitäten des täglichen Lebens (ADL), Instrumentelle Aktivitäten des täglichen Lebens (IADL), Stimmung sowie soziales und störendes Verhalten wurden mittels eines standardisierten Fragebogens mit einem quasi-experimentellen prospektiven Untersuchungsdesign analysiert. Zur Analyse der subjektiven Wirkung des Projektes auf Angehörige wurden in den Ergebnissen von grob strukturierten Interviews mittels eines iterativen Prozesses Themen identifiziert. Die Klientinnen (n=11) erhielten durchschnittlich 23 Stunden Case Management. Neben den typischen Case Management-Aufgaben führte die Case Managerin, basierend auf den Gewohnheiten, Interessen und Selbsteinschätzungen der Klientinnen, therapeutische und pflegerische Maßnahmen durch und unterstützte dabei die sozial-dinglichräumliche Umweltanpassung und Proaktivität der Klientinnen. Zusätzlich wurden Hauspflegerinnen von der Case Managerin individuell in der Wohnung von Klientinnen hinsichtlich der Kommunikation mit und Unterstützung der Proaktivität von Klientinnen angeleitet. Die Hauspflegerinnen führten die von der Case Managerin eingeleiteten Maßnahmen erfolgreich fort. Bei den Klientinnen zeigten sich signifikante Verbesserungen in Gedächtnis, Stimmung, IADL-Funktionen und Sozialverhalten, aber nicht in ADL-Funktionen und störendem Verhalten. Diese Verbesserungen wurden subjektiv von den Angehörigen (n=7) bestätigt. Zusätzlich empfanden Angehörige eine zeitliche aber keine psychische Entlastung. Mit diesem Projekt wurde gezeigt, dass ein zeitlich begrenztes klientenzentriertes Case Management kognitive, soziale und emotionale Funktionen von gerontopsychiatrisch Erkrankten verbessert, Angehörige zeitlich entlastet und dass Hauspflegerinnen bei entsprechender Anleitung die vom Case Management eingeleiteten Maßnahmen fortführen können. In Folgestudien mit größerem Umfang sollten diese Ergebnisse überprüft werden um dann zu entscheiden, ob dieser Ansatz geeignet ist, die ambulante gerontopsychiatrische Versorgung gemeindenah zu verbessern.

Dynamic characterization of olfactory receptors in the fruit fly Drosophila melanogaster

Temporal changes in odor concentration are vitally important to many animals orienting and navigating in their environment. How are such temporal changes detected? Within the scope of the present work an accurate stimulation and analysis system was developed to examine the dynamics of physiological properties of Drosophila melanogaster olfactory receptor organs. Subsequently a new method for delivering odor stimuli was tested and used to present the first dynamic characterization of olfactory receptors at the level of single neurons. Initially, recordings of the whole antenna were conducted while stimulating with different odors. The odor delivery system allowed the dynamic characterization of the whole fly antenna, including its sensilla and receptor neurons. Based on the obtained electroantennogram data a new odor delivery method called digital sequence method was developed. In addition the degree of accuracy was enhanced, initially using electroantennograms, and later recordings of odorant receptor cells at the single sensilla level. This work shows for the first time that different odors evoked different responses within one neuron depending on the chemical structure of the odor. The present work offers new insights into the dynamic properties of olfactory transduction in Drosophila melanogaster and describes time dependent parameters underlying these properties.

Identifying the factors governing attitude towards the e-Agriservice among dairy farmers in Maharashtra, India

Information and communication technology (ICT) projects have a great potential to revolutionise the information delivery system by bridging the gap between farmers and extension personnel. aAQUA (Almost All Questions Answered) portal was launched by the Developmental Informatics Laboratory (DIL) at Indian Institute of Technology (IIT) Mumbai, Maharashtra, India in 2003 as an information providing system to deliver technology options and tailored information for the problems and queries raised by Indian dairy farmers. To measure the effectiveness of this service the attitudinal dimensions of the users of aAQUA e-Agriservice were investigated using a 22 item scale. A simple random sampling technique was used to select 120 dairy farmers from which data were collected and subjected to factor analysis to identify the underlying constructs in this research. From the attitude items, four components were extracted and named as the pessimistic, utility, technical and efficacy perspective, which influenced the development of varied level of attitudinal inclination towards the e-Agriservice. These components explained 64.40 per cent of variation in the attitude of the users towards the aAQUA e-Agriservice. This study provides a framework for technically efficient service provision that might help to reduce the pessimistic attitude of target population to adopt e-Agriservice in their farming system. The results should also be helpful for researchers, academics, ICT based service providers and policy makers to consider these perspectives while planning and implementing ICT projects.

A Study of a Comprehensive Career Services System in Chinese Universities

Since 1999, with the adoption of expansion policy in higher education by the Chinese government, enrollment and graduate numbers have been increasing at an unprecedented speed. Accustomed to a system in which university graduates were placed, many students are not trained in “selling themselves”, which exacerbates the situation leading to a skyrocketing unemployment rate among new graduates. The idea of emphasizing career services comes with increasing employment pressure among university graduates in recent years. The 1998 “Higher Education Act” made it a legislative requirement. Thereafter, the Ministry of Education issued a series of documents in order to promote the development of career services. All higher education institutions are required to set up special career service centers and to set a ratio of 1:500 between career staff and the total number of students. Related career management courses, especially career planning classes, are required to be clearly included as specific modules into the teaching plan with a requirement of no less than 38 sessions in one semester at all universities. Developing career services in higher education has thus become a hot issue. One of the more notable trends in higher education in recent years has been the transformation of university career service centers from merely being the coordinators of on-campus placement into full service centers for international career development. The traditional core of career services in higher education had been built around guidance, information and placements (Watts, 1997). This core was still in place, but the role of higher education career services has changed considerably in recent years and the nature of each part is being transformed (Watts, 1997). Most services are undertaking a range of additional activities, and the career guidance issue is emphasized much more than before. Career management courses, especially career planning classes, are given special focus in developing career services in the Chinese case. This links career services clearly and directly with the course provision function. In China, most career service centers are engaging in the transformation period from a “management-oriented” organization to a “service-oriented” organization. Besides guidance services, information services and placement activities, there is a need to blend them together with the new additional teaching function, which follows the general trend as regulated by the government. The role of career services has been expanding and this has brought more challenges to its development in Chinese higher education. Chinese universities still remain in the period of exploration and establishment in developing their own career services. In the face of the new situation, it is very important and meaningful to explore and establish a comprehensive career services system to address student needs in the universities. A key part in developing this system is the introduction of career courses and delivering related career management skills to the students. So there is the need to restructure the career service sectors within the Chinese universities in general. The career service centers will operate as a hub and function as a spoke in the wheel of this model system, providing support and information to staff located in individual teaching departments who are responsible for the delivery of career education, information, advice and guidance. The career service centers will also provide training and career planning classes. The purpose of establishing a comprehensive career services system is to provide a strong base for student career development. The students can prepare themselves well in psychology, ideology and ability before employment with the assistance of effective career services. To conclude, according to the different characteristics and needs of students, there will be appropriate services and guidance in different stages and different ways. In other words, related career services and career guidance activities would be started for newly enrolled freshmen and continue throughout their whole university process. For the operation of a comprehensive services system, there is a need for strong support by the government in the form of macro-control and policy guarantee, but support by the government in the form of macro-control and policy guarantee, but also a need for close cooperation with the academic administration and faculties to be actively involved in career planning and employment programs. As an integral function within the universities, career services must develop and maintain productive relationships with relevant campus offices and key stakeholders both within the universities and externally.