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.

Evaluating the probability and the impact of a failure in GMPLS based networks

In this paper, we define a new scheme to develop and evaluate protection strategies for building reliable GMPLS networks. This is based on what we have called the network protection degree (NPD). The NPD consists of an a priori evaluation, the failure sensibility degree (FSD), which provides the failure probability, and an a posteriori evaluation, the failure impact degree (FID), which determines the impact on the network in case of failure, in terms of packet loss and recovery time. Having mathematical formulated these components, experimental results demonstrate the benefits of the utilization of the NPD, when used to enhance some current QoS routing algorithms in order to offer a certain degree of protection

Availability analysis of GMPLS connections based on physical network topology

This paper presents a study of connection availability in GMPLS over optical transport networks (OTN) taking into account different network topologies. Two basic path protection schemes are considered and compared with the no protection case. The selected topologies are heterogeneous in geographic coverage, network diameter, link lengths, and average node degree. Connection availability is also computed considering the reliability data of physical components and a well-known network availability model. Results show several correspondences between suitable path protection algorithms and several network topology characteristics

Systems Design: Use Case Modelling Lab using Visual Paradigm

This lab follows the lecture 'System Design: Using UML Use Cases'http://www.edshare.soton.ac.uk/9619/ It introduces Visual Paradigm as a UML modelling tool. Students work through Visual Paradigm online Tutorials and then create two projects.

On the design of education conditional cash transfer programs and non education outcomes: the case of teenage pregnancy

We investigate the effect of education Conditional Cash Transfer programs (CCTs) on teenage pregnancy. Our main concern is with how the size and sign of the effect may depend on the design of the program. Using a simple model we show that an education CCT that conditions renewal on school performance reduces teenage pregnancy; the program can increase teenage pregnancy if it does not condition on school performance. Then, using an original data base, we estimate the causal impact on teenage pregnancy of two education CCTs implemented in Bogot´a (Subsidio Educativo, SE, and Familias en Acci´on, FA); both programs differ particularly on whether school success is a condition for renewal or not. We show that SE has negative average effect on teenage pregnancy while FA has a null average effect. We also find that SE has either null or no effect for adolescents in all age and grade groups while FA has positive, null or negative effects for adolescents in different age and grade groups. Since SE conditions renewal on school success and FA does not, we can argue that the empirical results are consistent with the predictions of our model and that conditioning renewal of the subsidy on school success crucially determines the effect of the subsidy on teenage pregnancy

Extensión de la especificación IMS Learning Design desde la adaptación e integración de unidades de aprendizaje. `Extension of the IMS Learnin Design specification based on adaptation and integration of units of learning´.

La tesis se centra en el aprendizaje personalizado y en la integración de Unidades de Aprendizaje. El objetivo fundamental es mejorar la expresividad pedagógica de IMS-LD, refinando estructuras de modelado y arquitectura existentes y desarrollando estructuras complementarias que permitan una formalización más precisa, versátil y sencilla de procesos de aprendizaje adaptativo y de mecanismos y procesos de integración con sistemas de aprendizaje y otras especificaciones. En esta tesis se estudia la especificación desde la base, analizando su modelo de información y cómo se construyen Unidades de Aprendizaje. Se analiza la estructura de la especificación, basándose en un estudio teórico y una investigación práctica fruto del modelado de Unidades de Aprendizaje reales y ejecutables que proporcionan una información útil de base. A partir de este estudio, se analiza la integración de Unidades de Aprendizaje con otros sistemas y especificaciones, abarcando desde la integración mínima mediante un enlace directo hasta compartir variables y estados que permiten una comunicación en tiempo real de ambas partes. La conclusión es que IMS-LD necesita una reestructuración y modificación de ciertos elementos, así como la incorporación de otros nuevos, para mejorar una expresividad pedagógica y una capacidad de integración con otros sistemas de aprendizaje y estándares eLearning, si se pretenden alcanzar: la personalización del proceso de aprendizaje y la interoperabilidad real. La implantación de la especificación se vería mejorada si existieran unas herramientas de más alto nivel, preferiblemente con planteamiento visual, que permitieran un modelado sencillo por parte de los usuarios finales reales de este tipo de especificaciones, como son los profesores, los creadores de contenido y los pedagogos-didactas que diseñan la experiencia de aprendizaje.

Problem-based learning and legal education : a case study in integrated experiential study

Resumen basado en el de la publicaci??n

Analyzing data from a fuzzy rating scale-based questionnaire : a case study

Resumen tomado de la publicaci??n

Application of a support system to the design of wastewater treatment plants

This paper presents a case study that explores the advantages that can be derived from the use of a design support system during the design of wastewater treatment plants (WWTP). With this objective in mind a simplified but plausible WWTP design case study has been generated with KBDS, a computer-based support system that maintains a historical record of the design process. The study shows how, by employing such a historical record, it is possible to: (1) rank different design proposals responding to a design problem; (2) study the influence of changing the weight of the arguments used in the selection of the most adequate proposal; (3) take advantage of keywords to assist the designer in the search of specific items within the historical records; (4) evaluate automatically the compliance of alternative design proposals with respect to the design objectives; (5) verify the validity of previous decisions after the modification of the current constraints or specifications; (6) re-use the design records when upgrading an existing WWTP or when designing similar facilities; (7) generate documentation of the decision making process; and (8) associate a variety of documents as annotations to any component in the design history. The paper also shows one possible future role of design support systems as they outgrow their current reactive role as repositories of historical information and start to proactively support the generation of new knowledge during the design process

Prediction of postprandial blood glucose under intra-patient variability and uncertainty and its use in the design of insulin dosing strategies for type 1 diabetic patients

In this thesis I propose a novel method to estimate the dose and injection-to-meal time for low-risk intensive insulin therapy. This dosage-aid system uses an optimization algorithm to determine the insulin dose and injection-to-meal time that minimizes the risk of postprandial hyper- and hypoglycaemia in type 1 diabetic patients. To this end, the algorithm applies a methodology that quantifies the risk of experiencing different grades of hypo- or hyperglycaemia in the postprandial state induced by insulin therapy according to an individual patient’s parameters. This methodology is based on modal interval analysis (MIA). Applying MIA, the postprandial glucose level is predicted with consideration of intra-patient variability and other sources of uncertainty. A worst-case approach is then used to calculate the risk index. In this way, a safer prediction of possible hyper- and hypoglycaemic episodes induced by the insulin therapy tested can be calculated in terms of these uncertainties.

Private industrial project management: a systems-based case study

The technique of linear responsibility analysis is used for a retrospective case study of a private industrial development consisting of an extension to existing buildings to provide a warehouse, services block and packing line. The organizational structure adopted on the project is analysed using concepts from systems theory which are included in Walker's theoretical model of the structure of building project organizations (Walker, 1981). This model proposes that the process of building provision can be viewed as systems and subsystems which are differentiated from each other at decision points. Further to this, the subsystems can be viewed as the interaction of managing system and operating system. Using Walker's model, a systematic analysis of the relationships between the contributors gives a quantitative assessment of the efficacy of the organizational structure used. The causes of the client's dissatisfaction with the outcome of the project were lack of integration and complexity of the managing system. However, there was a high level of satisfaction with the completed project and this is reflected by the way in which the organization structure corresponded to the model's propositions.

A conventionally managed project: a systems based case study

The technique of linear responsibility analysis is used for a retrospective case study of a private development consisting of an extension to an existing building to provide a wholesale butchery facility. The project used a conventionally organized management process. The organization structure adopted on the project is analysed using concepts from the systems theory, which are included in Walkers theoretical model of the structure of building project organizations. This model proposes that the process of building provision can be viewed as systems and sub-systems that are differentiated from each other at decision points. Further to this, the sub-systems can be viewed as the interaction of managing system and operating system. Using Walkers model, a systematic analysis of the relationships between the contributors gives a quantitative assessment of the efficiency of the organizational structure used. The project's organization structure diverged from the models propositions resulting in delay to the project's completion and cost overrun but the client was satisfied with the project functionally.

An analysis of the management of a public sector project: a systems-based case study

The management of a public sector project is analysed using a model developed from systems theory. Linear responsibility analysis is used to identify the primary and key decision structure of the project and to generate quantitative data regarding differentiation and integration of the operating system, the managing system and the client/project team. The environmental context of the project is identified. Conclusions are drawn regarding the project organization structure's ability to cope with the prevailing environmental conditions. It is found that the complexity of the managing system imposed on the project was unable to achieve this and created serious deficiencies in the outcome of the project.