Being,feeling and acting: A qualitative study of Swedish home-help care recipients' understandings of dependence and independence

This article contributes to the debate on dependence and independence through a study of how a group of 29 cognitively healthy Swedish home-help care recipients between the ages of 77 and 93 perceive their situation. Two overall themes with regards to how the constructs of dependence and independence are understood were found. One of them concerns how being in need of help can be justified (i.e. the why of receiving help) and the other how the very situation of being in need of help and care can be regarded (i.e. the how of receiving help). The study reveals a clear distinction between receiving help and care and feeling dependent, as well as between receiving help and care and being able to remain an active agent. On the basis of these findings we argue for the fruitfulness of distinguishing between ‘being’, ‘feeling’ and ‘acting’ as aspects of dependence and independence.     

Einsatz von Simulationspatienten im Kommunikations- und Interaktionstraining für Medizinerinnen und Mediziner (Medi-KIT): Bedarfsanalyse — Training — Perspektiven

Communication skills are of central importance within daily medical life providing effective treatment. In the modern high-tech field of medicine, trustful conversations play a prominent role. In order to help students of the Heidelberg Medical Faculty to be ready for their highly responsible role as communication partner, training is carried out in the framework of HeiCuMed (short for Heidelberger Curriculum Medicinale) using specially trained simulation patients. The communication and interaction training program (referred to as Medi-KIT) enables to practice conducting conversations with challenging communication partners and grave conversational content in difficult situations. Feedback from the standardized patients, as well as from peers and tutors represents a central didactic element.In order to secure knowledge transfer into daily clinic life and as well to build a relation to cognitive knowledge transfer, all medical students are assigned, alongside Medi-KIT lessons, to a ward, and training units are coordinated in terms of content to correspond with symptom-oriented lectures and parallel POL-groups (problem-oriented learning groups). In addition, communication learning objectives are examined at the end of the semester in the form of a clinical practical exam (OSCE: Objective Structured Clinical Examination) and at patient’s bedside (Mini-CEX: Mini Clinical Examination). The goal in imparting communication skills within medical education is that the longitudinal communication curriculum be maintained and continued in subsequent medical specialization studies.     

Organisation als Freiraum und Zwang

Organisations are marked by contradictions: change and continuity, health and sickness, men and women, creativity and linearity, past and future and freedom and restriction are only a few poles in which these contradictions are made visible. Organisations try to give answers to these contradictions and give space for both: freedom and restriction. Here, systems and individuals are related in mutual challenge and in permanent negotiation. It is therefore important for management and employee to reflect on the preconditions for the chance of freedom and restriction. The organisation has to provide the possibility to legitimize the ‘Management of Paradox’ in order to generate answers which are necessary to guide change and contradiction.     

Reviews

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Optimum stratification with two variates

For the 2×2 rectilinear stratification of a bivariate normal distribution with proportional and optimum allocation the dependence of the objective function z(x₁;y₁) on the coefficient of correlation ρ and the sampling fraction q=n/N is investigated. With proportional allocation for great values of ρ (but already for q=0) a so-called ρ-effect arises, which results in a saddle-point of z as “optimum” stratification point in the center of gravity of the distribution and two additional minima. With optimum allocation first for smaller values of q also the ρ-effect arises; for grater values of q a so-called q-effect is superposed, which results in a multitude of minima, saddle-points and maxima of z. All these points satisfy the generalized conditions of Dalenius, but for practical use only the global minimum is of interest.