Zur Bedeutung der Supervision bei stationärer Psychotherapie am Beispiel von psychosomatischen Kliniken

The importance of supervision in inpatient psychotherapy settings such as hospitals for behavioral medicineThis article deals with the organization of supervision in hospitals that offer intensive inpatient psychotherapy (hospitals for behavioral medicine). The ?integrative model“ for supervision proposed by A. Schreyögg (1991) constitutes the theoretical basis. The author discusses the qualification of supervisors as well as aspects of different approaches to supervision, such as the psychoanalytical and the cognitive-behavioral approach. In doing so, she puts primary importance on the reflection of issues on the systemic, i.e. organizational level. At the end, a model for the organization of qualified internal supervision is proposed.     

No lollygagging for Dr. Lally

Jim Lally considers himself something of a late-bloomer because he spent years in the Army before earning his bachelor's degree and going on to medical school. But he's making up for lost time quickly. He already owns his own hospital.     

'Caducean ceiling' blocks docs from CEO posts

Physician executives face numerous obstacles in their quest to become CEOs. Take a look at what's standing in the way.     

Malpractice insurance rates reach boiling point. Physicians burned by lawyers, lawsuits and jury awards

Costs of medical malpractice insurance are soaring. Major insurers are refusing to write policies. And doctors are struggling to pay their premiums. Find out what's behind the insurance crisis.     

Quantification of follow-up time in oncology clinical trials with a time-to-event endpoint: Asking the right questions

For the analysis of a time-to-event endpoint in a single-arm or randomized clinical trial it is generally perceived that interpretation of a given estimate of the survival function, or the comparison between two groups, hinges on some quantification of the amount of follow-up. Typically, a median of some loosely defined quantity is reported. However, whatever median is reported, is typically not answering the question(s) trialists actually have in terms of follow-up quantification. In this paper, inspired by the estimand framework, we formulate a comprehensive list of relevant scientific questions that trialists have when reporting time-to-event data. We illustrate how these questions should be answered, and that reference to an unclearly defined follow-up quantity is not needed at all. In drug development, key decisions are made based on randomized controlled trials, and we therefore also discuss relevant scientific questions not only when looking at a time-to-event endpoint in one group, but also for comparisons. We find that different thinking about some of the relevant scientific questions around follow-up is required depending on whether a proportional hazards assumption can be made or other patterns of survival functions are anticipated, for example, delayed separation, crossing survival functions, or the potential for cure. We conclude the paper with practical recommendations.     

Evaluation of the Neurodegenerative Conditions Coordinated Care Program (NCCCP) in Western Australia: barriers to better service provision

This paper details a 2009-2010 evaluation of the Neurodegenerative Conditions Coordinated Care Program (NCCCP) commissioned by the Disability Services Commission (DSC) in Western Australia (WA). The program, run by the Multiple Sclerosis Society of WA (Inc.) provides in-home care and supports and respite for people who are under the age of sixty-five and diagnosed with a rapidly degenerative neurological condition. In 2009, the identified barriers to the better provision of services included: shortage of quality out-of-home respite providers, and convoluted paperwork requirements to qualify for the program. Some service providers were unaware of the program and so were not referring them into the NCCCP, a number of service providers were unwilling to refer their clients into the program, neurologists were unwilling to give a final diagnosis for a client, that would enable them to qualify for the service, there was a general lack of knowledge about what services were available in the general community, and existing equipment pools were under-resourced. In 2010, the study found that most of the issues had been addressed however, out-of-home respite services were still very limited especially in rural areas, and the eligibility criteria for entry to the program is confined to those 65 years and under. This paper discusses the issues that still remain with the program as examples of barriers to better provision of services.     

Evaluation of the mandatory construction induction training program in Western Australia: unanticipated consequences

Since January 1, 2007, Government legislation in Western Australia required all workers in construction to complete mandatory safety awareness training before they began work on site. During the implementation of this new legislation there was considerable resistance from the construction sector due to the mandatory nature of the training. The construction industry viewed this as an unnecessary impost as they considered that there was already sufficient safety training delivered through individual company and site inductions. In 2010, we evaluated the new Construction Induction Training (CIT) in the commercial construction sector in Western Australia to find that since 2007 there has been an unanticipated change in support for the mandatory training. The 2010 study shows a shift in the values of the safety culture for the commercial sector of the construction industry. In 2010, the industry not only supports the mandatory CIT, but is very vocal in its request to re-institute the refresher courses that were withdrawn in 2009. Indeed, 79% of respondents claimed there were measurable benefits to their business having their employees complete the CIT, while 96% claimed the CIT assisted in reducing accidents/incidents on their worksites. This 2010 study indicates that in this case, mandatory training has had a positive effect on safety culture change and gradually reduced work-related injury in the industry since 2007 to the present. The paper uses data from two studies conducted in 2006 and 2010 to highlight the unanticipated change in perception of the value of mandatory safety training in the WA construction industry to one which is positive and supportive.     

„Nem Kind nun vorzumachen, du kriegst’ ne Lehrstelle, ist für mich unrealistisch.“

Subject of this contribution are the strategies of action and the practices of social binding under the condition of precarious employment relations. In the case of a young retail saleswoman I want to explore the question if and how situations of insecurity and uncertainty produce specific habitual changes and acquisitions. Which significance do discontinuous life courses have on biographical self-construction? How do the practices of everyday life and the relation to an uncertain future differ between the younger generation and their parents? And finally: which consequences do the pragmatic use of chance and contingency have on lived gender arrangements?