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Biomedical subjects

A Kruse

Publications and source records attributed to A Kruse.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Promotion and maintenance of independence in older people with intellectual disability-results of an intervention study].

Results of gerontological research have seldom been used for the development of new concepts for housing, promotion and supply in people with intellectual disability. However, recent findings from international studies support the assumption that capability to learn and plasticity are also apparent in people with intellectual disability. The present study was designed as an empirical test of this assumption. As a theoretical starting point we describe competence as a comprehensive construct which integrates aspects of independence, self-responsibility, self-determination and experienced meaning of life. Moreover, the construct of competence refers to the impact of the physical, social, and infrastructural environment on the aforementioned aspects. We hypothesised that independent living in older people with intellectual disability could be enhanced by a more differentiated perception of respective potentials by the members of the institutional staff. An intervention program for caregivers was developed to initiate an examination of their own behaviour in daily interaction with intellectually disabled residents, particularly in terms of a possible support of dependent and ignorance of independent behaviour. We expected that unmasking contingencies between behaviour of care-givers and dependency in intellectual disabled residents should lead to increases in residents' independent behaviour and everyday competence. 40 intellectually disabled residents and 40 staff members participated in the present study. Videotapes were used to assess behaviour of staff members and residents in daily care and support. Moreover, a questionnaire was developed for further assessment of independence and everyday competence in intellectually disabled residents. Effects of the developed intervention program were tested with a pre-post-control group-design. Results show highly significant increases in residents' independence and everyday competence. Therefore, our hypothesis that independent living in older people with intellectual disability could be enhanced by a more differentiated perception of existing potentials by the members of the institutional staff received strong support.

Activities of Daily Living↗
PubMed2003

[Situations of emotional significance in residents suffering from dementia].

An advanced stage of dementia implies a loss of the ability to express emotions verbally. However, this does not mean that these patients do not feel emotions anymore. Analyses of nonverbal behaviour are the only way to realise the aim of assessing emotional states in people suffering from severe dementia. In the present study, we tried to identify characteristic situations which are regularly accompanied by positive or negative emotions. Such situations should be described by members of the institutional staff. Moreover, patients' nonverbal behaviour was analysed with psychological instruments developed for analyses of mimic expressions of emotion (FACS, EMFACS). Twenty-nine female residents of nursing homes suffering from moderate or severe dementia participated in the study. Nearly all of them were perceived to show different emotional states by the staff. Most emotions seemed to occur regularly in specific situations. Measures of FACS and AMFACS suggest that predictions of the staff are highly valid. Analyses of situations which were said to be accompanied by positive emotions showed that the respective situations are often created by the residents themselves. This finding implies that even an advanced stage of dementia does not necessarily prevent people from leading a self-determined life. Concentrated and individualised attention enables the staff to shape positive emotions in residents suffering from moderate or severe dementia.

Activities of Daily Living↗
PubMed2002

Nitric oxide synthase activity in human pituitary adenomas.

OBJECTIVES: The purpose of the present study was to examine human pituitary adenomas for nitric oxide synthase (NOS) activity by immunohistochemical and enzymatic methods. MATERIALS AND METHODS: Adenomatous tissue from 16 patients were obtained during operation and stained immunohistochemically for hormone production and for the three NOS isoenzymes. Cell types that expressed NOS immunoreactivity (IR) were identified, and the NOS isoform was noted. NOS activity was measured enzymatically by the conversion of L-arginine to L-citrulline in tissue samples. RESULTS: Endothelial cells of pituitary adenomas showed increase of eNOS IR compared with control tissue. The nNOS and iNOS IR were the same in adenomas and controls. There was no correlation between NOS IR and NOS activity measured enzymatically and the endocrine activity of the tumour or other clinical variables. CONCLUSION: The observation of increased eNOS IR in endothelial cells of adenomas may suggest that NO plays a role in the regulation of blood flow in pituitary adenomas.

Adenoma↗
PubMed2002

Are gastroenterologists aware of the role of ethics committees?

BACKGROUND/AIMS: A hospital ethics committee (EC) is an organized body of people, convened to identify, analyze and help resolve moral problems that arise in the care of patients. The aim of this study was to investigate the need to educate endoscopists about the role of the ECs in European and Mediterranean countries. METHODS: A structured questionnaire concerning the role of ECs was sent to the representatives of endoscopy societies, which are also members of the European Society of Gastrointestinal Endoscopy. RESULTS: The response rate was 59% (26/44). About half of the responding representatives had attended more than 1 lecture or read more than 1 article about ethics during the previous 10 years. The percentage of hospitals with an established EC varied between countries. In 15% of the countries <20% but in 58% of the countries >60% of the hospitals have established ECs. Sixty-five percent of the responders believe that the EC is an advisory committee and 31% an executive committee. Endoscopists believe that ECs have been of great help to their specialty in their country. CONCLUSIONS: The roles of the ECs are not clear to endoscopists and there is a need for education in this field.

Endoscopy, Gastrointestinal↗
PubMed2002

Informed consent for gastrointestinal endoscopy: a 2002 ESGE survey.

BACKGROUND/AIM: Gastroenterologists are required to obtain informed consent before undertaking any endoscopic examination. Published data indicate that in practice there are many deficiencies in this process. The aim of this survey was to determine the quality of information given to patients before the endoscopic procedures in countries that are members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: A structured questionnaire was sent to representatives of endoscopic societies that are members of ESGE regarding the quality of informed consent. RESULTS: The response rate was 59% (26/44). The endoscopist is responsible for giving the required information prior to written consent in only 23.1% (6/26) of the countries. Although information about the procedure is given to the patients in 96% of the responding countries, in only 77% is there sufficient time for the patients to ask questions about the nature of the procedure. In 15% (4/26) of the countries neither the diagnostic or therapeutic alternatives to endoscopy are discussed nor the potential complication rates. Finally, the procedure-related mortality is provided in only 23% (6/26) of countries. CONCLUSION: The procedure of obtaining informed consent for endoscopy varies considerably and may need reevaluation.

Endoscopy, Gastrointestinal↗
PubMed2001

[Utilization of family practice by unemployed persons. Results of a survey of 250 family and primary care physicians].

The results of a questionnaire-based poll of 25 general practitioners from five German Länder show that providing medical care to the jobless confronts the family doctor with specific personal and health problems requiring more treatment time and more comprehensive medication--including antidepressants and tranquilizers--than age-matched working patients. Most practitioners had a skeptical attitude towards cooperation with institutions offering options to the jobless. Family doctors are faced with the dilemma of not being able to delegate the resolution of the patients' personal problems to others, while having no opportunity of obtaining remuneration from health insurance carriers for the time they spend counseling these patients.

Family Practice↗
PubMed2001

[Anterior screw fixation of fractures of the dens axis].

INTRODUCTION: The aim of the present study was to evaluate the results of anterior screw fixation in the treatment of odontoid fracture. MATERIALS AND METHODS: The clinical and radiographic records of the first 14 patients treated with anterior screw fixation for odontoid fracture were reviewed retrospectively. RESULTS: Satisfying stabilisation of the fracture was achieved in 10 patients (71%). In four patients, two of whom had severe osteoporosis, additional posterior C1/C2 fusion, owing to failure of screw treatment was needed. Two patients developed small occipital bedsores caused by preoperative treatment, but no further complications were observed. CONCLUSION: Although only a few patients were entered in the study, the results justify the use of anterior screw fixation as the treatment of odontoid fracture in selected patients.

Adolescent↗