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Biomedical subjects

H Koester

Publications and source records attributed to H Koester.

18 recordsLinked to original sources
PubMed1988

[A district psychiatric clinic and therapeutic pedagogic facility--development of a management concept for mentally handicapped patients].

There is a general consensus of opinion that adult mentally handicapped persons--if we leave aside the treatment of severe and psychiatrically relevant concomitant diseases or abnormal behaviour--are misfits in a psychiatric hospital. The aim of an independent care of the mentally handicapped can be achieved in different ways based on medical paedagogy. The Home for Medical Paedagogy in Düren, Lower Rhine District, is a case in point. Despite many difficulties and conflicts this hospital attained an outstanding standard of medical care within just ten years. Its location is on the same site as that of the psychiatric hospital.

Combined Modality Therapy↗
PubMed1987

[1981-1983 breast feeding studies of 1,500 mothers in Dortmund and Haltern. I. Collectives studied and rates of breast feeding in the maternity ward].

Rates of breast-feeding were studied in collectives of 998 mothers (Dortmund) and 500 mothers (Haltern) in two large maternity wards encouraging breast-feeding. In both hospitals the collectives were representative for the population in the surrounding region. Mothers were asked to take part in the study as they were admitted. Response rates were 99%. Age and parity of mothers in Dortmund were in agreement with population statistics, whereas in the Haltern collective there was a smaller proportion of younger mothers. The collective in Haltern had a slight edge with respect to social background. The different types of delivery had the same percentages in both wards. Birthweight was on the average 100 g higher in Haltern neonates. There were no differences in mean length. In both wards feeding on demand was practised during the rooming-in period during daytime, whereas at night infants were bottle-fed on demand in the infant's room. In Haltern supplementary formula feeding was offered more liberally. In Dortmund 92%, in Haltern 97% of the mothers tried to breast-feed; only 5% and 2% respectively were unsuccessful. Mothers who did not want to breast-feed (8% and 3% respectively) rarely mentioned relevant obstacles as a reason for their decision. On discharge 80-90% of the mothers were breast-feeding, with only about one half of them fully breast-feeding. Caesarean section was hardly detrimental to initiation of breast-feeding, but often to success.

Adult↗
PubMed1987

[Breast feeding studies 1981-1983 in 1,500 mothers in Dortmund and Haltern. III. Rates of breast feeding and duration of breast feeding in the first half year].

With two collectives of mothers from the large maternity wards in Dortmund (n = 998) and Haltern (n = 500) breast-feeding patterns were studied prospectively after dismissal. 95 and 93% of initially breast-feeding mothers kept simple protocols of duration and intensity of breast-feeding. 20 and 13% respectively of the breast-feeding mothers in Dortmund and Haltern stopped breast-feeding within 3 days following discharge, only 2 and 6% respectively of all mothers fully breast-fed for a period of a months as recommended. Already from the beginning of the 2nd month some mothers introduced (unnecessarily) juices as Beikost. Reasons given by the mothers for termination of breast-feeding were mostly connected with problems concerning the mother (50%) and nursing problems (35%). Statistical analysis (Cox proportional hazards model) revealed that the mothers' age (less than 25 years), low educational level, bad breast-feeding experience and use of a pump significantly reduce duration of breast-feeding. Promotion and support of breast-feeding is urgently needed especially during the first weeks after birth and with inexperienced, young and less educated mothers.

Breast Feeding↗
PubMed1979

[Further developments in legislation governing guardianship and nursing care laws (author's transl)].

The legal measures covering protection and care in connection with legislation governing guardianship and fosterage involving medical nursing, which have remained unchanged in principle since 1896, increasingly create the risk of obstructing and hampering the treatment and rehabilitation of mental patients. In order to counteract this development, which is hostile to therapy, as can be demonstrated by means of concrete examples, a number of differentiated deliberations to improve the situation have been included in the expertise preparatory to the inquiry on the situation of psychiatry in the Federal Republic of Germany, dated 1975. These suggestions, which are well differentiated and aim at a minimum restriction of the rights of the individual in respect of protection of his personality, seem to be hardly sufficiently known, so that no use is made of them in public, political and expert discussions. Hence it appeared necessary to point once again to these suggestions as impressively as possible.

Child↗
PubMed1977

[Development and significance of occupational and iatrogenic contact sensitization in nummular microbial eczema].

The pathogenesis of the epidermal and cutaneous reactions to a microbic invasion comprises many criteria for the diagnosis of a nummular microbial eczema. Detection of the focus, healing of the eczema after focal sanitation, positive reactions to bacterial antigens, decrease of Igm and IgG, and other parameters represent the cutaneous component of the disease, while the lack of epidermal sensitizations to low-molecular haptenes and the predominantly negative epicutaneous tests constitue the accentuating criteria. The results obtained in 95 patients with nummular microbic eczema show the part played by epidermal alterations in the development of occupational an iatrogenic contact sensitizations. Moreover, these alterations allow to recognize to what extent these dermatoses are due to occupational causes.

Antigens, Bacterial↗