Supervision, Teamentwicklung und Organisationsentwicklung als Mittel der Lehrerfortbildung

Wir beschreiben in einem ersten Abschnitt, was Supervision alles nicht ist. Gerade in einer Zeit, da die Schule als interessantes Beratungsfeld von Anbietern aller Art überschwemmt wird, scheint eine solche klärende Abgrenzung nötig zu sein. In einem zweiten Abschnitt beschreiben wir aufgrund des Dreiecks Individuum- Rolle-Organisation verschiedene Formen von "Supervision", die sich letztlich alle als Formen von Organisationsentwicklung (OE) verstehen lassen. In einem darauf folgenden Exkurs zeigen wir auf, wie die traditionelle Fallsupervision sich in Supervision von Fall zu Fall verwandeln kann. In einem weiteren Teil wird auf die Bedeutung der Information über Supervision in der Lehrerausbildung hingewiesen. In einem abschliessenden Teil werden Anmerkungen zu notwendigen Qualifikationen von Supervisoren, die in der Lehrerfortbildung tätig sind, gemacht

Necrosis of Hippocampus and Piriform Lobe in 38 Domestic Cats with Seizures: A Retrospective Study on Clinical and Pathologic Findings

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Local anesthesia for transurethral manipulations: is a transrectal periprostatic nerve block effective?

Periprostatic nerve block has been reported to be an effective form of anesthesia for prostatic surgery. Recent studies have shown the simplicity and the efficacy of a transrectal approach for periprostatic nerve block. The goal of our study was to evaluate the effect of a transrectal periprostatic nerve block on the discomfort associated with rigid cystoscopy. A total of 73 patients underwent cystoscopy. Group 1 (n=39) received a transrectal periprostatic lidocaine infiltration prior to the cystoscopy. Group 2 (n=34) underwent cystoscopy alone. The pain that patients experienced during cystoscopy was assessed on a visual analog scale. The patients in the two groups were very similar in regard to age and size of the prostate. The mean pain score was 3.4 in group 1 and 3.9 in group 2. This difference was not statistically significant. We conclude that nerve block does not seem to reduce the pain associated with transurethral manipulation

Wenn ein Teil von dir geht… : wie Pflegefachpersonen Eltern von Kindern und Jugendlichen mit onkologischer Erkrankung am Lebensende unterstützen können

Hintergrund: Krebs ist in der Schweiz eine häufige Todesursache bei Kindern. Eltern fühlen sich während der letzten Lebensphase ihres Kindes oft nicht angemessen unterstützt. Zudem empfinden viele Pflegefachpersonen die Kommunikation mit den Eltern in dieser Zeit als herausfordernd und unangenehm. Fragestellung: Wie können Pflegefachpersonen Eltern von Kindern und Jugendlichen mit einer onkologischen Erkrankung in der End-of-life-Phase unterstützen?’ Methode: Auf ‚PubMed’, ‚CINAHL Complete’ und ‚PsycINFO’ wurde eine systematisierte Literaturrecherche durchgeführt. Es wurden vier qualitative Studien, eine quantitative Studie und ein qualitatives Review selektiert, zusammengefasst, kritisch gewürdigt und auf ihre Evidenz geprüft. Anhand des Modells von King (1981) wurde ein Theorie-Praxis-Transfer hergestellt. Relevante Ergebnisse: Aus den inkludierten Studien kristallisierten sich drei Themenbereiche heraus, welche für Pflegefachpersonen essenziell sind: ‚Relevanz von Kommunikation und Hoffnung’, ‚Aufbau und Relevanz von Beziehungen’ sowie ‚Gewährleisten von Kontrolle und Selbstbestimmung’. Schlussfolgerung: Pflegefachpersonen können Eltern von schwerkranken Kindern unterstützen, indem sie offen und ehrlich kommunizieren und Hoffnung aufrechterhalten. Eine empathische und verständnisvolle Pflege stellt einen zentralen Faktor für einen gelingenden Beziehungsaufbau dar. Zudem soll auf die Bedürfnisse der Eltern eingegangen werden, um ihnen ein Gefühl der Kontrolle und Selbstbestimmung zu geben

Neuropathological and molecular comparison between clinical and asymptomatic bovine spongiform encephalopathy cases

Interest in the proper neuropathological and molecular characterization of bovine spongiform encephalopathy (BSE) has increased since asymptomatic and atypical cases were detected in the cattle population by active disease surveillance. In this respect we investigated a total of 95 confirmed BSE cases originating from different active and passive surveillance categories (clinical suspects, emergency-slaughter, fallen stock and routinely slaughter) in Switzerland for their neuropathological and molecular phenotype. We looked for measurable differences between these categories in lesion profile, severity of spongiform change, degree of astrocytosis as well as immunohistochemical and molecular patterns of the disease-associated isoform of the prion protein (PrPd) in the caudal brainstem. Our results indicate significantly higher intensities of spongiform change in clinically affected compared to asymptomatic BSE cases. Similar effects were in trend observed for the intensities of PrPd deposition and astrocytosis, whereas the frequencies of morphological PrPd types and the molecular patterns in Western immunoblot were not different. Importantly, none of the animals included in this study revealed features of atypical BSE. Taken together, this study suggests that both clinically affected as well as asymptomatic Swiss BSE cases in cattle share the neuropathological and molecular phenotype of classical BSE and that asymptomatic classical BSE cases are at a pre-clinical stage of the disease rather than representing a true sub-clinical form of BS

Neuropathological and molecular comparison between clinical and asymptomatic bovine spongiform encephalopathy cases

Interest in the proper neuropathological and molecular characterization of bovine spongiform encephalopathy (BSE) has increased since asymptomatic and atypical cases were detected in the cattle population by active disease surveillance. In this respect we investigated a total of 95 confirmed BSE cases originating from different active and passive surveillance categories (clinical suspects, emergency-slaughter, fallen stock and routinely slaughter) in Switzerland for their neuropathological and molecular phenotype. We looked for measurable differences between these categories in lesion profile, severity of spongiform change, degree of astrocytosis as well as immunohistochemical and molecular patterns of the disease-associated isoform of the prion protein (PrPd) in the caudal brainstem. Our results indicate significantly higher intensities of spongiform change in clinically affected compared to asymptomatic BSE cases. Similar effects were in trend observed for the intensities of PrPd deposition and astrocytosis, whereas the frequencies of morphological PrPd types and the molecular patterns in Western immunoblot were not different. Importantly, none of the animals included in this study revealed features of atypical BSE. Taken together, this study suggests that both clinically affected as well as asymptomatic Swiss BSE cases in cattle share the neuropathological and molecular phenotype of classical BSE and that asymptomatic classical BSE cases are at a pre-clinical stage of the disease rather than representing a true sub-clinical form of BS

Robotic-assisted laparoscopic extended pelvic lymph node dissection for prostate cancer: surgical technique and experience with the first 99 cases

BACKGROUND: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. OBJECTIVE: To assess the technical feasibility of RALEPLND and to present our surgical technique. DESIGN, SETTING, AND PARTICIPANTS: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) >/=10 ng/ml or a preoperative Gleason score >/=7. The data were evaluated retrospectively. SURGICAL PROCEDURE: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. MEASUREMENTS: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. RESULTS AND LIMITATIONS: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). CONCLUSIONS: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection