["Pflegestützpunkte": Care Support Centers in Germany. Where are We Heading? Results of the Evaluation of all 48 Care Support Centers in Baden-Württemberg]. / Pflegestützpunkte in Deutschland. Quo vadis? Ergebnisse der Evaluation aller baden-württembergischen Pflegestützpunkte.

"Pflegestützpunkte", care support centers in Germany. Where are we heading? Results of the evaluation of all 48 care support centers in Baden-Württemberg. Objectives: The quantitative part of the study was based on an analysis of the structures and concepts as well as the type of services and demand for counseling services for elderly and vulnerable people of all 48 care support centers in Baden-Württemberg. The qualitative part included interviews of employees of the care support centers on the underlying concepts of their organization. Objectives: The counseling infrastructure for elderly and vulnerable people needs to be improved in terms of transparency, networking and coordination of its services. According to the German Care Reform, care support centers, known as "Pflegestützpunkte," should solve this problem by placing all relevant counseling services under one roof. The objective of this study was to distinguish between the various care models of care support centers currently in existence and to investigate how different models meet legal requirements. Results and Conclusions: An evaluation of the interviews and surveys shows that not all legal requirements are met. The 4 main models of care support centers vary widely and are partially incomprehensible. It also remains unclear what role the care support centers play in counseling by health and nursing insurances. These needs for further development should be kept in mind in the planned expansion of care support centers.

[Provision of services and demand for care support centers. Results of the evaluation of all care support centers in Baden-Württemberg]. / Angebot und Nachfrage von Pflegestützpunkten. Ergebnisse der Evaluation aller baden-württembergischen Pflegestützpunkte.

BACKGROUND: The counseling infrastructure for elderly and vulnerable people is characterized by overuse, underuse and misuse. According to the German care reform, care support centers should solve this problem by putting all relevant counseling services under one roof. OBJECTIVE: The aim of this study was to analyze the type of services and demand of German care support centers 5 years after the German care reform came into force. MATERIAL AND METHODS: The study was based on an analysis of the documentation of all 48 care support centers in Baden-Württemberg after the German care reform came into force and of counseling services for elderly and vulnerable people. RESULTS AND CONCLUSION: The results of the evaluation of all care support centers in Baden-Württemberg showed that they offer a wide range of services ranging from counseling services for simple assistance to promoting self-help, up to comprehensive case management. The wide variety of counseling services offered also showed that these care support centers can meet the many different needs and requirements of the clientele. Findings from this study enabled a positive conclusion about the demand to be drawn. It became clear that the services offered are used by many people of all ages who are already in need of care or who are trying to prevent this need from occurring. A consensus about the conceptual development of care provision models employed by care support centers has not yet been achieved in Germany. Findings from this study could be useful in highlighting the need to further develop the care support centers.

Biophysical characterization of Vpu from HIV-1 suggests a channel-pore dualism.

Vpu from HIV-1 is an 81 amino acid type I integral membrane protein which consists of a cytoplasmic and a transmembrane (TM) domain. The TM domain is known to alter membrane permeability for ions and substrates when inserted into artificial membranes. Peptides corresponding to the TM domain of Vpu (Vpu(1-32)) and mutant peptides (Vpu(1-32)-W23L, Vpu(1-32)-R31V, Vpu(1-32)-S24L) have been synthesized and reconstituted into artificial lipid bilayers. All peptides show channel activity with a main conductance level of around 20 pS. Vpu(1-32)-W23L has a considerable flickering pattern in the recordings and longer open times than Vpu(1-32). Whilst recordings for Vpu(1-32)-R31V are almost indistinguishable from those of the WT peptide, recordings for Vpu(1-32)-S24L do not exhibit any noticeable channel activity. Recordings of WT peptide and Vpu(1-32)-W23L indicate Michaelis-Menten behavior when the salt concentration is increased. Both peptide channels follow the Eisenman series I, indicative for a weak ion channel with almost pore like characteristics.

Towards a mechanism of function of the viral ion channel Vpu from HIV-1.

Vpu, an integral membrane protein encoded in HIV-1, is implicated in the release of new virus particles from infected cells, presumably mediated by ion channel activity of homo-oligomeric Vpu bundles. Reconstitution of both full length Vpu(1-81) and a short, the transmembrane (TM) domain comprising peptide Vpu(1-32) into bilayers under a constant electric field results in an asymmetric orientation of those channels. For both cases, channel activity with similar kinetics is observed. Channels can open and remain open within a broad series of conductance states even if a small or no electric potential is applied. The mean open time for Vpu peptide channels is voltage-independent. The rate of channel opening shows a biphasic voltage activation, implicating that the gating is influenced by the interaction of the dipole moments of the TM helices with an electric field.

Perceiving oneself as 'disabled' or as having a 'disabling condition': a discriminant function analysis.

Using discriminant function analysis, information obtained in telephone interviews with a national, random sample of 1000 Americans with self-ascribed disabling conditions was analysed to cast light on differences between individuals who did and did not consider themselves 'disabled'. Maximum separation between the two groups was attained by an equation of six descriptors. In the order of their importance they were (1) the belief that others who knew them well considered them disabled, (2) self-rated severity of disability, (3) identification with others with disabilities, (4) gender, (5) perceived extent of limitations, and (6) needing equipment to walk. Somewhat different equations were generated for sampled men and women. An appreciation of these results in terms of a person's fit with his or her environment is offered.

Investigations on the relation of dysgnathias and S-sound pronunciation.

A registration-form phonetic test has been developed which incorporates an established method for checking fine motor skills. Using an objective measuring and computing technique (electro-acoustic sound analysis according to the sound-seeking method), the author studied the pronunciation of the S-sound of one group of eugnathic and three groups of dysgnathic test persons. There were significant differences in sound characteristics between the normal group and all groups with dysgnathia (P = 0.001). Therefore it is considered that not every patient with an anomaly of the tooth position must have a disturbance of the S-sound. In contrast to the relatively narrow variations in the normal group, in all groups with dysgnathia considerable dispersions were registered. The anterior open bite occupies first place with regard to its susceptibility to disturbances of the S-sound. The statistical analysis of the partial energy values of all the S-sound spectra revealed typical normal behaviour on the one hand, and characteristic differences between the groups with dysgnathia and the group with eugnathia on the other. The information which is most important for the valuation of the S-sound are contained in the frequency area up to 9 kHz.