Abordando la problemática de las armas biológicas en el siglo XXI: el papel de una red de prevención 2.0 / No disponible

El uso estratégico de la enfermedad en la guerra ha demostrado ser una amenaza para la humanidad desde hace mucho tiempo; sin embargo, la naturaleza cambiante tanto de la ciencia como de Ia seguridad tiene, al combinarse, el potencial idóneo para estimular la adopción de nuevas (y clásicas) armas biológicas. Este breve artículo se inicia con la descripcion de algunos de estos cambios antes de considerar los medios y las medidas establecidas para hacer frente al desafío de las armas biológicas. Posteriormente, se procederá a delinear una red de prevención 2.0, compuesta por hebras que se refuerzan mutuamente, con la que se pretende formar un marco para un enfoque más holistico que sirva para hacer frente al desafío de las armas biológicas en el siglo XXI (AU)

The strategic use of disease in Warfare has long proven a menace to humankind; however, the changing nature of both science and security has the potential to encourage the assimilation of new (and old) biological weapons. This short article begins by outlining some of these changes before considering the means and measures in place to deal with the challenge of biological weapons. It proceeds to outline a Web of Prevention 2.0, comprised of mutually reinforcing strands that are intended to form a framework for a more holistic approach to dealing with the challenge of biological Weapons around the globe ln the 21st century (AU)

[Medicolegal aspects of tumor boards]. / Medizinrechtliche Aspekte von Tumorboards.

The presentation of tumor patients to tumor boards has widely developed into a medical standard. The necessary compliance to the medical standard can lead to obligatory presentation if the complexity of a case dictates that this cannot be comprehensively covered by a single treating physician. The organization of a tumor board must be so that the structure and specialist competence guarantees an adequate consultative function of the represented specialties. Tumor board members are not automatically promoted to become part of the treating team just by participation and therefore do not have a guarantor position but do have the obligation of care of a consulting physician. Tumor board decisions have a recommendation character, are not binding in the legal sense and do not relieve the treating physician from the obligation to critically scrutinize the recommendations before implementation. On the other hand the treating physician must be able to justify not following the recommendations on the basis of the medical obligation to care. The tumor board must fulfil the same requirements for documentation as any other consultative activity.

[Quality assurance in sociomedical evaluation]. / Qualitätssicherung in der sozialmedizinischen Begutachtung.

Presented is the work of the Quality Assurance in Sociomedical Evaluation Project Group and its findings so far. The Project Group has developed a quality assurance concept for the outcome quality of sociomedical evaluations with personal examination and for evaluations on the basis of medical records. The quality criteria proposed by the Project Group are divided into primary as well as particular criteria. The primary criteria are: plausibility and conclusiveness, reproducibility, neutrality; the particular criteria are: formal and content programming, medical-scientific foundations, understandability, completeness, transparency, and efficiency. Both, the primary and the particular criteria are operationalized through examination questions. To fulfill a primary quality criterion, all related examination questions have to be answered in the affirmative. The particular criteria are related using a scoring system. The quality assurance programme also provides for a peer-review procedure; however, the manual for this procedure has yet to be developed. Research projects will be needed to determine the methodological requirements that have to be fulfilled for the proposed peer review procedure. Prior to implementation of the programme with the financially responsible pension insurance agencies it will be necessary to estimate the amount of time and manpower involved.

[Operationalized psychodynamic diagnostic (OPD)--potential for quality assurance]. / Potenzial der Operationalisierten Psychodynamische Diagnostik (OPD) für die Qualitatssicherung.

OBJECTIVES: Psychotherapy is subjected to the legal conditions of quality assurance(QA). Does operationalized psychodynamic diagnostics (OPD) contribute substantially to this? METHODS: We investigated the application of OPD in outpatient psychodynamic psychotherapy, inpatient treatment, rehabilitation, and legal assessment. RESULTS: Psychodynamic diagnostics, treatment plan, and evaluation by means of the OPD and Heidelberg Structural Change Scale (HSCS) may be comprehensibly described for quality assurance (QA) of outpatient and inpatient psychotherapy. Virtually all psychodynamic conceptualized departments for psychosomatic medicine and psychotherapy as well as some rehabilitation centres applied OPD. Furthermore, data-collection periods were defined during and after inpatient short- and long-term psychotherapy. OPD serves QA in legal assessment and is of a pivotal significance in judicial proceedings. CONCLUSIONS: It must be deliberated whether more extensive use of QA, in cooperation with outpatient psychotherapists and in comparison to institutions, could be of benefit to patients.

[Medical assessment]. / Arztliche Begutachtung.

Multimorbidity and comorbidity in insured persons require a single medical assessment. The key aspects of such an assessment are the ability to view insured persons holistically, a functional interpretation of structural organ disorders, and test results. The performance of a medical report (form and content) is a further important quality factor.