RESUMO
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)
Assuntos
Humanos , Masculino , Feminino , História do Século XXI , Armas Biológicas/história , Armas Biológicas/legislação & jurisprudência , Armas Biológicas/normas , Ética , Cooperação Técnica , Prova Pericial/normas , Prova Pericial , Bioterrorismo/tendências , Contenção de Riscos Biológicos/legislação & jurisprudência , Contenção de Riscos Biológicos/métodos , Contenção de Riscos Biológicos/prevenção & controle , Biotecnologia/métodos , Biotecnologia/tendênciasRESUMO
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.
Assuntos
Competência Clínica , Comportamento Cooperativo , Comunicação Interdisciplinar , Neoplasias/terapia , Serviço Hospitalar de Oncologia/legislação & jurisprudência , Serviço Hospitalar de Oncologia/organização & administração , Comitê de Profissionais/legislação & jurisprudência , Comitê de Profissionais/organização & administração , Encaminhamento e Consulta/legislação & jurisprudência , Encaminhamento e Consulta/organização & administração , Competência Clínica/legislação & jurisprudência , Documentação/normas , Prova Pericial/legislação & jurisprudência , Prova Pericial/normas , Alemanha , Humanos , Imperícia/legislação & jurisprudência , Programas Nacionais de Saúde/legislação & jurisprudência , Equipe de Assistência ao Paciente/legislação & jurisprudência , Equipe de Assistência ao Paciente/organização & administraçãoRESUMO
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.
Assuntos
Avaliação da Deficiência , Definição da Elegibilidade/normas , Garantia da Qualidade dos Cuidados de Saúde/normas , Reabilitação Vocacional/normas , Previdência Social/normas , Prova Pericial/normas , Alemanha , Humanos , Manuais como Assunto , Programas Nacionais de Saúde/normas , Revisão por ParesRESUMO
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.
Assuntos
Transtornos Mentais/diagnóstico , Teoria Psicanalítica , Terapia Psicanalítica/normas , Garantia da Qualidade dos Cuidados de Saúde/legislação & jurisprudência , Assistência Ambulatorial , Conflito Psicológico , Prova Pericial/legislação & jurisprudência , Prova Pericial/normas , Alemanha , Humanos , Relações Interpessoais , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Admissão do Paciente , Determinação da Personalidade/normas , Psicometria , Garantia da Qualidade dos Cuidados de Saúde/normas , Resultado do TratamentoRESUMO
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.