[Interdisciplinary teleconsultation: first practical experiences with 100 patients]. / Interdisziplinäre Telekonsultation: Erste praktische Erfahrungen mit 100 Patienten.

UNLABELLED: PROBLEM DEFINITION: Increasing specialization can be observed in the various medical fields and as a consequence there is little professional exchange between ear nose and throat (ENT) specialists and general practitioners. At the same time there has been significant technological development in telemedicine over the last 5 years; however, this potential is not being sufficiently exploited. The objective of this project is to implement a practicable solution for teleconsulation between ENT specialists and general practitioners. MATERIALS AND METHODS: The connection is based on a secure broadband internet connection, the corresponding server structure and a video endoscopic system. In the period from 01 January 2011 to 30 June 2012 (18 months) a total of 102 patients were included in the study in which 4 general practitioners and 5 ENT specialists participated. The protocol comprised the following parameters: indications and typical questions, number of patients presenting to the ENT specialist due to the available teleconsultation service (CBO), number of patients referred to the ENT specialist after teleconsultation (CIO), assessment of the quality of the additional expert opinion (LOQ GP), assessment of the accuracy of the specialist physician tele-diagnosis (TDS-FA) and assessment of the impact of the expert physician diagnosis on the general medical treatment (COS). RESULTS: Teleconsultation was most frequently used for diagnostics on tonsils (37% of the presented cases), the external auditory canal (32%) and the inner nose (15%). Of the patients analyzed were 53.9% presented to the ENT specialist only because the teleconsultation service provided an effortless opportunity and after teleconsultation 40.1% of the patients were referred to the ENT specialist. General practitioners assessed the benefit from the specialist opinion with 64 points. Diagnostic certainty of the specialist opinion, i.e. the validity scale of the diagnosis made, was on average 2.0. In approximately 35.3% of the cases (36 out of 102 patients) participating general practitioners documented a considerable impact of teleconsultation on the diagnosis and/or therapy. CONCLUSIONS: Teleconsultation between general practitioners and ENT specialists can provide an advantage in treatment quality and patient comfort. According to the experience gained there is a very low risk of diminishing the professional competency of ENT medicine and the involvement of the expert group in the early project stage allows a greater leeway in project implementation. This could also have an impact on future medical performance specifications. According to the ENT experts involved in the project further applications of teleconsultation are very conceivable.

[Housing for the handicapped--handicapped housing?]. / Wohnen Behinderter--behindertes Wohnen?

The article in the first line points out the housing problems faced by people with a severe physical handicap, especially with regard to nursing/care dependence. In this framework, linkages are established with the needs associated with housing, the various practical approaches in the satisfaction of housing needs are outlined. The legal basis with regard to architectural aspects as well as relative to the financing mechanisms for nursing/care and income maintenance are essential factors in view of their practical implementation, as is the acquisition of life skills on the part of those concerned. A number of possible changes in these respects are described.

[Parent counseling between crisis intervention and preventive intervention]. / Elternarbeit zwischen Krisenintervention und antizipierender Vorsorge.

The presence of impairments in their newborn child entails parental mourning and coping processes, which are either accelerated, prolonged, or repressed by the professional help provided, depending on the nature and quality of such intervention. Based on Schuchardt's model of coping with crisis (1980), the interactional difficulties between professional helpers/parents and child in the various phases are set out, inferring potential modifications in this interaction, but also changes in training and research contents.

[Partnership and sexuality of thalidomide-affected young people (author's transl)]. / Partnerschaft und Sexualität thalidomidgeschädigter Jugendlicher.

In the 1977-1979 period, 84 thalidomide-affected young people who had followed secondary education up to level I (Sekundarstufe I; school leaving age approx. 16 years), had been interviewed on their sexual experiences. The group was composed of young people with purely orthopaedical impairments, which were rank-ordered in four degrees of disability severity according to the extent of medical lesion. The group under examination was matched by a parallel group of non-disabled young people who had been selected on the criteria of sex, age, educational level, vocational objectives, and occupational status of the father. In comparison to the non-disabled, physically disabled young people are demonstrated to have deficits in sexual experience, which are getting more pronounced with increasing severity of the disability. These deficits in sexual experience do not seem to stem from a lack of social contacts, but rather from their perceived non-compliance with the norms that govern non-disabled people's concepts of performance, attractiveness, and sexuality. The physically disabled young people are aware of these problems; they however seem to be able to cope with them through their leading a "normal" life as regards such aspects as school education, vocational training, and social contacts. Special emotional problems may however develop in the severely disabled young people. An additional sexual problem may arise from their partly less pronounced acquisition of typical sex-role identities, which may however also be viewed as a potentially positive circumstance.