APL: a corporate strategy.

This paper is based on, and summarises, papers read at the second annual international conference of Nurse Education Tomorrow held at the University of Durham (UK) September 1991. To this end this paper will offer: Some Accreditation of Prior Learning (APL) definition and process as reflected in the literature available. A distinction will be made between APL and Accreditation of Prior Experiential Learning (APEL) although the procedures and processes for assessing them will be shown to be the same. A brief outline of corporate strategy, as it applies to APL, will be given to form the basis for logical demonstration of how Derbyshire Institute of Health and Community Studies has employed such a corporate strategy. Insights developed and gained from APL research currently being undertaken through the college of nursing and midwifery will be used to inform the development and nature of corporate strategy. A flowchart of the operationalisation of the corporate strategy is offered as an integrative summary of how all the APL ideas have had a positive cumulative effect. The paper finishes by highlighting the possible strengths and limitations of APL corporate strategy.

[Overview of brief psychotherapies--a basis for discussion of problem-oriented therapy]. / Kurzpsychotherapien im Uberblick--Diskussionsgrundlage für eine problemorientierte Therapie (POT).

Historical and pragmatic reasons justify short term practice of psychotherapy. Some of the better known methods are discussed in respect to their concept, indication and setting: Malan and the Tavistock-group; Mann: Time limited psychotherapy; Sifneos: STAP, Short term anxiety provoking psychotherapy; Davenloo: Broad focus short term dynamic psychotherapy; Strupp: TLDP, Time limited dynamic psychotherapy; Luborksy: Supportive-expressive psychoanalytic psychotherapy; Klerman: Interpersonal psychotherapy; Beck: Cognitive therapy. After a cross-comparison arguments are given why there is still a need for a more problem- and patient-oriented, eclectic and limited psychotherapy. Besides theoretical reasons there are practical and didactic aspects in favour of such a method.

[Problem oriented therapy. A new therapeutic and didactic concept]. / Problemorientierte Therapie (POT). Ein therapeutisches und didaktisches Konzept.

Problem Oriented Therapy (POT) is a short-term therapy concept that is characterized by the following essentials: Problem orientation, patient orientation, eclecticism and process-structuring. These essentials will be explained and their therapeutic and didactic implications shown. POT is not committed to a certain psychotherapeutic school but uses selectively reliable methods from different therapeutic approaches. The indication to specific therapeutic strategies is made from a pragmatic point of view on the level of problem definition and takes account of the patient's own comprehension of the problem. Transparency and flexibility of therapeutic thinking and acting are essential in POT. This will be illustrated by a case report. The training-settings of POT will also be briefly described.

[The value of subjective illness theories in problem oriented therapy]. / Zum Stellenwert subjektiver Krankheitstheorien in der Problemorientierten Therapie (POT).

Subjective illness concepts mean the more or less comprehensive psychological explanations about causes and functions of actual psychosocial problems by the patient. These concepts historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at monitoring the individuals' experience of being ill or healthy. Often they don't accomplish this aim because they are deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as an important issue for our problemoriented therapy.

Teaching problem-oriented therapy.

The therapeutic concept is problem- and patient-oriented. In analogy to it the didactic concept is problem- and therapist-oriented. The essential point is learning in groups from practical cases. Problem-oriented in this context means that the problems-solving process in which the patient and the therapist are engaged is supported by the observer group. Therapist-oriented means that the learning process should take account of the different preferences and experiences of the therapists. That can only be accomplished by problem-oriented learning. Each psychotherapy training group consists of 4 assistant doctors and a supervisor and stays together about 1 year. The strongly structured concept of problem-oriented therapy (POT) [Blaser et al., 1988] offers the beginner a framework by which he can guide the dialogue with the patient. The eclecticism of POT allows the more experienced therapist to try out new methods without losing track of the problem. The constantly changing role of being observer or therapist supports the group coherence, and furthermore it promotes an important element of therapeutic competence, the ability to get into a close relation with the patient and at the same time being able to observe oneself, the patient and the therapeutic process from a more distant view. In addition to the POT training group tutorials in special psychotherapy methods and single supervision sessions are offered.

Theory and technique of problem-oriented therapy.

Problem-oriented therapy (POT) features the following essentials: problem orientation, eclecticism, patient orientation and brevity. These ingredients, above all the eclecticism, are detailed: diverse psychotherapeutic interventions are administered to foster awareness, modification of thought patterns, modification of behavior, emotionality, awareness of the body, ability to relax, and support. The required abilities of the therapist are mainly flexibility and transparency of his therapeutic actions. The definition of the problem which is negotiated together with the patient is decisive for the selection of the intervention strategy. An example illustrates the use of POT especially as in contrast to school-consistent traditional therapies.

Subjective illness concepts and problem-oriented therapy.

Subjective illness concepts mean the comprehensive psychological explanations about causes and functions of actual problems by the patient. These concepts are related to basic needs and they historically arise from interactions with the social environment. In respect to the actual situation they are constructed in a new way. They aim at reorganizing the needs of the sick individual as well as monitoring his experience of being ill. Often they do not accomplish this aim because they appear to be deficient for many reasons. In the therapeutic situation the patient is confronted with the scientific theories of his therapist. Both concepts represent different perspectives of the same problem. However, both have to be discussed in a cooperative manner and ultimately result in a complementary view which we denote as 'problem definition'.

Investigations of the Host Range of the Corn Cyst Nematode, Heterodera zeae, from Maryland.

The host range of the corn cyst nematode, Heterodera zeae, recently detected in Maryland, was investigated. A total of 269 plant entries, representing 68 families, 172 genera, and 204 species, was inoculated with cysts or a mixture of eggs and second-stage juveniles of H. zeae. The host range of the Maryland population of H. zeae was limited to plants of the Gramineae and included 11 tribes, 33 genera, 42 species, and 77 entries. All 22 corn (Zea mays) cultivars tested were hosts. Other economic hosts included certain cultivars of barley (Hordeum vulgare), oat (Arena sativa), rice (Oryza sativa), sorghum (Sorghum bicolor), sugar cane (Saccharum interspecific hybrid), and wheat (Triticum aestivum). Fall panicum (Panicum dichotomiflorum), a weed species common to cultivated fields in Maryland, was also a host for H. zeae. Other hosts included meadow foxtail (Alopecurus pratensis), Calamagrostis eipgeios, Job's tears (Coix Lachryma-Jobi), green sprangletop (Leptochloa dubia), witchgrass (Panicum capillare), broomcorn (Panicum miliaceum), fountain grass (Pennisetum rueppeli), reed canary grass (Phalaris arundinacea), common reed (Phragmites australis), eastern gamagrass (Tripsacum dactyloides), corn (Zea mays), and teosinte (Zea mexicana).

Diagnosis of alcoholism: the Munich Alcoholism Test (MALT).

The purpose of our project was to develop and empirically test a diagnostic instrument which would permit sufficiently reliable differentiation between alcoholics and healthy as well as sick persons and which would also be easy and economical to administer. For this purpose, roughly 250 diagnostically relevant items were selected from the extensive literature on alcoholism and, with a total of 1335 patients (661 of these were alcoholics), were evaluated in three separate phases for their ability to differentiate. The best items were selected on the basis of various statistical criteria and then cross-validated. The result is the Munich Alcoholism Test (MAT) which consists of two complementary parts: a 7-item physician's assessment part and a 24-item self-assessment part. In a cross-validation study on 675 unselected in- and outpatients a validity of r = 0.94 was obtained. The reliability of the self-assessment part was r = 0.84.

[Diagnosis of alcoholism. The Munich Alcoholism test (MALT) (author's transl)]. / Diagnose des Alkoholismus Der Münchner Alkoholismustest (MALT).

From the extensive literature on alcoholism 250 relevant diagnostic items were selected and tested for their selectivity in 3 independent inquiries among 1335 patients (661 of them alcoholic), both outpatients and inpatients. The outcome is a two-part test: a section of 7 questions answered by the doctor and a self-assessment section comprising 24 questions answered by the patient. Its validity (validity of the whole test r=0.85) and reliability (reliability of the self-assessment section r=0.94) are high. A diagnosis of alcoholism made according to the usual clinical aspects was confirmed in 90% of 675 unselected medical, surgical and psychiatric patients and alcoholism was suspected in a further 8%.

[A short questionnaire for problem drinkers. An empirical analysis (author's transl)]. / Kurzfragebogen für Alkoholgefährdete (KFA). Eine empirische Analyse

This short questionnaire for alcoholics (KFA) has so far been used as an aid for the clinical diagnosis of alcoholism. In the presented empirical study the KFA was tested on its efficiency as an independent diagnostic instrument for the identification of alcoholics. The questionnaire was given to 120 male alcoholics and 80 male controls (nonalcoholic inpatients). Its validity (correlation of test scores by independent criterion) of r = 0.81 with a reliability of r = 0.94 is fairly high, considering the nature of our control group being inpatients in contrast to the normally used healthy controls. A further improvement of discrimination could be achieved in weighting certain items. On this basis given a cutting score of 6 points the misclassifications in both alcoholics and controls could be reduced to 4%. Allowing this error rate the KFA can be considered a suitable test for the identification of alcoholics.