Cornelia R. Karger

Application of early risk detection concepts and methods to environmental health. A German feasibility study

Early risk detection is essential for being able to address the most important environmental health risk‐topics in a persistent and prospective manner. In support of the action programme “Environment and Health” (APUG) of the German Federal Ministry of Health and Social Security (BMGS) and the Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU) which recommended that a detection and evaluation system for the timely recognition of emerging risk problems be developed, a qualitative feasibility study was commissioned. The results of this study are presented here and support the development of an early risk detection system based on the insights gained from the investigation of case studies and the differentiation and presentation of a risk typology, methods, tools, and suggested organizational processes. The study has shown that early risk detection includes the identification, characterization, evaluation and dissemination of information on possible risks as well as the circumstances of appearance and distribution. The goal is the recognition of possible risks in order for risk management to be able to introduce swift and appropriate measures. Consequently, it can also serve as an instrument towards further development of a balanced and structured implementation of the precautionary principle in the environmental health policy.

Adoption of stationary fuel cells: a focus group study with potential users

This study is concerned with the adoption of stationary Fuel Cells (FCs) for energy supply by different user groups. FCs are an emerging technology, which many enterprises hope to launch on the market in the coming years. Based on Rogerss innovation diffusion theory, we conducted six focus groups with 49 industrial users and six focus groups with 54 different private end-consumers. We analysed advantages and barriers as seen by the potential users and investigated what relevant motives underlay their decisions to invest in such an innovative technology. The findings indicate that FCs may not be adopted very quickly. In our conclusion, we point towards communication strategies that could be used when this technology is launched on the market.

Citizen Scenarios for the Future of Personalized Medicine

The rapid development of biomedicine could, in the future, facilitate a kind of medicine that identifies morbidity risks early, even before clinical symptoms occur, and that provides therapy options tailored to the needs of each patient. There is a growing call for a greater participation of the young generation in establishing future technological developments with due regard to their ethical, social and economic concerns. This article reports on the development and implementation of a citizen scenario workshop which was highly structured, moderated and supported by experts. For six months, 22 German participants in the European Youth Parliament developed four scenarios of personalized health care in 2025. The participants identified 25 driving factors that influence the future of personalized medicine in the German health care system and characterized the essential risks and chances of each scenario. Results and evaluation both show that as a participatory tool, the scenario method is suitable for fostering societal involvement in the debate about possible futures. The methodology employed is presented, followed by a detailed description of each of the four scenarios.

Mediationsverfahren und ihre Nutzungsmöglichkeiten für Unternehmen

Fruher konnten Unternehmen darauf vertrauen, sich allein durch wirtschaftliche Kompetenz im Markt zu behaupten. Dies hat sich jedoch geandert. Neben dem marktbezogenen Umfeld des Unternehmens spielt die gesellschaftliche Dimension im Wettbewerb eine immer entscheidendere Rolle. Die Wertauffassungen der Gesellschaft werden an Unternehmen herangetragen, wie z.B. im Zusammenhang mit Rustungsgeschaften oder in bezug auf die Frauenfrage. Gelingt es Anspruchsgruppen, solche Themen zu politisieren und das Konsumentenverhalten mit Hilfe grosangelegter Kampagnen zu beeinflussen, bedeutet dies haufig enorme Imageverluste und Umsatzeinbusen fur die betreffenden Unternehmen.

Emotional experience in patients with advanced Alzheimer's disease from the perspective of families, professional caregivers, physicians, and scientists

ABSTRACT Objectives: The objective of this qualitative study was to gain insight into families’ and professionals’ understanding of the emotional experience in patients with advanced Alzheimers disease. Method: A total of ten focus group interviews were carried out with 63 participants (relatives n = 20; caregivers n = 17; physicians n = 12; scientists n = 14) recruited using purposive sampling strategies. Each focus group was audiotaped, transcribed and analysed using the method of structured qualitative content analysis. Results: Study findings show that for all groups with the exception of relatives, emotionality is one of the most important characteristics retained despite the illness. Indicators are patients continued ability to produce emotional signals, be responsive to others, and retain emotional information despite memory loss. In the spectrum of emotions, professional caregivers emphasize positive emotional states more strongly than physicians or scientists. In contrast, relatives emphasize the loss of emotional experience. Critical indicators denying subjective emotional experience are impairment of (autobiographical) memory (especially the non-recognition of relatives), the reduction of means of verbal expression with simultaneous uncertainty in interpreting nonverbal expression as well as the perceived discrepancy between present emotional experience and behaviour and that of the premorbid personality. Conclusion: When relatives anchor on the premorbid personality, the perceived discontinuity of emotional reactions to stimuli triggering an emotional response in contrast to their own expectations gives rise to an extremely ambiguous situation. Training programmes should be developed for families to help them comprehend and respond to nonverbal emotional expression.