[Reintegration into the profession--report on the first reintegration course in Krefeld].
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Education, Nursing, Continuing↗
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Reintegration to Normal Living as a proxy to quality of life.
The impact of disease and treatment on patients' lives is frequently measured by endpoints such as health status, well being and quality of life. The objective of this paper is to introduce a new but related outcome concept termed "reintegration to normal living" and to compare it to the quality of life. The concept of "reintegration" is closely allied to functional performance. Like quality of life, it is important to measure when therapeutic goals cannot include a cure but are directed at controlling the disease process or fostering compensation for impairment. A Reintegration to Normal Living (RNL) Index has been developed. Although more limited in conceptual focus, its content is similar to global quality of life measures. It is internally consistent, demonstrates content and construct validity, can be completed by patients or significant others and is sensitive to changes in patient status. The degree of reintegration achieved by patients after an incapacitating illness is seen as contributing to the quality of their lives.
Health Status Indicators↗
Factors influencing reintegration to normal living after amputation.
This study identified factors affecting reintegration to normal living (RNL) after lower extremity amputation. A questionnaire was used to evaluate RNL at a veterans' medical center and private rehabilitation clinic. The patients were 42 elderly individuals (68 +/- 1.5 years). Eighty-eight percent were men and 76% had additional health problems. Unilateral below-knee amputations, unilateral above-knee amputations, and bilateral amputations accounted for 38%, 36%, and 26% of subjects, respectively. Eleven questions were asked to evaluate mobility, self-care, work, recreation, social activities (daily functioning), relationships, social self, and life events (perception of self). The median overall RNL score was 16 of 22 (range, 5 to 22). Poor reintegration occurred in community mobility, work, and recreation. Perception of self questions showed satisfactory reintegration. Examination of variables impacting reintegration showed only additional illness significantly reducing the RNL score. It was concluded that current rehabilitative efforts regarding home mobility and psychological adjustment are satisfactory. More attention to community mobility, recreation, and additional illnesses would improve RNL after amputation.
Activities of Daily Living↗
Recovery of some functional properties of the detergent-extracted cholinergic receptor protein from Torpedo marmorata after reintegration into a membrane environment.
The change of affinity of the acetylcholine receptor for agonists and the influence of local anaesthetics has been studied in detail in receptor-rich membranes. These properties are changed after solubilisation by ionic detergents. A method for reproducibly reintegrating the receptor protein into a lipid environment is described. Reintegration of the receptor results in partial recovery of the binding and fluorescence properties of the membrane-bound receptor protein. In particular, the slow affinity change caused by agonists can be recovered but not the effect of local anaesthetics on this change. The fluorescence response to cholinergic ligands of the reintegrated receptor protein labelled with quinacrine does not appear identical to that found with the native receptor-rich membranes. It is suggested that the failure to recover the sensitivity to local anaesthetics is at the origin of the difficulties to regain functional reconstitution.
Animals↗
Excision and reintegration of the Escherichia coli K-12 chromosomal element e14.
The genetic element e14 is a natural component of the Escherichia coli K-12 chromosome. On induction of the SOS pathways, e14 excises as a 14.4-kilobase circle. We report here on the reintegration of e14 into the chromosome of cured (e14 degrees) E. coli K-12 derivatives. Using a Tn10 insertion mutant of e14, we found that reintegration occurred specifically at the locus originally occupied by e14 and with the same orientation. The reintegration event required neither the RecA nor the RecB functions. The attachment site of the free form was located within a 950-base-pair HindIII-AvaI fragment and shared sufficient homology with the host attachment site to form detectable DNA-DNA hybrids. Even though E. coli C and B/5 did not contain e14, they did possess a HindIII restriction fragment that hybridized to the free e14 attachment fragment. E. coli C could be transformed with e14-1272::Tn10, resulting in integration at this site of homology. The Tn10 mutants were also used in mapping the point of e14 attachment. We found the following sequence: fabD purB atte14 umuC. Furthermore, analysis of a recombinant plasmid that contained both the e14 attachment site and the purB locus showed that these two loci occur within 11 kilobases of each other.
Chromosome Mapping↗
Community reintegration program.
A specific program in practice for community reintegration of the patient with burns is described. It has been demonstrated that a gradual transition for the patient with burns between the acute care setting and active participation in family, leisure, and vocational roles enhances psychosocial and functional recovery. A systematic process of community reintegration within a rehabilitation setting can facilitate this transition for patient and family through Community Skills Training with a therapist and Community Skills Practice before the patient assumes outpatient status.
Activities of Daily Living↗
[Prognosis, long-term sequelae and occupational reintegration 2-4 years after severe craniocerebral trauma].
122 patients with severe head injuries were assessed in terms of their global outcome and social and vocational reintegration 2 to 4 years after trauma. Some patients were studied with regard to physical, psychological, psychosocial, and cognitive long-term consequences. Less than half of the patients (43%) were found to be without employment handicap, while the remainder showed various degrees of occupational difficulty. Most of the patients had significant long-term problems related to cognitive and psychosocial dysfunction. The cognitive disorder, physical handicap, age, and duration of unconsciousness are all important prognostic factors for vocational reintegration, neuropyschological impairment being the single most important factor.
Activities of Daily Living↗
Memory retraining to support educational reintegration.
A memory retraining package specifically designed to facilitate reintegration of head injured patients into an educational environment is described. Two adolescent patients who had severe head injuries were administered the memory retraining package approximately three months postinjury. A single case study and multiple baseline design was used to evaluate the efficacy of the memory retraining program. The results suggested that this is a promising avenue for improving memory functioning and facilitating educational reintegration, but only where moderate rather than severe memory deficits are involved. Studies involving groups of patients and the collection of data on generalization are required to confirm usefulness.
Adolescent↗
School programmes in drug rehabilitation and social reintegration in the Philippines.
In recognition of the role of education in the process of the social reintegration of drug-dependent persons, the Dangerous Drugs Board, the Philippines' highest policy-making and co-ordinating body on all matters pertaining to drug abuse control, the Department of Education, Culture and Sports, and other drug-rehabilitation centres have jointly initiated and are implementing a formal school programme at the secondary level, within the confines of rehabilitation centres. Thus far, a built-in school programme has been established in the three rehabilitation centres existing in the country, from which 500 individuals have graduated. A follow-up study is currently underway to determine the effect that these programmes have had with respect to the successful reintegration of those individuals into community life.
Adolescent↗
School reintegration: a rehabilitation goal for spinal cord injured adolescents.
This article describes how the Education for All Handicapped Children Act of 1975, Public Law 94-142, assists in achieving the rehabilitation goal of school reintegration for spinal cord injured (SCI) adolescents. It also describes how subordinate goals are achieved during the inpatient rehabilitation phase. Comments from a survey of 13 SCI adolescents who returned to school demonstrate the need to prepare SCI adolescents for the services to which they are entitled, to acquaint them with ways of resolving possible problems they may encounter, and, when they return for follow-up care, to encourage them to continue in school.
Adolescent↗
Nuclear factor 1 (NF-1) binding sites in the genomes of human oncoviruses: a hypothetic role for reintegrated cellular origins of replication in malignant transformation.
We have found that genomes of human T cell leukemia-lymphoma virus type I (HTLV-I), BK virus (BKV), and a hepatitis B virus (HBV) DNA sequence integrated into DNA of a hepatoma-derived cell line contain binding sites for nuclear factor 1 (NF-1), a cellular protein which binds to adenoviral and putative cellular origins of DNA replication. We suggest that cellular origins of DNA replication acquired by oncoviruses may play a role in malignant transformation after reintegration into the cellular genome by providing new targets for cellular factors initiating DNA replication and by perturbing the temporal order of replication.
Binding Sites↗
Community reintegration and quality of life following spinal cord injury.
This report contains a brief overview of issues related to community reintegration and quality of life for persons with spinal cord injuries. Current data from the National Spinal Cord Injury Statistical Center are provided on place of residence, employment, education and marital status after rehabilitation discharge. The health policy implications of these data are discussed along with prospects for continued improvement of long term social outcomes and directions for future research.
Employment↗
SV40 DNA amplification and reintegration in surviving hamster cells after 60Co gamma-irradiation.
SV40-transformed Chinese hamster embryo cells were exposed to 60Co gamma-irradiation and the fate of the integrated SV40 sequences was pursued over a period of 20 days following radiation exposure. As shown by colony hybridization, integrated SV40 sequences were amplified in surviving and non-surviving cells. At later times, however, clonal sublines of surviving cells grown for 20-30 cell generations after irradiation had lost most of their amplified SV40 copies but showed altered restriction fragment patterns indicating reintegration of SV40 sequences at new sites of the hamster genome. This suggests that 60Co gamma-irradiation can generate mutations by inducing over-replication of chromosome segments that are then substrates of enzymatic rearrangements.
Animals↗
Social reintegration of sexual delinquents by a combination of psychotherapy and anti-androgen treatment.
The high frequency of recidivism with convicted sexual perverts is mainly due to the compulsive character of perversion. The classical methods of treatment are seldom satisfactory: Surgery provokes ethical objections, psychopharmaca and oestrogens lead to disagreeable side effects, psychotherapy of any kind is unlikely to be efficacious because of the unfavourable atmosphere the nature of perversion causes it to take place in. However, the climate of both psychoanalytical treatment and suggestive and directive psychotherapy can be enhanced by a combination with an anti-androgen treatment, which eliminates the patient's fear of conviction by inhibiting his sexual urge. Two cases illustrate this combined method. On the basis of a positive disposition, which arises from the improved climate, sublimation of the sex drive and the achievement of a feeling of social responsibility is aimed at. The advantages of the combined therapy are then discussed in comparison with the existing treatments. It is concluded that this combined treatment, next to social guidance and an attempt at solving the fundamental problem of loneliness, can promote the social reintegration of the convicted sexual pervert.
Adult↗
[Reintegration to work in persons having survived a myocardial infarction: current review and ways of development for clinical interventions].
The main purpose of this article is to update the state of knowledge regarding work reintegration following myocardial infarction. Occupational perspectives have greatly evolved during the second half of this century. This can be attributed mainly to a better understanding of the pathology itself and to a development of new therapeutic avenues which are part of a more global vision of the bio-psycho-social characteristics of the patient. The authors did not intend to realize an extensive review of the literature on the subject, but analysed the most significant articles published over the past 20 years. They were selected because of their frequent citation on the scientific literature which seems to confirm their significance and credibility. Following the analysis of the articles selected, the authors conclude that the scientific community has reached a consensus to the effect that the general evolution of the patient post myocardial infarction is greatly determined by psychosocial factors. It follows that comprehensive rehabilitation programs despite their limited impact in an experimental setting offer some stimulating perspectives. They suggest that some research effort be oriented towards the evaluation of the actual long term outcomes of rehabilitative programs especially on quality of life in general and on quality of life at work more specifically.
Employment↗
Reintegrating the healed burned adult into society: psychological problems and solutions.
This article reviews important psychosocial factors that effect reintegration of the burned patient into society. Issues of pain, brain injury, the psychological reaction, posttraumatic stress, the impact on the family, and alcohol and substance abuse are discussed, and possible solutions to these problems are offered.
Adult↗
[Concepts, experiences and problems in the gradual reintegration into the work process. Results of an inventory taking].
Within the scope of an exploratory inventory check on measures of gradual reintegration into the work process, basic information has been collected for the first time. The programmes up to now implemented by rehabilitating agencies are presented with regard to their structural principles and various financing schemes. A critical assessment of introduction, implementation and success of these measures and their determinants is given, as well as proposed improvements and demands made by experts and the patients concerned.
Adult↗
Reintegration for stroke survivors. Home and community considerations.
Plans for home and community re-entry for the stroke patient should begin as soon as medical stability is achieved. The majority of stroke patients will require a comprehensive program of rehabilitation. Patients and their families should be educated about stroke and the impairments associated with it to promote active participation in the rehabilitation process and to solve problems before they happen. The participation of the family and the use of appropriate community health resources for the stroke patient who is in a safe and accessible home and community environment will markedly enhance a successful outcome. A systematic approach is necessary for people with stroke to achieve their optimum functional level and proper reintegration to home and community.
Cerebrovascular Disorders↗