The definition of community integration: perspectives of people with brain injuries

Despite considerable attention to community integration and related topics in the past decades, a clear definition of community integration continues to elude researchers and service providers. Common to most discussions of the topic, however, are three ideas: that integration involves relationships with others, independence in one s living situation and activities to fill one s time. The present study sought to expand this conceptualization of community integration by asking people with brain injuries for their own perspectives on community integration. This qualitative study resulted in a definition of community integration consisting of nine indicators: orientation, acceptance, conformity, close and diffuse relationships, living situation, independence, productivity and leisure. These indicators were empirically derived from the text of 116 interviews with people with moderate-severe brain injuries living in the community. Eighteen adults living in supported living programmes were followed for 1 year, to track their evolving definition of integration and the factors they felt were related to integra tion. The study also showed a general trend toward more positive evaluation over the year, and revealed that positive evaluation was frequently related to meeting new people and freedom from staff supervision. These findings are interpreted in the light of recommendations for community programmes.     

Repatriation Community Programs, Part I: A collaborative model of service delivery

The Repatriation Community Programs pilot project was funded by the Ontario Ministry of Health in 1990. Its mandate is to facilitate the return of brain-injured individuals from US rehabilitation facilities to their home communities in Ontario. Most Ontario residents receiving rehabilitation in the US fall into one of two 'hard to serve' groups: (1) those with severe behavioural difficulties; and (2) those at various levels of post-comatose unawareness whose families are unwilling to accept chronic care 'maintenance'. The pilot programme has been charged with demonstrating the feasibility of community-based care for severely brain-injured individuals and their families, as well as developing a model of service delivery and interagency collaboration which will expedite province-wide implementation of similar programmes. This paper describes the collaborative model developed over the first 2 years of the project. Issues leading to this model are identified and elements of the model are discussed.     

MUC1 dysregulation as the consequence of a t(1;14)(q21;q32) translocation in an extranodal lymphoma

Cytogenetic abnormalities at chromosome 1q21 are among the most common lesions in diffuse large-cell lymphoma and have been associated with a poor prognosis. A novel cell line, SKI-DLCL-1, was established from ascitic fluid that carries a t(1;14)(q21;q32) chromosomal translocation. Using pulsed-field gel electrophoresis, the breakpoint on the IgH locus mapped to a gamma locus between Calpha(1) and Calpha(2). A cosmid library was prepared from SKI-DLCL-1, and Cgamma-positive clones spanning the breakpoint were identified by screening with fluorescence in situ hybridization. The breakpoint occurs 860 bp downstream of the 3' UTR of the MUC1 gene. The break appears to be a staggered double-strand break consistent with an error in immunoglobulin class switching. The MUC1 gene is highly transcribed and translated, and the protein is highly glycosylated. It is postulated that MUC1 expression is brought under the control of the 3'Ealpha enhancer. MUC1 lies in a region of chromosome 1 characterized by an unusually high density of genes, with 7 known genes in a region of approximately 85 kb. To determine whether there was a pleiotropic effect of the expression of genes in the region as a consequence of the translocation, the expression of 6 additional genes was assessed. None of the other genes in this region (CLK2, propin, COTE1, GBA, metaxin, and thrombospondin 3) are overexpressed in SKI-DLCL-1. Thus, the translocation t(1;14)(q21;q32) seen in both the primary tumor and the derived cell line results in the marked overexpression of MUC1 without affecting the expression of other genes in the region. (Blood. 2000;95:2930-2936)     

社会医疗保险制度改革指标体系构建与评估探索

构建社会医疗保险制度改革评估指标体系,并运用层次分析法和熵技术支持的权系数赋值方法,对构建的社会医疗保险制度评价指标体系进行了评估,定量分析了我国目前医疗保险制度改革的现况。     

Prevalence of Workplace Violence Against Chinese Nurses and Its Association with Mental Health: A Cross-sectional Survey

OBJECTIVES

The aim of this study to investigate the prevalence of workplace violence (WPV) in nurses in hospitals in China, and its influence on nurses' mental health.