Biomedical subjects
Publications and source records attributed to G Bosch.
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The article reports on the results of vocational rehabilitation efforts in 399 schizophrenic patients. The criterion for assessing the rehabilitation outcome was a regular job for at least three months after discharge from the hospital - which was achieved in 51% of the schizophrenics as compared to 63% of the control group. In the majority of cases good rehabilitation results could be achieved only by placement in a job which, compared with the previous position, required less skills. In analysing the rehabilitation success in its relation to different variables it was noted that the diagnostic assignment to paranoid types of schizophrenia was positive whereas the opposite was found in the cases of hebephrenic courses and defective conditions. As a rule, better success could be achieved with older patients, which is attributed to vocational stabilisation before the onset of the disease. More effective than the correlation with diagnostic and psychopathological data was the examination of the relationship between success and the variables 1) social background and 2) attitudes. Very negative factors turned out to be social origin and milieu conditions, economic and family situations, the states of unemployment at the time before admission and an insufficient adjustment to the training programme. No correlation could be found between success and a longer history of employment. Social isolation could be largely eliminated through the therapeutic family milieu offering identification possibilities. In addition, the study revealed the importance of a continuous psychosocial follow-up care.
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The objectives of the augmentation prostheses are to increase the volume, enhance the shape, and improve the projection of the breast. Since 1962, plastic surgeons have used the silicone gel-filled breast implant created by Cronin and Gerow. The contents of the standard implant have been modified: silicone gel-filled, PVP, dextran, oil, saline hydrogel, etc. The shell of the prostheses had been made with a smooth surface, textured silicone, and polyurethane-covered silicone. The shape has been modified: In 1993, A. Miller patented the stacked breast implant used in breast reconstruction. This contribution tends to improve the projection of the breast. In 1994, the authors described a new surgical procedure for locating the standard implants named the double pocket technique. Simultaneously, the authors modified the shape of the prosthesis creating the double implant prostheses.
With regard to gerontological problems (multiple morbidity, insufficient epidemiological knowledge, under-assessment of mental illness, displacement) the results of a total survey of residents over 65 of age in all the geriatric nursing homes and homes for the elderly in the Berlin (W) district of Charlottenburg are presented. Our main interest was in the following items: diagnosis, psychopathology, clinical and personal data, medical and social care, extent of personal contacts with non-residents, and the institutional environment. Results are discussed and inferences for better care, particularly of the mentally ill residents, are indicated.
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The possibilities as well as the limits of day-hospital treatment for elderly mentally ill patients are described, using as a basis a general survey on the situation of psychiatric day-hospitals in the Federal Republic of Germany and West Berlin. As of July 1, 1982, there were at least seven day-hospitals specializing in psychogeriatric patients, whereas a further eight institutions admitted elderly mentally ill patients as well as the usual patients. For all these day-hospitals a review of the current status is given regarding funds, size of program, integration into the existing network of psychiatric services, referral sources, the individual programs perceived mission, clientele, exclusionary criteria, duration of stay, therapeutic activities and staffing. Finally problems such as indication, clientele and delimitation of other ways of treatment are discussed. Questions are asked with regard to the purpose and the necessity of specialized psycho-geriatric partial hospitalization programs.