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Social integration, leisure activity, and life satisfaction in older adults: activity theory revisited.

The relative contributions of objective integration, subjective integration, and total leisure activity to the life satisfaction of older adults are examined. A random sample of 400 persons ages forty through eighty-nine residing in a demographically typical midwestern city were interviewed by phone. Results show that Objective Integration does not contribute incrementally to Life Satisfaction except among males under age sixty-five. Subjective Integration, on the other hand, contributes significantly to Life Satisfaction of males and females under and over age sixty-five. Even when demographic variables, Objective Integration, and Subjective Integration are taken into account statistically, Total Leisure Activity contributes significantly to Life Satisfaction in all groups examined.

Adult↗

Integration of Bacillus thuringiensis H-14 formulations and pyriproxyfen for the control of larvae of Aedes aegypti and Aedes albopictus.

Studies were carried out on the bioefficacy and residual activity of Bacillus thuringiensis israelensis H-14 (Bti) (water-dispersible granules of VectoBac ABG 6511 and liquid formulations of VectoBac 12AS) and pyriproxyfen (insect growth regulator, Sumilarv 0.5%) as direct applications for control of larvae of Aedes aegypti and Aedes albopictus. Two dosages of each Bti formulation (285 and 570 international toxic units [ITU]/liter) and the integration of both Bti formulations and pyriproxyfen were used for residual tests with 45-liter earthen jars for a period of 4 wk. In 1 test series, the treated water was replenished daily with 6 liters of seasoned untreated water. In the 2nd test series, the water in the jars was topped up to the 40-liter level during evaluation. Neither Bti formulation remained effective for a full week. Water-dispersible Bti granules provided effective initial control activity against Ae. aegypti and Ae. albopictus for both test designs (with replenishment and without replenishment of water). The higher dosage (570 ITU/liter) for both Bti formulations was only partially effective at the end of 1 wk after being diluted. After 1 wk, water-dispersible Bti granules provided greater larval mortality than did liquid Bti formulation against both mosquito species when integrated with pyriproxyfen. Pyriproxyfen (79.5 and 159 mg/liter) on its own showed low larvicidal activity but provided very effective control of adult emergence. In this study, integration of Bti (285 and 570 ITU/liter) with pyriproxyfen (79.5 mg/liter) extended the duration of partial larval control somewhat, but live larvae persisted throughout the 4-wk test. The integration effect was more obvious when water-dispersible Bti granules were integrated with pyriproxyfen than when liquid Bti was used. Integration of Bti with pyriproxyfen had a negative effect on adult emergence, which was completely inhibited by pyriproxyfen after day 1. Daily replenishment of water increased Bti activity and provided slightly better larval control. Aedes albopictus and Ae. aegypti were both completely susceptible to the higher concentration of Bti and pyriproxyfen in both test designs (with replenishment and without replenishment of water).

Aedes↗

Identification of integrated hepatitis B virus DNA sequences in human hepatocellular carcinomas in Korea.

The rate of HBV DNA integration into the genome of hepatocellular carcinoma (HCC) cells varies greatly among HCC tissues from different geographical districts. Because of the potential etiological significance of identifying HBV DNA integration in HCC tissues from Korea, we investigated 13 aseptically obtained HCC surgical specimens by Southern blot analysis. Among 13 HCCs, eight (61.5%) contained integrated HBV DNA. Of eight HBsAg-positive patients, six (75%) had integrated HBV DNA in their HCCs while two (40%) out of five HBsAg-negative patients had integrated HBV DNA. Those two HBsAg-negative patients with integrated HBV DNA were all anti-HBs-positive. However, it was not demonstrated in the patient without any HBV serological markers. These findings highly suggest a prominent etiologic role of HBV in the development of HCC. On the other hand, it also strongly favors a multifactorial etiology of human HCC in korea.

Adult↗

Memory for the process of constructing an integrated mental model.

We report two experiments in which people read descriptions of integrated spatial configurations, together with comparable descriptions that did not describe integrated spatial configurations. The integrated spatial descriptions, but not the comparable descriptions, thus supported the construction of a coherent mental model. In Experiment 1, each sentence of the comparable descriptions described the spatial relation between two objects that were not mentioned elsewhere in the description. In Experiment 2, the comparable descriptions were nonspatial, having been constructed by replacing the spatial relations with nonspatial relations. In both experiments, participants were given a surprise recognition test in which they had to identify each of the original descriptions--of both integrated spatial configurations and nonspatial configurations--among a set of distractors. When the sentences in the original description were reordered (and participants were instructed to ignore sentence order), recognition memory was reliably depressed, but only for the integrated spatial descriptions. Reordering descriptions does not change their propositional content, nor does it change the described situation; however, it does change the process of constructing a mental model of that situation. These findings thus suggest that memory for the descriptions retains a trace of the process of constructing an integrated mental model and that reordering the sentences disrupts this memory because the reordering reduces the similarity of the processing of the descriptions at recognition.

Cognition↗

Integration of speed signals in the direction of motion.

Speed discrimination tasks were used to examine the spatial and temporal characteristics of the integration mechanism involved when signals are extended in the direction of motion. We varied the aspect ratio of a signal patch whose speed differed from the background, while holding the area of the signal patch constant, so that the signal patch could be either extended in the direction of motion or extended orthogonal to the direction of motion. Speed discrimination thresholds decreased dramatically as the signal patch was extended in the direction of motion. The spatial and temporal integration regions were larger than would be expected if the integration mechanism were a low-level motion detector. The mechanism was tuned for direction of motion. The data are discussed with reference to two alternative integration mechanisms: a low-level detector that is elongated in the direction of motion and a higher level integration mechanism characterized by cooperative or facilitatory interactions between low-level detectors tuned to the same direction of motion. Our data are consistent with a second-level, direction-specific process that integrates the responses of low-level motion detectors.

Discrimination, Psychological↗

Temporal integration and segregation of brief visual stimuli: patterns of correlation in time.

Two brief sequential displays separated by a brief interstimulus interval (ISI) are often perceived as a temporally integrated unitary configuration. The probability of temporal integration can be decreased by increasing the ISI or (counterintuitively) by increasing stimulus duration. We tested three hypotheses of the relative contributions of stimulus duration and ISI to the breakdown of temporal integration (the storage, processing, and temporal correlation hypotheses). In the first of two experiments, stimulus duration and ISI were varied factorially, and estimates of temporal integration were obtained with a form-part integration task. The second experiment was a replication of the first at two levels of stimulus intensity. The outcomes were inconsistent with the storage and processing options, but confirmed predictions from the temporal correlation hypothesis. Whether two sequential stimuli are perceived as temporally integrated or disjoint depends not on the availability of visible persistence, but on the emergence of a neural code that is based on the temporal correlation between the two visual responses.

Humans↗

Limits on phonetic integration in duplex perception.

The telling fact about duplex perception is that listeners integrate into a unitary phonetic percept signals that are coherent from a phonetic point of view, even though the signals are, on purely auditory grounds, separate sources. Here we explore the limits on the integration of a sinusoidal consonant cue (the F3 transition for [da] vs. [ga]) with the resonances of the remainder of the syllable. Perceiving duplexly, listeners hear the whistle of the sinusoid, but also the [da] and [ga] for which the sinusoid provides the critical information. In the first experiment, phonetic integration was significantly reduced, but not to zero, by a precursor that extended the transition cue forward in time so that it started 50 msec before the cue. The effect was the same above and below the duplexity threshold (the intensity of sinusoid in the combined pattern at which the whistle was just barely audible). In the second experiment, integration was reduced once again by the precursor, and also, but only below the duplexity threshold, by harmonics of the cues that were simultaneous with it. The third experiment showed that the simultaneous harmonics reduced phonetic integration only by serving as distractors while also permitting the conclusion that the precursor produced its effects by making the cue part of a coherent and competing auditory pattern, and so "capturing" it. The fourth experiment supported this interpretation by showing that for some subjects the amount of capture was reduced when the capturing tone was itself captured by being made part of a tonal complex. The results support the assumption that the independent phonetic system will integrate across disparate sources according to the cohesive power of that system as measured against the evidence for separate sources.

Adult↗

Temporal integration of acoustic and cutaneous stimuli shown in the blink reflex.

Temporal integration of pairs of brief blink-eliciting acoustic and cutaneous stimuli was investigated to determine if there was integration of stimuli from different modalities. Reflexes elicited by a tone burst or by a brief electrical shock to the supraorbital nerve followed by a second tone burst or shock at short stimulus onset asynchronies (SOAs) were larger and faster than control reflexes elicited by a single stimulus identical to the lead stimulus of the stimulus pairs. Reflex amplitude was augmented at longer SOAs where there was no effect on latency. Temporal integration was evident for all stimulus pairs, showing that it is due, at least in part, to processes that occur outside specific sensory pathways. Heterogeneous stimulus pairs produced greater reflex enhancement than did homogeneous stimulus pairs. This finding was examined further in Experiment 2, which showed that reflex enhancement with pairs of acoustic pulses was unaffected by the frequency of the second stimulus, suggesting that sensory masking was not acting to suppress reflex expression with acoustic pulse pairs. Integration of reflexogenic acoustic stimuli shown in the blink reflex is restricted to shorter intervals than is integration of acoustic stimuli shown by psychophysical procedures, suggesting that the two methods reflect different aspects of stimulus processing. Integration of reflexogenic stimuli may result from summation of activity associated more directly with reflex expression than with perceptual awareness.

Acoustic Stimulation↗

Variables affecting the academic and social integration of nursing students.

This study attempted to analyze the variables that influence the academic integration of nursing students. The theoretical model presented by Leigler was adapted to the existing conditions in a school of nursing in northern Israel. The independent variables included the student's background; amount of support received in the course of studies; extent of outside family and social commitments; satisfaction with the school's facilities and services; and level of social integration. The dependent variable was the student's level of academic integration. The findings substantiated four central hypotheses, with the study model explaining approximately 45% of the variance in the dependent variable. Academic integration is influenced by a number of variables, the most prominent of which is the social integration of the student with colleagues and educational staff. Among the background variables, country of origin was found to be significant to both social and academic integration for two main groups in the sample: Israeli-born students (both Jewish and Arab) and immigrant students.

Acculturation↗

Community integration and life satisfaction after traumatic brain injury: long-term findings.

OBJECTIVE: This study examines the relationship of the degree of community integration to the life satisfaction of persons with traumatic brain injury (TBI). METHOD: The responses to two self-administered questionnaires measuring aspects of community integration and life satisfaction were studied for 30 persons with TBI who were 26 to 60 years of age. RESULTS: A significant relationship (rho = .37, p < .05) was found between life satisfaction and social integration (a component of community integration). No significant association was found between the total community integration score and life satisfaction. CONCLUSION: The results suggest the need for rehabilitation programs to provide long-term assistance with community-based social integration as well as more effective treatment strategies to develop these skills in persons with TBI.

Adult↗

A meta-analysis of research on sensory integration treatment.

OBJECTIVE: The purpose of this study was to find whether existing studies of treatment using sensory integration approaches support the efficacy of these approaches. METHOD: With meta-analysis, the results of sensory integration efficacy research studies published from 1972 to the present were synthesized and analyzed. Sixteen studies were used to compare sensory integration effect with no treatment (SI/NT), and 16 were used to compare sensory integration effect with alternative treatments (SI/ALT). Overall average effect sizes, comparisons of the effect sizes for different dependent variables, and secondary factors associated with effect size variation were examined. RESULTS: The weighted average effect size of SI/NT studies was .29. However, there was a significant difference between the average effect sizes of the earlier studies (.60) and the more recent studies (.03). Of the outcome measures, larger effect sizes were found in the psychoeducational category (.39) and motor category (.40). Of SI/ALT studies, the average effect size was .09, not significantly different from zero. CONCLUSION: Three central conclusions can be made. First, in the SI/NT comparison, a significant effect was replicated for sensory integration treatment effects in earlier studies, but more recent studies did not show overall positive effects. Second, larger effect sizes were found in psychoeducational and motor categories. Third, sensory integration treatment methods were found to be as effective as various alternative treatment methods.

Child↗

Integrating heterogeneous pieces of evidence in systematic reviews.

Researchers preparing systematic reviews often encounter various types of evidence, which can generally be categorized as direct or indirect. The former directly relates an exposure, diagnostic strategy, or therapeutic intervention to the occurrence of a principal health outcome. Evidence is indirect if two or more bodies of evidence are required to relate the exposure, diagnostic strategy, or intervention to the principal health outcome. Heterogeneity of data sources complicates integration of both direct and indirect evidence. Participants in different studies may have a wide spectrum of baseline risk and sociodemographic and cultural characteristics. A variety of formulations and intensities of exposures, diagnostic strategies, and interventions, as well as diversity in the selection and definition of control groups, may be encountered. Outcome measures may be different, and similar outcomes may be measured or reported differently. Heterogeneity of study designs and of methodologic features and quality within a given design may be found. The effective integration of direct and indirect evidence requires development of explicit models that serve as analytic frameworks for linking the important pieces of evidence. A model can be viewed as a series of subquestions, with each important subquestion warranting a systematic review. Several subjective and quantitative methods can then be used to integrate the evidence. Tabular displays of major findings and strength of evidence for each subquestion can help reviewers, patients, and providers to integrate the differing research findings and draw reasonable conclusions. Various quantitative techniques, such as decision analysis and the confidence profile method, are also available. No single integration approach is clearly superior, none obviates uncertainty, and all underscore the role of careful judgment in integrating evidence.

Evidence-Based Medicine↗

Integrated visualization of functional and anatomic brain data: a validation study.

UNLABELLED: Two-dimensional SPECT display and three methods for integrated visualization of SPECT and MRI patient data are evaluated in a multiobserver study to determine whether localization of functional data can be improved by adding anatomical information to the display. METHODS: SPECT and MRI data of 30 patients were gathered and presented using four types of display: one of SPECT in isolation, two integrated two-dimensional displays and one integrated three-dimensional display. Cold and hot spots in the peripheral cortex were preselected and indicated on black-and-white hard copies of the image data. Nuclear medicine physicians were asked to assign the corresponding spots in the image data on the computer screen to a lobe and a gyrus and give a confidence rating for both localizations. Interobserver agreement using kappa statistics and average confidence ratings were assessed to interpret the reported observations. RESULTS: Both the interobserver agreement and the confidence of the observers were greater for the integrated two-dimensional displays than for the two-dimensional SPECT display. An additional increase in agreement and confidence was seen with the integrated three-dimensional display. CONCLUSION: Integrated display of SPECT and MR brain images provides better localization of cerebral blood perfusion abnormalities in the peripheral cortex in relation to the anatomy of the brain than single-modality display and increases the confidence of the observer.

Cerebral Cortex↗

The pharmacy as part of an integrated hospital information system: a focus on benefits.

An integrated hospital information system benefits not only the pharmacy but also each department within a hospital, including the physician and patient. The Composite Health Care System (CHCS) is a fully integrated healthcare information system that has been developed for the Department of Defense's medical treatment facilities. CHCS provides modules for Patient Administration, Patient Appointment Scheduling, Radiology, Laboratory, Pharmacy, and Physician/Nursing Order Entry and Results Retrieval, which serve to integrate inpatient wards, clinical services, administrative departments, and remote outpatient clinics. CHCS provides an integrated patient profile to care givers throughout the medical facility, improving the quality of their clinical decisions. The integrated hospital information system also helps to coordinate the delivery of patient care and automates many interdepartmental transactions, which allows for more efficient use of resources and increases the turnaround time for delivery of services. This article focuses on the system's pharmacy component to demonstrate the benefits realized with an integrated hospital information system.

Clinical Pharmacy Information Systems↗

Detection of high-risk cervical intraepithelial neoplasia and cervical cancer by amplification of transcripts derived from integrated papillomavirus oncogenes.

Cervical cancer emerges from cervical intraepithelial neoplasia (CIN) induced by high-risk HPV (HR-HPV) infections. However, the vast majority of CIN lesions regresses spontaneously, and only a few lesions persist or progress to invasive carcinoma. On the basis of morphological criteria, it is not possible to differentiate high-grade lesions that will regress or persist from those that inevitably will progress to invasive cancers. In most cervical carcinomas, human papillomavirus (HPV) genomes are integrated into host cell chromosomes and transcribed into mRNAs encompassing viral and cellular sequences. In contrast, in early preneoplastic lesions, HPV genomes persist as episomes, and derived transcripts contain exclusively viral sequences. Thus, detection of HPV transcripts derived from integrated HPV genomes may specifically indicate both CIN lesions at high risk for progression as well as invasive cervical cancers. Here, we established a protocol for the amplification of papillomavirus oncogene transcripts (APOT) from cervical specimens that allows us to distinguish episome- from integrate-derived HPV mRNAs. Cervical swab and biopsy samples from 549 patients attending outpatient clinics for cervical dysplasia were screened for the presence of HPV DNA, and 155 samples that were positive for either HPV type 16 (n = 143) or 18 (n = 12) were subjected to the APOT assay. In samples derived from normal cervical epithelia (n = 19) or low-grade cervical lesions (CIN I, n = 10), no integrate-derived HPV transcripts were found. In contrast, in 1 (5%) of 22 samples derived from CIN II lesions, in 10 (16%) of 64 samples from patients with CIN III lesions, and in 35 (88%) of 40 samples from patients with cervical cancer, integrate-derived HPV transcripts were detected. Thus, detection of integrate-derived HPV transcripts in cervical swabs or biopsy specimens by the APOT assay points to advanced dysplasia or invasive cervical cancer.

Biopsy↗

An integral approach to the victims of war.

Contemporary psychotherapy is of integral nature. It is a part of integral medicine and of the integral viewpoint in science. Integrity is the opposite of polarity. There can be no doubt about it, sub-specialisation deepens the insight, simultaneously narrowing the efficiency of any activity. Integration is mandatory if we are to approach the victims of the Patriotic war in Croatia. Biological, psychological, social, philosophical and religious standpoints of an individual and a group of facilitators make the appropriate form of that approach. This is why education of facilitators has been directed towards integral way of thinking.

Croatia↗

Suicide: a 15-year review of the sociological literature. Part II: modernization and social integration perspectives.

This article reviews the findings of 84 sociological studies published over a 15-year period. These studies deal with tests of the modernization and/or social integration perspectives on suicide. Research on modernization, religious integration, and political integration often questioned or reformulated the traditional Durkheimian perspective. A major new theoretical development, Pescosolido's religious networks perspective, gained some empirical support in the 15-year period. The strongest support for social integration theory came from research on marital integration, wherein more than three quarters of the research found a significant relationship. Finally, further research on migration, a force lowering social integration, continued to tend to find a positive link to suicide.

Age Factors↗

Clinical integration at ground zero: perceptions of patients and families.

As an alternative to the administrative and management views of clinical integration, the perceptions and current research of patients and their families about integration initiatives are presented at "ground zero," i.e., the caregiving level. If there is no integration at ground zero, the other levels are of little merit. Contrary to the pervading opinion, clinical integration is not a value-added endeavor to boost satisfaction scores of patients and families or to make a health care system look good to regulators. Rather, clinical integration is fundamental to the precision, efficiency, and effectiveness of care delivery. Examples of the need for integration spanning situations from critical care to self-care are described.

Case Management↗