Search

The Health Advisory Board of the German Federal Association for Rehabilitation (BAR) describes future trends and challenges in rehabilitation as deriving from the socio-demographic development in Germany and the structural characteristics of its Social and Health Care Insurance System. The focus is on elder employees to sustain and regenerate their capacity for employment, on people which are no longer employed to activate their autonomy and ability for self-support, and on rehabilitation as a holistic and integrative process extending through the social security and health insurances. There is an urgent need and a real chance to benefit from already existing scientific findings more frequently and to integrate them effectively into adequate further education and training programmes for professionals. Finally the conclusion summarises 8 theses to facilitate rehabilitation as an integral and essential part of the German social security and health sector. This paper was fully accredited by the members of the BAR Managing Board.

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurance. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurances. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

Until now, reports have been given on 249 spontaneous spinal epidural haematomas. Two own cases are included in the submitted analysis. In approximately 78 per cent, the disease begins with pain and radicular disturbances according to the lactation of the haematoma, in 18 per cent with a primary to the location of the haematoma, in 18 per cent with a primary transverse syndrome. The incidence peak is seen around the 60th year of liefe. Men are taken ill more frequently than women, the ratio being 5:3. At the age of 10 to 50 years, the ratio is 3:1. In one third of the patients, no cause of the disease can be detected. One quarter of the patients were given anticoagulants. The prognosis depends on the interval between the first symptoms and the transverse lesion of the cord with paraplegia as well as the time of the operation. For the myelon region (C 1-L 1), the remission rate obtained by an operation within 24 hours after formation of the transverse syndrome is bad in about 34 per cent, for the caudal region (L 2-S 1) it is better in approximately 57 per cent. It the operation is carried out within eight hours, the remission rate is about 84 per cent. In most cases, the disease is diagnosed with a delay and the patients are referred for a surgical treatment too late.