Development of a Programme Theory for Early Intervention Vocational Rehabilitation: A Realist Literature Review

Journal of Occupational Rehabilitation - Purpose Little is currently known about how early intervention vocational rehabilitation (EIVR) works for people with newly acquired neurological conditions...     

A SCANNING ELECTRON MICROSCOPIC STUDY OF WEAR IN THE PLASTIC COMPONENTS OF PROSTHETIC KNEE AND HIP JOINTS

The polyethylene surfaces of four metal on plastic prosthetic knee joints were compared with those of four hip joint replacements, by the use of scanning electron microscopy. The acetabular components of the hip joints showed concentric machining marks, but were generally smooth, and in some areas plastic deformation of the articular surface was evident after 24 months' use. In contrast, the tibial components of knee joints removed after 12 to 22 months showed deep scoring and pitting near the centre of their articular surfaces. This appeared to be due to abrasion by a third material, possibly fragments of cement, which sometimes became embedded in the joint surface. These results indicate that wear in prosthetic knee joints may be much more rapid than in hip joint replacements made from similar materials.     

A scanning electron microscopic study of wear in the plastic components of prosthetic knee and hip joints.

The polyethylene surfaces of four metal on plastic prosthetic knee joints were compared with those of four hip joint replacements, by the use of scanning electron microscopy. The acetabular components of the hip joints showed concentric machining marks, but were generally smooth, and in some areas plastic deformation of the articular surface was evident after 24 months' use. In contrast, the tibial components of knee joints removed after 12 to 22 months showed deep scoring and pitting near the centre of their articular surfaces. This appeared to be due to abrasion by a third material, possibly fragments of cement, which sometimes became embedded in the joint surface. These results indicate that wear in prosthetic knee joints may be much more rapid than in hip joint replacements made from similar materials.     

Physical self-concept and physical activity enjoyment in elementary school children

The present study examined gender differences and relationships of seven specific domains of physical self-concept (PSC) (Strength, Endurance, Speed, Flexibility, Coordination, Global Sport Competence, and Appearance) and physical activity enjoyment (PAE) in 447 elementary school children by self-report questionnaires. Boys reported higher self-concepts of Strength, Endurance, Speed, Coordination, and Global Sport Competence than girls. Conversely, girls showed higher self-concepts of Flexibility than boys. Moreover, all seven specific domains of children's PSC and PAE were positively interrelated and children's self-concepts of Endurance and Global Sport Competence predicted their PAE. Implications for physical education targeting to enhance children's PSC and PAE are discussed.     

Neglected ruptures of the patellar tendon. A case series of four patients

We describe a series of four patients treated for chronic ruptures of the patellar tendon (more than 6 months old). The proximally retracted patella was brought back to its anatomic position, and the tendon stumps were repaired and protected with multiple strands of strong circlage wire, in a figure-of-8 pattern, from the quadriceps tendon to the tibial tubercle. Postoperatively, immediate mobilization without the use of a brace was initiated. The patients averaged 29 months (range, 8 to 80) from the time of injury until definitive treatment and were observed for an average of 27 months (range, 11 to 40) after treatment. Before treatment, all patients had an extensor lag of at least 20 degrees. At initial follow-up, all patients had full active extension with no extensor lag, and this did not deteriorate postoperatively or after wire removal. At the last follow-up, the average flexion was 0 degrees to 112 degrees. This technique avoids the use of autograft or allograft tissue and does not require lengthening of the quadriceps tendon.     

Maintenance of airway epithelium in acutely rejected orthotopic vascularized mouse lung transplants

Lung transplantation remains the only therapeutic option for many patients suffering from end-stage pulmonary disease. Long-term success after lung transplantation is severely limited by the development of bronchiolitis obliterans. The murine heterotopic tracheal transplantation model has been widely used for studies investigating pathogenesis of obliterative airway disease and immunosuppressive strategies to prevent its development. Despite its utility, this model employs proximal airway that lacks airflow and is not vascularized. We have developed a novel model of orthotopic vascularized lung transplantation in the mouse, which leads to severe vascular rejection in allogeneic strain combinations. Here we characterize differences in the fate of airway epithelial cells in nonimmunosuppressed heterotopic tracheal and vascularized lung allograft models over 28 days. Up-regulation of growth factors that are thought to be critical for the development of airway fibrosis and interstitial collagen deposition were similar in both models. However, while loss of airway epithelial cells occurred in the tracheal model, airway epithelium remained intact and fully differentiated in lung allografts, despite profound vascular rejection. Moreover, we demonstrate expression of the anti-apoptotic protein Bcl-2 in airway epithelial cells of acutely rejected lung allografts. These findings suggest that in addition to alloimmune responses, other stimuli may be required for the destruction of airway epithelial cells. Thus, the model of vascularized mouse lung transplantation may provide a new and more physiologic experimental tool to study the interaction between immune and nonimmune mechanisms affecting airway pathology in lung allografts.