Search results for: Inger N. Sierevelt

Authors: Raymond Puijk, Rachid Rassir, Inger N. Sierevelt, Anneke Spekenbrink-Sporen, Bart G. C. W. Pijls, Rob G. H. H. Nelissen, Peter A. Nolte

Abstract:

Background: Among uncemented total knee arthroplasty (TKA), a wide variety of metal surface structures (MSS) and coatings exist to enhance implants' biological properties (i.e., bone ingrowth). This study explores the variety of MSS-coating combinations and compares their mid-long-term survivorships with cemented TKAs, by using data from the Dutch Arthroplasty Register. Methods: A total of 235,500 cemented and 11,132 uncemented primary TKAs with a median follow-up of 5.1 years were included. MSS-coating combinations were (1) Porous-uncoated (n=8986), (2) Beaded-hydroxyapatite (HA)(n=1093), (3) Matte-uncoated (n=846), (4) Matte-Titanium-nitride (TiN) (n=207). Five- and 10-year revision-free survival for all-cause revisions, and aseptic loosening of the tibial component, were calculated and compared by using Kaplan-Meier, Log-rank tests, and multivariable Cox proportional hazard regression analyses. Results: Ten-year survival rates with all-cause revisions as an endpoint, were 94.2% for cement, and 94.7%, 96.3%, 92.1%, and 79.0% for porous-uncoated, beaded-HA, matte-uncoated, and Matte-TiN, respectively (p<0.01). Rates for aseptic loosening were 98.8% for cemented, and 98.7%, 99.8%, 97.2%, and 94.9% for the uncemented, respectively (p<0.01).The beaded-HA implants were half the risk for an all-cause revision compared to cemented implants (p<0.01). Matte-uncoated and matte-TiN implants were at more risk of an all-cause revision than cemented implants (p=0.01, p<0.01). Proportions of revisions for aseptic loosening were comparable among most groups. Conclusion: Based on Dutch registry data, four main MSS-coating combinations among uncemented TKAs were found. survivorships for all-cause revisions and aseptic release differed widely between groups. Beaded-HA and porous-uncoated implants had the best survival rates among the uncemented TKAs and were non-inferior to the cemented TKAs.

Keywords: total knee arthroplasty, cement, uncemented, cementless;, metal surface structure, coating

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Authors: Dwarika P. Shrestha, Dipendra Gurung, Rushma Shrestha, Inger Rosdahl

Abstract:

Introduction: Skin diseases are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of skin diseases and impact on quality of life in rural areas in Nepal. Materials and methods: A house-to-house survey was conducted, to obtain socio-demographic data and identify individuals with skin diseases, followed by health camps, where the villagers were examined. A pilot study was conducted in one village, which was then extended to 10 villages in 4 districts. To assess the impact on quality of life, the villagers were interviewed with Skin Disease Disability Index. This is a questionnaire developed and validated by the authors for use in Nepal. Results: In the pilot study, the overall prevalence of skin diseases was 20.1% (645/3207). In the additional 10 villages with 7348 (3651/3787 m/f) inhabitants, 1862 (721/1141 m/f, mean age 31.4 years) had one or more skin diseases. The overall prevalence of skin diseases was 25%. The most common skin disease categories were eczemas (13.7%, percentage among all inhabitants) pigment disorders (6.8%), fungal infections (4.9%), nevi (3.7%) and urticaria (2.9%). These five most common skin disease categories comprise 71% of all skin diseases seen in the study. The mean skin disease disability index score was 13.7, indicating very large impact on the quality of life. Conclusions: This population-based study shows that skin diseases are very common in the rural areas of Nepal and have significant impact on quality of life. Targeted intervention at the primary health care level should help to reduce the health burden due to skin diseases.

Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions

Procedia PDF Downloads 453

Authors: Inger Eriksson, Lisbeth Ohlsson, Jeremias Rosenqvist

Abstract:

Ingress: Focus in the study is directed towards phenomena and concepts of segregation, integration, and inclusion of students attending a special school form in Sweden, namely compulsory school for pupils with learning disabilities (in Swedish 'särskola') as an alternative to mainstream compulsory school. Aim: The aim of the study is to examine the school situation for students attending särskola from a historical perspective focussing the 1980s, 1990s and the 21st century, from an integration perspective, and from a perspective of power. Procedure: Five sub-studies are reported, where integration and inclusion are looked into by observation studies and interviews with school leaders, teachers, special and remedial teachers, psychologists, coordinators, and parents in the special schools/särskola. In brief, the study about special school students attending mainstream classes from 1998 takes its point of departure in the idea that all knowledge development takes place in a social context. A special interest is taken in the school’s role for integration generally, and the role of special education particularly and on whose conditions the integration is taking place – the special school students' or the other students,' or may be equally, in the class. Pedagogical and social conditions for so called individually integrated special school students in elementary school classes were studied in eleven classes. Results: The findings are interpreted in a power perspective supported by Foucault and relationally by Vygotsky. The main part of the data consists of extensive descriptions of the eleven cases, here called integration situations. Conclusions: In summary, this study suggests that the possibilities for a special school student to get into the class community and fellowship and thereby be integrated with the class are to a high degree dependant on to what extent the student can take part in the pedagogical processes. The pedagogical situation for the special school student is affected not only by the class teacher and the support and measures undertaken but also by the other students in the class as they, in turn, are affected by how the special school student is acting. This mutual impact, which constitutes the integration process in itself, might result in a true integration if the special school student attains the status of being accepted on his/her own terms not only being cared for or cherished by some classmates. A special school student who is not accepted even on the terms of the class will often experience severe problems in the contacts with classmates and the school situation might thus be a mere placement.

Keywords: integration/inclusion, mainstream school, power, special school students

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