Occupational therapy and return to work: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was to be able to select the most efficient OTI.</p> <p>Methods</p> <p>A systematic literature review of peer-reviewed papers was conducted using electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo). The search focussed on randomised controlled trials and cohort studies published in English from 1980 until September 2010. Scientific validity of the studies was assessed.</p> <p>Results</p> <p>Starting from 1532 papers with pertinent titles, six studies met the quality criteria. Results show systematic reviewing of OTIs on RTW was challenging due to varying populations, different outcome measures, and poor descriptions of methodology. There is evidence that OTIs as part of rehabilitation programs, increase RTW rates, although the methodological evidence of most studies is weak.</p> <p>Conclusions</p> <p>Analysis of the selected papers indicated that OTIs positively influence RTW; two studies described precisely what the content of their OTI was. In order to identify the added value of OTIs on RTW, studies with well-defined OT intervention protocols are necessary.</p

Progressive ductile shearing during till accretion within the deforming bed of a palaeo-ice stream

This paper presents the results of a detailed microstructural study of a thick till formed beneath the Weichselian (Devensian) Odra palaeo-ice stream, west of Środa Wielkopolska, Poland. This SE-flowing ice stream was one of a number of corridors of faster flowing ice which drained the Scandinavian Ice Sheet in the Baltic region. Macroscopically, the massive, laterally extensive till which formed the bed of this ice stream lacks any obvious evidence of glaciotectonism (thrusting, folding). However, microscale analysis reveals that bed deformation was dominated by foliation development, recording progressive ductile shearing within a subhorizontal subglacial shear zone. Five successive generations of clast microfabric (S1 to S5) have been identified defining a set of up-ice and down-ice dipping Riedel shears, as well as a subhorizontal shear foliation coplanar to the ice-bed interface. Cross-cutting relationships between the shear fabrics record temporal changes in the style of deformation during this progressive shear event. Kinematic indicators (S-C and ECC-type fabrics) within the till indicate a consistent SE-directed shear sense, in agreement with the regional ice flow pattern. A model of bed deformation involving incremental progressive simple shear during till accretion is proposed. The relative age of this deformation was diachronous becoming progressively younger upwards, compatible with subglacial shearing having accompanied till accretion at the top of the deforming bed. Variation in the relative intensity of the microfabrics records changes in the magnitude of the cumulative strain imposed on the till and the degree of coupling between the ice and underlying bed during fast ice flow

Relationship between dysplasia, p53 protein accumulation, DNA ploidy, and Glut1 overexpression in Barrett metaplasia

Background: There is a need for molecular markers of malignant progression in Barrett metaplasia (BM). The aim of this study is to determine the relationship between dysplasia, p53 protein accumulation, DNA ploidy, and Glut1 in BM. Methods: Sections of esophageal biopsy specimens from 120 patients with BM were evaluated for dysplasia, p53 protein, and Glut1 expression by immunohistochemistry, and DNA ploidy by Feulgen stain and image analysis. In cases with diploid DNA histograms, the percentage cells in the G0G1 and G2M phases of the cell cycle were determined. Results: Of 108 diploid cases 19 (28%) of 69 cases with G0G1 ≥ 90% or G2M ≥ 8.33% were p53- positive, in contrast to only 1 (3%) of 39 cases with lower G0G1 or G2M (P = 0.0008). Of 32 p53-positive cases 11 (32%) were aneuploid, in contrast to none (0%) of 88 p53-negative cases (P \u3c 0.0001). Ten (91%) of 11 aneuploid cases were high-grade dysplasia/adenocarcinoma (HGD/CA), compared with only 1 (1%) of 109 diploid cases (P \u3c 0.0001). Five (45%) of 11 cases with HGD/CA were Glut1-positive, in contrast to none (0%) of 109 cases without HGD/CA (P \u3c 0.0001). Conclusions: Our data strongly suggest that in BM, after oxidative DNA damage, as a result of gastroesophageal reflux, there is an increase in the percentage of cells in the G0G1 or G2M phases of the cell cycle to enable repair of damaged DNA; in some of these cases this is followed sequentially by p53 gene mutation and protein accumulation, DNA aneuploidy, HGD, and CA with or without Glut1 overexpression. These events can be detected in routinely processed biopsy samples