Health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders.

This exploratory study attempted to estimate the severity of health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders in the Netherlands. Information on the severity and the distribution of the complaints in these patients is important to acquire insight in the problems which these patients experience, and moreover is essential for further research, especially for evaluating effects of patients undergoing foot orthosis treatment. Patients with degenerative foot disorders aged 18 years and over were recruited from nine orthopaedic workshops over a period of three months in 2000. One hundred and twenty-two (122) patients were included in the study. Two approaches were used to obtain data. Firstly, shoe technicians and orthotists inspected patients' feet and legs and interviewed them at their initial visit. Data on gender, age, height, weight, existing and prescribed orthotic devices were recorded on a report form. Secondly, patients were asked to fill in a questionnaire assessing type, location, frequency, intensity and duration of health complaints, and disability. Data indicate that females with degenerative foot disorders and foot orthoses are twice as common as men. Patients supplied with foot orthoses are twice as often overweight compared to subjects in the general population. Besides frequent and protracted pain there are also fatigue complaints, particularly in the feet and lower leg. Duration and frequency of the complaints suggest that these patients suffer from a chronic pain syndrome. In addition, the results indicate that the functional level of these patients is below that of the general population, in particular regarding physical activities.

[Medicine's scientific ideals--a setback for reduction. Different explanatory models valid at different levels]. / Medicinens vetenskapsideal--reduktionismen får mothugg. Olika förklaringsmodeller giltiga på olika systemnivåer.

Although the breakthrough of molecular biology has favoured reductionist perspectives, a countertrend has recently emerged which emphasises multidisciplinary approaches linking research efforts in different fields in what has become known by such terms as 'integrative biology.' Subscribing to this trend entails critical reflection on the epistemological status of different models and explanations in order to avoid the fallacy of misplaced concreteness (i.e., totalising views or ideals of science). One strategy is to articulate more clearly the scope and relationships of concepts and models vis-à-vis the phenomena or 'system(s)' they are intended to represent. Thus, models and explanations at different systemic levels should be seen as mutually complementary, a standpoint for which the article provides a metatheoretical rationale.

Rehabilitation management for a patient with a radical forequarter amputation with chest wall resection.

Since the improvement of surgical oncological operative procedures, anaesthesiology and intensive care facilities, forequarter amputations are being performed with increasing frequency and decreasing morbidity and mortality. This clinical note reports the rehabilitation and prosthetic management of a patient with an extensive forequarter amputation including pneumectomy.

Credit for discoveries: citation data as a basis for history of science analysis.

Citation data have become an increasingly significant source of information for historians, sociologists, and other researchers studying the evolution of science. In the past few decades elaborate methodologies have been developed for the use of citation data in the study of the modern history of science. This article focuses on how citation indexes make it possible to trace the background and development of discoveries as well as to assess the credit that publishing scientists assign to particular discoverers. Kuhn's notion of discovery is discussed. The priority dispute over the discovery of the AIDS virus is used as an example.