CAPAbility: Comparison of the JOURNEY II Bi-Cruciate Stabilised and GENESIS II total knee arthroplasty in performance and functional ability: protocol of a randomised controlled trial

Background: Osteoarthritis of the knee is a common condition that is expected to rise in the next two decades leading to an associated increase in total knee replacement (TKR) surgery. Although there is little debate regarding the safety and efficacy of modern TKR, up to 20% of patients report poor functional outcomes following surgery. This study will investigate the functional outcome of two TKRs; the JOURNEY II Bi-Cruciate Stabilised knee arthroplasty, a newer knee prosthesis designed to provide guided motion and improve knee kinematics by more closely approximating a normal knee, and the GENESIS II, a proven existing design. Aim: To compare the change in Patient-reported Outcome Measures (PROMs) scores of the JOURNEY II BCS and the GENESIS II from pre-operation to 6 months post operation. Methods: CAPAbility is a pragmatic, blinded, two-arm parallel, randomised controlled trial recruiting patients with primary osteoarthritis due to have unilateral TKR surgery across two UK hospitals. Eligible participants (n = 80) will be randomly allocated to receive either the JOURNEY II or the GENESIS II BCS knee prosthesis. Baseline measures will be taken prior to surgery. Patients will be followed at 1 week, 6 to 8 weeks and 6 months post-operatively. The primary outcome is the Oxford Knee Score (OKS) at 6 months post-operatively. Secondary outcomes include: Other PROMs, biomechanical, radiological (computerised tomography, (CT)), clinical efficacy and safety outcomes. An embedded qualitative study will also investigate patients' perspectives via interview pre and post surgery on variables known to affect the outcome of TKR surgery. A sub-sample (n = 30) will have additional in-depth interviews to explore the themes identified. The surgeons' perspectives on the operation will be investigated by a group interview after all participants have undergone surgery. Discussion: This trial will evaluate two generations of TKR using PROMS, kinematic and radiological analyses and qualitative outcomes from the patient perspective

Web Services and IT Management in Healthcare and Grid Computing

Alma Ata Declaration on Primary Health Care defines , health as not just absence of disease but fitness at all levels i.e.Physically, mentally, Psychologically, spirtually, socially, and so on. RCH emphasizes fitness at all level along with health education and medical education. For the last one decade IT has contributed substantially in the healthcare domain. Tele-Medicine, Health informatics, using IT for Health for Prevention, curing, rehabilitation, Medical Education and accessing resources are the some of them.Web Services, IT Management, IT in healthcare, Health Informatics

A study to understand the acceptance of DICOM Structured Reports on Breast Imaging

Purpose: To create a Digital Imaging and Communication in Medicine Structured Reports (DICOM-SR) Repository and compare the acceptance of Free Text (FT) versus Structured Reports (SR) in communication of Breast Imaging findings. Materials and Methods: It was conceptualized the MamoCatalogue to the structuring of the Reports and the SR were converted into DICOM-SR and integrated with Dicoogle. After that, seven representative Breast Imaging Reports were selected and evaluated by a group of 25 Physicians. Each Physician evaluated the seven Reports, in FT and SR with a 3 months timelag, about their, Structure, Clarity and assertiveness, Diagnostic/Recommendations, Easiness of reading, Full reading, Partially reading with Breast Imaging Reporting and Data System (BI-RADS) focus and Ambiguity. Results: A DICOM-SR Repository was created and the assessment of the acceptance of the FT vs. SR revealed that there is a global trend favoring FT. Nevertheless, a group wise analysis revealed that for Gynaecologists and General Practitioners (GP) the differences between FT and SR weren't significant, unlike what happens with Radiologists. Conclusion: The DICOM-SR Repository allows the query/retrieve data for Reports and the communication with Gynaecologists and GP by SR was satisfactory. Although, Radiologists acceptance must be reinforced upon global communication and management strategy

A timely computer-aided detection system for acute ischemic and hemorrhagic stroke on CT in an emergency environment

Standalone Presentations: no. LL-IN1105BACKGROUND: When a patient is accepted in the emergency room suspected of stroke, time is of the most importance. The infarct brain area suffers irreparable damage as soon as three hours after the onset of stroke symptoms. Non-contrast CT scan is the standard first line of investigation used to identify hemorrhagic stroke cases. However, CT brain images do not show hyperacute ischemia and small hemorrhage clearly and thus may be missed by emergency physicians. We reported a timely computer-aided detection (CAD) system for small hemorrhages on CT that has been successfully developed as an aid to ER physicians to help improve detection for Acute Intracranial Hemorrhage (AIH). This CAD system has been enhanced for diagnosis of acute ischemic stroke in addition to hemorrhagic stroke, which becomes a more complete and clinically useful tool for assisting emergency physicians and radiologists. In the detection algorithm, brain matter is first segmented, realigned, and left-right brain symmetry is evaluated. As in the AIH system, the system confirms hemorrhagic stroke by detecting blood presence with anatomical and medical knowledge-based criteria. For detecting ischemia, signs such as regional hypodensity, blurring of grey and white matter differentiation, effacement of cerebral sulci, and hyperdensity in middle cerebral artery, are evaluated …published_or_final_versio

Assessment scales in stroke: clinimetric and clinical considerations

As stroke care has developed, there has been a need to robustly assess the efficacy of interventions both at the level of the individual stroke survivor and in the context of clinical trials. To describe stroke-survivor recovery meaningfully, more sophisticated measures are required than simple dichotomous end points, such as mortality or stroke recurrence. As stroke is an exemplar disabling long-term condition, measures of function are well suited as outcome assessment. In this review, we will describe functional assessment scales in stroke, concentrating on three of the more commonly used tools: the National Institutes of Health Stroke Scale, the modified Rankin Scale, and the Barthel Index. We will discuss the strengths, limitations, and application of these scales and use the scales to highlight important properties that are relevant to all assessment tools. We will frame much of this discussion in the context of "clinimetric" analysis. As they are increasingly used to inform stroke-survivor assessments, we will also discuss some of the commonly used quality-of-life measures. A recurring theme when considering functional assessment is that no tool suits all situations. Clinicians and researchers should chose their assessment tool based on the question of interest and the evidence base around clinimetric properties

The European Security Industry: A Research Agenda

The security industry can be defined, in the first instance, as the industry that produces the goods and services required to protect citizens from insecurity. Yet, this industry, as opposed to defence, has not been an area of intense research. Their boundaries are unclear and the industry is not well characterised. This paper analyses this knowledge gap and presents some ideas for a research agenda for this industry that could assist in unveiling the main features, the potential weaknesses and strengths, and the capability to solve the security needs of society in an efficient and effective way. The paper discusses a definition of this economic sector useful in setting its boundaries, and it briefly describes the main types of industries operating within the sector. It analyses methods for gathering information regarding the industry, customers, and other market agents. Finally, it outlines ways for assessing market performance in terms of the structure-conduct-performance paradigm.security industry, security market, terrorism and organised crime countermeasures, competition, market performance

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2011

Highlights examples of preparedness programs and capacities at risk of federal budget cuts or elimination, examines state and local public health budget cuts, reviews ten years of progress and shortfalls, and outlines policy issues and recommendations

Department of Homeland Security Science and Technology Directorate: Developing Technology to Protect America

In response to a congressional mandate and in consultation with Department of Homeland Security's (DHS) Science and Technology Directorate (S&T), the National Academy conducted a review of S&T's effectiveness and efficiency in addressing homeland security needs. This review included a particular focus that identified any unnecessary duplication of effort, and opportunity costs arising from an emphasis on homeland security-related research. Under the direction of the National Academy Panel, the study team reviewed a wide variety of documents related to S&T and homeland security-related research in general. The team also conducted interviews with more than 200 individuals, including S&T officials and staff, officials from other DHS component agencies, other federal agencies engaged in homeland security-related research, and experts from outside government in science policy, homeland security-related research and other scientific fields.Key FindingsThe results of this effort indicated that S&T faces a significant challenge in marshaling the resources of multiple federal agencies to work together to develop a homeland security-related strategic plan for all agencies. Yet the importance of this role should not be underestimated. The very process of working across agencies to develop and align the federal homeland security research enterprise around a forward-focused plan is critical to ensuring that future efforts support a common vision and goals, and that the metrics by which to measure national progress, and make changes as needed, are in place

EJP-CONCERT. D3.7 Second joint roadmap for radiation protection research

EJP-CONCERT Work Package 3, Deliverable 3.7