Managing employees undergoing total hip and knee replacement: experiences of workplace representatives

Joint replacement is a cost-effective and efficient method of relieving pain, and improving function and health related quality of life, for people with arthritis of the hip and knee [1]. Arthritis-related loss of physical function is associated with unemployment, reduced income and increased sickness absence [2]. In a survey investigating the impact of osteoarthritis (OA), Fautrel et al found that OA has a substantial impact on work, with 20% of patients surveyed still in the workforce and two thirds of those reporting that OA was affecting their work [3]. These factors, in combination with an ageing workforce and changes to the pension age, have resulted in an increase in the number of hip and knee replacements carried out on people of working age over the past ten years. In 2015, 17,293 of 84,462 (20%) hip replacements and 16,121 of 94,437 (17%) knee replacements performed in England, Wales and Northern Ireland were in people aged under 60 years; 25,249 (30%) hip replacements and 32,321 (34%) knee replacements were performed on inpatients aged between 60-69 years [4]. Projections from 2005 suggest that by 2030, the demand for primary total hip (THR) and knee (TKR) replacements will increase by 174% and 673% respectively [5].Consequently return to work (RTW) will be a priority for an increasing proportion of the population following surgery

Effects of follicular phase exercise on luteinizing hormone pulse characteristics in sedentary eumenorrhoeic women

OBJECTIVE Current studies reveal little regarding the Inception of exercise-induced LH changes during physical training. This study aimed to assess the susceptibility of the hypothalamic–pituitary axis to the acute physical stress of exercise in untrained, physically inactive women. The acute effects of submaximal endurance exercise upon the pulsatile LH secretion in the follicular phase were compared with those accompanying leisurely strolling for a similar time period. SUBJECTS All subjects were eumenorrhoelc, as determined by biphasic temperature patterns, detection of the urinary LH surge, and mid-luteal serum progesterone levels. Subjects were not physically active and had little history of strenuous exercise ( V o 2 max = 38·0 ± 1·8) (mean ± SEM) ml/kg/min). DESIGN All women completed a 13·5-hour pulsatility test which included three consecutive 20-minute runs on a treadmill at 50, 60 and 70% of the subjects’maximum oxygen uptake ( n = 16). Six of these same subjects completed a separate test on another occasion in which one hour of leisurely strolling was substituted for exercise. Blood was sampled every 10 minutes via an indwelling cannula for 4·5 hours before and 8 hours after one hour of exercise and or strolling. MEASUREMENTS A pulse algorithm (Pulsar) was used to quantify LH pulse characteristics. RESULTS Exercise produced no significant effects upon LH pulse frequency or mean serum LH concentration. However, exercise of moderate intensity caused a significant increase in LH pulse amplitude ( P < 0·05). Strolling produced no significant changes in LH secretion. CONCLUSION Acute exercise of moderate intensity in the follicular phase of untrained women is an insufficient stimulus to inhibit the GnRH pulse generator in the post-exercise period, yet may produce a slight stimulatory effect on the amount of LH released per pulsePeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73507/1/j.1365-2265.1994.tb02794.x.pd

Confining QCD Strings, Casimir Scaling, and a Euclidean Approach to High-Energy Scattering

We compute the chromo-field distributions of static color-dipoles in the fundamental and adjoint representation of SU(Nc) in the loop-loop correlation model and find Casimir scaling in agreement with recent lattice results. Our model combines perturbative gluon exchange with the non-perturbative stochastic vacuum model which leads to confinement of the color-charges in the dipole via a string of color-fields. We compute the energy stored in the confining string and use low-energy theorems to show consistency with the static quark-antiquark potential. We generalize Meggiolaro's analytic continuation from parton-parton to gauge-invariant dipole-dipole scattering and obtain a Euclidean approach to high-energy scattering that allows us in principle to calculate S-matrix elements directly in lattice simulations of QCD. We apply this approach and compute the S-matrix element for high-energy dipole-dipole scattering with the presented Euclidean loop-loop correlation model. The result confirms the analytic continuation of the gluon field strength correlator used in all earlier applications of the stochastic vacuum model to high-energy scattering.Comment: 65 pages, 13 figures, extended and revised version to be published in Phys. Rev. D (results unchanged, 2 new figures, 1 new table, additional discussions in Sec.2.3 and Sec.5, new appendix on the non-Abelian Stokes theorem, old Appendix A -> Sec.3, several references added

Small-scale magnetic buoyancy and magnetic pumping effects in a turbulent convection

We determine the nonlinear drift velocities of the mean magnetic field and nonlinear turbulent magnetic diffusion in a turbulent convection. We show that the nonlinear drift velocities are caused by the three kinds of the inhomogeneities, i.e., inhomogeneous turbulence; the nonuniform fluid density and the nonuniform turbulent heat flux. The inhomogeneous turbulence results in the well-known turbulent diamagnetic and paramagnetic velocities. The nonlinear drift velocities of the mean magnetic field cause the small-scale magnetic buoyancy and magnetic pumping effects in the turbulent convection. These phenomena are different from the large-scale magnetic buoyancy and magnetic pumping effects which are due to the effect of the mean magnetic field on the large-scale density stratified fluid flow. The small-scale magnetic buoyancy and magnetic pumping can be stronger than these large-scale effects when the mean magnetic field is smaller than the equipartition field. We discuss the small-scale magnetic buoyancy and magnetic pumping effects in the context of the solar and stellar turbulent convection. We demonstrate also that the nonlinear turbulent magnetic diffusion in the turbulent convection is anisotropic even for a weak mean magnetic field. In particular, it is enhanced in the radial direction. The magnetic fluctuations due to the small-scale dynamo increase the turbulent magnetic diffusion of the toroidal component of the mean magnetic field, while they do not affect the turbulent magnetic diffusion of the poloidal field.Comment: 13 pages, 4 figure, REVTEX4, Geophysical and Astrophysical Fluid Dynamics, in pres

Antimicrobial resistance in dairy slurry tanks: A critical point for measurement and control

publishedVersionpublishedVersio

Maximising Synergy among Tropical Plant Systematists, Ecologists, and Evolutionary Biologists

Closer collaboration among ecologists, systematists, and evolutionary biologists working in tropical forests, centred on studies within long-term permanent plots, would be highly beneficial for their respective fields. With a key unifying theme of the importance of vouchered collection and precise identification of species, especially rare ones, we identify four priority areas where improving links between these communities could achieve significant progress in biodiversity and conservation science: (i) increasing the pace of species discovery; (ii) documenting species turnover across space and time; (iii) improving models of ecosystem change; and (iv) understanding the evolutionary assembly of communities and biomes

Multilocal programming and applications

Preprint versionMultilocal programming aims to identify all local minimizers of unconstrained or constrained nonlinear optimization problems. The multilocal programming theory relies on global optimization strategies combined with simple ideas that are inspired in deflection or stretching techniques to avoid convergence to the already detected local minimizers. The most used methods to solve this type of problems are based on stochastic procedures and a population of solutions. In general, population-based methods are computationally expensive but rather reliable in identifying all local solutions. In this chapter, a review on recent techniques for multilocal programming is presented. Some real-world multilocal programming problems based on chemical engineering process design applications are described.Fundação para a Ciência e a Tecnologia (FCT

Coherent π0 photoproduction on the deuteron up to 4 GeV

The differential cross section for 2H(γ,d)π0 has been measured at deuteron center-of-mass angles of 90° and 136°. This work reports the first data for this reaction above a photon energy of 1 GeV, and permits a test of the apparent constituent counting rule and reduced nuclear amplitude behavior as observed in elastic ed scattering. Measurements were performed up to a photon energy of 4.0 GeV, and are in good agreement with previous lower energy measurements. Overall, the data are inconsistent with both constituent-counting rule and reduced nuclear amplitude predictions