Health benefits of joint replacement surgery for patients with osteoarthritis: prospective evaluation using independent assessments in Scotland

Study objectives - To determine extent of change in psychological, functional, and social health after knee and hip joint replacement surgery using independent assessments. Design - Patients were recruited before surgery and interviewed preoperatively, three months after surgery, and nine months after surgery. Interviews were conducted in the patients' own homes. Setting - Two orthopaedic surgery units in Scotland. Participants - A consecutive sample of 107 patients with osteoarthritis having primary replacement of the knee or hip. Main outcome measures - Assessments of depression, anxiety, pain, functional activity, informal care, and formal service utilisation were made at three time points. Main results - Anxiety and pain were significantly reduced and functional activity levels significantly increased after surgery. While gains in anxiety and pain reduction occurred between the preoperative and three month assessments, gains in activity were made between the three month and nine month assessments. Although pain was reduced and activity increased, levels of depression were unchanged after surgery. Patients reported need for assistance with fewer activities after surgery, but increases in the use of formal services and increases in the number of hours per week of informal support received were observed at both three month and nine month follow up. Conclusions - The main benefit of joint replacement surgery is pain relief. Gains in functional activity, particularly mobility and leisure activities are made by many patients. Paradoxically, surgery for osteoarthritis seems to act as a 'gateway' to increases in formal and informal community support, which are maintained into the longer term

Gender nonconformity of identical twins with discordant sexual orientations: Evidence from childhood photographs

Childhood gender nonconformity (femininity in males, masculinity in females) predicts a non-straight (gay, lesbian, or bisexual) sexual orientation in adulthood. In previous work, non-straight twins reported more childhood gender nonconformity than their genetically identical, but straight, co-twins. However, self-reports could be biased. We therefore assessed gender nonconformity via ratings of photographs from childhood and adulthood. These ratings came from independent observers naïve to study hypotheses. Identical twins with discordant sexual orientations (24 male pairs, 32 female pairs) visibly differed in their gender nonconformity from mid childhood, with higher levels of gender nonconformity for the non-straight twins. This difference was smaller than the analogous difference between identical twins who were concordant straight (4 male pairs, 11 female pairs) and identical twins unrelated to them who were concordant non-straight (19 male pairs, 8 female pairs). Further, twins in discordant pairs correlated in their observer-rated gender nonconformity. Non-genetic factors likely differentiated the discordant twins’ gender-related characteristics in childhood, but shared influences made them similar in some respects. We further tested how recall of past rejection from others related to gender nonconformity. Rejection generally increased with gender nonconformity, but this effect varied by the twins’ sexual orientation

Finger Length Ratios of Identical Twins with Discordant Sexual Orientations

A proposed marker of prenatal androgen exposure is the ratio of the index finger to ring finger (2D:4D). Within each sex, this ratio may be lower for those who were exposed to higher levels of androgens and become attracted to women, as compared to those who were exposed to lower levels of androgens and become attracted to men. We examined these patterns in identical twins with discordant sexual orientations. Because these twins are enetically identical, differences in prenatal androgen exposure, as reflected in their different finger length ratios, might contribute to their discordance. For 18 female twin pairs, nonstraight (bisexual or lesbian) twins had significantly lower, or more masculinized, 2D:4D ratios than their straight co-twins, but only in the left hand. For 14 male pairs, non-straight twins had, contrary to our prediction, more masculinized finger length ratios than straight cotwins, but this difference was not significant. A reanalysis of present and previous data (Hall & Love, 2003; Hiraishi, Sasaki, Shikishima, & Ando, 2012) suggested that these patterns were robust. Furthermore, males had more masculinized 2D:4D ratios than females. This sex difference did not vary by sexual orientation

How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis

Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers

Why do people fail to turn good intentions into action? : The role of executive control processes in the translation of healthy eating intentions into action in young Scottish adults

Non peer reviewedPublisher PD

Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

Peer reviewedPublisher PD

Deep Reinforcement Learning for Efficient Measurement of Quantum Devices

Deep reinforcement learning is an emerging machine learning approach which can teach a computer to learn from their actions and rewards similar to the way humans learn from experience. It offers many advantages in automating decision processes to navigate large parameter spaces. This paper proposes a novel approach to the efficient measurement of quantum devices based on deep reinforcement learning. We focus on double quantum dot devices, demonstrating the fully automatic identification of specific transport features called bias triangles. Measurements targeting these features are difficult to automate, since bias triangles are found in otherwise featureless regions of the parameter space. Our algorithm identifies bias triangles in a mean time of less than 30 minutes, and sometimes as little as 1 minute. This approach, based on dueling deep Q-networks, can be adapted to a broad range of devices and target transport features. This is a crucial demonstration of the utility of deep reinforcement learning for decision making in the measurement and operation of quantum devices

Women's knowledge about cervical cancer risk factors, screening, and reasons for non-participation in cervical cancer screening programme in Estonia

<p>Abstract</p> <p>Background</p> <p>The attendance rate in Estonian cervical cancer screening programme is too low therefore the programme is hardly effective. A cross-sectional population based survey was performed to identify awareness of cervical cancer risk factors, reasons why women do not want to participate in cervical screening programme and wishes for better organisation of the programme.</p> <p>Method</p> <p>An anonymous questionnaire with a covering letter and a prepaid envelope was sent together with the screening invitation to 2942 randomly selected women. Results are based on the analysis of 1054 (36%) returned questionnaires.</p> <p>Results</p> <p>Main reasons for non-participation in the national screening programme were a recent visit to a gynaecologist (42.3%), fear to give a Pap-smear (14.3%), long appointment queues (12.9%) and unsuitable reception hours (11.8%). Fear to give a Pap-smear was higher among women aged 30 and 35 than 50 and 55 (RR 1.46; 95% CI: 0.82-2.59) and women with one or no deliveries (RR 1.56, 95% CI: 0.94-2.58). In general, awareness of cervical cancer risk factors is poor and it does not depend on socio-demographic factors. Awareness of screening was higher among Estonians than Russians (RR 1.64, 95% CI: 1.46-1.86). Most women prefer to receive information about screening from personally mailed invitation letters (74.8%).</p> <p>Conclusions</p> <p>Women need more information about cervical cancer risk factors and the screening programme. They prefer personally addressed information sharing. Minority groups should be addressed in their own language. A better collaboration with service providers and discouraging smears outside the programme are also required.</p