Physiotherapy exercise rehabilitation with tailored exercise adherence support for people with osteoporosis and vertebral fractures: protocol for a randomised controlled trial – the OsteoPorosis Tailored exercise adherence INtervention (OPTIN) study

Introduction Vertebral fragility fractures affect at least 20% of the older population in the UK. Best practice guidelines recommend the use of exercise to slow the rate of bone loss, to maintain muscle strength and physical function, and to prevent falls and further fractures. However, treatment effects are often small and difficult to sustain and adherence, or the extent to which patients engage in treatment, has been identified as an important issue by many studies. Our hypothesis is that integrating adherence intervention strategies with an exercise intervention will be beneficial. We will compare physiotherapy exercise rehabilitation with adherence support versus physiotherapy exercise rehabilitation alone in terms of effects on (A) physical function, quality of life and fear of falling and (B) exercise self-efficacy and adherence. Methods and analysis A multicentre, two-arm, parallel group, superiority randomised controlled trial with blinded assessments at baseline (0) and 4, 8 and 12 months, with a nested qualitative study and health economic analysis. 116 participants will be allocated to either (1) outpatient physiotherapy which will include a musculoskeletal assessment and treatment including balance, posture, strength training and low impact weight-bearing exercises over 16 weeks or (2) OsteoPorosis Tailored exercise adherence INtervention intervention. This includes standard physiotherapy as above plus an additional, integrated assessment interview (30 min) and 60 min of adherence support spread over the subsequent 16 weeks. Ethics and dissemination The study protocol was approved by West of Scotland Research Ethics Committee 4 (21/WS/0071). Trial registration number ISRCTN 14465704. The paper is based on Protocol V.4. Trial registration number ISRCTN 14465704.</p

Guidelines concerning health aspects of personnel involved in production of biologicals

Dit rapport bevat globale richtlijnen betreffende gezondheidsaspecten van personeel, binnen het RIVM betrokken bij de bereiding van biologische prudkten voor humane toepassing, gericht op bescherming van deze produkten. In het rapport : a) wordt het betreffende produktiepersoneel (PP) nader gedefinieerd ; b) worden aanwijzingen gegeven over het type aandoeningen dat personeel ongeschikt maakt voor produktietaken ; c) wordt geconcludeerd dat periodiek medisch onderzoek, m.u.v. enkele categorieen personeel, niet noodzakelijk is en een meldings- en bewakingsplicht betreffende aandoeningen dient te worden ingevoerd ; d) wordt aanbevolen PP een garantie te geven dat bij blijvende ongeschiktheid voor produktietaken een passende andere functie wordt aangeboden ; e) wordt geconcludeerd dat een serumbank van PP, althans uit oogpunt van produktbescherming, niet noodzakelijk is.RIV

Non-intercepting diagnostics for the HIF neutralized transport experiment

The NTX experiment at the Heavy Ion Fusion Virtual National Laboratory is exploring the performance of neutralized final focus systems for high purveyance heavy ion beams. We are developing a non-destructive beam diagnostic system to characterize the ion beam during its operation. Ion beam space charge is sensed by measuring deflection of mono energetic electron passing transversely through the ion beam. In this diagnostic system an electron beam of a submillimeter size with 1-5 {micro}A current and 5-8 kV energy will be injected perpendicularly through the ion beam. The position and intensity of the deflected e-beam would be registered on a scintillator for optical analysis to characterize the ion beam. An electron beam of negligible space charge will be deflected at an angle that depends on the charge density and energy distribution of the ion beam along its trajectory. The ebeam current and energy are chosen such that its trajectory will be significantly perturbed without perturbing the ion beam. We present a progress report on this diagnostic system including the characterization of the electron gun, the design of the e-beam transport system, and a study of the scintillator and its associate electronics and photonic components