Lessons for effective government IT outsourcing: education and immigration in New Zealand

Information technology (IT) tends to be viewed as ancillary to core government functions. Consequently, IT is often outsourced to the private sector. Unfortunately, there is a long line of failed outsourced projects. This article uses two New Zealand case studies, the particularly public failure of the recent school payroll system and the successful introduction of electronic immigration processing, to examine how the design and governance of outsourced government IT projects could be improved. It concludes that an awareness of historic trends is important for project success, that governments need to be more active in combating market based transaction costs and that contract management becomes a core government competency when projects are outsourced. It also argues that better change management and cognisance of design-reality gaps would positively impact the outcomes of future projects

Hypogravity reduces trunk admittance and lumbar muscle activation in response to external perturbations

Reduced paraspinal muscle size and flattening of spinal curvatures have been documented after spaceflight. Assessment of trunk adaptations to hypogravity can contribute to develop specific countermeasures. In this study, parabolic flights were used to investigate spinal curvature and muscle responses to hypogravity. Data from five trials at 0.25g, 0.50g and 0.75g were recorded from six participants, positioned in a kneeling-seated position. During the first two trials, participants maintained a normal, upright posture. In the last three trials, small-amplitude perturbations were delivered in the anterior direction at the T10 level. Spinal curvature was estimated using motion capture cameras. Trunk displacement and contact force between the actuator and participant were recorded. Muscle activity responses were collected using intramuscular electromyography (iEMG) of the deep and superficial lumbar multifidus, iliocostalis lumborum, longissimus thoracis, quadratus lumborum, transversus abdominis, obliquus internus and obliquus externus muscles. The root mean square iEMG and the average spinal angles were calculated. Trunk admittance and muscle responses to perturbations were calculated as closed-loop frequency response functions. Compared with 0.75g, 0.25g resulted in: lower activation of the longissimus thoracis (P=0.002); lower responses of the superficial multifidus at low frequencies (P=0.043); lower responses of the superficial multifidus (P=0.029) and iliocostalis lumborum (P=0.043); lower trunk admittance (P=0.037) at intermediate frequencies; and stronger responses of the transversus abdominis at higher frequencies (p=0.032). These findings indicate that exposure to hypogravity reduces trunk admittance, partially compensated by weaker stabilizing contributions of the paraspinal muscles and coinciding with an apparent increase of the deep abdominal muscle activity

Effects of a six-week exercise intervention on function, pain and lumbar multifidus muscle cross-sectional area in chronic low back pain: A proof-of-concept study

Introduction Exercise with the Functional Re-adaptive Exercise Device (FRED) has previously been shown to activate the lumbar multifidus (LM) and transversus abdominis (TrA) muscles in non-symptomatic volunteers. This study aimed to determine the effects of a six-week FRED exercise intervention on pain intensity, patient-reported function and LM cross sectional area (CSA) in people with chronic non-specific low back pain (LBP). Methods Thirteen participants undertook six weeks of FRED exercise for up to 15 min, three times per week. At six weeks pre-, immediately pre-, immediately post-, and six and 15 weeks post-intervention, participants completed the Numeric Pain Rating Scale, Patient-Specific Functional Scale, and ultrasound imaging was used to assess the size of the LM muscles at L5 level. Changes in outcomes were assessed using effect size, confidence intervals and minimum clinically important difference (MCID). Results There was no improvement in pain intensity following the intervention. Patient-reported function improved by at least twice the MCID for all follow-up assessments compared to immediately pre-intervention (d = 4.20–6.58). Lumbar multifidus CSA showed a large effect size increase from immediately pre-intervention to immediately post-intervention (d = 0.8–1.1); this was maintained at six weeks post-intervention (not measured at 15 weeks post-intervention). Conclusion Six weeks of FRED exercise improved physical function in all 13 participants with chronic non-specific LBP who took part in this study and most participants' lumbar multifidus muscle CSA. On this basis, it may be an effective intervention for people with chronic LBP and should now be tested in a randomised controlled trial

Comparison of microfluidic digital PCR and conventional quantitative PCR for measuring copy number variation

One of the benefits of Digital PCR (dPCR) is the potential for unparalleled precision enabling smaller fold change measurements. An example of an assessment that could benefit from such improved precision is the measurement of tumour-associated copy number variation (CNV) in the cell free DNA (cfDNA) fraction of patient blood plasma. To investigate the potential precision of dPCR and compare it with the established technique of quantitative PCR (qPCR), we used breast cancer cell lines to investigate HER2 gene amplification and modelled a range of different CNVs. We showed that, with equal experimental replication, dPCR could measure a smaller CNV than qPCR. As dPCR precision is directly dependent upon both the number of replicate measurements and the template concentration, we also developed a method to assist the design of dPCR experiments for measuring CNV. Using an existing model (based on Poisson and binomial distributions) to derive an expression for the variance inherent in dPCR, we produced a power calculation to define the experimental size required to reliably detect a given fold change at a given template concentration. This work will facilitate any future translation of dPCR to key diagnostic applications, such as cancer diagnostics and analysis of cfDNA

The effects of reconditioning exercises following prolonged bed rest on lumbopelvic muscle volume and accumulation of paraspinal muscle fat

Reduced muscle size and accumulation of paraspinal muscle fat content (PFC) have been reported in lumbopelvic muscles after spaceflights and head-down tilt (HDT) bed rest. While some information is available regarding reconditioning programs on muscle atrophy recovery, the effects on the accumulation of PFC are unknown. Recently, a device (the Functional Re-adaptive Exercise Device-FRED) has been developed which aims to specifically recruit lumbopelvic muscles. This study aimed to investigate the effects of a standard reconditioning (SR) program and SR program supplemented by FRED (SR+FRED) on the recovery of the lumbopelvic muscles following 60-day HDT bed rest. Twenty-four healthy participants arrived at the facility for baseline data collection (BDC) before the bed rest period. They remained in the facility for 13-days post-HDT bed rest and were randomly allocated to one of two reconditioning programs: SR or SR+FRED. Muscle volumes of the lumbar multifidus (LM), lumbar erector spinae (LES), quadratus lumborum (QL), and psoas major (PM) muscles were measured from axial T1-weighted magnetic resonance images (MRI) at all lumbar intervertebral disc levels. PFC was determined using a chemical shift-based lipid/water Dixon sequence. Each lumbopelvic muscle was segmented into four equal quartiles (from medial to lateral). MRI of the lumbopelvic region was conducted at BDC, Day-59 of bed rest (HDT59), and Day-13 after reconditioning (R13). Comparing R13 with BDC, the volumes of the LM muscle at L4/L5 and L5/S1, LES at L1/L2, and QL at L3/L4 had not recovered (all - P<0.05), and the PM muscle remained larger at L1/L2 (P=0.001). Accumulation of PFC in the LM muscle at the L4/L5 and L5/S1 levels remained higher in the centro-medial regions at R13 than BDC (all - P<0.05). There was no difference between the two reconditioning programs. A 2-week reconditioning program was insufficient to fully restore all volumes of lumbopelvic muscles and reverse the accumulation of PFC in the muscles measured to BDC values, particularly in the LM muscle at the lower lumbar levels. These findings suggest that more extended reconditioning programs or alternative exercises may be necessary to fully restore the size and properties of the lumbopelvic muscles after prolonged bed rest

Intramuscular lipid concentration increased in localized regions of the lumbar muscles following 60-day bedrest

BACKGROUND CONTEXT Prolonged bedrest induces accumulation of intramuscular lipid concentration (ILC) in the lumbar musculature; however, spatial distribution of ILC has not been determined. Artificial gravity (AG) mitigates some adaptations induced by 60-day bedrest by creating a head-to-feet force while participants are in a supine position. PURPOSE To quantify the spatial distribution of accumulation of ILC in the lumbar musculature after 60-day bedrest, and whether this can be mitigated by AG exposure. STUDY DESIGN Prospective longitudinal study. PATIENT SAMPLE Twenty-four healthy individuals (8 females) participated in the study: Eight received 30 min continuous AG (cAG); Eight received 6 × 5min AG (iAG), interspersed with rests; Eight were not exposed to AG (CRTL). OUTCOME MEASURES From 3T magnetic resonance imaging (MRI), axial images were selected to assess lumbar multifidus (LM), lumbar erector spinae (LES), quadratus lumborum (QL), and psoas major (PM) muscles from L1/L2 to L5/S1 intervertebral disc levels. Chemical shift-based 2‐echo lipid/water Dixon sequence was used to measure tissue composition. Each lumbar muscle was segmented into four equal quartiles (from medial to lateral). METHODS Participants arrived at the facility for the baseline data collection before undergoing a 60-day strict 6° head-down tilt (HDT) bedrest period. MRI of the lumbopelvic region was conducted at baseline and Day-59 of bedrest. Participants performed all activities, including hygiene, in 6° HDT and were discouraged from moving excessively or unnecessarily. RESULTS At the L4/L5 and L5/S1 intervertebral disc levels, 60-day bedrest induced a greater increase in ILC in medial and lateral regions (∼+4%) of the LM than central regions (∼+2%; P<0.05). A smaller increase in ILC was induced in the lateral region of LES (∼+1%) at L1/L2 and L2/L3 than at the centro-medial region (∼+2%; P<0.05). There was no difference between CRTL and intervention groups. CONCLUSIONS Inhomogeneous spatial distribution of accumulation of ILC was found in the lumbar musculature after 60-day bedrest. These findings might reflect pathophysiological mechanisms related to muscle disuse and contribute to localized lumbar spine dysfunction. Altered spatial distribution of ILC may impair lumbar spine function after prolonged body unloading, which could increase injury risk to vulnerable soft tissues, such as the lumbar intervertebral discs. These novel results may represent a new biomarker of lumbar deconditioning for astronauts, bedridden, sedentary individuals, or those with chronic back pain. Changes are potentially modifiable but not by the AG protocols tested here

Intermittent short-arm centrifugation is a partially effective countermeasure against upright balance deterioration following 60-day head-down tilt bed rest

This study investigated whether artificial gravity (AG), induced by short-radius centrifugation, mitigated deterioration in standing balance and anticipatory postural adjustments (APAs) of trunk muscles following 60-day head-down tilt bed rest. Twenty-four participants were allocated to one of three groups: control group (N=8); 30 minutes continuous AG daily (N=8); intermittent 6x5 minutes AG daily (N=8). Before and immediately after bed rest, standing balance was assessed in four conditions: eyes open and closed on both stable and foam surfaces. Measures including sway path, root-mean-square, and peak sway velocity, sway area, sway frequency power, and sway density curve were extracted from the centre of pressure displacement. APAs were assessed during rapid arm movements using intramuscular or surface electromyography electrodes of the rectus abdominis, obliquus externus and internus abdominis, transversus abdominis, erector spinae at L1, L2, L3, and L4 vertebral levels, and deep lumbar multifidus muscles. The relative latency between the EMG onset of the deltoid and each of the trunk muscles was calculated. All three groups had poorer balance performance in most of the parameters (all P<0.05) and delayed APAs of the trunk muscles following bed rest (all P<0.05). Sway path and sway velocity were deteriorated, and sway frequency power was less in those who received intermittent AG than in the control group (all P<0.05), particularly in conditions with reduced proprioceptive feedback. These data highlight the potential of intermittent AG to mitigate deterioration of some aspects of postural control induced by gravitational unloading, but no protective effects on trunk muscle responses were observed

Gluteal muscle atrophy and increased intramuscular lipid concentration are not mitigated by daily artificial gravity following 60-day head-down tilt bed rest

Exposure to spaceflight and head-down tilt (HDT) bed rest leads to decreases in the mass of the gluteal muscle. Preliminary results have suggested that interventions, such as artificial gravity (AG), can partially mitigate some of the physiological adaptations induced by HDT bed rest. However, its effect on the gluteal muscles is currently unknown. This study investigated the effects of daily AG on the gluteal muscles during 60-day HDT bed rest. Twenty-four healthy individuals participated in the study: eight received 30 minutes of continuous AG; eight received 6x5 minutes of AG, interspersed with rest periods; eight belonged to a control group. T1-Weighted Dixon magnetic resonance imaging of the hip region was conducted at baseline and day 59 of HDT bed rest to establish changes in volumes and intramuscular lipid concentration (ILC). Results showed that, across groups, muscle volumes decreased by 9.2 for gluteus maximus (GMAX), 8.0 for gluteus medius (GMED), and 10.5 for gluteus minimus after 59-day HDT bed rest (all P<0.005). The ILC increased by 1.3 for GMAX and 0.5 for GMED (both P<0.05). Neither of the AG protocols mitigated deconditioning of the gluteal muscles. Whereas all gluteal muscles atrophied, the ratio of lipids to intramuscular water increased only in GMAX and GMED muscles. These changes could impair the function of the hip joint and increased the risk of falls. The deconditioning of the gluteal muscles in space may negatively impact the hip joint stability of astronauts when reexpose to terrestrial gravity

Lumbar muscle atrophy and increased relative intramuscular lipid concentration are not mitigated by daily artificial gravity after 60-day head-down tilt bed rest

Exposure to axial unloading induces adaptations in paraspinal muscles, as shown after spaceflights. This study investigated whether daily exposure to artificial gravity (AG) mitigated lumbar spine flattening and muscle atrophy associated with 60-day head-down tilt (HDT) bed rest (Earth-based space analogue). Twenty-four healthy individuals participated in the study: Eight received 30 minutes continuous AG; eight received 6x5 minutes AG, interspersed with rest periods; eight received no AG exposure (control group). Magnetic Resonance Imaging (MRI) of the lumbopelvic region was conducted at baseline (BDC) and at day 59 of HDT (HDT59). T1-weighted images were used to assess morphology of the lumbar spine (spinal length, intervertebral disc angles, disc area) and volumes of the lumbar multifidus (LM), lumbar erector spinae (LES), quadratus lumborum (QL), and psoas major (PM) muscles from L1/L2 to L5/S1 vertebral levels. A chemical shift-based 2‐point lipid/water Dixon sequence was used to evaluate muscle composition. Results showed that: spinal length and disc area increased (P<0.05); intervertebral disc angles (P<0.05) and muscle volumes of LM, LES, and QL reduced (P<0.01); and fat/water ratio for the LM and LES muscles increased (P<0.01) after HDT59 in all groups. Neither of the AG protocols mitigated the lumbar spinal deconditioning induced by HDT bed rest. The increase in lipid/water ratio in LM and LES muscles indicates an increased relative intramuscular lipid concentration. Altered muscle composition in atrophied muscles may impair lumbar spine function after body unloading, which could increase injury risk to vulnerable soft tissues. This relationship needs further investigation