The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listin

Generic Subsequence Matching Framework: Modularity, Flexibility, Efficiency

Subsequence matching has appeared to be an ideal approach for solving many problems related to the fields of data mining and similarity retrieval. It has been shown that almost any data class (audio, image, biometrics, signals) is or can be represented by some kind of time series or string of symbols, which can be seen as an input for various subsequence matching approaches. The variety of data types, specific tasks and their partial or full solutions is so wide that the choice, implementation and parametrization of a suitable solution for a given task might be complicated and time-consuming; a possibly fruitful combination of fragments from different research areas may not be obvious nor easy to realize. The leading authors of this field also mention the implementation bias that makes difficult a proper comparison of competing approaches. Therefore we present a new generic Subsequence Matching Framework (SMF) that tries to overcome the aforementioned problems by a uniform frame that simplifies and speeds up the design, development and evaluation of subsequence matching related systems. We identify several relatively separate subtasks solved differently over the literature and SMF enables to combine them in straightforward manner achieving new quality and efficiency. This framework can be used in many application domains and its components can be reused effectively. Its strictly modular architecture and openness enables also involvement of efficient solutions from different fields, for instance efficient metric-based indexes. This is an extended version of a paper published on DEXA 2012.Comment: This is an extended version of a paper published on DEXA 201

Cognitive load selectively influences the interruptive effect of pain on attention.

Pain is known to interrupt attentional performance. Such interference effects seem to occur preferentially for tasks that are complex and/or difficult. However, few studies have directly manipulated memory load in the context of pain interference to test this view. Therefore, the present study examines the effect of experimental manipulations of both memory load and pain on three tasks previously found to be sensitive to pain interference. Three experiments were conducted. A different task was examined in each experiment, each comprising of a high and low cognitive load versions of the task. Experiment 1 comprised of an attention span (n-back) task, Experiment 2 an attention switching task, and Experiment 3 a divided attention task. Each task was conducted under painful and non-painful conditions. Within the pain condition, an experimental thermal pain induction protocol was administered at the same time participants completed the task. The load manipulations were successful in all experiments. Pain-related interference occurred under the high load condition, but only for the attention span task. No effect of pain was found on either the attentional switching or divided attention task. These results suggest that while cognitive load may influence the interruptive effect of pain on attention, this effect may be selective. Since pain affected the high load version of the n-back task, but did not interrupt performance on attentional switching or dual task paradigms, this means our findings did not completely support our hypotheses. Future research should explore further the parameters and conditions under which pain-related interference occurs

Exercise for acute respiratory infections

No abstract available

Morality, responsibility and risk: Gay men and proximity to HIV

No abstract available

ACUTE EFFECTS OF VERBAL FEEDBACK ON EXPLOSIVE UPPER-BODY PERFORMANCE IN ELITE ATHLETES

The purpose of this study was to determine the effects of verbal feedback on the explosive upper-body performance of well-trained rugby union athletes in a resistance training session. Athletes (n = 9) completed two sessions of bench-throws with peak velocity feedback after each repetition, and two identical sessions without feedback. Within each session, three sets of four repetitions of bench-throw were completed. When feedback was received there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in average peak power and velocity when averaged over the three sets. When individual sets were compared, there was a tendency towards greater increases in average peak power in the second and third sets. Benefits of feedback may be greatest in the latter sets of training and could improve training quality and adaptation

Time Series Classification: Lessons Learned in the (Literal) Field while Studying Chicken Behavior

Poultry farms are a major contributor to the human food chain. However, around the world, there have been growing concerns about the quality of life for the livestock in poultry farms; and increasingly vocal demands for improved standards of animal welfare. Recent advances in sensing technologies and machine learning allow the possibility of monitoring birds, and employing the lessons learned to improve the welfare for all birds. This task superficially appears to be easy, yet, studying behavioral patterns involves collecting enormous amounts of data, justifying the term Big Data. Before the big data can be used for analytical purposes to tease out meaningful, well-conserved behavioral patterns, the collected data needs to be pre-processed. The pre-processing refers to processes for cleansing and preparing data so that it is in the format ready to be analyzed by downstream algorithms, such as classification and clustering algorithms. However, as we shall demonstrate, efficient pre-processing of chicken big data is both non-trivial and crucial towards success of further analytics.Comment: arXiv admin note: text overlap with arXiv:1811.0314

Characteristic Vertical Response of a Footbridge Due to Crowd Loading

The characteristic vertical vibration of a flexible footbridge subject to crowd loading is examined in this paper. Typically, bridge vibrations produced from a crowd of pedestrians are estimated by using an enhancement factor applied to the effect caused by a single pedestrian. In this paper, a single pedestrian model, represented by a spring mass damper, which incorporates variables such as pedestrian mass and body stiffness, is used to calibrate a computationally efficient moving force model. This calibrated moving force model is further used in Monte Carlo simulations of non-homogenous crowds to estimate characteristic vertical vibration levels. Enhancement factors, which could be applied to simple single pedestrian moving force models in estimating the response due to a crowd are thus derived. Such enhancement factors are then compared to previously published values. It is found that the greatest difference between the spring mass damper and moving force models respectively occurs when the bridge frequency is at the mean crowd pacing frequency. For bridges with frequencies even slightly removed from this mean, moving force models appear adequate

Grevious harm: Use of the Offences Against the Person Act 1861 for sexual transmission of HIV

No abstract available