Effectiveness and Cost-effectiveness of Outpatient Physiotherapy After Knee Replacement for Osteoarthritis: Study Protocol for a Randomised Controlled Trial

Background: Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short-term function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long-term clinical effectiveness and cost-effectiveness of a 6-week group-based outpatient physiotherapy intervention following knee replacement. Methods/design: Two hundred and fifty-six patients waiting for knee replacement because of osteoarthritis will be recruited from two orthopaedic centres. Participants randomised to the usual-care group (n = 128) will be given a booklet about exercise and referred for physiotherapy if deemed appropriate by the clinical care team. The intervention group (n = 128) will receive the same usual care and additionally be invited to attend a group-based outpatient physiotherapy class starting 6 weeks after surgery. The 1-hour class will be run on a weekly basis over 6 weeks and will involve task-orientated and individualised exercises. The primary outcome will be the Lower Extremity Functional Scale at 12 months post-operative. Secondary outcomes include: quality of life, knee pain and function, depression, anxiety and satisfaction. Data collection will be by questionnaire prior to surgery and 3, 6 and 12 months after surgery and will include a resource-use questionnaire to enable a trial-based economic evaluation. Trial participation and satisfaction with the classes will be evaluated through structured telephone interviews. The primary statistical and economic analyses will be conducted on an intention-to-treat basis with and without imputation of missing data. The primary economic result will estimate the incremental cost per quality-adjusted life year gained from this intervention from a National Health Services (NHS) and personal social services perspective. Discussion: This research aims to benefit patients and the NHS by providing evidence on the long-term effectiveness and cost-effectiveness of outpatient physiotherapy after knee replacement. If the intervention is found to be effective and cost-effective, implementation into clinical practice could lead to improvement in patients’ outcomes and improved health care resource efficiency

Planck pre-launch status: HFI beam expectations from the optical optimisation of the focal plane

Planck is a European Space Agency (ESA) satellite, launched in May 2009, which will map the cosmic microwave background anisotropies in intensity and polarisation with unprecedented detail and sensitivity. It will also provide full-sky maps of astrophysical foregrounds. An accurate knowledge of the telescope beam patterns is an essential element for a correct analysis of the acquired astrophysical data. We present a detailed description of the optical design of the High Frequency Instrument (HFI) together with some of the optical performances measured during the calibration campaigns. We report on the evolution of the knowledge of the pre-launch HFI beam patterns when coupled to ideal telescope elements, and on their significance for the HFI data analysis procedure

Using biomass-based fuels including pyrolysis liquids for power and CHP production

The use of biomass-derived liquids (in short: bioliquids) instead of solid biomass can help overcome some of the barriers hindering a wider use of biomass in smaller-scale CHP systems. Relevant bioliquids included biodiesel, vegetable oils as well straight and upgraded pyrolysis oil. In this joint EU-Russian research project Bioliquids-CHP prime movers (engines and turbines) will be developed and modified so that these can run efficiently on bioliquids. At the same time, bioliquids will be upgraded and blended in order to facilitate their use in prime movers. Preliminary results with regard to bioliquid selection, production, and characterisation; the selection and modification of a micro gas turbine; and the development of engines and components are discussed. The research also covers NOx emission reduction and control and an assessment of the benefits and economics of bioliquids-based CHP systems in EU and Russian markets

ACBAR: The Arcminute Cosmology Bolometer Array Receiver

We describe the Arcminute Cosmology Bolometer Array Receiver (ACBAR); a multifrequency millimeter-wave receiver designed for observations of the Cosmic Microwave Background (CMB) and the Sunyaev-Zel'dovich effect in clusters of galaxies. The ACBAR focal plane consists of a 16-pixel, background-limited, 240 mK bolometer array that can be configured to observe simultaneously at 150, 220, 280, and 350 GHz. With 4-5' FWHM Gaussian beam sizes and a 3 degree azimuth chop, ACBAR is sensitive to a wide range of angular scales. ACBAR was installed on the 2 m Viper telescope at the South Pole in January 2001. We describe the design of the instrument and its performance during the 2001 and 2002 observing seasons.Comment: 59 pages, 16 figures -- updated to reflect version published in ApJ

Intelligence within BAOR and NATO's Northern Army Group

During the Cold War the UK's principal military role was its commitment to the North Atlantic Treaty Organisation (NATO) through the British Army of the Rhine (BAOR), together with wartime command of NATO's Northern Army Group. The possibility of a surprise attack by the numerically superior Warsaw Pact forces ensured that great importance was attached to intelligence, warning and rapid mobilisation. As yet we know very little about the intelligence dimension of BAOR and its interface with NATO allies. This article attempts to address these neglected issues, ending with the impact of the 1973 Yom Kippur War upon NATO thinking about warning and surprise in the mid-1970s. It concludes that the arrangements made by Whitehall for support to BAOR from national assets during crisis or transition to war were - at best - improbable. Accordingly, over the years, BAOR developed its own unique assets in the realm of both intelligence collection and special operations in order to prepare for the possible outbreak of conflict