Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial

Introduction: Management of osteoarthritis (OA) includes the use of non-pharmacological and pharmacological therapies. Although walking is commonly recommended for reducing pain and increasing physical function in people with OA, glucosamine sulphate has also been used to alleviate pain and slow the progression of OA. This study evaluated the effects of a progressive walking program and glucosamine sulphate intake on OA symptoms and physical activity participation in people with mild to moderate hip or knee OA. Methods: Thirty-six low active participants (aged 42 to 73 years) were provided with 1500 mg glucosamine sulphate per day for 6 weeks, after which they began a 12-week progressive walking program, while continuing to take glucosamine. They were randomized to walk 3 or 5 days per week and given a pedometer to monitor step counts. For both groups, step level of walking was gradually increased to 3000 steps/day during the first 6 weeks of walking, and to 6000 steps/day for the next 6 weeks. Primary outcomes included physical activity levels, physical function (self-paced step test), and the WOMAC Osteoarthritis Index for pain, stiffness and physical function. Assessments were conducted at baseline and at 6-, 12-, 18-, and 24-week follow-ups. The Mann Whitney Test was used to examine differences in outcome measures between groups at each assessment, and the Wilcoxon Signed Ranks Test was used to examine differences in outcome measures between assessments. Results: During the first 6 weeks of the study (glucosamine supplementation only), physical activity levels, physical function, and total WOMAC scores improved (P<0.05). Between the start of the walking program (Week 6) and the final follow-up (Week 24), further improvements were seen in these outcomes (P<0.05) although most improvements were seen between Weeks 6 and 12. No significant differences were found between walking groups. Conclusions: In people with hip or knee OA, walking a minimum of 3000 steps (~30 minutes), at least 3 days/week, in combination with glucosamine sulphate, may reduce OA symptoms. A more robust study with a larger sample is needed to support these preliminary findings. Trial Registration: Australian Clinical Trials Registry ACTRN012607000159459.

Factors associated with physical activity in Australians with hip or knee osteoarthritis

Background: Physical activity (PA) is recommended for managing osteoarthritis (OA). However, few people with OA are physically active. Understanding the factors associated with PA is necessary to increase PA in this population. This cross-sectional study examined factors associated with leisure-time PA, stretching exercises, and strengthening exercises in people with OA. Methods: For a mail survey, 485 individuals, aged 68.0 y (SD=10.6) with hip or knee OA, were asked about factors that may influence PA participation, including use of non-PA OA management strategies and both psychological and physical health-related factors. Associations between factors and each PA outcome were examined in multivariable logistic regression models. Results: Non-PA management strategies were the main factors associated with the outcomes. Information/education courses, heat/cold treatments, and paracetamol were associated with stretching and strengthening exercises (P<0.05). Hydrotherapy and magnet therapy were associated with leisure-time PA; using orthotics and massage therapy, with stretching exercises; and occupational therapy, with strengthening exercises (P<0.05). Few psychological or health15 related factors were associated with the outcomes. Conclusions: Some management strategies may make it easier for people with OA to be physically active, and could be promoted to encourage PA. Providers of strategies are potential avenues for recruiting people with OA into PA programs.

A robust structure and motion replacement for bundle adjustment

This paper demonstrates the application of a robust form of pose estimation and scene reconstruction using data from camera images. We demonstrate results that suggest the ability of the algorithm to rival methods of RANSAC based pose estimation polished by bundle adjustment in terms of solution robustness, speed and accuracy, even when given poor initialisations. Our simulated results show the behaviour of the algorithm in a number of novel simulated scenarios reflective of real world cases that show the ability of the algorithm to handle large observation noise and difficult reconstruction scenes. These results have a number of implications for the vision and robotics community, and show that the application of visual motion estimation on robotic platforms in an online fashion is approaching real-world feasibility.

Lineage replacement accompanying duplication and rapid fixation of an RNA element in the nsP3 gene in a species of alphavirus

A sequence of thirty-six nucleotides in the nsP3 gene of Ross River virus (RRV), coding for the amino acid sequence HADTVSLDSTVS, was duplicated some time between 1969 and 1979 coinciding with the appearance of a new lineage of this virus and with a major outbreak of Epidemic Polyarthritis among residents of the Pacific Islands. This lineage of RRV continues to circulate throughout Australia and both earlier lineages, which lacked the duplicated element, now are extinct. Multiple copies of several other elements also were observed in this region of the nsP3 gene in all lineages of RRV. Multiple copies of one of these, coding for the amino acid sequence P*P*PR, were detected in the C-terminal region of the nsP3 protein of all alphaviruses except those of African origin. The fixation of duplications and insertions in 3' region of nsP3 genes from all lineages of alphaviruses, suggests they provide some fitness advantage

That's a rap : the making of an Australian hip hop integrated musical film

To date, the majority of films that utilise or feature hip hop music and culture, have either been in the realms of documentary, or in ‘show musicals’ (where the film musical’s device of characters’ bursting into song, is justified by the narrative of a pursuit of a career in the entertainment industry). Thus, most films that feature hip hop expression have in some way been tied to the subject of hip hop. A research interest and enthusiasm was developed for utilising hip hop expression in film in a new way, which would extend the narrative possibilities of hip hop film to wider topics and themes. The creation of the thesis film Out of My Cloud, and the writing of this accompanying exegesis, investigates a research concern of the potential for the use of hip hop expression in an ‘integrated musical’ film (where characters’ break into song without conceit or explanation). Context and rationale for Out of My Cloud (an Australian hip hop ‘integrated musical’ film) is provided in this writing. It is argued that hip hop is particularly suitable for use in a modern narrative film, and particularly in an ‘integrated musical’ film, due to its: current vibrancy and popularity, rap (vocal element of hip hop) music’s focus on lyrical message and meaning, and rap’s use as an everyday, non-performative method of communication. It is also argued that Australian hip hop deserves greater representation in film and literature due to: its current popularity, and its nature as a unique and distinct form of hip hop. To date, representation of Australian hip hop in film and television has almost solely been restricted to the documentary form. Out of My Cloud borrows from elements of social realist cinema such as: contrasts with mainstream cinema, an exploration/recognition of the relationship between environment and development of character, use of non-actors, location-shooting, a political intent of the filmmaker, displaying sympathy for an underclass, representation of underrepresented character types and topics, and a loose narrative structure that does not offer solid resolution. A case is made that it may be appropriate to marry elements of social realist film with hip hop expression due to common characteristics, such as: representation of marginalised or underrepresented groups and issues in society, political objectives of the artist/s, and sympathy for an underclass. In developing and producing Out of My Cloud, a specific method of working with, and filming actor improvisation was developed. This method was informed by improvisation and associated camera techniques of filmmakers such as Charlie Chaplin, Mike Leigh, Khoa Do, Dogme 95 filmmakers, and Lars von Trier (post-Dogme 95). A review of techniques used by these filmmakers is provided in this writing, as well as the impact it has made on my approach. The method utilised in Out of My Cloud was most influenced by Khoa Do’s technique of guiding actors to improvise fairly loosely, but with a predetermined endpoint in mind. A variation of this technique was developed for use in Out of My Cloud, which involved filming with two cameras to allow edits from multiple angles. Specific processes for creating Out of My Cloud are described and explained in this writing. Particular attention is given to the approaches regarding the story elements and the music elements. Various significant aspects of the process are referred to including the filming and recording of live musical performances, the recording of ‘freestyle’ performances (lyrics composed and performed spontaneously) and the creation of a scored musical scene involving a vocal performance without regular timing or rhythm. The documentation of processes in this writing serve to make the successful elements of this film transferable and replicable to other practitioners in the field, whilst flagging missteps to allow fellow practitioners to avoid similar missteps in future projects. While Out of My Cloud is not without its shortcomings as a short film work (for example in the areas of story and camerawork) it provides a significant contribution to the field as a working example of how hip hop may be utilised in an ‘integrated musical’ film, as well as being a rare example of a narrative film that features Australian hip hop. This film and the accompanying exegesis provide insights that contribute to an understanding of techniques, theories and knowledge in the field of filmmaking practice.

Reliability analysis and economic equipment replacement appraisal for substation and sub-transmission systems with explicit inclusion of non-repairable failures

The modern society has come to expect the electrical energy on demand, while many of the facilities in power systems are aging beyond repair and maintenance. The risk of failure is increasing with the aging equipments and can pose serious consequences for continuity of electricity supply. As the equipments used in high voltage power networks are very expensive, economically it may not be feasible to purchase and store spares in a warehouse for extended periods of time. On the other hand, there is normally a significant time before receiving equipment once it is ordered. This situation has created a considerable interest in the evaluation and application of probability methods for aging plant and provisions of spares in bulk supply networks, and can be of particular importance for substations. Quantitative adequacy assessment of substation and sub-transmission power systems is generally done using a contingency enumeration approach which includes the evaluation of contingencies, classification of the contingencies based on selected failure criteria. The problem is very complex because of the need to include detailed modelling and operation of substation and sub-transmission equipment using network flow evaluation and to consider multiple levels of component failures. In this thesis a new model associated with aging equipment is developed to combine the standard tools of random failures, as well as specific model for aging failures. This technique is applied in this thesis to include and examine the impact of aging equipments on system reliability of bulk supply loads and consumers in distribution network for defined range of planning years. The power system risk indices depend on many factors such as the actual physical network configuration and operation, aging conditions of the equipment, and the relevant constraints. The impact and importance of equipment reliability on power system risk indices in a network with aging facilities contains valuable information for utilities to better understand network performance and the weak links in the system. In this thesis, algorithms are developed to measure the contribution of individual equipment to the power system risk indices, as part of the novel risk analysis tool. A new cost worth approach was developed in this thesis that can make an early decision in planning for replacement activities concerning non-repairable aging components, in order to maintain a system reliability performance which economically is acceptable. The concepts, techniques and procedures developed in this thesis are illustrated numerically using published test systems. It is believed that the methods and approaches presented, substantially improve the accuracy of risk predictions by explicit consideration of the effect of equipment entering a period of increased risk of a non-repairable failure.

Maximum recovery after knee replacement - the MARKER study rationale and protocol

Background There is little scientific evidence to support the usual practice of providing outpatient rehabilitation to patients undergoing total knee replacement surgery (TKR) immediately after discharge from the orthopaedic ward. It is hypothesised that the lack of clinical benefit is due to the low exercise intensity tolerated at this time, with patients still recovering from the effects of major orthopaedic surgery. The aim of the proposed clinical trial is to investigate the clinical and cost effectiveness of a novel rehabilitation strategy, consisting of an initial home exercise programme followed, approximately six weeks later, by higher intensity outpatient exercise classes. Methods/Design In this multicentre randomised controlled trial, 600 patients undergoing primary TKR will be recruited at the orthopaedic pre-admission clinic of 10 large public and private hospitals in Australia. There will be no change to the medical or rehabilitative care usually provided while the participant is admitted to the orthopaedic ward. After TKR, but prior to discharge from the orthopaedic ward, participants will be randomised to either the novel rehabilitation strategy or usual rehabilitative care as provided by the hospital or recommended by the orthopaedic surgeon. Outcomes assessments will be conducted at baseline (pre-admission clinic) and at 6 weeks, 6 months and 12 months following randomisation. The primary outcomes will be self-reported knee pain and physical function. Secondary outcomes include quality of life and objective measures of physical performance. Health economic data (health sector and community service utilisation, loss of productivity) will be recorded prospectively by participants in a patient diary. This patient cohort will also be followed-up annually for five years for knee pain, physical function and the need or actual incidence of further joint replacement surgery. Discussion The results of this pragmatic clinical trial can be directly implemented into clinical practice. If beneficial, the novel rehabilitation strategy of utilising outpatient exercise classes during a later rehabilitation phase would provide a feasible and potentially cost-effective intervention to optimise the physical well-being of the large number of people undergoing TKR.

Effect of modular neck variation on bone and cement mantle mechanics around a total hip arthroplasty stem

Background Total hip arthroplasty carried out using cemented modular-neck implants provides the surgeon with greater intra-operative flexibility and allows more controlled stem positioning. Methods In this study, finite element models of a whole femur implanted with either the Exeter or with a new cemented modular-neck total hip arthroplasty (separate, neck and stem components) were developed. The changes in bone and cement mantle stress/strain were assessed for varying amounts of neck offset and version angle for the modular-neck device for two simulated physiological load cases: walking and stair climbing. Since the Exeter is the gold standard for polished cemented total hip arthroplasty stem design, bone and cement mantle stresses/strains in the modular-neck finite element models were compared with finite element results for the Exeter. Findings For the two physiological load cases, stresses and strains in the bone and cement mantle were similar for all modular-neck geometries. These results were comparable to the bone and cement mechanics surrounding the Exeter. These findings suggest that the Exeter and the modular neck device distribute stress to the surrounding bone and cement in a similar manner. Interpretation It is anticipated that the modular-neck device will have a similar short-term clinical performance to that of the Exeter, with the additional advantages of increased modularity.