Guideline for the non-surgical management of hip and knee osteoarthritis

Introduction: Chronic disease is a major public health burden on Australian society. An increasing proportion of the population has risk factors for, or at least one, chronic disease, leading to increasing public health costs. Health service policy and delivery must not only address acute conditions, it must also effectively respond to the wide range of health and public service requirements of people with chronic illness.^1,2 Strong primary health care policy is an important foundation for a successful national health delivery system and long term management of public health, and is linked to practical outcomes including lower mortality, decreased hospitalisation and improved health outcomes.¹ National strategic health policy has recently given increased recognition to the importance of chronic disease management, with the Australian Federal Government endorsement of a number of initiatives for the prevention (or delay in onset), early detection and evidence based management of chronic disease, including osteoarthritis.^1,3
Chronic musculoskeletal conditions, including arthritis, account for over 4% of the national disease burden in terms of disability adjusted life years. Over 6 million Australians (almost one-third of the population) are estimated to have a chronic musculoskeletal disease; chronic musculoskeletal disease represents the main cause of long term pain and physical disability. In Australia, osteoarthritis is self reported by more than 1.4 million people (7.3% of the population4) and is the tenth most commonly managed problem in general practice.5 This number is set to rise as the elderly population grows. Osteoarthritis exerts a significant burden on the individual and the community through reduction in quality of life, diminished employment capacity and an increase in health care costs. For further details, refer to the Evidence to support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: Opportunities to improve health-related quality of life and reduce the burden of disease and disability (2004).⁶
As such, federal government health policy has identified arthritis as a National Health Priority Area and adopted a number of initiatives aimed at decreasing the burden of chronic disease and disability; raising awareness of preventive disease factors; providing access to evidence based knowledge; and improving the overall management of arthritis within the community.4 In 2002, all Australian health ministers designated arthritis and musculoskeletal conditions as Australia’s seventh National Health Priority Area. In response, a National Action Plan was developed in 2004 by the National Arthritis and Musculoskeletal Conditions Advisory Group (NAMSCAG).6 The aim of this document was to provide a blueprint for national initiatives to improve the health related quality of life of people living with osteoarthritis, rheumatoid arthritis and osteoporosis; reduce the cost and prevalence of these conditions; and reduce the impact on individuals, their carers and their communities within Australia. The National Action Plan was developed to complement both the National Chronic Disease Strategy – which is broader – and the National Service Improvement Framework for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis, in addition to other national and state/ territory structures.

Peak to average power ratio analysis for LTE systems

The 3rd generation partnership project (3GPP) long term evolution (LTE) standard uses single carrier frequency division multiple access (SCFDMA) scheme for the uplink transmissions and orthogonal frequency division multiplexing access (OFDMA) in downlink. SCFDMA uses DFT spreading prior to OFDMA modulation to map the signal from each user to a subset of the available subcarriers i.e., single carrier modulation. The efficiency of a power amplifier is determined by the peak to average power ratio (PAPR) of the modulated signal. In this paper, we analyze the PAPR in 3GPP LTE systems using root raised cosine based filter. Simulation results show that the SCFDMA subcarrier mapping has a significantly lower PAPR compared to OFDMA. Also comparing the three forms of SCFDMA subcarrier mapping, results show that interleave FDMA (IFDMA) subcarrier mapping with proposed root raised cosine filter reduced PAPR significantly than localized FDMA (LFDMA) and distributed (DFDMA) mapping. This improves its radio frequency (RF) power amplifier efficiency and also the mean power output from a battery driven mobile terminal.

Investigation of proton dynamics and the proton transport pathway in choline dihydrogen phosphate using solid-state NMR

Choline dihydrogen phosphate has previously been shown to be a good ionic conductor as well as an excellent host for acid doping, leading to high proton conductivities required for e.g., electrochemical devices including proton membrane fuel cells and sensors. A combination of variable-temperature ¹H solid-state NMR and 2D NMR pulse sequences, including ³¹P and ¹³C CODEX and ¹H BaBa, show that the proton conduction mechanism primarily involves assisted transport via a restricted three-site motion of the phosphate unit around the P–O bond that is hydrogen bonded to the choline and exchange of protons between these anions. In other words, proton transport at ambient temperatures appears to occur most favorably along the crystallographic b axis, from phosphate dimer to dimer. At elevated temperatures exchange between the protons of the hydroxyl group on the choline cation and the hydrogen-bonded dihydrogen phosphate groups also contributes to the structural diffusion of the protons in this solid state conductor.

Proton transport in choline dihydrogen phosphate/H3PO4 mixtures

Mixtures of the plastic crystal material choline dihydrogen phosphate [Choline][DHP] and phosphoric acid, from 4.5 mol% to 18 mol% H₃PO₄, were investigated and shown to have significantly higher proton conductivity compared to the pure [Choline][DHP]. This was particularly evident from the electrochemical hydrogen reduction reaction and the proton NMR diffusion measurements, in addition to ionic conductivity measured from the impedance spectroscopy. The ionic conductivity was observed to increase by more than an order of magnitude in phase I (i.e. the highest temperature solid phase in [Choline][DHP]) reaching up to 10⁻² S cm⁻¹. The multinuclear NMR spectroscopy data suggest that, at least on the timescale of the NMR measurement, the H⁺ cations and [DHP] anions are equivalent in both phases. The pulsed field gradient NMR diffusion measurements of the 18 mol% acid sample indicate that all three ions are mobile, however the H⁺ diffusion coefficient is an order of magnitude higher than for the [Choline] cation or the [DHP] anion, and therefore conduction in these materials is dominated by proton conductivity. The thermal stability, as measured by TGA, is unaffected with increasing acid additions and remains high; i.e. no significant mass loss below 200 °C.

Low complexity MMSE based channel estimation technique for LTE OFDMA systems

Long term evolution (LTE) is designed for high speed data rate, higher spectral efficiency, and lower latency as well as high-capacity voice support. LTE uses single carrierfrequency division multiple access (SC-FDMA) scheme for the uplink transmission and orthogonal frequency division multiple access (OFDMA) in downlink. The one of the most important challenges for a terminal implementation are channel estimation (CE) and equalization. In this paper, a minimum mean square error (MMSE) based channel estimator is proposed for an OFDMA systems that can avoid the ill-conditioned least square (LS) problem with lower computational complexity. This channel estimation technique uses knowledge of channel properties to estimate the unknown channel transfer function at non-pilot subcarriers.

PAPR reduction technique for LTE OFDMA systems

Long term evolution (LTE) is the final step toward the 4th generation (4G) of radio technologies designed to increase the capacity and speed of mobile networks. LTE uses orthogonal frequency division multiple access (OFDMA) for the downlink transmission and single carrier-frequency division multiple access (SC-FDMA) for uplink. OFDMA meets the 4G requirement for spectrum flexibility and enables cost-efficient solutions for very wide carriers with high peak rates. However, the potentially large peak-to-average power ratio (PAPR) of the transmitting signals has limited its application. This high PAPR causes interference when the OFDM signals are passed through an amplifier which does not have enough linear range. In this article, we investigate a clipping based PAPR reduction method for LTE OFDMA systems. Simulation results show that the clipping method is reduced PAPR significantly which decreases as the number of clip and filtering level is increased. As a results, increase the mean transmit power, and improve the power amplifier efficiency. This comes at the outlay of complexity, efficiency as well as cost.

Channel estimation scheme for 3.9G wireless communication systems using RLS algorithm

Main challenges for a terminal implementation are efficient realization of the receiver, especially for channel estimation (CE) and equalization. In this paper, training based recursive least square (RLS) channel estimator technique is presented for a long term evolution (LTE) single carrier-frequency division multiple access (SC-FDMA) wireless communication system. This CE scheme uses adaptive RLS estimator which is able to update parameters of the estimator continuously, so that knowledge of channel and noise statistics are not required. Simulation results show that the RLS CE scheme with 500 Hz Doppler frequency has 3 dB better performances compared with 1.5 kHz Doppler frequency.

Improving care for people with osteoarthritis of the hip and 'knee : how has national policy for osteoarthritis been translated into service models in Australia?

There is strong rationale for improving care for people with chronic conditions, including osteoarthritis (OA). Successful implementation of healthcare reform requires new concepts and directions that are strongly supported by policy, new models of care (service redesign) and changes in day-to-day practice (healthcare provider and patient practice). In this paper we discuss the extent to which policy about management of OA of the hip and knee has been translated into new service models in Australia. A structured search of government and other key health websites in Australia was performed to identify policy, funding initiatives and new services models for managing OA of the hip and knee. This search was supported by a literature review. Musculoskeletal conditions were designated a National Health Priority in Australia in 2002. Under the Better Arthritis and Osteoporosis Care initiative, Australia has developed a national policy for OA care and national evidence-based clinical practice guidelines for management of OA of the hip and knee. Only two well described examples of new chronic disease management service models, the Osteoarthritis Clinical Pathway (OACP) model and the Osteoarthritis Hip and Knee Service (OAHKS) were identified. Primarily focused within acute care public hospital settings, these have been shown to be feasible and acceptable but have limited data on clinical impact and cost-effectiveness. While policy is extant, implementation has not been systematic and comprehensive. Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently.

Production of green nanomaterials

While our awareness towards sustainable society and environment grows, the importance of ‘green’ materials and manufacturing is gaining significant recognition. We have demonstrated that naturally-occurring fibers as renewable raw materials can be converted into nanoparticles and nano fibers using simple top-down methods without introducing hazardous chemicals. This new class of green nanomaterials will have a wide range of environmental and biomedical applications owing to the inherent biocompatible, biodegradable and carbon-neutral nature.

Protic ionic liquids based on phosphonium cations : comparison with ammonium analogues

Novel protic ionic liquids (PILs) based on a tributyl phosphonium cation have been synthesised and characterised, revealing that the phosphonium based ILs show high thermal stability, high ionic conductivity and facile proton reduction compared to the corresponding ammonium based ILs.

An organic ionic plastic crystal electrolyte based on the triflate anion exhibiting high proton transport

A novel organic ionic plastic crystal (OIPC) electrolyte based on a quaternary ammonium cation and the triflate anion has been synthesized, which shows fast proton transport and high thermal stability in the solid state when doped with triflic acid.

Recognising faces in unseen modes : a tensor based approach

This paper addresses the limitation of current multilinear techniques (multilinear PCA, multilinear ICA) when applied to face recognition for handling faces in unseen illumination and viewpoints. We propose a new recognition method, exploiting the interaction of all the subspaces resulting from multilinear decomposition (for both multilinear PCA and ICA), to produce a new basis called multilinear-eigenmodes. This basis offers the flexibility to handle face images at unseen illumination or viewpoints. Experiments on benchmarked datasets yield superior performance in terms of both accuracy and computational cost.

Efficient tensor based face recognition

This paper addresses the limitation of current multilinear PCA based techniques, in terms of pro- hibitive computational cost of testing and poor gen- eralisation in some scenarios, when applied to large training databases. We define person-specific eigen-modes to obtain a set of projection bases, wherein a particular basis captures variation across light- ings and viewpoints for a particular person. A new recognition approach is developed utilizing these bases. The proposed approach performs on a par with the existing multilinear approaches, whilst sig- nificantly reducing the complexity order of the testing algorithm.