4 Return to golf post arthroplasty

Aim

To determine the impact of arthroplasty on player handicap, frequency of golf played, return to club competitions and overall mental and physical health using the SF-12.

Method

A three page, 30 item, open access survey was sent to a community of over 500,000 golfers via the newsletter for the HowDidIDo® app between 18/04/2019–30/04/2019, inviting users who had undergone a joint replacement to complete. Responses were analysed using Microsoft excel and StatsDirect.

Results

A total of 3043 valid responses were received, the majority were male (n=2392). Mean age was 70 years (25–92). Most respondents had only a single joint replacement (n=1977). Within the cohort, there were mostly hips (n=2092) and knees (n=2069) replaced with far fewer shoulders (n=101), although this concurred with NJR population data. Across the whole cohort, most respondents were playing more (40%) or the same (44%) amount of golf following arthroplasty. Across the cohort only 4% were assumed unable to return to club competitions, while 76% of respondents returned to competitions within six months. Mean handicap prior to arthroplasty was increased (17.6 to 18.9) with no significant difference between hips, knees and shoulders. The SF-12 results were completed for 1094 respondents which when matched for age, demonstrated higher physical (48.59 vs. 43.65) and mental health (55.59 vs.52.10) scores.

Conclusions

Joint replacement enables the vast majority of patients to continue or increase the amount of golf played with most returning to club competitions within six months. A slight increase in handicap is demonstrated following surgery in this cohort, with stabilisation after this initial increase. Patients playing golf following arthroplasty demonstrate better physical and mental health than their age matched counterparts.

Haemophilus influenzae serotype B (Hib) seroprevalence in England and Wales in 2009

A national seroprevalence study was performed to determine the prevalence of Haemophilus influenzae type b (Hib) antibodies in England and Wales in 2009, when Hib disease incidence was the lowest ever recorded. A total of 2,693 anonymised residual sera from routine diagnostic testing submitted by participating National Health Service hospital laboratories were tested for Hib anti-polyribosyl-ribitol phosphate (PRP) IgG antibodies using a fluorescent bead assay. Median anti-PRP IgG concentrations were highest in toddlers aged 1–4 years (2.65 μg/ml), followed by children aged 5–9 years (1.95 μg/ml). Antibody concentrations were significantly lower after this age, but were still significantly higher among 10–19 year-olds (0.54 μg/ml) compared with adults aged >20 years (0.16 μg/ ml; p<0.0001). Half of the adults (51%) did not have Hib antibody concentrations ≥0.15 μg/ml, the level considered to confer short-term protection. Thus, the current excellent Hib control appears to be the result of high anti-PRP antibody concentrations in children aged up to 10 years, achieved through the various childhood vaccination campaigns offering booster immunisation. The lack of seroprotection in adults emphasises the importance of maintaining control of the disease and, most probably carriage, in children, therefore raising the question as to whether long-term routine boosting of either pre-school children or adolescents may be required.

Can higher education improve the professional identity of CNNs?

Community nursery nurses (CNNs) are an important part of the multidisciplinary team. This paper discusses how two students undertaking a foundation degree in early years experienced changes to their personal and professional identities. A 'life history' approach was used to understand and interpret their experiences in depth. Both students would not have entered higher education had it not been for the widening participation drive. The higher education experience had a positive influence on personal and professional identity for the learners. They underlined that the widening participation drive can enable those students from 'non-traditional backgrounds' to enter and benefit from higher education. However, changes to higher education funding and public sector cutbacks have raised grave concerns about the continued ability of CNNs and other early years practitioners to access such courses. This could have a negative effect on the continuing professional development and subsequent changing identities within this particular group.

A symbiosome membrane is not required for the actions of two host signalling compounds regulating photosynthesis in symbiotic algae isolated from cnidarians

In many cnidarians, symbiotic algae live within host-derived symbiosomes. We determined whether a symbiosome membrane alters the response of isolated symbiotic algae to two signalling compounds that regulate algal carbon metabolism. Host release factor (HRF), which stimulates photosynthate release, and photosynthesis inhibiting factor (PIF), which inhibits photosynthetic carbon fixation, are found in homogenised tissue of the scleractinian coral Plesiastrea versipora. Compared with seawater controls, photosynthate release from isolated algae incubated in P. versipora homogenate for 2 h in the light was: 6 to 19-fold higher from its own algae (free of symbiosomes); 19 to 32-fold higher from Zoanthid robustus algae (within symbiosomes) and 3 to 24-fold higher from Z. robustus algae (free of symbiosomes); and from cultured algae (free of symbiosomes) was seven-fold higher from Montipora verrucosa and four-fold higher from Cassiopeia xamachana. Incubation of algae in P. versipora homogenate inhibited photosynthesis by: 33-49% in P. versipora algae; 29-47% in Z. robustus algae (regardless of whether or not the symbiosome was present); and 25% in M. verrucosa algae. In C. xamachana algae, photosynthesis increased. We conclude that the symbiosome is not essential for, yet does not block, the effects of HRF and PIF.