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Matthew D Barrett,1 Terence F McLoughlin,2 Kieran R Gallagher,1 Don Gatherer,3 Michael TR Parratt,1 Jonathan R Perera,1 Tim WR Briggs1 1Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom; 2Royal Liverpool University Hospital, Liverpool, Mersey Deanery, United Kingdom; 3The Gatherer Partnership, Aylesbury, United Kingdom Purpose: To investigate the effect of a tailored neck muscle conditioning program on neck muscle strength, neck muscle fatigue, and range of neck movement in 16–18-year-old male rugby players. Materials and methods: Thirty-four male rugby players were divided into forward and back playing positions and randomized within these groups. Seventeen players were randomly assigned to each group. The test group was given a tailored 6-week exercise regime based on their baseline measurements to be performed three times a week in addition to their normal training and playing. The control group trained and played as normal. The outcome measures used were cervical spine range of movement, neck strength, and neck muscle fatigability. Results: There were no clinically relevant statistically significant differences between the two groups. Trends identified between the two groups suggest that a tailored neck exercise program increases neck strength, particularly neck extension, and increases resistance to fatigue, as well as influencing right- and left-sided neck muscle balance. A reduction in range of movement was also demonstrated in the test group. There was a great deal of variability in range of movement and strength within this age group. No previously undiagnosed neck conditions were detected, and there were no adverse events reported. Conclusion: This study has shown that neck strength, range of movement, and susceptibility of the neck muscles to fatigue can be influenced using a focused neck training regime. It forms an important basis for a larger, multicenter study to ensure the neck is given due attention in rugby training

peer-reviewed, The development of solid dosage forms and manufacturing processes are governed by complex physical properties of the powder and the type of pharmaceutical unit operation the manufacturing processes employs. Suitable powder flow properties and compactability are crucial bulk level properties for tablet manufacturing by direct compression. It is also generally agreed that small scale powder flow measurements can be useful to predict large scale production failure. In this study, predictive multilinear regression models were effectively developed from critical material properties to estimate static powder flow parameters from particle size distribution data for a single component and for binary systems. A multilinear regression model, which was successfully developed for ibuprofen, also efficiently predicted the powder flow properties for a range of batches of two other active pharmaceutical ingredients processed by the same manufacturing route. The particle size distribution also affected the compactability of ibuprofen, and the scope of this work will be extended to the development of predictive multivariate models for compactability, in a similar manner to the approach successfully applied to flow properties.

Introduction: Oxford Hip Scores (OHS) and Oxford Knee Scores (OKS) are being collected as part of the Patient Reported Outcome Measures (PROMs) evaluation programme on total hip and knee replacement. This study compares the PROMs outcomes from best and poorest performing English hospitals, as defined by NHS England’s data of elective hip and knee surgery. This was to quantify the difference and identify the scope for improvement. Materials and Methods: OHS and OKS were obtained from the Health and Social Care Information Centre for April 2013 to March 2014. Results: Seven sites for OHS and 10 sites for OKS were above the upper 95% control limit. Fourteen sites for OHS and 10 sites for OKS were below the lower 95% control limit. Median pre-operative scores were similar between best and poorest performers. Median post-operative scores were 4 points higher in best performers. Top OHS-performers scored better in limping, stairs, work, transport, dressing and shopping. Top OKS-performers scored better in walking, shopping and kneeling. Discussion: Pre-operative scores were similar for the best and poorest performers. The differences between best and poorest performing hospitals for OHS and OKS were below the minimum important difference. There was only moderate consistency for outliers. Results for any single year should be treated with caution. Conclusions: PROMs, one of many key tools in measuring and increasing person-centered healthcare, can be useful as part of an evaluation of practice but do not always reveal the full picture. It is important that balanced measures of quality should be used when benchmarking hospitals.