INTRODUCTION: The aim of this study was to evaluate the impact of a pre-operative education programme on length of hospital stay after surgery for primary and revision knee arthroplasty patients. The programme was introduced at our hospital in October 2006 to encourage patients to play an active role in their recovery process after surgery. PATIENTS AND METHODS: A multidisciplinary team educated knee arthroplasty patients about their care pathway, knee surgery, pain management, expected discharge goals, in-patient and out-patient arthroplasty rehabilitation. Prospective data were collected from 472 consecutive patients who underwent (primary or revision) knee arthroplasty in the period between January 2006 and November 2007. Patients were separated into two groups, one that received conventional pre-operative treatment (n = 150; Conventional group) and another that received the pre-operative education (n = 322; Education group). Length of hospital stay was compare using the Mann Whitney U test. In-patient complications, hospital re-admissions within 24 h and 3 months of hospital discharge were compared using the chi-squared test. RESULTS: The mean length of stay was significantly reduced from 7 days in the Conventional group to 5 days in the Education group (P < 0.01). In addition, 20% more patients were discharged early (within 1–4 days) in the Education group compared to the Conventional group (P < 0.01). There was no difference in the percentage of in-patient complications and re-admissions in 24 h (P = 1.00) and 3 months of discharge (P = 0.92) between the two groups. CONCLUSIONS: The results suggest that pre-operative education is a safe and effective method of reducing length of stay for knee arthroplasty patients.

Ed male cyclists each completed four 4000-m time trials. The first trial was a habituation and the data from the second trial was used to form a baseline (BL). During trials 3 and 4, participants raced against an avatar, which they were informed represented their BL performance. However, whereas one of these trials was an accurate (ACC) representation of BL, the power output in the other trial was set at 102% of BL and formed the deception condition (DEC). Oxygen uptake and RER were measured continuously and used to determine aerobic and anaerobic contributions to power output. Results There was a significant difference between trials for time to completion (F = 15.3, P = 0.00). Participants completed DEC more quickly than BL (90% CI = 2.1–10.1 s) and ACC (90% CI = 1.5–5.4 s) and completed ACC more quickly than BL (90% CI = 0.5–4.8 s). The difference in performance between DEC and ACC was attributable to a greater anaerobic contribution to power output at 90% of the total distance (F = 5.3, P = 0.02, 90% CI = 4–37 W). Conclusions The provision of surreptitiously augmented feedback derived from a previous performance reduces time taken for cyclists to accomplish a time trial of known duration. This suggests that cyclists operate with a metabolic reserve even during maximal time trials and that this reserve can be accessed after deception....

Testing of the null hypothesis is a fundamental aspect of the scientific method and has its basis in the falsification theory of Karl Popper. Null hypothesis testing makes use of deductive reasoning to ensure that the truth of conclusions is irrefutable. In contrast, attempting to demonstrate the new facts on the basis of testing the experimental or research hypothesis makes use of inductive reasoning and is prone to the problem of the Uniformity of Nature assumption described by David Hume in the eighteenth century. Despite this issue and the well documented solution provided by Popper's falsification theory, the majority of publications are still written such that they suggest the research hypothesis is being tested. This is contrary to accepted scientific convention and possibly highlights a poor understanding of the application of conventional significance-based data analysis approaches. Our work should remain driven by conjecture and attempted falsification such that it is always the null hypothesis that is tested. The write up of our studies should make it clear that we are indeed testing the null hypothesis and conforming to the established and accepted philosophical conventions of the scientific method.

Objectives: The objective of this systematic review and meta-analysis was to examine controlled trial evidence for the effectiveness of mindfulness-based interventions on stress, anxiety and depression in the perinatal period in women without pre-existing mental health issues. Methods: Six databases were searched for studies exploring the effects of mindfulness-based interventions on mental health outcomes of women during the perinatal period. Quality of both controlled trial meeting inclusion criteria were assessed using a tool specifically designed for meta-analyses of mindfulness-based interventions. Effect sizes were extracted for measures of mindfulness, depression, stress and anxiety outcomes. Effects were pooled in separate meta-analyses for all outcomes except anxiety which lacked sufficient studies. Results: Twelve studies were analysed. Pooled effects suggest that mindfulness-based interventions cause small but clear increases in mindfulness and reductions in depression in women without pre-existing disorders. Effects of mindfulness-based interventions on other outcomes were unclear and confounded by heterogeneity. Conclusions: Available controlled trial evidence suggests that mindfulness-based interventions improve mindfulness and decrease symptoms of depression during pregnancy in women without pre-existing mental health issues and might be a useful approach to prevent or attenuate the development of depression in the perinatal period.