Clinical outcomes and response to treatment of patients receiving topical treatments for pyoderma gangrenosum: a prospective cohort study

Background: pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment. Objective: to estimate the effectiveness of topical therapies in the treatment of PG. Methods: prospective cohort study of UK secondary care patients with a clinical diagnosis of PG suitable for topical treatment (recruited July 2009 to June 2012). Participants received topical therapy following normal clinical practice (mainly Class I-III topical corticosteroids, tacrolimus 0.03% or 0.1%). Primary outcome: speed of healing at 6 weeks. Secondary outcomes: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality-of-life; treatment failure and recurrence. Results: Sixty-six patients (22 to 85 years) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28/66 (43.8%) of ulcers healed by 6 months. Median time-to-healing was 145 days (95% CI: 96 days, ∞). Initial ulcer size was a significant predictor of time-to-healing (hazard ratio 0.94 (0.88;80 1.00); p = 0.043). Four patients (15%) had a recurrence. Limitations: No randomised comparator Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone

A study of the physical and photophysical properties of some novel phthalocyanines

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Practitioner suggestions for improving continence care in hospitals

Difficulties with bladder control affect one in five people in the UK and bowel problems affect one in ten. The quality of continence care can be poor and is then associated with increased admission to nursing or residential homes. Our study, which is summarised in this article, set out to identify factors that help and hinder good continence care for patients aged ≥65 years in hospital medical ward settings. We carried out 27 face-to-face interviews with nursing, medical and allied health practitioners in three hospitals. Examples of good-quality care included person-centred care that encouraged independence; poor-quality care resulted from over-reliance on products, such as pads or catheters, with an associated risk of infections. Practitioners suggested that continence care could be improved through open communication with patients, conservative treatments and regular continence care trainin

Facilitating the deposit of experimental chemistry data in institutional repositories: Project SPECTRa

Institutional Open Access repositories are becoming established as an important part of the university library and information services infrastructure. While early efforts to populate them with content have concentrated on the deposit of peer-reviewed research papers, there is a growing awareness of their potential as repositories of data and other non-text materials, and consequently a need to develop strategies and procedures that can realise this potential. Chemistry as a discipline has been slower than the physical and biomedical sciences to adopt and exploit Open Access concepts in the handling of experimental data and research publications. Chemical information is essential to many sciences outside chemistry, and the reporting of the synthesis and properties of new chemical compounds is central to this. But most of the essential experimental data associated with peer-reviewed publications from chemistry departments are never communicated to the scientific community. These data are all available in high-quality electronic form in the laboratories but there is no effective method for archiving them or making them openly accessible. The SPECTRa (Submission, Preservation, and Exposure of Chemistry Teaching and Research Data) project addressed this problem. It was a JISC-funded 18-month collaboration, ending in March 2007, between the university libraries and chemistry departments of the University of Cambridge and Imperial College London, in co-operation with the eBank-UK project. Its main objective was to develop a set of customized software tools that would enable chemists routinely to deposit experimental data in Open Access repositories, employing the DSpace repository platform used by the two libraries. The work was informed by surveys of research chemists in the two universities, exploring their use of information technology and assessing their interest in using repositories and Open Access principles for data management. This paper presents the project\u27s outcomes and discusses the implications for the development of library-managed institutional repositories

Muon Spin Rotation Studies of Enediynes

Muon spin rotation spectra of muoniated radicals of the enediyne compounds (E)- and (Z)-RCCCHCHCCR where R = -CH2CH2CH2CH3 are reported and the temperature variation of these spectra from 250 to 400 K investigated. All primary radicals expected were observed and assigned using ab initio DFT calculations. The properties of a six membered secondary radical likely to be formed by the cyclization of the muoniated Z-isomer were estimated using an ab initio DFT calculation

Hospital practitioner views on the benefits of continence education and best ways to provide training

Aim: To explore practitioners’ experiences and perspectives on continence training, in order to understand its relevance to practice and how take-up of, and engagement with, such training may be improved. Methods: We analysed data thematically, both manually and with the aid of NVivo software. The research adheres to the consolidated criteria for reporting qualitative research checklist.Results: Practitioners asserted the likely benefits of evidence-based continence training, including more judicious use of products, reduction in associated infection, better patient skin care and more facilitative communication with patients. Practitioners also identified preferred methods of continence training, according to their role and workload. To ensure better take-up of, and engagement with, continence training, it must be authorised as essential and provided in ways that reflect professional preferences and pragmatic resource considerations

‘We tend to get pad happy’: a qualitative study of health practitioners’ perspectives on the quality of continence care for older people in hospital

Background Bladder and bowel control difficulties affect 20% and 10% of the UK population, respectively, touch all age groups and are particularly prevalent in the older (65+ years) population. However, the quality of continence care is often poor, compromising patient health and well-being, increasing the risk of infection, and is a predisposing factor to nursing and residential home placement.Objective To identify factors that help or hinder good continence care for patients aged 65 years and over in hospital medical ward settings. Medical care, not surgical, was our exclusive focus.Methods We conducted 27 qualitative interviews with nursing, medical and allied health practitioners in three hospitals. We used a purposive sample and analysed data thematically, both manually and with the aid of NVivo software.Results Interviews revealed perspectives on practice promoting or inhibiting good quality continence care, as well as suggestions for improvements. Good continence care was said to be advanced through person-centred care, robust assessment and monitoring, and a proactive approach to encouraging patient independence. Barriers to quality care centred on lack of oversight, automatic use of incontinence products and staffing pressures. Suggested improvements centred on participatory care, open communication and care planning with a higher bladder and bowel health profile. In order to drive such improvements, hospital-based practitioners indicate a need and desire for regular continence care training.Conclusions Findings help explain the persistence of barriers to providing good quality care for patients aged 65 years and over with incontinence. Resolute continence promotion, in hospitals and throughout the National Health Service, would reduce reliance on products and the accompanying risks of patient dependency and catheter-associated gram-negative bacteraemia. Robust assessment and care planning, open communication and regular continence care training would assist such promotion and also help mitigate resource limitations by developing safer, time-efficient continence care