Wounds : an overlooked burden (Part 2) – Wound treatment : a daunting decision

Various types of wounds are encountered daily in medical practice, and due to the numerous treatment options available on the market, making the most appropriate choice of treatment may be a rather daunting decision. The wound treatment should not inconvenience the patient to the point that the wound care becomes compromised. It is for this reason that a proper assessment of the wound status be conducted in order to select an appropriate treatment intervention or dressing type, as this will directly impact the way in which the wound heals. This article is based on the expertise of three active wound care practitioners and aims to provide guidance to clinicians when providing primary wound care. The downloadable tables can be printed and used as reference materials in daily practice.https://journals.co.za/journal/mp.sagphttps://journals.co.za/journal/mp.sagpam2022Pharmacolog

Wounds : an overlooked burden (Part 3) - Chronic wounds : a conundrum of complications

Wound healing is a complex process which may be hindered by a range of interfering factors, especially in patients with underlying pathologies. This results in the formation of chronic, non-healing wounds which subject the patient to significant discomfort while placing strain on the resources of any medical system. Primary healthcare practitioners are often the first to encounter chronic wounds of various aetiologies. This article provides guidelines on the assessment, wound bed preparation and treatment of various types of chronic wounds, which have been summarised into downloadable reference tables for use in everyday practice.National Research Foundation – Blue Skies Granthttp://www.sagpj.co.za/index.php/SAGPJPharmacolog

Increases in the longevity of desiccation-phase developing rice seeds: response to high temperature drying depends on harvest moisture content

• Background and Aims Earlier studies have suggested that the drying conditions routinely used by genebanks may not be optimal for subsequent seed longevity. The aim of this study was to compare the effect of hot-air drying with low temperature drying on subsequent seed longevity for 20 diverse rice accessions and to consider how factors related to seed production history might influence the results. • Methods Seeds were produced according to normal regeneration procedures at IRRI. They were harvested at different times (harvest date and days after anthesis (DAA), once for each accession) and dried either in a drying room (DR; 15% RH, 15°C), or in a flat-bed heated-air batch dryer (BD; 45°C, 8 h d-1) for up to 6 daily cycles followed by drying in the DR. Relative longevity was assessed by storage at 10.9% moisture content (m.c.) and 45°C. • Key Results Initial drying in the BD resulted in significantly greater longevity compared with the DR for 14 accessions (seed lots): the period of time for viability to fall to 50% for seeds dried in the BD as a percentage of that for seeds dried throughout in the DR varied between 1.3 and 372.2% for these 14 accessions. The seed lots that responded the most were harvested earlier in the season and at higher moisture content. Drying in the BD did not reduce subsequent longevity compared with DR drying for any of the remaining accessions. • Conclusions Seeds harvested at a m.c. where, according to the moisture desorption isotherm, they could still be metabolically active (>16.2%), may be in the first stage of the post-mass maturity, desiccation phase of seed development and able to increase longevity in response to hot-air drying. The genebank standards regarding seed drying for rice and, perhaps, for other tropical species should be reconsidered

Seed development and maturation in early spring-flowering Galanthus nivalis and Narcissus pseudonarcissus continues post-shedding with little evidence of maturation in planta

Background and Aims: Seeds of the moist temperate woodland species Galanthus nivalis and Narcissus pseudonarcissus, dispersed during spring or early summer, germinated poorly in laboratory tests. Seed development and maturation were studied to better understand the progression from developmental to germinable mode in order to improve seed collection and germination practices in these and similar species. Methods: Phenology, seed mass, moisture content, and ability to germinate and tolerate desiccation were monitored during seed development until shedding. Embryo elongation within seeds was investigated during seed development and at several temperature regimes after shedding. Key Results: Seeds were shed at high moisture content (> 59%) with little evidence that dry mass accumulation or embryo elongation were complete. Ability to germinate developed prior to the ability of some seeds to tolerate enforced desiccation. Germination was sporadic and slow. Embryo elongation occurred post-shedding in moist environments, most rapidly at 20C in G. nivalis and 15C in N. pseudonarcissus. The greatest germination also occurred in these regimes, 78 and 48%, respectively, after 700 d. Conclusions: Seeds of G. nivalis and N. pseudonarcissus seeds were comparatively immature at shedding and substantial embryo elongation occurred post-shedding. Seeds showed limited desiccation tolerance at dispersal

A qualitative study of patients' views on quality of primary care consultations in Hong Kong and comparison with the UK CARE Measure

<b>Background</b> Patients' priorities and views on quality care are well-documented in Western countries but there is a dearth of research in this area in the East. The aim of the present study was to explore Chinese patients' views on quality of primary care consultations in Hong Kong and to compare these with the items in the CARE measure (a process measure of consultation quality widely used in the UK) in order to assess the potential utility of the CARE measure in a Chinese population.<p></p> <b>Methods</b> Individual semi-structured interviews were conducted on 21 adult patients from 3 different primary care clinics (a public primary healthcare clinic, a University health centre, and a private family physician's clinic). Topics discussed included expectations, experiences, and views about quality of medical consultations. Interviews were typed verbatim, and a thematic approach was taken to identify key issues. These identified issues were then compared with the ten CARE measure items, using a CARE framework: Connecting (Care Measure items 1–3), Assessing (item 4), Responding (items 5,6), and Empowering (items 7–10).<p></p> <b>Results</b> Patients judged doctors in terms of both the process of the consultation and the perceived outcomes. Themes identified that related to the interpersonal process of the consultation fitted well under the CARE framework; Connecting and communicating (18/21 patients), Assessing holistically (10/21 patients), Responding (18/21 patients) and Empowering (19/21 patients). Patients from the public clinic, who were generally of lower socio-economic status, were least likely to expect holistic care or empowerment. Two-thirds of patients also judged doctors on whether they performed an adequate physical examination, and three-quarters on the later outcomes of consultation (in terms of relief or cure and/or side-effects of prescribed drugs).<p></p> <b>Conclusion</b> These findings suggest that Chinese patients in Hong Kong value engaged, empathic primary care doctors and judge the quality of consultations largely on these human skills and the attitudes and values that underpin them, as well as on the perceived outcomes of treatment. The match between themes relating to consultation process and the CARE Measure items suggests utility of this measure in this population, but further quantitative validation is required

Medium-term seed storage of 50 genera of forage legumes and evidence-based genebank monitoring intervals

Genebanks maintaining seeds for long-term genetic resources conservation monitor seed lots to detect early loss in viability. Monitoring is costly and depletes valuable seed. Three decades of genebank seed germination test results of diverse forage species from 50 legume genera in the International Livestock Research Institute’s medium-term store (circa 8° C with 5 % moisture content) were analysed to determine whether advice on seed monitoring intervals could be derived. Cumulative normal distributions were fitted by probit analysis for each seed lot and compared within each genus. Six patterns of within-genus variation were identified: no detectable trend in germination test results during storage (4 genera); detectable trends, but variable (positive to negative) amongst lots (5); consistent slope of loss in viability amongst lots (17); consistent slope of increase in ability to germinate amongst lots (21); common loss in viability amongst lots (2); common increase in ability to germinate amongst lots (1). Seed lot monitoring intervals for the medium-term store were derived for each of 19 genera with consistent loss in viability across seed lots: three genera provided comparatively rapid deterioration, five met the general expectations for a medium-term store (2-10 years’ maintenance of high viability), whilst 11 provided much better survival. Moreover, 26 further genera provided no evidence as yet of seed deterioration; of these, 22 improved in ability to germinate during storage indicating confounding of hardseededness with viability in germination tests

Randomised controlled trial of school-based humanistic counselling for emotional distress in young people: Feasibility study and preliminary indications of efficacy

The purpose of this study was to test the feasibility of a randomised controlled trial comparing six weeks of humanistic school-based counselling versus waiting list in the reduction of emotional distress in young people, and to obtain initial indications of efficacy. Following a screening procedure, young people (13 - 15 years old) who experienced emotional distress were randomised to either humanistic counselling or waiting list in this multi-site study. Outcomes were assessed using a range of self-report mental health measures, with the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) acting as the primary outcome indicator. Recruitment procedures were successful, with 32 young people consenting to participate in the trial and 27 completing endpoint measures. Trial procedures were acceptable to all involved in the research. No significant differences were found between the counselling and waiting list groups in reductions in levels of emotional symptoms (Hedges' g = 0.03), but clients allocated to counselling showed significantly greater improvement in prosocial behaviour (g = 0.89) with an average effect size (g) across the nine outcome measures of 0.25. Participants with higher levels of depressive symptoms showed significantly greater change. This study suggested that a randomised controlled trial of counselling in schools is acceptable and feasible, although initial indications of efficacy are mixed