A clinical algorithm for wound biofilm identication

Broj publiciranih referenci koje ukazuju na prisutnost biofi lma u kroničnim ranama je u porastu. Sve je veći broj dokaza koji potvrđuju da biofilm značajno sudjeluje u nezacijeljivanju rane i u bakterijskim infekcijama. Iz navedenih razloga postavlja se pitanje nedostatka postupnika o dokazima prisutnosti biofilma u rani. Namjera je ovog rada specifi cirati vidljive dokaze i indirektno dati kliničke smjernice tretmana biofilma u rani, te predložiti određeni postupnik za olakšanje kliničkog prepoznavanja biofi lma da bi se potom promijenilo ciljano liječenje vrijeda.Recognition of the existence of biofilm in chronic wounds is increasing among wound care practitioners, and a growing body of evidence indicates that biofilm contributes significantly to wound recalcitrance. While clinical guidelines regarding the involvement of biofilm in human bacterial infections have been proposed, there remains uncertainty and lack of guidance towards biofilm presence in wounds. The intention of this report is to collate knowledge and evidence of the visual and indirect clinical indicators of wound biofilm, and propose an algorithm designed to facilitate clinical recognition of biofilm and subsequent wound management practices

Islamophobia in the National Health Service: an ethnography of institutional racism in PREVENT's counter‐radicalisation policy

In 2015, the UK government made its counter‐radicalisation policy a statutory duty for all National Health Service (NHS) staff. Staff are now tasked to identify and report individuals they suspect may be vulnerable to radicalisation. Prevent training employs a combination of psychological and ideological frames to convey the meaning of radicalisation to healthcare staff, but studies have shown that the threat of terrorism is racialised as well. The guiding question of our ethnography is: how is counter‐radicalisation training understood and practiced by healthcare professionals? A frame analysis draws upon 2 years of ethnographic fieldwork, which includes participant observation in Prevent training and NHS staff interviews. This article demonstrates how Prevent engages in performative colour‐blindness – the active recognition and dismissal of the race frame which associates racialised Muslims with the threat of terrorism. It concludes with a discussion of institutional racism in the NHS – how racialised policies like Prevent impact the minutia of clinical interactions; how the pretence of a ‘post‐racial’ society obscures institutional racism; how psychologisation is integral to the performance of colour‐blindness; and why it is difficult to address the racism associated with colourblind policies which purport to address the threat of the Far‐Right

Access to palliative care for patients with advanced cancer: A longitudinal population analysis

Background The UK National Health Service is striving to improve access to palliative care for patients with advanced cancer however limited information exists on the level of palliative care support currently provided in the UK. We aimed to establish the duration and intensity of palliative care received by patients with advanced cancer and identify which cancer patients are missing out. Methods Retrospective cancer registry, primary care and secondary care data were obtained and linked for 2474 patients who died of cancer between 2010 and 2012 within a large metropolitan UK city. Associations between the type, duration, and amount of palliative care by demographic characteristics, cancer type, and therapies received were assessed using Chi-squared, Mann-Whitney or Kruskal-Wallis tests. Multinomial multivariate logistic regression was used to assess the odds of receiving community and/or hospital palliative care compared to no palliative care by demographic characteristics, cancer type, and therapies received. Results Overall 64.6% of patients received palliative care. The average palliative care input was two contacts over six weeks. Community palliative care was associated with more palliative care events (p<0.001) for a longer duration (p<0.001). Patients were less likely to receive palliative care if they were: male (p = 0.002), aged 80 years or over (p<0.05), diagnosed with lung cancer (p<0.05), had not received an opioid prescription (p<0.001), or had not received chemotherapy (p<0.001). Patients given radiotherapy were more likely to receive community only palliative care compared to no palliative care (Odds Ratio = 1.49, 95% Confidence Interval = 1.16–1.90). Conclusion Timely supportive care for cancer patients is advocated but these results suggest that older patients and those who do not receive anti-cancer treatment or opioid analgesics miss out. These patients should be targeted for assessment to identify unmet needs which could benefit from palliative care input