Development of a Health-Related Quality of Life Questionnaire (HRQL) for patients with Extremity Soft Tissue Infections (ESTI)

BACKGROUND: Past clinical trials of antimicrobial treatment in soft tissue infections have focused on non-standardized clinical and physiological outcome variables, and have not considered the subjective experience of patients. The objective of this study was to develop a health-related quality of life questionnaire (HRQL) for patients with extremity soft tissue infections (ESTI) for future use in clinical trials. METHODS: The design of this study followed published guidelines and included item generation, item reduction, and questionnaire preparation. Study subjects were consenting English-speaking adults with acute ESTI requiring prescription of at least two days of outpatient intravenous antibiotic therapy. RESULTS: A list of 49 items that adversely impact the quality of life of patients with ESTI was generated by literature review, informal health professional feedback, and semi-structured interviews with twenty patients. A listing of these items was then administered to 95 patients to determine their relative importance on quality of life. A questionnaire was prepared that included the twenty most important items with a 5-point Likert scale response. Questionnaire domains included physical symptoms, problems performing their activities of daily living, impairment of their emotional functioning, and difficulties in their social interactions as related to their ESTI. The final questionnaire was pre-tested on a further ten patients and was named the ESTI-Score. CONCLUSION: The ESTI-Score is a novel instrument designed to quantify the impact of ESTI on quality of life. Future study is required to determine its validity and responsiveness before use as an outcome measure in clinical trials

Tourist Photographers and the Promotion of Travel: the Polytechnic Touring Association, 1888–1939

The Polytechnic Touring Association (PTA) was a London-based, originally philanthropic turned commercial travel firm whose historical origins coincided with the arrival of the Kodak camera in 1888 – thus, of popular (tourist) photography. This article examines the PTA’s changing relationship with tourist photographers, and how this influenced the company’s understanding of what role photography could play in promoting the tours, in the late nineteenth and early twenty century. This inquiry is advanced on the basis of the observation that, during this time, the PTA’s passage from viewing tourists as citizens to educate, to customers to please, paralleled the move from using photography-based images to mixed media. Such a development was certainly a response to unprecedented market demands; this article argues that it should also be considered in relation to the widening of photographic perceptions engendered by the democratization of the medium, to which the PTA responded, first as educator, then as service provider. In doing so, the article raises several questions about the shifting relationship between “high”, or established, and “low”, or emerging, forms of culture, as mass photography and the mass marketing of tourism developed