The nose in children with unilateral cleft lip and palate

Surgeons and orthodontists are still challenged to achieve \xe2\x80\x98better\xe2\x80\x99 noses for children with a unilateral cleft or lip, alveolus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced facial clefts, untreated patients with congenital clefts, the radical primary correction of the UCLP nose, the unsolved problems in secondary rhinoplasty and suggestions for scientific communication

Health Care Professionals’ perspectives on self-management for people with Parkinson’s: qualitative findings from a UK study

Background: Parkinson’s disease is a long-term, complex health condition. To improve or maintain quality of life, people with Parkinson’s can have an active involvement in their care through self-management techniques. Given the complexity and individualization of self-management, people with Parkinson’s will need support and encouragement from their healthcare professionals (HCPs). Despite the key role HCPs have in this, research has seldom explored their perspectives and understanding of self-management for people with Parkinson’s. Methods: Multi-disciplinary teams providing care for people with Parkinson’s across London, Coventry and Hertfordshire were approached and took part in either one of four focus groups or individual interviews. Forty-two HCPs, including a range of specialist doctors, general practitioners, allied health professionals, nurses, and social workers, took part in this study. Interviews were transcribed and analysed using thematic analysis to identify themes. Results: Four themes were developed from the data: 1) Empowerment of patients through holistic care and being person-centred; 2) Maximising motivation and capability for patients, for example using asset based approaches and increasing opportunities; 3) importance of empowerment of carers to support selfmanagement and 4) contextual barriers to self-management such as the social context. Conclusions: This study is the first to explore the perspectives of HCPs on self-management in people with Parkinson’s. Our findings have identified important considerations surrounding empowerment, motivation, carers and contextual barriers to better understand how we enable effective selfmanagement techniques in people with Parkinson’s. Research should build on these findings on to develop acceptable and effective self-management tools for use in practice with people affected by Parkinson’s

Inflammation and Progressive Nephropathy in Type 1 Diabetes in the Diabetes Control and Complications Trial

OBJECTIVE—Progressive nephropathy represents a substantial source of morbidity and mortality in type 1 diabetes. Increasing albuminuria is a strong predictor of progressive renal dysfunction and heightened cardiovascular risk. Early albuminuria probably reflects vascular endothelial dysfunction, which may be mediated in part by chronic inflammation

Physical activity as a treatment for depression: the TREAD randomised trial protocol

Depression is one of the most common reasons for consulting a General Practitioner (GP) within the UK. Whilst antidepressants have been shown to be clinically effective, many patients and healthcare professionals would like to access other forms of treatment as an alternative or adjunct to drug therapy for depression. A recent systematic review presented some evidence that physical activity could offer one such option, although further investigation is needed to test its effectiveness within the context of the National Health Service.The aim of this paper is to describe the protocol for a randomised, controlled trial (RCT) designed to evaluate an intervention developed to increase physical activity as a treatment for depression within primary care

ROBINS-I: a tool for assessing risk of bias in non-randomized studies of interventions

Non-randomised studies of the effects of interventions are critical to many areas of healthcare evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I ("Risk Of Bias In Non-randomised Studies-of Interventions"), a new tool for evaluating risk of bias in estimates of the comparative effectiveness (harm or benefit) of interventions from studies that did not use randomisation to allocate units (individuals or clusters of individuals) to comparison groups. The tool will be particularly useful to those undertaking systematic reviews that include non-randomised studies

Investigating tree foliar preference by the earthworms Aporrectodea longa and Allolobophora chlorotica in reclaimed and loam soil

Afforestation can improve the delivery of ecosystem services from reclaimed landfill sites. Tree health is a key determinant of ecosystem service delivery, and is directly impacted by soil quality; which is driven by biological processes in the soil, reliant on leaf litter inputs to function. Different tree species have different litter quality, affecting the degree to which they support biological processes in soils and the development of abundant and diverse soil faunal communities. In recognition of their key role in improving soil structure and fertility - key attributes of soil quality, earthworms have often been the subject of research as a part of land reclamation, and these organisms have displayed preferences for specific types of leaf litter. This work utilised a choice chamber design to measure the foliar material palatability of two tree species used in land restoration (Alnus cordata and Acer platanoides) as a food source for two common European earthworm species (Aporrectodea longa and Allolobophora chlorotica), and the effect of a reclaimed soil quality on earthworm growth, survival and feeding preferences. The research revealed that both earthworm species initially preferred the foliar material of A. cordata over A. platanoides, with the leaves of the latter requiring higher degradation to become palatable to earthworms. The consumption of fresh leaves showed these are a suitable food source for earthworms in choice chamber experiments, which historically have instead relied on senescent leaf litter. Finally, high survival rates of both A. longa and A. chlorotica in the reclaimed soil treatment, in addition to consumption of leaf material of two tree species now widely used on reclaimed landfill sites, demonstrated that these earthworm species are suitable candidates for inoculation to reclaimed land