Topical agents or dressings for pain in venous leg ulcers.

Venous leg ulcers affect up to 1% of people at some time in their lives and are often painful. The main treatments are compression bandages and dressings. Topical treatments to reduce pain during and between dressing changes are sometimes used

Pressure ulcer related pain in community populations: a prevalence survey.

BACKGROUND: Pressure ulcers are costly to the healthcare provider and can have a major impact on patient's quality of life. One of the most distressing symptoms reported is pain. There is very little published data on the prevalence and details of pain experienced by patients with pressure ulcers, particularly in community populations. The study was conducted in two community NHS sites in the North of England. METHODS: The aim was to estimate the prevalence of pressure area related pain within a community population. We also explored the type and severity of the pain and its association with pressure ulcer classification. A cross-sectional survey was performed of community nurses caseloads to identify adult patients with pressure ulcers and associated pain. Consenting patients then had a full pain assessment and verification of pressure ulcer grade. RESULTS: A total of 287 patients were identified with pressure ulcers (0.51 per 1000 adult population). Of the 176 patients who were asked, 133 (75.6%) reported pain. 37 patients consented to a detailed pain assessment. Painful pressure ulcers of all grades and on nearly all body sites were identified. Pain intensity was not related to number or severity of pressure ulcer. Both inflammatory and neuropathic pain were reported at all body sites however the proportion of neuropathic pain was greater in pressure ulcers on lower limbs. CONCLUSIONS: This study has identified the extent and type of pain suffered by community patients with pressure ulcers and indicates the need for systematic and regular pain assessment and treatment

Acute gastroenteritis in Hong Kong: A population-based telephone survey

A population-based telephone survey of acute gastroenteritis (AG) was conducted in Hong Kong from August 2006 to July 2007. Study subjects were recruited through random digit-dialling with recruitments evenly distributed weekly over the 1-year period. In total, 3743 completed questionnaires were obtained. An AG episode is defined as diarrhoea 3 times or any vomiting in a 24-h period during the 4 weeks prior to interview, in the absence of known non-infectious causes. The prevalence of AG reporting was 7%. An overall rate of 091 (95% CI 081-101) episodes per person-year was observed with women having a slightly higher rate (094, 95% CI 079-108) than men (088, 95% CI 073-104). The mean duration of illness was 36 days (s.d.=552). Thirty-nine percent consulted a physician, 19% submitted a stool sample for testing, and 26% were admitted to hospital. Of the subjects aged 15 ≥ years, significantly more of those with AG reported eating raw oysters (OR 24, 95% CI 13-44), buffet meals (OR 18, 95% CI 13-25), and partially cooked beef (OR 18, 95% CI 12-27) in the previous 4 weeks compared to the subjects who did not report AG. AG subjects were also more likely to have had hot pot, salad, partially cooked or raw egg or fish, sushi, sashimi, and snacks bought at roadside in the previous 4 weeks. This first population-based study on the disease burden of AG in Asia showed that the prevalence of AG in Hong Kong is comparable to that experienced in the West. The study also revealed some risky eating practices that are more prevalent in those affected with AG. Copyright © 2009 Cambridge University Press.published_or_final_versio

A Bound on the Superpotential

We prove a general bound on the superpotential in theories with broken supersymmetry and broken R-symmetry, 2|W|< f_a F, where f_a and F are the R-axion and Goldstino decay constants, respectively. The bound holds for weakly coupled as well as strongly coupled theories, thereby providing an exact result in theories with broken supersymmetry. We briefly discuss several possible applications.Comment: 20 page

Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community

published_or_final_versio

Steady-state modulation of voltage-gated K+ channels in rat arterial smooth muscle by cyclic AMP-dependent protein kinase and protein phosphatase 2B

Voltage-gated potassium channels (Kv) are important regulators of membrane potential in vascular smooth muscle cells, which is integral to controlling intracellular Ca2+ concentration and regulating vascular tone. Previous work indicates that Kv channels can be modulated by receptor-driven alterations of cyclic AMP-dependent protein kinase (PKA) activity. Here, we demonstrate that Kv channel activity is maintained by tonic activity of PKA. Whole-cell recording was used to assess the effect of manipulating PKA signalling on Kv and ATP-dependent K+ channels of rat mesenteric artery smooth muscle cells. Application of PKA inhibitors, KT5720 or H89, caused a significant inhibition of Kv currents. Tonic PKA-mediated activation of Kv appears maximal as application of isoprenaline (a β-adrenoceptor agonist) or dibutyryl-cAMP failed to enhance Kv currents. We also show that this modulation of Kv by PKA can be reversed by protein phosphatase 2B/calcineurin (PP2B). PKA-dependent inhibition of Kv by KT5720 can be abrogated by pre-treatment with the PP2B inhibitor cyclosporin A, or inclusion of a PP2B auto-inhibitory peptide in the pipette solution. Finally, we demonstrate that tonic PKA-mediated modulation of Kv requires intact caveolae. Pre-treatment of the cells with methyl-β-cyclodextrin to deplete cellular cholesterol, or adding caveolin-scaffolding domain peptide to the pipette solution to disrupt caveolae-dependent signalling each attenuated PKA-mediated modulation of the Kv current. These findings highlight a novel, caveolae-dependent, tonic modulatory role of PKA on Kv channels providing new insight into mechanisms and the potential for pharmacological manipulation of vascular tone

Multifaceted self-management interventions for older women with urinary incontinence: a systematic review and narrative synthesis.

OBJECTIVE:To synthesise the evidence for the multifaceted self-management interventions for older women with urinary incontinence (UI) and to understand the outcomes associated with these interventions. DESIGN:A systematic review and narrative synthesis to identify randomised controlled trials that investigated the effect of multifaceted self-management interventions for older women with UI. METHODS:MEDLINE, PsycINFO, EMBASE, The Cochrane Library, CINAHL and Applied Social Sciences Index and Abstracts databases were searched (January 1990 to May 2019) using a systematic search strategy, complemented by manually screening the reference lists and citation indexes. Study selection, data extraction and risk of bias assessment were undertaken independently. A narrative synthesis was undertaken in which studies, interventions and outcomes were examined based on the intervention components. The effect size and 95% CI were estimated from each study. RESULTS:A total of 13 147 citations were identified and 16 studies were included. There was no study rated as of high quality. Three types of multifaceted interventions were found: those that had an element of pelvic floor muscle exercises (PFME), those with bladder retraining and some with combination behavioural interventions. Outcome measures varied across studies. A statistically significant improvement in incontinence symptoms was reported in the intervention group compared with the control in 15 studies. CONCLUSION:Multifaceted interventions that included PFME, bladder retraining or combination behavioural techniques appear to be useful in some settings for UI management in older women, but the quality of the evidence was poor and unclear. There was insufficient evidence to determine whether any of the combination of components is superior to others in improving UI symptoms. There is a need for high-quality studies to confirm the effectiveness of these interventions and to identify comparative effectiveness

“Your drinking is my problem”: recording alcohol’s harm to others in Nigeria

The negative consequences of alcohol consumption on the drinker are well documented. Alcohol is the cause of many physical and mental health conditions and is associated with social problems affecting the drinker, the family and the society at-large. Nondrinkers also experience the impact of other people’s drinking though the extent of this experience is not well documented. This paper presents preliminary data from the WHO/Thai Health project on the harm to others from drinking. A sample of 16 health, security and social welfare agencies in Akwa Ibom State of Nigeria was selected and a nominated key informant in each agency was approached for information using a qualitative interview schedule. The information sought from respondents included types of harms to others seen at the agency, the frequency of such cases, how information about the cases are recorded and handled, and whether regular records are kept at the agency on harm to others from alcohol. Findings show that few agencies collected data on harm to others from drinking but several reported seeing people affected by the drinking of others, with most cases reported by social welfare agencies. Almost all the agencies contacted expressed interest in collecting relevant data and being involved more in addressing the problem. The reported low levels of awareness and action on harm to others from drinking have potentially serious implications in a society with a rapidly growing rate of alcohol consumption.Key words: Alcohol, harm to others, Nigeria, drinking problem

Modelling the electrical resistivity of concrete with varied water and chloride contents

The electrical resistivity of concrete is an important property in the assessment of reinforcement corrosion in concrete and an essential parameter in the design and operation of cathodic protection for reinforced-concrete (RC) structures. Water and chloride contents in concrete are highly variable in RC structures in real-world hostile environments, meaning that characterisation of their coupled effects on concrete electrical resistivity is important. The currently available models are investigated in this paper. As all the current models are purely empirical, an improvement with a semi-empirical model is proposed. The improvement highlights the intrinsic linkage between concrete electrical resistivity and water content and the pore size distribution of concrete. The proposed model was tested using two sets of experimental data and was also compared with other two empirical models