Clinical outcomes and response to treatment of patients receiving topical treatments for pyoderma gangrenosum: a prospective cohort study

Background: pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment. Objective: to estimate the effectiveness of topical therapies in the treatment of PG. Methods: prospective cohort study of UK secondary care patients with a clinical diagnosis of PG suitable for topical treatment (recruited July 2009 to June 2012). Participants received topical therapy following normal clinical practice (mainly Class I-III topical corticosteroids, tacrolimus 0.03% or 0.1%). Primary outcome: speed of healing at 6 weeks. Secondary outcomes: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality-of-life; treatment failure and recurrence. Results: Sixty-six patients (22 to 85 years) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28/66 (43.8%) of ulcers healed by 6 months. Median time-to-healing was 145 days (95% CI: 96 days, ∞). Initial ulcer size was a significant predictor of time-to-healing (hazard ratio 0.94 (0.88;80 1.00); p = 0.043). Four patients (15%) had a recurrence. Limitations: No randomised comparator Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Partnership working in local electronic government

This research explores how English local authorities and their partners work together on electronic government. E-government is the use of computer technologies by government to transform the provision of services and information, improve internal organisation, encourage citizen participation and promote sharing between partners. In the UK and elsewhere there is increasing emphasis on public sector organisations working together in local partnerships. Partnerships can potentially encourage the delivery of joined-up services to citizens, promote democracy and improve public policy making, but partnership working is not always easy and can be challenging for the individuals and organisations involved. This thesis addresses the research question: "How can local authorities and their partners work together to successfully implement electronic government? " The research is based on a systematic literature review and comparative case studies of three sub-regional e-government partnerships, using a mixed methods approach. The literature review covers local governance, e-government, public sector partnerships, dissemination of best practice and social networks. In each case study social network data was collected from participants using a short questionnaire to ascertain who they dealt with in relation to e-government. This data was analysed using social network software and then used during qualitative interviews and workshops to generate discussion. A model of partnership effectiveness has been developed which identifies network structure, governance, maturity and context as four themes contributing to the success of local e-government partnerships. Network structure influences effectiveness in three ways: cohesion amongst the partners encourages organisational learning; a central core agency is important to ensure that partnership ideas reach fruition; opinion leaders come up with good ideas and can mobilise others. Governance includes the existence of a clear shared vision and strategy, the commitment of leaders, accountability and getting the right people involved. Maturity refers to a stable group of people from different perspectives working together over time, facing challenges and persevering. Councils with smaller populations have more to gain from partnership working because they lack the capacity to develop e-government solutions alone. The study contributes to academic research by developing a theoretical model of the factors contributing to effective e-government partnerships. This is the first study to examine how public organisations network together on e-government and the methodological approach is novel in research into UK local governance