Podiatry
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Item Encouraging GPs to complete postal questionnaires-one big prize or many small prizes? A randomized controlled trial(2004-12) Thomson, Colin E.; Paterson-Brown, S.; Russell, D.; McCaldin, D.; Russell, I.Background. Low response rates to surveys are a problem in general practice. There is evidence that offering GPs incentives improves response rates to postal questionnaires. However, there is less evidence about the most effective form of incentive. Objective. Our trial aimed to maximize response to a postal questionnaire and to test the most effective form of incentive. Methods. The study involved a randomized controlled trial of a postal survey Results. The incentive of a lottery for six bottles of champagne generated a response rate of 79%. Furthermore, one chance of six bottles generated 9% more responses than six chances of one bottle. Conclusions. This study has established that, among incentives for postal questionnaires, one big prize improves the yield more than many small prizes despite the lower odds of winning. It has also confirmed that offering a modest incentive to GPs generates good response rates for postal questionnairesItem Honey dressing versus paraffin tulle gras following toenail surgery(2006) McIntosh, C.; Thomson, Colin E.Objective: Anecdotal reports suggest that certain honey dressings have a positive effect on wound healing. However, there is limited empirical evidence supporting its use. This double-blind randomised controlled trial investigated the effect of a honey dressing on wound healing following toenail surgery with matrix phenolisation. Method: Participants (n=100) were randomly assigned to receive either an active manuka honey dressing (n=52) or paraffin-impregnated tulle gras (n=48). The primary outcome was time (days) taken for complete re-epithelialisation of the nail bed. Results: Mean healing times were 40.30 days (SD 18.21) for the honey group and 39.98 days (SD 25.42) for the paraffin tulle gras group. Partial avulsion wounds healed statistically significantly faster (p=0.01) with paraffin tulle gras (19.62 days, SD 9.31) than with the honey dressing (31.76 days, SD 18.8), but no significant difference (p=0.21) was found following total avulsion when comparing honey (45.28 days, SD 18.03.) with paraffin tulle gras dressings (52.03 days, SD 21.3). Conclusion: The results suggest that patients may benefit more from paraffin tulle gras dressings than honey dressings following partial toenail avulsion. No statistically significant difference was found for healing times after total toenail avulsion, although the marginal benefit of the honey dressing on these healing times warrants further investigationItem A modular device to measure the effects of plantar foot pressure on the microcirculation of the heel(Elsevier Science Ltd, 2003-03) Santos, Derek; Carline, Tom; Richmond, R.; Abboud, R.Background: Past research has concentrated on foot function and plantar foot pressure, with many devices developed for this purpose. However, little is known of how cutaneous blood flow compensates for ambulatory repetitive circulatory insults and how ulceration occurs. Objectives: To develop a system to measure the effects of plantar foot pressure on cutaneous blood flow in the supine and semi-weight bearing positions. Method: A system was developed that integrated a laser Doppler fluxmeter with a pressure probe, allowing plantar foot pressure and skin blood flow to be recorded simultaneously. The system was tested using four volunteers (288.6 years). Results: A significant difference existed between baseline laser Doppler flowmetry (LDF) in the supine and semi-weight bearing positions (P=0.023). Differences between both positions also existed in the reduction in LDF levels following application of pressure (P=0.015), the maximum hyperaemic response (P=0.034) and time taken to reach maximum hyperaemic response (P=0.019). Conclusion: The device has shown that with current technology it is now possible not only to investigate plantar foot pressure but also how it affects skin blood flow, which in some cases can lead to ulceration. The effect of plantar foot pressure on cutaneous blood flow differs depending on whether the subject is supine or semi-weight bearing. Thus, to understand the effects of plantar foot pressure on skin blood flow future researchers must ensure that subjects are in an upright position when recording.Item A study to ascertain the potential inhalation hazard of toenail dust(The Society of Chiropodists and Podiatrists, 2003-02) Donaldson, C. L.; Carline, Tom; Brown, D. M.; Gilmour, P. S.; ELEGI Colt Laboratories; Donaldson, K.The use of the podiatric nail drill has become an acceptable way of reducing onychogryphotic nails in the clinical setting. The present study has demonstrated the presence of particles that are potentially dangerous to the human lung when they are contaminated with bacterial endotoxin (bacterial cell wall components that may cause an inflammatory response). Toenail dust collected from podiatric nail drills was examined for size, endotoxin content and the ability to stimulate release of IL-8 (IL- interleukins stimulate the release of other mediators in septic shock and inflammation) from macrophages and lung epithelial cells in vitro. The size distribution revealed a large number of particles that would deposit in the nose, airways and lung alveoli. Endotoxin was detected in extracts of nail particles and, interestingly, a component of these particles was able to stimulate substantial release of IL-8 from lung epithelial cells. Suspensions of toenail particles stimulated IL-8 release from monocyte-derived macrophages. Destruction of the endotoxin with the antibiotic polymyxin B still resulted in IL-8 release, suggesting that the particles themselves initiated the response and not necessarily the endotoxin. The authors conclude that podiatrists who routinely carry out nail reduction could be inhaling particles that could deposit throughout the respiratory tract, where they could contribute to inflammation by stimulating release of IL-8 from cells via the particles themselves and via endotoxin.Item Identification of staff training and development needs.(Queen Margaret University, 2007) Dunlop, G.; Peacock, Susi; Scottish Funding Council's e-Learning Transformation ProgrammeThis interim report will present the findings to date of current practice in using and maintaining an electronic portfolio (ePortfolio) for personal development planning across the tertiary education sector that have implications for staff development. A review of the current literature and a series of staff interviews have consistently identified a number of key issues relating to current and future ePortfolio practice which require serious consideration by institutions within higher and further education within a staff development programme. The terminology used to refer to an ePortfolio is also discussed in an attempt to differentiate between an ePortfolio as a process and an ePortfolio as a software program. Recommendations are made for staff development in current learning and teaching practice that include the use of reflection and story telling-. Additional areas for consider are: assessment; blogging;legal issues and an institution' rationale for use on an eportfolio.Item Worldwide opportunity in the online learning environment-reflections on the expansion and development of the degree conversion programmefor diplomatehealth professionals at QMU(2009-11-27) Weir, Evelyn C.The subject area of podiatry began offering a conversion degree for diplomate podiatrists in 1994. This was an attendance programme, and had around 12-20 students each year, with numbers dwindling to 4-6 students in the late 1990s.Item Arthrodesis or total replacement arthroplasty for hallux rigidus: a randomized controlled trial(American Orthopaedic Foot and Ankle Society, Inc., 2005) Gibson, J. N. A.; Thomson, Colin E.Item Economic evaluation of ingrown toenail surgery in Scotland(Springer, 2006) Graham, B.; Dench, H.; Thomson, Colin E.; Russell, I. T.Item Interventions for treating Morton's neuroma: a systematic review(2004) Thomson, Colin E.; Martin, D. J.; Gibson, J. N. A.Background Morton's neuroma is a common, paroxysmal neuralgia affecting the web spaces of the toes, typically the third. The pain is often so debilitating that patients become anxious about walking or even putting their foot to the ground. Insoles, corticosteroid injections, excision of the nerve, transposition of the nerve and neurolysis of the nerve are commonly used treatments. Their effectiveness is poorly understood. Objectives To examine the evidence from randomised controlled trials concerning the effectiveness of interventions in adults with Morton's neuroma. Search strategy We searched the Cochrane Neuromuscular Disease Group trials register (searched January 2003), MEDLINE (January 1966 to January Week 2 2003), EMBASE (January 1980 to February Week 2 2003), and CINAHL (January 1982 to February Week 1 2003). Selection criteria Randomised or quasi-randomised (methods of allocating participants to an intervention which were not strictly random e.g. date of birth, hospital record, number alternation) controlled trials of interventions for Morton's neuroma were selected. Studies where participants were not randomised into intervention groups were excluded. Data collection and analysis Two reviewers selected trials for inclusion in the review, assessed their methodological quality and extracted data independently. Main results Three trials involving 121 people were included. There is, at most, a very limited indication that transposition of the transected plantar digital nerve may yield better results than standard resection of the nerve in the long term. There is no evidence to support the use of supinatory insoles. There are, at best, very limited indications to suggest that dorsal incisions for resection of the plantar digital nerve may result in less symptomatic post-operative scars when compared to plantar excision of the nerve. Authors' conclusions There is insufficient evidence with which to assess the effectiveness of surgical and non-surgical interventions for Morton's neuroma. Well designed trials are needed to begin to establish an evidence base for the treatment of Morton's neuroma pain.Item Evaluating World Wide Web-based foot care information(2006) Ellis, Mairghread JH; Ellis, B. M.