Podiatry
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Item Assessment of pain in an elderly population: Practical difficulties.(Mark Allen Publishing LTD, 1998) Weir, Evelyn C.; Burrow, J. G.; Bell, F.Few studies focus on pain assessment in an elderly population. This article considers the applicability of several methods of pain assessment for an elderly subject group. Methods are discussed in terms of practical usage, preference, failure rates and sample studies. Assessment techniques for pain assessment in the older adult with pain are discussed. Problems particular to an elderly population are outlined. Complexities of pain assessment in the older adult are detailed with recommendations.Item A survey of babywalkers in GP's, health visitors and orthopaedic surgeons(The Society of Chiropodists and Podiatrists, 1999) Cashley, D.; Carline, TomItem 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 Accidental intra-arterial injection -a cause of lower limb ischaemia in intravenous drug users(The Society of Chiropodists and Podiatrists, 1998) Weir, Evelyn C.; Carline, TomItem Violence in health care: the reality of occupational risk(Mark Allen Publishing LTD, 1999-02-01) Weir, Evelyn C.Violence in the workplace is an increasing occupational risk for health-care workers and can range from verbal abuse to serious physical assault. Health-care professionals are at risk from patients, patients' relatives and professional colleagues. This article provides an overview of the type and mode of violence evident in the health-care setting.Item 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 Clinical audit of a patient teaching programme in the care of wounds following toenail removal(Elsevier Science Ltd, 1998) Dunlop, G.A programme of patient teaching has been used in wound care after nail removal to reduce the number of healing weeks and to reduce the number of clinical visits for the patient. A stratified sample of podiatry patients who had undergone nail removal in a podiatry teaching centre was monitored regarding: the number of weeks attended; the interval of weeks between appointments; and the infection rate. The simplest and cheapest dressing was used to dress the wound between clinical visits. The mean number of healing weeks was 5.2 (standard deviation of 3.8) and the mean number of clinical visits was 3.2 (standard deviation of 1.5). As all the patients attending the unit were taught how to care for the wound between visits, the outcome would suggest that the care conducted by the patients themselves has been an influencing factor on the final result of the study.Item Gli effetti dalla droga sugli arti inferiori(1998) Weir, Evelyn C.; Carline, Tom