Intersectionality, vulnerability and foot health inequity.

Foot health and wellbeing in the UK are often overlooked in healthcare. Foot health outcomes are strongly interlinked to the social determinants of health, in that the way these determinants intersect can impact an individual's vulnerability to foot pain and disorders. In this commentary we explore some social determinants that hinder individuals from improving their foot health behaviour and ultimately reducing foot pain and foot disorder vulnerability.

The Validity and Reliability of the SINBAD Classification System for Diabetic Foot Ulcers.

Diabetic foot ulcers (DFUs) are a serious and costly complication of diabetes mellitus with a global prevalence of 6.3% and cost of £8,800 per unhealed DFU in the National Health Service. The three main types of DFU are neuropathic, ischemic, and neuroischemic, with an estimated prevalence of 35%, 15%, and 50%, respectively.

Exploring 10 years of dissemination of the F-words for Child Development: A multifaceted case study.

Background: There is growing interest in exploring how to move research findings into practice. Since 2014, a team of families and researchers has been working to promote and study the dissemination of the "F-words for Child Development" (Function, Family, Fitness, Fun, Friends, and Future). This case study describes our dissemination strategies and uses the Diffusion of Innovation theory to understand the factors contributing to the uptake of the F-words-a function-promoting, strengths-based, and family-centred innovation in child health and development.

A Web-Based Knowledge Translation Resource for Families and Service Providers (The "F-Words" in Childhood Disability Knowledge Hub): Developmental and Pilot Evaluation Study.

Background: The "F-words in Childhood Disability" (Function, Family, Fitness, Fun, Friends, and Future) are an adaptation and an attempt to operationalize the World Health Organization's (2001) International Classification of Functioning, Disability and Health (ICF) framework. Since the paper was published (November 2011), the "F-words" have attracted global attention (>12,000 downloads, January 2018). Internationally, people have adopted the "F-words" ideas, and many families and service providers have expressed a need for more information, tools, and resources on the "F-words".

A decade of experience of thyroglossal cyst excision.

Introduction: We report our ten-year experience of thyroglossal cyst excision at Queen's Medical Centre, Nottingham, comparing outcomes, practice and technique.

Methods: Retrospective case note analysis was conducted alongside surgical histopathology review for all thyroglossal cyst excisions performed between 2000 and 2010. This yielded 108 patients with histopathology results confirming a thyroglossal cyst.

Outcome of laparoscopic duodenal switch for morbid obesity.

Background: The aim of this study was to determine the safety and efficacy of laparoscopic duodenal switch (LDS) as a treatment option in a selected group of patients with morbid obesity.

Methods: This retrospective analysis of a prospective database assessed the frequency of all complications and alterations in weight, body mass index (BMI), co-morbidity and quality of life.

Results: One hundred and twenty-one patients underwent LDS between April 2003 and March 2009.

Measuring the quality of urinary continence care in long-term care facilities: an analysis of outcome indicators.

Background: the National Centre for Health Outcomes Development has produced outcome indicators for the assessment of quality of care in the management of urinary incontinence. Three measures relate to the management of older people in long-term care: the prevalence of incontinence, the use of indwelling catheters and clinical assessment rates.

Objective: to evaluate the recommended outcome measures in clinical practice.

Laxatives and faecal incontinence in long-term care.

High levels of faecal incontinence and laxative use in long-term care settings for older people are revealed in this study. Further research, together with more considered prescribing policies are needed, the authors suggest.

Sequential audits of geriatric care: measuring change in structure and process and the contribution of clinical audit.

Background: Sequential audits of care in geriatric practice can demonstrate improvement in its content and quality, and identify its strengths and weaknesses. However, there are problems in such sequential audit, particularly if it depends on data entry by lay staff rather than trained researchers. These include: changes in staff and patients from one audit to the next; having to take into account instances where the desired standards are already in place and therefore no further improvement can be shown, or where initial standards are so low that only improvement can take place.

Autonomy for elderly people in long-term care.

A cross-sectional view of the extent to which residents in long-term care exercise autonomy has been obtained from an audit using the Royal College of Physicians' CARE scheme (Continuous Assessment Review and Evaluation) in 17 long-term care facilities among 298 residents. Most centres have procedures in place to enable residents to exercise choice, on information or services provided and how to complain, but only half provide opportunities to comment on policy and procedures and planned changes. There was a high level of personal care plans but many of these were disappointing in their detailed content; less than half of the residents had a key worker; a series of indicators of choice scored reasonably high in nursing homes but lower in hospitals; independent advocates are in evidence where patients' mental competence is in question.

Urinary incontinence in the community--analysis of a MORI poll.

Objectives: To investigate the prevalence of urinary incontinence among people living at home, their responses to it, and its emotional and social effects.

Design: Random sample of 4007 adults interviewed in their own homes.

Setting: Random sample of 178 constituency sampling points throughout Great Britain.

Assessment of the use of bladder washouts/instillations in patients with long-term indwelling catheters.

A randomised cross-over study of 3 bladder washout treatments--saline, Suby G and Solution R--was conducted on 25 elderly females with long-term catheters in order to examine crystal formation and catheter encrustation. With 2 exceptions, all patients produced crystals; only 14 completed the study. While a significant reduction in struvite crystals was found in the returned acidic washout fluid, there was no significant reduction of crystals in the neutral (saline) washout following any of the 3-week periods of treatment.

Parallel access read/write memory using an optically addressed ferroelectric spatial light modulator.

The ability is demonstrated to use optically addressed ferroelectric spatial light modulators in designing digital optical computers involving data processing and storage athigh rates and contrast levels. Key words: Bistability, ferroelectric SLM, parallel access memory.

Bacteriuria in non-catheterized elderly patients in the first eight days of hospital stay.

One hundred and sixty-one non-catheterized consecutive acute geriatric admissions were screened for bacteriuria on the day following admission, both in the morning and in the afternoon and seven days later--morning and afternoon. The prevalence of bacteriuria was 29% on admission. A correlation between bacteriuria and leucocyturia was shown.

Rectal motility studies in faecally incontinent geriatric patients.

Rectal motility was assessed in three groups of geriatric patients (faecally incontinent, continent faecally impacted and control patients) to determine whether 'uninhibited' rectal contractions are a cause of faecal incontinence. The incidence of rectal contractions in response to rectal distension did not differ between the three study groups. Two-thirds of the incontinent patients were unable to retain a condom distended with water (soft-stool model) during a proctometrogram.

Predicting urodynamic dysfunction from clinical features in incontinent elderly women.

In a retrospective survey of 296 elderly women referred with urinary incontinence and in whom urodynamic studies were completed, multiple logistic regression was used to determine the optimal set of clinical features to predict the urodynamic dysfunction. Three formulae were obtained expressing the predicted probabilities (p) of the urodynamic dysfunctions as functions of the clinical variables. By choosing the cut-off values of p which gave equal weighting to sensitivity and specificity, we found that clinical features (symptoms, signs, residual volume) are helpful in diagnosing the presence of unstable detrusor and voiding dysfunction, but not incompetent urethra.