Publications by authors named "Elwell R"

After nearly 50 years of searching, the vacuum ultraviolet Th nuclear isomeric transition has recently been directly laser excited and measured with high spectroscopic precision. Nuclear clocks based on this transition are expected to be more robust than and may outperform current optical atomic clocks. These clocks also promise sensitive tests for new physics beyond the standard model.

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LiSrAlF_{6} crystals doped with ^{229}Th are used in a laser-based search for the nuclear isomeric transition. Two spectroscopic features near the nuclear transition energy are observed. The first is a broad excitation feature that produces redshifted fluorescence that decays with a timescale of a few seconds.

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There is some confusion surrounding the management of people with lymphoedema in the presence of deep vein thrombosis (DVT). This may be in relation to the suitability of commencing compression therapy or regarding the continuation of compression therapy in those who develop DVT. The purpose of this British Lymphology Society position paper is to support evidence-based practice and debunk the myths surrounding the management of DVT and lymphoedema.

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This consensus document is endorsed by The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS).

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Antibiotic misuse is a rampant problem the world over and it in turn leads to other issues, the main one being the rise of antibiotic-resistant microorganisms. Often, bilateral red legs are mistaken for acute cellulitis, an infection of the skin, and are inappropriately treated with antibiotics. The British Lymphology Society's Red Legs Pathway aims to support differential diagnosis in patients with bilateral red legs to enable prompt and effective management and improve patient experience.

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Compression hosiery is commonly used for the management of lymphoedema as well as lipoedema, but it is more commonly indicated for the lower limbs than for the upper limbs. The effects of compression hosiery on upper-limb lipoedema are poorly understood and researched. It is known that compression hosiery works in conjunction with activity or movement when standing or walking, which produces anti-inflammatory and oxygenating effects in the tissues.

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Prompt application of appropriate compression therapy is essential for effective treatment of lymphoedema. However, it is accepted that prior to the application of compression to the lower limbs, either with bandaging or compression garments, patients should demonstrate a satisfactory vascular status, as assessed via axillary brachial pressure index (ABPI). Unfortunately, the presence of peripheral oedema may render a reading impossible or grossly inaccurate.

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Lymphoedema results from a failure of the lymphatic system. The consequences are swelling, skin and tissue changes and predisposition to infection. Lipoedema, however, results from the predisposition of an excessive number of fat cells in the lower limbs, typically from the ankle to the waist.

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Rebecca Elwell, Macmillan Lymphoedema Advanced Nurse Practitioner, Royal Stoke University Hospital, discusses recommendations on management of this skin problem, which may co-occur with chronic oedema.

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Article Synopsis
  • Selecting the right compression garments is crucial for managing venous disease and chronic oedema, with improved styles and options now available on the UK Drug Tariff.
  • Practitioners can choose from various fabrics, colors, compression classes, and styles, allowing them to meet both clinical and aesthetic needs, which helps enhance patient compliance.
  • The article also emphasizes the features of different compression garments, reasons for their prescription, and showcases Haddenham's Veni made-to-order garments through three case studies demonstrating their effectiveness.
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Chronic oedema in the lower limbs can be a debilitating condition and has a negative effect on a patient's quality of life. As yet, there is no known cure for this condition; however, it can be controlled and managed, and its recurrence can be prevented. One of the most common and successful ways of managing this condition is the use of compression hosiery.

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As the population ages, more complex care is required to manage multiple comorbidities. In response, a nurse-led service was developed to care for patients with 'red legs'. This chronic inflammatory condition is often misdiagnosed as acute cellulitis and can result in unnecessary hospital admission and inappropriate treatment, with substantial resource and financial implications for trusts.

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Among other risk factors, chronic venous insufficiency predisposes an individual to chronic oedema. The use of compression bandaging in the intensive phase of treatment is indicated to reduce distortion, lymphorrhoea, and achieve wound healing. When applying a compression bandage, it is essential that the clinician considers the laws that underpin the theory of compression.

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This article discusses the use of Microfine toe caps (Haddenham, UK) for the treatment of digit swelling. It will discuss the indications and contraindications of the device and offers some case studies where toe caps have been used in clinical practice. The use of the Microfine toe cap offers an alternative to toe bandaging, has many different applications and can be safe and time-saving to apply when used appropriately following a full and holistic assessment.

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There are a number of recognised skin conditions associated with chronic oedema, but the lack of agreed definitions and terminology often leads to poor recognition and a delay in treatment. Many patients are given a diagnostic 'label' (e.g.

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