Ageing in a non-heterosexual context.

There is increasing recognition of the importance of social and cultural differences in shaping the diversity of the ageing experience in contemporary Britain. Various social and cultural factors, such as those associated with class, ethnicity, gender and disability, influence people’s living circumstances and sources of support in later life. While they have been the subject of considerable speculation, ageing in a non-heterosexual context remains remarkably under-studied. This paper examines the difference that being non-heterosexual makes to how people experience ageing and later life. It draws on quantitative and qualitative data gathered for a British study of the living circumstances of non-heterosexuals aged between the fifties and the eighties. Previous work has overwhelmingly emphasised how individuals manage their sexual identities, but this paper focuses on the factors that shape the non-heterosexual experience of ageing and later life. Particular attention is paid to the relational and community contexts in which non-heterosexuals negotiate personal ageing. This not only provides insights into the specific challenges that ageing presents for non-heterosexuals, but also offers insights into the challenges faced by ageing non-heterosexuals and heterosexuals in ‘ detraditionalised ’ settings.

Feasibility study to inform the design of a UK multi-centre randomised controlled trial of prophylactic antibiotics for the prevention of recurrent cellulitis of the leg

Background: This paper describes the results of a feasibility study for a randomised controlled trial (RCT). Methods: Twenty-nine members of the UK Dermatology Clinical Trials Network (UK DCTN) expressed an interest in recruiting for this study. Of these, 17 obtained full ethics and Research & Development (R&D) approval, and 15 successfully recruited patients into the study. A total of 70 participants with a diagnosis of cellulitis of the leg were enrolled over a 5-month period. These participants were largely recruited from medical admissions wards, although some were identified from dermatology, orthopaedic, geriatric and general surgery wards. Data were collected on patient demographics, clinical features and willingness to take part in a future RCT. Results: Despite being a relatively common condition, cellulitis patients were difficult to locate through our network of UK DCTN clinicians. This was largely because patients were rarely seen by dermatologists, and admissions were not co-ordinated centrally. In addition, the impact of the proposed exclusion criteria was high; only 26 (37%) of those enrolled in the study fulfilled all of the inclusion criteria for the subsequent RCT, and were willing to be randomised to treatment. Of the 70 participants identified during the study as having cellulitis of the leg (as confirmed by a dermatologist), only 59 (84%) had all 3 of the defining features of: i) erythema, ii) oedema, and iii) warmth with acute pain/tenderness upon examination. Twenty-two (32%) patients experienced a previous episode of cellulitis within the last 3 years. The median time to recurrence (estimated as the time since the most recent previous attack) was 205 days (95% CI 102 to 308). Service users were generally supportive of the trial, although several expressed concerns about taking antibiotics for lengthy periods, and felt that multiple morbidity/old age would limit entry into a 3-year study. Conclusion: This pilot study has been crucial in highlighting some key issues for the conduct of a future RCT. As a result of these findings, changes have been made to i) the planned recruitment strategy, ii) the proposed inclusion criteria and ii) the definition of cellulitis for use in the future trial.