The effectiveness of a four layer compression bandage system in comparison to Class 3 compression hosiery on healing and quality of life for patients with venous leg ulcers : a randomised controlled trial

There are an increasing number of compression systems available for treatment of venous leg ulcers and limited evidence on the relative effectiveness of these systems. The purpose of this study was to conduct a randomised controlled trial to compare the effectiveness of a 4-layer compression bandage system with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers. Data were collected from 103 participants on demographics, health, ulcer status, treatments, pain, depression and quality of life for 24 weeks. After 24 weeks, 86% of the 4-layer bandage group and 77% of the hosiery group were healed (p=0.24). Median time to healing for the bandage group was 10 weeks, in comparison to 14 weeks for the hosiery group (p=0.018). Cox proportional hazards regression found participants in the 4-layer system were 2.1 times (95% CI 1.2–3.5) more likely to heal than those in hosiery, while longer ulcer duration, larger ulcer area and higher depression scores significantly delayed healing. No differences between groups were found in quality of life or pain measures. Findings indicate these systems were equally effective in healing patients by 24 weeks, however a 4-layer system may produce a more rapid response.

Indications for early hip revision surgery in the UK : A re-analysis of NJR data

This study determined the rate and indication for revision between cemented, uncemented, hybrid and resurfacing groups from NJR (6 th edition) data. Data validity was determined by interrogating for episodes of misclassification. We identified 6,034 (2.7%) misclassified episodes, containing 97 (4.3%) revisions. Kaplan-Meier revision rates at 3 years were 0.9% cemented, 1.9% for uncemented, 1.2% for hybrids and 3.0% for resurfacings (significant difference across all groups, p<0.001, with identical pattern in patients <55 years). Regression analysis indicated both prosthesis group and age significantly influenced failure (p<0.001). Revision for pain, aseptic loosening, and malalignment were highest in uncemented and resurfacing arthroplasty. Revision for dislocation was highest in uncemented hips (significant difference between groups, p<0.001). Feedback to the NJR on data misclassification has been made for future analysis. © 2012 Wichtig Editore.

Poly[mu3-aqua-aqua(mu3-3,5-dinitrobenzoato-kO1:O3:O5)caesium]

In the structure of the title complex [Cs(C7H3N2O6)(H2O)2]n, the Cs salt of 3,5-dinitrobenzoic acid, the metal complex centres have have irregular CsO8 coordination, comprising two water molecules (one triply bridging, the other monodentate) and four O-donors from two nitro groups and one bridging carboxyl-O donor group from the ligand. Intra-unit O-H...O hydrogen-bonding interactions involving both water molecules are observed in the three-dimensional polymeric complex structure.

Nangkha Nangdrik in the land of the Thunder Dragon : psychology, religion and the potential of mediation in the Kingdom of Bhutan

This article will consider the role that Alternative Dispute Resolution (‘Dham Kha Chen Ki Khendum’ or ‘Nangkha Nangdrik’) currently plays in resolving legal conflict in Bhutan. With a Constitution that has committed to the pursuit of Gross National Happiness, non-adversarial dispute resolution processes that promote continuing relationships and goodwill assume greater importance. One difficulty for Bhutan is that alternative dispute resolution procedures such as mediation (Dhum Drik) are being referred to in enactments of the Bhutanese National Council and National Assembly (bicameral parliament), without a shared understanding as to the characteristics and functionality of these procedures. This article will focus particularly on the current practice of mediation in Bhutan and investigate whether particular models of mediation are more suited to the Bhutanese context, given the particularities of Bhutanese culture, the search for gross national happiness, psychological understandings of happiness and the omnipresent influence of Mahayana Buddhism.

Omega-3 polyunsaturated fatty acids in the treatment of kidney disease

After more than 25 years of published investigation, including randomized controlled trials, the role of omega-3 polyunsaturated fatty acids in the treatment of kidney disease remains unclear. In vitro and in vivo experimental studies support the efficacy of omega-3 polyunsaturated fatty acids on inflammatory pathways involved with the progression of kidney disease. Clinical investigations have focused predominantly on immunoglobulin A (IgA) nephropathy. More recently, lupus nephritis, polycystic kidney disease, and other glomerular diseases have been investigated. Clinical trials have shown conflicting results for the efficacy of omega-3 polyunsaturated fatty acids in IgA nephropathy, which may relate to varying doses, proportions of eicosapentaenoic acid and docosahexaenoic acid, duration of therapy, and sample size of the study populations. Meta-analyses of clinical trials using omega-3 polyunsaturated fatty acids in IgA nephropathy have been limited by the quality of available studies. However, guidelines suggest that omega-3 polyunsaturated fatty acids should be considered in progressive IgA nephropathy. Omega-3 polyunsaturated fatty acids decrease blood pressure, a known accelerant of kidney disease progression. Well-designed, adequately powered, randomized, controlled clinical trials are required to further investigate the potential benefits of omega-3 polyunsaturated fatty acids on the progression of kidney disease and patient survival.

Walking the Coleridge Way : using cultural tourism to change perceptions of Somerset after the foot and mouth epidemic of 2001

This paper explores one of the ways in which the Somerset region in the United Kingdom, devastated by the foot and mouth epidemic in 2001, is trying to free itself from recurring negative representations and create more positive images of the area. After the epidemic projects were sought that would promote a more positive image and draw tourists back to the area. One of these projects drew on literary tourism to reinvigorate the site. A Walking and Bridle trail called the ‘Coleridge Way Walk’ has been implemented to take the images of the area from ones of disease and dirtiness to ones of Romantic longing. The Coleridge Way Walk uses past imaginings to re-energise the area. This energy, in part, comes from ‘re-imagining’ the site through past imaginings. The Coleridge Way Walk uses the past to create future direction for the once tainted area.

Cutting down the Cypress leylandii, pittosporums, and cotoneasters on your neighbours' land - the resolution of spite hedges

Queensland, New South Wales, and the United Kingdom have enacted legislation that governs what are colloquially known as spite hedges. These are barriers, commonly horticultural, that once constructed, block the view or sunlight from a neighbouring property. The matter was also recently raised in the Tasmanian Parliament. This article examines whether legislation should be enacted to deal with this issue, and if so, what is the regulatory model that need be adopted. The conclusion is that a layered nuanced response is needed to balance the interests and obligations of neighbouring landowners.

A Companion to New Media Dynamics

A Companion to New Media Dynamics presents a state-of-the-art collection of multidisciplinary readings that examine the origins, evolution, and cultural underpinnings of the media of the digital age in terms of dynamic change Presents a state-of-the-art collection of original readings relating to new media in terms of dynamic change. - Features interdisciplinary contributions encompassing the sciences, social sciences, humanities and creative arts - Addresses a wide range of issues from the ownership and regulation of new media to their form and cultural uses - Provides readers with a glimpse of new media dynamics at three levels of scale: the ‘macro’ or system level; the ‘meso’ or institutional level; and ‘micro’ or agency level

A limb lost every 3 hours: can Australia reduce amputations in people with diabetes?

Recommendations to improve national diabetes-related foot disease (DRFD) care • National data collection on incidence and outcomes of DRFD. • Improved access to care, through the Medicare Benefits Schedule, for people with diabetes who have a current or past foot complication. • Standardised national model for interdisciplinary DRFD care. • National accreditation of interdisciplinary foot clinics and staff. • Subsidies for evidence-based treatments for DRFD, including medical-grade footwear and pressure off-loading devices. • Holistic diabetes care initiatives to “close the gap” on inequities in health outcomes for Aboriginal and Torres Strait Islander peoples.

Freshwater, habitats and ecosystems

While the Ramsar Convention for the Protection of Wetlands of International Importance was the first habitat-based treaty, much of the recent focus of international attention in the area of freshwater has been on the regulation of watercourses. Attention is only beginning to be given to the interconnectedness of freshwater, habitats and ecosystems. This chapter explores and analyses the context, structure and substantive rules for the couservation and managemet of freshwater, habitats and ecosystems across the complex range of multilateral environmental agreements.