Liquid nitrogen and salicylic/lactic acid paint in the treatment of cutaneous warts in general practice

Patients with common hand warts and simple plantar warts attending a general practice wart clinic in Northern Ireland were assigned to one of three treatment groups - liquid nitrogen applied weekly, daily application of wart paint (lactic acid one part, salicylic acid one part, collodion four parts), or a combination of the two. Combination therapy cured 87% of common hand warts over a six week period, and was significantly more effective than either agent used separately (P

Pinch grafting for chronic venous leg ulcers in general practice

Twenty-five patients with chronic venous leg ulcers were treated in general practice by pinch grafting. Fifteen of the ulcers (60%) were completely healed one year after grafting. Prior to grafting 19 patients (76%) complained of daily pain in the ulcer. These patients experienced complete relief from pain after grafting. Pinch grafting is a simple, safe and effective therapy when applied in a domiciliary environment.

Primary dermatological care in general practice

Out of 2,409 clinical cases analysed over an eight-week period, 199 (8.2 per cent) were of a dermatological nature. Atopic eczema, warts, seborrhoeic eczema and acne vulgaris were encountered most frequently. The reaction to a skin clinic in the general practice, with access to liquid nitrogen, electrocautery and histopathology is described. Treatment of patients is summarized. It is suggested that having a practice skin clinic reduces the rate of hospital referrals by two thirds.

Warts in general practice

Eight hundred and ninety seven patients referred by their general practitioner to Health Centre Wart Clinics were interviewed. Seventy one patients (7.9%) were found to have lesions other than cutaneous warts. Females were significantly more likely to have plantar warts on their toes (p less than 0.002) and non-plantar warts on their fingers (p less than 0.03) and less likely to have non-plantar warts on the palms of their hands (p less than 0.03) than males. Patients living in large households (5+ persons) were more likely than patients living in smaller households (2-4 persons) to report an infected co-habitant (p less than 0.001). Patients with periungual warts were significantly more likely to be nailbiters. (p less than 0.001). Patients presenting with warts greater than two years in duration were more likely to have multiple warts than those with warts less than one month in duration (p less than 0.001). Patients who frequently immersed their hands in water were more likely to present with multiple warts on the hands (p less than 0.001). Multiple plantar warts were associated with moist or macerated feet (p less than 0.001). The role of the family doctor in diagnosing and preventing the spread of this infection is discussed.

"The End" for piano and computer. Performed by Shiau-uen Ding. Composer's Voice Concert Series: 15 Minutes of Fame. Jan Hus Church, NYC. General information State: Published Organisations: School of Creative Arts, Sonic Arts, UOA35 - Music, Drama, Dance and Performing Arts Authors: Lyon, E.

Performed by Shiau-uen Ding. Composer's Voice Concert Series: 15 Minutes of Fame. Jan Hus Church, NYC.

The importance of validating the diagnosis of coronary heart disease when measuring secondary prevention:a cross-sectional study in general practice

To compare levels of recorded risk factors and drug treatment between patients with validated and non-validated diagnoses of coronary heart disease (CHD) in Northern Ireland.

Occupational stress in the chef profession

Purpose – The purpose of this paper is to consider the occupational stress experienced by chefs and the moderating influence of coping behaviour and locus of control on stress outcomes. Design/methodology/approach – A total of 40 working chefs were surveyed. They were asked to complete an occupational stress questionnaire, the General Health Questionnaire. Differences were
sought between gender and locus of control and stress measures, and correlations were carried out between key variables. Findings – The reported stress was markedly higher than in previous research. Excessive workload,
feeling undervalued and communication issues were common and bullying and threats of violence were present for some. Unexpectedly, locus of control was unable to predict stress experiences. Explanations were offered, such as the possibility that those who perceive they have a strong sense of control may believe that this, paradoxically, affords them the opportunity to engage in unhealthy behaviours. Research limitations/implications – Limitations of the research include the influence of the wider environment, specifically the history of political violence in the province, and its possible effect on stress outcomes. However, this may be negated by the many positive effects peace has brought over the last decade. In drawing conclusions it is important to note the limitations of the sample size and the self-reporting nature of survey responses. Further research could usefully incorporate well-being as well as stress measures, including physiological ones. It would be worth exploring further how one’s sense of control affects perceptions of stress and, in turn, the coping behaviours engaged in. Practical implications – Practical implications include the need for managers and head chefs to provide more feedback to employees, to validate their good work and to foster a supportive working environment. Norms in the working environment endorsing aggressive behaviour must be challenged.
Staff appraisals should consider the need to have work that involves variety and challenge, especially where changes involve increases in workload. Originality/value – This paper identifies some important ingredients to reduce distress and it will be of value to chefs and other kitchen staff and, more broadly, to those involved in people management.

A comparative analysis of the health and wellbeing of cancer survivors to the general population

Background
The population of people surviving cancer is continually increasing and currently cancer survivors represent approximately 3.7% of the American population and 3% of the UK population. There is limited and inconclusive empirical evidence regarding the long-term health and well-being of cancer survivors.

Methods
Two hundred eighty-nine cancer survivors and 262 matched-age and sex patients from the same group of General (primary care) Practices completed postal questionnaires measuring health and well-being, health service utilisation and satisfaction and health care needs.

Main Results
Cancer survivors reported poorer health and well-being and health service utilisation than the general population. Despite this poorer health, the majority of cancer survivors reported satisfaction with services and almost two-thirds of the survivors did not report any needs.

Conclusions
The majority of cancer survivors do not appear to require additional support services. There is, however, a subgroup of survivors who warrant specialist support, particularly survivors who are older, experience late effects and have had adjuvant treatments. Future research should focus on developing methods that could be used in routine clinical practice to identify ‘at risk’ or vulnerable patients and to provide appropriate and timely support.

The influence of the new general ophthalmic services (GOS) contract in optometrist referrals for glaucoma in Scotland

Purpose: To assess the quality of referrals from community optometrists in the northeast of Scotland to the hospital glaucoma service before and after the implementation of the new General Ophthalmic Services (GOS) contract in Scotland. Methods: Retrospective study encompassing two 6-month periods, one before the implementation of the new GOS (Scotland) contract in April 2006 (from June to November 2005), and the other after (from June to November 2006). The community optometrist referral forms and hospital glaucoma service notes were reviewed. Comparisons were performed using the t-test and ?- test. Results: In all, 183 referrals were made during the first 6-month period from June to November 2005, and 120 referrals were made during the second 6-month period from June to November 2006. After the introduction of the new GOS contract, there was a statistically significant increase in true-positive referrals (from 18.0 to 31.7%; P=0.006), decrease in false-positive referrals (from 36.6 to 31.7%; P=0.006), and increase in the number of referrals with information on applanation tonometry (from 11.8 to 50.0%; P=0.000), dilated fundal examination (from 2.2 to 24.2%; P=0.000), and repeat visual fields (from 14.8 to 28.3%; P=0.004) when compared to the first 6-month period. However, only 41.7% of referrals fulfilled the new GOS contract requirements, with information on applanation tonometry the most commonly missing. Conclusions: After the implementation of the new GOS (Scotland) contract in April 2006, there has been an improvement in the quality of the glaucoma referrals from the community optometrists in the northeast of Scotland, with a corresponding reduction in false-positive referrals. Despite the relatively positive effect so far, there is still scope for further improvement. © 2009 Macmillan Publishers Limited All rights reserved.