482 people with leg ulcers were identified among those receiving health care in Bradford, UK. Of these wounds 195 (40.4%) were venous leg ulcers. Typically the people who experienced these wounds were elderly Caucasian females however a sub-group of younger males of Asian descent were seen to experience ulcers involving neuropathy. The leg ulcers were typically small in size although 33 people had wounds over 25 cm2 in surface area. The leg ulcers tended to persist with many present for at least 1 year with 4 wounds active for over 5 years. 205 people had experienced previous episodes of leg ulcer occurrence. Of the leg ulcers encountered 18.0% (n = 87) were infected and where wounds were swabbed for their microbial burden MRSA was identified in 8.5% of cases. Use of Doppler ultrasound to assess the aetiology of the wound had been performed in 66.4% of cases and where wounds remained undiagnosed (n = 69) only 8 had been Doppler assessed. While 75% of all venous leg ulcers received compression 48 people with venous leg ulcers did not have compression applied to their wound.

No description available.

No / While most motorcyclists focus on the maintenance of their motorcycle and personal safety equipment, recent research has highlighted the impact of motorcycling on lowerlimb health. This article underlines the importance of regular health checks to recognise early warning signs of venous disease and how health promotion initiatives linked to preventative strategies may help to minimise the risk of developing venous leg ulcers in this difficult-to-reach population.

Yes / BACKGROUND: Venous leg ulcers (VLUs) are the commonest cause of leg ulceration, affecting 1 in 100 adults. There is a significant health burden associated with VLUs - it is estimated that the cost of treatment for 1 ulcer is up to pound1300 per year in the NHS. The mainstay of treatment is with graduated compression bandaging; however, treatment is often prolonged and up to one quarter of venous leg ulcers do not heal despite standard care. Two previous trials have suggested that low-dose aspirin, as an adjunct to standard care, may hasten healing, but these trials were small and of poor quality. Aspirin is an inexpensive, widely used medication but its safety and efficacy in the treatment of VLUs remains to be established. METHODS/DESIGN: AVURT is a phase II randomised double blind, parallel-group, placebo-controlled efficacy trial. The primary objective is to examine whether aspirin, in addition to standard care, is effective in patients with chronic VLUs (i.e. over 6 weeks in duration or a history of VLU). Secondary objectives include feasibility and safety of aspirin in this population. A target of 100 participants, identified from community leg ulcer clinics and hospital clinics, will be randomised to receive either 300 mg of aspirin once daily or placebo. All participants will receive standard care with compression therapy. The primary outcome will be time to healing of the reference ulcer. Follow-up will occur for a maximum of 27 weeks. The primary analysis will use a Cox proportional hazards model to compare time to healing using the principles of intention-to-treat. Secondary outcomes will include ulcer size, pain evaluation, compliance and adverse events. DISCUSSION: The AVURT trial will investigate the efficacy and safety of aspirin as a treatment for VLU and will inform on the feasibility of proceeding to a larger phase III study. This study will address the paucity of information currently available regarding aspirin therapy to treat VLU. TRIAL REGISTRATION: The study is registered on a public database with clinicaltrials.gov ( NCT02333123 ; registered on 5 November 2014).

Health related quality of life (HRQoL) refers to the impact of disease and treatment on disability and daily living. Living with a venous leg ulcer (VLU) has a negative impact on HRQoL. The aim of the present study was to investigate the aspects of HRQoL affected by VLUs in a local SA sample. A post hoc research design was utilised comparing 30 VLU patients and 30 non-VLU participants. Four hypotheses were investigated: (1) the experience of having a VLU on HRQoL, (2) the relation between gender and HRQoL of VLU patients, (3) the relation between age and HRQoL of VLU patients and (4) the interrelation between the underlying constructs of HRQoL of VLU patients. A structured questionnaire was used to obtain information on demographic variables and HRQoL using the SF-36 questionnaire. Interviews were conducted to obtain qualitative data to complete the investigation. Correlation analysis and t-tests confirmed that having a VLU negatively affected HRQoL and that interrelations existed among the constructs of HRQoL. There were no significant relations between gender, age and HRQoL of VLU patients. In line with the social constructivist approach, social support and restructuring a sense of meaning in life to increase HRQoL, are important goals in the management of VLUs. / Psychology / M.Sc. (Psychology)

I Sverige lider ca 50 000 människor av svårläkta bensår och av dessa är ca 50 procent or-sakade av venös insufficiens. Patienter med bensår upplever ofta att de påverkas negativt fysiskt, psykiskt och socialt. Syftet med studien var att beskriva distriktssköterskors upple-velser av att kunna främja hälsa hos patienter med venösa bensår. Metoden som valdes var kvalitativ innehållsanalys med induktiv ansats. Data samlades in genom intervjuer med nio distriktssköterskor. Ur analysen framkom fyra teman; Samtala och informera för att skapa ökad förståelse, Arbeta med livsstilsrådgivning, Kunna underlätta vardagen samt Kunna se hela människan i omvårdnaden. Slutsatsen är att distriktssköterskorna blir ett stöd för pati-enterna, både under den tid de har sina sår och även genom att ge patienterna kunskap för att förebygga uppkomst av nya sår. Distriktssköterskorna upplever att de kan främja hälsa genom att flytta fokus från bensåret och istället se till hela människan. Fortsatt forskning inom området behövs ur ett patientperspektiv; hur patienter med venösa bensår upplever att distriktssköterskor kan ge stöd och främja hälsa. / Approximately 50 000 people in Sweden are suffering from slow healing leg ulcers, and about 50 per cent of these ulcers are caused by venous insufficiency. Patients with leg ul-cers often experience being adversely affected physically, psychologically and socially. The purpose of the study was to describe district nurses experiences of being able to pro-mote health in patients with venous leg ulcers. The chosen method was qualitative content analysis with inductive approach. Data was collected through interviews with nine district nurses. The analysis resulted in four themes; Communicate and inform to increase com-prehension, Work with lifestyle counselling, Being able to facilitate everyday life and Be-ing able to have an holistic approach in nursing care. The conclusion is that district nurses become a support to the patients during the time they are affected by ulcers, and also by providing the patients with knowledge of how to prevent the emergence of new ulcers. District nurses experience they are able to promote health by not only focus on the ulcer but also see the person behind the ulcer. Further research is needed from a patient perspec-tive; how patients with venous leg ulcers experience that district nurses can provide sup-port and promote health.

Introduction: Chronic diseases can be prevented and improved by regular physical activity and reduced sedentary time. An adequate leg strength and leg function in treatment and prevention of these disease is something to strive for. To the Lifestyle Reception at Karlskoga Hospital are patients with mild to moderate mental illness referred where a new method Self-measurement tests of leg strength is used, containing 30 seconds chair-stand test, squat, heel rise and maximal step-up test, aiming to simple training and indicating an objective measure of leg strength. Objective: To describe the group of patients referred to the Lifestyle Reception and investigate change of leg strength/leg function using Self-measurement tests, self-rated health and self-rated physical function following 12 weeks of intervention. Methods: A clinical intervention study of 29 patients referred to the Lifestyle Reception at Karlskoga Hospital between Nov 2017 and March 2018. They participated in an intervention consisting of group training twice a week for 12 weeks. A sign-in and a sign-out interview was carried out where data (tests and a questionnaire) of the study was collected. Result: 29 patients (24 women / 5 men) participated. The mean age was 39 years and the mean BMI was 31 (corresponding to obesity). All patients were on sick leave to some extent. The theoretical individual maximal step-up height (% -tMSH) improved from 65% to 75% (p <0.001). The patients could on average do 5.5 more 30s-chair-stand-test (p <0.001) and the proportion who managed to do squats without support increased from 57% to 90%. Significant improvements were seen for the self-rated health (p <0.001) and also for the HAD scale (anxiety p = 0.012; depression p = 0.04). However, the improvement of the self-rated physical function was not significant. Conclusion: Significant improvements in all four self-tests of leg strength / leg function could be measured after the intervention as well as a significant improvement of self-rated health. Self-measurement test of leg strength is considered to be a simple and useful test method in clinical practice.

After reviewing land based freight growth trends nationally and internationally, this thesis discusses the main parameters governing fuel consumption, as well as past approaches in modelling road and rail energy consumption. Past work on comparing these two main modes is also reviewed here. The review included ways of estimating energy consumption of a complete freight task i.e., from origin to destination. Mathematical models estimating modal energy consumption are presented in this thesis. Modal energy consumption is a complex function to be approximated in practice due to numerous variables affecting their outcome. Energy demands are particularly sensitive to changes in vehicle characteristics such as mass and size; route parameters such as grade and curvature; traffic conditions such as level of congestion; and less sensitive to ambient conditions, such as temperature and altitude. There is a large set of energy estimation models available to transportation planners. Unfortunately, unless simple relationships are established for energy estimation and modal comparison, their application in freight movement planning and corridor development becomes computationally prohibitive. This thesis describes the development of a modal freight energy comparison tool to quantify the energy advantage from mode choice, corridor development and vehicle types and loading improvements. The thesis also describes the used modelling processes and the trade-offs between model complexity and data quality. The tool developed in this thesis is based on well established relationships between energy consumption and traffic flow, route and vehicle operating characteristics for road freight movement. The rail freight component was developed from equations of motion together with parameters obtained from past studies. The relationships have been enhanced to fit the purpose of corridor level comparative analysis. The comparison tool has been implemented using a spreadsheet based approach developed specifically to calculate the total door to door energy consumption for given task options. A series of linked sheets enable the user to: specify all necessary inputs; estimate road and rail energy by trip segment. The outputs consist of trip segment energy demand and total energy efficiency of each option. A case study approach, for aiding in model development and testing, is presented. Toowoomba second range crossing in Southern Queensland, Australia (section between below Postman's Ridge and Gowrie Junction) was selected. Four options considered include existing and proposed road and rail corridors. The existing rail and road corridors could be taken as a typical poor case, with very high grades and sharp curvatures. The proposed new road section has a relaxed curvature and gradient. The section of proposed rail corridor, under consideration here, still contains a high grade section. However, the proposed track length is considerably shorter than the base-case. The new proposed train alignment was found as the most efficient mode and the existing trains as the least efficient mode when measured based on absolute expected fuel gain (litres/tonnage of freight moved). This could be attributed to the improvement in curvature and load carrying capacity. However, when the options are compared in terms of litres/1000 NTK, the new train option did not show a significant advantage. Furthermore, the developed model was applied on some simulated cases to test the functionality of other aspects of the model. The total door-to-door energy consumption and the efficiency were compared for all the simulated cases. It showed that the energy efficiency of scenarios varies exponentially with the variation in the ratio of road pickup and delivery legs to the rail line-haul length. In general, energy efficiency of the intermodal options was found to be better unless the best case of the road and the worst case of intermodal option was compared. The modelling approaches presented in the thesis and the comparison model developed in this study could be used for several purposes namely: to assess the energy (and hence greenhouse gas) implications of specific modal freight movements; to aid in the economic and environmental evaluation of transport options; and to assess the potential for energy efficiency gains from vehicle and infrastructure improvements. A number of suggested improvements to the model are also discussed.

Thesis (Ph. D.)--University of Washington, 2005. / Vita. Includes bibliographical references.

Health related quality of life (HRQoL) refers to the impact of disease and treatment on disability and daily living. Living with a venous leg ulcer (VLU) has a negative impact on HRQoL. The aim of the present study was to investigate the aspects of HRQoL affected by VLUs in a local SA sample. A post hoc research design was utilised comparing 30 VLU patients and 30 non-VLU participants. Four hypotheses were investigated: (1) the experience of having a VLU on HRQoL, (2) the relation between gender and HRQoL of VLU patients, (3) the relation between age and HRQoL of VLU patients and (4) the interrelation between the underlying constructs of HRQoL of VLU patients. A structured questionnaire was used to obtain information on demographic variables and HRQoL using the SF-36 questionnaire. Interviews were conducted to obtain qualitative data to complete the investigation. Correlation analysis and t-tests confirmed that having a VLU negatively affected HRQoL and that interrelations existed among the constructs of HRQoL. There were no significant relations between gender, age and HRQoL of VLU patients. In line with the social constructivist approach, social support and restructuring a sense of meaning in life to increase HRQoL, are important goals in the management of VLUs. / Psychology / M.Sc. (Psychology)