WUTH publication: Management of abductor mechanism deficiency following total hip replacement.

Citation: The bone & joint journal, 2013 Mar;95-B(3):343-7.
Author: Odak S, Ivory J
Abstract: Deficiency of the abductor mechanism is a well-recognised cause of pain and limping after total hip replacement (THR). This can be found incidentally at the time of surgery, or it may arise as a result of damage to the superior gluteal nerve intra-operatively, or after surgery owing to mechanical failure of the abductor muscle repair or its detachment from the greater trochanter. The incidence of abductor failure has been reported as high as 20% in some studies. The management of this condition remains a dilemma for the treating surgeon. We review the current state of knowledge concerning post-THR abductor deficiency, including the aetiology, diagnosis and management, and the outcomes of surgery for this condition.

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WUTH publication: Parr and colleagues' response to Tang and colleagues.

Citation: BMJ, 2013 Apr 16
Author: Parr NJ, Lucky MA, Rogers B

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WUTH publication: The NHS working at weekends as it does during the week is a non-starter.

Citation: BMJ (Clinical Research Edition), 2013, Mar 26, 346
Author: Blair S

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Celebrate international Womens day - with our free recommended resources

To celebrate international Womens day on the 8th of March we are linking to a series of recommended and favourite sites covering women and gender studies. http://lselibraryresearch.blogspot.co.uk/

In this first section: International Womens day resources.
A collection of special sites created by organisations to celebrate this event

Hear the One Woman Song from the UN

UN website
Has a history of the event, records of past days, news and basic facts and figures about women.

ILO puts the spotlight on sexual harassment. See their statement

Council of Europe Statements and files.

internationalwomensday.com is a global hub for sharing International Women’s Day information, events, news and resources. Find out about the history of the day and events in your area.
Follow it in real time on the Twitter section.
The resources section. has posters badges and online videos.

UK Government has released an interesting map showing its efforts to encourage female empowerment worldwide.
Goldman Sachs 10,000 women - photo site sharing the success stories of Women entrepreneurs worldwide.
Accenture have released research on what makes women happy in the workplace

TES- teaching guides for schools about Womens day

See our scoop.it guide http://www.scoop.it/t/women-and-gender-studies

Heather dawson

LSE

WUTH publication: Ankle Arthrodesis vs TTC Arthrodesis: Patient Outcomes, Satisfaction, and Return to Activity.

Citation: Foot and Ankle International, 2013, March 6th, epub ahead of print
Authors: Ajis A, Tan KJ, Myerson MS
Abstract: BACKGROUND: It is believed that patients with an ankle arthrodesis (AA) have better outcomes than after a tibiotalocalcaneal (TTC) arthrodesis due to preservation of subtalar motion. However, there are no studies comparing actual functional outcomes and patient satisfaction between AA and TTC arthrodesis. METHODS: We retrospectively analyzed patient satisfaction and functional outcomes of patients after an AA and TTC arthrodesis using a postal survey. A total of 173 patients who underwent TTC and 100 AA patients from 2002 to 2010 were identified with a minimum of 24 months follow-up. In all, 53 AA and 64 TTC arthrodesis patients were included in the study, with the remainder lost to follow-up. A return to activity questionnaire and SF-12 scores were used to compare functional outcomes. The mean follow-up time was 63 months.
RESULTS: Both groups showed good outcomes with a low visual analogue pain score (2.7 for AA and 2.8 for TTC), high satisfaction score (90.6% for AA and 87.5% for TTC), and return to work (77.4% for AA and 73.0% for TTC). In all, 84.6% of AA and 81.0% of TTC patients would have the surgery again. There were no significant differences between the 2 groups for these parameters. However, when asked if their desired activity level was met, fewer AA patients met their desired level (58.5% for AA and 66.5% for TTC, P = .02). AA patients were also more likely to feel their level was unmet due to the foot and ankle (85.6% for AA vs 25.7% for TTC, P < .001).
CONCLUSIONS: Both AA and TTC arthrodesis were associated with good functional outcomes and satisfaction. AA patients had higher postoperative activity expectations and were less likely to meet them. When they failed to meet these expectations, they were much more likely to attribute it to their operated ankle. We believe it is because of the different ways the 2 groups of patients are counseled preoperatively, which highlights the importance of managing patient expectations.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.

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NHS Change Day – collective action to demonstrate how small changes can have a big impact

WHAT IS CHANGE DAY?

NHS Change Day – collective action to demonstrate how small changes can have a big impact

On the 13 March 2013 NHS Change Day will bring together the individual creativity, energy and innovative thinking of thousands of NHS staff from across clinical and non-clinical areas of work, in a single day of collective action to improve care for patients, their families and their carers.  The idea is to make a small change and make it every day practice.

Change Day is an NHS grassroots initiative devised and driven by emergent clinical and managerial leaders and improvement leaders, who want to make this call to action the single largest simultaneous improvement event in the NHS.

It is about galvanising and engaging the frontline in improvement, through individuals and teams pledging to make a change in their practice which will improve patient experience, clinical outcomes or spreading and adopting best practice and championing innovation. This will be a countrywide event and will coincide with Healthcare Innovation Expo at Excel in the same day.

The idea of NHS Change Day is create a mass movement of people working in the NHS demonstrating the difference they can make - by one simple act – and proving that we can make a big impact is possible when we work together in the NHS. Our initial aim was for 65,000 people to take part, 65 being the number of years the NHS has been in existence. To date we have over 90,000 supported pledges.

You can take part by going to the NHS Change Day website at http://www.changemodel.nhs.uk/changeday and make their pledge online, share you story of what happened, make a video clip, join in the discussions on the forum and become part of the growing list of active supporters and organisations taking part on the day.

Follow us on:

Twitter - #NHSchangeday

facebook.com/NHSchangeday

YouTube – http://www.youtube.com/user/NHSchangeDay

iTunes or at http://nhschangeday.podbean.com  

Access evidence based Dermatology topics via UpToDate

UpToDate content now covers all the major areas of dermatology, including medical dermatology, paediatric dermatology and procedural dermatology.  UpToDate’s graphics search also allows you to search for and download a range of dermatology images.

What is UpToDate?

UpToDate provides you with a summary of the latest evidence in your specialty or area of interest. It can be used as a tool to help you answer clinical questions quickly, increase your clinical knowledge, and improve patient care. A topic summary provides you with a synthesis of the literature, the latest evidence, and specific recommendations for patient care.

How can I access UpToDate?

You can access UpToDate via the WUTH intranet (click on the ‘UpToDate’ link in the Clinical box) or via www.uptodate.com with your Athens account.

Dermatology topics include:

·         Acne and rosacea
·         Bullous disease
·         Cosmetic dermatology
·         Cutaneous lymphoma
·         Dermatitis
·         Dermatologic diagnosis
·         Dermatologic surgery
·         Drug eruptions
·         Genodermatoses
·         Hair and scalp disease
·         Infections and infestations
·         Melanocytic lesions and disorders of pigmentation
·         Nonmelanoma skin cancer and related disorders
·         Other topics in dermatology
·         Papulosquamous disorders
·         Pediatric dermatology
·         Photodermatology
·         Skin and systemic disease
·         Urticaria and angioedema

You can register for an Athens account at www.evidence.nhs.uk.  For more information please contact the Integrated Library Service on extension 8610 or visit our webspages at www.whnt.nhs.uk/library. The library service can provide individual or group training on using UpToDate and a whole range of useful resources.  Please request training here.

Self Service Unit

Come and try our self service unit

Want to be able to borrow books at the weekend or late at night?

Want to return or renew materials?

Want to know what you have on loan and when the items are due back?

Try the self service unit today. Our friendly, helpful staff will show you how.

WUTH publication: Zinc induced damage to kidney proximal tubular cells: Studies on chemical speciation leading to a mechanism of damage.

Citation: Journal of Trace Elements in Medicine and Biology, 2013, 27(3), 242-8
Author: Sargazi M, Shenkin A, Roberts NB
Abstract: This study was carried out to investigate whether zinc can potentiate renal toxicity using monolayer cultures of kidney proximal tubular cells and if so to establish the chemical species and the mechanism involved. METHODS: Zinc was prepared as the citrate complex at pH 7.4 in phosphate buffered saline. Monolayers of kidney proximal tubular cells under standard cell culture conditions were exposed to zinc concentrations of 0, 5 10, 20, 50 and 100μmol/L. To assess cellular damage, thiazol blue (MTT) uptake, NAG and LDH release, DAPI staining and Tunel assay were used. Cytoprotective agents: trolox, cysteine, glutathione, ascorbic acid and sodium selenite were used to investigate if the damage was reversible. RESULTS: Incubation of kidney cells with zinc citrate showed a dose related reduction in cell viability (p<0.005) associated with cellular uptake of zinc ions. After 24h incubation with 100μmol/L Zn citrate, NAG release was not significantly different compared to the control whereas LDH increased 3 fold. DAPI staining showed apoptotic bodies within the cells confirmed by Tunel assay using flow cytometry. Electron microscopy showed significant morphological changes including loss of brush border, vacuolated cytoplasm and condensed nuclei. Trolox almost completely (>85±5%) and sodium selenite partially recovered (40±4%) the viability of cells exposed to Zn but no protection was observed with other cytoprotectants, e.g. glutathione, cysteine or ascorbic acid. In conclusion zinc can induce damage to kidney cells by a mechanism dependent on zinc ions entering the cell, binding to the cell organelles and disrupting cellular processes rather than damage initiated by free radical and ROS production.

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Final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis report)

The final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, conducted by Robert Francis QC, was published on Wednesday 6 February 2013.  His Inquiry followed concerns about standards of care at the Trust, and an investigation and report published by the Healthcare Commission in March 2009.  Robert Francis has heard evidence from patients, their relatives and staff to inform his report and the 18 recommendations he makes.

Read the full report here.

The Guardian website gives a useful overview of the key recommendations from the report.

The Department of Health has published three reports to help embed effective governance and detect and prevent such serious failures occurring again: Review of Early Warning Systems in the NHS, Assuring the quality of senior NHS managers, The Healthy NHS Board.

Read the Care Quality Commission's response to the report here.