Background: A healthcare professional's aptitude to develop research skills and actively engage in research is necessary to optimise healthcare efficacy. The present study investigated the factors that contribute to research capacity within the Australian dietetic workforce. Methods: Queensland-based dietitians scored their department and individual skill or success in research on a 10-point scale using an anonymous online survey that incorporated the validated Research Capacity in Context tool. Descriptive statistics were assessed against geographical setting, dietetic experience and the proportion of role (Full Time Equivalent; FTE) designated to research. Research activities were defined by the number of items currently involved in or completed in the past 6 months (n = 11). Factors associated with research activities were assessed by multivariable linear regression. Results: Dietitians (n = 130) identified having a moderate skill or success in 14 research items [mean (SD) 5.1 (1.7)] and perceived that their departments provided a moderate level of research support in 19 research items [mean (SD) 6.1 (2.5)]. Geographical setting, the proportion of role designated to research (FTE) and participation in research activities were associated with individual and department ratings of research skill or success. Research involvement was predicted by the proportion of role (FTE) designated to research (b = 0.34, t = 4.16, P < 0.001) and years of experience in dietetics (b = 0.32, t = 2.67, P < 0.009). Conclusions: A dietitian's capacity for research is related to professional experience and the designation of research in the role description. The findings of the present study will provide a baseline of research capacity and expertise among dietitians, and also inform the strategic development of building research capacity.
This study was undertaken to investigate the prevalence of basement membrane zone (BMZ) antibodies, their subtypes and clinical correlations in 96 patients attending the Oxford vulval clinic with lichen sclerosus (LS) of the vulva. Indirect immunofluorescence of serum (intact and split skin) to immunoglobulin (Ig)G was performed looking for the presence or absence of staining at the BMZ. Eighteen patients' sera (14 with positive indirect immunofluorescence to IgG) were examined for IgG antibodies of subclasses IgG1, 2 and 3, and 23 sera were examined for IgG4 subclass. Immunoblotting was performed in seven patients, and showed antibodies to BP180 in six patients and BP230 in one. One-third of patients with vulval LS had BMZ antibodies binding to the epidermal side of salt split skin. Immunoblotting showed antibodies to BP180 collagen XVII (six of seven patients) and BP230 in one. The subclasses were chiefly IgG1 and 2, different from those seen in bullous pemphigoid. No clinical correlation was found between the presence of antibodies and the presence of erosions, severity of scarring, age of onset of disease or response to treatment. These antibodies may be a reflection of a tendency to produce autoantibodies or be relevant to pathogenesis.
Summary. This study was designed to assess the efficacy and safety of substituting cisplatin with oxaliplatin in the DHAP (dexamethasone, cytarabine and cisplatin) regimen for patients with relapsed or refractory non-Hodgkin's lymphoma. Twenty-four evaluable patients with intermediate or high-grade non-Hodgkin's lymphoma were treated at 3-weekly intervals with oxaliplatin (130 mg/m 2 , d 1), cytarabine (2 g/m 2 for two doses, d 2) and dexamethasone (40 mg, d 1±4). The median age of the patients was 58 (range 18±70). Histological subtypes were diffuse large B cell, 20; mantle cell, two; anaplastic large cell, one; and peripheral T cell, one. The overall objective response rate (RR) was 50% [95% confidence interval (CI) 29±71%] including four complete responses and eight partial responses. RR for those patients treated at first relapse was higher than those treated at second and subsequent relapse (77% versus 29%). Grade 3 and 4 toxicity was mainly haematological: anaemia 17%, neutropenia 75% and thrombocytopenia 75%. No grade 4 non-haematological toxicity was reported. No significant renal and neurotoxicity was demonstrated. Median survival was 10´6 months. Probabilities of 1-year progression-free survival and overall survival were 47% (95% CI 26±66%) and 50% (95% CI 23±72%) respectively. In conclusion, dexamethasone, cytarabine and oxaliplatin (DHAX) is a novel combination in salvage therapy for relapsed or refractory non-Hodgkin's lymphoma. It has clinically significant activity with an acceptable toxicity profile. Lack of renal toxicity makes DHAX an attractive cytoreductive regimen before high-dose chemotherapy.
A follow-up study was performed to determine the outcomes of all patients (five males and seven females, mean age 18.4 years) who were referred to a specialist nail clinic with trachyonychia. The average number of affected nails per patient was 8.8 fingernails and 6.2 toenails. None of our patients tested positive for onychomycosis. Nail biopsies were performed in two patients, revealing non-specific changes. Eight patients did not present with or develop accompanying skin or mucosal disease. Two patients presented with alopecia areata and two others with psoriasis. Of our patients, 50% showed total resolution or marked improvement in their nail disease within the first 6 years regardless of treatment.
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