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Background The multi-morbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse COVID-19 outcomes but data are limited. Objective Characterize the course of COVID-19 in psoriasis and identify factors associated with hospitalization. Methods Clinicians reported psoriasis patients with confirmed/suspected COVID-19 via an international registry, PsoProtect. Multiple logistic regression assessed the association between clinical/demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviours. Results Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% a non-biologic and 10% no systemic treatment for psoriasis. 348 (93%) fully recovered from COVID-19, 77 (21%) were hospitalized and nine (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted OR 1.59 per 10 years, 95% CI 1.19-2.13), male sex (OR 2.51, 95% CI 1.23-5.12), non-white ethnicity (OR 3.15, 95% CI 1.24-8.03) and comorbid chronic lung disease (OR 3.87, 95% CI 1.52-9.83). Hospitalization was more frequent in patients using non-biologic systemic therapy than biologics (OR 2.84, 95% CI 1.31-6.18). No significant differences were found between biologic classes. Independent patient-reported data (n=1,626 across 48 countries) suggested lower levels of social isolation in individuals receiving non-biologic systemic therapy compared to biologics (OR 0.68, 95% CI 0.50-0.94). Conclusion In this international moderate-severe psoriasis case series, biologics use was associated with lower risk of COVID-19-related hospitalization than non-biologic systemic therapies, however further investigation is warranted due to potential selection bias and unmeasured confounding. Established risk factors (being older, male, non-white ethnicity, comorbidities) were associated with higher hospitalization rates. Clinical Implications We identify risk factors for COVID-19-related hospitalization in psoriasis patients, including older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic therapies., Capsule summary: In this global registry-based study, risk factors for COVID-19-related hospitalization in psoriasis patients were older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic treatment.

A Dermatology walk‐in clinic available to all hospital staff (HS) was commenced to treat skin problems related to personal protective equipment (PPE) during the COVID‐19 pandemic. An observational case series was conducted in a single district general hospital within Wales (United Kingdom) to record the dermatological diagnoses. Our participant sample comprised of clinical and non‐clinical staff working in COVID‐19 and non‐COVID‐19 areas of the hospital. Over the data collection period (6 weeks), a total of 72 patients attended the clinic of whom 62 were female and 10 were male (mean age = 43yrs). Data comprised of demographic data, current occupation (shown in Table 1), duration of symptoms, past medical history, regular medication and treatment interventions. An analysis of the clinical diagnoses seen are reported in Table 2.

Objectives The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. Methods Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. Results Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. Clinical Significance Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.

The COVID-19 pandemic forced changes to the daily work routine of hospital staff (HS) around the world. HS faced skin problems caused or worsened by the use of personal protective equipment (PPE), but also by the rigorous hand hygiene regimen. A dermatology clinic that took place twice weekly and

These (fig 1) are chilblain-like lesions in a woman in her late 20s. Fig 1 She presented with a two week history of burning and itching of her fingers and toes, with erythematous and purple papules. Erosions were present on her …

The main utility I see in my erstwhile mountaineering was this education of my composure, which enabled me to sleep upright on the narrowest ledge overlooking an abyss.1 1. Marcel Mauss, ‘Technique...

Introduction: Women diagnosed with cancer and facing potentially sterilising cancer treatment have to make time-pressured decisions regarding fertility preservation with specialist fertility services whilst undergoing treatment of their cancer with oncology services. Oncologists identify a need for resources enabling them to support women’s fertility preservation decisions more effectively; women report wanting more specialist information to make these decisions. The overall aim of the ‘Cancer, Fertility and Me’ study is to develop and evaluate a new evidence-based patient decision aid (ptDA) for women with any cancer considering fertility preservation to address this unmet need. Methods and analysis: This is a prospective mixed-method observational study including women of reproductive age (16 years +) with a new diagnosis of any cancer across two regional cancer and fertility centres in Yorkshire, UK. The research involves three stages. In Stage 1 the aim is to develop the ptDA using a systematic method of evidence synthesis and multidisciplinary expert review of current clinical practice and patient information. In Stage 2, the aim is to assess the face validity of the ptDA. Feedback on its content and format will be ascertained using both questionnaires and interviews with patients, user groups and key stakeholders. Finally, in Stage 3 the acceptability of using this resource when integrated into usual cancer care pathways at the point of cancer diagnosis and treatment planning will be evaluated. This will involve a quantitative and qualitative evaluation of the ptDA in clinical practice. Measures chosen include using count data of the ptDAs administered in clinics and accessed online, decisional and patient-reported outcome measures and qualitative feedback. Quantitative data will be analysed using descriptive statistics, paired sample t tests and confidence intervals; interviews will be analysed using thematic analysis. Ethics and dissemination: Research Ethics Committee approval (Ref: 16/EM/0122) and Health Research Authority approval (Ref: 194751) has been granted. Findings will be published in open access peer-reviewed journals, presented at conferences for academic and health professional audiences, with feedback to health professionals and program managers. The Cancer, Fertility and Me ptDA will be disseminated via a diverse range of open-access media, study and charity websites, professional organisations and academic sources. External endorsement will be sought from the International Patient Decision Aid Standards (IPDAS) Collaboration inventory of ptDAs and other relevant professional organisations e.g. the British Fertility Society. Trial registration number: NCT02753296 (www.clinicaltrials.gov); pre-results.

The Deal Versus the People was a theatrical response created by people in Bradford (UK) to the Transatlantic Trade and Investment Partnership (TTIP). A controversial trade deal between the European Union and United States being negotiated at the time of the production, TTIP threatened to deepen trade liberalisation, with potentially negative impacts for communities on both sides of the Atlantic. In this article, I examine the ways The Deal Versus the People critically engaged with TTIP, and the neoliberal economic paradigm that it is an expression of, by mobilising a ‘commons’ across the theatrical and social landscapes of its production.

Within TACCLE 3 – Coding European Union Erasmus+ KA2 Programme project, a review and evaluation of a set of resources that can contribute to teaching programming to younger children has made. This paper presents a survey of this review including the most outstanding products in order to help teachers to introduce programming in pre-university studies.

Background Cow’s milk allergy (CMA) is the commonest food allergy in UK children with many misleading presentations. In 2011, the National Institute for Health and Care Excellence (NICE) provided primary care guidelines on food allergy. In Northern Ireland (NI), a regional expert group was convened in 2012 to develop a CMA-focused guidance document, later published as Milk Allergy in Primary care (MAP) guideline, along with other infant feeding issues. MAP was designed for shortcomings of national and international guidelines in the initial clinical recognition and management of mild to moderate non-IgE-mediated disease in primary care.

The Men’s Room is an arts and social care agency that works creatively with young men, offering them opportunities to get involved in arts projects whilst accessing support for challenges they may be facing in their lives. The project engages different constituencies of young men experiencing severe and multiple disadvantage, including those involved with sex work or with experience of sexual exploitation, and those with experience of homelessness and/or the criminal justice system. ‘Surviving in Manchester’ was commissioned by the Lankelly Chase Foundation (LCF) and aimed to explore young men’s routes into the Men’s Room as well as how they defined successful service provision. The research included ethnographic fieldwork, walking tours led by young men to sites that they connected with their survival in the city, and a Visual Matrix conducted with staff and volunteers. It argues that the relational approach of the Men’s Room is a key organisational strength. This approach combines informal and formal support, unconditional acceptance, clear ground rules, and gauging of supportive interventions in ways that are sensitive to the young men’s readiness and ability to ‘move on’. It also includes valuable opportunities for social gathering, creative expression and public storytelling and image-making that extend the artistic and imaginative capacities of the young men and celebrate their abilities and experiences.

Background: There is now general agreement that a comprehensive psychiatric service can operate with the minimum use of in-patient facilities. Consequently, the emphasis in most European countries is on reducing the number of inpatient beds and expanding the range of community care facilities, including day hospital services, available to mentally ill patients. Decision-making with respect to placement is now even more important given the changes currently taking place on the supply side. Method: The study examines the factors that influence placement decision-making between inpatient care and day hospital care in one Health Board in Ireland. Placement was examined over a 9 month period for all patients presenting for treatment in one particular area with a population of 39 000 people. Patients were not randomized between the two settings due to ethical concerns about the randomization process. The issue of placement is analysed using a logit estimation procedure. Results: The results suggest that two variables have a significant affect on placement for the population under review: whether the patient is accompanied at the time of admission and the domicile of the patient. Conclusions: Greater flexibility with respect to the opening hours of day hospital facilities, linked to improved transport facilities, together with further analysis on the process of admission to hospital, particularly the dynamics of the interaction between providers, patients, and accompanying persons, may improve placement decision-making for mentally ill patients. Copyright © 1999 John Wiley & Sons, Ltd.

BACKGROUND: There is now general agreement that a comprehensive psychiatric service can operate with the minimum use of in-patient facilities. Consequently, the emphasis in most European countries is on reducing the number of inpatient beds and expanding the range of community care facilities, including day hospital services, available to mentally ill patients. Decision-making with respect to placement is now even more important given the changes currently taking place on the supply side. METHOD: The study examines the factors that influence placement decision-making between inpatient care and day hospital care in one Health Board in Ireland. Placement was examined over a 9 month period for all patients presenting for treatment in one particular area with a population of 39000 people. Patients were not randomized between the two settings due to ethical concerns about the randomization process. The issue of placement is analysed using a logit estimation procedure. RESULTS: The results suggest that two variables have a significant affect on placement for the population under review: whether the patient is accompanied at the time of admission and the domicile of the patient. CONCLUSIONS: Greater flexibility with respect to the opening hours of day hospital facilities, linked to improved transport facilities, together with further analysis on the process of admission to hospital, particularly the dynamics of the interaction between providers, patients, and accompanying persons, may improve placement decision-making for mentally ill patients.

In a small open economy with fixed exchange rates, tandard theory suggests that domestic inflation and interest rates should equal those abroad. In a credible target zone, the same theories suggest that inflation and interest rates should be 'close'. Here, we seek to make precise this idea of limits on inflation and interest rate differentials consistent with limits on exchange rate movements. We then examine the case of Ireland, which joined the Exchange Rate Mechanism (ERM) of the European Monetary System (EMS) in 1979 attracted by the prospects of lower, German influenced, inflation and interest rates. We find in the early years of the ERM, both Irish inflation and interest rastes were inconsistent with credibility of the exchange rate regime; in he latter years, from 1987 on, rates were in the derived range around German rates.

The fundamental premiss of Gods, Ghosts and Men in Melanesia (Lawrence and Meggitt 1965) was that the epistemology of people of the Seaboard of Papua New Guinea was more dominated by religion than was that of the Highlanders. Among the latter, the Chimbu have commonly been portrayed as supreme pragmatists. However, they believe in a complex and variegated spirit-world, described in some detail in this paper.