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The author reflects on the Department of Health (DH) policy and the announcement made Lord Howe on a legislation put before Parliament to enable podiatrists and physiotherapists to be non-medical independent prescribers. He also informs that Health and Care Professions Council (HCPC) will undertake public consultation on the new prescribing standards to ensure effective regulatory control. He offers an appreciation to the DH team for making possible to access to medicines as and when needed.

The author requests readers to share their views on the Medicines Committee's proposal of removing some medicines, including, Fenticlor, Diamthazole, and Thiomersal from the "exemption list," of prescription only medicines (POMs) and pharmacy medicines for external use.

The authors reflect that the year 2012 is going to be the centenary celebration of the National Society of Chiropodists, which was founded in 1912. They discuss the remarkable changes achieved, which include the emergence of podiatric surgery and its firm establishment within the National Health Service (NHS). The authors also highlight that Biomed Central will provide an unofficial Impact Factor by 2012, which will help gauge the progress of Journal of Foot and Ankle Research."

Over the past 20 years, the healthcare work force has been transformed. For eligible allied healthcare professions, non-medical prescribing has been introduced. This move has given fast and safe access to appropriate medicines for a range of patients. Supplementary prescribing rights were extended to include the podiatry profession in 2005, but few podiatrists have taken on this role. At present, around just 120 UK podiatrists are qualified supplementary prescribers (Health Professions Council, 2010). With so few practising supplementary prescribers in podiatry, it is perhaps unsurprising that their impact -- on the health service, patient care and, ultimately, outcomes -- may be considered minimal. So what are the benefits of non-medical prescribing, and what value does it add to the health service? More specifically, how does supplementary prescribing improve outcomes in the management of people with long-term conditions, such as diabetes and diabetes-related complications of the foot? Here, the authors offer various perspectives -- that of the patient (Umberto Saoncella), the professor and physician (Philip Wiles) and the podiatrists (Louise Stuart, Martin Fox) - on the benefits of supplementary prescribing. In conclusion, Alan Borthwick looks at the possibilities of independent prescribing for podiatrists and projects currently under way to determine the best path forward. [ABSTRACT FROM AUTHOR]

The article offers information on the "Journal of Foot and Ankle Research," the official journal of the Society of Chiropodists and Podiatrists (SCP) and the Australasian Podiatry Council (APodC). The first editorial of the journal reflected the relevance of a meeting held at the 18th FIP World Congress of Podiatry to the emergence of the journal. As of April 2009, the journal has published 22 articles, with 10 under review and 15 were rejected. Editors of the journal continue to encourage the publication of relevant materials, and invite comment and discussion on topics related to podiatry. Overview of the plans of SCP and APodC for the journal is also presented.

Background: The UK medicines legislation was amended ten years ago (2013) to allow podiatrists and physiotherapists independent prescribing rights, the first of the allied health professions to do so. Non-medical prescribing formed one part of a broader policy agenda promoting role flexibility in response to the challenge of an ageing population and the need to maintain effective health provision in the face of a contracting workforce. Aim: The aim of this study was to outline the experiences of the Department of Health AHP medicines project board team in working towards independent prescribing for podiatry and physiotherapy, with a particular focus on the challenges encountered. Methods: In depth, open-ended interviews were conducted with eight of the core members of the project team, drawn from those individuals who served throughout the duration of the project (2010–2013). Included were the former Department of Health Chief and Deputy Chief Allied Health Professions Officers; the Department of Health Engagement and Communications Officer; representatives of the Health and Care Professions Council; the Medicines and Healthcare products Regulatory Agency; the Council of Deans of Health; the Royal College of Podiatry and the Chartered Society of Physiotherapy (The team also included the representative of the Allied Health Professions Federation. However, as that representative is also a researcher in this study, he has recused himself from any role as a participant.). Data were transcribed and subject to a thematic analysis. Results: A complex picture of the project emerged revealing a range of obstacles and challenges, including inter-professional role boundary tensions and negative prior assumptions about the two professions. Success hinged upon the adoption of a dual strategy involving submission of a robust case of need focused on patient benefit coupled with the careful management of professional expectations. Underpinning theory from the sociology of the professions offers a supportive explanatory framework for understanding the relationships between the various stakeholders involved. Conclusions: Ultimately, success depended upon aligning the project aims with healthcare policy through a clear focus on patient benefit. Balancing competing professional and policy demands through a continual emphasis on improved patient care laid the foundations for future projects by other allied health professions. [ABSTRACT FROM AUTHOR]

The author discusses some of the rewarding aspects of the 2013 Federation Internationale des Podologues World Congress of Podiatry, including the presentations on podiatric medical education and the quality of podiatric education in Europe.

The article discusses a Canadian Federation of Podiatric Medicine (CFPM) conference that was held in Hilton Hotel, London, Ontario on October 25-26, 2012.

The article discusses a meeting on the innovative developments in podiatric education and also revealed that the fascinating insight was transformed to the contemporary development in the educational practice.

Background: Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility. Methods: An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both 'before' and 'after' the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data. Results: Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of problematic access to foot health services. Conclusion: Whilst the findings from this study mirror those within the existing literature, which report improvements in physical function related to biological therapy, foot problems clearly remained an unremitting feature of life for patients with rheumatoid disease, even when in receipt of biologics. [ABSTRACT FROM AUTHOR]

The article announces the beginning of the public consultation on independent prescribing for podiatrists, which includes the practice guidance on medicines management for podiatrists and the outline curriculum framework for delivery of the courses in prescribing. It mentions that readers can access the link http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981 for more information on the consultation. INSET: What you need to do to respond.

The article presents a statement from the Medicines Committee highlighting an error concerning the use of terminology in Bruce McCulloch's paper published in the September 2010 issue of Podiatry Now. McCulloch's paper demonstrated the effectiveness of podiatric intervention through the administration and supply of relevant medicines and its role in enhancing patient care. Also mentioned is the committee's paper on the specific rights of podiatrists concerning the use of medicines.

The article focuses on government policies and legislation concerning the dispensing of drugs by British podiatrists including resources that address the issue.

Background: Across the Western world, demographic changes have led to healthcare policy trends in the direction of role flexibility, challenging established role boundaries and professional hierarchies. Population ageing is known to be associated with a rise in prevalence of chronic illnesses which, coupled with a reducing workforce, now places much greater demands on healthcare provision. Role flexibility within the health professions has been identified as one of the key innovative practice developments which may mitigate the effects of these demographic changes and help to ensure a sustainable health provision into the future. However, it is clear that policy drives to encourage and enable greater role flexibility among the health professions may also lead to professional resistance and inter-professional role boundary disputes. In the foot and ankle arena, this has been evident in areas such as podiatric surgery, podiatrist prescribing and extended practice in diabetes care, but it is far from unique to podiatry. Methods: A systematic review of the literature identifying examples of disputed role boundaries in health professions was undertaken, utilising the STARLITE framework and adopting a focus on the specific characteristics and outcomes of boundary disputes. Synthesis of the data was undertaken via template analysis, employing a thematic organisation and structure. Results: The review highlights the range of role boundary disputes across the health professions, and a commonality of events preceding each dispute. It was notable that relatively few disputes were resolved through recourse to legal or regulatory mandates. Conclusions: Whilst there are a number of different strategies underpinning boundary disputes, some common characteristics can be identified and related to existing theory. Importantly, horizontal substitution invokes more overt role boundary disputes than other forms, with less resolution, and with clear implications for professions working within the foot and ankle arena. [ABSTRACT FROM AUTHOR]

This paper presents a critical review of literature on interprofessional education in the continuum of professional development in health and social care. In particular it explores the range and variety of theoretical frameworks underpinning interprofessional education initiatives across the United Kingdom. In doing so this paper highlights the limited application of educational theory within the broader literature, particularly in the description of the methods employed and in the choices of processes or outcome measures selected. Despite these drawbacks, a focus on the learning and teaching methods used within each interprofessional education programme enabled an explicit categorization of the educational theories being applied (albeit implicitly). The educational theories identified predominantly linked to adult learning theory and reflective practitioner theory. It is, however, acknowledged that such theories alone are not enough to underpin interprofessional education. Theories were therefore also derived from social psychological studies of group behaviour and teamwork approaches; group development and team learning theories focusing on intragroup collaboration; and bio-psychological theories to inform interprofessional education. The paper concludes that (a) more explicit consideration of theory is required in the development of new interventions; (b) reference to educational theory in evaluation should be encouraged and facilitated; (c) evaluation of different models of interprofessional educational interventions is required if interprofessional education in health and social care is to develop as an informed practice rather than become a transient educational fashion. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to explore the views of stakeholders in podiatry services, patients, commissioners and general practitioners (GP), to further understand experiences of referral, access and provision of treatment in the National Health Service (NHS) for foot problems for patients living with arthritis. Method: To explore in-depth individual views and experiences of stakeholders in podiatry services, 19 patients who had arthritis (osteoarthritis and/or rheumatoid arthritis) participated in one of four focus groups. In addition, seven commissioners and/or GPs took part in semi structured interviews. A purposive sampling strategy was adopted for all focus groups and semi structured interviews. To account for geographical variations, the focus groups and semi structured interviews were conducted across two predetermined regions of the United Kingdom (UK), Yorkshire and Hampshire. Data was rendered anonymous and transcribed verbatim. Thematic analysis was employed to identify key meanings and report patterns within the data. Results: Five key themes derived from the focus groups and interviews suggest a variety of factors influencing referral, access and provision of treatment for foot problems within the UK. 1. Systems working together (navigation of different care pathways, access and referral opportunities for people with OA or RA, education around foot health services for people with OA or RA); 2.Finance (financial variations, different care systems, wasting resources); 3. Understanding what podiatry services have to offer (podiatrists are leaders in foot health services, service requirements in relation to training standards and health needs); 4. Person factors of foot pain (arthritis is invisible, affects quality of life, physical and mental wellbeing); 5. Facilitators of foot care (NICE guidelines, stakeholder events, supporting self-management strategies). Conclusion: The findings indicate that patients, commissioners and GPs have very similar experiences of referral, access and provision of treatment for foot problems, for patients living with arthritis. Essentially, commissioners and GPs interviewed called for a transformational approach in current systems to include newer models of care that meet the footcare needs of individual patient circumstances. Patients interviewed called for better signposting and information about the different services available to help them manage their foot health needs. To address this, we have formulated a signposting pack for all stakeholders to help them facilitate access to appropriate clinicians 'at the right time, in the right place' to manage foot health problems. [ABSTRACT FROM AUTHOR]

Diabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a 'postprofessional' group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Oxadiazole replacement of an amide linkage in an RARα agonist template 1 , followed by lead optimisation, has produced a highly potent and selective RARβ agonist 4-(5-(4,7-dimethylbenzofuran-2-yl)-1,2,4-oxadiazol-3-yl)benzoic acid (10) with good oral bioavailability in the rat and dog. This molecule increases neurite outgrowth in vitro and induces sensory axon regrowth in vivo in a rodent model of avulsion and crush injury, and thus has the potential for the treatment of nerve injury. [ABSTRACT FROM AUTHOR]

A ligand-based virtual screening exercise examining likely bioactive conformations of AM 580 ( 2 ) and AGN 193836 ( 3 ) was used to identify the novel, less lipophilic RARα agonist 4-(3,5-dichloro-4-ethoxybenzamido)benzoic acid 5 , which has good selectivity over the RARβ, and RARγ receptors. Analysis of the medicinal chemistry parameters of the 3,5-substituents of derivatives of template 5 enabled us to design a class of drug-like molecules with lower intrinsic clearance and higher oral bioavailability which led to the novel RARα agonist 4-(3-chloro-4-ethoxy-5-isopropoxybenzamido)-2-methylbenzoic acid 56 that has high RARα potency and excellent selectivity versus RARβ (2 orders of magnitude) and RARγ (4 orders of magnitude) at both the human and mouse RAR receptors with improved drug-like properties. This RARα specific agonist 56 has high oral bioavailability (>80%) in both mice and dogs with a good PK profile and was shown to be inactive in cytotoxicity and genotoxicity screens. [ABSTRACT FROM AUTHOR]

Background: Diabetes educators provide self-management education for people living with diabetes to promote optimal health and wellbeing. Their national association is the Australian Diabetes Educators Association (ADEA), established in 1981. In Australia the diabetes educator workforce is a diverse, interdisciplinary entity, with nurses, podiatrists, dietitians and several other health professional groups recognised by ADEA as providers of diabetes education. Historically nurses have filled the diabetes educator role and anecdotally, nurses are perceived to have wider scope of practice when undertaking the diabetes educator role than the other professions eligible to practise diabetes education. The nature of the interprofessional role boundaries and differing scopes of practice of diabetes educators of various primary disciplines are poorly understood. Informed by a documentary analysis, this historical review explores the interprofessional evolution of the diabetes educator workforce in Australia and describes the major drivers shaping the role boundaries of diabetes educators from 1981 until 2017. Methods: This documentary analysis was undertaken in the form of a literature review. STARLITE framework guided the searches for grey and peer reviewed literature. A timeline featuring the key events and changes in the diabetes educator workforce was developed. The timeline was analysed and emerging themes were identified as the major drivers of change within this faction of the health workforce. Results: This historical review illustrates that there have been drivers at the macro, meso and micro levels which reflect and are reflected by the interprofessional role boundaries in the diabetes educator workforce. The most influential drivers of the interprofessional evolution of the diabetes educator workforce occurred at the macro level and can be broadly categorised according to three major influences: the advent of non-medical prescribing; the expansion of the Medicare Benefits Schedule to include rebates for allied health services; and the competency movement. Conclusion: This analysis illustrates the gradual movement of the diabetes educator workforce from a nursing dominant entity, with an emphasis on interprofessional role boundaries, to an interdisciplinary body, in which role flexibility is encouraged. There is however, recent evidence of role boundary delineation at the meso and micro levels. [ABSTRACT FROM AUTHOR]

Background: Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. Method: A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Results: Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly met the needs of the practitioners with whom they worked. However, the resource intensiveness of the traineeship model was acknowledged by most who participated in the programme. Conclusions: This research has demonstrated that the implementation of a PA using a traineeship approach requires good coordination and communication with a number of agencies and staff and substantial resources to support training and supervision. There are added benefits of the new role to the podiatry service in terms of regaining control over podiatric services which was perceived to improve clinical governance and patient pathways. [ABSTRACT FROM AUTHOR]

Occupational therapy pre-registration education stands at the intersection of the fields of health and social care and higher education. UK Government agendas in both fields have seen an increase in the number of students entering with non-traditional academic backgrounds, a group noted to experience particular challenges in negotiating the transition to, and persisting and succeeding within, higher education. Drawing on data from an ongoing longitudinal case study, a Bourdieuian lens is applied to exploring the early educational experiences of a group of these students during their first year of study and highlights a number of key issues, including the high-value status of linguistic capital and its relationship to understanding the rules governing practices within the learning environment, the processes via which students manage to adapt to or interestingly, to resist, the dominant culture of the field, and some of the barriers to finding a foothold and legitimate position within the new field. [ABSTRACT FROM AUTHOR]

Spontaneous and induced uterine contractions in the rat were found to be inhibited by a novel and selective oxytocin receptor antagonist GSK221149A (3R,6R)-3-Indan-2-yI-1-[(1R)-1-(2-methyl-1,3-oxazol-4-yl)-2-morpholin-4-yl-2-oxoethyll-6-[(1S)-1-methylpropyli-2,5-piperazinedione. GSK221149A displayed nanomolar affinity (K = 0.65 nM) for human recombinant oxytocin receptors with >1,400-fold selectivity over human V1a, V1b, and V2 receptors. GSK221149A had similar affinity (Ki = 4.1 nM) and selectivity for native oxytocin receptors from rat and produced a functional, competitive block of oxytocin-induced contractions in isolated rat myometrial strips with a pA2 value of 8.18. Intravenous administration of GSK221149A produced a dose-dependent decrease in oxytocin-induced uterine contractions in anesthetized rats with an 1D50 = 0.27 ± 0.60 mg/kg (corresponding plasma concentrations were 88 ng/ml). Oral administration of GSK221149A (5 mg/kg) was effective in inhibiting oxytocin-induced uterine contractions after single and multiple (4-day) dosing. Spontaneous uterine contractions in late-term pregnant rats (19-21 days gestation) were significantly reduced by intravenous administration of 0.3 mg/kg of GSK221149A. These results provide further evidence that selective oxytocin receptor antagonism may offer an effective treatment for preterm labor. [ABSTRACT FROM AUTHOR]