Showing papers by "Northampton Community College published in 2012"

Worldwide prevalence of red-green color deficiency

Abstract: Literature that describes the prevalence of inherited red-green color deficiency in different populations is reviewed. Large random population surveys show that the prevalence of deficiency in European Caucasians is about 8% in men and about 0.4% in women and between 4% and 6.5% in men of Chinese and Japanese ethnicity. However, the male: female prevalence ratio is markedly different in Europeans and Asians. Recent surveys suggest that the prevalence is rising in men of African ethnicity and in geographic areas that have been settled by incoming migrants. It is proposed that founder events and genetic drift, rather than natural selection, are the cause of these differences.

A systematic review of the evidence of clozapine's anti-aggressive effects.

Abstract: Reducing the risk of violent and aggressive behaviour in patients with schizophrenia remains a clinical priority. There is emerging evidence to suggest that the second-generation antipsychotic, clozapine, is effective at reducing this risk in patients with schizophrenia and some evidence to suggest that it may be best in selected patients. We conducted a systematic literature search in March 2011 of all prospective and retrospective studies, which investigated clozapine's anti-aggressive effects in a variety of mental disorders. The review identified six animal studies, four randomized controlled trials, 12 prospective non-controlled studies and 22 retrospective studies, with four case studies. We found considerable evidence in support of clozapine's ability to reduce violent and aggressive behaviour. Clozapine's anti-aggressive effect was most commonly explored in patients with schizophrenia, with less evidence available for other psychiatric disorders, including borderline personality disorder, autistic spectrum disorders, post-traumatic stress disorder, bipolar disorder and learning disability. There was mixed evidence to address the question of whether or not clozapine was any more effective than other antipsychotics. In the case of schizophrenia, there was evidence to suggest that clozapine's anti-aggressive effect was more marked particularly in those with treatment-resistant illness. Its anti-aggressive effects appeared to be 'specific', being to some extent greater than both its more general antipsychotic and sedative effects. There were significant methodological inconsistencies in the studies we identified, particularly surrounding patient recruitment criteria, the definition and measurement of violence and the lack of randomized, controlled trials. Data on therapeutic monitoring were also limited. Clozapine can reduce violence and persistent aggression in patients with schizophrenia and other psychiatric disorders. It may offer an advantage over other antipsychotics, although perhaps exclusively in the case of traditionally defined 'treatment resistance' or more broadly defined 'complex cases' with co-morbidity. Larger, randomized, blinded, controlled studies with robust characterization of participants, and standardized measures of violence and aggression are, however, needed to fully understand this link and explore the possible mechanisms.

Validating two survey methods for identifying cases of autism spectrum disorder among adults in the community

Abstract: BackgroundThere are no tested methods for conducting epidemiological studies of autism spectrum disorders (ASDs) in adult general population samples. We tested the validity of the Autism Diagnostic Observation Schedule module-4 (ADOS-4) and the 20-item Autism-Spectrum Quotient (AQ-20).MethodRandomly sampled adults aged ⩾16 years were interviewed throughout England in a general population multi-phase survey. The AQ-20 was self-completed by 7353 adults in phase 1. A random subset completed phase 2, ADOS-4 assessments (n=618); the probability of selection increased with AQ-20 score. In phase 3, informant-based Diagnostic Interview Schedule for Social and Communication Disorders (DISCO) and Autism Diagnostic Interview – Revised (ADI-R) developmental assessments were completed (n=56). Phase 1 and 2 data were presented as vignettes to six experienced clinicians (working in pairs). The probability of respondents having an ASD was compared across the three survey phases.ResultsThere was moderate agreement between clinical consensus diagnoses and ADOS-4. A range of ADOS-4 caseness thresholds was identified by clinicians: 5+ to 13+ with greatest area under the curve (AUC) at 5+ (0.88). Modelling of the presence of ASD using 56 DISCO assessments suggested an ADOS-4 threshold in the range of 10+ to 13+ with the highest AUC at ADOS 10+ to 11+ (0.93–0.94). At ADOS 10+, the sensitivity was 1 [95% confidence interval (CI) 0.59–1.0] and the specificity 0.86 (95% CI 0.72–0.94). The AQ-20 was only a weak predictor of ADOS-4 cases.ConclusionsClinically recommended ADOS-4 thresholds are also recommended for community cases: 7+ for subthreshold and 10+ for definite cases. Further work on adult population screening methods is needed.

Barriers and enablers to managing obesity in general practice: a practical approach for use in implementation activities

Abstract: BackgroundIn 2006, the National Institute of Health and Clinical Excellence (NICE) published guidelines for the prevention and management of overweight and obesity. To tailor the implementation of guidelines, information is needed about the prevailing barriers and enablers, and practical methods for identifying barriers and enablers. Aim To uncover and describe barriers and enablers to implementing NICE’s recommendations on the management of obesity in adults in general practice, using practical qualitative methods. MethodsA qualitative study involving semi-structured interviews with seven general practitioners, seven practice nurses and nine overweight or obese patients, exploring their views and experiences on the implementation of NICE guidelines on obesity. The interviews were undertaken and analysed by a health professional with support of a health service researcher; they were recorded and transcribed verbatim and analysed using a thematic framework approach. The analysis described the reported barriers and enablers. Results Barriers included: stigma, cost of private sector services, previous patient experience, practitioners not wanting to take responsibility for obesity management, lack of consistency in care, limited practitioner skills, perceived lack of NHS services and constraints imposed by commissioners. Trust between practitioners and patients, practitioners with the skills and confidence to raise the issue of obesity, practice-based procedures and weight management services being available were perceived as enablers to implementation. ConclusionThis pragmatic study found that there are many barriers to the implementation of NICE guidance on obesity, involving patients, practitioners and support services for primary care.

Label-free slot-waveguide biosensor for the detection of DNA hybridization

Abstract: A finite element method based on the full-vectorial H-field formulation has been employed to achieve the maximum field penetration in the sensing medium of the slot-waveguide-based ring resonator biosensor. The use of nanometer scale guiding structure where optical mode is confined in a low-index region permits a very compact sensor with high optical intensity in the region, which makes it possible to detect minimum refractive index change, and offers higher sensitivities. We analyze the change in effective refractive index of mode, sensitivity, and power confinement of the proposed slot-waveguide-based ring resonator biosensor for the detection of DNA hybridization. The biosensor exhibited theoretical sensitivity of 856 nm per refractive index unit (RIU) and a detection limit of 1.43×10−6 RIU.

The Effect of the Surgical Margins on the Outcome of Patients with Head and Neck Squamous Cell Carcinoma: Single Institution Experience

Abstract: Objective To assess the impact of close or positive surgical margins on the outcome, and to determine whether margin status influence the recurrence rate and the overall survival for patients with head and neck cancers. Methods Records from 1996 to 2001 of 413 patients with primary head and neck squamous cell carcinoma (SCC) treated with surgery as the fi rst line treatment were analysed. Of these patients, 82 were eligible for the study. Patients were followed up for 5 years. Results Patients with margins between 5-10 mm had 50% recurrence rate (RR), those with surgical margins between 1-5 mm had RR of 59% and those with positive surgical margins had RR of 90% ( P =0.004). The 5-year survival rates were 54%, 39% and 10%, respectively ( P =0.002). Conclusions Unsatisfactory surgical margin is an independent risk factor for recurrence free survival as well as overall survival regardless of the other tumor and patient characteristics.

Frequency of Lost Dogs and Cats in the United States and the Methods Used to Locate Them.

Abstract: A cross-sectional national random digit dial telephone interview was conducted between September and November 2010. There were 1,015 households that had owned a dog or cat within the past five years. Of these 817 households owned dogs and 506 owned cats. Fourteen percent of dogs (95% Confidence Interval (CI): 11-16%) and 15% (95% CI: 12-18%) of cats were lost in the past five years. No owner demographic variables were associated with losing a pet. Ninety three percent (95% CI: 86-97%) of dogs and 75% (95% CI: 64-85%) of cats were recovered. For dogs, searching the neighborhood and returning on their own were the most common methods of finding the dog; 14% were found through an identification tag. For cats, returning on their own was most common. Dogs were more likely than cats to be lost more than once. Cats were less likely than dogs to have any type of identification. Knowledge of the successful methods of finding dogs and cats can provide invaluable help for owners of lost pets. Since 25% of lost cats were not found, other methods of reuniting cats and their owners are needed. Collars and ID tags or humane trapping could be valuable approaches.

Preliminary Investigation of Food Guarding Behavior in Shelter Dogs in the United States

Abstract: A survey given to animal shelters across the US reported food bowl guarding as one of the most common reasons for euthanasia and only 34% attempted to modify this guarding behavior. This study identified 96 dogs that guarded their food bowl during an assessment, and then placed them into a home on a modification program. Food guarding behavior was identified as stiffening, gulping, growling, freezing, and/or biting a fake hand during the SAFER® food bowl assessment. Dogs that exhibited guarding behavior over toys were excluded. Follow-up was done at 3 days, 3 weeks, and 3 months post adoption to measure all guarding behavior in the home. Six adopters reported at least one incident involving guarding in the first three weeks, of which only one was around the food bowl. By three months, those adopters reported no guarding behavior except one new occurrence of a dog guarding a rawhide was reported in the third month. For dog identified with food guarding, the return rate to the shelter was 5% and 9% for adult dogs not identified with guarding behavior. Adopters did not comply with at least one aspect of the program, so it is unclear why so little guarding was reported. The key finding is that dogs that guarded their food bowl in the shelter were not guarding their food in their new homes.

Children in Lesbian and Gay Families: Theories and Evidence

Abstract: (1994). Children in Lesbian and Gay Families: Theories and Evidence. Annual Review of Sex Research: Vol. 5, No. 1, pp. 73-100.

Multi-period design of heat exchanger networks

Abstract: Heat exchanger networks are an integral part of chemical processes as they recover available heat and reduce utility consumption, thereby improving the overall economics of an industrial plant. This paper focuses on heat exchanger network design for multi-period operation wherein the operating conditions of a process may vary with time. A typical example is the hydrotreating process in petroleum refineries where the operators increase reactor temperature to compensate for catalyst deactivation. Superstructure based multi-period models for heat exchanger network design have been proposed previously employing deterministic optimisation algorithms, e.g. ( Aaltola, 2002 , Verheyen and Zhang, 2006 ). Stochastic optimisation algorithms have also been applied for the design of flexible heat exchanger networks recently ( Ma et al., 2007 , Ma et al., 2008 ). The present work develops an optimisation approach using simulated annealing for design of heat exchanger networks for multi-period operation. A comparison of the new optimisation approach with previous deterministic optimisation based design approaches is presented to illustrate the utilisation of simulated annealing in design of optimal heat exchanger network configurations for multi-period operation.

Comparative Study of Electrochromic Enhancement of Latent Fingerprints with Existing Development Techniques

Abstract: To address the challenge of capturing latent fingerprint evidence from metal surfaces, a new method of latent fingerprint enhancement based on electrochromic polymer films has recently been developed. Here, we present a study comparing the development and visualization of nonvisible fingerprints on stainless steel substrates using this electrochromic enhancement approach with three classical methods (dusting, wet powder, and cyanoacrylate fuming). Two variants of the electrochromic enhancement method were utilized with polyaniline and poly(3,4-ethylenedioxythiophene) as the electrochromic materials. Fingerprint samples were taken from different donors (varying in age and gender) and were exposed to different environments for systematically varied periods of time (up to 28 days). The environments represent plausible evidential scenarios: left under ambient conditions, washed with aqueous soap solution, washed with acetone, submerged in water, and maintained at elevated temperature. The electrochromic enhancement procedure frequently outperformed the traditional methods, particularly for samples exposed to more challenging histories.

Treatment of chronic anorexia nervosa: a 4‐year follow‐up of adult patients treated in an acute inpatient setting

Abstract: Despite evidence from a number of long-term follow-up studies of anorexia nervosa that nearly 50% of patients eventually make a full recovery, controlled trials of psychotherapy for anorexia nervosa are lacking. Those with severe and enduring problems represent a considerable therapeutic challenge. Thirty-four consecutive adult referrals to the inpatient treatment unit who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for anorexia nervosa were examined pre-admission, post-discharge and 4 years after admission. Characteristics of remitted and non-remitted patients were examined. Secondary analyses considered the differences between patients with anorexia nervosa, restricting type and anorexia nervosa binging/purging type. The findings highlight a number of differences between patients with anorexia nervosa (restricting type) versus anorexia nervosa (binging/purging type) as well as remitted versus non-remitted patients. The use of a comprehensive battery of assessments found that resolution of eating disorder symptomatology was paralleled by improvements in emotional and psychological distress and improvement in body image perception and coping skills. Better results were obtained for those who had continuity of care on an outpatient basis. This pattern is particularly significant given the more 'chronic' nature of the sample that were older, with a higher incidence of binge-eating and purging than previous samples. Results provide some encouragement for the treatment of those adults with anorexia nervosa who typically have less favourable outcomes.

Complications and Owner Assessment of Canine Total Hip Replacement: A Multicenter Internet Based Survey

Abstract: Objective To assess the variables associated with the complications of total hip replacement (THR) and report owner-assessed outcomes, through surgeon-based registration of cases via an online database, informed owner consent, and prospective outcomes assessment using a client-administered clinical metrology instrument. Study Design Prospective case series Animals Dogs (n = 170) Methods Entries into the British Veterinary Orthopaedic Association-Canine Hip Registry (BVOA-CHR) between January 2010 and August 2011 were reviewed. Variables evaluated included dog age, body weight, breed, and indication for THR and prosthesis. Associations between each variable and the incidence of complications were assessed using logistic regression. Additionally, an on-line, owner-administered outcomes assessment questionnaire (modified from the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire) was used to collect data from owners. Results One hundred and seventy cases met the inclusion criteria. Surgical indications included hip dysplasia and coxofemoral osteoarthritis (n = 150), Legg-Calves-Perthes disease (7), coxofemoral luxation (6), fracture (4), slipped capital physis (2), and femoral head and neck ostectomy revision (1). Surgical implants were from 4 systems. The incidence of surgeon-reported complication was 9.4%. No significant association was identified between weight, age, sex, breed, indication for THR, surgical technique and prosthesis, and the incidence of complications. In 82% of the cases, owners described their satisfaction with the outcome of THR as “very good” and a total of 20% complication rate was reported. There was a statistically significant improvement in owner-assessed questionnaire score before and after THR (P < .001). Conclusions The BVOA-CHR offers a novel framework for the prospective studies on THR and on a national/international scale. Initial complication rates from the BVOA-CHR are similar to previous studies.

Time-optimal control of the race car: influence of a thermodynamic tyre model

Abstract: The robustness of an existing numerical method for the time-optimal control of the race car is demonstrated through its application to a model of a Formula 1 car equipped with a simplified thermodynamic tyre model. The tyre model includes a temperature- and frequency-dependent model of road/tyre friction. A lumped parameter approach is used to model the thermodynamics of the various parts of the tyre such as the tread, carcass and inflation gas. The influence of tyre, track surface and ambient temperatures on time-optimal manoeuvring is presented.

Gambling in Britain: A Time of Change? Health Implications from the British Gambling Prevalence Survey 2010

Abstract: Gambling-related harm is a term that is being increasingly used in British policy circles to describe the negative impacts of gambling across a range of areas. It includes focus on the health and psychological impact on the individual but also has more comprehensive reach moving beyond the directly-affected gambler to include their families, wider social networks and community (Responsible Gambling Strategy Board 2010). The social and health costs of problem gambling are potentially large at both individual and societal levels. For instance, adverse health consequences for problem gamblers and their partners include depression, anxiety, insomnia, gastric/intestinal disorders, migraine, and other stress-related disorders (Griffiths 2004). In the UK, monitoring levels of gambling-related harm have focused on measuring the prevalence of problem gambling and estimating how many problem gamblers there are. However, from a public health perspective, this is inadequate. Not only does it fail to recognise the multiplier effect of impact associated with problem gambling, it also does not recognise a further important group of people; those at-risk of developing gambling problems. Int J Ment Health Addiction (2012) 10:273–277 DOI 10.1007/s11469-011-9319-4

A 225mW 28Gb/s SerDes in 40nm CMOS with 13dB of analog equalization for 100GBASE-LR4 and optical transport lane 4.4 applications

Abstract: A key challenge in optical networking is the development of low-power transceivers that interface to optical sub-assemblies (TOSAs & ROSAs). While SiGe technologies are often selected for jitter performance with optical links, especially on the egress path to the transmit optics, lower-power and higher levels of digital integration often result from CMOS approaches [1]. This paper describes a generic CMOS 25-to-30Gb/s SerDes for use within CDR or gearbox applications, targeting the draft requirements of the OIF 28G-VSR standard [2] and suitable for both 100GBASE-LR4/OTL4.4 gearbox and retiming applications, including CFP and CFP2 [3].

Memory in ASD: have we been barking up the wrong tree?:

Abstract: In this theoretical note, possible neural causes of episodic memory impairment in individuals with ASD and currently normal intellectual and linguistic function are considered. The neural causes most commonly argued for are hippocampal or prefrontal cortex dysfunction, associated with impaired neural connectivity. It is argued here that a hippocampal dysfunction hypothesis is weakened by differences in cued recall and paired associate learning in individuals with ASD compared with individuals with developmental or acquired hippocampus-related amnesia, and that recent findings on patients with posterior parietal lesions (PPC) offer a better fit with the dissociation between free and cued recall observed in ASD. The PPC forms part of the default system subserving mindreading, among other functions, and an association between PPC dysfunction and memory impairment in ASD is consistent with recent suggestions that neural disconnectivity within the default system underlies behaviours diagnostic of ASD.

Nutritional management of individuals with Huntington's disease: nutritional guidelines

Abstract: SUMMARY The delivery of good nutritional care is a fundamental element of the management of individuals with Huntington’s disease and all patients with Huntington’s disease will, at some time, need dietary intervention because of the sequela of the disease; yet there are no European nutritional guidelines. The European Huntington’s Disease Network Standards of Care Dietitians Group has brought together expert dietitians from across Europe to produce nutritional guidelines to improve the nutritional management of individuals with Huntington’s disease. The guidelines were developed to promote optimal nutritional screening, assessment and management of individuals throughout all stages of the disease, with the aim of improving the standard of nutritional care delivered. Literature was systematically searched in an attempt to ensure that the recommendations are based on sound evidence and where evidence is lacking, specific guidance is based on consensus expert dietetic opinion. The provision of nutritional care varies widely between countries. Implementation of these nutritional guidelines across Europe should improve the quality of nutritional care delivered to individuals with Huntington’s disease.

Realizing One's Rights under the 1951 Convention 60 Years On: A Review of Practical Constraints on Accessing Protection in Europe

Abstract: Sixty years after the signing of the Geneva Convention, not all refugees are able to access the protection promised, even in signatory States In this article, the authors outline the different constraints preventing refugees from accessing asylum in one European Union Member State These constraints are the difficulty asylum seekers have in entering Greek territory, their difficulties entering the Greek asylum system and finally, problems with the asylum system itself They further argue that such constraints are not unique to Greece

Judging a book by its cover: interface elements that affect reader selection of ebooks

Abstract: Digital library research has demonstrated the impact of content presentation on both search and reading behaviours. In this paper, we scrutinise the influence of ebook presentation on user behaviour, focussing on document thumbnails and the first page view. We demonstrate that flaws in presentation increase the volume of short time-span reading, and reduce the likelihood of long-span reading when compared to other documents. This reflects other patterns of information seeking behaviour that demonstrate increased short-term reading when information content is uncertain, and suggests an ineffective use of reader time on less useful content.

Effective therapeutic milieus in secure services for women: the service user perspective.

Abstract: Background: Women in secure setting represent a group for whom gender sensitive treatments are only emergent. Service users are viewed as participants in treatment developments. However, the opinions of forensic patients have, in contrast to other service users, been under researched.Aims: To identify service users' views of the constituents of an effective therapeutic milieu for women in secure settings and to help identify the extent to which services need to be specifically tailored for women.Method: A qualitative service user-led participatory research approach was used. Two focus groups with service users from low and medium secure settings discussed the ingredients of an effective therapeutic milieu based on their experience of gender-specific treatment. Group transcripts were subjected to thematic analysis.Results: Themes identified covered interpersonal relationships; treatment programming; service user empowerment; the ward as a place of safety; and hope for the future. Participants did not highl...

Long‐term Aβ exposure augments mCa2+‐independent mROS‐mediated depletion of cardiolipin for the shift of a lethal transient mitochondrial permeability transition to its permanent mode in NARP cybrids: a protective targeting of melatonin

Abstract: Mitochondrial dysfunction is a hallmark of amyloid β-peptide (Aβ)-induced neurodegeneration of Alzheimer's disease (AD). This study investigated whether mtDNA T8993G mutation-induced complex V inhibition, clinically associated with neurological muscle weakness, ataxia, and retinitis pigmentosa (NARP), is a potential risk factor for AD and the pathological link for long-term exposure of Aβ-induced mitochondrial toxicity and apoptosis in NARP cybrids. Using noninvasive fluorescence probe-coupled laser scanning imaging microscopy and NARP cybrids harboring 98% mutant genes along with its parental 143B osteosarcoma cells, we demonstrated that Aβ-augmented mitochondrial Ca(2+) (mCa(2+))-independent mitochondrial reactive oxygen species (mROS) formation for a cardiolipin (CL, a major mitochondrial protective phospholipid)-dependent lethal modulation of the mitochondrial permeability transition (MPT). Aβ augmented not only the amount but also the propagation rate of mROS-induced mROS formation to significantly depolarize mitochondrial membrane potential (∆Ψ(m)) and reduce mCa(2+) stress. Aβ-augmented mROS oxidized and depleted CL, thereby enhances mitochondrial fission and movement retardation, which promoted the NARP-augmented lethal transient-MPT (t-MPT) to switch to its irreversible mode of permanent-MPT (p-MPT). Interestingly, melatonin, a multiple mitochondrial protector, markedly reduced Aβ-augmented mROS formation and therefore significantly reduced mROS-mediated depolarization of ∆Ψ(m), fission of mitochondria and retardation of mitochondrial movement to stabilize CL and hence the MPT. In the presence of melatonin, Aβ-promoted p-MPT was reversed to a protective t-MPT, which preserved ∆Ψ(m) and lowered elevated mCa(2+) to sublethal levels for an enhanced mCa(2+)-dependent O(2) consumption. Thus, melatonin may potentially rescue AD patients associated with NARP symptoms.

Engagement in psychosocial treatment: its relationship to outcome and care pathway progress for women in medium-secure settings.

Abstract: Background Engaging patients in treatment in secure settings is a major challenge. Engagement is associated with a shorter length of stay, whereas treatment non-completion is associated with an increased risk of recidivism. Aims The aims of this study were to assess differences between high and low treatment attendees in a women's medium secure unit and to compare progress over the course of their stay. Methods Sixty consecutive admissions to a women's medium secure unit were classified into high and low treatment attendee groups. The two groups were compared in terms of risk behaviours and psychometric measures of symptomatology, impulsivity and personality. Results High treatment attendees had a shortened length of stay, showed less disturbed behaviour and made more progress in terms of a reduction in symptoms overall and traumatic stress symptoms specifically. Low treatment attendees were more likely to have a diagnosis of schizophrenia/schizotypal illness than personality disorder, less likely to be impulsive and more likely to have scores indicative of severe disorder on the personality subscales of the Millon Clinical Multiaxial Inventory—III. Conclusion Attendance at groups in this medium security unit had clear advantages for patients and potential cost savings for services and the community, but we found a subgroup of women who found it difficult to attend. Given the small sample size, we advocate replication, but our findings suggest the following: Implications for practice development of motivational interventions to help patients make a therapeutic alliance more accurate assessment of treatment readiness, to avoid mistimed interventions that are counterproductive more effective deployment of milieu therapeutic approaches to stabilise behaviour at an early stage of hospitalisation abandonment of a ‘one size fits all’ approach to groups for mixed patient populations. More ‘customised’ approaches would allow more appropriate ‘pacing’ of treatment and adaptations of interventions according to need during the treatment course. Copyright © 2012 John Wiley & Sons, Ltd.

Extending psychosocial assessment of patients with psoriasis in the UK, using a self-rateds, web-based survey.

Abstract: Summary Background. Quality of life self-rating using a web-based survey has not previously been evaluated for psoriasis in the UK. Aim. To use an open-access web-based survey to assess the effect of psoriasis on patients’ daily life. Methods. The survey was conducted using a dedicated website endorsed by a UK psoriasis patient charity. Results. In total, 1760 patients (1102 women, 658 men; median age range 40–44 years) assessed their psoriasis using the website. Psoriasis was ‘very’ or ‘extremely’ active in 52%, and 71% had been diagnosed > 10 years previously. Psoriasis had negatively affected the working life of 59% of patients, and the educational performance of 31%. Conclusions. The use of an open-access web-based survey may address potential bias in previous studies, but may itself introduce a bias towards younger patients. This is the first report of a web-based survey of UK patients with psoriasis, providing further recent evidence of how psoriasis affects patients’ lives.