University of Leeds

About: University of Leeds is a education organization based out in Leeds, United Kingdom. It is known for research contribution in the topics: Population & Context (language use). The organization has 43481 authors who have published 101856 publications receiving 3672065 citations. The organization is also known as: Leeds University.

Guidelines for topical photodynamic therapy: report of a workshop of the British Photodermatology Group

Abstract: Summary Topical photodynamic therapy (PDT) is effective in the treatment of certain non-melanoma skin cancers and is under evaluation in other dermatoses. Its development has been enhanced by a low rate of adverse events and good cosmesis. 5-Aminolaevulinic acid (ALA) is the main agent used, converted within cells into the photosensitizer protoporphyrin IX, with surface illumination then triggering the photodynamic reaction. Despite the relative simplicity of the technique, accurate dosimetry in PDT is complicated by multiple variables in drug formulation, delivery and duration of application, in addition to light-specific parameters. Several non-coherent and coherent light sources are effective in PDT. Optimal disease-specific irradiance, wavelength and total dose characteristics have yet to be established, and are compounded by difficulties comparing light sources. The carcinogenic risk of ALA-PDT appears to be low. Current evidence indicates topical PDT to be effective in actinic keratoses on the face and scalp, Bowen’s disease and superficial basal cell carcinomas (BCCs). PDT may prove advantageous where size, site or number of lesions limits the efficacy and ⁄ or acceptability of conventional therapies. Topical ALA-PDT alone is a relatively poor option for both nodular BCCs and squamous cell carcinomas. Experience of the modality in other skin diseases remains limited; areas where there is potential benefit include viral warts, acne, psoriasis and cutaneous T-cell lymphoma. A recent British Photodermatology Group workshop considered published evidence on topical PDT in order to establish guidelines to promote the efficacy and safety of this increasingly practised treatment modality.

AMEE Guide No. 27: effective educational and clinical supervision

Abstract: Background: This guide reviews what is known about educational and clinical supervision practice through a literature review and a questionnaire survey It identifies the need for a definition and for explicit guidelines on supervision There is strong evidence that, whilst supervision is considered to be both important and effective, practice is highly variable In some cases, there is inadequate coverage and frequency of supervision activities There is particular concern about lack of supervision for emergency and ‘out of hours work’, failure to formally address under-performance, lack of commitment to supervision and finding sufficient time for supervision There is a need for an effective system to address both poor performance and inadequate supervision Supervision is defined, in this guide as: ‘The provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainee’s experience of providing safe and appropriate patient care’ A framework for effective supervision is provided: (1) Effective supervision should be offered in context; supervisors must be aware of local postgraduate training bodies’ and institutions’ requirements; (2) Direct supervision with trainee and supervisor working together and observing each other positively affects patient outcome and trainee development; (3) Constructive feedback is essential and should be frequent; (4) Supervision should be structured and there should be regular timetabled meetings The content of supervision meetings should be agreed and learning objectives determined at the beginning of the supervisory relationship Supervision contracts can be useful tools and should include detail regarding frequency, duration and content of supervision; appraisal and assessment; learning objectives and any specific requirements; (5) Supervision should include clinical management; teaching and research; management and administration; pastoral care; interpersonal skills; personal development; reflection; (6) The quality of the supervisory relationship strongly affects the effectiveness of supervision Specific aspects include continuity over time in the supervisory relationship, that the supervisees control the product of supervision (there is some suggestion that supervision is only effective when this is the case) and that there is some reflection by both participants The relationship is partly influenced by the supervisor’s commitment to teaching as well as both the attitudes and commitment of supervisor and trainee; (7) Training for supervisors needs to include some of the following: understanding teaching; assessment; counselling skills; appraisal; feedback; careers advice; interpersonal skills Supervisors (and trainees) need to understand that: (1) helpful supervisory behaviours include giving direct guidance on clinical work, linking theory and practice, engaging in joint problem-solving and offering feedback, reassurance and providing role models; (2) ineffective supervisory behaviours include rigidity; low empathy; failure to offer support; failure to follow supervisees’ concerns; not teaching; being indirect and intolerant and emphasizing evaluation and negative aspects; (3) in addition to supervisory skills, effective supervisors need to have good interpersonal skills, good teaching skills and be clinically competent and knowledgeable

Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward

Abstract: Physiological track and trigger warning systems (TTs) are used to identify patients outside critical care areas at risk of deterioration and to alert a senior clinician, Critical Care Outreach Service, or equivalent. The aims of this work were: to describe published TTs and the extent to which each has been developed according to established procedures; to review the published evidence and available data on the reliability, validity and utility of existing systems; and to identify the best TT for timely recognition of critically ill patients. Systematic review of studies identified from electronic, citation and hand searching, and expert informants. Cohort study of data from 31 acute hospitals in England and Wales. Thirty-six papers were identified describing 25 distinct TTs. Thirty-one papers described the use of a TT, and five were studies examining the development or testing of TTs. None of the studies met all methodological quality standards. For the cohort study, outcome was measured by a composite of death, admission to critical care, ‘do not attempt resuscitation’ or cardiopulmonary resuscitation. Fifteen datasets met pre-defined quality criteria. Sensitivities and positive predictive values were low, with median (quartiles) of 43.3 (25.4–69.2) and 36.7 (29.3–43.8), respectively. A wide variety of TTs were in use, with little evidence of reliability, validity and utility. Sensitivity was poor, which might be due in part to the nature of the physiology monitored or to the choice of trigger threshold. Available data were insufficient to identify the best TT.

The Monte Carlo method for semiconductor device simulation

Abstract: There can be little doubt that the Monte Carlo method for semiconductor device simulation has enormous power as a research tool. It represents a detailed physical model of the semiconductor material(s), and provides a high degree of insight into the microscopic transport processes. However, if the authority ascribed to Monte Carlo models of devices at 1/spl mu/m feature size is to be maintained for devices below O.1/spl mu/m, modelling of the fundamental physics must be further improved. And if the Monte Carlo method is to be successful as a semiconductor device design tool, the device model must be made more realistic. Success in the industrial sector depends on this, but also on achieving fast run-times optimisation - where the scope and need for ingenuity is now greatest.