Patient perceptions of clear/almost clear skin in moderate-to-severe plaque psoriasis: results of the Clear About Psoriasis worldwide survey.

BACKGROUND: Therapeutic advances have made the achievement of clear/almost clear skin possible for many patients with moderate-to-severe plaque psoriasis. OBJECTIVE: To determine patient perceptions of the impact of psoriasis and of attaining clear/almost clear skin. METHODS: Global survey of patients with moderate-to-severe psoriasis. RESULTS: A total of 8338 patients from 31 countries participated. The majority (57%) had not achieved self-assessed clear/almost clear skin with their current therapy, and 56% of those who had not met this goal believed it would be impossible to do so. Among the patients who had clear/almost clear skin, 73% had not initiated their current treatment until >1 year after psoriasis diagnosis, and 28% had to wait >5 years. Eighty-four percent of all respondents experienced discrimination and/or humiliation due to psoriasis, and many reported negative effects on work, intimate relationships, sleep and mental health. Patients without clear/almost clear skin reported that such achievement would open new possibilities, such as swimming (58%), a wider choice of clothing (40%), and meeting new people (26%). A limitation of this study, as with any survey-based research, is that selection and recall bias may have been present. Additionally, respondent definitions of clear/almost clear skin were subjective and may have varied. CONCLUSION: Despite the importance of clear/almost clear skin to psoriasis patients, most are still not achieving it, and many are unaware it is possible.

Nurses' confidence and pharmacological knowledge: a study.

The introduction of nurse prescribing will assist the government to deliver its agenda of providing patients with faster access to advice and health services. This study evaluated the knowledge base, self-rated knowledge and confidence, for a prescribing role, in a group of community nurses in Essex. A questionnaire was distributed to 183 community nurses recruited using a random, stratified method, and 110 nurses returned completed forms. Nurse prescribers in the sample were more confident and rated their knowledge more highly when compared with non-prescribing nurses. However, prescribers' actual medication-related knowledge, relative to their high levels of confidence, was not confirmed with performance on case scenarios. In responses to the case scenarios, prescribers did not perform as well as non-prescribers on all five analysed scenarios. The overall assessment of the nurses' response to the OTC case scenarios showed a poor performance when compared with prescription cases. There is a need to improve community nurses' levels of confidence and their abilities in coping with medication-related issues at pre-registration and post-registration level.

Optical power filter: a new kind of passive nonlinear-optical device.

We show the possibility of a new kind of passive nonlinear-optical device: an optical power filter made of graded-index single-mode fiber (SMF) and a nonlinear medium (NLM). It is shown that, only for a particular power, the mode in the SMF matches the mode in the NLM. The transmission coefficient from the NLM to the SMF is determined, and it is shown that a laser beam with a particular power can be filtered out.

Transverse-magnetic-polarized nonlinear modes guided by a symmetric five-layer dielectric structure.

TM-polarized nonlinear modes supported by a symmetric five-layer dielectric structure consisting of a nonlinear medium of thickness theta (characterized by the diagonal dielectric tensor (1l) = (22) identical with (0), (33) = (0) + alpha|E(3)|(2), where E(3) is the TE-field component) sandwiched between two linear films of thickness beta (with dielectric constant (1)), which are bounded from the free ends by the same nonlinear medium, are analyzed. Dispersion relations and the expressions for the power flow, derived for the symmetric and antisymmetric modes, show that for a sufficiently large value of beta/lambda, where lambda is the wavelength, these modes should show bistable behavior, provided that power flow is the control parameter.

Propagation of optical pulses through cladded fibers: modified theory.

A realistic theory of propagation of pulses in optical fibers is presented. Time-bounded em pulses, when launched at the entrance aperture of the dispersive fiber, become spatially bounded as well. Following the Fourier technique, expressions for the time-delay difference and the broadening of the pulses are derived for the spatially bounded quasi-monochromatic pulses after they have traversed a known length in the fiber. The present results, when compared with the experimental observations of Smiley et al., show reasonably good agreement and there is marked improvement over the existing theoretical results.