BackgroundHoney has previously been shown to have wound healing and antimicrobial properties, but this is dependent on the type of honey, geographical location and flower from which the final product is derived. We tested the antimicrobial activity of a Chilean honey made by Apis mellifera (honeybee) originating from the Ulmo tree (Eucryphia cordifolia), against selected strains of bacteria.MethodsUlmo 90 honey was compared with manuka UMF® 25+ (Comvita®) honey and a laboratory synthesised (artificial) honey. An agar well diffusion assay and a 96 well minimum inhibitory concentration (MIC) spectrophotometric-based assay were used to assess antimicrobial activity against five strains of methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli and Pseudomonas aeruginosa.ResultsInitial screening with the agar diffusion assay demonstrated that Ulmo 90 honey had greater antibacterial activity against all MRSA isolates tested than manuka honey and similar activity against E. coli and P. aeruginosa. The MIC assay, showed that a lower MIC was observed with Ulmo 90 honey (3.1% - 6.3% v/v) than with manuka honey (12.5% v/v) for all five MRSA isolates. For the E. coli and Pseudomonas strains equivalent MICs were observed (12.5% v/v). The MIC for artificial honey was 50% v/v. The minimum bactericidal concentration for all isolates tested for Ulmo 90 honey was identical to the MIC. Unlike manuka honey, Ulmo 90 honey activity is largely due to hydrogen peroxide production.ConclusionsDue to its high antimicrobial activity, Ulmo 90 may warrant further investigation as a possible alternative therapy for wound healing.

Background. Pressure ulcers are common, costly and impact negatively on individuals. Pressure is the prime cause, and immobility is the factor that exposes individuals to pressure. International guidelines advocate repositioning; however, there is confusion surrounding the best method and frequency required. Design. A pragmatic, multi-centre, open label, prospective, cluster-randomised controlled trial was conducted to compare the incidence of pressure ulcers among older persons nursed using two different repositioning regimens. Method. Ethical approval was received. Study sites (n = 12) were allocated to study arm using cluster randomisation. The experimental group (n = 99) were repositioned three hourly at night, using the 30°tilt; the control group (n = 114) received routine prevention (six-hourly repositioning, using 90°lateral rotation). Data analysis was by intention to treat; follow-up was for four weeks. Results. All participants (n = 213) were Irish and white, among them 77% were women and 65% aged 80 years or older. Three patients (3%) in the experimental group and 13 patients (11%) in the control group developed a pressure ulcer (p = 0AE035; 95% CI 0AE031-0AE038; ICC = 0AE001). All pressure ulcers were grade 1 (44%) or grade 2 (56%). Mobility and activity were the highest predictors of pressure ulcer development (b = À0AE246, 95% CI = À0AE319 to À0AE066; p = 0AE003); (b = 0AE227, 95% CI = 0AE041-0AE246; p = 0AE006). Conclusion. Repositioning older persons at risk of pressure ulcers every three hours at night, using the 30°tilt, reduces the incidence of pressure ulcers compared with usual care. The study supports the recommendations of the 2009 international pressure ulcer prevention guidelines. Relevance to clinical practice. An effective method of pressure ulcer prevention has been identified; in the light of the problem of pressures ulcers, current prevention strategies should be reviewed. It is important to implement appropriate prevention strategies, of which repositioning is one.

Chronic non healing wounds have an elevated alkaline environment. The acidic pH of Manuka honey makes it a potential treatment for lowering wound pH, but the duration of effect is unknown. Lowering wound pH can potentially reduce protease activity, increase fibroblast activity and increase oxygen release consequently aiding wound healing. The aim of this study was to analyse the changes in surface pH and size of non healing ulcers following application of Manuka honey dressing after 2 weeks. The study was an open label, non randomised prospective study. Patients presenting consecutively with non healing chronic superficial ulcers, determined by aetiology and no reduction in wound size in previous 3 weeks. Single pH measurements recorded using Blueline 27 glass surface electrode and R 315 pH meter set (Reagecon/Alkem, Co. Clare Ireland). Area determined using Visitrak (Smith & Nephew, Mull, UK) digital planimetry. Apinate (Manuka honey) (Comvita, Slough, UK) applied to wounds for 2 weeks after which wounds re-evaluated. Eight males and nine females with 20 ulcers (3 bilateral) were included: venous, 50% (n = 10); mixed aetiology, 35% (n = 7); arterial, 10% (n = 2) and pressure ulcer, 5% (n = 1). Reduction in wound pH after 2 weeks was statistically significant (P < 0.001). Wounds with pH >or= 8.0 did not decrease in size and wounds with pH

There is evidence in the literature to suggest that mental health care staffs' attitudes towards clients with borderline personality disorder (BPD) are less than favourable. This study reports on a survey of psychiatric nurses' knowledge, experience and attitudes towards care received by clients with a diagnosis of BPD. The questionnaire was sent to all clinical nurses (n = 157) working in a psychiatric service in Dublin, Ireland and received a response rate of 41.4% (n = 65). The results indicate that the majority of nurses have regular contact with clients with BPD and nurses on inpatient units reported more frequent contact than nurses in the community. Eighty per cent of nurses view clients with BPD as more difficult to care for than other clients and 81% believe that the care they receive is inadequate. Lack of services was cited as the most important factor contributing to the inadequate care and the development of a specialist service is reported as the most important resource to improve care.

Pressure ulcers are common, costly and impact negatively on individuals. Current practices in prevention show several areas for improvement, namely, risk assessment, care planning and documentation.