659 research outputs found
Evening primrose, southern Utah
No full textPhoto shows an Evening primrose (probably Oenothera caespitosa) in bloom in the Glen Canyon area, southern Uta
Surgical leadership: the British concept
No full textIn the UK all surgeons need to have leadership skills as, despite the increasing importance of team management, the consultant surgeon still has overall responsibility for the patient under their care. Poor care is evident when clinical leadership fails. The UK hospital system is non-hierarchical within the consultant body. The clinical surgical manager in a hospital may not be the most senior clinician and the role will often rotate. The manager may or may not have the characteristics of a leader, and very often surgical leaders in a hospital may have no formal role. They are, however, essential to the functioning of the service. Nationally the roles in which professional leadership may reside are numerous. The country has multiple Surgical Royal Colleges and innumerable specialty associations and sub specialty associations all of which have councils and presidents and the multiple specialty and sub-specialty associations normally will have an annual meeting. In the long term this is probably unsustainable and although consolidation is desirable it is hard to achieve. In summary, good surgical leadership is found in many settings in the UK, some in formal roles within hospitals, some in the colleges and specialty associations and sometimes in individuals with no formal role but the capacity to make things happen.</p
Evening primrose, Hidden Bar Passage
No full textPhoto shows a blooming Evening primrose at Hidden Passage bar, Glen Canyon, Uta
Evening primrose, Glen Canyon
No full textPhoto shows a large number of Evening primrose (probably Oenothera caespitosa) in bloom in a sandy area, probably in Glen Canyon, southern Uta
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A study of John Clare in his historical and political context
No full textAs the title indicates, the basis of the thesis is to set John Clare’s life and work within the context of the social and political history of his time. It is a study that is long overdue. The manner in which topical and political matters were mediated to him and were reflected in his work are analysed. His introduction to the literary and social worlds of Stamford and London is evaluated, and the advantages and disadvantages of patronage assessed. The active and complex political culture of Stamford has been taken into account as this may have affected his later political statements and a growing awareness of his audience. His antagonism to enclosure and the social changes that it engendered are considered. Three major questions that arise from this are addressed. The two local newspapers that Clare is known to have read are used throughout. His correspondence with friends, colleagues and casual correspondents has provided valuable insights as have his poetry and prose writings. Research in the Northamptonshire Record Office has revealed important new information in the form of one book of Enclosure Commissioners’ Minutes dated 1809-14, the first five years of the enclosure of Helpstone, Clare’s native village
Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study
No full textBackground: the outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).Results: a total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.Conclusions: this is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives.</p
Consultants' new contract. Private practice is unlikely to be main cause of long waiting lists
No full textLetters. Colorectal cancer: a cautionary tale. CEA monitoring in colorectal cancer is not a waste of time
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