When can I drive? Advising patients when to drive after general surgical procedures

2018 ◽  
Vol 23 (6) ◽  
pp. 239-242
Author(s):  
Steven Dixon ◽  
Sean Woodcock
Keyword(s):  
Surgical Procedures ◽  
Online Survey ◽  
Insurance Companies ◽  
Medical Practitioners ◽  
North East ◽  
The North ◽  
Surgical Trainees ◽  
General Surgeons ◽  
Surgical Teams ◽  
The Uk

Introduction Advising patients when they are medically fit to drive following general surgical procedures is crucial to minimise risk to patients, the general public as road user’s and pedestrians and also avoid negligence claims against medical practitioners. Historically, in the UK, this advice has come from a number of sources including surgeons, general practitioners, insurers and the Driver and Vehicle Licensing Agency (DVLA). The aim of this study was to review how current surgical teams distribute this advice and what this advice is based upon. Materials and methods An online survey was devised and distributed to all consultant general surgeons and trainees in the North East of England via email. Leading vehicle insurance companies and the DVLA were contacted to assess what advice they gave for specific procedures (ventral hernia, appendicectomy, cholecystectomy, fundoplication). Results A total of 135 surveys were distributed, 56 were returned, with a response rate of 41.5%. Twenty-two (39.3%) of respondents were consultants, 30 (53.6%) were speciality trainees (ST3-8) and 4 (7.1%) were core surgical trainees (CT1-2). Some (14.2%) gave driving advice to every patient, 39.3% gave advice to most patients; 42.9% gave advice pre-operatively in clinic, 39.3% gave the advice pre-operatively on the day of surgery, and 96.4% of responders based their advice on traditional teaching. Discussion and conclusions: There is variation in the content and timing of advice regarding driving after general surgical procedures. This inconsistency will undoubtedly lead to incorrect information being distributed to patients and will impact post-operative patient safety. We suggest formulating consistent advice in a written format, standardising the process which in turn will protect patients and surgeons.

Negative attitudes to cyclists affect road space given to them: variation in drivers’ perceptions of adequate space when overtaking a cyclist on the road

2021 ◽  
Author(s):  
Tamsin Saxton ◽  
Andrew Thorp
Keyword(s):  
Online Survey ◽  
Big Five Personality ◽  
Negative Attitudes ◽  
The Road ◽  
Perceptions Of Risk ◽  
Driving Anger ◽  
North East ◽  
The North ◽  
On The Road ◽  
The Uk

Cycling has individual and collective benefits, and thus various initiatives have attempted to increase cycling uptake. Motivations and intentions around cycling can be influenced by perceptions of risk and safety, which can be derived in part from the overtaking manoeuvres of other road users. Yet we know little about the systematic variables between drivers that might give rise to differences in their overtaking of cyclists. Accordingly, we investigated how people’s personality and attitudinal variables covary with their perceptions of adequate space when overtaking cyclists. We recruited 386 participants (including 349 regular drivers and 114 regular cyclists) from networks within the UK (particularly the north-east of England) who completed an online survey where we assessed their Big Five personality traits, attitudes to cyclists, driving anger, optimism, and their perceptions of the acceptability of overtaking manoeuvres by drivers passing cyclists on roads, depicted in photographs. We found that people evaluated a greater number of overtaking manoeuvres as more acceptable in particular if they had more negative views of cyclists, and also if they did not cycle regularly, and if they reported more driving anger. People often report negative attitudes towards cyclists, but attitudes are subject to change, and future work could investigate whether encouraging drivers to view cyclists more positively could also reduce drivers’ close-pass overtaking manoeuvres.

scholarly journals Patient Experiences of Postinfectious Olfactory Dysfunction

ORL ◽  
2021 ◽  
pp. 1-5
Author(s):  
Carl M Philpott ◽  
James Boardman ◽  
Duncan Boak
Keyword(s):  
Online Survey ◽  
Unmet Need ◽  
Olfactory Dysfunction ◽  
Treatment Modalities ◽  
Medical Practitioners ◽  
Clinical Trials Unit ◽  
New Treatment ◽  
The Uk ◽  
Patients Experience ◽  
Age Range

<b><i>Introduction:</i></b> To highlight the importance of the need for new treatment modalities, this study aimed to characterise the experience of patients with postinfectious olfactory dysfunction (PIOD) in terms of the treatment they received. <b><i>Methods:</i></b> An online survey was hosted by the Norwich Clinical Trials Unit on the secure REDCap server. Members of the charity Fifth Sense (the UK charity that represents and supports people affected by smell and taste disorders) were invited to participate. <b><i>Results:</i></b> There were 149 respondents, of whom 127 had identified themselves as having (or had) PIOD. The age range of respondents to the survey was 28–85 years, with a mean of 58 ± 12 years, with the duration of their disorder &#x3c;5 years in 63% of cases. Respondents reported experiencing variable treatment with oral and/or intranasal steroids given typically (28%), often with no benefit, but with 50% receiving no treatment whatsoever; only 3% reported undertaking olfactory training. Over two-thirds of patients experience parosmia and, up to 5 years from the onset of the problem, were still actively seeking a solution. <b><i>Conclusion:</i></b> There appears to be a need to encourage greater use of guidelines for olfactory disorders amongst medical practitioners and also to develop more effective treatments for patients with PIOD, where there is clearly an unmet need.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

Information about Antimalarial Chemoprophylaxis in Hospitalised Patients — Is it Adequate?

1997 ◽  
Vol 42 (1) ◽  
pp. 13-15 ◽  
Author(s):  
D. Nathwani ◽  
J Spiteri
Keyword(s):  
Public Health ◽  
Plasmodium Falciparum ◽  
East Coast ◽  
Central Africa ◽  
Public Health Problem ◽  
Oil Boom ◽  
North East ◽  
The North ◽  
Hospitalised Patients ◽  
The Uk

Malaria remains a huge public health problem worldwide, with over 100 million new cases annually, causing one to two million deaths.1 This global problem spills over into the UK, with around 2000 cases of reported annually.2 The proportion of infections due to Plasmodium falciparum (PF) continues to increase and worse still accounts for five to 12 deaths per year. In 1992, Nathwani et al reported the 10 year experience of malaria cases admitted to the Regional Infection Unit, in Aberdeen, Scotland-the “Oil Capital”.3 This study was of interest in that 46% of those British residents who acquired infection had travelled to West or Central Africa on oil related business. The Oil boom of the 1980‘ s appeared to very much centred around Aberdeen and the neighbouring hinterland but did not appear to extend to Dundee which was only 60 miles further down the North-East coast. We, therefore, carried out a retrospective study of patients with malaria admitted to the Regional Infectious Diseases Unit in Dundee over a fifteen year period between 1980 and 1994.

Inequalities in awareness and availability of bereavement services in North-East England

2020 ◽  
pp. bmjspcare-2020-002422
Author(s):  
Donna Wakefield ◽  
Elizabeth Fleming ◽  
Kate Howorth ◽  
Kerry Waterfield ◽  
Emily Kavanagh ◽  
...  
Keyword(s):  
Phase 1 ◽  
Waiting Times ◽  
Financial Strain ◽  
Web Based ◽  
North East ◽  
The North ◽  
Referral Criteria ◽  
National Guidance ◽  
The Uk ◽  
The Impact

ObjectivesNational guidance recommends equality in access to bereavement services; despite this, awareness and availability appears inconsistent. The aim of this study was to explore availability and accessibility of bereavement services across the North-East of England and to highlight issues potentially applicable across the UK, at a time of unprecedented need due to the impact of COVID-19.MethodsPhase 1: an eight item, web-based survey was produced. A survey link was cascaded to all GP practices (General Practitioners) in the region. Phase 2: an email was sent to all services identified in phase 1, requesting details such as referral criteria and waiting times.ResultsAll 392 GP practices in the region were invited to participate. The response rate was 22% (85/392). Twenty-one per cent (18/85) of respondents reported that they do not refer patients, comments included ‘not aware of any services locally’. A total of 36 services were contacted with 72% responding with further information. Most bereavement specific support was reliant on charity-funded services including hospices, this sometimes required a pre-existing link with the hospice. Waiting times were up to 4 months.ConclusionsAlthough multiple different, usually charity-funded services were identified, awareness and accessibility were variable. This survey was conducted prior to the COVID-19 pandemic, where complex situations surrounding death is likely to impact on the usual grieving process and increase the need for bereavement support. Meanwhile, charities providing this support are under severe financial strain. There is an urgent need to bridge the gap between need and access to bereavement services.

scholarly journals Reducing pressure ulcers across multiple care settings using a collaborative approach

2019 ◽  
Vol 8 (3) ◽  
pp. e000409 ◽  
Author(s):  
Julia Wood ◽  
Bob Brown ◽  
Annette Bartley ◽  
Andreia Margarida Batista Custódio Cavaco ◽  
Anthony Paul Roberts ◽  
...  
Keyword(s):  
Pressure Ulcers ◽  
Length Of Hospital Stay ◽  
Community Services ◽  
Care Community ◽  
North East ◽  
The North ◽  
Healthcare Improvement ◽  
The Uk ◽  
Breakthrough Series Collaborative ◽  
The Impact

In the UK, over 700 000 patients are affected by pressure ulcers each year, and 180 000 of those are newly acquired each year. The occurrence of pressure ulcers costs the National Health Service (NHS) more than 3.8 million every day. In 2004, pressure ulcers were estimated to cost the NHS £1.4–£2.4 billion per year, which was 4% of the total NHS expenditure.The impact on patients can be considerable, due to increased pain, length of hospital stay and decreased quality of life. However, it is acknowledged that a significant number of these are avoidable.In early 2015, it was identified that for the North East and North Cumbria region the incidence of pressure ulcers was higher than the national average. Because of this, a 2-year Pressure Ulcer Collaborative was implemented, involving secondary care, community services, care homes and the ambulance service, with the aim of reducing the percentage of pressure ulcers developed by patients within their care.The Breakthrough Series Collaborative Model from the Institute for Healthcare Improvement provided the framework for this Collaborative.In year 1, pressure ulcers were reduced by 36%, and in year 2 by 33%, demonstrating an estimated cost saving during the lifespan of the Collaborative of £513 000, and a reduction in the number of bed days between 220 and 352.

scholarly journals Training Australian General Surgeons for Humanitarian Emergencies: A Comparison Between Trainee Logbooks and Emergency Medical Team Caseloads

2019 ◽  
Vol 34 (s1) ◽  
pp. s3-s3
Author(s):  
Charles Coventry ◽  
Lynette Dominquez ◽  
David Read ◽  
Miguel Trelles ◽  
Rebecca Ivers ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
The Philippines ◽  
Fracture Repair ◽  
Orthopedic Procedures ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Surgical Trainees ◽  
General Surgeons ◽  
Low And Middle Income

Introduction:Emergency medical teams (EMTs) have helped to provide surgical care in many recent sudden onset disasters (SODs), especially in low- and middle-income countries (LMICs). General surgical training in Australia has undergone considerable change in recent years, and it is not known whether the new generation of general surgeons is equipped with the broad surgical skills needed to operate as part of EMTs.Aim:To analyze the differences between the procedures performed by contemporary Australian general surgeons during training and the procedures performed by EMTs responding to SODs in low- and middle-income countries (LMICs).Methods:General surgical trainee logbooks between February 2008 and January 2017 were obtained from General Surgeons Australia. Operating theatre logs from EMTs working during the 2010 earthquake in Haiti, 2014 typhoon in the Philippines, and 2015 earthquake in Nepal were also obtained. These caseloads were collated and compared.Results:A total of 1,396,383 procedures were performed by Australian general surgical trainees in the study period. The most common procedure categories were abdominal wall hernia procedures (12.7%), cholecystectomy (11.7%), and specialist colorectal procedures (11.5%). Of note, Caesarean sections, hysterectomy, fracture repair, specialist neurosurgical, and specialist pediatric surgical procedures all made up <1% of procedures each. There were a total of 3,542 procedures recorded in the EMT case logs. The most common procedures were wound debridement (31.5%), other trauma (13.3%), and Caesarean section (12.5%). Specialist colorectal, hepato-pancreaticobiliary, upper gastrointestinal, urological, vascular, neurosurgical, and pediatric surgical procedures all made up <1% each.Discussion:Australian general surgical trainees get limited exposure to the obstetric, gynecological, and orthopedic procedures that are common during EMT responses to SODs. However, there is considerable exposure to the soft tissue wound management and abdominal procedures.

scholarly journals Shifting the Goalposts: A Longitudinal Mixed-Methods Study of the Health of Long-Term Incapacity Benefit Recipients during a Period of Substantial Change to the UK Social Security System

2014 ◽  
Vol 43 (2) ◽  
pp. 311-330 ◽  
Author(s):  
KAYLEIGH GARTHWAITE ◽  
CLARE BAMBRA ◽  
JONATHAN WARREN ◽  
ADETAYO KASIM ◽  
GRAEME GREIG
Keyword(s):  
Mixed Methods ◽  
Social Security ◽  
Safety Net ◽  
Health State ◽  
Disabled People ◽  
Welfare Benefits ◽  
North East ◽  
The North ◽  
The Uk

AbstractThe UK social security safety net for those who are out of work due to ill health or disability has experienced significant change, most notably the abolition of Incapacity Benefit (IB) and the introduction of Employment and Support Allowance (ESA). These changes have been underpinned by the assumption that many recipients are not sufficiently sick or disabled to ‘deserve’ welfare benefits – claims that have been made in the absence of empirical data on the health of recipients. Employing a unique longitudinal and mixed-methods approach, this paper explores the health of a cohort of 229 long-term IB recipients in the North East of England over an eighteen-month period, during a time of significant changes to the UK welfare state. In-depth interviews with twenty-five of the survey cohort are also presented to illustrate the lived experiences of recipients. Contributing to debates surrounding the conceptualisation of work-readiness for sick and disabled people, findings indicate IB recipients had significantly worse health than the general population, with little change in their health state over the eighteen-month study period. Qualitative data reinforced the constancy of ill health for IB recipients. Finally, the paper discusses the implications for social policy, noting how the changing nature of administrative definitions and redefinitions of illness and capacity to work can impact upon the lives of sick and disabled people.

Microzooplankton dynamics during the development of the spring bloom in the north-east Atlantic

2005 ◽  
Vol 85 (4) ◽  
pp. 741-753 ◽  
Author(s):  
E.S. Fileman ◽  
R.J.G. Leakey
Keyword(s):  
Developmental Stages ◽  
Spring Bloom ◽  
Mixed Layer Depth ◽  
Grazing Impact ◽  
East Atlantic ◽  
North East ◽  
The North ◽  
Protozoan Community ◽  
Community Growth ◽  
The Uk

Microzooplankton community composition, abundance, biomass and grazing impact were assessed, along with measurements of ciliate growth and mortality, during the onset of the spring bloom in the north-east Atlantic. The study was undertaken as part of the UK Biogeochemical Ocean Flux Study during 1 May to 15 June 1990. The microzooplankton community was composed of protozoans and metazoan developmental stages with respective mixed-layer depth integrated biomass values ranging from 127 to 638 and 74 to 394 mg C m−2. High numbers of aloricate ciliates (up to 35,000 cells l−1) dominated the microzooplankton community during early May prior to the onset of the spring bloom. Ciliate abundance then declined rapidly during mid-May with community growth rates ranging from −0·71 to 0·23 d−1. High abundances of metazoplankton (up to 400 l−1) were also recorded at this time and may have contributed to the decline in ciliate numbers. In late May and early June the protozoan community comprised a more even mix of dinoflagellates, tintinnids and aloricate ciliates. Phytoplankton mortality rates, measured using a dilution technique, ranged from 0·2 to 0·5 d−1. The microzooplankton consumed 8 to 44 μg C l−1 d−1, equivalent to between 16 and 40% of the chlorophyll biomass and 38 and 154% of primary production. These high rates of herbivory reflect the predominance of small (<5 μm in length) phytoplankton cells present throughout the first half of the study and support previous studies demonstrating the microzooplankton to be the main grazers of phytoplankton in the north-east Atlantic. However, there is also evidence that a disparity between predator and prey may have prevented a response by the microzooplankton to rapid increases in phytoplankton biomass and production during the spring bloom.

scholarly journals Mobilising knowledge in public health: reflections on ten years of collaborative working in Fuse, the Centre for Translational Research in Public Health

2020 ◽  
Vol 16 (4) ◽  
pp. 673-685 ◽  
Author(s):  
Peter van der Graaf ◽  
Mandy Cheetham ◽  
Amelia Lake ◽  
Mark Welford ◽  
Rosemary Rushmer ◽  
...  
Keyword(s):  
Public Health ◽  
Collaborative Research ◽  
Knowledge Exchange ◽  
Policy And Practice ◽  
Directional Information ◽  
North East ◽  
The North ◽  
Excellent Research ◽  
The Uk ◽  
Research Centres

Background: Fuse was established in 2008 as one of five public health research centres of excellence in the UK funded by the UK Clinical Research Centres collaboration. The centre works across five universities in the North East of England. This is an innovative collaboration and enables the pooling of research expertise. A prime focus of the centre is not just the production of excellent research, but also its translation into usable evidence, a dual focus that remains uncommon.Aims/objectives: This practice paper outlines Fuse’s approach to knowledge exchange (KE) by reflecting on ten years of collaborative research between academics and policy and practice partners in the North East of England. We will describe the principles and assumption underlying our approach and outline a conceptual model of four steps in Fuse’s KE process to develop collaborative research and achieve meaningful impact on policy and practice.Key conclusions: Our model describes a fluid and dynamic approach to knowledge exchange broken down in four steps in the KE process that are concurrent, iterative and vary in intensity over time: awareness raising; knowledge sharing; making evidence fit for purpose; and supporting uptake and implementation of evidence. These steps support the relational context of KE. Relationship building and maintenance is essential for all stages of KE to develop trust and explore the meaning and usefulness of evidence in a multi-directional information flow that supports the co-creating and application of evidence.

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