Operative training in otolaryngology in the United Kingdom: A specialist registrar survey

2005 ◽  
Vol 119 (5) ◽  
pp. 356-361 ◽  
Author(s):  
Christos Georgalas ◽  
Edward Hadjihannas ◽  
Khalid Ghufoor ◽  
Paul Pracy ◽  
Michael Papesch

Objective: To assess the current status of operative training for otolaryngology specialist registrars in the United Kingdom.Design: Web-based questionnaire survey.Participants: All otolaryngology specialist registrars in the United Kingdom.Main outcome measures: The overall satisfaction with operative training was assessed as wellas the number of operations performed and level of competency in stage-specific procedures, as defined by the Joint Committee for Higher Specialist Training.Results: Otolaryngology specialist registrars are generally satisfied with the quality of their operative training. The most important predictive factor of satisfaction with operative training was the number of theatre sessions per week. The vast majority of registrars (92 per centby the end of year one, 73 per cent at the end of years two to four) appear to attain all the stage-appropriate surgical competencies during the first four years. However, with respect to the last two years of registrar training, only 26 per cent can perform all the designated (complex) procedures. There are no significant differences between deaneries or geographic regions in the overall satisfaction rates, number of operative sessions, number of operations performedor operative competencies attained.Conclusion: It appears that the Specialist Advisory Committee (SAC) is generally successful in maintaining common operative training standards and providing a homogenous training environment. During the first four years registrars attain an appropriate level of general training while the last two years are mainly devoted to subspecialty interests.

Ultrasound ◽  
2005 ◽  
Vol 13 (4) ◽  
pp. 215-215
Author(s):  
David R. M. Lindsell

An increasing number of medical and surgical specialties are undertaking their own ultrasound scans. This brings challenges to those wishing to perform ultrasound to ensure that they are competent and for those who provide training to be adequately resourced to do this. In the United Kingdom it is proposed that ultrasound training becomes an integral part of the Urology Specialist Registrar (SpR) training programme. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) have defined three levels of minimum training standards and this concept has been embraced by the Royal College of Radiologists in a publication which outlines recommended syllabuses for 10 difference specialties.


2012 ◽  
Vol 10 (Suppl_2) ◽  
pp. S-69-S-74 ◽  
Author(s):  
Stephen G. Bown

Although photodynamic therapy (PDT) has been used successfully to treat an assortment of different types of cancer, it has yet to reach the level of mainstream medicine on either side of the Atlantic. Unsubstantiated claims of PDT’s efficacy in the past may be part of the reason for this. However, perhaps the main obstacle to PDT’s endorsement by conventional medicine is the limited number of high-quality randomized controlled trials (RCTs) comparing it with relevant comparators for all meaningful outcomes, including effectiveness, safety, adverse events, quality of life, survival, and cost. Based on a Health Technology Assessment report on the current status of PDT and consultation with professional groups, specialist societies, and clinical study groups in the United Kingdom, this article explores the current clinical guidelines for use of PDT in cancer treatment and the dearth of supportive data from RCTs.


Author(s):  
Di Long ◽  
Suzanne Polinder ◽  
Gouke J. Bonsel ◽  
Juanita A. Haagsma

Abstract Purpose To assess the test–retest reliability of the EQ-5D-5L and the reworded Quality of Life After Traumatic Brain Injury Overall Scale (QOLIBRI-OS) for the general population of Italy, the Netherlands, and the United Kingdom (UK). Methods The sample contains 1864 members of the general population (aged 18–75 years) of Italy, the Netherlands, and the UK who completed a web-based questionnaire at two consecutive time points. The survey included items on gender, age, level of education, occupational status, household annual income, chronic health status, and the EQ-5D-5L and reworded QOLIBRI-OS instrument. Test–retest reliability of the EQ-5D-5L dimensions, EQ-5D-5L summary index, EQ VAS, reworded QOLIBRI-OS dimensions and reworded QOLIBRI-OS level sum score was examined by Gwet’s Agreement Coefficient (Gwet’s AC) and Intraclass Correlation Coefficient (ICC). Results Gwet’s AC ranged from 0.64 to 0.97 for EQ-5D-5L dimensions. The ICC ranged from 0.73 to 0.84 for the EQ-5D-5L summary index and 0.61 to 0.68 for EQ VAS in the three countries. Gwet’s AC ranged from 0.35 to 0.55 for reworded QOLIBRI-OS dimensions in the three countries. The ICC ranged from 0.69 to 0.77 for reworded QOLIBRI-OS level sum score. Conclusion Test–retest reliability of the EQ-5D-5L administered via a web-based questionnaire was substantial to almost perfect for the EQ-5D-5L dimensions, good for EQ-5D-5L summary index, and moderate for the EQ VAS. However, test–retest reliability was less satisfactory for the reworded QOLIBRI-OS. This indicates that the web-based EQ-5D-5L is a reliable instrument for the general population, but further research of the reworded QOLIBRI-OS is required.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emilia Majsiak ◽  
Magdalena Choina ◽  
Dominik Golicki ◽  
Alastair M. Gray ◽  
Bożena Cukrowska

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.


1968 ◽  
Vol 3 (1) ◽  
pp. 19-37
Author(s):  
Oscar Gish

The factors conditioning immigration to the United Kingdom are analyzed in this article with the view to understand British immigration policy. The volume and place of origin of immigrants, the attitudes held toward immigrants by the British people, the legal and administrative framework placed around immigration, the emigration of highly skilled people from the United Kingdom in more recent years, all these aspects—the author shows—have contributed to the formulation of past governmental decisions and are likely to determine the volume and quality of future British immigration.


10.2196/19749 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e19749
Author(s):  
Laura Elizabeth Tinner ◽  
Eileen Kaner ◽  
Claire Garnett ◽  
Siobhan Mitchell ◽  
Matthew Hickman ◽  
...  

Background In the United Kingdom, despite some downward trends in alcohol use among young people, over one-fifth of young people reported excessive alcohol use in the past month, which is associated with short- and long-term harm to health. Digital interventions to reduce alcohol use, such as websites, among young people present an appealing and cost-effective mode of intervention that can be integrated into the education system. However, relatively few school-based digital alcohol-focused interventions have been developed and evaluated for young people in the United Kingdom. Objective This study aims to develop a novel web-based intervention, Rethink Alcohol, to prevent and reduce excessive alcohol use and related harm among young people aged between 14 and 15 years, and explore the views of young people, teachers, and youth workers in relation to the content, design, and usability of the intervention. Methods Intervention development followed the person-based approach, using theories of social norms and social influence. Qualitative “Think-Aloud” interviews, either one-to-one or paired, were conducted while participants perused and worked through the web-based intervention, talking aloud. Participants included 20 young people (12 female, 8 male), 5 youth workers (4 female, 1 male), 3 teachers (2 male, 1 female), and 1 (male) clinical professional, recruited via youth groups and professional networks. Interviews were audio recorded, transcribed verbatim, and analyzed thematically. Results The prototype web-based intervention included normative feedback, information, a quiz, interactive activities, and scenarios. On a rating scale of impressions from poor (1) to excellent (5), participants gave an average score of 3.6/5. A total of 5 themes were identified: content, credibility of the website, making the website easy to understand, design and navigation, and suitability for the audience. These themes reflected views that the content was interesting, credible, informative, and embodied a neutral and nonjudgmental tone, but stronger messaging was needed regarding social pressures and short-term risks regarding safety and risk behavior alongside clarity around pathways of risk; credibility and trustworthiness of information were critical features, determined in part, by the professionalism of design and referencing of sources of information provided; and messages should be succinct and come to life through design and interactive features. Conclusions Together, the data illustrated the importance and challenge of communicating nuanced alcohol-focused public health messages to young people in concise, clear, nonjudgmental, and appealing ways. Young people report interest in clear, credible, neutral, and interactive messages regarding social pressures and short-term risks of alcohol use via a web-based intervention. There is scope for optimization and feasibility testing of the Rethink Alcohol intervention.


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