scholarly journals Current challenges for women in orthopaedics

2021 ◽  
Vol 2 (10) ◽  
pp. 893-899
Author(s):  
Maryam Ahmed ◽  
Laura C. Hamilton
Keyword(s):  
Patient Outcomes ◽  
Lessons Learned ◽  
Business Sector ◽  
Left Behind ◽  
Diversity And Inclusion ◽  
The World ◽  
Female Surgeons ◽  
The Common ◽  
The Uk ◽  
The Military

Orthopaedics has been left behind in the worldwide drive towards diversity and inclusion. In the UK, only 7% of orthopaedic consultants are female. There is growing evidence that diversity increases innovation as well as patient outcomes. This paper has reviewed the literature to identify some of the common issues affecting female surgeons in orthopaedics, and ways in which we can address them: there is a wealth of evidence documenting the differences in the journey of men and women towards a consultant role. We also look at lessons learned from research in the business sector and the military. The ‘Hidden Curriculum’ is out of date and needs to enter the 21st century: microaggressions in the workplace must be challenged; we need to consider more flexible training options and support trainees who wish to become pregnant; mentors, both male and female, are imperative to provide support for trainees. The world has changed, and we need to consider how we can improve diversity to stay relevant and effective. Cite this article: Bone Jt Open 2021;2-10:893–899.

The Biggest Computer Programme in the World…Ever!’: Time for a Change in Mindset?

2007 ◽  
Vol 22 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Chris Clegg ◽  
Craig Shepherd
Keyword(s):  
Information Technology ◽  
Lessons Learned ◽  
Computer Programme ◽  
National Programme ◽  
Technology Project ◽  
Business Change ◽  
Wide Range ◽  
The World ◽  
Change Projects ◽  
The Uk

In this paper we offer a critique of The National Programme for Information Technology’ (NPfIT) currently being undertaken in the National Health Service (NHS) in the UK. We begin by offering a brief introduction to the project. Next, we review the lessons learned from a wide range of experience with IT and business change projects and comment on why changes in the NHS are likely to be harder than in most other organizations. We then elaborate the implications of these ideas and identify potential areas for change, with particular focus on the current guiding mindset that this project is about the provision of a technical infrastructure. We argue that this is, thus far, a technology project and question whether the current strategy is the most appropriate way forward to achieve service improvements. We suggest changes in the underlying mindset, along with the leadership, ownership, metrics and labelling of the project.

scholarly journals The Development and Use of Sustainability Criteria in SuRF-UK’s Sustainable Remediation Framework

2018 ◽  
Vol 10 (6) ◽  
pp. 1781 ◽  
Author(s):  
R. Bardos ◽  
Hayley Thomas ◽  
Jonathan Smith ◽  
Nicola Harries ◽  
Frank Evans ◽  
...  
Keyword(s):  
Decision Making ◽  
Land Management ◽  
Lessons Learned ◽  
Fine Tuning ◽  
Contaminated Land ◽  
Sustainability Criteria ◽  
Sustainable Remediation ◽  
The Social ◽  
The World ◽  
The Uk

Sustainability considerations have become widely recognised in contaminated land management and are now accepted as an important component of remediation planning and implementation around the world. The Sustainable Remediation Forum for the UK (SuRF-UK) published guidance on sustainability criteria for consideration in drawing up (or framing) assessments, organised across 15 “headline” categories, five for the environment element of sustainability, five for the social, and five for the economic. This paper describes how the SuRF-UK indicator guidance was developed, and the rationale behind its structure and approach. It describes its use in remediation option appraisal in the UK, and reviews the international papers that have applied or reviewed it. It then reviews the lessons learned from its initial use and the opinions and findings of international commentators, and concludes with recommendations on how the indicator categories might be further refined in the future. The key findings of this review are that the SuRF-UK framework and indicator guidance is well adopted into practice in the UK. It is widely recognised as the most appropriate mechanism to support sustainability-based decision making in contaminated land decision making. It has influenced the development of other national and international guidance and standards on sustainable remediation. However, there is room for some fine tuning of approach based on the lessons learned during its application.

SP5.1.3 Analysis of National Bariatric Surgery Related Clinical Incidents: Lessons Learned and a Proposed Safety Checklist for Bariatric Surgery

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Islam Omar ◽  
Brijesh Madhok ◽  
Chetan Parmar ◽  
Omar Khan ◽  
Michael Wilson ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Significant Proportion ◽  
Lessons Learned ◽  
Learning System ◽  
Left Behind ◽  
High Severity ◽  
Nasogastric Tubes ◽  
The Uk ◽  
Bariatric Surgery Worldwide ◽  
Learning Points

Abstract Background Hundreds of thousands of patient-safety clinical incidents are reported to the National Reporting and Learning System (NRLS) database in the UK every year. The purpose of this study was to identify bariatric surgery-related learning points from these incidents. Methods We analyzed bariatric surgery-related clinical incidents reported to the UK NRLS database between 01 April 2005 and 31st October 2020. The authors used their experience to identify learning themes and design a safety checklist. Results We identified 541 bariatric surgery-related clinical incidents in 58 different themes. Preoperative incidents represented 30.3% (N = 164), intraoperative 38.1% (N = 206), and postoperative accounted for 31.6% (N = 171). In terms of severity of incidents, (150;27.7%) were of high severity, whereas medium and low severity incidents were (244;45.1%) and (147;27.2%) respectively. The most commonly reported high severity theme was failure of thromboprophylaxis (50;9.2%). Intraoperative high severity incidents included 17 incidents of stapling of orogastric/nasogastric tubes or temperature probes, 8 missed needles, 8 broken graspers, and 6 incidents of band parts left behind. Postoperatively, the most commonly reported high severity theme was improper management of diabetes mellitus (35;6.5%). Medications errors represented a significant proportion of the medium severity incidents and included (26;4.8%) incidents of improper or missed prescription of routine medications and anticoagulants preoperatively and (45;8.3%) wrong prescriptions, dosage or prescribing of contraindicated medications postoperatively. Conclusion We identified 58 specific themes of bariatric surgery-related clinical incidents. We proposed specific recommendations for each incidents theme in addition to a bariatric safety checklist to help improve the safety of bariatric surgery worldwide.

scholarly journals Insights into rainfall undercatch for differing raingauge rim heights

2019 ◽  
Vol 50 (6) ◽  
pp. 1564-1576 ◽  
Author(s):  
Katie Muchan ◽  
Harry Dixon
Keyword(s):  
Ground Surface ◽  
Ground Level ◽  
Field Trials ◽  
The World ◽  
The Common ◽  
Operational Practices ◽  
South East England ◽  
The Uk ◽  
A Site ◽  
The Impact

Abstract The measurement of rainfall has a long history, but despite its apparent simplicity it is difficult to quantify accurately. The common installation of raingauges with rims above the ground surface results in a difference between the rainfall caught and the amount reaching ground level, termed undercatch. The UK standard installation of raingauges is for their rim to be sited at 0.305 m above the ground; however, the use of weighing gauges installed at a minimum rim height of 1 m has increased in recent years. The installation of these weighing raingauges raises complex questions of homogeneity in rainfall data across space and time. Here, we investigate the impact of these changes using field trials of commonly deployed UK raingauges at a site in south-east England. This paper discusses the results of the trial, exploring the variation in and potential drivers of undercatch with differing gauge sitings. With varying standards for gauge heights around the world and new rainfall measurement technologies coming to the market all the time, improved understanding of undercatch is needed to inform evolving operational practices and explore the possibility of developing catch correction algorithms to remove arising inhomogeneity in precipitation datasets.

Confidential Enquiries into Maternal Deaths

2020 ◽  
pp. 29-44
Author(s):  
Nuala Lucas ◽  
James Bamber
Keyword(s):  
Maternal Death ◽  
Time Lag ◽  
Developing Nations ◽  
Lessons Learned ◽  
Maternal Deaths ◽  
Healthcare Settings ◽  
The World ◽  
Emerging Patterns ◽  
The Uk ◽  
Causes Of Deaths

The Confidential Enquiries into Maternal Deaths is the longest running audit of maternal mortality in the world. From its inception in 1952 to 2011, triennial reports have been published on the direct and indirect causes of maternal death, with salutatory messages from the care delivered to these mothers. Since 2011, the report has been published annually, to facilitate a more rapid response to emerging patterns of disease and prevent a time-lag in dissemination and learning from cases. The historical trend in causes of deaths is well-described, with mortality figures for the UK and the current themes in lessons learned. Despite this representing UK demographics and healthcare, many of the lessons learnt are applicable in healthcare settings around the world, including developing nations.

scholarly journals Migrating architectures: Palladio’s legacy from Calcutta to New Delhi

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Pilar Maria Guerrieri
Keyword(s):  
Thomas Jefferson ◽  
New Delhi ◽  
Archival Material ◽  
The Us ◽  
The World ◽  
The Subject ◽  
The Common ◽  
Eighteenth And Nineteenth Centuries ◽  
The Uk ◽  
The Relationship

AbstractPalladianism, which originated in Italy, is a style of architecture which spread widely across the world and has been extensively studied. It is known that it migrated to the UK during the eighteenth century at the same time as it did to Germany through Georg Knobelsdorff, to Russia through the work of Charles Cameron and Giacomo Quarenghi, to the US through Thomas Jefferson between the eighteenth and nineteenth centuries, and was adopted in Poland, Sweden, and elsewhere. Palladianism became a tool of politicians and a status symbol for the elites to differentiate themselves from the common man. There are a few studies on the migration and adoption of Palladianism in India, primarily in relation to Calcutta’s architecture between the eighteenth and nineteenth centuries. In particular, there is specific research focusing on Lord Wellesley’s Palladian building programme, frequently highlighting the relationship between Government House, Calcutta and Kedleston Hall in Derbyshire. This essay focuses on the subject of the migration of Palladian architecture and, in particular, on its adoption by the capitals of India, Calcutta and Delhi, on the basis of primary archival material.

FAST in the deployed military setting

2018 ◽  
Vol 164 (5) ◽  
pp. 332-334 ◽  
Author(s):  
Nicholas James Carter ◽  
D Gay
Keyword(s):  
Decision Making ◽  
Patient Outcomes ◽  
Damage Control ◽  
Recent Change ◽  
Portable Ultrasound ◽  
Medical Treatment Facility ◽  
The Uk ◽  
Trauma Bay ◽  
The Military ◽  
Civilian Practice

IntroductionFocused assessment with sonography in trauma (FAST) is historically an effective method of assessing the patient in the trauma bay in order to aid decision-making and optimise patient outcomes. However, in the UK civilian practice, the use of FAST may decline given a recent change in National Institute for Health and Care Excellence guidance as a result of improvement in CT availability and resuscitation techniques.MethodIn the Role 3 Medical Treatment Facility, Camp Bastion, 187 patients with trauma who received FAST in the trauma bay in 2014 were reviewed to determine the accuracy of FAST in the deployed environment.ResultsThe data demonstrates the sensitivity and specificity of FAST to be 75% and 99.3%, respectively.ConclusionsThis study demonstrates that FAST is accurate on operations. FAST is provided by the integrated radiologist as part of damage control radiology, which gives the team leader rapid diagnostic information to improve decision-making and ultimately patient outcomes. CT is heavily utilised in civilian practice; however, the military operates in a different environment often with multiple casualties and limited access to CT, as a result, portable ultrasound will continue to be a valuable tool on operations if used properly. The next challenge is to develop and maintain this high diagnostic accuracy in future deployments where the memories of our prior success may fade.

scholarly journals Struggle for Liberation of the Peoples of Yugoslavia (Belgrade Operation)

2015 ◽  
pp. 76-84
Author(s):  
N. F. Azyasskiy
Keyword(s):  
World War Ii ◽  
Soviet Union ◽  
Armed Forces ◽  
Common Enemy ◽  
The World ◽  
Red Army ◽  
History Of ◽  
The Common ◽  
Balance Of Forces ◽  
The Military

In the military history of our homeland many memorable important dates leading up to the final victory over fascism are forever imprinted. One of these dates is October 20, 1944, the day of the liberation of Belgrade, the capital of Yugoslavia, and the day of completion of the Belgrade operation. This operation was of special significance for the peoples of Yugoslavia and the Soviet Union. It symbolized the military cooperation of the two countries, which at the most difficult times in their history have always been in the same ranks in the struggle against the common enemy. The Red Army and the People's Liberation Army of Yugoslavia (AVNOJ) were actively joined by the troops of the Fatherland Front of Bulgaria. Given the importance of preserving the memory for the present and future generations an example of joint struggle of our people against the common enemy it is necessary to recall the Belgrade offensive in 1944, as one of the most important events in the history of the World War II. Despite the fact that this topic was thoroughly researched in the Soviet and Yugoslav literature there are still contradictory assessments of combat and the strength of the Soviet Armed Forces groups, groups of interacting forces, the balance of forces involved in the operation. The results of the study of the experience of the offensive in the conditions of the Balkan region can be used for comprehensive training of troops, as the region is a source of international tension, both in Europe and in the world as a whole.

Is There One Optimal Medical Treatment and Evacuation Chain for All Situations: “Scoop-and-Run” or “Stay-and-Play”

2008 ◽  
Vol 23 (S2) ◽  
pp. s74-s78 ◽  
Author(s):  
Maarten J.J. Hoejenbos ◽  
John McManus ◽  
Timothy Hodgetts
Keyword(s):  
Emergency Medicine ◽  
Evidence Base ◽  
Lessons Learned ◽  
Medical Emergency ◽  
Medical Systems ◽  
The North ◽  
Emergency Medical ◽  
The World ◽  
Stay And Play ◽  
The Military

AbstractIn 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one “golden” treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization.A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion.Using the different experiences and the outcome of the discussions, it was concluded that there is not one “golden” medical emergency system, there are no “golden” timelines, and no “golden” skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems.The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.

scholarly journals Lessons Learned from Responsibility to Protect (R2P) in Libya

2018 ◽  
Vol 11 (2) ◽  
pp. 97
Author(s):  
Fadhila Inas Pratiwi
Keyword(s):  
Military Intervention ◽  
International Community ◽  
Lessons Learned ◽  
Great Powers ◽  
Responsibility To Protect ◽  
Success Story ◽  
International Aids ◽  
The Third ◽  
The World ◽  
The Military

As a new principle in the world, Responsibility to Protect (R2P) is an obligation on the part of the international community and on the part of the states to protect civilians from mass atrocities by doing several actions like giving international aids, reducing poverty, supporting peacebuilding, educating the population, until military intervention. However, military intervention under R2P norm in Libya produce a counterproductive result which then led the country into civil war. From this background, therefore, the purpose of this article is to examine the implementation of R2P in Libya into four types of lessons learned. The first lesson, R2P is corrupted by great powers that make the military intervention far from its mandate. The second lesson is the inconsistency practice from an R2P military intervention which led to the question of credibility of military intervention in Libya. The third lesson is diplomacy must be prioritized rather than military intervention since that there is an R2P success story without military intervention. The last is the recommendation to implement Responsibility while Protecting (RWP) principle in the R2P framework.Keywords: Responsibility to Protect (R2P), Libya, Diplomacy, Military Intervention, Responsibility while Protecting 

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