Should the NHS be privatized? Annual varsity medical debate - London, 22nd January 2010

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract The Varsity Medical Debate, between Oxford and Cambridge Universities, brings together practitioners and the public, professors, pupils and members of the polis, to facilitate discussion about ethics and policy within healthcare. The motion on privatizing the National Health Service (NHS) was specifically chosen to reflect the growing sentiment in the UK where further discourse upon models of healthcare was required. Time and again, the outcome of British elections pivots upon the topic of financial sustainability of the NHS. Having recently celebrated its sixtieth anniversary, the NHS has become heavily politicized in recent months, especially in the aftermath of the devastating global recession.Published versio

Training safer orthopedic surgeons Construct validation of a virtual-reality simulator for hip fracture surgery

BACKGROUND AND PURPOSE: Virtual-reality (VR) simulation in orthopedic training is still in its infancy, and much of the work has been focused on arthroscopy. We evaluated the construct validity of a new VR trauma simulator for performing dynamic hip screw (DHS) fixation of a trochanteric femoral fracture. PATIENTS AND METHODS: 30 volunteers were divided into 3 groups according to the number of postgraduate (PG) years and the amount of clinical experience: novice (1–4 PG years; less than 10 DHS procedures); intermediate (5–12 PG years; 10–100 procedures); expert (> 12 PG years; > 100 procedures). Each participant performed a DHS procedure and objective performance metrics were recorded. These data were analyzed with each performance metric taken as the dependent variable in 3 regression models. RESULTS: There were statistically significant differences in performance between groups for (1) number of attempts at guide-wire insertion, (2) total fluoroscopy time, (3) tip-apex distance, (4) probability of screw cutout, and (5) overall simulator score. The intermediate group performed the procedure most quickly, with the lowest fluoroscopy time, the lowest tip-apex distance, the lowest probability of cutout, and the highest simulator score, which correlated with their frequency of exposure to running the trauma lists for hip fracture surgery. INTERPRETATION: This study demonstrates the construct validity of a haptic VR trauma simulator with surgeons undertaking the procedure most frequently performing best on the simulator. VR simulation may be a means of addressing restrictions on working hours and allows trainees to practice technical tasks without putting patients at risk. The VR DHS simulator evaluated in this study may provide valid assessment of technical skill

The first South American free online virtual morphology laboratory: creating history

Fil: Ávila, Rodolfo Esteban . Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Samar, María Elena. Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Metcalfe, David. University Hospital Coventry & Warwickshire. Warwick Medical School; United Kingdoom.Fil: Evans, Jessica. Kingston Hospital. Department of Surgery. Kingston upon Thames; United Kingdoom.Fil: Abrahams, Peter H. University Hospital Coventry & Warwickshire. Warwick Medical School; United Kingdoom.Fil: Sugand, Kapil. Imperial College. MSk Lab; United Kingdoom.Biomedical teaching has been revolutionized through multimedia and global collaboration. In a joint effort between Argentina and the UK, a Virtual Laboratory has been created for teaching mor- phological topics interactively pertaining to cell biology, histology and embryology intended for Health Science students at the National University of Cordoba, Argentina. Aim: To observe whether the online resource has changed the attitudes of student-users and offers a suitable replacement to traditional labora- tory work. Methods: Through a central website that has evolved for almost a decade and most likely the first of its kind on the continent, the virtual laboratory program was launched and students were recruited to participate in a basic survey on the significance of the virtual laboratory program to their learning needs, attitudes to using electronic media and whether they agreed that classroom teaching should be obsolete altogether. Results: 291 student-users were recruited in the academic year of 2010. 267, of whom 92% used the virtual laboratory as a principal tool for learning. The online virtual practical work-guide de- signed by faculty was the most commonly used supplementary resource. A minority of students still pre- ferred to supplement their learning by traditional methods such as books and classroom notes as well as external online resources. Conclusion: Our interactive virtual program was unanimously preferred as the principle learning tool for morphological sciences. The Virtual Laboratory, using popular electronic mul- timedia and inter-continental partnership, will enhance all aspects of biomedical education as a unique teaching resource in South America.http://www.scirp.org/journal/PaperInformation.aspx?PaperID=36717info:eu-repo/semantics/publishedVersionFil: Ávila, Rodolfo Esteban . Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Samar, María Elena. Universidad Nacional de Córdoba. Facultad de Odontología; Argentina.Fil: Metcalfe, David. University Hospital Coventry & Warwickshire. Warwick Medical School; United Kingdoom.Fil: Evans, Jessica. Kingston Hospital. Department of Surgery. Kingston upon Thames; United Kingdoom.Fil: Abrahams, Peter H. University Hospital Coventry & Warwickshire. Warwick Medical School; United Kingdoom.Fil: Sugand, Kapil. Imperial College. MSk Lab; United Kingdoom.Otras Ciencias de la Salu

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years