Naval Narratives of Re-enactment: In Which We Serve and Sea of Fire

This essay examines two narrative examples of the Royal Navy and naval combat on screen, exploring their resemblances in the reenactment of naval history and their portrayal of the past through consistent representational strategies. In Which We Serve (Noel Coward and David Lean, 1942) and Sea of Fire (Ian Duncan, 2007) use deliberate and self-conscious recreations of the past to authenticate their interpretations of British naval history, and evince comparably conservative stances towards the Royal Navy and perceptions of its traditions. The similarity of their narratives, which describe the events leading up to the loss of two Navy destroyers, helps to reveal and reinforce the tonal, structural and stylistic parallels in their depictions. The correspondence in their portrayal of naval combat and the institution of the Royal Navy illustrates the consistencies of representation which characterise the naval war film as a distinctive, definable narrative form. Above all, their commitment to the recreation and reenactment of identifiable historical events underpins their importance in the representation and commemoration of the national, naval past. It is this aspect of both productions which is significant in the exploration of the role of visual representations to construct, affirm and broadcast pervasive and persuasive versions of popular history

Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort

BACKGROUND: Guidelines remain unclear over whether patients with early stage oral cancer without overt neck disease benefit from upfront elective neck dissection (END), particularly those with the smallest tumours. // METHODS: We conducted a randomised trial of patients with stage T1/T2 N0 disease, who had their mouth tumour resected either with or without END. Data were also collected from a concurrent cohort of patients who had their preferred surgery. Endpoints included overall survival (OS) and disease-free survival (DFS). We conducted a meta-analysis of all six randomised trials. // RESULTS: Two hundred fifty randomised and 346 observational cohort patients were studied (27 hospitals). Occult neck disease was found in 19.1% (T1) and 34.7% (T2) patients respectively. Five-year intention-to-treat hazard ratios (HR) were: OS HR = 0.71 (p = 0.18), and DFS HR = 0.66 (p = 0.04). Corresponding per-protocol results were: OS HR = 0.59 (p = 0.054), and DFS HR = 0.56 (p = 0.007). END was effective for small tumours. END patients experienced more facial/neck nerve damage; QoL was largely unaffected. The observational cohort supported the randomised findings. The meta-analysis produced HR OS 0.64 and DFS 0.54 (p < 0.001). // CONCLUSION: SEND and the cumulative evidence show that within a generalisable setting oral cancer patients who have an upfront END have a lower risk of death/recurrence, even with small tumours. // CLINICAL TRIAL REGISTRATION: NIHR UK Clinical Research Network database ID number: UKCRN 2069 (registered on 17/02/2006), ISCRTN number: 65018995, ClinicalTrials.gov Identifier: NCT00571883

Warrior nurse: duality and complementarity of role in the operational environment

Aim. This paper is a report of a study to explore the nature of military nursing in an environment of war, in particular the union of personal, professional and organizationaltenets and to identify the actual or potential effect this had on the nursing role in this unique environment. Background. The history of nursing is intrinsically linked with war. There is an irony to this relationship. Active involvement with military activities has provided a vehicle in which nursing has developed, albeit through fostering war, which itself destroys health and contravenes the ethos of nursing. Military nurses, one would assume, are able to reconcile the dichotomy existing between their caring role and being a member of an organization associated with conflict. Methods. A grounded theory design was adopted and the data were collected from 1999 to 2002 using a series of in-depth interviews and focus group with of 24 military nurses. Findings. Three categories were identified: ‘It’s Just Different Levels’, ‘That Double Hat’ and ‘It’s Who We Are!’ The first illustrates the reality of conflict. ‘That Double Hat’ outlines the military nurses dual role: those of caring and the military. ‘It’s Who We Are!’ demonstrates the transition from nurse-to-warrior. These integrate to create the core category: ‘Caring for War: Transition to Warrior’. Conclusion. The symbiotic relationship of carer and warrior arises as a consequence of strategies used by military nurses to embrace their dual role. Further research is needed to explore the essence of the caring role within a conflict zone from military and civilian perspectives