The Guinea Pig Club: Forces and factors that revolutionised burns plastic surgery

The ‘Guinea Pig Club’ has been described as the most exclusive club in the world, but the entrance fee is something most men would care not to pay, and the conditions of membership are arduous in the extreme. The Guinea Pig Club was formed in July 1941 to support aircrew who were undergoing reconstructive plastic surgery after receiving burn injuries in the Second World War. This paper will explore the novel surgical techniques employed to treat the Guinea Pig Club members, their experiences at the hospital and their lives after the war and how Sir Archibald McIndoe and the Guinea Pig club members revolutionised burns plastic surgery as we know it today

Mobilité de sexe et réussite scolaire au collégial

Cet article porte sur la vérification de certaines hypothèses relatives au lien entre sexe, identité de genre et réussite scolaire au collégial. Les chercheurs ont fait passer à tous les nouveaux inscrits au cégep d'Alma le questionnaire de BEM validé par Pelletier pour le Québec. Les résultats, exception faite de ce qui concerne les androgynes, semblent confirmer les hypothèses: ils indiquent que c'est le sexe plus que l'identité de genre qui influence la réussite scolaire au collégial et ce sont les étudiantes qui connaissent une véritable « mobilité de sexe » qui réussissent le mieux. Plus qu'une simple prise de distance du message social (transcendance des rôles sociaux de sexe), cette mobilité se traduit par une transgression de ce message social.This article examines various hypotheses describing the relationship between sex, gender identification and success at college. The authors administered the BEM questionnaire, validated in Quebec by Pelletier, to all newly enrolled students at Cegep Alma. The results show that except for androgynes, the hypotheses are confirmed: that sex more than gender identity influences success at college level; and that students who have "sexual mobility" have the highest success rate. This mobility seems to be manifested by a transgression of a social message which is more than a simple removal from this message ("transcendance of social sex roles").Este articulo estudia la verificacion de ciertas hipotesis sobre la relacion entre el sexo, la identidad del género y el éxito académico a nivel preuniversitario. Los investigadores aplicaron el cuestionario BEM, validado para el Québec por Pelletier, a todos los nuevos alumnos del colegio de Aima (Québec). Los resultados parecen confirmar que el sexo, mas que la identidad del género, tiene una influencia sobre el éxito académico a nivel preuniversitario excepto para androginos; y que los estudiantes con una verdadera "movilidad de sexo" obtienen un éxito mayor. Mas que un simple distanciamiento del mensaje social (la transcen-dencia de los papeles sociales del sexo), dicha movilidad se traduce en una transgresion de este mensaje social.Dieser Artikel behandelt die Verifikation gewisser Hypothesen beziiglich der Beziehung zwischen Geschlecht, sexueller Identitàt und Leistung auf dem College. Die Forscher haben aile neue Schiller des College von Alma den von Bern eingefuhrten und von Pelletier fur Quebec validierten Fragebogen ausftillen lassen. Abgesehen von den Zwittern scheinen die Ergebnisse die Hypothesen zu bestâtigen: der Erfolg im College hângt mehr vom Geschlecht ab als von der sexuellen Identitàt; aufierdem haben die Schiilerinnen mit richtiger "geschlechtsbezogener Mobilitât" den grôssten Erfolg. Uber eine einfache Abstandnahme gegeniiber der sozialen Regel (Transzendenz der geschlechtsbezogenen sozialen Rollen-verteilung) hinausgehend wird dièse Mobilitât zu einer Ubertretung dieser sozialen Regel

why are surgical never events still occurring: A Delphi study research sample across NHS England operating theatres.

This paper examines the application of the Surgical Safety Checklist (SSC) within NHS hospital operating theatres England. The aim of the study, through a combination of open-ended questions, was to solicit specific information including views and opinions from operating theatre experts to establish from how the World Health Organisations (WHO) SSC is being applied, and therefore and why intraoperative ‘Never Events’ continue to occur more than a decade after the SSC was introduced. Participants were from the seven regions identified by NHS England. The intention of this paper is not to establish definitively whether the quantitatively identified themes; including a lack of training and engagement with human factors explains the increased presence of intraoperative ‘Never Events’. However, these themes, when subjected to methodological triangulation with the current literature, do appear consistent, and therefore provide an exploratory approach to inform research intended to improve safety in the operating theatre by informing policy and its application to safe practice ultimately towards quality improvements

Indication of insensitivity of planetary weathering behavior and habitable zone to surface land fraction

It is likely that unambiguous habitable zone terrestrial planets of unknown water content will soon be discovered. Water content helps determine surface land fraction, which influences planetary weathering behavior. This is important because the silicate weathering feedback determines the width of the habitable zone in space and time. Here a low-order model of weathering and climate, useful for gaining qualitative understanding, is developed to examine climate evolution for planets of various land-ocean fractions. It is pointed out that, if seafloor weathering does not depend directly on surface temperature, there can be no weathering-climate feedback on a waterworld. This would dramatically narrow the habitable zone of a waterworld. Results from our model indicate that weathering behavior does not depend strongly on land fraction for partially ocean-covered planets. This is powerful because it suggests that previous habitable zone theory is robust to changes in land fraction, as long as there is some land. Finally, a mechanism is proposed for a waterworld to prevent complete water loss during a moist greenhouse through rapid weathering of exposed continents. This process is named a "waterworld self-arrest," and it implies that waterworlds can go through a moist greenhouse stage and end up as planets like Earth with partial ocean coverage. This work stresses the importance of surface and geologic effects, in addition to the usual incident stellar flux, for habitability.Comment: 15 pages, 6 figures, accepted at Ap

Increased insolation threshold for runaway greenhouse processes on Earth like planets

Because the solar luminosity increases over geological timescales, Earth climate is expected to warm, increasing water evaporation which, in turn, enhances the atmospheric greenhouse effect. Above a certain critical insolation, this destabilizing greenhouse feedback can "runaway" until all the oceans are evaporated. Through increases in stratospheric humidity, warming may also cause oceans to escape to space before the runaway greenhouse occurs. The critical insolation thresholds for these processes, however, remain uncertain because they have so far been evaluated with unidimensional models that cannot account for the dynamical and cloud feedback effects that are key stabilizing features of Earth's climate. Here we use a 3D global climate model to show that the threshold for the runaway greenhouse is about 375 W/m$^2$, significantly higher than previously thought. Our model is specifically developed to quantify the climate response of Earth-like planets to increased insolation in hot and extremely moist atmospheres. In contrast with previous studies, we find that clouds have a destabilizing feedback on the long term warming. However, subsident, unsaturated regions created by the Hadley circulation have a stabilizing effect that is strong enough to defer the runaway greenhouse limit to higher insolation than inferred from 1D models. Furthermore, because of wavelength-dependent radiative effects, the stratosphere remains cold and dry enough to hamper atmospheric water escape, even at large fluxes. This has strong implications for Venus early water history and extends the size of the habitable zone around other stars.Comment: Published in Nature. Online publication date: December 12, 2013. Accepted version before journal editing and with Supplementary Informatio

What Are the Real Procedural Costs of Bariatric Surgery? A Systematic Literature Review of Published Cost Analyses

This is the final version. Available on open access from Springer Verlag via the DOI in this recordThis review aims to evaluate the current literature on the procedural costs of bariatric surgery for the treatment of severe obesity. Using a published framework for the conduct of micro-costing studies for surgical interventions, existing cost estimates from the literature are assessed for their accuracy, reliability and comprehensiveness based on their consideration of seven ‘important’ cost components. MEDLINE, PubMed, key journals and reference lists of included studies were searched up to January 2017. Eligible studies had to report per-case, total procedural costs for any type of bariatric surgery broken down into two or more individual cost components. A total of 998 citations were screened, of which 13 studies were included for analysis. Included studies were mainly conducted from a US hospital perspective, assessed either gastric bypass or adjustable gastric banding procedures and considered a range of different cost components. The mean total procedural costs for all included studies was US$14,389 (range, US$7423 to US$33,541). No study considered all of the recommended ‘important’ cost components and estimation methods were poorly reported. The accuracy, reliability and comprehensiveness of the existing cost estimates are, therefore, questionable. There is a need for a comparative cost analysis of the different approaches to bariatric surgery, with the most appropriate costing approach identified to be micro-costing methods. Such an analysis will not only be useful in estimating the relative cost-effectiveness of different surgeries but will also ensure appropriate reimbursement and budgeting by healthcare payers to ensure barriers to access this effective treatment by severely obese patients are minimised.National Institute for Health Research (NIHR

Gliese 581g as a scaled-up version of Earth: atmospheric circulation simulations

We use three-dimensional simulations to study the atmospheric circulation on the first Earth-sized exoplanet discovered in the habitable zone of an M star. We treat Gliese 581g as a scaled-up version of Earth by considering increased values for the exoplanetary radius and surface gravity, while retaining terrestrial values for parameters which are unconstrained by current observations. We examine the long-term, global temperature and wind maps near the surface of the exoplanet --- the climate. The specific locations for habitability on Gliese 581g depend on whether the exoplanet is tidally-locked and how fast radiative cooling occurs on a global scale. Independent of whether the existence of Gliese 581g is confirmed, our study highlights the use of general circulation models to quantify the atmospheric circulation on potentially habitable, Earth-sized exoplanets, which will be the prime targets of exoplanet discovery and characterization campaigns in the next decade.Comment: Accepted by MNRAS. 15 pages, 13 figures. Sample movies of simulations are available at http://www.phys.ethz.ch/~kheng/fms

Eliciting risk preferences that predict risky health behaviour: A comparison of two approaches

Information on attitudes to risk could increase understanding of and explain risky health behaviors. We investigate two approaches to eliciting risk preferences in the health domain, a novel “indirect” lottery elicitation approach with health states as outcomes and a “direct” approach where respondents are asked directly about their willingness to take risks. We compare the ability of the two approaches to predict health-related risky behaviors in a general adult population. We also investigate a potential framing effect in the indirect lottery elicitation approach. We find that risk preferences elicited using the direct approach can better predict health-related risky behavior than those elicited using the indirect approach. Moreover, a seemingly innocuous change to the framing of the lottery question results in significantly different risk preference estimates, and conflicting conclusions about the ability of the indicators to predict risky health behaviors