This is a repository copy of Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. The Lancet. ISSN 0140-6736 https://doi.org/10.1016/S0140-6736(18)32521-2 eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/
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Implications of all the available evidenceDespite the success of some smaller projects, there was no survival benefit from a national quality improvement programme to implement a care pathway for patients undergoing emergency abdominal surgery. To succeed, large national quality improvement programmes need to allow for differences between hospitals and ensure teams have both the time and resources needed to improve patient care.
Audio. 377 spent talking has been to a great extent out of reach of computer technology. This loss of speech information is all the more striking, given the dominance of the audio medium in influencing communication outcomes regardless of the presence of visual and other media [Oschman and Chapanis 1974]. Furthermore, speech communication fulfills different communicative purposes than text communication and "is especially valuable for the more
A comparative study was carried out on a series of 72 ice-skating and 57 roller skating injuries over a sixteen month period. The average patient age was 20.5 years in the ice-skating group and 16.5 years in the roller skating group.Females predominated in both groups accounting for 72% of ice-skaters injured and 77% of roller skaters injured. Iceskaters sustained more serious injuries than roller skaters as was evident from the significant difference in fracture numbers in the two groups. Ice-skating fractures accounted for 40% of all injuries while roller skating fractures were only 14% of their total injuries. The majority of ice-skating fractures occurred in females. As a result of our study we recommend several preventative measures.
This article aims to discuss the role of deceased donor skin within the treatment of burn injuries with particular reference to the management of major burn disasters. The article begins with a review of wound healing before progressing to outline the development of the current modern day approach to burns surgery from its historical origins and the role of deceased donor skin within this. A detailed review of mass disasters within the UK over the past 29 years provides an indication as to the frequency and extent of mass disasters that might be predicted to occur. Combining this with a recent review of allograft requirements within burns surgery at a regional UK centre allows for more accurate planning and stockpiling of deceased donor skin reserves. UK awareness and emergency preparedness for major burn disasters can thus be improved.
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