This study demonstrates that transformational leadership and contingent reward positively influence leadership efficiency in healthcare researchers. Although we did not show an association between leadership behaviours and research performance metrics, further studies using contextual performance measures at team and organisational levels are required.
We sought to identify national trends in tool and machinery-related hand injuries. Hospital Episodes Statistics data in England from 1998 to 2017 were analysed. Data from our hand unit from 2011 to 2017 were also reviewed to establish the types of tool and machinery causing injury. During the 19-year study period 210,291 admissions occurred as a result of tool and machinery-related injuries. The overall incidence rate and mean age increased. The largest increase in incidence rate was in the oldest age group (75 years+). The incidence rate in children fell. During the period studied, 2150 patients underwent surgery in our unit for tool and machinery-related injuries. The hand was involved in 2069 (96%) of the injuries. Adult injuries were caused by a similar proportion of types of tool or machinery in all age groups. This study demonstrates a clear and sustained trend of increasing incidence of tool and machinery-related injuries in adults. The largest increase is in older patients. Level of evidence: IV
A 7-year-old girl presented with left hip pain and a limp, in the absence of any other systemic features, having recently been treated for a urinary tract infection. Examination revealed limited active hip movements on the left, with a tendency to weight bear on the contralateral side. Biochemical investigations were significant for raised inflammatory markers, and subsequent MRI imaging revealed osteomyelitis of the left pubis and ischium with an associated large soft tissue collection. Treatment was bimodal with surgical drainage and long-term antibiotics. The patient consequently recovered, without significant effect on either growth or mobility.
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