operative complications and therefore the day-case unit is not a suitable place for basic surgical training. All trainees should, however, benefit from experience in the day-case unit."' With the high level of day surgery in the United States much of trainees' teaching there must obviously go on in that setting. One of us (RH) performs 40% of his cataract operations as day cases and finds no real difficulty in teaching junior staff members while so doing. We certainly agree with Alistair R Fielder that this issue must not be used to stem the development of day case cataract surgery. Colin Dryden may be correct in claiming that modern general anaesthesia has many of the benefits associated with local anaesthesia.2 A recent study of cataract surgery comparing general anaesthesia with local anaesthesia found, however, that local anaesthesia was 15 times cheaper in material, led to a faster throughput of patients in the operating theatre, and halved the expenditure on staff (ophthalmologists gave the local anaesthetic).' These are important factors where waiting lists are long or units are competing to obtain contracts for work. Patients' opinions are hard to gauge, but a small study of 24 patients with cataract suggested a preference for local anaesthesia.4
The article considers the impact of new arterial roads on the mobilities of the wealthier inter-war Londoner, and argues that they occasioned an emergent form of automobility that was modern, sensational and exciting for the metropolitan driver, but was also highly dangerous, particularly for pedestrians and cyclists living in suburban homes near these roads.
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