Health trends
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The management of operating theatre time is a crucial element in the size of surgical waiting lists, and this paper reports a survey of causes of the cancellation of operations for orthopaedic surgery. The results show that, although the majority of cancellations were due to medical causes, others were the result of extended theatre schedules. These findings suggest that closer co-operation between surgical staff, general practitioners and theatre staff could help to reduce this problem.
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As part of an audit of clinical practice in an orthopaedic unit for elective surgery, a study was made of the causes of cancellation of operations. Despite careful liaison with general practitioners, and a booked admission policy, over 6% of patients were cancelled as unsuitable. The results of this study suggest that the number of cancellations on medical grounds would be reduced by closer liaison with general practitioners, and the establishment of preadmission clinics. Ensuring that only consultants book patients for surgery would also reduce the number of cancellations due to incorrect indications for surgery.
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A music festival was held in July 1989 near Liskeard in Cornwall. This paper comments on some of the organisational problems, and documents the workload of voluntary workers and professional medical agencies serving the festival. ⋯ There were two deaths and one birth at the site. It is suggested that, in addition to the services provided by voluntary agencies, organisers of mass gatherings should provide suitably qualified medical and nursing personnel on site.
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New community-based preventive initiatives are required if a reduction in deliberate self-poisoning is to be achieved. Local epidemiological data can be used in a health education approach, directed at professionals who have the most contact with potential cases of deliberate self-poisoning and also to those people falling within identified high-risk groups. Such initiatives require defined outcome measures and a number are proposed. The implications for data collection on deliberate self-poisoning are discussed.
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A number of reports have suggested that the incidence of deliberate self-harm has been declining since the late 1970s. Most of these findings have emerged from studies of hospital inpatients, but a large proportion of patients are sent home directly from Accident and Emergency Departments. ⋯ It is argued that age-specific trends, based on inpatient statistics, could be distorted by Accident and Emergency discharges. It is recommended that future epidemiological studies of deliberate self-harm include patients who progress no further than the Accident and Emergency Department.