JRSM Short Reports

OBJECTIVE: There have been concerns about the potential increases in operating time associated with the use of individually wrapped presterilized small orthopaedic implants compared with our traditional method of screw banks. We set out to quantify this theory. DESIGN: Prospective experimental study. SETTING: Theatre. PARTICIPANTS: Orthopaedic Surgical Trainees and Theatre Scrub team. MAIN OUTCOME MEASURE: The time taken to complete the operation...

As reported in the 2011 World Drug Report, cocaine is likely to be the most problematic drug worldwide in terms of trafficking-related violence and second only to heroin in terms of negative health consequences and drug deaths. Over a period of 60 years, cocaine evolved from the celebrated panacea of the 1860s to outlawed street drug of the 1920s. As demonstrated by the evolution of cocaine use and abuse in the United Kingdom and United States during this time period, cultural attitudes influenced both the acceptance of cocaine into the medical field and the reaction to the harmful effects of cocaine...

OBJECTIVES: To implement an identification and brief advice (IBA) intervention to detect low-risk/hazardous alcohol consumption. DESIGN: Implementation was guided through the use of quality improvement tools and training. SETTING: This study was conducted over an 18-month period from April 2010 to September 2011 on a 42-bed acute medical unit at a central London acute hospital. PARTICIPANTS: All medical patients over the age of 18 admitted to the acute assessment unit were eligible; any patient unable to provide a medical history either through language barriers or due to illness was excluded...

OBJECTIVE: To assess the incidence and distribution of recreational equestrian injuries seen in the Kent and Sussex region and review the available literature on this subject. DESIGN: This is a retrospective case series with historical controls. SETTING: Kent and Sussex region, England. MAIN OUTCOME MEASUREMENT: Injuries related to horses in the recreational setting. METHODS: Subjects were selected from our acute injury database...

OBJECTIVES: This paper revisits the same cohort of hospital consultants approximately five years after they were first appointed to investigate their reflections on establishing themselves in their role. DESIGN: Mixed methods using a short survey and in-depth semistructured interviews. SETTING: The study was conducted within one Deanery in the North of England. PARTICIPANTS: The same 45 hospital consultants who were invited to participate in the study in 2007 were asked to take part in the second stage of the project in February 2011...

No abstract text is available yet for this article.

OBJECTIVES: To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting. DESIGN: Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice...

Multiple clinical trials have shown that aspirin can reduce all cardiovascular events in primary and secondary prevention and yet there is a large population in whom aspirin fails. This review brings together the evidence and controversies surrounding the definition of 'aspirin treatment failure', its clinical significance and the possible approaches to managing such patients. Several different assays have been developed to measure the biochemical action of aspirin. At present there is no 'gold standard' and there is massive disparity between methods...

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OBJECTIVES: To investigate the importance of incorporating secondary care input to aid commissioning following National Health Service reforms which will see the replacement of Primary Care Trusts with Clinical Commissioning Groups; to determine barriers that might arise given that this issue had been raised during public consultations and to explore ways to improve this input. DESIGN: Qualitative project with semistructured one-to-one interviews which were audio recorded, transcribed and analysed using thematic content analysis by two investigators...

No abstract text is available yet for this article.

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UNLABELLED: The percentage that benefit from medical preventive measures is small but all are exposed to the risk of side effects so most of those harmed would never benefit from their use. There is no expression or acronym to describe the ratio of harm to benefit nor discussion of what level of harm is acceptable for what benefit. Here we describe the harm to benefit ratio (HBR) expressed as number harmed (H) for 100 to benefit (B) and calculated for commonly used medical interventions...

OBJECTIVES: The phrase 'Initial Clinical Experience' in a manuscript's title implies that the described technique offers promise of future clinical relevance. We assessed, using rates of subsequent citations, the actual academic relevance of such articles in comparison to articles not containing the phrase. DESIGN: We searched ISI database for articles that included the studied phrase in their titles between 1975 and 2009 and grouped the results by the related medical specialty...

No abstract text is available yet for this article.

OBJECTIVES: That health is now global is increasingly accepted. However, a 'mismatch between present professional competencies and the requirements of an increasingly interdependent world' has been identified. Postgraduate training should take account of the increasingly global nature of health; this paper examines the extent to which they currently do. DESIGN: Trainees across 11 medical specialties reviewed the content of their postgraduate curriculum. SETTING: Not relevant...