Medical support to Operation CORPORATE

2017 ◽  
Vol 103 (2) ◽  
pp. 83.3-88
Author(s):  
J G Penn-Barwell ◽  
R Jolly ◽  
R Rickard
Keyword(s):  
Decision Making ◽  
Surgical Procedures ◽  
Wound Management ◽  
Falkland Islands ◽  
Medical Support ◽  
Previous Generation ◽  
Management Procedures ◽  
The Future ◽  
The Uk ◽  
Inform Decision Making

AbstractThis article describes the medical support to Operation CORPORATE, and is derived from a range of sources, including surgical operative logbooks, journals and contemporaneous official reports.Eight hundred and fifty-five surgical procedures were performed by deployed medical units between 14 May and 13 July 1982 in support of Op CORPORATE. The rate peaked on the busiest day, 12 June 1982, when 86 operations were performed. The vast majority of operations were wound management procedures, although 20 laparotomies, four thoracotomies and six craniotomies were also performed. The four forward Role 2 (R2) surgical facilities at Ajax Bay, Teal Inlet, Fitzroy and on board SS CANBERRA collectively performed 354 operations.Argentine and British casualties were evacuated from the area of operations on board three Argentine vessels and three British HECLA-class survey ships. Between them, HMSs HECLA, HYDRA and HERALD made a total of nine 1000-NM journeys between the Falkland Islands and Montevideo, Uruguay, caring for a total of 601 patients. From Montevideo, British casualties were transferred by RAF VC-10 back to the UK.Reflection on how a previous generation supported this operation may inform decision-making when similar challenges are faced in the future.

scholarly journals An adaptive two-arm clinical trial using early endpoints to inform decision making: design for a study of sub-acromial spacers for repair of rotator cuff tendon tears

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Nick Parsons ◽  
Nigel Stallard ◽  
Helen Parsons ◽  
Philip Wells ◽  
Martin Underwood ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Rotator Cuff ◽  
Surgical Procedures ◽  
Adaptive Designs ◽  
Operating Characteristics ◽  
Worked Example ◽  
Patient Reported ◽  
Design Characteristics ◽  
Inform Decision Making

Abstract Background There is widespread concern across the clinical and research communities that clinical trials, powered for patient-reported outcomes, testing new surgical procedures are often expensive and time-consuming, particularly when the new intervention is shown to be no better than the standard. Conventional (non-adaptive) randomised controlled trials (RCTs) are perceived as being particularly inefficient in this setting. Therefore, we have developed an adaptive group sequential design that allows early endpoints to inform decision making and show, through simulations and a worked example, that these designs are feasible and often preferable to conventional non-adaptive designs. The methodology is motivated by an ongoing clinical trial investigating a saline-filled balloon, inserted above the main joint of the shoulder at the end of arthroscopic debridement, for treatment of tears of rotor cuff tendons. This research question and setting is typical of many studies undertaken to assess new surgical procedures. Methods Test statistics are presented based on the setting of two early outcomes, and methods for estimation of sequential stopping boundaries are described. A framework for the implementation of simulations to evaluate design characteristics is also described. Results Simulations show that designs with one, two and three early looks are feasible and, with appropriately chosen futility stopping boundaries, have appealing design characteristics. A number of possible design options are described that have good power and a high probability of stopping for futility if there is no evidence of a treatment effect at early looks. A worked example, with code in R, provides a practical demonstration of how the design might work in a real study. Conclusions In summary, we show that adaptive designs are feasible and could work in practice. We describe the operating characteristics of the designs and provide guidelines for appropriate values for the stopping boundaries for the START:REACTS (Sub-acromial spacer for Tears Affecting Rotator cuff Tendons: a Randomised, Efficient, Adaptive Clinical Trial in Surgery) study. Trial registration ISRCTN Registry, ISRCTN17825590. Registered on 5 March 2018.

The Promotion of an Entrepreneurial Culture in Universities

2003 ◽  
Vol 17 (3) ◽  
pp. 219-222 ◽  
Author(s):  
R. D. Handscombe
Keyword(s):  
Decision Making ◽  
Cultural Change ◽  
The Political ◽  
Entrepreneurial Culture ◽  
Web Framework ◽  
The Future ◽  
The Uk ◽  
The Way

This paper reviews the UK government's Science Enterprise Challenge (SEC) initiative, giving particular emphasis to the SEC objective of achieving cultural change. A ‘cultural web’ framework is applied to characterize the political, symbolic and structural issues that need to be addressed if change is to be effected. The author suggests that, if the vision of the future ‘enterprising university’ causes concern, there is a need to analyse assumptions and if necessary change activities. If the vision is acceptable, then the cultural web analysis assists in developing an understanding of the target and enables faster and better decision making on the way.

UK medical support to non-combatant evacuation operations

2019 ◽  
Vol 166 (1) ◽  
pp. 48-51 ◽  
Author(s):  
Giles Nordmann ◽  
N Aye Maung ◽  
P Reavley
Keyword(s):  
Chronic Disease ◽  
Infectious Diseases ◽  
Medical Management ◽  
The Elderly ◽  
Medical Support ◽  
The Future ◽  
The Common ◽  
Witness Statements ◽  
The Uk ◽  
Key Aspects

This review presents the UK Defence Medical Services’ involvement in non-combatant evacuation operations (NEOs) in the last two decades. It examines the key medical lessons identified from those operations from publications and witness statements, and discusses key aspects that medical commanders and clinicians should consider in the future, particularly preparation, training and equipping personnel and units for future NEOs. The majority of those UK medical assets that are likely to deploy on NEOs have little or no NEO training and are ill equipped to deal with the common non-battlefield casualties seen in NEOs. Medical management of the elderly, paediatrics, chronic disease and infectious diseases are particular capability gaps.

scholarly journals The UK and EU Foreign, Security and Defence Policy after Brexit: Integrated, Associated or Detached?

2016 ◽  
Vol 238 ◽  
pp. R43-R50 ◽  
Author(s):  
Richard G. Whitman
Keyword(s):  
Decision Making ◽  
Trade Policy ◽  
Security Policy ◽  
Costs And Benefits ◽  
Defence Policy ◽  
The Future ◽  
Foreign And Security Policy ◽  
Eu Policies ◽  
The Uk ◽  
The Eu

None of the existing models for the future trade policy relationship between the UK and the EU come with a predetermined foreign and security policy relationship. This article assesses how the future EU-UK foreign and security policy relationship might be organised post-Brexit. It provides evaluation of the current EU-UK interrelationship in the fields of the EU's Common Foreign and Security Policy (CFSP) and Common Security and Defence Policy (CSDP) and assesses the degree to which the UK is presently integrated into EU decision-making and implementation. It highlights that the UK needs to determine the degree to which it wants autonomy or even divergence from existing EU policies. The article concludes by rehearsing the costs and benefits of three possible future relationships between the UK and EU foreign, security and defence policy: integrated, associated or detached.

‘Walking on ice’: The future of parole in a risk-obsessed society

2019 ◽  
pp. 136248061988055
Author(s):  
Monica Barry
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Criminal Justice ◽  
High Risk ◽  
Risk Reduction ◽  
The Public ◽  
The Future ◽  
Key Drivers ◽  
The Uk ◽  
Risk Assessment And Management

The aim of risk assessment and management in criminal justice is increasingly about minimizing opportunities to create harm to the public rather than maximizing opportunities to create change in offenders. This seems to be particularly the case in respect of parole, where the balance of public protection with rehabilitation has become increasingly unstable in prioritizing the former. This article examines parole decision making and management within the UK from the perspectives of both high risk offenders on licence and parole professionals. It discusses two key drivers to burgeoning recall rates: the stringency of licence conditions and the propensity of professionals to recall in the name of risk elimination rather than risk reduction. The article concludes that the effectiveness of parole is in question, not least in enabling re-entry and reintegration of high risk prisoners. In particular, the future sustainability of parole itself is deemed to be under threat.

16. Negotiating a ‘future relationship’: EU external relations law

2020 ◽  
pp. 450-478
Author(s):  
Sylvia de Mars
Keyword(s):  
Decision Making ◽  
Transition Period ◽  
International Agreements ◽  
Internal Market ◽  
External Relations ◽  
The Future ◽  
The Uk ◽  
The Eu

This chapter examines the ‘future relationship’ agreement(s) that will apply between the UK and the EU. Following the adoption of the Withdrawal Agreement, the UK will be looking to conclude what the EU terms a ‘future relationship’ agreement with the EU over the course of the transition period. That ‘future relationship’ will address both the conditions under which the UK trades with the EU in the future — or what replaces the internal market — and how the UK and the EU relate to each other diplomatically — or what replaces ‘membership’ of the EU as an institution. The EU Treaties set out clear processes for the conclusion of international agreements between the EU and other countries. The chapter explores what those processes are, considering what powers the EU has to conclude international agreements. It also looks at how decision-making relating to those international agreements takes place within the EU institutions.

The Econocracy

2016 ◽  
Author(s):  
Joe Earle ◽  
Cahal Moral ◽  
Zach Ward-Perkins
Keyword(s):  
Decision Making ◽  
Environmental Sustainability ◽  
Financial Stability ◽  
The Public ◽  
Economic Decision Making ◽  
The Future ◽  
Fit For Purpose ◽  
The Public Sphere ◽  
The Uk ◽  
The Relationship

One hundred years ago the idea of ‘the economy’ didn’t exist. Now, improving ‘the economy’ has come to be seen as one of the most important tasks facing modern societies. Politics and policymaking are increasingly conducted in the language of economics and economic logic increasingly frames how political problems are defined and addressed. The result is that crucial societal functions are outsourced to economic experts. The econocracy is about how this particular way of thinking about economies and economics has come to dominate many modern societies and its damaging consequences. We have put experts in charge but those experts are not fit for purpose. A growing movement is arguing that we should redefine the relationship between society and economics. Across the world, students, the economists of the future, are rebelling against their education. From three members of this movement comes a book that tries to open up the black box of economic decision making to public scrutiny. We show how a particular form of economics has come to dominate in universities across the UK and has thus shaped our understanding of the economy. We document the weaknesses of this form of economics and how it has failed to address many important issues such as financial stability, environmental sustainability and inequality; and we set out a vision for how we can bring economic discussion and decision making back into the public sphere to ensure the societies of the future can flourish.

scholarly journals ‘Brexit’ and the Scots in England: A diaspora facing uncertainty?

2020 ◽  
Vol 29 (3) ◽  
pp. 354-369
Author(s):  
Murray Stewart Leith ◽  
Duncan Sim
Keyword(s):  
Decision Making ◽  
Current Position ◽  
The Future ◽  
Eu Referendum ◽  
The Uk ◽  
The Eu ◽  
Future Position ◽  
Citizenship Identity

Brexit has brought many uncertainties, including the future position of UK-based EU migrants. Our concern is with a much less studied group, albeit one of the largest socio-political sub-groups within England – the Scots. These are migrants who live in a different country but within the same state and recent constitutional decision making has not been kind to them. In 2014, English based Scots had no vote in the independence referendum and in the EU referendum they witnessed Scotland voting significantly differently to England, resulting in ongoing tensions between the UK and Scottish Governments. If Brexit leads to another independence referendum, what are the implications for Scots in England, in terms of their citizenship, identity, and residence in a very different (r)UK? We explore their status in a (r)UK outside the EU, we speculate on whether some might move back or whether, if they remain, they would experience hostility within post-Brexit England. Might the current position of the English Scots tell us something about the future relationship between England and Scotland?

scholarly journals LINKAGE: Factors in selecting a data linkage approach

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Kerina Jones ◽  
David Ford
Keyword(s):  
Decision Making ◽  
Data Science ◽  
Data Linkage ◽  
Population Data ◽  
Ground Truth ◽  
Position Information ◽  
Uk Government ◽  
The Uk ◽  
High Level ◽  
Inform Decision Making

Background The great benefits of linking health datasets for research in the public interest have long been demonstrated. More recently, we are seeing an increase in the availability of wider administrative data, such as employment, education and housing, to add new opportunities for population data science. However, there are challenges to be overcome in selecting a data linkage approach. Main Aim We set out to examine various data linkage approaches, and to formulate some high level questions to inform decision-making. Methods We used published literature to review various data linkage methods in theory and in practical settings. The study was commissioned by the UK Government Statistical Service and a key focus was privacy and confidentiality in data linkage. Results The questions we formulated are based on: Legislative position; Information systems; Nature of datasets; Knowledge-base; Aims and purposes; Ground truth; and Environment. Conclusion There are many factors influencing the selection of a data linkage approach. While not exhaustive, our set of questions covers some of the major ones. The findings of the study are being taken forward by UK Government Statistical Service and government departments to inform decision-making on options for data linkage research and the greater availability of their datasets.

Sign in / Sign up

Export Citation Format

Share Document