No abstract

It appears that hope is a significant predictor of adjustment to ESRF. Clinical implications of this research are discussed, along with suggestions for future research.

To our knowledge, this is the largest study to date examining ambient temperature association and epistaxis, and the first to investigate presentation rate in place of admission rate. We feel that the exclusion of all patients with epistaxis not admitted to hospital introduces a bias. In this series, there is no correlation between ambient temperature, seasonal preponderance, presentation rate or admission rate for patients with epistaxis. This is contrary to previously reported findings. We do not support the view that there is a relationship between epistaxis and temperature or seasonal variation. This contradicts the current belief that incidence of epistaxis displays seasonality, and has implications for the allocation of resources for healthcare provision within ENT departments.

The only complications in this series were in patients taking anticoagulation medication, undergoing revision surgery, or in whom the laryngeal tissue was atrophic or absent. Careful patient selection to exclude any of the above should reduce the risk of complications. The authors would therefore advocate type one thyroplasty for unilateral or bilateral vocal fold paralysis as a suitable procedure for day-case surgery within our department.

In recent years there has been a push to move away from traditional clinician led on treatment review of radiotherapy patients. Despite this impetus there has been little published work relating to how the new system can be implemented. This article describes how one department implemented a change in direction from the conventional and moved forward with radiographer-led review clinics. The Plan–Do–Check–Act cycle is used as a basis for evaluation with results of a small-scale patient audit and a comparison with other departments in the UK being presented. This method of implementation and evaluation proved successful and may serve as an early model for radiotherapy departments elsewhere.