Background Escalating demand for specialist health care puts considerable demand on hospital services. Technology offers a means by which health care providers may increase the efficiency of health care delivery. Objective The aim of this study was to conduct a pilot study of the feasibility, benefits, and drawbacks of a virtual clinic (VC) in the general surgical service of a busy tertiary center. Methods Patient satisfaction with current care and attitudes to VC were surveyed prospectively in the general surgical outpatient department (OPD; n=223). A subset of patients who had undergone endoscopy and day surgery were recruited to follow-up in a VC and subsequently surveyed with regard to their satisfaction (20/243). Other outcomes measured included a comparison of consultation times in traditional and virtual outpatient settings and financial cost to both patients and the institution. Results Almost half of the patients reported barriers to prospective use of VCs. However, within the cohort who had been followed-up in the VC, satisfaction was higher than the traditional OPD (100% as compared with 187/223, 83.9%). Significant savings in both time (P=.003) and financial costs to patients and the institution were found. Conclusions For an appropriately selected group of patients, VCs offer a viable alternative to traditional OPD. This alternative can improve both patient satisfaction and efficiency of patient care.

The historian and critic John Addington Symonds (1840-1893) was the first thinker in Britain to develop an academic model of male homosexual identity. Previous work on Symonds has not fully understood his distinctive blend of scholarship and sexual identity; this article situates Symonds' thinking about homosexuality within a wider context of nineteenth-century ideas about the classics, modern history, ethics, religion, and science. It argues that intellectual and ethical concerns were more fundamental to Symonds' sense of self than sexual expression, and that they shaped his understanding of his own and others' sexuality.

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eds.), Bodies, Sex and Desire from the Renaissance to the Present, Basingstoke: Palgrave Macmillan, 2011. xii + 275 pp (hbk), ISBN 978-0-230-28368-8.This volume, a collection of papers originally presented at a conference at Exeter University in 2007, offers an intriguingly multipaned window into the state of the history of sexuality in the twenty-first century. The articles, by historians and literary critics working in Britain, Europe, and Australia, address issues of continuity and change, the relation between sex and identity, and the extent to which it is possible to use history to understand present attitudes towards sexuality and the body. Above all, they suggest that there is little theoretical consensus about what the history of sexuality is and what it means to practice it.The twelve articles range widely over geographical and temporal as well as theoretical ground. Jennifer Jordan, working with British sources, complicates Thomas Laqueur's reading of early modern understandings of physiological sex; Sarah Toulalan builds upon the work of prominent theorists of childhood as she explores early modern ideas about puberty and childhood sexuality. Semiotics and postmodern literary criticism more generally loom large in Andrew Wells' analysis of sex and race in eighteenth-century anatomy and pornography, in Elizabeth Stephens' reading of nineteenth-century visual medical teaching tools, and in Margaretta Jolly's queer-theoretical approach to the life and work of artist Grayson Perry. Several contributors ground their studies in Foucault: Richard Cleminson and Francisco Va´squez Garcı´a on sexual nonnormativity, biopolitics, and the emergence of a modern state in nineteenth-century Spain; Peter Cryle in his discursive analysis of sexuality in eighteenth-century France; and Lisa Downing, who builds upon Foucault to include the sexualization of death (through avenues such as necrophilia and autoerotic asphyxiation) in a narrative of the history of sexuality as one of regulation and control transitioning from acts to identities. Different still are the approaches of Alison Oram, who here begins to do for the story of transsexuality in twentieth-century Britain what Joanne Meyerowitz has done for that story in the US; Fernanda Alfieri, who offers a historical survey of Catholic views of sex within marriage in early modern Spain and Portugal; Kate Fisher, who takes a social-history approach, grounded in oral testimony, to women's views of marital sexual duty in twentieth-century Britain; and Alison Moore, who presents a compelling intellectual history of attempts to connect Nazism to 'degenerate' sexualities such as homosexuality or sadism.