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28 Haziran 2014 Cumartesi

Hi-vis vests search industrious and existence-saving. No wonder politicians adore them | Andrew Martin

Chancellor George Osborne And Prime Minster David Cameron Visit Manchester

Now you see them … David Cameron and George Osborne go large-vis in Manchester this week. Photograph: Christopher Furlong/Getty Photos




In July 1964, the Railway Magazine reported that 15 platelayers operating on the Pollokshields to Eglinton Street line in the Scottish Region of British Railways had been issued with “a new variety of illuminous safety jacket which shines in half-light conditions”. In the absence of a photograph, the magazine strained to clarify this bizarre phenomenon to its readers. The jackets, “made from a fluorescent orange plastic material”, were “comparable in appearance to previous-fashioned ships’ lifejackets”. The writer speculated that these “human fire-fly jackets may possibly be adopted throughout British Railways”.


This is regarded as the first reference in British – and perhaps planet – journalism to high-visibility vests. Practically exactly 50 many years on, they have been adopted not only throughout our railways, but also the entirety of British society. A brief automobile drive across north London this week was met with the following substantial-vis action: two BT engineers fiddling with wires at a junction box wore them, as did a man pushing a black steel trolley along the pavement (his bearing a slogan: “Positive we can”). I stopped at a targeted traffic light up coming to a locked bike with a substantial-vis vest wrapped loosely about the crossbar. The owner was strolling away. It would have been fascinating to meet him, considering that he must be a combination of the prudent (betokened by his ownership of the vest) and the reckless (it was simply nickable from exactly where he’d left it). I was then passed by a guy sporting higher-vis who was driving a van marked “the indoor garden specialists”.


The question of what indoor gardening includes was a lot more pressing in my mind than why this kind of a practitioner may put on a substantial-visibility vest. Soon after all, when I parked my car and entered a shop selling work outfits in purchase to request the proprietor who bought higher-vis vests these days, he stated. “Anybody undertaking perform.” When I asked if revenue of them went up 12 months on year, he explained: “Yeah,” in the bored tone of someone questioning when he would ultimately be asked an interesting query. So I attempted the following: “What sort of men and women put on large-vis vests now but wouldn’t have worn them a few years ago?” “Absolutely everyone,” he stated. I pressed him for an example. “Window cleaners,” he said. “Why would a window cleaner want a large-vis vest?” I wondered. “Properly,” said the shopkeeper, “he’s walking down the street with his bucket and his ladder and he bumps into a person.” “But that,” I countered, “would be an argument for the man or woman he bumped into wearing higher-vis, not the window cleaner himself.” The shopkeeper did not consider a lot of that stage, and I wondered regardless of whether he believed that absolutely everyone who presently does not wear a substantial-vis vest as a matter of course ought to do so in buy to be observed by all the individuals who do put on them.


If so, he could not be bothered to express the view, his complacency perhaps attributable to the fact that he is riding that by no means-ending upward product sales curve. Everybody concerned in high-vis says the very same thing about the product sales, which tends to make me wonder why I’m not in the company myself. The rise can be traced back to the Well being and Security at Work Act 1974, which requires employers to guard against likely risks, and there is no cheaper way of guarding against hazards than to problem high-vis vests, which retail for three or 4 quid and are no doubt considerably less expensive wholesale.


The only gripe of the higher-vis traders is that substandard clothing comes on to the market place, without the CE mark denoting compliance with the European Neighborhood directive for Personalized Protective Products. Officially made vests conform to Class two of the European regular. Class one is substantial-vis trousers. These and a vest worn with each other turn into Class three, the highest attainable higher-vis ensemble: a high-vis suit, in truth. Both trousers and suits combine fluorescence with what is described as “retro reflective tape”. That is not “retro” as in vintage – a conscious reversion to some earlier, far more eye-catching type of high-vis – but as in bouncing light back from, say, auto headlights.


A good deal can be – and is – said towards large-vis clothing. It truly is not trendy. The Mitchell and Kenyon archive films showed us that Edwardian guys digging holes in the road wore dark suits with ties or neckerchiefs, which gave them a sort of dusky elegance. If a high-vis vest and shorts was a great appear for a postman, then why is not Postman Pat – who definitely sets the industry regular – so attired?


The substantial-vis vest is usually worn in location of the quasi-military uniforms of the past. I mean that it really is worn not so a lot to make the wearer conspicuous as to betoken authority. When I asked a single safety clothing insider to identify the class of man or woman who may give large-vis a poor identify, he muttered darkly, “stewards”. Rod Liddle has described large-vis as “the symbol of spurious authority”, and I feel the libertarian objection is that large-vis suggests both officialdom and victimhood. The wearer is bossing you about although also embodying the worry that you may possibly, through your sheer stupidity, run him down.


A couple of Darwinian steps from the bumptious steward is the sleek cabinet minister. The orange higher-vis vest worn by George Osborne at Manchester Victoria railway station this week (and not for the very first time) suggested that he personally would be building this high-speed railway for the north he was going on about. But the key was the blue Network Rail hardhat he also wore. Blue hat means visitor. White hat indicates “cleared for track accessibility”.


The high-vis wearer can also seem wimpish. My nearby publish office sells large-vis vests advertised by a image of a fluorescent household standing in a garden. Any individual scared to go into their personal garden without having wearing high-vis deserves to be struck down by one particular of those hazards high-vis can’t avert: a nice swift bolt of lightning, say.


But the case is diverse with the British employee. Most who disdain high-vis have by no means even worn the visitor hat at a development internet site, and I can’t recall carrying out so myself. But I discover it moving to see that motorway warning indicator “Workmen on the road”, specially when it’s late at night, and I am glad I’m not on the road myself. The sight of the Class 3 high-vis fits assuages my guilt, and I say to the libertarians: these guys are not protected as a collective mass, but as a series of individuals. To give them these fits is the least we as a society can do. It truly is as if they’re wearing spacesuits, which is fitting provided the remoteness of manual perform from most of our lives.


British health and safety in the workplace is the envy of the globe. The Well being and Security Executive press is nicely-armed with graphs displaying how far we have come. In his history of Britain’s railways, Fire and Steam, Christian Wolmar writes that, “in the five many years up to the finish of 1878, the railways killed an average of 682 of their staff each and every year”. In The Nation Railway, David St John Thomas wrote: “On scarcely a mile of track in Britain has a ganger not been run down by an sudden train.” Railway infrastructure jobs are nonetheless comparatively hazardous, but the deaths are in the lower single figures every year. It really is extremely hard to say how a lot this improvement owes to increased visibility. But when, travelling west from Paddington, I see the armies of orange-clad guys constructing Crossrail, I believe of the debt we owe to whoever made human fireflies of individuals 15 platelayers half a century ago.


Andrew Martin’s novel, Night Train to Jamalpur, is published in paperback by Faber &amp Faber on three July. Acquire it for £6.39 at guardianbookshop.co.united kingdom.




Hi-vis vests search industrious and existence-saving. No wonder politicians adore them | Andrew Martin

12 Nisan 2014 Cumartesi

NHS sufferers are missing out on existence-saving robot surgical procedure

Gynaecology roboto

A gynaecologist uses a robot. Photograph: Jean-Paul Chasse/Alamy




New life-saving surgical techniques are not being adopted quickly enough in British hospitals. That is the stark conclusion of a report by the Royal College of Surgeons (RCS) which warns this week that patients are missing out on new procedures because the NHS is failing to set up programmes to promote their use in the UK.


The report, Innovation to Adoption: Successfully Spreading Surgical Innovation, stresses the need to find ways to introduce new surgical techniques as quickly as possible, thus saving lives and helping the NHS to save money.


New surgical techniques – involving robotics, 3D-imaging and lasers – have been developed in recent years, but in many cases have only been introduced in a haphazard manner in British hospitals. This failure to act coherently is now causing concern among surgeons.


“Many patients are not benefiting from ground-breaking procedures, even when surgeons firmly believe that they can save or extend lives. This cannot continue,” said Professor Norman Williams, the RCS president. “We cannot afford to neglect the kind of surgical innovation that has made such a difference to survival and recovery, such as keyhole surgery and advancements in transplant surgery.” He added that the NHS, the government and doctors had to understand how to accelerate innovative surgical practices in the UK.


The point was backed by David Neal, professor of surgical oncology at Cambridge University. “The NHS is the perfect place to test new technologies,” he said. “It covers the whole country and gives us an ideal platform for showing the worth of a new surgical technique. Unfortunately, this is not being done. The NHS does not seem to be able to tackle this sort of thing. Instead, we are relying, in many cases, on tests being done in the US, where there are commercial pressures involved.”


Neal has been involved in using a semi-automated technique known as robot-assisted radical prostatectomy (Rarp) to treat prostate cancer in the UK. “The technique greatly improves a human surgeon’s performance,” said Neal. “Using current methods, a patient is typically in hospital for around five days, while around 20% of them need blood transfusions. With Rarp, they can leave the next day and only about 1% of patients need a transfusion.”


About 200 prostate cancer patients are now being treated every year using the new technique. “That is far to low a figure,” Neal added. “We need to introduce the technique to enough hospitals to treat around 10,000 patients a year, but that is not happening.” He added that the UK needed a network of about 10-15 hospitals where new medical techniques would be taught to surgeons.


The need to promote robots in medicine is seen as being particularly important in future. The first robot procedure was offered to NHS patients in 2004, but the NHS has yet to fund the purchase of a single surgical robot and has relied instead on charities and endowments to provide cash to buy them.


A programme to help surgeons learn keyhole colorectal surgery for patients with bowel cancer and other conditions was set up in 2007. Mark Coleman, a consultant at Plymouth Hospital involved in creating the programme, said: “In 2008, 10% of operations on the colon involved keyhole surgery. Now that figure has reached 50% and the saving for the NHS over that period has been calculated as being around £11m.”




NHS sufferers are missing out on existence-saving robot surgical procedure

13 Mart 2014 Perşembe

US Sufferers A lot more Most likely Than English Patients To Get Existence-Saving Surgical procedure

Individuals with a ruptured abdominal aortic aneurysm (rAAA)– a extremely significant daily life-threatening illness that takes place far more frequently in elderly men– have greater outcomes in the United States than in England, in accordance to a new study published in the Lancet.


Researchers at the University of London compared hospital data from eleven,799 rAAA patients in England with 23,838 rAAA individuals in the U.S. They discovered that U.S. sufferers have been more most likely than English individuals to have a process to repair the rAAA and to survive their hospital keep.



  • The in-hospital mortality rate was 53.05% in the U.S. in contrast with 65.9% in England.

  • A procedure to fix the rAAA, either surgical or endovascular, was performed in 80.43% of the U.S. sufferers compared with 58.45% of the English patients.

  • U.S. sufferers were a lot much more most likely to receive an endovascular restore (20.88% versus eight.54%).


The intervention fee appeared to play a important function in the final result, given that the mortality charge was 41% in each nations amongst the sufferers who obtained an intervention. U.S. patients had shorter hospital stays and have been a lot more likely to be discharged to a skilled nursing facility. These variables could have partly skewed the information to favor the U.S.. The authors did not have entry to thirty-day mortality charges.


In the two nations individuals were at greater risk when they had been admitted to the hospital on a weekend or to smaller sized or non educating hospitals — probably a reflection of the reduced availability of a prompt intervention.


“The large mortality distinction is concerning”, explained co-author Peter Holt in a Lancet press release. “Our data propose that failure to provide proven life-conserving surgical treatment is a important purpose why in-hospital survival for individuals with rAAA is reduce in England.”


The review suffers from the limitations of all observational studies, the variations in between the groups, and the shorter followup period in the U.S., write Martin Björck and Kevin Manian in an accompanying editorial. But, they state, since of the big distinction in final result “the conclusions would probably not have been modified even if these issues had been addressed.”


Nonetheless, they point out, the short-term point of view of the research possibly masks a grimmer view of rAAA: “With present day intensive care, several individuals with rAAA do survive the early postoperative time period, but fail to recover entirely. This is shown by the truth that mortality remains substantial up to 90 days following surgery following rAAA.”


Even though efforts to enhance entry to proper treatment should be encouraged, they publish, appropriate screening and prevention is far more important: “Prevention will prolong the lives of several more patients with AAA in the potential than efforts to improve treatment of ruptured AAA.”



US Sufferers A lot more Most likely Than English Patients To Get Existence-Saving Surgical procedure