Military civilian partnerships: International proposals for bridging the Walker Dip.

The Walker Dip refers to the cycle of the improvement of care for the battle injured soldier over the course of a conflict, followed by the decline in the skills needed to provide this care during peacetime, and the requisite need to relearn those skills during the next conflict. As the operational tempo of the conflicts in Afghanistan and Iraq has declined, concerns have arisen regarding whether US military surgeons are prepared to meet the demands of future conflicts. This problem is not unique to the US military, and allied nations have taken creative steps to address the Walker Dip in their own surgical communities.

Challenges in the training of military surgeons: experiences from Dutch combat operations in southern Afghanistan.

Background: To improve care for battle casualties, we analyzed the surgical workload during the Dutch deployment to Uruzgan, Afghanistan. This surgical workload was compared with the resident surgical training and the pre-deployment medical specialist program.

Methods: Patient data from the trauma registry (2006-2010) at the Dutch Role 2 Medical Treatment Facility (MTF) were analyzed.

Video assisted thoracoscopic surgery (VATS) for pneumothorax: a reason for unscheduled surgery?

Timing of urgent surgery, with full schedules and the businesslike attitude of operating room management, can lead to animated discussions, affecting quality of care and job satisfaction. No publication appears to address the timing of definitive care for a stable, spontaneous, pneumothorax (SP) by unscheduled, or urgent, video assisted thoracoscopic surgery (VATS). We reviewed the literature and describe our series of 38 patients with SP and VATS.

Psychoactive substance use and the risk of motor vehicle accidents.

The driving performance is easily impaired as a consequence of the use of alcohol and/or licit and illicit drugs. However, the role of drugs other than alcohol in motor vehicle accidents has not been well established. The objective of this study was to estimate the association between psychoactive drug use and motor vehicle accidents requiring hospitalisation.