The impact of teleradiology technology used in the management of neurosurgical emergencies between district general hospitals and tertiary neurosurgical centres is reviewed. Its effect on clinical management such as diagnostic accuracy and the prevention of secondary insults has been shown to be favourable. Problems and possible future developments are also discussed.

A catalytic meta-selective C-H functionalization of 2-phenylpyridines using a range of tertiary halides is described. The protocol is simple to perform and uses commercially available reagents to construct challenging quaternary carbon centres in a regioselective manner. Preliminary studies suggest the C-H functionalization proceeds through a radical process directed via a remote σ-activation.

Stereospecific [3,3]-sigmatropic rearrangement of O-substituted thiocarbamate derivatives of enantiopure allylic alcohols provides allylic thiocarbamates as single enantiomers. Intramolecular arylation by rearrangement of their allyllithium derivatives provides allylic tertiary thiols. Allylation and ring-closing metathesis gives 2,5-dihydrothiophenes containing sulfur-bearing quaternary centres.

The creation of carbon-carbon and carbon-heteroatom bonds by the oxidation of organocuprates is useful in a range of challenging contexts including the formation of biaryl bonds within medium rings, diene synthesis and the coupling of tertiary carbon centres. This tutorial review introduces these applications and recent developments which have served to improve its functional group tolerance an...

RRT is a collaboration between UKOLN and CETIS. CETIS (Centre for Educational Technology and Interoperability Standards http://jisc.cetis.ac.uk/) supports the educational use of technology in tertiary education in the UK. UKOLN (http://www.ukoln.ac.uk/) is a centre of excellence in digital information management, providing advice and services to the library, information and cultural heritage co...

INTRODUCTION The use of the laparoscopic approach in colorectal surgery (LCS) is the subject of active debate. Studies demonstrating its safety and feasibility in tertiary care centres are now available. The aim of this study was to examine the results of LCS performed in a community hospital setting. METHODS We prospectively studied 100 patients who underwent an LCS at the North Bay District...

1Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia. Asir General Directorate of Health Affairs, Asir, Saudi Arabia. Received: 08/04/02; accepted: 29/09/03 ABSTRACT Use of primary health care (PHC) services and satisfaction among elderly people (60 + years) in Asir was studied in 26 PHC centres. They visited PHC centres significantly les...

The shortage of adequate facilities and qualified staff at district and community level means that tertiary eye care services in Viet Nam have been overburdened by high volumes of patients, not all of whom needed tertiary-level care. In Quang Nam province, an additional challenge is the mountainous terrain, which makes travel very difficult. To help reduce the pressure on tertiary centres and i...

The reform of the Polish education system (both lower and higher education) that was carried out in recent years has shown need to improve efficiency schools. Therefore, it is reasonable analyse evaluate educational centres before implementing reforms. Educational units influence development human capital, which should translate into an increase wealth a given region. To our knowledge, there la...

OBJECTIVES To analyse simple national statistics and survival data collected in the central cardiac audit database after treatment for congenital heart disease and to provide long term comparative statistics for each contributing centre. DESIGN Prospective, longitudinal, observational, national cohort survival study. SETTING UK central cardiac audit database. MAIN OUTCOME MEASURES Surviva...