The Southern General Hospital (SGH) was a large teaching hospital with an acute operational bed complement of approximately 900 beds. The hospital was located in Linthouse in the south west of Glasgow, Scotland. All facilities and services have been succeeded by the Queen Elizabeth University Hospital which was constructed on the site of the old hospital.
In Poland, doctoral education remained outside the mainstream of public policy interest for many years. The 2018 reform is the first major change in the systemic approach to education at this level. Significant deregulation at the national level has introduced new requirements for conducting doctoral education and the need for its new organisation. The reform aimed to decrease the number of doctoral candidates while enhancing the quality and effectiveness of PhD education. For the first time in history, doctoral education has begun to be subject to a real external evaluation of its quality, too. The legal status of PhD candidates was also redefined, aligning them more closely with young researchers. The 2018 Act granted universities considerable autonomy in organising doctoral schools, resulting in diverse structural solutions and management models. Doctoral education is also influenced by the new rules of scientific evaluation and the instability of rules in this area; financing of the science and higher education sector; and first experience in conducting doctoral schools. The paper analyses the adopted system solutions against the background of policy changes in Europe. It also presents the initial conclusions from the implementation of new systemic solutions.
Non-compressible torso hemorrhage (NCTH), leading to exsanguination cardiac arrest, remains the primary cause of preventable death in combat trauma. As the future operational environment shifts toward large-scale combat operations (LSCO) with delayed evacuations and increased casualty volumes, existing damage control strategies may prove inadequate due to limited resources and delayed evacuation. In 1984, US Army Colonel Ronald Bellamy challenged military medicine to develop new interventions for hemorrhagic shock, emphasizing the need for technologies that could ‘buy time’ for evacuation and surgical intervention. Decades later, Emergency Preservation and Resuscitation (EPR), which induces a hypometabolic state through profound hypothermia, offers a potential solution to this problem. This review summarizes the historical evolution of the EPR concept, from early military observations to modern preclinical and clinical advancements in EPR. We explore emerging technologies, such as portable extracorporeal life support systems (eg, MobyBox and CARL), organ perfusion platforms (BrainEx and OrganEx) and adjunctive pharmacologic agents (eg, Frunexian, PEG-20K, TAT-PHLPP9c and mitochondrial transplantation), that can enhance the efficacy of EPR, leading to optimized organ recovery. These innovations provide a foundation for developing resource-expedient EPR capabilities tailored for future battlefields. By synthesizing current evidence and examining the military context of prolonged casualty care, this paper outlines how EPR could meet Bellamy’s challenge and serve as a next-generation tool for combat casualty care. As military medicine prepares for future conflicts, EPR may provide a critical capability to reduce mortality from NCTH and revolutionize combat trauma management in LSCO scenarios.
We study interactions between progressive labor taxation and social security reform. Increasing longevity puts fiscal strain that necessitates the social security reform. The current social security is redistributive, thus providing (at least partial) insurance against idiosyncratic income shocks, but at the expense of labor supply distortions. A reform which links pensions to individual incomes reduces distortions associated with social security contributions, but incurs insurance loss. We show that the progressive labor tax can partially substitute for the redistribution in social security, thus reducing the insurance loss. JEL C68, D72, E62, H55, J26
The EQ-DAPHNIE (EuroQol Data for Assessment of Population Health Needs and Instrument Evaluation) project is a large, multi-country survey initiative designed to generate population norms and enable comparative research using self-reported health measures. This paper describes the quality control processes and summarizes data quality metrics from the United Kingdom (UK) pilot and full implementation across 15 countries. Representative samples were recruited via Dynata, an online survey panel provider, using quota sampling by age, sex, income, community setting, and language (where applicable). The UK pilot (n = 3012) informed survey refinements ahead of full rollout (n = 68,411). Quality metrics included completion rates, bot detection, speeding, missing data, outliers, and quota achievement. Across countries, response rates ranged from 80.1 to 100
The utilities elicited with the composite time trade-off (cTTO) method for health states worse-than-dead (WTD) often correlate poorly with other severity measures, indicating a poor sensitivity of cTTO. We aimed to explore modifications to cTTO to better understand this phenomenon and identify potential improvements. A total of 480 respondents completed an online TTO interview, each valuing 12 EQ-5D-5L health states. The participants were randomized into four arms, A–D. Arm A followed the standard cTTO, serving as a reference. In arm B, we removed the sorting question comparing immediate death versus 10 years in a valued state. Arm C allowed for utility values <-1 by reducing the time in the valued state in the lead-time TTO (LT-TTO) part of cTTO. In arm D, we randomly selected the starting negative utility in LT-TTO. Utility value distributions, correlations between utilities and level sum score (LSS), and inconsistencies between Pareto-ordered states were analyzed. Arm A replicated the lack of significant correlation between LSS and the negative utility observed in previous work. Of the experimental arms, only arm B exhibited a significant negative correlation. Compared with arm A, arm B produced a higher proportion of WTD states ( 46.5% versus 26.3% ), less negative utility for WTD states on average ( -0.571 versus -0.752 ), and a lower mean censored utility for 55555 ( -0.486 versus -0.406 ). The observed lack of correlation between LSS and utility for WTD states appears linked to the use of comparison with immediate death in the sorting question. LT-TTO is capable of eliciting utility values in a way that is sensitive to severity. Modifying the initial questions in cTTO to identify whether health states are BTD or WTD should be considered.
