 Use of recording systems in surgery are often used on an informal basis to showcase operations, such as live-streaming to other locations, and for performance improvement, but only on a small scale. Systematic implementation for the purpose of training and safety has yet to take place. Despite this, there is a growing evidence base to show the utility of these systems in the operating room for training purposes. 1 Use of an audio-visual and data recording system can be employed to retrospectively review a wide range of components that contribute to human factors and human performance. These include the technical skills of the surgeon, the physical and verbal interactions between the operating team, and also for root-cause analysis of mistakes or operative morbidity.Therecognition of the value of coaching as a means to improve performance 2,3 The opportunity of the surgeon to review operations, by themselves or with another, and the highlighted operative mistakes, has been shown to enable the surgeon to improve more 4 However, locating a learning point in hindsight is often dif fi cult without de fi nitive data to analyse with a high degree of granularity. One study found that surgical teams, after being informed during review and debrie fi ng sessions, were unaware of 75% of errors that occurred during the operation. 5 Being aware of these errors is an important aspect of learning and improving. Surgeons that were made aware of these errors in retrospective review with audio-visual recordings had improved performance in subsequent operations compared to surgeons without this

Background:-Active surveillance (AS) is a strategy employed as an alternative to immediate standard active treatments for patients with low-risk localised prostate cancer (PCa). Active treatments such as radical prostatectomy and radiotherapy are associated with significant adverse effects which impair quality of life. The majority of patients with low-risk PCa undergo a slow and predictable course of cancer growth and do not require immediate curative treatment. AS provides a means to identify and monitor patients with low-risk PCa through regular PSA testing, imaging using MRI scans and regular repeat prostate biopsies. These measures enable the identification of progression, or increase in cancer extent or aggressiveness, which necessitates curative treatment. Alternatively, some patients may choose to leave AS to pursue curative interventions due to anxiety. The main benefit of AS is the avoidance of unnecessary radical treatments for patients at the early stages of the disease, hence avoiding over-treatment, whilst identifying those at risk of progression to be treated actively. The objective of this article is to provide a narrative summary of contemporary practice regarding AS based on a review of the available evidence base and clinical practice guidelines. Elements of discussion include the clinical effectiveness and harms of AS, what AS involves for healthcare professionals, and patient perspectives. The pitfalls and challenges for healthcare professionals are also discussed. Data sources: We consulted international guidelines, collaborative studies and seminal prospective studies on AS in the management of clinically localised PCa. Conclusion: AS is a feasible alternative to radical treatment options for low-risk PCa, primarily as a means of avoiding over-treatment, whilst identifying those who are at risk of disease progression for active treatment. There is emerging data demonstrating the long-term safety of AS as an oncological management strategy. Uncertainties remain regarding variation in definitions, criteria, thresholds and the most effective types of diagnostic interventions pertaining to patient selection, monitoring and reclassification. Efforts have been made to standardise the practice and conduct of AS. As data from high-quality prospective comparative studies mature, the practice of AS will continue to evolve. Implications for Nursing Practice: The practice of AS involves a multi-disciplinary team of healthcare professionals consisting of nurses, urologists, oncologists, pathologists and radiologists. Nurses play a prominent role in managing AS programmes, and are closely involved in patient selection and recruitment, counselling, organising and administering diagnostic interventions including prostate biopsies, and ensuring patients' needs are being met throughout the duration of AS. (C) 2020 Elsevier Inc. All rights reserved.

Introduction: Between 40,000 and 50,000 divers and swimmers are envenomated each year and diving as a hobby is becoming increasingly popular. In the Mediterranean, envenomation is most often by Weever fish, Scorpion fish and jellyfish but coral and sea urchins may also be venomous. Envenomation: Most stings cause local inflammation, oedema and pain. The severity of pain varies with the venom and the amount injected. In severe cases, stings may be life-threatening due to cardiogenic or anaphylactic shock or penetration of vital structures. Management: Most cases of envenomation are preventable with a combination of measures including the avoidance of contact through good buoyancy control, the wearing of body-suits, and by maintaining visual awareness Immediate management is to return to the surface, elevate and wash the site of injury. Immersion in hot water followed by simple analgesics for pain relief has been shown to be more effective than other methods. More severe cases should be identified by symptoms including confusion and heavy bleeding and referred to qualified medical care. Conclusion: Envenomation by subaquatic species is common and preventable yet the dissemination of the appropriate knowledge is limited. This knowledge summary provides pertinent information aimed at divers in preventing and managing such injuries.