General intelligence, personality traits, and motivation as predictors of performance, potential, and rate of advancement of Royal Navy senior officers.

This paper assesses the impact of general intelligence, as well as specific personality traits, and aspects of motivation, on performance, potential, and advancement of senior leaders. A questionnaire survey was conducted on the full population of 381 senior officers in the Royal Navy with an 80% response rate. Performance, potential, and rate of advancement were established direct from the organization's appraisal system; intelligence, personality traits and motivation were assessed, at the time of the study, using the Verify G+ Test, Occupational Personality Questionnaire, and Motivation Questionnaire. Findings suggest differences in motivation are more important than differences in general intelligence, or personality traits, in predicting assessed performance, potential within, and actual rate of advancement to, senior leadership positions. This is a rare example of a study into very senior leaders, validated against both formal appraisal data and actual rates of advancement. As a consequence of this study the Royal Navy has started to use psychometric-based assessments as part of the selection and development of its most Senior Officers.

Undertriage of the elderly major trauma patient continues in major trauma centre care: a retrospective cohort review.

BACKGROUND: Major trauma (Injury Severity Score (ISS) ≥16) in older people is increasing, but concerns persist that major trauma is not always recognised in older patients on triage. This study compared undertriage of older and younger adult major trauma patients in the major trauma centre (MTC) setting to investigate this concern. METHODS: A retrospective review of Trauma Audit and Research Network data was conducted for three MTCs in the UK for 3 months in 2014. Age, ISS, injury mechanism and injured areas were examined for all severely injured patients (ISS ≥16) and appropriate major trauma triage rates measured via the surrogate markers of trauma team activation and the presence of a consultant first attender, as per standards for major trauma care set by National Confidential Enquiry into Patient Outcomes and Deaths, Royal College of Surgeons of England and the British Orthopaedic Association. Trends in older (age ≥65) and younger (ages 18-64) adult major trauma presentation, triage and reception were reviewed. RESULTS: Of 153 severely injured patients, 46 were aged ≥65. Older patients were significantly less likely to receive the attention of a consultant first attender or trauma team. Similar trends were also seen on subgroup analysis by mechanism of injury or number of injured body areas. Older major trauma patients exhibit a higher mortality, despite a lower median ISS (older patient ISS=20 (IQR 16-25), younger patient ISS=25 (IQR 18-29)). CONCLUSION: Older major trauma patients are at greater risk of undertriage, even in the MTC environment. Existing hospital trauma triage practices should be further investigated to explain and reduce undertriage of elderly trauma patients.

Epidemiology of adolescent trauma in England: a review of TARN data 2008-2017.

OBJECTIVES: Trauma contributes significantly to adolescent morbidity and mortality. We aimed to ascertain the epidemiology of adolescent trauma to inform prevention strategies. METHODS: Data were abstracted from TARN (Trauma Audit Research Network) from English sites over a 10-year period (2008-2017). Adolescents were defined as 10-24 completed years. Descriptive statistical analysis was used in this study. RESULTS: There were 40 680 recorded cases of adolescent trauma. The majority were male (77.3%) and aged 16-24 years old (80.5%). There was a 2.6-fold increase during the study time frame (p<0.0001) in the total annual number of cases reported to TARN. To account for increasing hospital participation, the unit trauma cases per hospital per year was used, noting an increasing trend (p=0.048). Road traffic collision (RTC) was the leading cause of adolescent trauma (50.3%). Pedestrians (41.2%) and cyclists (32.6%) were more prevalent in the 10-15 year group, while drivers (22.9%) and passengers (17.8%) predominated in the 16-24 year group. Intentional injury was reported in 20.7% (alleged assault in 17.2% and suspected self-harm in 3.5%). This was more prevalent in the 16-24 year group. The proportion of trauma reported due to violence has increased with stabbings increasing from 6.9% in 2008 to 10.2% in 2017 (p<0.0001). Evidence of alcohol or drug use was recorded in 20.1% of cases. There was an increase in the number treated in major trauma centres (45.7% 2008 vs 63.5% 2017, p<0.0001). Trauma was more likely to occur between 08:00 and 00:00, at weekends and between April and October. Overall mortality rate was 4.1%. Those with a known psychiatric diagnosis had a higher mortality (6.3% vs 4.4%, p<0.001). CONCLUSIONS: RTCs and intentional injuries are leading aetiologies. Healthcare professionals and policy-makers need to prioritise national preventative public health measures and early interventions to reduce the incidence of trauma in this vulnerable age group.

A conserved salt bridge in the G loop of multiple protein kinases is important for catalysis and for in vivo Lyn function.

The glycine-rich G loop controls ATP binding and phosphate transfer in protein kinases. Here we show that the functions of Src family and Abl protein tyrosine kinases require an electrostatic interaction between oppositely charged amino acids within their G loops that is conserved in multiple other phylogenetically distinct protein kinases, from plants to humans. By limiting G loop flexibility, it controls ATP binding, catalysis, and inhibition by ATP-competitive compounds such as Imatinib. In WeeB mice, mutational disruption of the interaction results in expression of a Lyn protein with reduced catalytic activity, and in perturbed B cell receptor signaling. Like Lyn(-/-) mice, WeeB mice show profound defects in B cell development and function and succumb to autoimmune glomerulonephritis. This demonstrates the physiological importance of the conserved G loop salt bridge and at the same time distinguishes the in vivo requirement for the Lyn kinase activity from other potential functions of the protein.

Top-cited psoriasis authors in 4 high-impact dermatology journals: 2000-2012.

Psoriasis is a largely researched topic with abundant potential for publication in dermatologic journals. We used the Thomson Reuters' Web of Science citation database using the search term "psoriasis" in the titles of any literature published in 4 high-impact dermatology journals. We compiled a ranking of the top 25 cited first authors and top 25 cited authors overall on the subject of psoriasis between 2000-2012. We hope our analysis highlights the achievements of our colleagues and predecessors.

"Community health workers bring value and deserve to be valued too:" Key considerations in improving CHW career advancement opportunities.

Introduction: Community health workers (CHWs) are critical members of the public health workforce, who connect the individuals they serve with resources, advocate for communities facing health and racial inequities, and improve the quality of healthcare. However, there are typically limited professional and career building pathways for CHWs, which contribute to low wages and lack of career advancement, further resulting in turnover, attrition, and workforce instability. Methods: The Center for Community Health Alignment (CCHA), within the Arnold School of Public Health at the University of South Carolina, utilized a mixed-method data collection strategy to provide a more in-depth understanding of this issue and ways that employers, advocates, and CHWs can address it. Results: Themes across data sources emphasized the importance of retaining skilled and experienced CHWs and educating other health professions about CHWs' critical roles, and reported that doing so will result in decreased attrition professional growth, and improved program quality. CHWs and allies concluded that higher wages, valuing lived experience over formal education, and participation in additional training opportunities should be the primary factors considered for career advancement. Discussion: Utilizing input from experienced CHWs and CHW allies nationally, this article describes the importance of supporting CHW career advancement, shares best practices, and suggestions for designing strategies that organizations/employers can use to improve CHW career pathways to better support the CHW workforce and reduce attrition.

Lab-scale data and microbial community structure suggest shortcut nitrogen removal as the predominant nitrogen removal mechanism in post-aerobic digestion (PAD).

Implementing an aerobic digestion step after anaerobic digestion, referred to as "post aerobic digestion" (PAD), can remove ammonia without the need for an external carbon source and destroy volatile solids. While this process has been documented at the lab-scale and full-scale, the mechanism for N removal and the corresponding microbial community that carries out this process have not been established. This research gap is important to fill because the nitrogen removal pathway has implications on aeration requirements and carbon demand, that is, short-cut N-removal requires less oxygen and carbon than simultaneous nitrification-denitrification. The aims of this research were to (i) determine if nitrite (NO2 - ) or nitrate (NO3 - ) dominates following ammonia removal and (ii) characterize the microbial community from PAD reactors. Here, lab-scale PAD reactors were seeded with biomass from two different full-scale PAD reactors. The lab-scale reactors were fed with biomass from full-scale reactors and operated in batch mode to quantify nitrogen species concentrations (ammonia, NH4 + , NO2 - , and NO3 - ) over time. Experimental results revealed that NO2 - production rates were several orders of magnitude greater than NO3 - production rates. Indeed, nitrite accumulation rate (NAR) was greater than 90% at most temperatures, confirming that shortcut nitrogen removal was the dominant NH4 + removal mechanism in PAD. Microbial community analysis via 16S rRNA sequencing indicated that ammonia oxidizing bacteria (AOB) were much more abundant than nitrite oxidizing bacteria (NOB). Overall, this study suggests that aeration requirements for post-aerobic digestion should be based on NO2 - shunt and not complete simultaneous nitrification denitrification. PRACTITIONER POINTS: AOB are a key feature of PAD microbial communities NOB are present, but in much lower abundance than AOB High nitrite accumulation ratio suggests shortcut nitrite as the main mechanism for nitrogen removal Nitritation in PAD reactors is sustained at temperatures as high as 40°C No ammonia oxidation occurred at 50°C implying different mechanisms of nitrogen removal including ammonia stripping.

Solutions to kinking of the side stream carbon dioxide sampling line.

A sidestream gas analyzer samples gases from a sampling port in an adapter placed in a breathing circuit. Kinking of the sampling line of the sidestream capnogram is not an uncommon problem during head and neck surgeries. We have identified the main problem for kinking of the sampling line in head and neck surgeries to be its vertical origin from the connecting point of the breathing circuit. Angled attachment of the sampling line at its connection to the breathing circuit can minimize this problem of kinking significantly as has been shown by our study.

Evolution of plant senescence.

BACKGROUND: Senescence is integral to the flowering plant life-cycle. Senescence-like processes occur also in non-angiosperm land plants, algae and photosynthetic prokaryotes. Increasing numbers of genes have been assigned functions in the regulation and execution of angiosperm senescence. At the same time there has been a large expansion in the number and taxonomic spread of plant sequences in the genome databases. The present paper uses these resources to make a study of the evolutionary origins of angiosperm senescence based on a survey of the distribution, across plant and microbial taxa, and expression of senescence-related genes. RESULTS: Phylogeny analyses were carried out on protein sequences corresponding to genes with demonstrated functions in angiosperm senescence. They include proteins involved in chlorophyll catabolism and its control, homeoprotein transcription factors, metabolite transporters, enzymes and regulators of carotenoid metabolism and of anthocyanin biosynthesis. Evolutionary timelines for the origins and functions of particular genes were inferred from the taxonomic distribution of sequences homologous to those of angiosperm senescence-related proteins. Turnover of the light energy transduction apparatus is the most ancient element in the senescence syndrome. By contrast, the association of phenylpropanoid metabolism with senescence, and integration of senescence with development and adaptation mediated by transcription factors, are relatively recent innovations of land plants. An extended range of senescence-related genes of Arabidopsis was profiled for coexpression patterns and developmental relationships and revealed a clear carotenoid metabolism grouping, coordinated expression of genes for anthocyanin and flavonoid enzymes and regulators and a cluster pattern of genes for chlorophyll catabolism consistent with functional and evolutionary features of the pathway. CONCLUSION: The expression and phylogenetic characteristics of senescence-related genes allow a framework to be constructed of decisive events in the evolution of the senescence syndrome of modern land-plants. Combining phylogenetic, comparative sequence, gene expression and morphogenetic information leads to the conclusion that biochemical, cellular, integrative and adaptive systems were progressively added to the ancient primary core process of senescence as the evolving plant encountered new environmental and developmental contexts.

The effect of oral drying and astringent liquids on the perception of mouth wetness.

A feeling of mouth dryness occurs from actual drying of the oral surfaces or from sampling astringent substances such as polyphenols (e.g., tannins in brewed tea and wine), which bind proline-rich proteins in saliva to reduce its lubricity. Here we investigated the interactions between physical drying and the effect of polyphenols on the subjective state of oral hydration. Twelve subjects rated the perceived wetness/dryness of their mouth using a labeled magnitude scale, after the mouth was dried with air for 35 s, or the subjects waited for an equal period of time during which the mouth was not dried. Subsequently, 1.5 mL volumes of an astringent solution (5 g L(-1) tannic acid in distilled water), distilled drinking water, or a sweet solution (40 g L(-1) sugar in mango tea with no tannins) were introduced into the mouth. After swishing and swallowing, the subject rated the wetness of the mouth for 4.3 min. The liquids were found to differ in their ability to wet the mouth (p<0.0001). The least wet sensations were reported for the astringent solution, on average; however, the differences among liquids were not equally pronounced at all times during the observation period (p<0.02). When the mouth was normally hydrated (i.e., had not been dried), the wetting effectiveness of the three liquids, based on the ratings, differed most greatly immediately after they had been received and swallowed. In contrast, when the mouth was dried, the liquids did not differ at this time. That the astringent solution did not have less wetting effectiveness in the dried mouth was attributed to the absence of precipitable salivary proteins. The findings suggest that the refreshment value of astringent drinks, based on their perceived wetting effectiveness, may vary with the state of oral hydration.

Impact of atrial fibrillation on long-term survival following oesophagectomy: a 21-year observational study.

BACKGROUND: Post-operative atrial fibrillation (AF) is a common complication of oesophagectomy and thought to signal a complicated post-operative course. AF is associated with prolonged admissions, increased healthcare costs and inpatient mortality. However, the impact of post-operative AF on long-term outcomes remains uncertain. METHODS: Patients undergoing open Ivor-Lewis oesophagectomy from 1994 to 2014 at Palmerston North Hospital, New Zealand, were retrospectively evaluated. Demographic, perioperative and tumour variables were collected. Regression models were used to identify independent predictors of AF and assess post-discharge survival following oesophagectomy. RESULTS: In total, 89 patients were included. New-onset AF developed post-operatively in 27 patients (30%). Median follow-up was 6.3 years. Logistic regression identified volume of intravenous fluid in the first 24 h post-operatively as a predictor of AF. Post-discharge survival was predicted by AF occurrence (hazard ratio (HR): 2.99, 95% confidence interval (CI): 1.37-6.53, P = 0.006), preoperative chemoradiotherapy (HR: 0.43, 95% CI: 0.20-0.91, P = 0.03), 1-4 positive lymph nodes (HR: 2.29, 95% CI: 1.06-4.96, P = 0.04), ≥5 positive nodes (HR: 2.95, 95% CI: 1.25-6.94, P = 0.01) and year of operation from 2008 to 2014 (HR: 0.30, 95% CI: 0.12-0.75, P = 0.01). CONCLUSION: Post-operative AF was associated with poorer long-term survival following oesophagectomy in this cohort. Further research should evaluate the influence of AF on cardiovascular and oncological outcomes following oesophagectomy.

Natural killer cell inhibits human immunodeficiency virus replication in chronically infected immune cells.

Natural killer (NK) cells are a crucial component of the host innate immune system. We investigated the noncytolytic anti-human immunodeficiency virus (HIV) activity of NK cells in chronically HIV-infected immune cells. Supernatants collected from NK cell cultures (both primary NK cells and NK cell lines, YTS and NK 92) inhibited HIV activation in peripheral blood mononuclear cells (PBMCs) from HIV-infected subjects. NK supernatants (NK SN) also suppressed tumor necrosis factor (TNF)-alpha-induced HIV activation in chronically infected cell lines (U1 and ACH-2 cells). The antibody to interferon (IFN)-gamma blocked NK SN-mediated anti-HIV effect, while the antibodies to CC-chemokines had no impact on NK SN-mediated HIV inhibition in U1 and ACH-2 cells. Investigation of mechanism(s) responsible for the NK action showed that NK SN inhibited TNF-alpha-mediated activation of HIV-long-terminal repeat (LTR), and upregulated the expression of signal transducer and activator of transcription (STAT)-1 and phosphorylated P38 mitogen-activated protein kinase (MAPK). The P38 MAPK inhibitor (SB 203580) blocked NK SN-mediated HIV inhibition. These data provide compelling evidence that NK cells have a critical role in controlling HIV activation in the reservoirs.

Human cortical representation of oral temperature.

The temperature of foods and fluids is a major factor that determines their pleasantness and acceptability. Studies of nonhuman primates have shown that many neurons in cortical taste areas receive and process not only chemosensory inputs, but oral thermosensory (temperature) inputs as well. We investigated whether changes in oral temperature activate these areas in humans, or middle or posterior insular cortex, the areas most frequently identified for the encoding of temperature information from the human hand. In the fMRI study we identified areas of activation in response to innocuous, temperature-controlled (cooled and warmed, 5, 20 and 50 degrees C) liquid introduced into the mouth. The oral temperature stimuli activated the insular taste cortex (identified by glucose taste stimuli), a part of the somatosensory cortex, the orbitofrontal cortex, the anterior cingulate cortex, and the ventral striatum. Brain regions where activations correlated with the pleasantness ratings of the oral temperature stimuli included the orbitofrontal cortex and pregenual cingulate cortex. We conclude that a network of taste- and reward-responsive regions of the human brain is also activated by intra-oral thermal stimulation, and that the pleasant subjective states elicited by oral thermal stimuli are correlated with the activations in the orbitofrontal cortex and pregenual cingulate cortex. Thus the pleasantness of oral temperature is represented in brain regions shown in previous studies to represent the pleasantness of the taste and flavour of food. Bringing together these different oral representations in the same brain regions may enable particular combinations to influence the pleasantness of foods.

Oral hydration, parotid salivation and the perceived pleasantness of small water volumes.

Previous studies have suggested that the preference for drinking cold water is increased when the drinker has a dry mouth. In a first experiment, we investigated whether a positive shift in preference would occur for small water volumes (0.75 ml and 1.5 ml) at 8, 16 or 25 degrees C, delivered into a mouth that had been dried using a warmed airflow, versus a normally hydrated mouth. Subjects rated the perceived wetness (or dryness) of their mouth, and the perceived pleasantness (or unpleasantness) of the water samples, using a labeled magnitude scale. Cooler water samples were preferred, and consistent with previous research, this preference was slightly enhanced when the subject's mouth was dried. The coldest water sample led to significantly wetter mouthfeel than the other two less cold samples, consistent with the possibility that the coldest water increased the rate of salivation. However, a second experiment found that although the rate of parotid salivation was increased if the mouth had been dried using a warm airflow, the different water temperatures did not induce different rates of parotid salivation. This indicates that enhanced preference for cold water when the mouth is dry is not invariably based in the reward gained from mouth rewetting via increased parotid saliva flow.

Accuracy of magnetic resonance imaging for preoperative staging of rectal cancer.

BACKGROUND: New Zealand has one of the highest rates of rectal adenocarcinoma in the world. Magnetic resonance imaging (MRI) is widely used for preoperative staging of rectal cancer. The accuracy of MRI varies, which may affect treatment decisions. The accuracy of MRI for pretreatment staging of rectal adenocarcinoma in a provincial centre in New Zealand has not been investigated. We aimed to assess the accuracy of MRI for pretreatment staging of early rectal adenocarcinoma in patients managed via the MidCentral Regional Cancer Service Multidisciplinary Team. METHODS: A retrospective review of the MidCentral Regional Cancer Service Multidisciplinary Team database identified 54 patients with rectal adenocarcinoma who proceeded to surgery without preoperative long course chemo-radiotherapy. The pretreatment MRI stage was compared with the histological stage for each of these patients. RESULTS: MRI correctly staged the tumour invasion (T stage) in 24 patients (44% of cases), and lymph node stage in 38 patients (70% of cases). There was moderate agreement between MRI and histological staging for tumour invasion (κ=0.46) and for lymph node involvement (κ=0.41). Twenty-one cases were under-staged and five cases were over-staged with regards to invasion of the muscularis propria. Fourteen cases were under-staged, and two cases over-staged in regards to lymph node involvement. CONCLUSION: Although MRI provides important pretreatment staging information for rectal adenocarcinoma, in our experience MRI is not as accurate as in other reports. Multidisciplinary teams managing patients with rectal adenocarcinoma should be aware of the limitations of MRI for pretreatment staging.

Yeast-based automated high-throughput screens to identify anti-parasitic lead compounds.

We have developed a robust, fully automated anti-parasitic drug-screening method that selects compounds specifically targeting parasite enzymes and not their host counterparts, thus allowing the early elimination of compounds with potential side effects. Our yeast system permits multiple parasite targets to be assayed in parallel owing to the strains' expression of different fluorescent proteins. A strain expressing the human target is included in the multiplexed screen to exclude compounds that do not discriminate between host and parasite enzymes. This form of assay has the advantages of using known targets and not requiring the in vitro culture of parasites. We performed automated screens for inhibitors of parasite dihydrofolate reductases, N-myristoyltransferases and phosphoglycerate kinases, finding specific inhibitors of parasite targets. We found that our 'hits' have significant structural similarities to compounds with in vitro anti-parasitic activity, validating our screens and suggesting targets for hits identified in parasite-based assays. Finally, we demonstrate a 60 per cent success rate for our hit compounds in killing or severely inhibiting the growth of Trypanosoma brucei, the causative agent of African sleeping sickness.

Short and long term outcomes of oesophagectomy in a provincial New Zealand hospital.

BACKGROUND: Oesophagectomy is a complex procedure associated with a significant morbidity and mortality rate. There is very little published data from New Zealand, with no published data from a non-Tertiary New Zealand hospital. We aimed to evaluate the outcomes of oesophagectomy at a single provincial hospital in New Zealand. METHOD: Retrospective review of clinical records of all patients who underwent oesophagectomy at Palmerston North Hospital (a level II provincial New Zealand public hospital) between 1993 and 2010 was performed. Demographic data, operative details, postoperative recovery parameters, survival data, pathological data, and details of adjuvant treatment were collected. RESULTS: Data from all 68 patients who underwent oesophagectomy were included. Mean age was 63.6 plus or minus 10.9 years, and 69% of patients were male. Mean operating time was 438.37 plus or minus 101.8 min, and mean intraoperative blood loss was 934.5 plus or minus 790.2 ml. Median intensive care unit stay was 7 (1-29) days, and total day stay was 17.5 (4-60) days. Tracheostomy was performed in 20 patients (29.4%). Anastomotic leak occurred in 7 patients (10.3%), chylothorax in 6 patients (8.8%) and cardiopulmonary complications in 34 patients (50.0%). The all cause in-hospital mortality rate was 4.4%. Overall survival at 30 days was 98.5%, at 1 year was 78.3% and at 5 years was 30.3%. CONCLUSION: Survival outcomes of oesophagectomy in this provincial New Zealand hospital are comparable to published series from national and international tertiary centres.

Bioaccessibility of trace elements in soils in Northern Ireland.

Assessment of elevated concentrations of potentially toxic elements (PTE) in soils and the association with specific soil parent material have been the focus of research for a number of years. Risk-based assessment of potential exposure scenarios to identified elevated PTE concentrations has led to the derivation of site- and contaminant-specific soil guideline values (SGVs), which represent generic assessment criteria (GACs) to identify exceeded levels that may reflect an unacceptable risk to human health. A better understanding of the 'bioavailable' or 'bioaccessible' contaminant concentrations offers an opportunity to better refine contaminant exposure assessments. Utilizing a comprehensive soil geochemical dataset for Northern Ireland provided by the Tellus Survey (GSNI) in conjunction with supplementary bioaccessibility testing of selected soil samples following the Unified BARGE Method, this paper uses exploratory data analysis and geostatistical analysis to investigate the spatial variability of pseudo-total and bioaccessible concentrations of As, Cd, Co, Cr. Cu, Ni, Pb, U, V and Zn. The paper investigates variations in individual element concentrations as well as cross-element correlations and observed lithological/pedological associations. The analysis of PTE concentrations highlighted exceeded levels of GAC values for V and Cr and exceeded SGV/GAC values for Cd, Cu, Ni, Pb, and Zn. UBM testing showed that for some soil parent materials associated with elevated PTE concentrations e.g. the Antrim Lava Group with high Ni concentrations, the measured oral bioaccessible fraction was relatively low. For other soil parent materials with relatively moderate PTE concentrations, measured oral bioaccessible fraction was relatively high (e.g. the Gala Sandstone Group of the Southern Uplands-Down Longford Terrain). These findings have implications for regional human health risk assessments for specific PTEs.

Short-term outcomes of laparoscopic resection for colon cancer in a provincial New Zealand hospital.

BACKGROUND: Laparoscopic colectomy is associated with modest short-term benefits compared to equivalent open surgery. However, most published data comes from specialist colorectal units. We aimed to evaluate outcomes of laparoscopic colectomy in a provincial hospital setting. METHODS: Retrospective review of all patients who underwent laparoscopic colectomy at Palmerston North Hospital (a provincial New Zealand hospital) between March 2001 and April 2010 was performed. Demographic data, intraoperative parameters, postoperative outcome data, and pathological data were compared with published results from the Australasian Laparoscopic Colon Cancer Surgical trial (ALCCaS). RESULTS: Of 138 laparoscopic colonic resections performed, 76 satisfied criteria for inclusion. More left sided resections were performed in the PNH group versus the ALCCaS group (55% vs 40%). The intraoperative complication rate was significantly lower in the PNH group (2.6% vs 10.5%, P=0.039), and patients tolerated fluids one day earlier (P=0.0001), but mean days to passage of flatus, passage of bowel motion, and discharge were nearly identical. There were no statistically significant differences in the postoperative complication rate or in-hospital mortality. CONCLUSION: Short-term outcomes of laparoscopic colonic surgery for neoplasia in a secondary level provincial setting are equivalent to those from specialist colorectal units.