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Sample records for british army surgeons

  1. Battling Bullying in the British Army 1987 – 2004

    Directory of Open Access Journals (Sweden)

    James K. Wither

    2004-09-01

    Full Text Available This article explores the attempts by the UK MOD to eradicate bullying in the British Army. Although British recruits are not confronted by mistreatment that compares with the phenomenon of dedovshchina, the Army has struggled to eliminate incidents of bullying from the ranks, which have tarnished the image of the British Army. The article examines the nature and extent of the problem, the efficacy of official policy to combat it, and suggests reasons why bullying persists even in a long- standing professional army. It also seeks to provide instructive insights for those militaries of the successor states of the Soviet Union that are currently blighted by dedovshchina.

  2. Russian perceptions of the Boer and British Armies: An introduction ...

    African Journals Online (AJOL)

    Russian-French "Entente Cordial" when British turned from bitterest enemy to ..... As it was mentioned above, the army's food supplies were provided in an ... Cronje's capitulation will be a glorious page in the history of the British Anns forever. , ...

  3. Major Harvey Cushing's difficulties with the British and American armies during World War I.

    Science.gov (United States)

    Carey, Michael E

    2014-08-01

    This historical review explores Harvey Cushing's difficulties with both the British and American armies during his World War I service to definitively examine the rumor of his possible court martial. It also provides a further understanding of Cushing the man. While in France during World War I, Cushing was initially assigned to British hospital units. This service began in May 1917 and ended abruptly in May 1918 when the British cashiered him for repeated censorship violations. Returning to American command, he feared court martial. The army file on this matter (retrieved from the United States National Archives) indicates that US Army authorities recommended that Cushing be reprimanded and returned to the US for his violations. The army carried out neither recommendation, and no evidence exists that a court martial was considered. Cushing's army career and possible future academic life were protected by the actions of his surgical peers and Merritte Ireland, Chief Surgeon of the US Army in France. After this censorship episode, Cushing was made a neurosurgical consultant but was also sternly warned that further rule violations would not be tolerated by the US Army. Thereafter, despite the onset of a severe peripheral neuropathy, probably Guillian Barré's syndrome, Cushing was indefatigable in ministering to neurosurgical needs in the US sector in France. Cushing's repeated defying of censorship regulations reveals poor judgment plus an initial inability to be a "team player." The explanations he offered for his censorship violations showed an ability to bend the truth. Cushing's war journal is unclear as to exactly what transpired between him and the British and US armies. It also shows no recognition of the help he received from others who were instrumental in preventing his ignominious removal from service in France. Had that happened, his academic future and ability to train future neurosurgical leaders may have been seriously threatened. Cushing's foibles

  4. Identifying British Army infantry recruit population characteristics using biographical data.

    Science.gov (United States)

    Kiernan, M D; Arthur, A; Repper, J; Mukhuty, S; Fear, N T

    2016-04-01

    The infantry accounts for more than a quarter of the British Army but there is a lack of data about the social and educational background of its recruits. To provide an insight into British Army infantry recruits' personal, social and educational background prior to enlistment. The study sample consisted of infantry recruits who enlisted into the British Army School of Infantry. Each recruit completed a 95-item biographical questionnaire. Descriptive statistics were used to describe the sample in terms of demographic, physical, personal, social and educational attributes. The study sample consisted of 1000 male recruits. Over half of the recruits were consuming alcohol at a hazardous or harmful level prior to enlistment and 60% of recruits had used cannabis prior to joining the Army. Academic attainment was low, with the majority of recruits achieving GCSE grade C and below in most subjects, with 15% not taking any examinations. Over half the recruits had been in trouble with the police and either been suspended or expelled from school. Substance misuse and poor behaviour are highly prevalent among recruits prior to enlistment. Taken alongside existing evidence that some of these problems are commonplace among personnel in regular service, the assumption that the British Army infantry is, in itself, a cause of these behaviours should be questioned. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. British surgeons' experiences of mandatory online workplace-based assessment.

    Science.gov (United States)

    Pereira, Erlick A C; Dean, Benjamin J F

    2009-07-01

    An online workplace-based assessment tool, the Intercollegiate Surgical Curriculum Programme (ISCP), has become mandatory for all British surgical trainees appointed since August 2007. A compulsory pound125 annual trainee fee has also been introduced to fund its running costs. The study sought to evaluate user satisfaction with the ISCP. A total of 539 users across all surgical specialties (including 122 surgeons acting as assessors) were surveyed in late 2008 by online questionnaire regarding their experiences with the ISCP. Sixty-seven percent had used the tool for at least one year. It was rated above average by only 6% for its registration process and only 11% for recording meetings and objectives. Forty-nine percent described its online assessments as poor or very poor, only 9% considering them good or very good. Seventy-nine percent rated the website's user friendliness as average or worse, as did 72% its peer-assessment tool and 61% its logbook of procedures. Seventy-six percent of respondents had carried out paper assessments due to difficulties using the website. Six percent stated that the ISCP had impacted negatively on their training opportunities, 41% reporting a negative impact overall upon their training; only 6% reported a positive impact. Ninety-four percent did not consider the trainee fee good value, only 2% believing it should be paid by the trainee. The performance of the ISCP leaves large numbers of British surgeons unsatisfied. Its assessments lack appropriate evidence of validity and its introduction has been problematic. With reducing training hours, the increased online bureaucratic burden exacerbates low morale of trainees and trainers, adversely impacting potentially upon both competency and productivity.

  6. cooperation and conflict – the british army, the natal government

    African Journals Online (AJOL)

    hennie

    invasion of Natal, stand on the punishment of high treason? Martial law had .... The offensive of the British Army in Natal and the immediate results thereof. On 11 May 1900, .... also to exercise its authority and independence. In addition to the ...

  7. British Association of Plastic Surgeons Program from another generation.

    Science.gov (United States)

    Freshwater, M Felix

    2010-05-01

    To Compare the Association's Summer Programs of 1971 and 2008. I attended the 1971 meeting of BAPS that was held in London and kept the program. I compared the content of that meeting with the 2008 Provisional Program. A blow-up of that 1971 program will be the highlight of the poster. The 1971 meeting's registration fee was 10 pounds for me as an overseas non-member registering at the desk compared to the current fee of 500 pounds. The meeting was three day long, but only one day was devoted to papers. The first and third days of the meeting were devoted to watching live cranio-facial surgery performed by Tessier at the Hospital for Sick Children. To make the length of these televised sessions more tolerable, a cash bar was available and lunch including beer and squash were served from noon until 4 pm followed by tea from 4 pm to 6 pm Dinner Jackets were required for the 1971 Association dinner compared with dark lounge suits in 2008. In contrast to 2008, the 1971 scientific program consisted of only 13 papers of which all but five were written by single authors. Seven of the papers were published in the British Journal of Plastic Surgery. There were no cosmetic and no breast papers. There were no poster sessions. There were no panel discussions. There were no exhibits. The 1971 meeting was truly from another generation in both its form and content. Copyright (c) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. The War for Talent - the British Army's Strategy

    OpenAIRE

    Sherrard, Paddy

    2016-01-01

    Poster Presentation at the International Applied Military Psychology Symposium (IAMPS) 2016. The British Army must identify its future generals from its officer cadets and retain them for their 35 year career.  There is no written contract and the psychological contract differs considerably as they progress through the ranks with different jobs and remuneration. The PhD will identify how officer talent is managed in current policy, which will be cross-referenced against...

  9. Standing the Test of Time: Revising the British Army's Counterinsurgency Doctrine

    National Research Council Canada - National Science Library

    O'Herlihy, Simon

    2008-01-01

    The recent experiences in Iraq and Afghanistan confirm the fundamental validity of the British Army's counterinsurgency doctrine, but offer lessons which should be incorporated into a doctrinal review...

  10. Barossa Night: cohesion in the British Army officer corps.

    Science.gov (United States)

    Bury, Patrick

    2017-06-01

    Contrasting the classical explanation of military group cohesion as sustained by interpersonal bonds, recent scholars have highlighted the importance of ritualized communication, training and drills in explaining effective military performance in professional armies. While this has offered a welcome addition to the cohesion literature and a novel micro-sociological method of examining cohesion, its primary evidential base has been combat groups. Indeed, despite their prominent role in directing operations over the past decade, the British Army's officer corps has received relatively little attention from sociologists during this period. No attempt has been made to explain cohesion in the officer corps. Using a similar method to recent cohesion scholars, this paper seeks to address this imbalance by undertaking a micro-sociology of one ritual in particular: 'Barossa Night' in the Royal Irish Regiment. Firstly, it draws on the work of Durkheim to examine how cohesion amongst the officer corps is created and sustained through a dense array of practises during formal social rituals. It provides evidence that the use of rituals highlights that social solidarity is central to understanding officer cohesion. Secondly, following Hockey's work on how private soldiers negotiate order, the paper shows how this solidarity in the officer corps is based on a degree of negotiated order and the need to release organizational tensions inherent in a strictly hierarchical rank structure. It highlights how the awarding of gallantry medals can threaten this negotiated order and fuel deviancy. In examining this behaviour, the paper shows that even amongst an officer class traditionally viewed as the elite upholders of organizational discipline, the negotiation of rank and hierarchy can be fluid. How deviant behaviour is later accepted and normalized by senior officers indicates that negotiated order is as important to understanding cohesion in the British Army's officer corps as it is

  11. One surgeon's Army experience with "wound shock" from Pearl Harbor to the present.

    Science.gov (United States)

    Hardaway, Robert M

    2009-09-01

    The Army has had extensive experience in the study and treatment of shock, beginning with the American Civil War and continuing to the present. This is the story of one Army surgeon's experience, both in research and treatment of shock, from Pearl Harbor to the present.

  12. Privatizing Our Schools: Lessons from the British Army and World War II.

    Science.gov (United States)

    Lovoy, Thomas A.

    1996-01-01

    Notes how the British Army's Officer Corps, based on elitism and financial standing, brought the British Empire to its knees. Argues that privatization--a for-profit market system to ration out education--would have a similar effect. Suggests that charter schools (with considerable autonomy but still held accountable by the chain of command) are…

  13. Farmers' perception of the role of veterinary surgeons in vaccination strategies on British dairy farms.

    Science.gov (United States)

    Richens, I F; Hobson-West, P; Brennan, M L; Lowton, R; Kaler, J; Wapenaar, W

    2015-11-07

    There is limited research investigating the motivators and barriers to vaccinating dairy cattle. Veterinary surgeons have been identified as important sources of information for farmers making vaccination and disease control decisions, as well as being farmers' preferred vaccine suppliers. Vets' perception of their own role and communication style can be at odds with farmers' reported preferences. The objective of this study was to investigate how dairy farmers perceived the role of vets in implementing vaccination strategies on their farm. Semi-structured interviews were conducted with 24 dairy farmers from across Britain. The data were analysed using thematic analysis. Analysis revealed that farmers perceive vets to have an important role in facilitating decision-making in all aspects of vaccination, including the aspects of vaccine distribution and advice on implementation. This important role is acknowledged by farmers who have regular veterinary contact, but also farmers with solely emergency veterinary contact. Given this finding, future work should investigate the attitudes of vets towards vaccination and how they perceive their role. Combining this knowledge will enable optimisation of vaccination strategies on British dairy farms. British Veterinary Association.

  14. Is the Culture of the British Army Conducive to the Successful Execution of Mission Command

    Science.gov (United States)

    2016-06-10

    trait has such obvious implications. In all instances the author used literature to support inferences in an effort to diminish his bias .27...27 As a serving British Army Major, the author undoubtedly has a bias within this topic, developed through experiences of...be subconscious and therefore difficult to determine in a group.129 Because they are learned through the formative years they become very deep- rooted

  15. Does general surgery residency prepare surgeons for community practice in British Columbia?

    Science.gov (United States)

    Hwang, Hamish

    2009-01-01

    Background Preparing surgeons for clinical practice is a challenging task for postgraduate training programs across Canada. The purpose of this study was to examine whether a single surgeon entering practice was adequately prepared by comparing the type and volume of surgical procedures experienced in the last 3 years of training with that in the first year of clinical practice. Methods During the last 3 years of general surgery training, I logged all procedures. In practice, the Medical Services Plan (MSP) of British Columbia tracks all procedures. Using MSP remittance reports, I compiled the procedures performed in my first year of practice. I totaled the number of procedures and broke them down into categories (general, colorectal, laparoscopic, endoscopic, hepatobiliary, oncologic, pediatric, thoracic, vascular and other). I then compared residency training with community practice. Results I logged a total of 1170 procedures in the last 3 years of residency. Of these, 452 were performed during community rotations. The procedures during residency could be broken down as follows: 392 general, 18 colorectal, 242 laparoscopic, 103 endoscopic, 85 hepatobiliary, 142 oncologic, 1 pediatric, 78 thoracic, 92 vascular and 17 other. I performed a total of 1440 procedures in the first year of practice. In practice the break down was 398 general, 15 colorectal, 101 laparoscopic, 654 endoscopic, 2 hepatobiliary, 77 oncologic, 10 pediatric, 0 thoracic, 70 vascular and 113 other. Conclusion On the whole, residency provided excellent preparation for clinical practice based on my experience. Areas of potential improvement included endoscopy, pediatric surgery and “other,” which comprised mostly hand surgery. PMID:19503663

  16. Family Functioning Differences Across the Deployment Cycle in British Army Families: The Perceptions of Wives and Children.

    Science.gov (United States)

    Pye, Rachel E; Simpson, Leanne K

    2017-09-01

    Military deployment can have an adverse effect on a soldier's family, though little research has looked at these effects in a British sample. We investigated wives' of U.K.-serving soldiers perceptions of marital and family functioning, across three stages of the deployment cycle: currently deployed, postdeployment and predeployed, plus a nonmilitary comparison group. Uniquely, young (aged 3.5-11 years) children's perceptions of their family were also investigated, using the parent-child alliance (PCA) coding scheme of drawings of the family. Two hundred and twenty British military families of regular service personnel from the British Army's Royal Armoured Corps, were sent survey packs distributed with a monthly welfare office newsletter. Wives were asked to complete a series of self-report items, and the youngest child in the family between the ages of 3.5 and 11 years was asked to draw a picture of their family. Complete data were available for 78 military families, and an additional 34 nonmilitary families were recruited via opportunity sampling. Results indicated wives of currently deployed and recently returned personnel were less satisfied with their family and its communication, and children's pictures indicated higher levels of dysfunctional parent-child alliance, whereas predeployed families responded similarly to nonmilitary families. Marital satisfaction was similar across all groups except predeployed families who were significantly more satisfied. Nonmilitary and predeployed families showed balanced family functioning, and currently and recently deployed families demonstrated poor family functioning. In comparison to nonmilitary families, predeployed families showed a large "spike" in the rigidity subscale of the Family Adaptability and Cohesion Evaluation Scale IV. Wives' perceptions of family functioning, but not marital satisfaction, differed between the deployment groups. The results from the coded children's drawings correlated with the self

  17. Assessment of online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS): a strategic study.

    Science.gov (United States)

    Abu-Serriah, M; Wong, L; Dhariwal, D; Banks, R J

    2014-02-01

    The Internet is a powerful method of acquiring and sharing information. In marketing and business, online visibility is vital for publicity and the reputation of an organisation. To our knowledge, the importance of such visibility in medicine in general, and in Oral and Maxillofacial Surgery (OMFS) services in the UK, has not previously been investigated. We aimed to provide a better understanding of the way that patients use the Internet by asking 450 patients to complete a questionnaire when they attended outpatient OMFS departments at 2 centres. We also assessed the online visibility of the British Association of Oral and Maxillofacial Surgeons (BAOMS) and investigated the correlation between the strength of online visibility and professional reputation. Results from the self-administered, anonymous, validated questionnaires showed that 82% of patients agreed that the Internet was a powerful source of information, and two-thirds associated online visibility with a good reputation. However, the perceived online visibility of the BAOMS was poor (2%). This study mirrors findings in business publications, and confirms the link between online visibility and professional reputation. It also shows that there is a gap between patients' perceptions and the level of uptake of professional resources. We propose various strategies to bridge this gap and to promote the online visibility and professional reputation of the BAOMS and of OMFS services in the UK. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Prevalence and socio-demographic correlates of obesity in the British Army.

    Science.gov (United States)

    Sanderson, Paul W; Clemes, Stacy A; Biddle, Stuart J H

    2014-01-01

    The trend of escalating obesity has prompted some armed forces to employ comprehensive health surveys to report obesity trends and prevalence, the findings of which suggest that obesity is a growing concern in these specific populations. To provide an appraisal of obesity prevalence and risk to obesity-related diseases in the British Army in relation to age, gender, military rank and employment. An observational cohort study (n = 50 635) consisting of 47 173 men and 3462 women was drawn from a study sample hosted on the Fitness Information Software System (FISS) (n = 54 854). Multiple logistic regression techniques were employed separately for men and women. According to BMI, 56.7% of the study population were overweight and of those individuals 12% were obese. Whilst a higher percentage of males were obese (12.2% and 8.6%, respectively), when waist circumference data were added to the BMI data, the results indicate that females displayed a higher percentage of risk to obesity-related diseases than males (30.4% and 24%, respectively). Armed service personnel should be made aware of the implications of obesity in regards to health and occupation. Specific focus should be given to those older individuals employed in managerial positions undertaking low levels of occupational physical activity.

  19. The United States Army Battalion Surgeon: Frontline Requirement or Relic of a Bygone Era?

    Science.gov (United States)

    2009-12-11

    Battalion Aid Station BN Battalion BS Battalion Surgeon CBMM Core Battalion Medical Mission DOW Died of Wounds FSO Full Spectrum Operations GMO ...General Medical Officers or GMOs . Young, motivated, and greedy for knowledge, GMOs propelled the field of military medicine forward during...peacetime through analysis, research, and innovation. Their treated populations were small and exceedingly healthy. GMOs had no mission to treat dependents

  20. India’s British Army: the Honorable East India Company’s Lasting Military Impact

    Science.gov (United States)

    2017-06-09

    Canfield, all helped to characterize the public liabilities King George and British Parliament accepted in order directly control British interests in...EIC employees indigenous languages such as Arabic, Persian , Hindi, Tamil, and Telugu (Crowell 1982, 108) and cultural practices of the subcontinent...Already conversant in the Arabic and Persian languages, Jones learned Sanskrit while in India because it is the ancient language that articulates

  1. The Development of a Coalition Operational Architecture: A British and US Army Approach

    National Research Council Canada - National Science Library

    Galvin, K. E; Madigan, J. C

    2000-01-01

    ... (COA) to support a US Corps operating as a Combined Joint Task Force (CJTF) Headquarters with up to a UK Division as an integral part of its ORBAT would be investigated by staff from both countries' Army Operational Architecture (AOA) teams...

  2. Preparing General Purpose Forces in the United States and British Armies for Counterinsurgent Operations

    Science.gov (United States)

    2010-12-10

    Operations In Iraq: Planning, Combat, And Occupation,” Thomas Ricks’ Fiasco, and reports by Army historian Major Isaiah Wilson, and former CENCTOM J-4...established Multi-National Forces-Iraq, and Lieutenant General Thomas Metz, commander of the Army’s III Corps, assumed the mantle of Multi-National Corps...Donald P. Wright and Colonel Timothy R. Reese or Thomas Ricks’ Fiasco among other books. 18Dr. Carter Malkasian, “Counterinsurgency in Iraq: May 2003

  3. Russian perceptions of the Boer and British Armies: An introduction through Russian documents

    OpenAIRE

    Gennady Shubin

    2012-01-01

    On the eve of the outbreak of the Anglo-Boer War in South Africa, Colonel N.S. Yermolov, the Russian Military agent [attaché] in London reported on October1, 1899: "The War is inevitable ... The decision has been made to dispatch there from Britain the first army corps and at least 70 thousand [troops] ... The War is scheduled for half a year; many mounted infantry are under preparation; carts and mules being purchased in America. The general draft disposition is to defend the border of Natal...

  4. The scientific contributions of British Plastic Surgeons to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938).

    Science.gov (United States)

    Vrebos, J

    2001-01-01

    In 1931, Maurice Coelst, M.D. from Brussels started the publication of the first international journal of plastic surgery ever published: the Revue de Chirurgie Plastique (1931-1934), which eventually became the Revue de Chirurgie Structive (1935-1938). In 1936, he established the first European Society of Structive Surgery, which held its first congress in Brussels. Further congresses were held in London in 1937 and in Milan in 1938. It is the collaboration and the participation of British plastic surgeons in this Society, this journal, and these meetings that I want to stress, because I am firmly convinced that these documents fill a gap in the history of Plastic Surgery in Great Britain, since--as far as I know--no detailed information concerning this period was ever published in Plastic Surgery literature.

  5. Open radical cystectomy in England: the current standard of care - an analysis of the British Association of Urological Surgeons (BAUS) cystectomy audit and Hospital Episodes Statistics (HES) data.

    Science.gov (United States)

    Jefferies, Edward R; Cresswell, Joanne; McGrath, John S; Miller, Catherine; Hounsome, Luke; Fowler, Sarah; Rowe, Edward W

    2018-01-23

    To establish the current standard for open radical cystectomy (ORC) in England, as data entry by surgeons performing RC to the British Association of Urological Surgeons (BAUS) database was mandated in 2013 and combining this with Hospital Episodes Statistics (HES) data has allowed comprehensive outcome analysis for the first time. All patients were included in this analysis if they were uploaded to the BAUS data registry and reported to have been performed in the 2 years between 1 January 2014 and 31 December 2015 in England (from mandate onwards) and had been documented as being performed in an open fashion (not laparoscopic, robot assisted or the technique field left blank). The HES data were accessed via the HES website. Office of Population Censuses and Surveys Classification of Surgical Operations and Procedures version 4 (OPCS-4) Code M34 was searched during the same 2-year time frame (not including M34.4 for simple cystectomy or with additional minimal access codes Y75.1-9 documenting a laparoscopic or robotic approach was used) to assess data capture. A total of 2 537 ORCs were recorded in the BAUS registry and 3 043 in the HES data. This indicates a capture rate of 83.4% of all cases. The median operative time was 5 h, harvesting a median of 11-20 lymph nodes, with a median blood loss of 500-1 000 mL, and a transfusion rate of 21.8%. The median length of stay was 11 days, with a 30-day mortality rate of 1.58%. This is the largest, contemporary cohort of ORCs in England, encompassing >80% of all performed operations. We now know the current standard for ORC in England. This provides the basis for individual surgeons and units to compare their outcomes and a standard with which future techniques and modifications can be compared. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  6. British plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "the Big Four" in their Speciality.

    Science.gov (United States)

    Rogers, B O

    2001-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications devoted specifically to plastic, reconstructive, and aesthetic surgery. Publishing original articles by H.D. Gillies, P.T. Kilner, A.H. McIndoe, and R. Mowlem--the "Big Four" as they were known to both English and American plastic surgeons--the Revues drew attention to these four surgeons who were mainly responsible for developing the prestige of English plastic surgery in the early 1930s.

  7. Comparative analysis of field ration for military personnel of the ukrainian army and armies of other countries worldwide

    OpenAIRE

    M. Mardar; M. Hkrupalo; M. Stateva

    2017-01-01

    For the purpose of improvement of the Ukrainian nutritional standards this Article provides comparative analysis of field rations of different countries worldwide to make a proposal on improvement of food-stuff assortment in food ration for military personnel in the Armed Forces of Ukraine, Army of USA, the British Army, Army of Germany, Army of Italy, Army of Canada, Army of France, Army of Belarus, Army of Armenia. In accordance with the comparative analysis it was established that ration c...

  8. Headed the Wrong Way: The British Army’s Painful Re-Acquaintance with Its Own COIN Doctrine in Southern Iraq

    Science.gov (United States)

    2011-06-10

    Colonel John McCuen, taught COIN as an army officer at the US Army War College, after overseas tours in Vietnam, Thailand, and Indonesia that preceded...tactical advantages. The monsoon rains running June through September further hindered SAF‘s mobility and associated rough surf made resupply for

  9. “There is discrimination in the Russian army against religious minorities” - Interview with Abdurashid Saidov, surgeon, writer and Moscow correspondent for Dagestanskaia Pravda, Moscow, 7 October 2008

    Directory of Open Access Journals (Sweden)

    Elisabeth Sieca-Kozlowski

    2009-12-01

    Full Text Available PIPSS.ORG – What is it like for Dagestani conscripts? How do the officers relate to them? Are they able to fulfill all their religious duties? Do Dagestanis have the ability to rise to the officer ranks?Abdurashid Saidov: In Moscow, there are more than 10 million residents; in Dagestan, there are 2 million. In each conscription, however, Dagestan offers up many times more young men to the army than Moscow. Speaking of attitudes towards Muslims, it is possible to say with confidence that in th...

  10. [On the role of army physicians in the creation of Ukrainian medical terminology].

    Science.gov (United States)

    Radysh, Ia F; Holyk, L A

    2002-01-01

    Tha article is devoted to the analysis of the role army surgeons had in creation of Ukrainean medical terminology. In the article, medical dictionaries are briefly analyzed, of which Ukrainean army surgeons are authors or co-authors.

  11. British dental surgery and the First World War: the treatment of facial and jaw injuries from the battlefield to the home front.

    Science.gov (United States)

    Hussey, K D

    2014-11-01

    When Britain went to war in 1914, the British Expeditionary Force was deployed without a single dentist. Initially considered combatants, the only dental professionals who could serve at the Front were medically qualified dental surgeons in the Royal Army Medical Corps. In treating the traumatic facial and jaw injuries caused by trench warfare, the dental surgeons of this era earned their place on specialist surgical teams and established the principles of oral and maxillofacial surgery. This article will examine the contribution of specialist dental surgeons to the management of facial and jaw wounds in the First World War along the chain of evacuation from the battlefield to the home front, using illustrative examples from the Hunterian Museum at the Royal College of Surgeons of England.

  12. Smartphones and the plastic surgeon.

    Science.gov (United States)

    Al-Hadithy, Nada; Ghosh, Sudip

    2013-06-01

    Surgical trainees are facing limited training opportunities since the introduction of the European Working Time Directive. Smartphone sales are increasing and have usurped computer sales for the first time. In this context, smartphones are an important portable reference and educational tool, already in the possession of the majority of surgeons in training. Technology in the palm of our hands has led to a revolution of accessible information for the plastic surgery trainee and surgeon. This article reviews the uses of smartphones and applications for plastic surgeons in education, telemedicine and global health. A comprehensive guide to existing and upcoming learning materials and clinical tools for the plastic surgeon is included. E-books, podcasts, educational videos, guidelines, work-based assessment tools and online logbooks are presented. In the limited resource setting of modern clinical practice, savvy plastic surgeons can select technological tools to democratise access to education and best clinical care. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. The Woman's Land Army: 1918-1920.

    Science.gov (United States)

    Laughlin, Margaret

    1994-01-01

    Describes the origins and work of the Women's Land Army, a World War I British volunteer agricultural production unit. Details similar program in the United States. Identifies the impact of the Women's Land Army including enhanced political, economic, and physical freedom for the participants and future generations of women. (CFR)

  14. Inverting the Army Intelligence Pyramid

    Science.gov (United States)

    2011-05-19

    British experience fighting the Provisional Irish Republican Army ( PIRA ) in Northern Ireland, which began an insurgency in 1969.91...they became extremely successful.”93 Martin Van Creveld posits that the British Army’s success against the PIRA in Northern Ireland stands out as...and MI6 (Secret Intelligence Service) to defeat the PIRA .97 92 John Kiszely, "Learning About

  15. the relationship between british war correspondents in the field

    African Journals Online (AJOL)

    Lenovo

    sometimes army officers writing the occasional despatch to the British metropolitan press. There was ..... defence”.27 He was backed both by the army's commander-in-chief, Field Marshal. Lord Wolseley ..... The role of the press was less significant under succeeding directors of. Intelligence ..... Financial Times ? Unknown.

  16. British passports

    CERN Multimedia

    IT Department

    2008-01-01

    Please note that from 01/01/2009, the passport section of the British Consulate will move from Geneva to Paris. This change is part of a global initiative to rationalize passport services and reduce administrative costs while ensuring that the quality of the service remains high. The aim is to issue new passports within 10 working days of receiving applications (excluding transit time). From 1st January 2009 passport applications should be sent by courier or registered post directly to: British Consulate General BP111-08 75363 Paris CEDEX 08 France For further information please refer to: http://ukinswitzerland.fco.gov.uk/en/passports/passport-move/

  17. Army Technology

    Science.gov (United States)

    2015-02-01

    that allows them to perform applied research under the Institute for Biotechnology research team 1 2 3 20 | ARMY TECHNOLOGY MAGAZINE ...DASA(R&T) Deputy Assistant Secretary of the Army for Research and Technology Download the magazine , view online or read each individual story with...Army photo by Conrad Johnson) Front and back cover designs by Joe Stephens EXECUTIVE DEPUTY TO THE COMMANDING GENERAL Army Technology Magazine is an

  18. Book Review: "Indigenous Peoples of the British Dominions and the ...

    African Journals Online (AJOL)

    Book Review: "Indigenous Peoples of the British Dominions and the First World War"by Timothy C. Winegard. ... Timothy Winegard saw active duty in the Canadian Reserve Force from 2001 to 2010 and served on detachment duty to the British Army for a two-year period. He obtained various academic degrees from 1999 ...

  19. [The surgeon and deontology].

    Science.gov (United States)

    Sucila, Antanas

    2002-01-01

    The aim of study is to recall surgeons deontological principles and errors. The article demonstrates some specific deontological errors, performed by surgeon on patients and his colleagues; points out painful sequela of these errors as well. CONCLUSION. The surgeon should take in account deontological principles rigorously in routine daily practice.

  20. Scouts Out! The Development of Reconnaissance Units in Modern Armies

    Science.gov (United States)

    2008-01-01

    forces they encountered.61 The French command did not realize the Germans were still east of Neufchâteau, particularly after secondhand information...37; Seaton, 90–91; Robert Citino, Armored Forces: History and Source Book (Westport, CT: Greenwood Press, 1994), 57; Walter Goerlitz, History of the...British Army, 1943 (New York: Hippocrene Books , 1976), 41, 228; Ogorkiewicz, 57– 60. 43. Ellis and Chamberlain, 166; Leo Niehorster, “British Army

  1. Florence Nightingale: on feeding an army.

    Science.gov (United States)

    Calkins, B M

    1989-12-01

    Florence Nightingale's work for the British Army during the Crimean War earned her the well-deserved honor of being considered the mother of modern nursing. Less well recognized is her involvement with the development of nutritional services for the military. A nutrient-intake analysis is developed here based on her recommendations and recipes for army troops. The intake profile is compared with modern recommendations for dietary intake for adequacy of the diet.

  2. Surgeon Major Thomas Heazle Parke (1857-1893): Irish doctor, soldier and explorer.

    Science.gov (United States)

    Parke, Andrew

    2017-08-08

    Surgeon Major Thomas Heazle Parke (1857-1893) was a doctor from Drumsna, County Roscommon, who after completing his education at the Royal College of Surgeons in Ireland joined the British army as a medical officer. After several years of serving in Ireland and Egypt, he volunteered to be medical officer of the Emin Pasha Relief Expedition of 1887-1889. This was to become Henry Morton Stanley's largest, longest and most controversial African expedition. The epic journey saw Stanley, his eight European officers and 800 African porters take almost 3 years to cross the African continent from West to East via the Congo River, Southern Sudan and Uganda. During this time, Parke had to single-handedly deal with the myriad diseases and injuries that beset the expedition's members. Barely 200 of the Zanzibari, Sudanese and Somali porters survived, and two British officers also perished. In completing the expedition, Parke became the first Irishman to cross Africa, and he had also become the first European to lay eyes on the ' Mountains of the Moon ' or ' Ruwenzori '. He returned home to great acclaim, and was bestowed copious honours and fellowships. His account of the expedition, My Experiences in Equatorial Africa , was a bestseller. However, his own health never recovered from the hardships of his time in Africa, and he died suddenly in 1893. His statue stands outside the Natural History Museum in Dublin. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Building the Old Contemptibles: British Military Transformation and Tactical Development from the Boer War to the Great War, 1899-1914

    National Research Council Canada - National Science Library

    Risio, Andrew J

    2005-01-01

    Impressed with the tactical lessons of the Boer War, the British Army reformed its doctrine and training from 1899 to 1914, deploying a combat ready force, the "Old Contemptibles" of the British Expeditionary Force (BEF) in 1914...

  4. Army dreamers.

    Science.gov (United States)

    1988-05-14

    The birth of the Army Nursing Service took place in 1854, when Florence Nightingale, at the request of the Secretary of State for War, recruited and took to Scutari Hospital 38 women to tend the wounded of the Crimean war.

  5. The Surgeon and Advocacy

    African Journals Online (AJOL)

    and how the hospital administration handles and resolves ... regard to having systems that improve patient care. Surgeons have been ... implementation of the Surgical safety checklist (9). ... aviation industry, has helped to streamline patient.

  6. Civil Surgeon Info

    Data.gov (United States)

    Department of Homeland Security — USCIS designates certain doctors (also known as civil surgeons) to perform the medical exam required for most Green Card applicants. This data set represents the...

  7. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Apply for Membership Membership Directory Pay Your Dues Industry Mailing List License & eBlast Communications Programs Advertise on ... Hotel Discount Copyright © 2017 The Society of Thoracic Surgeons. ...

  8. Society of Laparoendoscopic Surgeons

    Science.gov (United States)

    ... the Minimally Invasive Surgery and Therapy World. Nezhat’s History of Endoscopy In 2005 pioneering surgeon Dr. Camran Nezhat was awarded a fellowship by The American College of Obstetrics and Gynecology to research and write this important ...

  9. British Intelligence Operations as They Relate to Britain’s Defeat at Yorktown, 1781

    Science.gov (United States)

    2010-06-11

    121Matthew H. Spring, With Zeal and With Bayonets Only: The British Army on Campaign in North America, 1775-1783 ( Norman , OK: University of Oklahoma...humorously complained to Lieutenant Colonel Francis Lord Rawdon, “All my accounts about [Major General] Smallwood agree with yours, but mine are: ‘I...Matthew H. With Zeal and With Bayonets Only: The British Army on Campaign in North America, 1775-1783. Norman , OK: University of Oklahoma Press, 2008

  10. Stress in surgeons.

    Science.gov (United States)

    Green, A; Duthie, H L; Young, H L; Peters, T J

    1990-10-01

    A sample of 1000 members of the Association of Surgeons of Great Britain and Ireland was circulated with a postal questionnaire relating to their occupational stressors, their type A coronary-prone behaviour and their mental health. Six hundred and seventy-two (67 per cent) useable forms were returned anonymously. The major individual stressors were: (1) the interference of the job with personal life, (2) general administration, and (3) the number of patients in clinics. Type A behaviour was similar to that of other professional groups. Surgeons showed mean scores significantly higher than the general population on two subscales of the mental health index (free-floating anxiety and hysterical anxiety). The findings for the few female surgeons (2 per cent) were similar to those in men but they did not exhibit raised free-floating anxiety levels.

  11. Surgeons' vision rewarded.

    Science.gov (United States)

    Baillie, Jonathan

    2010-08-01

    Surgeons and clinical staff, theatre circulation and scrub personnel, and anaesthetists, as well as the estates and facilities team at Kent's Maidstone Hospital, have worked with specialist supplier of integrated audio, video, and instrumentation systems for the operating room, Olympus Medical, to develop what is claimed is among the UK's most advanced operating theatres yet built for laparoscopic and endoscopic surgery. HEJ editor Jonathan Baillie discussed the project with Amir Nisar, the surgeon who championed efforts to get the facility built, and Olympus Medical national sales manager, systems integration, James Watts.

  12. Business knowledge in surgeons.

    Science.gov (United States)

    Satiani, Bhagwan

    2004-07-01

    Surgeons and residents in training receive little, if any, formal education in the economic side of clinical practice during medical school or residency. As medical professionals face shrinking reimbursement, loss of control over health care decisions, and limited resources, surgical specialties must reevaluate the need to teach their members business survival skills. Before designing business related-teaching modules, educators must know the exact gaps in knowledge that exist among surgeons. This article reports a survey of 133 surgeons in the Midwest who were asked to rate their knowledge base in 11 business topics relevant to the practice of medicine. The survey showed that the average surgeon perceives himself or herself to be poorly equipped to understand basic financial accounting principles, financial markets, economics of health care, tools for evaluating purchases, marketing, budgets, antitrust and fraud and abuse regulations, and risk and return on investments. Armed with this data, teaching faculty, health care systems, and medical specialty societies should design business education seminars to better position surgical specialists and trainees to communicate with insurers, hospital administrators, health care organizations, and their own personal financial advisors.

  13. Surgeon-performed ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias

    2017-01-01

    Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment...

  14. British Sign Name Customs

    Science.gov (United States)

    Day, Linda; Sutton-Spence, Rachel

    2010-01-01

    Research presented here describes the sign names and the customs of name allocation within the British Deaf community. While some aspects of British Sign Language sign names and British Deaf naming customs differ from those in most Western societies, there are many similarities. There are also similarities with other societies outside the more…

  15. Edward D. Churchill as a combat consultant: lessons for the senior visiting surgeons and today's military medical corps.

    Science.gov (United States)

    Cannon, Jeremy W; Fischer, Josef E

    2010-03-01

    In World War II, Edward D. Churchill volunteered as a combat consultant. In this role, he mentored many junior surgeons and challenged the Army leadership to treat hemorrhagic shock with blood rather than plasma. These lessons have continued relevance for today's Senior Visiting Surgeons and our military medical corps.

  16. Army TLS

    Science.gov (United States)

    2014-12-10

    Fast Deflation Device Tether marking Pennants Balloon / Tether marking LED Flashing light Loading Ramps Customized Trailer for transportation and Field...amount of xtra lift that permits the ballon to rise (if Res_Lift = 0, balloon is at equilibrium) RL = NL – Payload – Tether Payload: the weight of...Army TLS The TLS uses tethered aerodynamic blimps and precision-powered winches to loft one or more specialty-designed meteorological payloads that

  17. A history of US Army PAs.

    Science.gov (United States)

    Chalupa, Robyn L; Marble, W Sanders

    2017-11-01

    The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units. PAs lead in tactical and clinical settings, filling command roles, senior clinical positions, and administrative leadership roles.

  18. Lessons from the British Defeat Combating Colonial Hybrid Warfare in the 1781 Southern Theater of Operations

    Science.gov (United States)

    2014-05-22

    Society for Army Historical Research 16, no. 61 (1937): 3-23; Henry Clinton, The Headquarters Papers of the British Army in North America During the War...Rejoinder to ‘Future Threats and Strategic Thinking,” Infinity Journal 2, no. 2 (Spring 2012): 24-29. 19Department of the Army, ADRP 3-0, Unified Land...represented his security zone. The colony provided food for Greene’s army, a staging base for manufactured material and forces from New England, and a

  19. Mentoring the Afghan Army at the Officer Academy in Kabul

    DEFF Research Database (Denmark)

    Mynster Christensen, Maya

    Capacity building of host nation militaries is a central component of current multinational military operations, which is likely to become increasingly vital to future military interventions in conflict settings. Focusing on the mentoring of the Afghan National Army at the British-led officer...... academy in Kabul, this policy brief stresses the urgency with which Western militaries should improve military capacity building efforts. Based on qualitative data collected at the British Royal Military Academy Sandhurst and the Afghan National Army Officer Academy, the brief outlines five clusters...

  20. British Dance: Black Routes

    OpenAIRE

    Adair, C.; Burt, Ramsay, 1953-

    2016-01-01

    British Dance: Black Routes re-examines the distinctive contributions made to British dance by dancers who are Black. Covering the period 1946 to the present, it presents a radical re-reading of dancers and their companies, placing their achievements within a broader historical, cultural and artistic context. The result of a two year research project, British Dance and the African Diaspora, led by editors Christy Adair and Ramsay Burt, the collection looks at artists working with contempor...

  1. Planning for success: desired characteristics of special operations surgeons, a pilot study.

    Science.gov (United States)

    Campbell, Barrett H; Alderman, Shawn M

    2012-01-01

    Selection criteria for Special Operations Forces (SOF) physicians are often unclear to potential candidates without prior SOF experience. To date, no published career resource exists to guide the careers of physicians interested in becoming a SOF surgeon. Using a survey tool, desirable characteristics and personal attributes were identified that can be used to inform candidate career decisions and better prepare them for a future position in Special Operations. A descriptive, cross-sectional survey instrument was developed and distributed to current Army SOF Command Surgeons for further distribution to subordinate surgeons. RESULTS were analyzed as a cohort and by subordinate command. Respondents consisted of current SOF Surgeons. Uniformly, the individual characteristics most strongly desired are professionalism, being a team player, and leadership. Possessing or obtaining Airborne and Flight Surgeon qualifications prior to consideration for a surgeon position was highly desired. Residency training within Family Medicine or Emergency Medicine constituted the vast majority of specialty preference. Understanding which characteristics and attributes are desirable to current surgeons and commanders can aid physicians interested in SOF surgeon positions. Using this study and future studies can guide career planning and foster the selection of ideally trained physicians who will operate at the tip of the spear. The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. 2012.

  2. From precocious fame to mature obscurity: David Walker (1837-1917) MD, LRCSI, surgeon and naturalist to the Fox Arctic Expedition of 1857-59.

    Science.gov (United States)

    Froggatt, Peter; Walker, Brian M

    2012-11-01

    The Belfast-born David Walker was the 19-year-old surgeon and naturalist on the epic Fox Arctic Expedition (1857-59) that established the fate of Sir John Franklin's unsuccessful (1845) search for the North-West Passage. On return the crew were fêted as heroes and decorated, and shared in a £5000 government bounty: Walker was also received by the Queen and (in Ireland) by the Lord Lieutenant, was honoured by the principal British and Irish natural history societies and his portrait was exhibited in the National Portrait Gallery, London. This paper describes his adventurous life, including the Fox Expedition, which from 1862 was spent abroad and included time in the Cariboo gold fields, service in the United States Army, practice in a notorious Californian frontier town and, in later life, the comparative quiet of general and occupational medical practice in Portland, Oregon. Once a household name, his death went unrecorded in the British and Irish medical and lay press.

  3. Assessment, surgeon, and society.

    Science.gov (United States)

    Norcini, John; Talati, Jamsheer

    2009-08-01

    An increasing public demand to monitor and assure the quality of care provided by physicians and surgeons has been accompanied by a deepening appreciation within the profession of the demands of self-regulation and the need for accountability. To respond to these developments, the public and the profession have turned increasingly to assessment, both to establish initial competence and to ensure that it is maintained throughout a career. Fortunately, this comes at a time when there have been significant advances in the breadth and quality of the assessment tools available. This article provides an overview of the drivers of change in assessment which includes the educational outcomes movement, the development of technology, and advances in assessment. It then outlines the factors that are important in selecting assessment devices as well as a system for classifying the methods that are available. Finally, the drivers of change have spawned a number of trends in the assessment of competence as a surgeon. Three of them are of particular note, simulation, workplace-based assessment, and the assessment of new competences, and each is reviewed with a focus on its potential.

  4. The world's best-known surgeon.

    Science.gov (United States)

    Walt, A J

    1983-10-01

    Henry Norman Bethune was born in Ontario in 1890 and was to become the best-known physician in the world. Bethune, a thoracic surgeon, spent his professional life in Detroit and Montreal, with these periods separated by a year spent as a patient in a tuberculosis sanatorium. This was where his interest in pulmonary disease was stimulated. Pioneer thoracic surgeon, councillor to the American Association for Thoracic Surgery, artist, poet, polemist, conservative-turned-communist, iconoclast, and soldier, Bethune was a highly complex individual. Diverting his energies from surgery to social issues during the depression, Bethune participated in the Spanish Civil War, at which time he designed the world's first mobile blood transfusion unit. Eight months later, Bethune joined Mao Tse-tung's Eight Route Army in China. In 1939 he died of septicemia acquired from a sliver of infected bone while he was operating on a wounded Chinese patient. Bethune's fame today derives principally from the popularization of his accomplishments by Mao, whom he met once and who subsequently decreed that all in China should learn about him. Bethune's posthumous influence played an important role in the reopening of relations between China and the West.

  5. Administration: Army Congressional Fellowship Program

    National Research Council Canada - National Science Library

    2000-01-01

    This printing publishes a new Army Regulation. This regulation presents the policies and procedures under which the Army manages the Army Congressional Fellowship Program and supplements applicable Department...

  6. Army medical imaging system: ARMIS

    International Nuclear Information System (INIS)

    Siedband, M.P.; Kramp, D.C.

    1987-01-01

    Recent advances of stimulable phosphor screens, data cards using optical storage means, and new personal computers with image processing capability have made possible the design of economical filmless medical imaging systems. The addition of communication links means that remote interpretation of images is also possible. The Army Medical Imaging System uses stimulable phosphor screens, digital readout, a small computer, an optical digital data card device, and a DIN/PACS link. Up to 200 images can be stored in the computer hard disk for rapid recall and reading by the radiologist. The computer permits image processing, annotation, insertion of text, and control of the system. Each device contains an image storage RAM and communicates with the computer via the small computer systems interface. Data compression is used to reduce the required storage capacity and transmission times of the 1-mB images. The credit card-size optical data cards replace film and can store 12 or more images. The data cards can be read on an independent viewer. The research is supported by the U.S. Army Biomedical Research and Development Laboratory

  7. Body dysmorphia, self-mutilation and the reconstructive surgeon.

    Science.gov (United States)

    Chan, James Kwok-Kwan; Jones, Sophie M; Heywood, Anthony J

    2011-01-01

    Body dysmorphic disorder (BDD) is a disabling preoccupation with a slight or an imagined defect in appearance. It is recognised in some patients who present to the plastic surgeon requesting multiple cosmetic procedures. Very rarely, BDD patients may wish for amputation of a healthy limb and may even mutilate themselves deliberately in order to necessitate amputation. These patients pose a diagnostic challenge as BDD is uncommon and they are often uncooperative whilst appearing mentally sound. Furthermore, they raise difficult ethical and legal issues for the surgeon. Although there is some guidance for the management of BDD patients seeking elective amputation, there is currently none for the management of those who present in the emergency setting. Illustrated by the case of a man who, having failed to find a complicit surgeon, attempted self-amputation of the hand, we review the relevant ethical, legal and management issues with advice by the British Medical Association and General Medical Council. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Comparative analysis of field ration for military personnel of the ukrainian army and armies of other countries worldwide

    Directory of Open Access Journals (Sweden)

    M. Mardar

    2017-04-01

    Full Text Available For the purpose of improvement of the Ukrainian nutritional standards this Article provides comparative analysis of field rations of different countries worldwide to make a proposal on improvement of food-stuff assortment in food ration for military personnel in the Armed Forces of Ukraine, Army of USA, the British Army, Army of Germany, Army of Italy, Army of Canada, Army of France, Army of Belarus, Army of Armenia. In accordance with the comparative analysis it was established that ration composition used for the Armed Forces of Ukraine military personnel lags behind developed countries of the world both in nutrition arrangement and in nutrient composition, especially in relation to assortment and variety of ration food-stuff. Moreover, a field ration is strictly unified and doesn’t consider individual needs of military personnel in calories, proteins, fats, carbohydrates, food fibers. Selection of individual field ration takes to account only age of military personnel, i. e. individual needs related to nutrition composition such as physical abilities, level of physical activity, gender, type of occupation before military conscription and etc. are not consideredThe obtained results confirms practicability of assortment products assortment included to field rations for the purpose to correct nutrition rations towards optimal balance for military efficiency of army, adaptation of military personnel to physical and psychological loads.

  9. Colonial army recruitment patterns and post-colonial Military Coups ...

    African Journals Online (AJOL)

    Since time immemorial, societies, states and state builders have been challenged and transformed by the need and quest for military manpower. European states relied on conscript armies to 'pacify' and retain colonies in parts of the non-European world. These facts underscore the meticulous attention paid by the British to ...

  10. Surgeon-performed ultrasonography.

    Science.gov (United States)

    Todsen, Tobias

    2017-11-01

    Surgeons are increasingly using ultrasonography (US) in their clinical management of patients. However, US is a very user-dependent imaging modality and proper skills of the US operator are needed to ensure quality in patient care. This thesis explores the validity evidence for assessment of competence in abdominal and head & neck ultrasonography using the Objective Structured Assessment of Ultrasound Skills (OSAUS) scale. With the use of Messick's unitary framework of validity, five sources of validity evidence were explored: test content, response processes, inter-nal structure, relations to other variables, and consequences. Research paper I examined validity evidence for the use of the OSAUS scale to assess physicians' abdominal point-of-care US competence in an experimental setting using patient cases with and without pathological conditions. The RESULTS provided validity evidence of the internal structure of the OSAUS scale and a deci-sion study predicted that four cases and two raters or five cases and one rater could ensure sufficient reliability in future test setups. The relation to other variables was supported by a signifi-cant difference in scores between US experience levels, and by a strong correlation between the OSAUS score and diagnostic accuracy. Research paper II explored the transfer of learning from formal point-of-care US training to performance on patients in a randomized controlled study. The RESULTS supported validity evi-dence regarding OSAUS scores' relation to other variables by demonstrating a significant discrimination in the progress of training-a more refined validity evidence than the relation to difference experience levels. The RESULTS showed that physicians could transfer the skills learned on an ultrasonography course to improved US performance and diagnostic accuracy on patients. However, the RESULTS also indicated that following an initial course, additional training is needed for physicians to achieve competence in US

  11. Army Task Force on Behavioral Health: Corrective Action Plan

    Science.gov (United States)

    2013-01-01

    Veterans Affairs Legal Section KNOWLEDGE MGMT SECTION • KMO • CAA Analyst Figure I-1. Task Force Organization. ACRONYM Key ASA(M&RA): Assistant...Army Audit Agency OTIG: Office of the Inspector General OTSG: Office of the Surgeon General KMO : Knowledge Management Officer CAA: Center for

  12. Strategic Analysis and Associated Management Products Supporting the Reengineering of Bayne-Jones Army Community Hospital: Consultative Products and Findings

    National Research Council Canada - National Science Library

    Fulton, Larry

    1998-01-01

    .... ̂Product 2 - "Bayne-Jones Army Community Hospital Web Site," a strategic Internet web site for marketing health and wellness, the TRICARE medical network, the Joint Readiness Training Center Surgeon's...

  13. The surgeon and casemix.

    Science.gov (United States)

    Hart, J A; Wallace, D

    1998-10-19

    Casemix funding has markedly increased surgeons' awareness of the economies of the activities they undertake. Surgery has become a major focus at all large public hospitals, because of its high earning potential, and this pressure to maximise funding could influence surgical practice. Casemix funding's emphasis on length of hospital stay has encouraged forward planning for earlier discharge after surgical procedures. Patients are now assessed in pre-admission clinics, educated about their condition and their hospital stay, and a plan formulated for their discharge and rehabilitation. Funding for major surgical procedures of long duration in patients with complex conditions should reflect the higher level of resource utilisation. Tertiary referral centres, because of their commitment to training and research and their more severely ill patient population, are less cost-effective and require funding to ensure their viability. The improved information that casemix generates should be used to evaluate outcomes and improve patient care; efficiency must not take precedence over quality of care and compassion.

  14. [Viktor Borisovich von Gyubbenet--a military physician, a surgeon and a social activist].

    Science.gov (United States)

    Ishutin, O S

    2015-02-01

    The current article is dedicated to a talented surgeon, an organizer of military health care, an extraordinary personality and a public figure--Doctor of Medicine, a privy councilor Victor Borisovich von Guebbenet. A talent of von Gyubbenea as a doctor-surgeon and an organizer of the surgical help on theater of war was especially brightly shown during two big military conflicts of the beginning of the XX century--the Russo-Japanese War (1904-1905) and the First World War I (1914-1918). In the first case doctor von Gyubbenet, being a surgeon of the 3rd Siberian corps successfully manage the activity of military-medical divisions and establishments of Port Arthur garrison. In the second military conflict Victor Borisovich as a doctor and an organizer headed sanitary part of armies of the Western front and successfully directed a medical support of armies of the front since 1915 and until the end of war.

  15. 2009 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Education

    Science.gov (United States)

    2010-06-11

    right time, handling pre- education attitudes, and tracking performance gains and career advantages related to academics.  Developing current, relevant...Army Leadership Technical Report 2010-2 2009 CENTER FOR ARMY LEADERSHIP ANNUAL SURVEY OF ARMY LEADERSHIP (CASAL): ARMY EDUCATION ...Joshua Hatfield ICF International John P. Steele Center for Army Leadership June 2010 The Center for Army Leadership An

  16. 50 Div in Normandy: A Critical Analysis of the British 50th (Northumbrian) Division on D-Day and in the Battle of Normandy

    National Research Council Canada - National Science Library

    Williams, Ethan R

    2007-01-01

    In late 1943, the British Army ordered the veteran 7th Armored, 51st (Highland) and 50th (Northumbrian) Divisions to return to Great Britain to provide combat experienced troops for the D-Day invasion of northwest Europe...

  17. [The chief surgeon Claude Louis Sommé (1772-1855) French military physician, surgeon of Antwerp hospital].

    Science.gov (United States)

    Tricot, Jean-pierre

    2015-01-01

    Claude Louis Sommé was born in Paris in 1772. After surgical studies between 1790 and 1792, he successfully embraced a military career in the armies of Napoleon at different fronts and in several hospitals. In 1806 he submitted his doctoral thesis at the Special Medical School of Strasburg, Dissertation upon Pain. The same year he presented his dismissal from he imperial armies and became chief-surgeon at the St Elisabeth hospital of Antwerp where he stayed on duty until his death in 1855. Sommé wrote a lot of medical books: surgical, anatomical and physiological. After the battle of Waterloo one third of the injured soldiers were transferred to Antwerp and were attended in his department. He also played an important role as a professor at the Primary Medical School of Antwerp. Sommé also created the botanical garden of Antwerp, close to the hospital.

  18. Society and the British Army: Implications for Fighting Spirit

    Science.gov (United States)

    2017-05-25

    as a side effect of war. It has been instrumentalized as a risk to be avoided, which is profoundly at odds, of course, with the humanist message at...unforeseen events may disrupt the current trend. For example, a prolonged reversal of the United Kingdom’s prosperity, or an existential security threat

  19. "Odds and Sods": Minorities in the British Empire's Campaign for Palestine, 1916-1919

    OpenAIRE

    Saltman, Julian

    2013-01-01

    This dissertation examines the role of minority soldiers in Britain's Army during the campaign for Palestine in the First World War. It compares the experiences of two distinct, yet parallel, groups--three battalions of black, British West Indians (the British West Indies Regiment) and three battalions of Jewish soldiers (the "Jewish Legion"). Past scholarship has mostly ignored the history of these men, and what does exist has tended to conflate or subsume the specific experiences of the men...

  20. Thomas Vicary, barber-surgeon.

    Science.gov (United States)

    Thomas, Duncan P

    2006-05-01

    An Act of Parliament in 1540 uniting the barbers and surgeons to form the Barber-Surgeons' Company represented an important foundation stone towards better surgery in England. Thomas Vicary, who played a pivotal role in promoting this union, was a leading surgeon in London in the middle of the 16th century. While Vicary made no direct contribution to surgical knowledge, he should be remembered primarily as one who contributed much towards the early organization and teaching of surgery and to the consequent benefits that flowed from this improvement.

  1. British-Zionist Military Cooperation in Palestine, 1917-1939

    Directory of Open Access Journals (Sweden)

    Mohsen M. Saleh

    2003-12-01

    Full Text Available The essence of the British military and security formula in Palestine was the smooth establishment of the Jewish national home with minimum costs of lives and money. However, this British pro-Zionist policy created a continuous security problem, and opened the door to all possibilities of Palestinian revolts and uprisings of both national and religious nature. The British were very active in disarming the Arabs and adopted stringent measures to crush their uprisings and revolts. But, they turned a blind eye to the Jewish arms smuggling and Jewish military organizations, especially, the Hagana, which later became the backbone of the Israeli Army. During Palestinian uprisings of 1920, 1921 and 1929 against the Zionists, most of the Palestinian casualties were inflicted by the British forces despite the fact that the Palestinians avoided attacking the British. The British-Zionist cooperation reached its peak during the Palestinian revolt of 1936-1939, and took different forms, including allowing the Jews to establish a military force of twenty two thousand men under the pretext of protecting the Jewish community.

  2. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  3. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle surgeons are the surgical ... every age. What education has a foot and ankle surgeon received? After completing undergraduate education, the foot ...

  4. Chronocentrism and British criminology.

    Science.gov (United States)

    Rock, Paul

    2005-09-01

    Criminologists display a largely unexamined propensity to ignore writings that are more than fifteen or so years old, with evident consequences for the public presentation and validation of expert knowledge. A citation study was combined with detailed observations from British criminologists to ascertain quite how that disavowal of the past was accomplished.

  5. Louisa Garrett Anderson (1873-1943), surgeon and suffragette.

    Science.gov (United States)

    Geddes, Jennian F

    2008-11-01

    Louisa Garrett Anderson, daughter of Britain's first woman doctor, has been largely forgotten today despite the fact that her contribution to the women's movement was as great as that of her mother. Recognized by her contemporaries as an important figure in the suffrage campaign, Anderson chose to lend her support through high-profile action, being one of the few women doctors in her generation who risked their professional as well as their personal reputation in the fight for women's rights by becoming a suffragette - in her case, even going so far as to spend a month in prison for breaking a window on a demonstration. On the outbreak of war, with only the clinical experience she had gained as outpatient surgeon in a women's hospital, Anderson established a series of women-run military hospitals where she was a Chief Surgeon. The most successful was the Endell Street Military Hospital in London, funded by the Royal Army Medical Corps and the only army hospital ever to be run and staffed entirely by women. Believing that a doctor had an obligation to take a lead in public affairs, Anderson continued campaigning for women's issues in the unlikely setting of Endell Street, ensuring that their activities remained in the public eye through constant press coverage. Anderson's achievement was that her work played no small part in expunging the stigma of the militant years in the eyes of the public and - more importantly - was largely instrumental in putting women doctors on equal terms with their male colleagues.

  6. Discovering the Army's Core Competencies

    National Research Council Canada - National Science Library

    Rudesheim, Frederick

    2001-01-01

    This paper seeks to answer the question, "Has the Army correctly identified its core competencies to ensure the Army can adequately respond to the national military strategy?" FM 1, The Army (Prototype Draft...

  7. Women in the Army

    Science.gov (United States)

    1980-06-06

    Army womenpower re- quirements with no apparent end in sight. No country, not even Russia or Israel, has ever made a conscious decision to include...provide a basis for decision making. iiI CHAPTER ONE AN HISTORICAL OVERVIEW Few books have been written which outline the history of military women...with a bill introducing the Women’s Army Auxillary Corps (WAAC). In order 7 that the Army could maintain control over this sensitive issue, General

  8. Army Maintenance System Transformation

    National Research Council Canada - National Science Library

    Gilbertson, Frank V

    2006-01-01

    .... Used in conjunction with pertinent historical data and developed with Army transformation goals in mind, General Systems thinking can provide the framework for guiding maintenance transformation...

  9. The lesser spotted pregnant surgeon.

    Science.gov (United States)

    Hamilton, L C

    2017-10-19

    With more women entering surgical training, it will become more commonplace to encounter pregnant surgeons. This paper discusses the evidence for work-related risk factors as well as outlining the rights of a pregnant doctor. There are, in fact, very few real risks to pregnancy encountered as a surgeon, with the main risks involving standing or sitting for long periods and fatigue, which can be managed with support from the department. It is important for women in surgery to know that it is possible to continue their training while pregnant so they do not feel pressured into changing to a less demanding specialty or even leaving medicine entirely. It is also important for other professionals to understand the risks and choices faced by pregnant surgeons so that they can better support them in the workplace.

  10. British Museum paintings

    OpenAIRE

    Edmonds, Frances

    2011-01-01

    Frances Edmonds is one of a group of artists selected for the show ‘Territories’ taking place at Galerie Windkracht 13 in Den Helder, Holland this July 2012. This exhibition is curated by Sharon Beavan and Gethin Evans. The artists represented work across the boundaries of two and three-dimensional and time based form. The brief – to interrogate and explore the notion of territories. Frances will be showing several paintings from the British Museum series, based on imagery collected ...

  11. ARMY CYBER STRUCTURE ALIGNMENT

    Science.gov (United States)

    2016-02-16

    content/?q=historic-cyber-unit-begins- daily-action . 14 John M. McHugh , Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary of...support-plays-role-in-tactical-operations/75545442/. McHugh , John M., Secretary of the Army, HQDA General Order 2014-02, Affirmation of Secretary of

  12. Kant and the cosmetic surgeon.

    Science.gov (United States)

    Carey, J S

    1989-07-01

    Philosophers know that modern philosophy owes a great debt to the intellectual contributions of the 18th century philosopher Immanuel Kant. This essay attempts to show how cosmetic surgeons, and all surgeons at that, could learn much from his work. Not only did Kant write about the structure of human reasoning and how it relates to appearances but he also wrote about the nature of duties and other obligations. His work has strongly influenced medical ethics. In a more particular way, Kant wrote the most important work on aesthetics. His theory still influences how philosophers understand the meaning of the beautiful and how it pertains to the human figure. This essay presents an exercise in trying to apply Kantian philosophy to aesthetic plastic surgery. Its intention is to show cosmetic surgeons some of the implicit and explicit philosophical principles and potential arguments undergirding their potential surgical evaluations. It is meant to challenge the surgeon to reconsider how decisions are made using philosophical reasoning instead of some of the more usual justifications based on psychology or sociology.

  13. From Surgeon General's bookshelf to National Library of Medicine: a brief history.

    Science.gov (United States)

    Blake, J B

    1986-10-01

    The National Library of Medicine originated as a few books in the office of the army's surgeon general, Joseph Lovell, between 1818 and 1836. It became the nation's largest medical library after the Civil War under the direction of John Shaw Billings and began publishing the Index-Catalogue of the Library of the Surgeon General's Office and preparing the Index Medicus. After Billings retired in 1895, the library marked time as army medical officers were rotated through as directors until modernization began under Harold Wellington Jones during World War II. during the directorship of Frank B. Rogers (1949-1963), who introduced MEDLARS, guided the move to a new building in Bethesda, and revitalized other operations, the institution received statutory authority as the National Library of Medicine within the Public Health Service (1956). By 1965, which was marked by the passage of the Medical Library Assistance Act, the library had again regained a position of world leadership.

  14. Mapping discussion of canine obesity between veterinary surgeons and dog owners: a provisional study.

    Science.gov (United States)

    Cairns-Haylor, Theodora; Fordyce, Peter

    2017-02-11

    This study maps communication between veterinary surgeons and dog owners on obesity management in four first-opinion practices in the UK. A total of 74 dog owners who met the study's inclusion criteria and 24 veterinary surgeons were interviewed using oral questionnaires between November 2013 and May 2014. The dog owner questionnaire was based on potential discussion areas that could influence an owner's intention to act (initiate a weight loss regime) based on Ajzen's Theory of Planned Behaviour. The veterinary surgeons' questionnaires assessed perception of canine obesity, their personal communication strategies and current practice-level interventions. The findings identify opportunities for more proactive approaches to obesity management by veterinary surgeons and their practices. British Veterinary Association.

  15. Women surgeons in the new millennium.

    Science.gov (United States)

    Troppmann, Kathrin M; Palis, Bryan E; Goodnight, James E; Ho, Hung S; Troppmann, Christoph

    2009-07-01

    Women are increasingly entering the surgical profession. To assess professional and personal/family life situations, perceptions, and challenges for women vs men surgeons. National survey of American Board of Surgery-certified surgeons. A questionnaire was mailed to all women and men surgeons who were board certified in 1988, 1992, 1996, 2000, or 2004. Of 3507 surgeons, 895 (25.5%) responded. Among these, 178 (20.3%) were women and 698 (79.7%) were men. Most women and men surgeons would choose their profession again (women, 82.5%; men, 77.5%; P = .15). On multivariate analysis, men surgeons (odds ratio [OR], 2.5) and surgeons of a younger generation (certified in 2000 or 2004; OR, 1.3) were less likely to favor part-time work opportunities for surgeons. Most of the surgeons were married (75.6% of women vs 91.7% of men, P women surgeons (OR, 5.0) and surgeons of a younger generation (OR, 1.9) were less likely to have children. More women than men surgeons had their first child later in life, while already in surgical practice (62.4% vs 32.0%, P women surgeons vs 79.4% of men surgeons (P women surgeons than men surgeons thought that maternity leave was important (67.8% vs 30.8%, P work (86.5% vs 69.7%, P Women considering a surgical career should be aware that most women surgeons would choose their profession again. Strategies to maximize recruitment and retention of women surgeons should include serious consideration of alternative work schedules and optimization of maternity leave and child care opportunities.

  16. Army Hearing Program Status Report Quarter 1 Fiscal Year 2017

    Science.gov (United States)

    2017-03-27

    Occupational Health Objectives for Fiscal Year 2016, 21 October 2015. Memorandum, Office of the Surgeon General, subject: Public Health Management System ...Army’s Safety and Occupational Health objectives. U.S. Army Medical Command (MEDCOM) Chief of Staff Memorandum, dated 15 December 2016, mandates... Occupational and Environmental Health Readiness System – Hearing Conservation (DOEHRS-HC), and an average of 2 CIV and 3 MIL losses were recorded

  17. Social media and the surgeon.

    Science.gov (United States)

    Margolin, David A

    2013-03-01

    As the Internet has matured, social media has developed and become a part of our everyday life. Whether it is Facebook, YouTube, or LinkedIn, we now communicate with each other and the world in a very different manner. As physicians, and specifically colon and rectal surgeons, it is important that we understand this new technology, learn its limitations, and utilize it to foster growth of our practice, trade, and potentially result in better patient care.

  18. Musculoskeletal Pain in Gynecologic Surgeons

    Science.gov (United States)

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  19. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  20. Surgeon General's Family Health History Initiative

    Science.gov (United States)

    ... Source Code The Surgeon General's Family Health History Initiative To help focus attention on the importance of ... health campaign, called the Surgeon General's Family History Initiative, to encourage all American families to learn more ...

  1. [Improving the surgeon's image: introduction].

    Science.gov (United States)

    Tajima, Tomoo

    2004-05-01

    The number of medical students who aspire to become surgeons has been decreasing in recent years. With a vicious spiral in the decreasing number and the growing deterioration of surgeons' working conditions, there is fear of deterioration of surgical care and subsequent disintegration of overall health care in Japan. The purpose of this issue is to devise a strategy for improving surgeons' image and their working conditions to attract future medical students. However, we cannot expect a quick cure for the problem of the decreasing number of applicants for surgery since this issue is deeply related to many fundamental problems in the health care system in Japan. The challenge for surgical educators in coming years will be to solve the problem of chronic sleep deprivation and overwork of surgery residents and to develop an efficient program to meet the critical educational needs of surgical residents. To solve this problem it is necessary to ensure well-motivated surgical residents and to develop an integrated research program. No discussion of these issues would be complete without attention to the allocation of scarce medical resources, especially in relation to financial incentives for young surgeons. The authors, who are conscientious representatives of this society, would like to highlight these critical problems and issues that are particularly relevant to our modern surgical practice, and it is our sincere hope that all members of this society fully recognize these critical issues in the Japanese health care system to take leadership in improving the system. With the demonstration of withholding unnecessary medical conducts we may be able to initiate a renewal of the system and eventually to fulfill our dreams of Japan becoming a nation that can attract many patients from all over the world. Furthermore, verification of discipline with quality control and effective surgical treatment is needed to avoid criticism by other disciplines for being a self

  2. Basil A. Pruitt Jr. MD and the US Army Institute for Surgical Research: Five Decades of Science, Clinical Care, Mentorship, and Leadership.

    Science.gov (United States)

    Stewart, Ronald M

    2017-08-24

    Over the past half century Dr. Basil A. Pruitt, Jr., a great citizen, surgeon, innovator, mentor and leader, transformed our world through his dogged commitment to science and service to humanity. Dr. Pruitt's contribution lives on in the work of the US Army Institute of Surgical Research and the surgeons, physicians and scientists he shaped and inspired.

  3. Conference Proceedings: Photography and Britishness

    Directory of Open Access Journals (Sweden)

    Sean Willcock

    2016-11-01

    Full Text Available The video-recordings presented here were made at the conference Photography and Britishness, held at the Yale Center for British Art on November 4 – 5, 2016. The conference was the result of a collaboration between the Yale Center for British Art, New Haven, the Paul Mellon Centre for Studies in British Art, London, and the Huntington Library, Art Collections, and Botanical Gardens in San Marino—three research institutions that have a converging interest in British art. The conference sought to investigate the various ways in which notions of “Britishness” have been communicated, inflected, and contested through the photographic image. It was not a conference about the history of photography in Britain, or about British photography. Rather, it sought to consider the nature of the relationship between photography and Britishness: the notion that photography can capture images of Britishness, at the same time that our sense of what Britishness constitutes is produced by the photographic image. A key question for the conference was whether Britishness can have a photographic referent—or whether it is itself an effect of representation. Speakers at the conference approached these questions from a wide range of perspectives and focusing on a diverse number of photographic materials—from family albums and studio portraits to advertisements, reportage, and aerial photography—which demonstrated the complexities and instabilities not only of the term Britishness, but also of the medium of photography. The conference was opened with an introduction by John Tagg. The videos included here are presented in the order they were delivered.

  4. 21 CFR 878.4460 - Surgeon's glove.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgeon's glove. 878.4460 Section 878.4460 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4460 Surgeon's glove. (a) Identification. A surgeon's glove is a device made of natural or synthetic rubber intended to be worn by...

  5. The Nonwhite Woman Surgeon: A Rare Species.

    Science.gov (United States)

    Frohman, Heather A; Nguyen, Thu-Hoai C; Co, Franka; Rosemurgy, Alexander S; Ross, Sharona B

    2015-01-01

    As of 2012, 39% of medical student graduates were nonwhite, yet very few nonwhite women graduates chose to become surgeons. To better understand issues regarding nonwhite women in surgery, an online survey was sent to surgeons across the United States. Results are based on self-reported data. Mean data are reported. A total of 194 surgeons (42% women) completed the survey; only 12% of responders were nonwhite. Overall, 56% of nonwhite women felt they earned less than what men surgeons earn for equal work. Nonwhite women surgeons earned less than what men surgeons ($224,000 vs. 351,000, p women surgeons ($285,000, p = 0.02) earned. Overall, 96% of nonwhite surgeons believed that racial discrimination currently exists among surgeons. The few nonwhite women surgeons in the United States recognize that they are paid significantly less than what other surgeons are paid. Inequitable remuneration and a discriminatory work environment encountered by nonwhite women surgeons must be addressed. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  6. The Army Ethic

    Science.gov (United States)

    2015-06-12

    The Constitution and Declaration of Independence simultaneously hold two different views of human nature, an individualist and a collectivist view...Profession, defines the Army Ethic as “the evolving set of laws, values, and beliefs, deeply embedded within the core of the Army culture and...incorporate other viewpoints or respond to shifts in morality, religion, economics, and other socio- cultural factors. This thesis will use the term

  7. The Total Army

    Science.gov (United States)

    2016-01-01

    http://thediplomat.com/2015/04/chinas-growing-cyberwar-capabilities/ (accessed April 25, 2016); Nicolas Giacometti, “China’s Nuclear Modernization and...link between the operational and tactical levels of war.48 47. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve Gotten...unveils-its-big-8-initiatives/81882852/ (accessed March 16, 2016). 58. Michelle Tan , “US Army Generals Criticize Outdated Deployment Model: ‘We’ve

  8. Army Leader Transitions Handbook

    Science.gov (United States)

    2008-01-01

    The courseware allows users to tailor training materials to specific needs. Users access this at the CAL AKO website or Army eLearning https...usarmy.skillport.com/ skillportfe/login/usarmylogin.cfm. New users must register with eLearning . Then login, select “Army Custom Curricula” and scroll to...challenges of your transition. Patience, flexibility and a good understanding of influence techniques on your part will help make any needed realignment a

  9. Privatising British electricity

    International Nuclear Information System (INIS)

    Holmes, A.

    1992-01-01

    The privatisation of the British electricity industry was intended to be the most radical change made to a European power system in the post-war period. It was of an experimental nature, imposing on electricity a way of operating which has no equivalent anywhere in the world. This report shows, however, that in the long run-up to privatisation, a number of factors combined to pull the plan far from its original aims and to produce a hybrid system which has caused many new difficulties without establishing a fully commercial market. The original ideas behind the new system - most notably the establishment of a fully competitive commercial system - have not been fulfilled. Many of them were wholly impractical. The problems of establishing a competitive market in electricity were never properly addressed until the planning for the new system was well under way. (author)

  10. Revolting Soldiers: The Origins of Education in the Armies of the Empire in World War I.

    Science.gov (United States)

    Boshier, Roger

    1985-01-01

    Explores the circumstances surrounding the creation of education schemes in the armies of the British Empire. Discusses attitudes toward war and toward the soldier's role in the early 1900s, attitudes of the soldiers toward war, the University of Vimy Ridge, the Canadian Khaki University, the Oatlands program, and education for the New Zealand…

  11. Cultural Frictions: Mentoring the Afghan Army at 'Sandhurst in the Sand'

    DEFF Research Database (Denmark)

    Mynster Christensen, Maya

    2015-01-01

    The Afghan National Army Officer Academy (ANAOA) is a significant indicator of the success of the NATO-led mission in Afghanistan. This success relies on the local ownership and sustainability of an academy modelled on the British Royal Military Academy Sandhurst. Based on qualitative research...

  12. Ageing midface: The impact of surgeon's experience on the consistency in the assessment and proposed management.

    Science.gov (United States)

    Hazrati, Ali; Izadpanah, Ali; Zadeh, Teanoosh; Gosman, Amanda; Chao, James J; Dobke, Marek K

    2011-02-01

    residents group produced variations with less consistency. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. British Nuclear Fuels (Warrington)

    International Nuclear Information System (INIS)

    Hoyle, D.; Cryer, B.; Bellotti, D.

    1992-01-01

    This adjournment debate is about British Nuclear Fuels plc and the 750 redundancies due to take place by the mid-1990s at BNFL, Risley. The debate was instigated by the Member of Parliament for Warrington, the constituency in which BNFL, Risley is situated. Other members pointed out that other industries, such as the textile industry are also suffering job losses due to the recession. However the MP for Warrington argued that the recent restructuring of BNFL restricted the financial flexibility of BNFL so that the benefits of contracts won for THORP at Sellafield could not help BNFL, Risley. The debate became more generally about training, apprentices and employment opportunities. The Parliamentary Under-Secretary of State for Energy explained the position as he saw it and said BNFL may be able to offer more help to its apprentices. Long- term employment prospects at BNFL are dependent on the future of the nuclear industry in general. The debate lasted about half an hour and is reported verbatim. (U.K)

  14. 1970 British Cohort Study

    Directory of Open Access Journals (Sweden)

    Matt Brown

    2014-10-01

    Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London.  BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.

  15. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    ... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...

  16. Army Business Transformation - Next Steps

    National Research Council Canada - National Science Library

    2006-01-01

    As a follow-on to the Army Science Board 2005 Summer Study on Best Practices, the Army Science Board was tasked to identify areas where alternative approaches and application of transforming practices...

  17. Army Contract Writing System (ACWS)

    Science.gov (United States)

    2016-03-01

    2016 Major Automated Information System Annual Report Army Contract Writing System (ACWS) Defense Acquisition Management Information Retrieval...Information 4 Responsible Office 4 References 4 Program Description 5 Business Case 5 Program Status 6 Schedule 7 Performance...Program Information Program Name Army Contract Writing System (ACWS) DoD Component Army Responsible Office Program Manager References MAIS

  18. Regional futures: British Columbia

    International Nuclear Information System (INIS)

    Rees, W.

    1993-01-01

    Two paradigms that are the source of present-day economic development policies are described. The dominant paradigm is the expansionist world view that assumes economic growth is essentially unlimited, subject to certain constraints, and that the best way to monitor the human economy is through money flows. The steady-state or ecological world view assumes there are real constraints on material throughput and growth, and puts a significant emphasis on natural capital as a form of wealth which is distinct from economic or manufactured capital. Over the long term, each generation must receive from the previous generation at least an adequate stock of natural capital assets to ensure long-term sustainability. For every major category of consumption, such as food and energy, an ecological footprint can be assigned which represents the land needed to sustain a given pattern of consumption. For the lower mainland of British Columbia, this footprint would be about 22 times the actual land area; for the Netherlands, it would be about 15 times larger than the country itself. On a global basis, only about 1.7 hectares per capita of ecologically productive land is actually available, showing that Canadian material standards would not be sustainable on a global level. The steady-state approach to economic development would involve a local and regional approach from the bottom up, preferring small-scale labor-intensive enterprise. Trade would be limited to trading in real ecological surpluses, and value-added products would be made locally instead of shipping raw materials for processing elsewhere. 5 figs

  19. War of the British Worlds

    DEFF Research Database (Denmark)

    Mercau, Ezequiel

    2016-01-01

    The 1982 Falklands War was shrouded in symbolism, bringing to the fore divergent conceptions of Britishness, kinship, and belonging. This article casts light on the persistent purchase of the idea of Greater Britain long after the end of empire, addressing a case that would normally be deemed...... outside its spatial and temporal boundaries. By highlighting the inherent contradictions of this transnational bond, the South Atlantic conflict had a profound effect on an underexposed British community with a lingering attachment to a “British world”: the Anglo-Argentines. As they found themselves...... wedged between two irreconcilable identities, divisions threatened to derail this already enfeebled grouping. Yet leaders of the community, presuming a common Britishness with the Falkland Islanders and Britons in the United Kingdom, sought to intervene in the conflict by reaching out to both...

  20. [What Do Young Surgeons Want? Modern Requirements for Senior Surgeons].

    Science.gov (United States)

    Roeth, Anjali A; Mille, Markus

    2018-02-01

    Due to the shortage of surgical specialists, the question arises as to what surgical residents want and how the fascination of general and visceral surgery may be highlighted. The surgical working group "Young Surgeons" (CAJC) of the German Society for General and Visceral Surgery (DGAV) has organised and subdivided the aspects of an attractive surgical workplace and provides solutions. On the one hand, there is the structured and transparent residency which includes a defined curriculum, assistance of sub-steps during surgery, residency dialogues held on a regular basis, logbooks, the possibility of training and simulation in the clinic as well as permission to participate in further education and training. This has to go hand in hand with a "livable surgery" that is characterised by the compatibility of family and work, better planning of the routine in the clinic, a positive feedback culture, work-life balance, new work (time) models and more time for teaching and research. For many of these aspects, the head of surgery has to be the central role model to initiate structural changes in the clinic, especially as many of these key points may be easily implemented. In this way, the attraction of surgery can be rapidly enhanced and a "livable surgery" may be lived. Georg Thieme Verlag KG Stuttgart · New York.

  1. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    Science.gov (United States)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert

    2016-06-01

    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

  2. The Army Lawyer

    Science.gov (United States)

    2007-07-01

    authors in the articles do not necessarily reflect the view of The Judge Advocate General or the Department of the Army. Masculine or feminine...for the hegemonic power (read ‘United States’) and its followers to determine international public enemy on a case-by-case basis. A legal

  3. Army Sustainability Report 2010

    Science.gov (United States)

    2011-09-01

    the Fairfax Village Neighborhood Center’s native plant and butterfly garden. The center is the first LEED platinum military project (photo: US Army... Bush in 2007. 11 Statement of Deputy Under Secretary of Defense for Strategy, Plans, and Forces, Kathleen Hicks before the Senate Environment and

  4. Burnout and career satisfaction among American surgeons.

    Science.gov (United States)

    Shanafelt, Tait D; Balch, Charles M; Bechamps, Gerald J; Russell, Thomas; Dyrbye, Lotte; Satele, Daniel; Collicott, Paul; Novotny, Paul J; Sloan, Jeff; Freischlag, Julie A

    2009-09-01

    To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout. : Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons. Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments. Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon. Burnout is common among American surgeons and is the single greatest predictor of surgeons' satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

  5. Irish (Republic) versus British (North West) orthopaedic trainees: what are the differences?

    LENUS (Irish Health Repository)

    Banks, L N

    2012-02-01

    British Trainees have gradually had their working week curtained over the last 8 years. The Republic of Ireland Trainees have not been subjected to the European Working Time Directive prior to 2009 and have therefore worked on average, more hours than their British counterparts. We wanted to see if the differing schemes had an impact on recruiting and training orthopaedic surgeons. We surveyed Republic of Ireland orthopaedic specialist registrars (SpRs) and North West (NW) British SpRs\\/specialist trainees (ST3 and above) to see if there were any discernable differences in working patterns and subsequent training exposure. A standard proforma was given to Irish Trainees and to NW SpRs\\/STs at their National or regional teaching (January\\/February 2009). 62% of Irish and 47% of British NW Trainees responded. Irish trainees were more likely to have obtained a post-graduate degree (p = 0.03). The Irish worked more hours per week (p < 0.001) doing more trauma operative lists (p = 0.003) and more total cases per 6 months than the NW British (p = 0.003). This study suggests that more hours worked, equals more operative exposure, without detriment to the academic side of training. Obviously it is not possible to say whether fewer operations make for a poorer surgeon, but the evidence suggests that it may be true.

  6. Breast imaging: a surgeon's prospective

    International Nuclear Information System (INIS)

    Wallace, Anne M.; Comstock, Christopher; Hoh, Carl K.; Vera, David R.

    2005-01-01

    Mammography, ultrasound, magnetic resonance imaging, positron emission tomography, gamma camera and intraoperative gamma detection, and computed tomography are employed in the diagnosis and treatment of breast cancer. This paper summarizes the role of each modality from the perspective of the physician responsible for management of the patient's care. An understanding of an imaging modality's current role can provide insights into the design of new applications and diagnostic agents. Moreover, knowledge of the mechanism by which each modality provides clinical information can guide the design of new imaging methods that complement and add certainty to the patient's management. The reader should note the lack of molecular information provided by the current imaging methods. The perspective concludes with a request for an imaging technique that can measure the biologic aggressiveness of a woman's cancer. The surgeon notes that basing the formation of an image on a molecular process would be compatible with current medical practice, which utilizes molecular concepts to base medical decisions. In addition, molecular imaging will enable rapid translation between basic science and medical practice

  7. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

    Amirian, Ilda; Andersen, Lærke T; Rosenberg, Jacob

    2015-01-01

    BACKGROUND: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts. METHODS: Surgeons were monitor...

  8. The Future Medical Science and Colorectal Surgeons.

    Science.gov (United States)

    Kim, Young Jin

    2017-12-01

    Future medical technology breakthroughs will build from the incredible progress made in computers, biotechnology, and nanotechnology and from the information learned from the human genome. With such technology and information, computer-aided diagnoses, organ replacement, gene therapy, personalized drugs, and even age reversal will become possible. True 3-dimensional system technology will enable surgeons to envision key clinical features and will help them in planning complex surgery. Surgeons will enter surgical instructions in a virtual space from a remote medical center, order a medical robot to perform the operation, and review the operation in real time on a monitor. Surgeons will be better than artificial intelligence or automated robots when surgeons (or we) love patients and ask questions for a better future. The purpose of this paper is looking at the future medical science and the changes of colorectal surgeons.

  9. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad

    2014-01-01

    BACKGROUND AND AIM: Advancements in minimally invasive surgery have led to increases in popularity of single-incision laparoscopic surgery (SILS) and natural orifice translumenal surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American...... Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) due to their postulated benefits of better cosmesis, less pain, and quicker recovery. This questionnaire-based study investigated Danish surgeons' attitudes toward these new procedures. SUBJECTS AND METHODS: A 26-item questionnaire was developed...... and distributed electronically via e-mail to a total of 1253 members of The Danish Society of Surgeons and The Danish Society of Young Surgeons. RESULTS: In total, 352 (approximately 30%) surgeons completed the questionnaire, 54.4% were over 50 years of age, and 76.6% were men. When choosing surgery, the most...

  10. Department of the Army - The Fiscal Year 2008 Military Personnel, Army Appropriation and the Antideficiency Act

    Science.gov (United States)

    2010-06-22

    of the Army, U.S. Army Audit Agency, Budgeting for the Military Personnel, Army Appropriation, Report No. A-2010-0028- FFM (Jan. 6, 2010); Department...of the Army, U.S. Army Audit Agency, Military Personnel, Army FY 05 Subsistence Charges, Report No. A-2008-0037- FFM (Feb. 12, 2008); Department of

  11. A Surgical Business Composite Score for Army Medicine.

    Science.gov (United States)

    Stoddard, Douglas R; Robinson, Andrew B; Comer, Tracy A; Meno, Jenifer A; Welder, Matthew D

    2016-06-01

    Measuring surgical business performance for Army military treatment facilities is currently done through 6 business metrics developed by the Army Medical Command (MEDCOM) Surgical Services Service Line (3SL). Development of a composite score for business performance has the potential to simplify and synthesize measurement, improving focus for strategic goal setting and implementation. However, several considerations, ranging from data availability to submetric selection, must be addressed to ensure the score is accurate and representative. This article presents the methodology used in the composite score's creation and presents a metric based on return on investment and a measure of cases recaptured from private networks. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  12. Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons.

    Science.gov (United States)

    Coyne, L A; Latham, S M; Williams, N J; Dawson, S; Donald, I J; Pearson, R B; Smith, R F; Pinchbeck, G L

    2016-11-01

    The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  13. Army Programs: Army Finance and Accounting Quality Assurance Program

    National Research Council Canada - National Science Library

    1988-01-01

    This regulation discusses the primary responsibilities of commanders and staff officers at installation and higher levels for execution of the Army Finance and Accounting Quality Assurance (QA) Program...

  14. The British Monarchy On Screen

    OpenAIRE

    Merck, Mandy

    2016-01-01

    Moving images of the British monarchy, in fact and fiction, are almost as old as the moving image itself, dating back to an 1895 American drama, The Execution of Mary Queen of Scots. British monarchs even appeared in the new ‘animated photography’ from 1896, led by Queen Victoria. Half a century later, the 1953 coronation of Elizabeth II was a milestone in the adoption of television, watched by 20 million Britons and 100 million North Americans. At the century’s end, Princess Diana’s funeral ...

  15. British Values and British Identity: Muddles, Mixtures, and Ways Ahead

    Science.gov (United States)

    Richardson, Robin

    2015-01-01

    In the final eleven months of its five-year term, the Coalition Government placed much emphasis in the education system on what it called fundamental British values (FBV). The phrase had its origins in counter-terrorism strategies that were of dubious validity both conceptually and operationally, and the trigger for its introduction into the…

  16. Projecting surgeon supply using a dynamic model.

    Science.gov (United States)

    Fraher, Erin P; Knapton, Andy; Sheldon, George F; Meyer, Anthony; Ricketts, Thomas C

    2013-05-01

    To develop a projection model to forecast the head count and full-time equivalent supply of surgeons by age, sex, and specialty in the United States from 2009 to 2028. The search for the optimal number and specialty mix of surgeons to care for the United States population has taken on increased urgency under health care reform. Expanded insurance coverage and an aging population will increase demand for surgical and other medical services. Accurate forecasts of surgical service capacity are crucial to inform the federal government, training institutions, professional associations, and others charged with improving access to health care. The study uses a dynamic stock and flow model that simulates future changes in numbers and specialty type by factoring in changes in surgeon demographics and policy factors. : Forecasts show that overall surgeon supply will decrease 18% during the period form 2009 to 2028 with declines in all specialties except colorectal, pediatric, neurological surgery, and vascular surgery. Model simulations suggest that none of the proposed changes to increase graduate medical education currently under consideration will be sufficient to offset declines. The length of time it takes to train surgeons, the anticipated decrease in hours worked by surgeons in younger generations, and the potential decreases in graduate medical education funding suggest that there may be an insufficient surgeon workforce to meet population needs. Existing maldistribution patterns are likely to be exacerbated, leading to delayed or lost access to time-sensitive surgical procedures, particularly in rural areas.

  17. Retention of Mohs surgeons in academic dermatology.

    Science.gov (United States)

    Zhang, Shali; Mina, Mary Alice; Brown, Marc D; Zwald, Fiona O

    2015-08-01

    Retention of academic Mohs surgeons is important for the growth of this specialty and teaching of residents and students. To examine factors that influence retention of Mohs surgeons in academics and to better understand reasons for their departure. A survey was electronically distributed to academic Mohs surgeons in the American College of Mohs Surgery, asking them to rate the importance of several variables on their decision to remain in academia. Private practice Mohs surgeons who had left academics were also surveyed. Two hundred thirty-six dermatologic surgeons completed the survey. Twenty-nine percent work full time in academics, and approximately 7% work part time. The top reasons for practicing in the academic setting are intellectual stimulation, teaching opportunities, and collaboration with other university physicians and researchers. Seventy-one percent of respondents reported they would stay in academics, 7% indicated they would not, and 22% were unsure. Unfair compensation, inadequate support staff, poor leadership, increased bureaucracy, and decreased autonomy were top reasons that may compel a Mohs surgeon to leave. Opportunities for intellectual stimulation, collaboration, and teaching remain the main draw for academic Mohs surgeons. A supportive environment, strong leadership, and establishing fair compensation are imperative in ensuring their stay.

  18. Union Directions - Army Response.

    Science.gov (United States)

    1985-12-06

    reflects the long-held belief in the Army that employee participation in decisions that affect their worklife is healthy and desirable. Although some...pluralistic society, checks and balances are as important for the economy as for the government. Business executives who salivate at the thought of vanishing...Unions. Reading, MA: Addison-Wesley, 1976. 37. National Federation of Federal Employees. NFFE’s Guide to Quality of Worklife Programs. No. G-21

  19. Operationalizing Army Cyber

    Science.gov (United States)

    2013-03-01

    killed just under 3,000 people and cost the U.S. economy somewhere between three and five trillion dollars. The Japanese attacked with a state... economy , and military readiness. The challenge is to design an Army Cyber force that can support the United States Cyber Command (USCYBERCOM) national...still keeps the intelligence and signal functions separate in most units today from battalion to echelon above Corps ( EAC ). There are many past reasons

  20. 2007 Army Modernization Plan

    Science.gov (United States)

    2007-03-01

    Additional confi gurations include two NATO li ers with patients and one medical a endant. The aircra has a hoist for use in emergency...including airframes, wiring bundles and hydraulic systems on the remanufactured CH-47Fs are new. Program Status. The Army received its fi rst fully...Expansible Van and the 10T Dump Truck. Another new variant, the FMTV-Load Handling System, is expected to be fi elded in late-2007, initially to medical

  1. 1998 Army Modernization Plan

    Science.gov (United States)

    1998-01-01

    Biological (CB) Protective Duty Uniform (STO) • Biometrics (SRO) • Nanoscience (SRO) • Millimeter Wave Material and Dissemination Technology... Biometrics and Nanoscience SROs will enable the development of advanced NBC detection and characterization systems, including the exploitation of biologically...Requirements Trailers • Procure HEMAT Trailers Figure K-23 K-19 //;<?. U.S. Army 1997Modernization Plan This final fleet assessment, made against the

  2. Surgeon Participation in Early Accountable Care Organizations.

    Science.gov (United States)

    Resnick, Matthew J; Graves, Amy J; Buntin, Melinda B; Richards, Michael R; Penson, David F

    2018-03-01

    We aimed to characterize the landscape of surgeon participation in early accountable care organizations (ACOs) and to identify specialty-, organization-, and market-specific factors associated with ACO participation. Despite rapid deployment of alternative payment models (APMs), little is known about the prevalence of surgeon participation, and key drivers behind surgeon participation in APMs. Using data from SK&A, a research firm, we evaluated the near universe of US practices to characterize ACO participation among 125,425 US surgeons in 2015. We fit multivariable logistic regression models to characterize key drivers of ACO participation, and more specifically, the interaction between ACO affiliation and organizational structure. Of 125,425 US surgeons, 27,956 (22.3%) participated in at least 1 ACO program in 2015. We observed heterogeneity in participation by subspecialty, with trauma and transplant reporting the highest rate of ACO enrollment (36% for both) and plastic surgeons reporting the lowest (12.9%) followed by ophthalmology (16.0%) and hand (18.6%). Surgeons in group practices and integrated systems were more likely to participate relative to those practicing independently (aOR 1.57, 95% CI 1.50, 1.64; aOR 4.87, 95% CI 4.68, 5.07, respectively). We observed a statistically significant interaction (P organization. Model-derived predicted probabilities revealed that, within each specialty, surgeons in integrated health systems had the highest predicted probabilities of ACO and those practicing independently generally had the lowest. We observed considerable variation in ACO enrollment among US surgeons, mediated at least in part by differences in practice organization. These data underscore the need for development of frameworks to characterize the strategic advantages and disadvantages associated with APM participation.

  3. Digital Footprint of Neurological Surgeons.

    Science.gov (United States)

    Kim, Christopher; Gupta, Raghav; Shah, Aakash; Madill, Evan; Prabhu, Arpan V; Agarwal, Nitin

    2018-05-01

    Patients are increasingly turning to online resources to inquire about individual physicians and to gather health information. However, little research exists studying the online presence of neurosurgeons across the country. This study aimed to characterize these online profiles and assess the scope of neurosurgeons' digital identities. Medicare-participating neurologic surgeons from the United States and Puerto Rico were identified using the Centers for Medicare and Medicaid Services (CMS) Physician Comparable Downloadable File. Each physician was characterized by his or her medical education, graduation year, city of practice, gender, and affiliation with an academic institution. Using a Google-based custom search tool, the top 10 search results for each physician were extracted and categorized as 1 of the following: 1) physician, hospital, or healthcare system controlled, 2) third-party or government controlled, 3) social media-based, 4) primary journal article, or 5) other. Among the physicians within the CMS database, 4751 self-identified as being neurosurgeons, yielding a total of 45,875 uniform resource locator search results pertinent to these physicians. Of the 4751 neurosurgeons, 2317 (48.8%) and 2434 (51.2%) were classified as academic and nonacademic neurosurgeons, respectively. At least 1 search result was obtained for every physician. Hospital, healthcare system, or physician-controlled websites (18,206; 39.7%) and third-party websites (17,122; 37.3%) were the 2 most commonly observed domain types. Websites belonging to social media platforms accounted for 4843 (10.6%) search results, and websites belonging to peer-reviewed academic journals accounted for 1888 (4.1%) search results. The frequency with which a third-party domain appeared as the first search result was higher for nonacademic neurosurgeons than for academic neurosurgeons. In general, neurosurgeons lacked a controllable online presence within their first page of Google Search results

  4. Lifelong Learning for the Hand Surgeon.

    Science.gov (United States)

    Adkinson, Joshua M; Chung, Kevin C

    2015-09-01

    Hand surgeons are faced with the impossible task of mastering a rapidly expanding pool of knowledge and surgical techniques. Dedication to lifelong learning is, therefore, an essential component of delivering the best, most up-to-date care for patients. Board certification, participation in continuing medical education and maintenance of certification activities, and attendance at national meetings are essential mechanisms by which hand surgeons may foster the acquisition of essential knowledge and clinical skills, This article highlights the history, current status, and emerging needs in continuing medical education for the hand surgeon. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    .... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...

  6. Hakim Mohammad: A Persian Military Surgeon in Safavid Era (1501-1736 CE).

    Science.gov (United States)

    Khodaie, S-Ali; Ghaffari, Farzaneh; Zargaran, Arman; Naseri, Mohsen

    2017-12-31

    Wars and injuries have accompanied mankind throughout history. Physicians and surgeons from various civilizations made difficult attempts to manage wounds and injuries. Among various civilizations, the Persian Empires had great armies which were well equipped. One of the most important organizations in Persian troops was the military surgery. This study presents a brief biography of Hakim Mohammad (a military surgeon in Safavid era) and introduces his book, Dhakhira-yi-Kamilah. Safavid kings (1501-1736 CE) with unifying all of Persian regions and provinces reconstructed the Persian Empire. Great scholars and physicians were raised in this era. It seems that Persian physicians and surgeons were well trained in Safavid era and many of them were even employed by other countries like Ottoman Empire and India. Hakim Mohammad as a military surgeon was one of such physicians who served in Ottoman Empire for some time. He gathered his surgical experiences and others in the book of Dhakhira-yi-Kamilah. This book was written in Persian. He has mainly written about the management of wounds and practical techniques. Later, he came back to his homeland and dedicated his book to the king of Persia.

  7. Medical slang in British hospitals.

    Science.gov (United States)

    Fox, Adam T; Fertleman, Michael; Cahill, Pauline; Palmer, Roger D

    2003-01-01

    The usage, derivation, and psychological, ethical, and legal aspects of slang terminology in medicine are discussed. The colloquial vocabulary is further described and a comprehensive glossary of common UK terms provided in appendix. This forms the first list of slang terms currently in use throughout the British medical establishment.

  8. Nuclear power in British politics

    International Nuclear Information System (INIS)

    Pocock, R.F.

    1987-01-01

    The paper concerns the subject of nuclear power in British politics in 1986. The policies of the major political parties towards nuclear power are briefly outlined, along with public attitudes to nuclear energy, Chernobyl, and the rise of the anti-nuclear campaigners. (UK)

  9. British Columbia : an alternative design

    International Nuclear Information System (INIS)

    Ostergaard, P.

    2003-01-01

    This PowerPoint presentation outlined the British Columbia Ministry of Energy and Mines' approach to the electricity market. A brief overview of the electric system in the province was provided, examining capacity (primarily hydro based) and the utility sector with its public ownership. In British Columbia, 80 per cent of the electricity is generated by British Columbia Hydro (BC Hydro). The rates are based on cost of service. British Columbia's market is western North America. A comparison of monthly bills for several large cities, both Canadian and American, was displayed. The market reviews conducted in 1995, 1998, and 2002 were reviewed and the major recommendations discussed. The author identified the opportunities in the province, discussing natural gas and coal for electricity production, resource potential, demand, and private sector capacity. The challenges facing the province are: cost effective development of resources to meet energy demand; aging infrastructure, high reliability requirements and economic growth; evolving electricity market structure in the United States; and, monopoly. The transmission system was reviewed with reference to trade with the Pacific Northwest, flexibility and storage. The energy plan objectives for the future were presented, including low rates and public ownership, secure and reliable supply, more private sector opportunities, and environmental responsibility. The alternative market structure includes regulated market characteristics, access to trade, and customer focus. figs

  10. Young British Art / Hanno Soans

    Index Scriptorium Estoniae

    Soans, Hanno, 1974-

    2001-01-01

    1990ndate kunsti muutumisest. Inglise kunstniku Peter Daviese maalist "Kuum esimene sada" (1996), Gavin Turki vahakujuna valminud autoportreest "Pop". "Young British Art'i" uuskunstist ja Jasper Zoova installatsioonist "F1". Eri analüüsivõimalusi pakkuvatest töödest (Marko Laimre & Ene-Liis Semperi 2000. a. novembri ühisnäituse osa töid).

  11. Drowning of British children abroad.

    Science.gov (United States)

    Cornall, P; Howie, S; Mughal, A; Sumner, V; Dunstan, F; Kemp, A; Sibert, J

    2005-09-01

    To quantify the risks of British children drowning abroad. The numbers of British children drowning abroad were estimated for 1996-2003 using the RoSPA/RLSS press cutting database. We compared these figures with the numbers of British children going abroad from the International Passenger Survey from the Office of National Statistics. Sixty-eight children (45 boys-23 Girls) drowned in the eight-year period: 48 (71%) in swimming pools (mostly in hotels). Allowing for exposure, the rate was higher in North America [5.2 (CI 2.9-9.4)/million tourists] than the European Union [1.9 (CI 1.4-2.5)/million tourists] p = 0.002. On average eight British children drown each year abroad. This is therefore a rare but tragic event. Most of these episodes happen in swimming pools and this needs to be compared to the one child that dies each year in municipal swimming pools in the United Kingdom where there is adequate lifeguarding. It may be that parents have a false sense of security for their children in pools abroad. We believe that there needs to be action from the European Union on this important event.

  12. Surgeon-patient communication during awake procedures.

    Science.gov (United States)

    Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

    2017-06-01

    Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The Internet and the paediatric surgeon.

    Science.gov (United States)

    Srinivas, M; Inumpudi, A; Mitra, D K

    1998-12-01

    The Internet, which has truly united the world, is an extensive network of inter-linked computers storing immense bytes of information that can be accessed by anyone, transcending all barriers. The paediatric surgery Internet consists of exponentially growing material that deals with information specifically for paediatric surgeons and patients of the paediatric age group. We reviewed the methods available to take advantage of this network to enable busy paediatric surgeons to accrue the benefits easily and efficiently rather than be lost in the information ocean by surfing individually. By getting connected to the Internet, the paediatric surgeon gains enormous information that can be useful for patient care. The Internet has revolutionised scientific publications by virtue of its fast and accurate transmission of manuscripts. Paediatric surgeons can send manuscripts by this channel and also access journals, obviating the inherent lag period of communication by post.

  14. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

    Dalager, Tina; Søgaard, Karen; Bech (Katrine Tholstrup Pedersen), Katrine Tholstrup

    in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...... put the patients at a higher risk of complications, and on the longer term there is an increasing risk for the surgeon to develop chronic musculoskeletal pain that will disable him/her to perform his/her job. Therefore, surgeons’ musculoskeletal health is of vital importance and must be considered...... alongside patient safety. The present literature study supports the need for a randomized controlled trial evaluating the effect of an individually designed training program for surgeons performing MIS....

  15. Income, productivity, and satisfaction of breast surgeons.

    Science.gov (United States)

    Bendorf, David C; Helmer, Stephen D; Osland, Jacqueline S; Tenofsky, Patty L

    2010-03-01

    The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. There were 772 responses. An increasing percentage of breast care was associated with lower incomes (P=.0001) and similar income satisfaction (P=.4517) but higher job satisfaction (P=.0001). The increasing proportion of breast care was also associated with fewer hours worked per week (P=.0001). Although incomes were lower in surgeons with a higher proportion of their practice in breast care, income satisfaction was not affected. Although cause and effect relationships between income and breast surgery are difficult to establish, several trends do emerge. Most significantly, we found that dedicated breast surgeons have higher job satisfaction ratings and similar income satisfaction despite lower incomes. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  16. Prevention of suicidal behaviour among army personnel: a qualitative study.

    Science.gov (United States)

    Crawford, M J; Sharpe, D; Rutter, D; Weaver, T

    2009-09-01

    To examine the context of suicidal behaviour among soldiers in the United Kingdom and identify factors that could reduce the risk of such behaviour. A series of in-depth interviews with service providers involved in treating soldiers following deliberate self harm. Their responses were compared with those of a small sub-sample of soldiers who presented to Army medical services following self harm. We interviewed 21 service providers with a range of experience and professional backgrounds and 10 soldiers. Service providers told us that the rarity of suicide among soldiers together with lower levels of mental illness amongst those who end their lives made suicide prevention in the Army a difficult task. However they highlighted concerns about recruitment and retention of young soldiers, and stated that stigmatisation of mental illness in the Army sometimes prevented those with suicidal ideation seeking help. They also highlighted the role of alcohol use in precipitating self-harm. Soldiers who had self-harmed told us that they struggled to balance the demands of work and family life and described harming themselves impulsively often while intoxicated with alcohol. Soldiers look to sources of support outside the Army, and see commanding officers, rather than healthcare professionals, as helping resolve their problems. Neither service providers nor soldiers mentioned helplines and other 'independent' sources of confidential advice and support which are available to soldiers serving with the British Army. Our findings highlight problems associated with efforts to reduce suicide among soldiers but suggest that these should focus continuing to try to reduce stigmatisation of mental distress and specifically on the role of commanding officers. Greater efforts should also be made to publicise existing sources of help and reduce levels of alcohol misuse.

  17. Canadian cardiac surgeons' perspectives on biomedical innovation.

    Science.gov (United States)

    Snyman, Gretchen; Tucker, Joseph E L; Cimini, Massimo; Narine, Kishan; Fedak, Paul W M

    2012-01-01

    Barriers to successful innovation can be identified and potentially addressed by exploring the perspectives of key stakeholders in the innovation process. Cardiac surgeons in Canada were surveyed for personal perspectives on biomedical innovation. Quantitative data was obtained by questionnaire and qualitative data via interviews with selected survey participants. Surgeons were asked to self-identify into 1 of 3 categories: "innovator," "early adopter," or "late adopter," and data were compared between groups. Most surgeons viewed innovation favourably and this effect was consistent irrespective of perceived level of innovativeness. Key barriers to the innovation pathway were identified: (1) support from colleagues and institutions; (2) Canada's health system; (3) sufficient investment capital; and (4) the culture of innovation within the local environment. Knowledge of the innovation process was perceived differently based on self-reported innovativeness. The majority of surgeons did not perceive themselves as having the necessary knowledge and skills to effectively translate innovative ideas to clinical practice. In general, responses indicate support for implementation of leadership and training programs focusing on the innovation process in an effort to prepare surgeons and enhance their ability to successfully innovate and translate new therapies. The perspectives of cardiac surgeons provide an intriguing portal into the challenges and opportunities for healthcare innovation in Canada. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  18. The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work-Home Balance.

    Science.gov (United States)

    Bentz, Michael L

    2016-10-01

    Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work-home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons.

  19. A cross-sectional study of the presence of United Kingdom (UK) plastic surgeons on social media.

    Science.gov (United States)

    Mabvuure, Nigel Tapiwa; Rodrigues, Jeremy; Klimach, Stefan; Nduka, Charles

    2014-03-01

    To determine the uptake and usage of websites and social media (SM) by UK consultant (attending) plastic surgeons. Professional profiles of full BAPRAS members were searched on Facebook, Twitter, LinkedIn, RealSelf, YouTube, ResearchGate in May 2013. Additional surgeons were identified from the follower lists of @BAPRASvoice and @BAAPSMedia. Website ownership was determined on Google. Searches were repeated three times. Dual BAAPS-BAPRAS members were identified from www.baaps.org.uk. There were 156 (48.3%) dual BAAPS-BAPRAS members and 36 BAPRAS-only members. Fifty seven (18%) surgeons had no account on any platform whereas 266 (82%) were on at least one platform. One hundred and sixty four (51%) had personal websites whilst 37 (11%) had profiles on partnership websites. One hundred and sixteen (36%) had no website presence whilst 2% had websites under construction. The platform most surgeons use is LinkedIn (52%) whilst smaller proportions used Facebook (4%) and Twitter (22%). Surgeons had a mean of 126 (range: 0-3270) Twitter followers and 368 (range: 7-3786) fans/'likes' of their Facebook profiles. Time spent in postgraduate practice was not predictive of website ownership or SM use. However, dual BAAPS-BAPRAS members were significantly more likely to own a personal website, Twitter, RealSelf and YouTube accounts. There has been an increase in the uptake of social media by UK plastic surgeons, especially in those with aesthetic surgery interests. However, very few surgeons have optimised their web presence. Continued education and appropriate usage guidance may promote uptake, particularly by reconstructive surgeons. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Army Blast Claims Evaluation Procedures

    Science.gov (United States)

    1994-03-01

    ATIN: AFZX-JA Building 4551 Fort Polk, LA 71459-5000 Commander U.S. Army Engineer Center and Fort Leonard Wood ATIN: AlZT-JA Building 1706 East...U.S. Armed Forces Claims Service, Korea APO AP 96205-0084 No. of Copies Organization 1 Commander U.S. Army South ATI’N: SOJA Building 154 APO

  1. The Army Study Program.

    Science.gov (United States)

    1980-10-09

    STUDDIES BY CATEGORY STUDY TITLE SPONSOR NMtTHOO PPA ADM RE:MOTE LINK PRUG DARCOM CONTRACT ADV TECH MODEL FULL DARCON CONTRACT ARMY COMMAND ANDi CONTROL...HOUUSE NUN -RLCURRIN 1 LMANUS DARCON I"-HUSL FF-TH-hLLI TM~k ECUNLNI(. ANALYSIS DARCOM CUNTRALT FOR SFELTKUM ANALYZERS UPLRA1IUN&L FLt)AI/EKPSL TKADL...TECHNULOGY A5 AESM:NT TRADOC bUTH *TEN YEAR INSTRUMENTATIOft ANALYSkIS OCSA ot" PHASE I TERRAIN MODELS DARCOM bUTH lEST CRITLRIA FUOR NUN -IIILLL-K WEAPUN

  2. Attitudes and beliefs about placebo surgery among orthopedic shoulder surgeons in the United Kingdom.

    Directory of Open Access Journals (Sweden)

    Karolina Wartolowska

    Full Text Available To survey surgeons on their beliefs and attitudes towards the use of placebo in surgery.British orthopedic shoulder surgeons, attending a national conference in the United Kingdom, were asked to complete a self-report online questionnaire about their beliefs and attitudes towards the use of placebo related to surgical intervention. The survey included questions about ethical issues, the mechanism of placebo effects, and any concerns regarding its use.100 surgeons who participated in the survey believed that placebo surgery is ethically acceptable (96%, especially as a part of a clinical trial (46%. Respondents thought that a placebo effect in surgery is real i.e. has a scientific basis (92%, that placebo can be therapeutically beneficial (77%, and that it involves psychological mechanisms (96%. Over half of the respondents (58% have used a surgical procedure with a significant placebo component at least once in their professional career. Their main concern about placebo use in surgery was that it might involve an element of deception.Surgeons generally agreed that a placebo component to surgical intervention might exist. They also supported placebo use in clinical trials and considered it ethical, providing it does not involve deception of patients. More studies are needed, particularly among other surgical specialties and with larger numbers of participants, to better understand the use of placebo in surgery.

  3. 76 FR 66282 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-10-26

    ... Committee: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: November 15, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  4. 76 FR 72914 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-11-28

    ...: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: December 14, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... issues and matters related to the continued growth and development of the United States Army War College...

  5. Young transplant surgeons and NIH funding.

    Science.gov (United States)

    Englesbe, M J; Sung, R S; Segev, D L

    2011-02-01

    Transplant surgeons have historically been instrumental in advancing the science of transplantation. However, research in the current environment inevitably requires external funding, and the classic career development pathway for a junior investigator is the NIH K award. We matched transplant surgeons who completed fellowships between 1998 and 2004 with the NIH funding database, and also queried them regarding research effort and attitudes. Of 373 surgeons who completed a fellowship, only 6 (1.8%) received a K award; of these, 3 subsequently obtained R-level funding. An additional 5 individuals received an R-level grant within their first 5 years as faculty without a K award, 3 of whom had received a prior ASTS-sponsored award. Survey respondents reported extensive research experience during their training (78.8% spent median 24 months), a high proportion of graduate research degrees (36%), and a strong desire for more research time (78%). However, they reported clinical burdens and lack of mentorship as their primary perceived barriers to successful research careers. The very low rate of NIH funding for young transplant surgeons, combined with survey results that indicate their desire to participate in research, suggest institutional barriers to access that may warrant attention by the ASTS and the transplant surgery community. ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

  6. Designing a leadership development program for surgeons.

    Science.gov (United States)

    Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

    2016-01-01

    Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The Surgeons' Leadership Inventory (SLI): a taxonomy and rating system for surgeons' intraoperative leadership skills.

    Science.gov (United States)

    Henrickson Parker, Sarah; Flin, Rhona; McKinley, Aileen; Yule, Steven

    2013-06-01

    Surgeons must demonstrate leadership to optimize performance and maximize patient safety in the operating room, but no behavior rating tool is available to measure leadership. Ten focus groups with members of the operating room team discussed surgeons' intraoperative leadership. Surgeons' leadership behaviors were extracted and used to finalize the Surgeons' Leadership Inventory (SLI), which was checked by surgeons (n = 6) for accuracy and face validity. The SLI was used to code video recordings (n = 5) of operations to test reliability. Eight elements of surgeons' leadership were included in the SLI: (1) maintaining standards, (2) managing resources, (3) making decisions, (4) directing, (5) training, (6) supporting others, (7) communicating, and (8) coping with pressure. Interrater reliability to code videos of surgeons' behaviors while operating using this tool was acceptable (κ = .70). The SLI is empirically grounded in focus group data and both the leadership and surgical literature. The interrater reliability of the system was acceptable. The inventory could be used for rating surgeons' leadership in the operating room for research or as a basis for postoperative feedback on performance. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Do Surgeons Treat Their Patients Like They Would Treat Themselves?

    NARCIS (Netherlands)

    Janssen, Stein J.; Teunis, Teun; Guitton, Thierry G.; Ring, David; Spoor, Andy B.; Chauhan, Aakash; Shafritz, Adam B.; Wasterlain, Amy; Terrono, Andrew L.; Neviaser, Andrew S.; Schmidt, Andrew; Nelson, Andy; Miller, Anna N.; Kristan, Anze; Apard, Thomas; Berner, Arne; Ilyas, Asif; Jubel, Axel; Jost, Bernhard; Babis, George; Watkins, Barry; Kreis, Barbara; Nolan, Betsy M.; Crist, Brett D.; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo Jose Romero; Ekholm, Carl; Swigart, Carrie; Spath, Catherine; Zalavras, Charalampos; Cassidy, Charles; Garnavos, Christos; Moreno-Serrano, Constanza L.; Rodner, Craig; Klostermann, Cyrus; Osei, Daniel A.; Rikli, Daniel A.; Haverkamp, Daniel; Polatsch, Daniel; Drosdowech, Darren; Edelstein, David M.; Eygendaal, Denise; Verbeek, Diederik O. F.; Doornberg, Job N.; van den Bekerom, Michel P. J.; Schep, Niels; Kloen, Peter; Haverlag, Robert; Schepers, Tim

    2015-01-01

    There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. (1) Are surgeons more likely to recommend surgery when choosing for

  9. Concurrent Surgery and the Role of the Pediatric Attending Surgeon: Comparing Parents' and Surgeons' Expectations.

    Science.gov (United States)

    Choe, Jennie K; Ibarra, Christopher; Feinn, Richard S; Rodriguez-Davalos, Manuel I; Carter, Cordelia W

    2018-06-01

    The common practice of performing concurrent or overlapping operations has been intensely scrutinized by lay media and academic press to investigate its safety and cost-effectiveness. However, there is little information about its use within the pediatric population. Even less is known about parents' expectations about the surgeon's role on the day of operation and how they align with those of pediatric surgeons and surgical trainees, despite the potential for significant discrepancies in expectations to erode trust and damage the physician-family relationship. A 5-point Likert-style survey was designed to characterize expectations about the degree of involvement by pediatric attending surgeons throughout a surgical case (1 = strongly disagree, 3 = neutral, 5 = strongly agree). The survey was administered to parents of pediatric patients undergoing elective operations during a 3-month interval at a single academic institution. The survey was also administered to surgeons and surgical residents at the same institution. Multivariate multiplicity-adjusted t-tests were used to identify significant differences between responders. One hundred and ten parents and 84 pediatric surgeons and trainees completed the survey. Parents' responses to the survey ranged from 4.15 to 4.89, compared with 2.75 to 4.86 from surgeons. The differences achieved statistical significance (p children. There is a significant mismatch between parents' expectations and those of pediatric surgeons about the role of the surgeon on the day of operation, with parents consistently expecting more direct involvement by the attending surgeon. These discrepancies can have implications for both parent/patient satisfaction and medical education. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Portraying the Army Reserve Components in Army War Games and Exercises

    National Research Council Canada - National Science Library

    Dillon, Dick

    2002-01-01

    .... Ensuring that accuracy and realism was the primary purpose of the Role of the Army National Guard and Army Reserve in Army Exercises workshop conducted at the Collins Center for Strategic Leadership from 23-26 September 2002.

  11. [Doctor Albéric Pont (1870-1960). Dental surgeon, doctor and creator of the center of maxillo-facial surgery of Lyon in 1914].

    Science.gov (United States)

    Riaud, Xavier

    2008-01-01

    As Stomatologist and Dental Surgeon Albéric Pont founded with six other Dental Surgeons the School of Dentistry in Lyons which he ran for a long time. When he enlisted in the French Army in 1914 he soon became aware of the extent of facial damage that occurred among the injured soldiers. His subsequent decision was to create and run a Centre for maxillofacial surgery in Lyons. He died in 1960 and left a significant scientific work as well as technical elements of surgery, dental index and devices which still bear his name.

  12. The Great British Music Hall: Its Importance to British Culture and ‘The Trivial’

    Directory of Open Access Journals (Sweden)

    Steven Gerrard

    2013-12-01

    Full Text Available By 1960, Britain’s once-thriving Music Hall industry was virtually dead. Theatres with their faded notions of Empire gave way to Cinema and the threat of Television. Where thousands once linked arms singing popular songs, watch acrobatics, see feats of strength, and listen to risqué jokes, now the echoes of those acts lay as whispers amongst the stalls’ threadbare seats. The Halls flourished in the 19th Century, but had their origins in the taverns of the 16th and 17th Centuries. Minstrels plied their trade egged on by drunken crowds. As time passed, the notoriety of the Music Hall acts and camaraderie produced grew. Entrepreneurial businessman tapped into this commerciality and had purpose-built status symbol theatres to provide a ‘home’ for acts and punters. With names like The Apollo giving gravitas approaching Olympian ideals, so the owners basked in wealth and glory. The Music Hall became the mass populist entertainment for the population. Every town had one, where everyone could be entertained by variety acts showing off the performers’ skills. The acts varied from singers, joke-tellers, comics, acrobats, to dancers. They all aimed to entertain. They enabled audiences to share a symbiotic relationship with one another; became recruitment officers for the Army; inspired War Poets; showed short films; and they and the halls reflected both the ideals and foibles of their era. By using Raymond Williams’ structures of feeling as its cornerstone, the article will give a brief history of the halls, whilst providing analysis into how they grew into mass populist entertainment that represented British culture. Case studies of famous artistes are given, plus an insight into how Music Hall segued into radio, film and television.

  13. Improving operation notes to meet British Orthopaedic Association guidelines.

    Science.gov (United States)

    Morgan, David; Fisher, Noel; Ahmad, Aman; Alam, Fazle

    2009-04-01

    Operation notes are an important part of medical records for clinical, academic and medicolegal reasons. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. Surgeon education and the use of a checklist produce better quality total knee replacement operation notes in line with BOA guidelines. Further improvements may be made by making the data points part of the operation note itself.

  14. Science and the British Empire.

    Science.gov (United States)

    Harrison, Mark

    2005-03-01

    The last few decades have witnessed a flowering of interest in the history of science in the British Empire. This essay aims to provide an overview of some of the most important work in this area, identifying interpretative shifts and emerging themes. In so doing, it raises some questions about the analytical framework in which colonial science has traditionally been viewed, highlighting interactions with indigenous scientific traditions and the use of network-based models to understand scientific relations within and beyond colonial contexts.

  15. Increasing Army Retention Through Incentives

    National Research Council Canada - National Science Library

    Beerman, Kevin

    2006-01-01

    .... If the Army fails to address the enlisted retention issue in the near future departures of experienced NCOs will have a detrimental impact our military's ability to provide for our nation's security...

  16. Christian Contributions to Army Values

    National Research Council Canada - National Science Library

    D'Emma, Gregory

    2000-01-01

    .... The Army builds the soldier's heart, spirit, and soul by the values we instill. Over the years these values of loyalty, duty, respect, selfless service, honor, integrity, and personal courage have been trained and reinforced...

  17. Racial Extremism in the Army

    National Research Council Canada - National Science Library

    Hudson, Walter M

    1998-01-01

    ... modem phenomenon of "skinheads." I then discuss the history of white supremacist extremism in the Army, culminating in the December, 1995 murders of two black civilians by soldiers assigned to the 82d Airborne Division at Fort Bragg, North Carolina...

  18. Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy.

    Science.gov (United States)

    Lee, Doh Young; Baek, Seung-Kuk; Jung, Kwang-Yoon

    2017-01-01

    This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.

  19. Cardiac Surgeons after Vacation: Refreshed or Rusty?

    Science.gov (United States)

    Welk, Blayne; Winick-Ng, Jennifer; McClure, Andrew; Dubois, Luc; Nagpal, Dave

    2017-10-01

    Many surgeons describe feeling a bit out of practice when they return from a vacation. There have been no studies assessing the impact of surgeon vacation on patient outcomes. We used administrative data from the province of Ontario to identify patients who underwent a coronary artery bypass grafting. Using a propensity score, we matched patients who underwent their procedure immediately after their surgeon returned from vacation of at least 7 days (n = 1,161) to patients who were not operated immediately before or after a vacation period (n = 2,138). There was no significant difference in patient mortality (odds ratio: 1.23, p = 0.52), length of operation (relative risk [RR]: 1.00 p = 0.58), or intensive care unit/ hospital stay (RR: 0.97 p = 0.66/RR: 0.98 p = 0.54, respectively). There was not a significant change in risk of death, operative length, or hospital stay after a surgeon vacation.

  20. The nature of surgeon human capital depreciation.

    Science.gov (United States)

    Hockenberry, Jason M; Helmchen, Lorens A

    2014-09-01

    To test how practice interruptions affect worker productivity, we estimate how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). Examining 188 surgeons who performed 56,315 CABG surgeries in Pennsylvania between 2006 and 2010, we find that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points. Among emergent patients treated by high-volume providers, where temporal distance is most plausibly exogenous, an additional day away raised mortality risk by 0.398 percentage points (11.4% relative effect) but reduced cost by up to 1.4 percentage points. This is consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications. Our estimates imply additional intraprocedural treatment intensity has a cost per life-year preserved of $7871-18,500, well within conventional cost-effectiveness cutoffs. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. The U.S. Army Occupational and Environmental Medicine Residency at Aberdeen Proving Ground, Maryland: 1960-1996.

    Science.gov (United States)

    Gaydos, Joel C; Mallon, Timothy M; Rice, William A

    2016-11-01

    Reorganization of the Army and critical assessment of Army Graduate Medical Education programs prompted the Occupational and Environmental Medicine (OEM) Consultant to the Army Surgeon General to initiate a review of current Army OEM residency training. Available information indicated the Army OEM residency at Aberdeen Proving Ground, MD, was the first and longest operating Army OEM residency. Describing this residency was identified as the first step in the review, with the objectives of determining why the residency was started and sustained and its relevance to the needs of the Army. Records possibly related to the residency were reviewed, starting with 1954 since certification of physicians as Occupation Medicine specialists began in 1955. Interviews were conducted with selected physicians who had strong affiliations with the Army residency and the practice of Army OEM. The Army OEM residency began in 1960 and closed in 1996 with the transfer of Army OEM residency training to the Uniformed Services University of the Health Sciences, Bethesda, MD. Over 36 years, 47 uniformed residency graduates were identified; 44 were from the Army. Forty graduated between 1982 and 1996. The OEM residency was part of a dynamic cycle. Uniformed OEM leaders identified the knowledge and skills required of military OEM physicians and where these people should be stationed in the global Army. Rotations at military sites to acquire the needed knowledge and skills were integrated into the residency. Residency graduates were assigned to positions where they were needed. Having uniformed residents and preceptors facilitated the development of trust with military leaders and access to areas where OEM physician skills and knowledge could have a positive impact. Early reports indicated the residency was important in recruiting and retaining OEM physicians, with emphasis placed on supporting the Army industrial base. The late 1970s into the 1990s was a more dynamic period. There was

  2. Immunization delivery in British Columbia

    Science.gov (United States)

    Omura, John; Buxton, Jane; Kaczorowski, Janusz; Catterson, Jason; Li, Jane; Derban, Andrea; Hasselback, Paul; Machin, Shelagh; Linekin, Michelle; Morgana, Tamsin; O’Briain, Barra; Scheifele, David; Dawar, Meena

    2014-01-01

    Abstract Objective To explore the experiences of family physicians and pediatricians delivering immunizations, including perceived barriers and supports. Design Qualitative study using focus groups. Setting Ten cities throughout British Columbia. Participants A total of 46 family physicians or general practitioners, 10 pediatricians, and 2 residents. Methods A semistructured dialogue guide was used by a trained facilitator to explore participants’ experiences and views related to immunization delivery in British Columbia. Verbatim transcriptions were independently coded by 2 researchers. Key themes were analyzed and identified in an iterative manner using interpretive description. Main findings Physicians highly valued vaccine delivery. Factors facilitating physician-delivered immunizations included strong beliefs in the value of vaccines and having adequate information. Identified barriers included the large time commitment and insufficient communication about program changes, new vaccines, and the adult immunization program in general. Some physicians reported good relationships with local public health, while others reported the opposite experience, and this varied by geographic location. Conclusion These findings suggest that physicians are supportive of delivering vaccines. However, there are opportunities to improve the sustainability of physician-delivered immunizations. While compensation schemes remain under the purview of the provincial governments, local public health authorities can address the information needs of physicians. PMID:24627403

  3. Leukaemia near british nuclear installations

    International Nuclear Information System (INIS)

    Hubert, D.

    1991-01-01

    An excess of childhood leukaemia has been seen near some British nuclear installations, especially near the Sellafield reprocessing plant. The same result was found in a more general study including a large number of nuclear sites. Similar studies made in USA, Canada and France have been negative. Moreover, epidemiological studies made in England have discovered other childhood leukaemia clusters in areas far from nuclear facilities, and especially near potential sites of nuclear installations. Several explanations are suggested but no definite conclusion is yet possible. Doses from radioactive releases seem to be too low to account for the additional deaths from leukaemia by environmental contamination. A virus activation, which might be associated with population influx into rural isolated areas, has been considered. The hypothesis of genetic mutation induced by ionising radiation in the fathers of children with leukaemia has been made because a higher risk of leukaemia was observed for children of fathers employed at Sellafield. No firm conclusion is possible considering the small number of observed cases and the lack of excess leukaemias in the offspring of Hiroshima and Nagasaki survivors. The possibility of internal contamination, chemicals or even radon is discussed as other causes. Studies in progress might allow to find an answer to the problem of leukaemia in the vicinity of British nuclear installations [fr

  4. Robotics In Manufacturing: Army View

    Science.gov (United States)

    Michel, F. J.

    1983-05-01

    (Figure 1) This is an outline of my presentation today. The U. S. Army has a dual interest in the use of robots, namely: 1. As a substitute for or an extension of the soldier in the battlefield, and 2. in the factories that make Army materiel, or - as we call it -the the production base. The Production Base can again be divided into three separate segments, i.e., the Army owned and operated facilities or GOG6s, such as Rock Island and Watervliet arsenals, and not to be overlooked, the depot operations. There the Army manufactures gun tubes and other related parts for artillery weapons and repairs and overhauls them. A second category is the Army owned and contractor operated facilities or GOCOs,such as the ammunition plants, the tank plants at Lima, Ohio and Warren, Michigan and the Stratford Engine Plant in Connecticut where gas turbines for helicopter and the Abrams tank are manufactured. The last category covers the industrial base, that is those factories which are not only operated but also owned by the contractor himself also referred to as COCOs. You can see from this description that the Army is supported by a base which produces a diversified line of products. Therefore, the task of technology development and technology insertion is considerably more complex than what one encounters in the average U. S. Manufacturing organization.

  5. British coal-down to the line

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The long-running saga of British Coal's decline is in its final stages with virtually no change from last October when the British government announced plants to close 31 of the 50 remaining mines. That announcement produced a political outcry but having privatized the electricity industry in 1990 the government had effectively left itself up the creek without a paddle. It had no powers to force the generators to buy more coal. The status of the British coal industry is discussed

  6. Should we all go to the PROM? The first two years of the British Spine Registry.

    Science.gov (United States)

    Breakwell, L M; Cole, A A; Birch, N; Heywood, C

    2015-07-01

    The effective capture of outcome measures in the healthcare setting can be traced back to Florence Nightingale's investigation of the in-patient mortality of soldiers wounded in the Crimean war in the 1850s. Only relatively recently has the formalised collection of outcomes data into Registries been recognised as valuable in itself. With the advent of surgeon league tables and a move towards value based health care, individuals are being driven to collect, store and interpret data. Following the success of the National Joint Registry, the British Association of Spine Surgeons instituted the British Spine Registry. Since its launch in 2012, over 650 users representing the whole surgical team have registered and during this time, more than 27 000 patients have been entered onto the database. There has been significant publicity regarding the collection of outcome measures after surgery, including patient-reported scores. Over 12 000 forms have been directly entered by patients themselves, with many more entered by the surgical teams. Questions abound: who should have access to the data produced by the Registry and how should they use it? How should the results be reported and in what forum? ©2015 The British Editorial Society of Bone & Joint Surgery.

  7. Choosing a Surgeon: An Exploratory Study of Factors Influencing Selection of a Gender Affirmation Surgeon.

    Science.gov (United States)

    Ettner, Randi; Ettner, Frederic; White, Tonya

    2016-01-01

    Purpose: Selecting a healthcare provider is often a complicated process. Many factors appear to govern the decision as to how to select the provider in the patient-provider relationship. While the possibility of changing primary care physicians or specialists exists, decisions regarding surgeons are immutable once surgery has been performed. This study is an attempt to assess the importance attached to various factors involved in selecting a surgeon to perform gender affirmation surgery (GAS). It was hypothesized that owing to the intimate nature of the surgery, the expense typically involved, the emotional meaning attached to the surgery, and other variables, decisions regarding choice of surgeon for this procedure would involve factors other than those that inform more typical healthcare provider selection or surgeon selection for other plastic/reconstructive procedures. Methods: Questionnaires were distributed to individuals who had undergone GAS and individuals who had undergone elective plastic surgery to assess decision-making. Results: The results generally confirm previous findings regarding how patients select providers. Conclusion: Choosing a surgeon to perform gender-affirming surgery is a challenging process, but patients are quite rational in their decision-making. Unlike prior studies, we did not find a preference for gender-concordant surgeons, even though the surgery involves the genital area. Providing strategies and resources for surgical selection can improve patient satisfaction.

  8. Diversity Issues in the Army as Perceived by Army Students at the United States Army War College

    National Research Council Canada - National Science Library

    Webster, Cecil

    1997-01-01

    ..., welfare, and other related programs. In recognizing this diversity, this paper identifies some diversity issues within the Army, analyzes the perception of those diversity issues by the resident Army students in the USAWC Class of 1997...

  9. Medical students' unique experience of army leadership training: a qualitative study.

    Science.gov (United States)

    Earis, John; Garner, J; Haddock, D; Jenkins, J; Jha, V

    2017-10-01

    To assess the interactive experience of first year medical students attending the leadership and management course hosted by a British Army Reserve Field Hospital developed in partnership with Liverpool University. 244 students submitted a 1000-word structured reflective learning assignment about their reaction to, learning from and any behaviour and attitude changes as a result of, the training. The assignments were thematically analysed to identify how aspects of the training had impacted upon the students' understanding of leadership and teamwork. Their comments relating to the army were analysed to gain insight into their views and experience of the training. Students were surprised at how enjoyable and useful they found the course. Initially they expressed scepticism about what they could learn in an army-based environment. However, the training, particularly command and planning tasks, helped them appreciate and understand the different skills individuals can bring to a team environment, and the importance of everyone contributing. While some students were challenged by aspects of the course, with support and encouragement from team-mates and the army personnel, they learned they could achieve more together. Teaching leadership and management skills to medical students is a challenge which can be effectively addressed by adapting and developing army training resources. Students overcame initial scepticism about participating, and learned a lot about themselves and each other. In addition, the army developed a better understanding of the doctors of the future. The expertise of the army in delivering this training was crucial to its success as the medical school could not have provided this experience unsupported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. The power of British Energy

    International Nuclear Information System (INIS)

    Hawley, R.

    1997-01-01

    When the power industry in Britain was privatized, British Energy plc (BE), whose head office is in Edingburgh, Scotland, was founded in July 1996. It is the only power utility in the world exclusively operating nuclear power stations. Operative business has remained the responsibility of the two regional supply companies, Nuclear Electric (NE) and Scottish Nuclear (SN) which, in addition to the modern PWR nuclear generating unit of Sizewell B, have included in the new holding company their advanced gas-cooled and gas-moderated reactor (AGR) units. The older gas-graphite reactor (GGR) plants were combined in the new Magnox Electric plc, Berkeley; at some later date, this company is to be merged with another nuclear power plant operator, British Nuclear Fuels plc (BNFL). Sizewell B, which was commissioned in 1995, is the last nuclear generating unit to be started up in the United Kingdom, for the time being. In times of low raw material prices and the need for a quick return on invested capital, BE is reluctant to run the risk associated with tying up capital for a long time. Instead, the company has backfitted its plants so that the production of electricity from nuclear power in Britain in 1996 of 92,476 GWh was increased by almost 10% over the 1995 level of 84,174 GWh. In addition to modernization and rationalization at home, BE together with Sizewell B vendor Westinghouse is engaged worldwide in the development and commercialization of future advanced reactors. This ensures that the know-how accumulated will be preserved and will be available for new nuclear power plants to be built in Britain in the next century. (orig.)

  11. Conflict resolution: practical principles for surgeons.

    Science.gov (United States)

    Lee, Liz; Berger, David H; Awad, Samir S; Brandt, Mary L; Martinez, George; Brunicardi, F Charles

    2008-11-01

    Historically, surgeons have had little formal training in conflict resolution; however, there has been an increasing body of evidence that poor conflict resolution skills may have an adverse impact on patient outcomes and career advancement. Furthermore, the Accreditation Council for Graduate Medical Education has recognized the importance of conflict resolution skills in resident training by mandating the training of communication skills and professionalism. These skills have often been taught in other professions, and surgeons may need to acquaint themselves with the literature from those fields. Conflict resolution techniques such as the 7-step model or principle-based conflict resolution can be applied to conflict in the operating room, wards, and among colleagues. We propose a model for conflict resolution by using the basic tools of the history and physical exam, a process well known to all physicians.

  12. Smart apps for the smart plastic surgeon

    Directory of Open Access Journals (Sweden)

    Aniketh Venkataram

    2015-01-01

    Full Text Available Smartphones have the ability to benefit plastic surgeons in all aspects of patient care and education. With the sheer number of applications available and more being created everyday, it is easy to miss out on apps which could be of great relevance. Moreover, the range of android applications available has not been extensively discussed in the literature. To this end, we have compiled an exhaustive list of android smartphone applications, which we feel can help our day to day functioning. The apps have been extensively reviewed and neatly described along with all their potential uses. In addition, we have made an effort to highlight ′non-medical′ or efficiency apps which can improve departmental functioning. These apps have not been described in prior articles, and their functionality might not be known to all. We believe that the technology savvy plastic surgeon can make maximum use of these apps to his benefit.

  13. Professionalism and Commercialism on Cosmetic Surgeons' Websites.

    Science.gov (United States)

    Park, Sung-Yeon; Park, SangHee

    2017-07-01

    This study analyzed the homepages of 250 cosmetic surgeons' websites by focusing on the representation of cosmetic surgery providers, cosmetic surgery recipients, and cosmetic surgery practice itself. Based on a literature review, some common elements of the webpages were preidentified as the indicators of professionalism or commercialism. Subsequently, each homepage was scrutinized for their presence and salience. Overall, cosmetic surgeons' websites were high in professionalism and low in commercialism in their representation of the service providers. In depicting the recipients, the websites were moderate in both professionalism and commercialism. The representation of practice was low in professionalism and moderate in commercialism. Implications of these findings for doctors, regulators, and consumer advocates are discussed and directions for future research are proposed.

  14. Clinical decision making: how surgeons do it.

    Science.gov (United States)

    Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

    2013-06-01

    Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  15. Answering the Hottest Question in Army Education: What Is Army University?

    Science.gov (United States)

    Kem, John S.; LeBoeuf, Eugene J.; Martin, James B.

    2016-01-01

    The most common question heard by senior members of Army University is always, "What is Army University?" The newest education institution in the U.S. Army was created to unify the training and educational institutions of the Army, making the large learning organization more effective and efficient for its soldiers, bringing together 37…

  16. Meeting Increasing Demands for Rural General Surgeons.

    Science.gov (United States)

    Mccarthy, Mary C; Bowers, Howard E; Campbell, Damon M; Parikh, Priti P; Woods, Randy J

    2015-12-01

    Dynamic assessment of the effective surgical workforce recommends 27,300 general surgeons in 2030; 2,525 more than are presently being trained. Rural shortages are already critical and there has been insufficient preparation for this need. A literature review of the factors influencing the choice of rural practice was performed. A systematic search was conducted of PubMed and the Web of Science to identify applicable studies in rural practice, surgical training, and rural general surgery. These articles were reviewed to identify the pertinent reports. The articles chosen for review are directed to four main objectives: 1) description of the challenges of rural practice, 2) factors associated with the choice of rural practice, 3) interventions to increase interest and preparation for rural practice, and 4) present successful rural surgical practice models. There is limited research on the factors influencing surgeons in the selection of rural surgery. The family practice literature suggests that physicians are primed for rural living through early experience, with reinforcement during medical school and residency, and retained through community involvement, and personal and professional satisfaction. However, more research into the factors drawing surgeons specifically to rural surgery, and keeping them in the community, is needed.

  17. The Current Canon in British Romantics Studies.

    Science.gov (United States)

    Linkin, Harriet Kramer

    1991-01-01

    Describes and reports on a survey of 164 U.S. universities to ascertain what is taught as the current canon of British Romantic literature. Asserts that the canon may now include Mary Shelley with the former standard six major male Romantic poets, indicating a significant emergence of a feminist perspective on British Romanticism in the classroom.…

  18. British Box Business: A History of OCL

    DEFF Research Database (Denmark)

    Poulsen, René Taudal

    2018-01-01

    Book review of British Box Business: A History of OCL / edited by A. Bott SCARA, Goldaming, 2009, £17 (hb) 288 pages, illustrations, bibliography, index iSBn 139780955922701......Book review of British Box Business: A History of OCL / edited by A. Bott SCARA, Goldaming, 2009, £17 (hb) 288 pages, illustrations, bibliography, index iSBn 139780955922701...

  19. British Celtic influence on English phonology

    NARCIS (Netherlands)

    Laker, Stephen

    2010-01-01

    The dissertation assesses the influence of British Celtic on the phonological development of English during and shortly after the Anglo-Saxon settlement period, ca. AD 450–700. By reconstructing and then comparing the phonological systems of both British Celtic and English at the time of contact, an

  20. There's No Such Thing as British Art

    Directory of Open Access Journals (Sweden)

    Richard Johns

    2015-11-01

    Full Text Available “Conversation Piece” is a British Art Studies series that draws together a group of contributors to respond to an idea, provocation or question. The conversation will develop as more respondents enter the debate. Fifteen contributors respond to the provocation "There's No Such Thing as British Art".

  1. African Journals Online: Virgin Islands (British)

    African Journals Online (AJOL)

    African Journals Online: Virgin Islands (British). Home > African Journals Online: Virgin Islands (British). Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free to read Titles This Journal ...

  2. Operational Reach: Is Current Army Doctrine Adequate?

    National Research Council Canada - National Science Library

    Heintzelman, Scott

    2003-01-01

    The term operational reach, an element of operational design, is new to U.S. Army doctrine. Operational reach is not found in the previous edition of the Army's basic operational doctrine, Field Manual...

  3. The Evolution of Army Leader Development

    Science.gov (United States)

    2013-03-01

    Human Resources Command, OPMD- MFE -I. 4 U.S. Army General Officer Management Office, Army General Officer Roster (Washington, DC, U.S. Department of the...Human Resources Command, Command Management Branch post board data analysis. 15 Data from the United States Army Human Resources Command, OPMD- MFE -A...May 1, 2008), D-1. 25 19 Data from the United States Army Human Resources Command, OPMD- MFE -A, 01 February, 2013. 20 U.S. Joint Chiefs of

  4. Surgeon Reliability for the Assessment of Lumbar Spinal Stenosis on MRI: The Impact of Surgeon Experience.

    Science.gov (United States)

    Marawar, Satyajit V; Madom, Ian A; Palumbo, Mark; Tallarico, Richard A; Ordway, Nathaniel R; Metkar, Umesh; Wang, Dongliang; Green, Adam; Lavelle, William F

    2017-01-01

    Treating surgeon's visual assessment of axial MRI images to ascertain the degree of stenosis has a critical impact on surgical decision-making. The purpose of this study was to prospectively analyze the impact of surgeon experience on inter-observer and intra-observer reliability of assessing severity of spinal stenosis on MRIs by spine surgeons directly involved in surgical decision-making. Seven fellowship trained spine surgeons reviewed MRI studies of 30 symptomatic patients with lumbar stenosis and graded the stenosis in the central canal, the lateral recess and the foramen at T12-L1 to L5-S1 as none, mild, moderate or severe. No specific instructions were provided to what constituted mild, moderate, or severe stenosis. Two surgeons were "senior" (>fifteen years of practice experience); two were "intermediate" (>four years of practice experience), and three "junior" (< one year of practice experience). The concordance correlation coefficient (CCC) was calculated to assess inter-observer reliability. Seven MRI studies were duplicated and randomly re-read to evaluate inter-observer reliability. Surgeon experience was found to be a strong predictor of inter-observer reliability. Senior inter-observer reliability was significantly higher assessing central(p<0.001), foraminal p=0.005 and lateral p=0.001 than "junior" group.Senior group also showed significantly higher inter-observer reliability that intermediate group assessing foraminal stenosis (p=0.036). In intra-observer reliability the results were contrary to that found in inter-observer reliability. Inter-observer reliability of assessing stenosis on MRIs increases with surgeon experience. Lower intra-observer reliability values among the senior group, although not clearly explained, may be due to the small number of MRIs evaluated and quality of MRI images.Level of evidence: Level 3.

  5. Current trends in chaperone use by plastic and reconstructive surgeons.

    Science.gov (United States)

    Choudry, Umar; Barta, Ruth J; Kim, Nicholas

    2013-06-01

    There is a paucity of literature regarding the use of chaperones by surgeons when examining patients. Use of a chaperone not only makes the patient comfortable but also potentially protects the surgeon from perceived misconduct. This is especially true for plastic surgeons who examine sensitive areas commonly. The purpose of this study was to determine the current trends in chaperone use by plastic surgeons when examining patients. A 23-question online survey was sent to all members of the American Society of Plastic Surgeons. Data collected online were analyzed using Student t test and Pearson χ test. A P use by plastic surgeons during all examinations of patients was 30%. This rate increased up to 60% while examining sensitive areas. Male surgeons reported a higher frequency of chaperone use than female surgeons (P use compared to reconstructive surgeons (P = 0.001). Similarly, surgeons who had been in practice for more than 20 years reported a higher rate of chaperone use compared to surgeons in practice for less than 20 years (P = 0.032). Sixty-one (7.6%; 56 male and 5 female) surgeons reported being accused of inappropriate behavior by patients, of whom 49 (80%) did not have a chaperone present. There was no significant difference among male and female surgeons in rates of being accused of inappropriate behavior (7.9% vs 4.2%, P = 0.19). There was a higher rate of chaperone use by male plastic surgeons, surgeons with more than 20 years experience, and cosmetic surgeons. Despite the difference in chaperone use between the sexes, both had similar rates of being accused of inappropriate behavior during examinations by patients, and although these incidents were quite low, most had no chaperone present during those examinations.

  6. 76 FR 12087 - Army Educational Advisory Committee

    Science.gov (United States)

    2011-03-04

    ...: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Dates of Meeting: March 24, 2011. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command... faculty; table and examine online College issues; assess resident and distance education programs, self...

  7. 75 FR 7255 - Army Educational Advisory Committee

    Science.gov (United States)

    2010-02-18

    ... Committee: U.S. Army War College Subcommittee of the Army Education Advisory Committee. Date of Meeting: March 11, 2010. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command...; table and examine online College issues; assess resident and distance education programs, self- study...

  8. 32 CFR 631.14 - Army policy.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Army policy. 631.14 Section 631.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL...-Installation Operations (Military Patrols and Investigative Activities) and Policy § 631.14 Army policy. (a...

  9. Perspectives of South African general surgeons regarding their ...

    African Journals Online (AJOL)

    Objectives. To canvass the perceptions of SA general surgeons regarding certain aspects of their training. Methods. An electronic postal survey was conducted. All general surgeons on the Association of Surgeons of South Africa database were requested to complete a structured questionnaire. Four Likert scale items were ...

  10. HISTORICAL NOTE JOHN HUNTER (SURGEON) John Hunter FRS ...

    African Journals Online (AJOL)

    JOHN HUNTER (SURGEON). John Hunter FRS (13 February 1728-16 October 1793) was a Scottish surgeon, one of the most distinguished scientists and surgeons of his day. He was an early advocate of careful observation and scientific method in medicine. He was the husband of Anne Hunter, a teacher, friend and ...

  11. Patient Attitudes Toward Orthopedic Surgeon Ownership of Related Ancillary Businesses.

    Science.gov (United States)

    Yi, Paul H; Cross, Michael B; Johnson, Staci R; Rasinski, Kenneth A; Nunley, Ryan M; Della Valle, Craig J

    2016-08-01

    Physician ownership of businesses related to orthopedic surgery, such as surgery centers, has been criticized as potentially leading to misuse of health care resources. The purpose of this study was to determine patients' attitudes toward surgeon ownership of orthopedic-related businesses. We surveyed 280 consecutive patients at 2 centers regarding their attitudes toward surgeon ownership of orthopedic-related businesses using an anonymous questionnaire. Three surgeon ownership scenarios were presented: (1) owning a surgery center, (2) physical therapy (PT), and (3) imaging facilities (eg, Magnetic Resonance Imaging scanner). Two hundred fourteen patients (76%) completed the questionnaire. The majority agreed that it is ethical for a surgeon to own a surgery center (73%), PT practice (77%), or imaging facility (77%). Most (>67%) indicated that their surgeon owning such a business would have no effect on the trust they have in their surgeon. Although >70% agreed that a surgeon in all 3 scenarios would make the same treatment decisions, many agreed that such surgeons might perform more surgery (47%), refer more patients to PT (61%), or order more imaging (58%). Patients favored surgeon autonomy, however, believing that surgeons should be allowed to own such businesses (78%). Eighty-five percent agreed that patients should be informed if their surgeon owns an orthopedic-related business. Although patients express concern over and desire disclosure of surgeon ownership of orthopedic-related businesses, the majority believes that it is an ethical practice and feel comfortable receiving care at such a facility. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. How surgeons make decisions when the evidence is inconclusive

    NARCIS (Netherlands)

    Hageman, Michiel G. J. S.; Guitton, Thierry G.; Ring, David; Osterman, A. Lee; Spoor, A. B.; van der Zwan, A. L.; Shrivastava, Abhay; Wahegaonkar, Abhijeet L.; Aida, E. Garcia G.; Aita, M. A.; Castillo, Alberto Pérez; Marcus, Alexander; Ladd, Amy; Terrono, Andrew L.; Gutow, Andrew P.; Schmidt, Andrew; Wang, Angela A.; Eschler, Anica; Miller, Anna N.; Wikerøy, Annette K. B.; Barquet, Antonio; Armstrong, April D.; van Vugt, Arie B.; Bedi, Asheesh; Shyam, Ashok K.; Mazzocca, Augustus D.; Jubel, Axel; Babst, Reto H.; Nolan, Betsy M.; Arciero, Bob; Bremer, Vanden; Bamberger, Brent; Peterson, Bret C.; Crist, Brett D.; Cross, Brian J.; Badman, Brian L.; Henley, C. Noel; Ekholm, Carl; Swigart, Carrie; Manke, Chad; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Cornell, Charles; Getz, Charles L.; Metzger, Charles; Wilson, Chris; Heiss, Christian; Perrotto, Christian J.; Wall, Christopher J.; Walsh, Christopher J.; Garnavos, Christos; Jiang, Chunyan; Lomita, Craig; Torosian, Craig M.; Rikli, Daniel A.; Whelan, Daniel B.; Wascher, Daniel C.; Hernandez, Daniel; Polatsch, Daniel; Beingessner, Daphne; Drosdowech, Darren; Tate, David E.; Hak, David; Rowland, David J.; Kalainov, David M.; Nelson, David; Weiss, David; McKee, Desirae M.; van Deurzen, D. F. G.; Endrizzi, Donald; Erol, Konul; Overbeck, Joachim P.; Baer, Wolfgang; Schwab, Eckart; Maza, Edgardo Ramos; Harvey, Edward; Rodriguez, Edward K.; Preloggler, Elisabeth; Schemitsch, Emil H.; Shin, Eon K.; Hofmeister, Eric P.; Kaplan, Thomas D.; Beeres, F. J. P.; Suarez, Fabio; Fernandes, C. H.; Cayón, Fidel Ernesto Cayón; Dolatowski, Filip Celestyn; Martin, Fischmeister; Sierra, Francisco Javier Aguilar; Lopez-Gonzalez, Francisco; Walter, Frank; Seibert, Franz Josef; Baumgaertel, Fred; Frihagen, Frede; Fuchs, P. C.; Huemer, Georg M.; Kontakis, George; Athwal, George S.; Dyer, George S. M.; Thomas, George; Kohut, Georges; Williams, Gerald; Hernandez, German Ricardo; Caro, Gladys Cecilia Zambrano; Garrigues, Grant; Merrell, Greg; DeSilva, Gregory; Della Rocca, Gregory J.; Regazzi, Gustavo; de Azevedo, Gustavo Borges Laurindo; Ruggiero, Gustavo Mantovani; Helling, H. J.; MccUtchan, Hal; Goost, Hans; Kreder, Hans J.; Hasenboehler, Paula M.; Routman, Howard D.; van der Heide, Huub; Kleinlugtenbelt, I.; McGraw, Iain; Harris, Ian; Ibrahim, Ibrahim Mohammad; Lin, Ines C.; Iossifidis, A.; Andrew, J.; Trenholm, I.; Goslings, J. Carel; Wiater, J. Michael; Choueka, Jack; Ahn, Jaimo; Kellam, James; Biert, Jan; Pomerance, Jay; Johnson, Jeff W.; Greenberg, Jeffrey A.; Yao, Jeffrey; Watson, Jeffry T.; Giuffre, Jennifer L.; Hall, Jeremy; Park, Jin-Young; Fischer, Jochen; Murachovsky, Joel; Howlett, John; McAuliffe, John; Evans, John P.; Taras, John; Braman, Jonathan; Hobby, Jonathan L.; Rosenfeld, Jonathan; Boretto, Jorge; Orbay, Jorge; Rubio, Jorge; Ortiz, Jose A.; Abboud, Joseph; Conflitti, Joseph M.; Vroemen, Joseph P. A. M.; Adams, Julie; Clarke, J. V.; Kabir, K.; Chivers, Karel; Prommersberger, Karl-Josef; Segalman, Keith; Lee, Kendrick; Eng, Kevin; Chhor, Kimberlly S.; Ponsen, K. J.; Jeray, Kyle; Marsh, L.; Poelhekke, L. M. S. J.; Mica, Ladislav; Borris, Lars C.; Halperin, Lawrence; Weiss, Lawrence; Benson, Leon; Elmans, Leon; de Mendonca, Leonardo Alves; Rocha, Leonardo; Katolik, Leonid; Lattanza, Lisa; Taitsman, Lisa; Guenter, Lob; Catalano, Louis; Buendia, Luis Antonio; Austin, Luke S.; Palmer, M. Jason; de Vries, M. R.; Bronkhorst, Maarten W. G. A.; Abdel-Ghany, Mahmoud I.; van de Sande, M. A. J.; Swiontkowski, Marc; Rizzo, Marco; Lehnhardt, Marcus; Pirpiris, Marinis; Baratz, Mark; Lazarus, Mark D.; Boyer, Martin; Richardson, Martin; Kastelec, Matej; Mormino, Matt; Budge, Matthew D.; Turina, Matthias; Wood, Megan M.; Baskies, Michael; Baumgaertner, Michael; Behrman, Michael; Hausman, Michael; Jones, Michael; LeCroy, Michael; Moskal, Michael; Nancollas, Michael; Prayson, Michael; Grafe, Michael W.; Kessler, Michael W.; van den Bekerom, Michel P. J.; Mckee, Mike; Merchant, Milind; Tyllianakis, Minos; Felipe, Naquira Escobar Luis; Chen, Neal C.; Saran, Neil; Wilson, Neil; Shortt, Nicholas L.; Schep, Niels; Rossiter, Nigel; Lasanianos, N. G.; Kanakaris, Nikolaos; Weiss, Noah D.; Harvey, Norah M.; van Eerten, P. V.; Melvanki, Parag; McCulloch, Patrick T.; Martineau, Paul A.; Appleton, Paul; Guidera, Paul; Levin, Paul; Giannoudis, Peter; Evans, Peter J.; Jebson, Peter; Kloen, Peter; Krause, Peter; Brink, Peter R. G.; Peters, J. H.; Blazar, Philip; Streubel, Philipp N.; Inna, Prashanth; Prashanth, S.; Solanki, Punita V.; Wang, Qiugen; Quell, M.; Benafield, R. Bryan; Haverlag, R.; Peters, R. W.; Varma, Rajat; Nyszkiewicz, Ralf; Costanzo, Ralph M.; de Bedout, Ramon; Ranade, Ashish S.; Smith, Raymond Malcolm; Abrams, Reid; Fricker, Renato M.; Omid, Reza; Barth, Richard; Buckley, Richard; Jenkinson, Richard; GIlbert, Richard S.; Page, Richard S.; Wallensten, Richard; Zura, Robert D.; Feibel, Robert J.; Gray, Robert R. L.; Tashijan, Robert; Wagenmakers, Robert; Pesantez, Rodrigo; van Riet, Roger; Norlin, Rolf; Pfeifer, Roman; Liem, Ronald; Kulick, Roy G.; Poolman, Rudolf W.; Shatford, Russell; Klinefelter, Ryan; Calfee, Ryan P.; Moghtaderi, Sam; Sodha, Samir; Sprujt, Sander; Kakar, Sanjeev; Kaplan, Saul; Duncan, Scott; Kluge, Sebastian; Rodriguez-Elizalde, Sebastian; Checchia, Sergio L.; Rowinski, Sergio; Dodds, Seth; Hurwit, Shep; Sprengel, K.; van der Stappen, W. A. H.; Kronlage, Steve; Belded, Steven; Morgan, Steven J.; Rhemrev, Steven J.; Hilliard, Stuart; Gosens, Taco; Sasaki, Takashi; Taleb, C.; Pritsch, Tamir; Tosounidis, Theodoros; Wyrick, Theresa; DeCoster, Thomas; Dienstknecht, Thomas; Stackhouse, Thomas G.; Hughes, Thomas; Wright, Thomas; Ly, Thuan V.; Havenhill, Timothy G.; Omara, Timothy; Siff, Todd; McLaurin, Toni M.; Wanich, Tony; Rueger, Johannes M.; Vallim, Frederico C. M.; Sabesan, Vani J.; Nikolaou, Vasileios S.; Knoll, Victoria D.; Telang, Vidyadhar; Iyer, Vishwanath M.; Jokhi, Vispi; Batson, W. Arnnold; Willems, W. Jaap; Smith, Wade R.; Belangero, William Dias; Wolkenfelt, J.; Weil, Yoram

    2013-01-01

    To address the factors that surgeons use to decide between 2 options for treatment when the evidence is inconclusive. We tested the null hypothesis that the factors surgeons use do not vary by training, demographics, and practice. A total of 337 surgeons rated the importance of 7 factors when

  13. Legacy in the Sand: The United States Army Armament, Munitions and Chemical Command in Operations Desert Shield and Desert Storm

    Science.gov (United States)

    1992-12-21

    States Army Medical Department, over 1.5 million British-designed Small Box Respirator ( SBR ) masks, utilizing activated coconut charcoal as a filter, had...conflicts this nation will tfce-short in rjuration but of high intensity. In such a war, relance must bpp oaced upon the established stockpile and the...Supply System SAW squad automatic weapon SBA Small Business Administration SBR small box respirator SCR senior command representati’e SCRAM self-contained

  14. Comparison of Complications and Surgical Outcomes of Adolescent Idiopathic Scoliosis Between Junior Attending Surgeons and Senior Attending Surgeons.

    Science.gov (United States)

    Qiao, Jun; Xiao, Lingyan; Xu, Leilei; Shi, Benlong; Qian, Bangping; Zhu, Zezhang; Qiu, Yong

    2018-04-24

    To our knowledge, few studies have compared complications and surgical outcomes of adolescent idiopathic scoliosis (AIS) between junior attending surgeons and senior attending surgeons. To compare surgical strategies, complications, and outcomes of posterior corrective surgery for AIS between junior attending surgeons and senior attending surgeons. According to experience level of operation surgeons, the patients were assigned to 2 groups. Group A was the "junior surgeon" group. Group B was the "senior surgeon" group. The following parameters were compared between the 2 groups: age, sex, diagnosis, hospital of record, surgeon experience level, type of instrumentation, type of screws, estimated blood loss, duration of surgery, length of fusion, correction techniques, main curve correction, and thoracic kyphosis correction. A total of 132 patients with AIS were included in group A, whereas 207 were in group B. The translational technique was used more often in group A (P Senior surgeons used more monoaxial screws than junior surgeons (P senior group (P senior group had significant better correction rates of severe main curve (>70°) and thoracic kyphosis than the junior group (P Senior attending surgeons outperformed junior surgeons in blood loss control, thoracic kyphosis correction, and correction of severe curves. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Surgeons' motivation for choice of workplace.

    Science.gov (United States)

    Kähler, Lena; Kristiansen, Maria; Rudkjøbing, Andreas; Strandberg-Larsen, Martin

    2012-09-01

    To ensure qualified health care professionals at public hospitals in the future, it is important to understand which factors attract health care professionals to certain positions. The aim of this study was to explore motives for choosing employment at either public or private hospitals in a group of Danish surgeons, as well as to examine if organizational characteristics had an effect on motivation. Eight qualitative interviews were conducted with surgeons from both public and private hospitals sampled using the snowball method. The interviews were based on a semi-structured interview guide and analyzed by means of phenomenological theory. Motivational factors such as personal influence on the job, the opportunity to provide the best possible patient care, challenging work tasks colleagues, and ideological reasons were emphasized by the surgeons as important reasons for their choice of employment. Motivational factors appeared to be strongly connected to the structure of the organization; especially the size of the organization was perceived to be essential. It is worth noting that salary, in contrast to the general belief, was considered a secondary benefit rather than a primary motivational factor for employment. The study revealed that motivational factors are multidimensional and rooted in organizational structure; i.e. organizational size rather than whether the organization is public or private is crucial. There is a need for further research on the topic, but it seems clear that future health care planning may benefit from taking into account the implications that large organizational structures have for the staff working within these organizations. not relevant. not relevant.

  16. Assessment of surgeon fatigue by surgical simulators

    Directory of Open Access Journals (Sweden)

    Tuwairqi K

    2015-04-01

    Full Text Available Khaled Tuwairqi,1 Jessica H Selter,2 Shameema Sikder3 1College of Medicine, University of Utah, Salt Lake City, UT, 2Johns Hopkins School of Medicine, 3Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Background: The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms “simulator”, “surgery”, and “fatigue”. In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical

  17. What expects orthopedic surgeon from bone scan?

    International Nuclear Information System (INIS)

    Sutter, B.; Cazenave, A.

    2003-01-01

    The isotope bone scan continues to be one of the 'lost widely performed nuclear medicine investigations. Beyond the common clinical indication like detection of skeletal metastases, bone scan use is increasing in benign orthopedic conditions, and after orthopedic surgery, despite development of new investigations modalities (US, MRI). Three (or two) phase bone scintigraphy, Single Photon Emission Computer Tomography have increased its value and provided new clinical roles. This review emphasizes through some practical clinical examples how to increase diagnostic value of the method and to offer an adapted response to the orthopedic surgeon's attempts. (author)

  18. British power generation/delivery handbook

    Energy Technology Data Exchange (ETDEWEB)

    Bagley, R.

    1986-01-01

    Describes the British electricity-supply system and covers: the CEGB, nuclear power - AGR design, boiler plant development coal-fired boilers and oil-fired boilers, steam turbine/generators, boiler-feed pumps, pumped storage, gas turbine plants, transmission system including the link to France, the Sizewell-BPWR, future AGR development, future coal-fired stations, fluidized bed combustion, coal gasification, and wind energy developments. Also included is a list of British equipment suppliers to the electricity supply industry, and a buyer's guide to British equipment and services.

  19. Male parentage in army ants

    DEFF Research Database (Denmark)

    Kronauer, Daniel J C; Schöning, Caspar; Boomsma, Jacobus J

    2006-01-01

    of active research in insect sociobiology. Here we present microsatellite data for 176 males from eight colonies of the African army ant Dorylus (Anomma) molestus. Comparison with worker genotypes and inferred queen genotypes from the same colonies show that workers do not or at best very rarely reproduce...

  20. The Army word recognition system

    Science.gov (United States)

    Hadden, David R.; Haratz, David

    1977-01-01

    The application of speech recognition technology in the Army command and control area is presented. The problems associated with this program are described as well as as its relevance in terms of the man/machine interactions, voice inflexions, and the amount of training needed to interact with and utilize the automated system.

  1. Army Transformation to Expeditionary Formations

    National Research Council Canada - National Science Library

    Bryson, Jeff

    2008-01-01

    This thesis explores the path of transformation in the U.S. Army from its inception in the late 1990s by then Chief of Staff GEN Eric Shinseki to the Interim Brigade Combat Team and through Operations Enduring and Iraqi Freedom...

  2. Opportunities in Total Knee Arthroplasty: Worldwide Surgeons' Perspective.

    Science.gov (United States)

    Dunbar, Michael; Newman, Jared M; Khlopas, Anton; Chughtai, Morad; Martinez, Nick; Bhowmik-Stoker, Manoshi; Mont, Michael A

    2017-07-25

    This study surveyed a group of US and international orthopaedic surgeons to prioritize areas of improvement in primary total knee arthroplasty (TKA). Specifically, we assessed surgeon responses regarding the top five areas of TKA needing improvement; which were stratified by: a) US surgeons, b) international surgeons, c) US surgeons' implant-brand-loyalty, and d) surgeons' years of experience and case volume. Four hundred and eighteen surgeons who were board-certified, in practice for at least two years, spent 60% of their time in clinical practice, and performed a minimum of 25 lower extremity joint arthroplasties per year were surveyed. They chose the top five areas (among 17) needing improvement for TKA. Results were stratified by surgeons' location (US and international), implant-brand-loyalty, years of experience, and case volume. Functional outcomes was the top identified area for improvement (US 63% and international 71%), followed by brand loyalty (Company I 68%, other brand 59%, and multi-brand/no loyalty 66%), years of experience (early-career 64%, mid-career 63%, and late-career 75%) and case volume (low-volume 69%, mid-volume 60%, and high-volume 71%). Following this was costs for US surgeons (47%) and implant survivorship for international surgeons (57%). While costs were the next highest area for specific Company-loyal surgeons (57%), implant survivorship was the next highest area for the other two cohorts. Implant survivorship was the second most important area of improvement regardless of years of experience and for low- and mid-volume surgeons. Surgeons identified functional outcomes as the most important area needing improvement. Cost of implants was more important for American as compared to international surgeons.

  3. Perspectives of being spouse, parent, and surgeon.

    Science.gov (United States)

    Murtha, Yvonne

    2013-10-01

    Achieving a balance between one's career and personal life is a never-ending challenge. As a surgeon, add-on cases and double-booked clinics can lead to long hours at work and make availability for family time unpredictable. It may seem like the threat of interruption because of patient needs always loom. Disruptions to family time extend beyond the long hours spent in surgery and clinics. Inattentiveness at home because of the technology tethers that keep one available for constant questions and patient care issues can also distract from time spent with family. Although the practice of an orthopaedic trauma surgeon can involve unpredictable schedules and patient care issues, there are means of mitigating the chaos that can envelop one's personal life as a result of a chosen career track. Clear priorities and expectations in both personal and professional arenas can improve the work-life balance. Flexible jobs that allow for more time with family do exist. Negotiating for this flexibility and self-assurance in holding fast to personal ideals are important in achieving a successful balance.

  4. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  5. American British Canadian, Australian Armies Standardization Program Catalog of War Games

    Science.gov (United States)

    1991-05-21

    operations (Europe, Korea , etc); requirements; capacities; interaction among nodes in the movement doctrine; etc. OUTPUT: Outputs can be in the form...Bragg, Korea , Ft. Carson, Ft. Campbell, and Ft. Devens - fielded sites. 18 Comments: Managed through a configuration control board (CCB...Sidedness: Two-sided, with one or more controllers. 38 LIMITATIONS: Requires experienced military gamers and computer operators all working from table top

  6. British women's attitudes to surrogacy.

    Science.gov (United States)

    Poote, A E; van den Akker, O B A

    2009-01-01

    There has been little interest in the research literature on public opinions regarding assisted conception and surrogacy, particularly in European countries, despite the growing evidence showing that problems in adaptation and coping may be related to perceived normative values. This study investigated British women's attitudes to surrogacy using components of the theory of planned behaviour (TPB). Questionnaires on attitudes to surrogacy and reasons for parenthood were completed by 187 women from the general public. Significant socio-demographic differences were found between women who were possibly willing (n = 76) and those who were unwilling (n = 111) to become surrogate mothers. General attitudes to surrogacy also differed between groups (P = 0.000). This study supported the predictive utility of components of the TPB, and differentiated adequately between groups on attitudes to recruitment for surrogacy (P = 0.000), the consequences of surrogacy (P = 0.000), factors that induce people to become surrogates (P = 0.000), social support (P = 0.000), having personal control (P = 0.002) and reasons for parenthood (P = 0.000). Age (P = 0.000), attitudes to advertising (P = 0.02) and the consequences of surrogacy (P = 0.05) predicted (un)willingness to become a potential surrogate mother. Further research is needed with larger sample sizes of potential surrogates to determine whether the predictive attitudes reported here translate to actual behaviours. The larger group which was not interested in considering becoming a surrogate scored significantly more negatively on all attitudes towards surrogacy. The negative attitudes reported by the 'unwilling to consider being a surrogate' group may reflect attitudes held by the majority of the population and are likely to be influenced by reports of stigma associated with surrogacy.

  7. British and American attitudes toward credit cards.

    Science.gov (United States)

    Yang, Bijou; James, Simon; Lester, David

    2006-04-01

    American university students owned more than twice as many credit cards as British university students. However, scores on a credit card attitude scale predicted the number of cards owned by respondents in both countries.

  8. The British Empire and the English Curriculum.

    Science.gov (United States)

    Thron, E. Michael

    1987-01-01

    Examines the recent call for English departments to recognize literature that falls outside the British and American tradition. Suggests that we recognize English as a world language and choose books to teach accordingly. (JC)

  9. Efficiency Studies in the British Universities.

    Science.gov (United States)

    Lockwood, Geoffrey

    1986-01-01

    The background, purposes, and methods of institutional efficiency studies conducted at selected British universities are discussed. The evaluations focused on financial management, purchasing, and building maintenance and space utilization. (MSE)

  10. 2013 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Army Civilian Leaders

    Science.gov (United States)

    2014-05-30

    Army civilian workforce with regard to gender and ethnic origin (Office of the Assistant G-1 for Civilian Personnel, 2013). The reported education...climates of perceived inequality . Civilian leader comments frequently referenced favoritism as reflecting cronyism, unfair personnel actions, and...interests of others, unequal enforcement of standards and discipline, and use of discretion in workplace justice. As demonstrated in previous CASAL

  11. The Demography of Royal Navy Surgeons: Some Views on the Process of Prosopography

    Directory of Open Access Journals (Sweden)

    Christopher H Myers

    2015-08-01

    Full Text Available This study is a brief social biography and demography of British naval doctors during the nineteenth century, asking why Scottish-educated surgeons were so prominent.  Understanding the demography and changing dynamics of naval surgeons’ labor illuminates the complex relationship among the military, discrimination, and nationalism that shaped this influential labor market. This study reviews how to collect demographic information from multiple types of sources: university archives, matriculation records, digitized medical journals, and student rolls.  It also uses chi-square tests to show the significance of the demographic information collected.  The results show us the entangled relationship between database conceptualization, data collection, and data analysis.  

  12. 77 FR 50089 - Army Education Advisory Committee Meeting

    Science.gov (United States)

    2012-08-20

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... learning environment. The agenda will include topics relating to Army Learning Model 2015 and support to...

  13. 77 FR 11084 - Army Education Advisory Committee Meeting

    Science.gov (United States)

    2012-02-24

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Committee Meeting AGENCY... the Army announces the following committee meeting: Name of Committee: Army Education Advisory... Army 2020 learning environment. The agenda will include topics relating Arm Learning Model 2015 and to...

  14. 75 FR 19302 - Radiation Sources on Army Land

    Science.gov (United States)

    2010-04-14

    ... possession of ionizing radiation sources by non-Army agencies (including their civilian contractors) on an... radiation sources on Army land. The Army requires Non-Army agencies (including their civilian contractors... ionizing radiation sources on an Army Installation. For the purpose of this proposed rule, ``ionizing...

  15. 78 FR 33074 - Army Science Board Summer Study Session

    Science.gov (United States)

    2013-06-03

    ...--This study evaluates what science and technology competencies the Army must maintain and/or develop as... DEPARTMENT OF DEFENSE Department of the Army Army Science Board Summer Study Session AGENCY... the Army announces the following committee meeting: 1. Name of Committee: Army Science Board (ASB). 2...

  16. Burnout in the Plastic Surgeon: Implications and Interventions.

    Science.gov (United States)

    Prendergast, Christina; Ketteler, Erika; Evans, Gregory

    2017-03-01

    A career as a plastic surgeon is both rewarding and challenging. The road to becoming a surgeon is a long arduous endeavor and can bring significant challenges not only to the surgeon but their family. A study by the American College of Surgeons (ACS) suggested that over 40% of surgeons experience burnout and a recent survey of American Society of Plastic Surgeons (ASPS) showed that more than one-fourth of plastic surgeons have signs of professional burnout. Burnout is a state of physical and mental exhaustion. The three main components of burnout are emotional exhaustion, depersonalization, and reduced personal accomplishment. Exhaustion occurs as a result of emotional demands. Depersonalization refers to a cynical, negative or a detached response to patient care. The reduced accomplishment refers to a belief that one can no longer work effectively. There has been a recent explosion in the literature characterizing burnout within the surgical profession. Reports of burnout, burnout victims, and burnout syndrome are filling the medical literature, books, blogs, and social media across all different specialties. Burnout in a plastic surgeon has negative and potentially fatal repercussions to the surgeon, their family, their patients, their staff, colleagues, coworkers, and their organization. To date, there are a limited number of publications addressing burnout in the plastic surgery community. The goals of this paper are to review the symptoms of burnout, its effect on plastic surgeons, and discuss potential solutions for burnout prevention and physician wellness.

  17. Drs. Smith Brothers: dental surgeons of Calcutta.

    Science.gov (United States)

    Sanjeev, Kumar

    2014-01-01

    During the British raj, India attracted dental practitioners from all over the world who set up practices in the Presidency towns of Calcutta, Bombay, Madras and Bangalore. Lured by the abundant opportunity to make good money, these mercenary but courageous dentists counted Viceroys, Indian royalty and political leaders amongst their clients. Some, like the famous American Smith Brothers of Calcutta, were sought after even by the rulers of neighboring countries. Dr. Mark Smith's hazardous visit to the Amir of Afghanistan made worldwide headlines more than 100 years ago for the fabulous fee he was paid for the dental treatment. This paper briefly describes the exploits and experiences of the Smith brothers while in India.

  18. Should advertising by aesthetic surgeons be permitted?

    Directory of Open Access Journals (Sweden)

    Neeraj Nagpal

    2017-01-01

    Full Text Available Cosmetic, aesthetic and cutaneous surgical procedures require qualified specialists trained in the various procedures and competent to handle complications. However, it also requires huge investments in terms of infrastructure, trained staff and equipment. To be viable advertising is essential to any establishment which provides cosmetic and aesthetic procedures. Business men with deep pockets establish beauty chains which also provide these services and advertise heavily to sway public opinion in their favour. However, these saloons and spas lack basic medical facilities in terms of staff or equipment to handle any complication or medical emergency. To have a level playing field ethical advertising should be permitted to qualified aesthetic surgeons as is permitted in the US and UK by their respective organisations.

  19. Norman Bethune, Canadian surgeon: his Chinese connection.

    Science.gov (United States)

    Summers, G V

    1983-07-01

    Norman Bethune, a Canadian thoracic surgeon who dabbled in painting, poetry, criticism, teaching and invention, was a member of the Communist Party of Canada. He became involved in two civil wars on opposite sides of the world and amassed both criticism and respect from colleagues and national leaders. The author describes Bethune's time in China, during which he developed front line field hospitals for Mao Tse-tung and his guerrillas in their struggle against the Japanese during 1938 and 1939. His efforts in China on behalf of the wounded brought him into contact with the primitive military medicine of the country and the poverty of its people; it earned for him a local reputation as saviour and benefactor and gave him an honoured place in Chinese military history.

  20. 76 FR 56406 - Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army...

    Science.gov (United States)

    2011-09-13

    ... DEPARTMENT OF DEFENSE Office of the Secretary Science and Technology Reinvention Laboratory Demonstration Project; Department of the Army; Army Research, Development and Engineering Command; Tank... personnel management demonstration project for eligible TARDEC employees. Within that notice the table...

  1. Risk of ionising radiation to trainee orthopaedic surgeons.

    Science.gov (United States)

    Khan, Ishrat A; Kamalasekaran, Senthil; Fazal, M Ali

    2012-02-01

    We undertook this study to determine the amount of scattered radiation received by the primary surgeon, assistant and patient during dynamic hip screw fixation for proximal femoral fractures. Data was collected from fifty patients. Five registrars were included as operating surgeon and four senior house officers as assistant surgeon. Radiation was monitored by thermo luminescent dosimeters placed on the surgeon and assistant. The approximate distance of surgeon and assistant from the operative site was measured. A dosimeter on the unaffected hip of patients measured the radiation to the patient. The results show that the surgeon's dominant hand receives the highest dose of radiation and radiation exposure is dependent on the experience of the operator. Our study concludes that exposure to radiation during this procedure is well below the toxic levels; however greater awareness is needed for harmful effects of exposure to long term low dose radiation.

  2. Solving the surgeon ergonomic crisis with surgical exosuit.

    Science.gov (United States)

    Liu, Shanglei; Hemming, Daniel; Luo, Ran B; Reynolds, Jessica; Delong, Jonathan C; Sandler, Bryan J; Jacobsen, Garth R; Horgan, Santiago

    2018-01-01

    The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery. This is a prospective randomized crossover study approved by the Internal Review Board (IRB). The study involves three phases of testing. In each phase, general surgery residents or attendings were randomized to wearing the surgical exosuit at the beginning or at the crossover point. The first phase tests for surgeon manual dexterity wearing the device using the Minnesota Dexterity test, the Purdue Pegboard test, and the Fundamentals of Laparoscopic Surgery (FLS) modules. The second phase tests the effect of the device on shoulder pain and fatigue while operating the laparoscopic camera. The third phase rates surgeon experience in the operating room between case-matched operating days. Twenty subjects were recruited for this study. Surgeons had the similar dexterity scores and FLS times whether or not they wore the exosuit (p value ranges 0.15-0.84). All exosuit surgeons completed 15 min of holding laparoscopic camera compared to three non-exosuit surgeons (p Exosuit surgeons experienced significantly less fatigue at all time periods and arm pain (3.11 vs 5.88, p = 0.019) at 10 min. Surgeons wearing the exosuit during an operation experienced significant decrease in shoulder pain and 85% of surgeons reported some form of pain reduction at the end of the operative day. The progressive arm support exosuit can be a minimally intrusive device that laparoscopic surgeons wear to reduce pain and fatigue of surgery without significantly interfering with operative skills or manual dexterity.

  3. Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout.

    Science.gov (United States)

    van Wulfften Palthe, Olivier D R; Neuhaus, Valentin; Janssen, Stein J; Guitton, Thierry G; Ring, David

    2016-08-01

    Burnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions. We asked: (1) For surgeons treating musculoskeletal conditions, what risk factors are associated with worse job dissatisfaction? (2) What risk factors are associated with burnout symptoms? Two hundred ten (52% of all active members of the Science of Variation Group [SOVG]) surgeons who treat musculoskeletal conditions (94% orthopaedic surgeons and 6% trauma surgeons; in Europe, general trauma surgeons do most of the fracture surgery) completed the Global Job Satisfaction instrument, Shirom-Malamed Burnout Measure, and provided practice and surgeon characteristics. Most surgeons were male (193 surgeons, 92%) and most were academically employed (186 surgeons, 89%). Factors independently associated with job satisfaction and burnout were identified with multivariable analysis. Greater symptoms of burnout (β, -7.13; standard error [SE], 0.75; 95% CI, -8.60 to -5.66; p job satisfaction. Having children (β, -0.45; SE, 0.0.21; 95% CI, -0.85 to -0.043; p = 0.030; adjusted R(2), 0.046) was the only factor independently associated with fewer symptoms of burnout. Among an active research group of largely academic surgeons treating musculoskeletal conditions, most are satisfied with their job. Efforts to limit burnout and job satisfaction by optimizing engagement in and deriving meaning from the work are effective in other settings and merit attention among surgeons. Level II, prognostic study.

  4. 2013 CENTER FOR ARMY LEADERSHIP ANNUAL SURVEY OF ARMY LEADERSHIP (CASAL): MAIN FINDINGS

    Science.gov (United States)

    2014-04-30

    The Center for Army Profession and Ethic (CAPE) has fielded education and training materials (including doctrine, pamphlets , videos, brochures , and...Army Pamphlet (DA PAM) 600-3, Commissioned Officer Development and Career Management, states that a goal of warrant officer training and education... Pamphlet 600-25, U.S. Army noncommissioned officer professional development and career management. Washington, D.C.: Headquarters, Department of the Army

  5. The legacy of Douglas Guthrie (1885-1975), surgeon and medical historian.

    Science.gov (United States)

    Macintyre, Iain

    2018-01-01

    After graduating in medicine Douglas Guthrie embarked on a career as an ENT surgeon. When his Edinburgh hospital appointment ended in 1936 he began to write History of Medicine, which, thanks to a favourable review by George Bernard Shaw, became a worldwide best seller when first published in 1945. This marked the start of Guthrie's second career as a lecturer in history of medicine at the University of Edinburgh where his prime responsibility was delivering systematic lectures on medical history to medical undergraduates. At a time when history of medicine was virtually the exclusive preserve of medical doctors, Guthrie promoted to them the historiography techniques of the academic historian. His vision that social historians should become involved in the field and that history of medicine should be taught in arts and humanities faculties began to be adopted in British universities a decade or so after Guthrie made the recommendation. His legacy includes the Scottish Society of the History of Medicine and the British Society for the History of Medicine, both of which he helped to found. His name is commemorated in various charitable trusts which he established to promote the study of history of medicine.

  6. Racial Extremism in the Army

    Science.gov (United States)

    1998-04-01

    of Deference ...................................................................................................... 46 1. The Separation of Powers Doctrine...to the military. This deference has a two-fold basis. First, the separation of powers in the U.S. Constitution gives authority to the executive (and...Why should there be judicial deference to the Army’s policy on extremism? There are two principal reasons. First, the Constitution’s separation of powers doctrine

  7. 2011 Army Strategic Planning Guidance

    Science.gov (United States)

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  8. Information Management: Army Information Management

    Science.gov (United States)

    2002-05-31

    funds or personnel to produce free programming solely for the benefit of a commercial CATV company. (6) The Army will require that the CATV franchisee ...provided, future customer requirements, and emerging IT capabilities which can benefit the customer. The Army’s increasing employment of IT dictates a...proactive oversight/insight system is operational and ensures mission benefit , cost, and schedule goals are met. (2) IT performance measures at the

  9. British Teachers' Transnational Work within and beyond the British Empire after the Second World War

    Science.gov (United States)

    Whitehead, Kay

    2017-01-01

    Focusing on British graduates from Gipsy Hill Training College (GHTC) in London, this article illustrates transnational history's concerns with the reciprocal flows of people and ideas within and beyond the British Empire. GHTC's progressive curriculum and culture positioned women teachers as agents of change, and the article highlights the lives…

  10. 78 FR 24735 - Army Education Advisory Committee Meeting

    Science.gov (United States)

    2013-04-26

    ... include topics relating to the Army Learning Model that seeks to improve the Army's learning model by leveraging technology without sacrificing standards so the Army can provide credible, rigorous, and relevant...

  11. Issues and Insights from the Army Technology Seminar Game

    National Research Council Canada - National Science Library

    Darilek, Richard

    2001-01-01

    ...). The AAN goals were to link Army XXI to a long-term vision of the Army extending well into the 21st century and to ensure that this vision informed evolving Army research and development requirements...

  12. Mentorship as Experienced by Women Surgeons in Japan.

    Science.gov (United States)

    Yorozuya, Kyoko; Kawase, Kazumi; Akashi-Tanaka, Sadako; Kanbayashi, Chizuko; Nomura, Sachiyo; Tomizawa, Yasuko

    2016-01-01

    Women have accounted for over 30% of new medical students since 1995 in Japan. Establishing support systems for women surgeons to continue their work is a major issue in Japan. Mentorship can be one of the most effective means to help women surgeons to continue their work. The purpose of this study was to clarify the current status of mentorship among Japanese women surgeons and to discuss the role of mentors for women surgeons. Invitation letters were sent to all female members of the Japan Association of Women Surgeons in April 2011. An 84-item questionnaire survey was sent to those who agreed to participate in this study via the internet. Fifty-five surgeons participated in this study, a response rate of 48.7%. Sixty-seven percent of respondents found it difficult to continue in their job; 85% thought mentorship was necessary for women surgeons to progress in their careers; and 84% reported that they already had a mentor. Respondents thought that a mentor helped them to advance their clinical career, to stay in their job, and to provide moral support. However, mentors appeared to be less useful in helping them to advance their research career, to network, to increase their status, and to achieve a work-life balance. This study revealed areas where mentors appeared to be less helpful to women surgeons. The survey gave an indication of how to help improve and develop the career and personal life of women surgeons in Japan.

  13. [Management abilities of the head surgeon: essential for survival!].

    Science.gov (United States)

    Jähne, J

    2012-04-01

    Due to increased economic challenges in the management of hospitals head surgeons do not only need excellent surgical expertise but also significant management qualities. The personality of head surgeons should include authenticity, sincerity, fairness and the ability to cooperate. Visionary leadership, strategic thinking and strategic management of the personnel are further prerequisites for success. Besides good abilities in communication head surgeons need knowledge of the operating figures for interpretation. To keep up with the own capabilities time and self-management is essential. A survival as head surgeon is likely if these qualities and abilities exist.

  14. Army Reserve Military Intelligence: Time for Change

    Science.gov (United States)

    2010-04-20

    Miramax Books, 2002. Goleman , Daniel . Emotional Intelligence . New York: Bantam Books, 1997. Goleman , Daniel , Richard Boyatzis, and Annie McKee...or position of the Department of the Army, Department of Defense, or the U.S. Government. ARMY RESERVE MILITARY INTELLIGENCE : TIME FOR CHANGE...Research Project 3. DATES COVERED 00-00-2009 to 00-00-2010 4. TITLE AND SUBTITLE Army Reserve Military Intelligence : Time for Change 5a

  15. Effectiveness of the Army Mentorship Program

    National Research Council Canada - National Science Library

    Nieberding, Richard J

    2007-01-01

    ...). From the artifacts associated with this mentorship program, it appears that the Army highly values this program as a way to create a culture and climate that fosters learning and development for future leadership. This project will examine the effectiveness of mentorship in the today's Army and evaluate whether the program is sufficient to meet the needs for the Army's next generation of soldiers and leaders.

  16. The United States Army 1996 Modernization Plan.

    Science.gov (United States)

    1996-03-08

    time and with less risk. IMA technology improvements are leveraged and inserted into the Army’s information architectures as the competitive market place...to procure a family of complementary, interoperable systems. At the end of the near-term, "Active Defense RD&A Startegy Army will begin fielding...Haul and Engineer tractors were fielded that brought modern technologies from the commercial market to the Army. However, adequate quantities were

  17. Did Senior British Officers Effectively Lead Change?

    Science.gov (United States)

    2014-12-12

    into the wider workforce’s skillsets. This active role was characterized by greater integration with the Regular Army, and due to the outsourcing of...three years and be responsible for the welfare of soldiers, that overall, this group of majors still seem to be unaware of what the New Employment

  18. Key performance indicators in British military trauma.

    Science.gov (United States)

    Stannard, Adam; Tai, Nigel R; Bowley, Douglas M; Midwinter, Mark; Hodgetts, Tim J

    2008-08-01

    Key performance indicators (KPI) are tools for assessing process and outcome in systems of health care provision and are an essential component in performance improvement. Although KPI have been used in British military trauma for 10 years, they remain poorly defined and are derived from civilian metrics that do not adjust for the realities of field trauma care. Our aim was to modify current trauma KPI to ensure they more faithfully reflect both the military setting and contemporary evidence in order to both aid accurate calibration of the performance of the British Defence Medical Services and act as a driver for performance improvement. A workshop was convened that was attended by senior, experienced doctors and nurses from all disciplines of trauma care in the British military. "Speciality-specific" KPI were developed by interest groups using evidence-based data where available and collective experience where this was lacking. In a final discussion these were streamlined into 60 KPI covering each phase of trauma management. The introduction of these KPI sets a number of important benchmarks by which British military trauma can be measured. As part of a performance improvement programme, these will allow closer monitoring of our performance and assist efforts to develop, train, and resource British military trauma providers.

  19. Brigadier General James Stevens Simmons (1890-1954), Medical Corps, United States Army: a career in preventive medicine.

    Science.gov (United States)

    Marble, Sanders

    2012-02-01

    James Simmons began his career in the US Army as a laboratory officer and his assignments progressed into tropical medicine research. His interests and work evolved into preventive medicine (PM, as the Army termed public health), and he took both a PhD and a Doctorate in Public Health. As the Army's leading PM officer he was appointed head of PM in 1940 and guided the Army's PM effort through World War II. His responsibility ran from gas masks through healthy nutrition and occupational health to an enormous variety of diseases; by the war's end, the breadth and importance of PM was reflected in the Preventive Medicine Division, having fully one-sixth of all military personnel at the Surgeon General's Office. Simmons used his strong professional credentials to tap into civilian medicine for expertise the Army lacked and he established organizations that survive to this day. After retirement, he sought to expand the field of public health and raise another generation of public health physicians.

  20. A Pilotless Army in the Megalopolis

    National Research Council Canada - National Science Library

    Wegner, Robert

    2004-01-01

    .... Although Army aviation can provide mobility, intelligence gathering, and massive precision fires, its current aviation systems are highly vulnerable within the urban environment and a solution...

  1. Army Cost Culture: What Is It? What Should It Become?

    Science.gov (United States)

    2013-03-01

    Army leaders to implement inclusion of this Army cost culture value into the larger Army culture. Kotter warns us that failure to complete each step...inculcation of a cost culture. However, this circumstance does not really apply to the Army. Army senior leaders clearly understand that mission comes...changed: In this challenging environment, an improved Army cost culture will enable senior leaders to preserve the nation’s security. This Strategy

  2. Techniques used by United Kingdom consultant plastic surgeons to select implant size for primary breast augmentation.

    Science.gov (United States)

    Holmes, W J M; Timmons, M J; Kauser, S

    2015-10-01

    Techniques used to estimate implant size for primary breast augmentation have evolved since the 1970s. Currently no consensus exists on the optimal method to select implant size for primary breast augmentation. In 2013 we asked United Kingdom consultant plastic surgeons who were full members of BAPRAS or BAAPS what was their technique for implant size selection for primary aesthetic breast augmentation. We also asked what was the range of implant sizes they commonly used. The answers to question one were grouped into four categories: experience, measurements, pre-operative external sizers and intra-operative sizers. The response rate was 46% (164/358). Overall, 95% (153/159) of all respondents performed some form of pre-operative assessment, the others relied on "experience" only. The most common technique for pre-operative assessment was by external sizers (74%). Measurements were used by 57% of respondents and 3% used intra-operative sizers only. A combination of measurements and sizers was used by 34% of respondents. The most common measurements were breast base (68%), breast tissue compliance (19%), breast height (15%), and chest diameter (9%). The median implant size commonly used in primary breast augmentation was 300cc. Pre-operative external sizers are the most common technique used by UK consultant plastic surgeons to select implant size for primary breast augmentation. We discuss the above findings in relation to the evolution of pre-operative planning techniques for breast augmentation. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Shark attack-related injuries: Epidemiology and implications for plastic surgeons.

    Science.gov (United States)

    Ricci, Joseph A; Vargas, Christina R; Singhal, Dhruv; Lee, Bernard T

    2016-01-01

    The increased media attention to shark attacks has led to a heightened fear and public awareness. Although few sharks are considered dangerous, attacks on humans can result in large soft tissue defects necessitating the intervention of reconstructive surgeons. This study aims to evaluate and describe the characteristics of shark-related injuries in order to improve treatment. The Global Shark Accident File, maintained by the Shark Research Institute (Princeton, NJ, USA), is a compilation of all known worldwide shark attacks. Database records since the 1900s were reviewed to identify differences between fatal and nonfatal attacks, including: geography, injury pattern, shark species, and victim activity. Since the 1900s, there have been 5034 reported shark attacks, of which 1205 (22.7%) were fatal. Although the incidence of attacks per decade has increased, the percentage of fatalities has decreased. Characteristics of fatal attacks included swimming (p = 0.001), boating (p = 0.001), three or more bite sites (p = 0.03), limb loss (p = 0.001), or tiger shark attack (p = 0.002). The most common attacks were bites to the legs (41.8%) or arms (18.4%), with limb loss occurring in 7% of attacks. Geographically, the majority of attacks occurred in North America (36.7%) and Australia (26.5%). Most attacks in the USA occurred in Florida (49.1%) and California (13.6%). Although rare, shark attacks result in devastating injuries to patients. As these injuries often involve multiple sites and limb loss, this creates a significant challenge for reconstructive surgeons. Proper identification of the characteristics of the attack can aid in providing optimal care for those affected. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Influence of new military athletic footwear on the kinetics and kinematics of running in relation to army boots.

    Science.gov (United States)

    Sinclair, Jonathan; Taylor, Paul J

    2014-10-01

    Musculoskeletal injuries in the lower extremities are common in military recruits. Army boots have frequently been cited as a potential mechanism behind these high injury rates. In response to this, the British Army introduced new footwear models, the PT-03 (cross-trainer) and PT1000 (running shoes), which are issued to each new recruit in an attempt to reduce the incidence of these injuries. The aim of the current investigation was to examine the kinetics and kinematic of the PT-03 and PT1000 footwear in relation to conventional army boots. Thirteen participants ran at 4.0 m·s in each footwear condition. Three-dimensional kinematics from the hip, knee, and ankle were measured using an 8-camera motion analysis system. In addition, simultaneous ground reaction forces were obtained. Kinetic parameters were obtained alongside joint kinematics and compared using repeated-measures analyses of variance. The kinetic analysis revealed that impact parameters were significantly greater when running in the army boot compared with the PT-03 and PT1000. The kinematic analysis indicated that, in comparison with the PT-03 and PT1000, running in army boots was associated with significantly greater eversion and tibial internal rotation. It was also found that when running in the PT-03 footwear, participants exhibited significantly greater hip adduction and knee abduction compared with the army boots and PT1000. The results of this study suggest that the army boots and PT-03 footwear are associated with kinetic and kinematic parameters that have been linked to the etiology of injury; thus, it is recommended that the PT1000 footwear be adopted for running exercises.

  5. Phonemic Transcriptions in British and American Dictionaries

    Directory of Open Access Journals (Sweden)

    Rastislav Šuštaršič

    2005-06-01

    Full Text Available In view of recent criticisms concerning vowel symbols in some British English dictionaries (in particular by J. Windsor Lewis in JIPA (Windsor Lewis, 2003, with regard to the Oxford Dictionary of Pronunciation (Upton, 2001, this article extends the discussion on English phonemic transcriptions by including those that typically occur in standard American dictionaries, and by comparing the most common conventions of British and American dictionaries. In addition to symbols for both vowels and consonants, the paper also deals with the different representations of word accentuation and the issue of consistency regarding application of phonemic (systemic, broad, rather than phonetic (allophonic, narrow transcription. The different transcriptions are assessed from the points of view of their departures from the International Phonetic Alphabet, their overlapping with orthographic representation (spelling and their appropriateness in terms of reflecting actual pronunciation in standard British and/or American pronunciation.

  6. British firms mark progress off Viet Nam

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    British companies are making more inroads in exploring for oil and gas off Viet Nam. British Gas plc won a 25 year production sharing contract for a license off southern Viet Nam in the South China Sea. Meantime, London independent Lasmo plc started seismic surveys on the block adjoining the British Gas block. Separately, Thailand and Viet Nam have reached agreement to jointly explore for and develop oil and gas found in waters claimed by both countries. Plans call for the two countries to draw up joint development plans covering oil and gas resources in the southeastern fringe of the Gulf of Thailand. Bangkok officials say they would have preferred to delineate maritime boundaries with Hanoi, but opted for the joint development accord, noting that Thailand and Malaysia had taken 12 years to resolve a similar dispute

  7. Impact of Different Surgeons on Dental Implant Failure.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

  8. The Glass Houses of Attending Surgeons: An Assessment of Unprofessional Behavior on Facebook Among Practicing Surgeons.

    Science.gov (United States)

    Langenfeld, Sean J; Sudbeck, Craig; Luers, Thomas; Adamson, Peter; Cook, Gates; Schenarts, Paul J

    2015-01-01

    Our recent publication demonstrated that unprofessional behavior on Facebook is common among surgical residents. In the formulation of standards and curricula to address this issue, it is important that surgical faculty lead by example. Our current study refocuses on the Facebook profiles of faculty surgeons involved in the education of general surgery residents. The American College of Surgeons (ACS) web site was used to identify general surgery residencies located in the Midwest. Departmental web sites were then searched to identify teaching faculty for the general surgery residency. Facebook was then searched to determine which faculty had profiles available for viewing by the general public. Profiles were then placed in 1 of the 3 following categories: professional, potentially unprofessional, or clearly unprofessional. A chi-square test was used to determine significance. In all, 57 residency programs were identified on the ACS web site, 100% of which provided an institutional web site listing the surgical faculty. A total of 758 general surgery faculty were identified (133 women and 625 men), of which 195 (25.7%) had identifiable Facebook accounts. In all, 165 faculty (84.6%) had no unprofessional content, 20 (10.3%) had potentially unprofessional content, and 10 (5.1%) had clearly unprofessional content. Inter-rater reliability was good (88.9% agreement, κ = 0.784). Clearly unprofessional behavior was found only in male surgeons. For male surgeons, clearly unprofessional behavior was more common among those in practice for less than 5 years (p = 0.031). Alcohol and politics were the most commonly found variables in the potentially unprofessional group. Inappropriate language and sexually suggestive material were the most commonly found variables in the clearly unprofessional group. Unprofessional behavior on Facebook is less common among surgical faculty compared with surgical residents. However, the rates remain unacceptably high, especially among men and

  9. Alternative strategies for the British coal industry

    Energy Technology Data Exchange (ETDEWEB)

    Manners, G

    1973-01-01

    The Green Paper, 'Energy Policy - a Consultative Document' (HC-Cmnd--7101) affords a valuable insight into official attitudes towards the future of the British energy market. The present author challenges some of the energy supply and demand forecasts that are presented in the Working Document; in particular, he questions the optimistic market forecasts that continue to dominate official thinking about the coal industry; and he proposes that an alternative strategy is required for the British coal industry, one that involves quite painful choices of an economic, geographical, social and environmental nature.

  10. Richard von Volkmann: surgeon and Renaissance man.

    Science.gov (United States)

    Willy, Christian; Schneider, Peter; Engelhardt, Michael; Hargens, Alan R; Mubarak, Scott J

    2008-02-01

    Richard von Volkmann (1830-1889), one of the most important surgeons of the 19(th) century, is regarded as one of the fathers of orthopaedic surgery. He was a contemporary of Langenbeck, Esmarch, Lister, Billroth, Kocher, and Trendelenburg. He was head of the Department of Surgery at the University of Halle, Germany (1867-1889). His popularity attracted doctors and patients from all over the world. He was the lead physician for the German military during two wars. From this experience, he compared the mortality of civilian and war injuries and investigated the general poor hygienic conditions in civilian hospitals. This led him to introduce the "antiseptic technique" to Germany that was developed by Lister. His powers of observation and creativity led him to findings and achievements that to this day bear his name: Volkmann's contracture and the Hueter-Volkmann law. Additionally, he was a gifted writer; he published not only scientific literature but also books of children's fairy tales and poems under the pen name of Richard Leander, assuring him a permanent place in the world of literature as well as orthopaedics.

  11. [Surgeons and Neurosurgeons as Nobel Prize Winners].

    Science.gov (United States)

    Chrastina, Jan; Jančálek, Radim; Hrabovský, Dušan; Novák, Zdeněk

    Since 1901 Nobel Prize is awarded for exceptional achievements in physics, chemistry, literature, peace, economy (since 1968) and medicine or physiology. The first aim of the paper is to provide an overview of surgeons - winners of Nobel Prize for medicine or physiology. Although the prominent neurosurgeons were frequently nominated as Nobel Prize candidates, surprisingly no neurosurgeon received this prestigious award so far despite that the results of their research transgressed the relatively narrow limits of neurosurgical speciality.The most prominent leaders in the field of neurosurgery, such as Victor Horsley, Otfrid Foerster, Walter Dandy and Harvey Cushing are discussed from the point of their nominations. The overview of the activity of the Portuguese neurologists and Nobel Prize Winter in 1949 Egas Moniz (occasionally erroneously reported as neurosurgeon) is also provided. Although his work on brain angiography has fundamentally changed the diagnostic possibilities in neurology and neurosurgery, he was eventually awarded Nobel Prize for the introduction of the currently outdated frontal lobotomy.The fact that none of the above mentioned prominent neurosurgeons has not been recognised by Nobel Prize, may be attributed to the fact that their extensive work cannot be captured in a short summary pinpointing its groundbreaking character.

  12. Nanotechnology tolls the bell for plastic surgeons.

    Science.gov (United States)

    Salehahmadi, Zeinab; Hajiliasgari, Fatemeh

    2013-06-01

    Nanotechnology is an emerging discipline, having power to revolutionarize every scientific field to a very deep level which previously thought to be a science fiction. Having a great potential to beneficially change the way a disease is diagnosed, treated and prevented, nanotechnology practically impacts on state of the art healthcare technologies and plays a crucial role in changing the field of surgery. Surgeons are constantly looking for minimally invasive ways to treat their patients, as recovery is faster when a lesser trauma is inflicted upon a patient, scarring is lessened and there are usually fewer complications in the aftermath of the operation. Through nanotechnology, tiny biosensors could be constructed which could take these factors into account, thus shortening the patient recovery period and saving hospitals money, reducing infection rates within the hospital, reducing the waiting lists for operation and allowing doctors to treat more patients in the same period of time. This review employs a thematic analysis of online series of academic papers focuses on the potentials of nanotechnology in surgery, especially in plastic surgery and addresses the possible future prospects of nanotechnology in this field.

  13. Augmented reality for the surgeon: Systematic review.

    Science.gov (United States)

    Yoon, Jang W; Chen, Robert E; Kim, Esther J; Akinduro, Oluwaseun O; Kerezoudis, Panagiotis; Han, Phillip K; Si, Phong; Freeman, William D; Diaz, Roberto J; Komotar, Ricardo J; Pirris, Stephen M; Brown, Benjamin L; Bydon, Mohamad; Wang, Michael Y; Wharen, Robert E; Quinones-Hinojosa, Alfredo

    2018-04-30

    Since the introduction of wearable head-up displays, there has been much interest in the surgical community adapting this technology into routine surgical practice. We used the keywords augmented reality OR wearable device OR head-up display AND surgery using PubMed, EBSCO, IEEE and SCOPUS databases. After exclusions, 74 published articles that evaluated the utility of wearable head-up displays in surgical settings were included in our review. Across all studies, the most common use of head-up displays was in cases of live streaming from surgical microscopes, navigation, monitoring of vital signs, and display of preoperative images. The most commonly used head-up display was Google Glass. Head-up displays enhanced surgeons' operating experience; common disadvantages include limited battery life, display size and discomfort. Due to ergonomic issues with dual-screen devices, augmented reality devices with the capacity to overlay images onto the surgical field will be key features of next-generation surgical head-up displays. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Exposure of the orthopaedic surgeon to radiation

    Energy Technology Data Exchange (ETDEWEB)

    Katoh, Kiyonobu; Koga, Takamasa; Matsuzaki, Akio; Kido, Masaki; Satoh, Tetsunori [Fukuoka Univ. (Japan). Chikushi Hospital

    1995-09-01

    We monitored the amount of radiation received by surgeons and assistants during surgery carried out with fluoroscopic assistance. The radiation was monitored with the use of MYDOSE MINIX PDM107 made by Aloka Co. Over a one year period from Aug 20, 1992 to Aug 19, 1993, a study was undertaken to evaluate exposure of the groin level to radiation with or without use of the lead apron during 106 operation (Group-1). In another group, radiation was monitored at the breast and groin level outside of the lead apron during 39 operations (Group-2). In Group-1, the average exposure per person during one year was 46.0 {mu}SV and the average exposure for each procedure was 1.68 {mu}SV. The use of the lead apron affirmed its protective value; the average radiation dose at the groin level out-side of the apron was 9.11 {mu}SV, the measured dose beneath the apron 0.61 {mu}SV. The average dose of exposure to the head, breast at groin level outside of the lead apron, were 7.68 {mu}SV, 16.24 {mu}SV, 32.04 {mu}SV respectively. This study and review of the literature indicate that the total amount of radiation exposure during surgery done with fluoroscopic control remains well within maximum exposure limits. (author).

  15. Exposure of the orthopaedic surgeon to radiation

    International Nuclear Information System (INIS)

    Katoh, Kiyonobu; Koga, Takamasa; Matsuzaki, Akio; Kido, Masaki; Satoh, Tetsunori

    1995-01-01

    We monitored the amount of radiation received by surgeons and assistants during surgery carried out with fluoroscopic assistance. The radiation was monitored with the use of MYDOSE MINIX PDM107 made by Aloka Co. Over a one year period from Aug 20, 1992 to Aug 19, 1993, a study was undertaken to evaluate exposure of the groin level to radiation with or without use of the lead apron during 106 operation (Group-1). In another group, radiation was monitored at the breast and groin level outside of the lead apron during 39 operations (Group-2). In Group-1, the average exposure per person during one year was 46.0 μSV and the average exposure for each procedure was 1.68 μSV. The use of the lead apron affirmed its protective value; the average radiation dose at the groin level out-side of the apron was 9.11 μSV, the measured dose beneath the apron 0.61 μSV. The average dose of exposure to the head, breast at groin level outside of the lead apron, were 7.68 μSV, 16.24 μSV, 32.04 μSV respectively. This study and review of the literature indicate that the total amount of radiation exposure during surgery done with fluoroscopic control remains well within maximum exposure limits. (author)

  16. Decreased heart rate variability in surgeons during night shifts

    DEFF Research Database (Denmark)

    Amirian, Ilda; Toftegård Andersen, Lærke; Rosenberg, Jacob

    2014-01-01

    BACKGROUND: Heart rate variability (HRV) has been used as a measure of stress and mental strain in surgeons. Low HRV has been associated with death and increased risk of cardiac events in the general population. The aim of this study was to clarify the effect of a 17-hour night shift on surgeons'...

  17. Surgeons' Leadership Styles and Team Behavior in the Operating Room.

    Science.gov (United States)

    Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

    2016-01-01

    The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards and transformational (team-oriented) leaders inspire performance beyond expectations. We videorecorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (Multifactor Leadership Questionnaire) was correlated with surgeon behavior (Surgical Leadership Inventory) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. All surgeons scored similarly on transactional leadership (range 2.38 to 2.69), but varied more widely on transformational leadership (range 1.98 to 3.60). Each 1-point increase in transformational score corresponded to 3 times more information-sharing behaviors (p leadership and its impact on team performance in the operating room. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development, therefore, has the potential to improve the efficiency and safety of operative care. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. ORIGINAL ARTICLES Surgeons and HIV: South African attitudes

    African Journals Online (AJOL)

    2009-02-01

    Feb 1, 2009 ... Local policies and those from developed countries may not .... National Health Act 61 of 2003, such information (surgeon HIV ... specialist surgeon trainees established that 91% did not think .... 2008 Report on the Global AIDS ... Schulman KA, McDonald RC, Lynn LA, Frank I, Christakis NA, Schwartz JS.

  19. The anatomy lessons of the Amsterdam Guild of Surgeons

    NARCIS (Netherlands)

    IJpma, F.F.A.

    2014-01-01

    Mandatory lessons in anatomy, taught by the praelector anatomiae (lecturer in anatomy) of the Amsterdam Guild of Surgeons, were an important part of the surgical training starting in the 16th century. We describe how surgeons were trained approximately 350 years ago at the Surgeons’ Guild. The role

  20. English law for the surgeon II: clinical negligence.

    Science.gov (United States)

    Jerjes, Waseem; Mahil, Jaspal; Upile, Tahwinder

    2011-12-21

    Traditionally, in the United Kingdom and Europe, the surgeon was generally not troubled by litigation from patients presenting as elective as well as emergency cases, but this aspect of custom has changed. Litigation by patients now significantly affects surgical practice and vicarious liability often affects hospitals. We discuss some fundamental legal definitions, a must to know for a surgeon, and highlight some interesting cases.

  1. Surgeons' Perspectives on Premium Implants in Total Joint Arthroplasty.

    Science.gov (United States)

    Wasterlain, Amy S; Bello, Ricardo J; Vigdorchik, Jonathan; Schwarzkopf, Ran; Long, William J

    2017-09-01

    Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs. Descriptive and univariate analyses were performed. A total of 126 surgeons responded from all 5 regions of the United States. Although 76.9% believed new products advance technology in orthopedics, most (66.7%) supported informing patients that new implants lack long-term clinical data and restricting new implants to a small number of investigators prior to widespread market launch. The survey revealed that 66.7% would forgo gain-sharing incentives in exchange for more freedom to choose implants. Further, 76.9% believed that patients should be allowed to pay incremental costs for "premium" implants. Surgeons who believed that premium products advance orthopedic technology were more willing to forgo gain-sharing (P=.040). Surgeons with higher surgical volume (P=.007), those who believed implant companies should be allowed to charge more for new technology (Pnew implants with patients. Many surgeons support alternative payment models permitting surgeons and patients to retain implant selection autonomy. Most respondents prioritized patient beneficence and surgeon autonomy above personal financial gain. [Orthopedics. 2017; 40(5):e825-e830.]. Copyright 2017, SLACK Incorporated.

  2. Effect of Individual Surgeons and Anesthesiologists on Operating Room Time

    NARCIS (Netherlands)

    van Eijk, Ruben P A; van Veen-Berkx, Elizabeth; Kazemier, Geert; Eijkemans, Marinus J C

    BACKGROUND:: Variability in operating room (OR) time causes overutilization and underutilization of the available ORs. There is evidence that for a given type of procedure, the surgeon is the major source of variability in OR time. The primary aim was to quantify the variability between surgeons and

  3. Review of CD Rom: The Virtual Surgeon: ACL Reconstruction ...

    African Journals Online (AJOL)

    THE VIRTUAL SURGEON: ACL RECONSTRUCTION Professor George Bentley ChM FRCS, Russell E LVindsor MD, Mr Andrew Williams FRCS(0rth); 4150 + VAT(UK) The Virtual Surgeon - 3D Anatomy of the Knee 469 + VAT(UK). TVF Multimedia Ltd, 375 City Road, London, EClV lNB, UK ...

  4. Role of Surgeons in Determining Outcome of Histopathology ...

    African Journals Online (AJOL)

    Conclusion: To ensure the quality of histopathological diagnosis with minimal turnaround time, the surgeon plays a vital role by ensuring adequate and prompt fixation of tissue biopsies, put in the right container and accompanied by well labeled request cards. Keywords: Formalin, fixative, outcome, pathologist, surgeon ...

  5. Ultrasound of the acute abdomen performed by surgeons in training

    DEFF Research Database (Denmark)

    Eiberg, J.P.; Grantcharov, T.P.; Eriksen, J.R.

    2008-01-01

    , specificity and kappa-agreement of the surgeon performed ultrasound examination was 1.00 (0.77-1.00), 0.96 (0.79-0.99), 0.94 (0.3-1.00) and 0.40 (0.12-0.77), 0.97 (0.83-0.99), 0.44 (0.00-0.96); respectively. Visualization of the common bile duct was poor having 73% non-diagnostic surgeon-performed ultrasound...... perform valid abdominal ultrasound examinations of patients referred with acute abdominal pain. METHODS: Patients referred with acute abdominal pain had an ultrasound examination by a surgeon in training as well as by an experienced consultant radiologist whose results served as the gold standard. All...... participating surgeons were without any pre-existing ultrasound experience and received one hour of introduction to abdominal ultrasound. RESULTS: Thirty patients underwent 40 surgeon performed and 30 radiologist performed ultrasound examinations. Regarding gallstone and cholecholecystitis the sensitivity...

  6. Disparities between resident and attending surgeon perceptions of intraoperative teaching.

    Science.gov (United States)

    Butvidas, Lynn D; Anderson, Cheryl I; Balogh, Daniel; Basson, Marc D

    2011-03-01

    This study aimed to assess attending surgeon and resident recall of good and poor intraoperative teaching experiences and how often these experiences occur at present. By web-based survey, we asked US surgeons and residents to describe their best and worst intraoperative teaching experiences during training and how often 26 common intraoperative teaching behaviors occur in their current environment. A total of 346 residents and 196 surgeons responded (51 programs; 26 states). Surgeons and residents consistently identified trainee autonomy, teacher confidence, and communication as positive, while recalling negatively contemptuous, arrogant, accusatory, or uncommunicative teachers. Residents described intraoperative teaching behaviors by faculty as substantially less frequent than faculty self-reports. Neither sex nor seniority explained these results, although women reported communicative behaviors more frequently than men. Although veteran surgeons and current trainees agree on what constitutes effective and ineffective teaching in the operating room, they disagree on how often these behaviors occur, leaving substantial room for improvement. Published by Elsevier Inc.

  7. Toward late career transitioning: a proposal for academic surgeons.

    Science.gov (United States)

    Richards, Robin; McLeod, Robin; Latter, David; Keshavjee, Shaf; Rotstein, Ori; Fehlings, Michael G; Ahmed, Najma; Nathens, Avery; Rutka, James

    2017-09-01

    In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future. In this commentary, the literature on the science of aging is reviewed as it pertains to surgeons, and guidelines for late career transition planning are shared. It is hoped that these guidelines will be of some value to academic programs and surgeons across the country as late career transition models are developed and adopted.

  8. Real/Life: New British Art and the Reception of Contemporary British Art in Japan

    Directory of Open Access Journals (Sweden)

    Kajiya Kenji

    2016-07-01

    Full Text Available This essay explores the ways in which the exhibition Real/Life: New British Art was conceived and received in Japan, where contemporary British art has been shown since the 1960s. Taking place at five museums in the country between 1998 and 1999, the exhibition aimed to showhow British artists in the 1990s struggled with realities, internal and external, but its response was not as satisfactory as was expected. The essay examines the exhibition as a turning point for the transformation of exhibition culture in Japan from nationally themed exhibitions to showcases of contemporary art in the global context.

  9. Army industrial, landscaping, and agricultural water use

    Energy Technology Data Exchange (ETDEWEB)

    Stoughton, Kate McMordie [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Loper, Susan A. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Boyd, Brian K. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States)

    2014-09-18

    The Pacific Northwest National Laboratory conducted a task for the Deputy Assistant Secretary of the Army to quantify the Army’s ILA water use and to help improve the data quality and installation water reporting in the Army Energy and Water Reporting System.

  10. 2004 Army Research Office in Review

    Science.gov (United States)

    2004-01-01

    the thermal decomposition of nitrate - ester propellants. This is the first such data ever measured and will provide reliable input for Army...strain has been set for the actuator. The research program includes: Multiscale modeling of microstructural evolution and its affect on mechanical... Multiscale modeling and process optimization for engineered microstructural complexity” have had multiple transition interactions with the Army Research

  11. Occupational Stress and Burnout among Surgeons in Fiji.

    Science.gov (United States)

    Patel, Rajeev; Huggard, Peter; van Toledo, Annik

    2017-01-01

    This study examined the levels of occupational stress and burnout among surgeons in Fiji. A document set comprising a cover letter; a consent form; a sociodemographic and supplementary information questionnaire; the Maslach Burnout Inventory (MBI); the 12-item General Health Questionnaire (GHQ-12); the Alcohol Use Disorders Identification Test (AUDIT); and the Professional Quality of Life (ProQOL) questionnaires were provided to surgeons from three public divisional hospitals in Fiji. Thirty-six of 43 (83.7%) invited surgeons participated in the study. According to their MBI scores, surgeons suffered from low (10, 27.8%), moderate (23, 63.9%), and high (3, 8.3%) levels of burnout. Comparatively, 23 (63.9%) demonstrated moderate burnout according to their ProQOL scores. Substantial psychiatric morbidity was observed in 16 (44.0%) surgeons per their GHQ-12 scores. Consumption of alcohol was noted in 29 (80.6%) surgeons, and 12 (33.4%) had AUDIT scores characterizing their alcohol use in excess of low-risk guidelines or as harmful or hazardous drinking. Surgeons of Fijian nationality showed higher MBI emotional exhaustion and depersonalization scores compared with surgeons of other nationalities. Surgeons with an awareness of the availability of counseling services at their hospitals showed low AUDIT and ProQOL burnout scores. Smokers, alcohol drinkers, and kava drinkers showed higher AUDIT scores. This study highlights a level of occupational stress and burnout among surgeons in Fiji and a lack of awareness of their mental and physical well-being. The authors recommend that occupational stress and burnout intervention strategies be put in place in hospitals in Fiji.

  12. British Higher Education and Its Older Clients.

    Science.gov (United States)

    Woodley, Alan; Wilson, Jane

    2002-01-01

    Using results from a survey of British graduates, examined outcomes of higher education for older students, including their current employment situation, relationship of degree to job, and student satisfaction. Found that mature students are an extremely heterogeneous group, with differences in outcomes by age and mode of study. (EV)

  13. Considerations for Education Reform in British Columbia

    Science.gov (United States)

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  14. Spitsbergen - Imperialists beyond the British Empire

    NARCIS (Netherlands)

    Kruse, Frigga; Hacquebord, Louwrens

    2012-01-01

    This paper looks at the relationship between Spitsbergen in the European High Arctic and the global British Empire in the first quarter of the twentieth century. Spitsbergen was an uninhabited no man's land and comprised an unknown quantity of natural resources. The concepts of geopolitics and New

  15. The British official response to Chernobyl

    International Nuclear Information System (INIS)

    Webster, D.

    1988-01-01

    The author criticizes the British authorities' response to Chernobyl fallout, briefly examines the deficiencies in monitoring arrangements in Scotland, in particular the lack of weather radar cover for that region, and comments on the new National Response Plan and monitoring network, with reference to venison, rainwater, freshwater fish and game, and milk. (U.K.)

  16. British Nuclear Fuels - a dirty business

    International Nuclear Information System (INIS)

    Bunyard, P.

    1983-01-01

    The radioactive discharges from British Nuclear Fuels Sellafield, Cumbria, reprocessing plant to the sea are discussed. Statements that have been made by various individuals and groups about the contamination of the sea, the coast and places inland, and the biological effects of plutonium and americium, are discussed in detail. Particular stress is placed on statements about increased incidence of cancers. (U.K.)

  17. Four former British mining settlements on Spitsbergen

    NARCIS (Netherlands)

    Kruse, Frigga; Claughton, P.; Mills, C.

    2011-01-01

    The LASHIPA project participated in the recent International Polar Year to evaluate the large-scale historical exploitation of polar areas. This sub-project looks at the role of British actors in the economic and geopolitical development of the European High Arctic during the early twentieth

  18. Dance History Matters in British Higher Education

    Science.gov (United States)

    Carter, Alexandra

    2007-01-01

    In response to concerns about the place and nature of dance history in British higher education curricula, a database was compiled of representative but significant examples of modules which focused directly on the teaching and learning of history, or had history as a key component. An analysis is presented of these modules in terms of the place…

  19. Academic Advising in British Columbia. Executive Summary

    Science.gov (United States)

    British Columbia Council on Admissions and Transfer, 2016

    2016-01-01

    "Advising" consists of those activities and tasks that result in providing information to students. British Columbia's (BC) post-secondary education has evolved over the past number of years and student advising has changed along with it. Post-secondary institutions are currently challenged to increase student engagement, improve…

  20. British physics Newton's law of funding

    CERN Multimedia

    2007-01-01

    In Britain, fundamental physics is in a pickle ISAAC NEWTON, besides being the founder of modern physics, was also master of Britain's mint. That is a precedent which many British physicists must surely wish had become traditional. At the moment, money for physics is in short supply in Britain.

  1. The Core Competencies for General Orthopaedic Surgeons.

    Science.gov (United States)

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

    2017-01-18

    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

  2. Evaluation of anatomical and round breast implant aesthetics and preferences in Dutch young lay and plastic surgeon cohort.

    Science.gov (United States)

    Bletsis, Patrick P; Bouwer, Lesley R; Ultee, Klaas H; Cromheecke, Michel; van der Lei, Berend

    2018-04-16

    Literature remains inconclusive on the attractiveness and natural aspect of anatomical breast implants, and thus far, studies have failed to demonstrate the visible difference in implants that are in practice compared to those that are round. This study was undertaken to evaluate (1) whether lay and professional participants can distinguish between breasts augmented with either round or anatomical breast implants and (2) their opinion with regard to naturalness and attractiveness of these augmented breasts. Twenty breast augmentations (10 anatomical and 10 round implants), each depicted by two postoperative pictures, were scored by 100 lay participants and 15 plastic surgeons. Implant volume ranged from 275 to 400 g. Ptotic or malformed breasts were excluded. Finally, they had to score the most natural, unnatural, attractive, and unattractive breast shapes on a schematic depiction of breast types with varying upper poles. The rate of correct implant identifications was 74.0% (1480/2000 observations, p lay and 67.3% (202/300 observations, p lay participants and surgeons. Participants preferred breasts with a neutral or slightly negative upper pole contour. Participants were able to distinguish between the results achieved with either anatomical or round textured Allergan breast implants and found augmented breasts with the anatomical implants more natural and attractive. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Who should lead a trauma team: surgeon or non surgeon? A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Shahab Hajibandeh

    2017-05-01

    Full Text Available Background: Presence of a trauma team leader (TTL in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL were searched to identify randomized and non-randomized studies investigating outcomes associated with surgeon versus non-surgeon TTL in management of trauma patients. The Newcastle-Ottawa scale was used to assess the methodological quality and risk of bias of the selected studies. Fixed-effect model was applied to calculate pooled outcome data. Results: Three retrospective cohort studies, enrolling 2,519 adult major trauma patients, were included. Our analysis showed that there was no difference in survival [odds ratio (OR: 0.82, 95% confidence interval (CI 0.61-1.10, P=0.19] and length of stay when trauma team was led by surgeon or non-surgeon TTLs; however, fewer injuries were missed when the trauma team was led by a surgeon (OR: 0.48, 95% CI 0.25-0.92, P=0.03. Conclusions: Despite constant debate, the comparative evidence about outcomes associated with surgeon and non-surgeon trauma team leader is insufficient. The best available evidence suggests that there is no significant difference in outcomes of surgeon or non-surgeon trauma team leaders. High quality randomized controlled trials are required to compare

  4. United States Army, Seventh Army Field Order No. 1 (ANVIL)

    Science.gov (United States)

    1944-07-29

    sites in the ARGENS’Valley (See Operat Lone Instruc- tions No.1), bobwcon FREJUS and LE L,U~.. fr.o’! ground-observed enen:y Artillery fire. ,(8) Protcct...1� pcroonncl will be cautioned thnt ,ll:-:criccm and British porn - o chute nnd glider troops will be opcr at tng inland fro,:: the ben ch ea , A...defended. At immediate site there is a light 3-gun battery and a 4-gun c/d battery. 915918 map XXXIII-46 586. Radar coast-watcher. Position: Details

  5. Characterizing and fostering charity care in the surgeon workforce.

    Science.gov (United States)

    Wright, D Brad; Scarborough, John E

    2011-07-01

    We sought to determine which demographic and practice characteristics are associated with both a surgeon's willingness to provide any charity care as well as the amount of charity care provided. Although it is known that surgeons tend to provide a greater amount of charity care than other physicians, no studies have attempted to look within the surgeon population to identify which factors lead some surgeons to provide more charity care than others. Using 4 rounds of data from the Community Tracking Study, we employ a 2-part multivariate regression model with fixed effects. A greater amount of charity care is provided by surgeons who are male, practice owners, employed in academic medical centers, or earn a greater proportion of their revenue from Medicaid. Surgeons who work in a group HMO are significantly less likely to provide any charity care. Personal resources (eg, time and money) had a minimal association with charity care provision. Surgeons whose characteristics are associated with a greater propensity for charity care provision as suggested by this study, should be considered as a potential source for building the volunteer workforce.

  6. Surgeons' Leadership Styles and Team Behavior in the Operating Room

    Science.gov (United States)

    Hu, Yue-Yung; Parker, Sarah Henrickson; Lipsitz, Stuart R; Arriaga, Alexander F; Peyre, Sarah E; Corso, Katherine A; Roth, Emilie M; Yule, Steven J; Greenberg, Caprice C

    2016-01-01

    Background The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a well-characterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations. Study Design We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (psupportive behaviors (pleadership and its impact on team performance in the OR. As in other fields, our data suggest that transformational leadership is associated with improved team behavior. Surgeon leadership development therefore has the potential to improve the efficiency and safety of operative care. PMID:26481409

  7. Ethical challenges in surgery as narrated by practicing surgeons

    Directory of Open Access Journals (Sweden)

    Nordam Ann

    2005-02-01

    Full Text Available Abstract Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.

  8. Discrepancies in the female pelvic medicine and reconstructive surgeon workforce.

    Science.gov (United States)

    Muffly, Tyler M; Weterings, Robbie; Barber, Mathew D; Steinberg, Adam C

    2015-01-01

    It is unclear whether the current distribution of surgeons practicing female pelvic medicine and reconstructive surgery in the United States is adequate to meet the needs of a growing and aging population. We assessed the geographic distribution of female pelvic surgeons as represented by members of the American Urogynecologic Society (AUGS) throughout the United States at the county, state, and American Congress of Obstetricians and Gynecologists district levels. County-level data from the AUGS, American Congress of Obstetricians and Gynecologists, and the United States Census were analyzed in this observational study. State and national patterns of female pelvic surgeon density were mapped graphically using ArcGIS software and 2010 US Census demographic data. In 2013, the 1058 AUGS practicing physicians represented 0.13% of the total physician workforce. There were 6.7 AUGS members available for every 1 million women and 20 AUGS members for every 1 million postreproductive-aged women in the United States. The density of female pelvic surgeons was highest in metropolitan areas. Overall, 88% of the counties in the United States lacked female pelvic surgeons. Nationwide, there was a mean of 1 AUGS member for every 31 practicing general obstetrician-gynecologists. These findings have implications for training, recruiting, and retaining female pelvic surgeons. The uneven distribution of female pelvic surgeons throughout the United States is likely to worsen as graduating female pelvic medicine and reconstructive surgery fellows continue to cluster in urban areas.

  9. Review of orthognathic surgery and related papers published in the British Journal of Oral and Maxillofacial Surgery 2011-2012.

    Science.gov (United States)

    Goodson, Alexander M C; Payne, Karl F B; Tahim, Arpan; Colbert, Serryth; Brennan, Peter A

    2015-04-01

    This review summarises all orthognathic and related papers published between January 2011 and December 2012 in the British Journal of Oral and Maxillofacial Surgery (BJOMS). A total of 36 articles were published, a high proportion of which (78%) were full-length papers. The remainder consisted of short communications and technical notes. The topics included operative planning and postoperative outcomes, and there was a strong focus on distraction osteogenesis. There were fewer orthognathic articles published in BJOMS than articles on other subspecialties such as trauma or head and neck oncology. Only 8 (29%) of the full-length articles were prospective studies or randomised trials, which highlights a need for well-designed clinical studies in orthognathic research. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. 78 FR 69077 - Army Education Advisory Subcommittee Meeting Notice

    Science.gov (United States)

    2013-11-18

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... leading to provisional findings will be referred to the Army Education Advisory Committee for deliberation...: ATFL-APO, Monterey, CA 93944, [email protected]us.army.mil , (831) 242-5828. SUPPLEMENTARY INFORMATION...

  11. 77 FR 27209 - Army Education Advisory Subcommittee Meeting Notice

    Science.gov (United States)

    2012-05-09

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice...: Board of Visitors, U.S. Army War College Subcommittee. Date of Meeting: May 31, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...

  12. 77 FR 4026 - Army Education Advisory Subcommittee Meeting Notice

    Science.gov (United States)

    2012-01-26

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Date of Meeting: February 23, 2012. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle...

  13. 78 FR 23759 - Army Education Advisory Subcommittee Meeting Notice

    Science.gov (United States)

    2013-04-22

    ... DEPARTMENT OF DEFENSE Department of the Army Army Education Advisory Subcommittee Meeting Notice... Visitors, U.S. Army War College Subcommittee. Dates of Meeting: May 16, 2013. Place of Meeting: U.S. Army War College, 122 Forbes Avenue, Carlisle, PA, Command Conference Room, Root Hall, Carlisle Barracks...

  14. An online review of plastic surgeons in southern California.

    Science.gov (United States)

    Lewis, Priya; Kobayashi, Emily; Gupta, Subhas

    2015-05-01

    It has become commonplace for patients to access online reviews of physicians when making choices about health care, just as any consumer would in today's computer-dependent world. Previous studies have shown that online reviews of physicians are generally positive. However, 1 negative review has the potential to adversely affect business and reputations. To characterize the online presence of plastic surgeons in Southern California as portrayed by physician rating websites (PRWs). An extensive online database of board-certified plastic surgeons was used to generate a list of surgeons within a 50-mile radius of Pomona, CA. Ratings from the PRWs HealthGrades.com, Vitals.com, and UCompareHealthcare.com were cataloged by number of reviews and ratings. Two hundred sixty-three surgeons were evaluated with the most-represented cities being Beverly Hills (N=47), Los Angeles (N=31), and Newport Beach (N=27). Ninety-seven percent of the surgeons were rated on at least 1 of the 3 PRWs chosen. In general, surgeons were rated highly, with a mean rating of 85%, SD, 14% (Ponline ratings ranged from 0 to 222 per surgeon. The median number of total reviews was 25 and the mean rating for those surgeons above and below the median were equivocal, at 86% and 85%, respectively (P=0.284). In this study, we found that plastic surgeons in Southern California have an online presence that can be influenced by their patients; they should be aware of this and conscious of their online reputations. Overall, the ratings were high, regardless of the number of reviews.

  15. Comprehensive feedback on trainee surgeons' non-technical skills

    DEFF Research Database (Denmark)

    Spanager, Lene; Dieckmann, Peter; Beier-Holgersen, Randi

    2015-01-01

    OBJECTIVE: This study aimed to explore the content of conversations, feedback style, and perceived usefulness of feedback to trainee surgeons when conversations were stimulated by a tool for assessing surgeons' non-technical skills. METHODS: Trainee surgeons and their supervisors used the Non...... qualitatively analyzed for content and feedback style. Usefulness was investigated using a scale from 1 to 5 and written comments were qualitatively analyzed. RESULTS: Six trainees and six supervisors participated in eight feedback conversations. Eighty questionnaires (response rate 83 percent) were collected...

  16. The West African currency board and economic integration of British ...

    African Journals Online (AJOL)

    WACB) as an economic integration effort in British West Africa. Through a collaborative effort between this public institution and a private company, the Bank of British West Africa, British West African colonies were not only unified but also the way ...

  17. Comparing U.S. Army suicide cases to a control sample: initial data and methodological lessons.

    Science.gov (United States)

    Alexander, Cynthia L; Reger, Mark A; Smolenski, Derek J; Fullerton, Nicole R

    2014-10-01

    Identification of risk and protective factors for suicide is a priority for the United States military, especially in light of the recent steady increase in military suicide rates. The Department of Defense Suicide Event Report contains comprehensive data on suicides for active duty military personnel, but no analogous control data is available to permit identification of factors that differentially determine suicide risk. This proof-of-concept study was conducted to determine the feasibility of collecting such control data. The study employed a prospective case-control design in which control cases were randomly selected from a large Army installation at a rate of four control participants for every qualifying Army suicide. Although 111 Army suicides were confirmed during the study period, just 27 control soldiers completed the study. Despite the small control sample, preliminary analyses comparing suicide cases to controls identified several factors more frequently reported for suicide cases, including recent failed intimate relationships, outpatient mental health history, mood disorder diagnosis, substance abuse history, and prior self-injury. No deployment-related risk factors were found. These data are consistent with existing literature and form a foundation for larger control studies. Methodological lessons learned regarding study design and recruitment are discussed to inform future studies. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  18. Army Study Shows Decline In Behavioral Health Stigma

    Science.gov (United States)

    2012-01-01

    Army Study Shows Decline in Behavioral Health Stigma By Rob McIlvaine Army News Service WASHINGTON, Jan. 20, 2012 - A newly released Army study on...conference yesterday. The three-year study outlines the problem of suicide in the Army and related issues of substance abuse, spouse abuse and child abuse...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Army Study Shows Decline In Behavioral Health Stigma 5a. CONTRACT

  19. Army Hearing Program Status Report Quarter 2 Fiscal Year 2017

    Science.gov (United States)

    2017-07-01

    U.S. Army Publ ic Heal th Center Army Hearing Program Status Report Q2 FY17 Clinical Public Health and Epidemiology Directorate Army... Hearing Division General Medical: 500A July 2017 Approved for public release; distribution unlimited Army Hearing Program Status Report, Q2FY17...56               INTRODUCTION The Army Hearing Program Status Report (AHPSR) is a component of the Public Health

  20. The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons.

    Directory of Open Access Journals (Sweden)

    Julia C Seelandt

    Full Text Available BACKGROUND: The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. METHODS: Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. RESULTS: With respect to the factors that promote surgery as a profession, 40.8% (209/492 of the surgeons stated that surgery is a calling, 29.1% (149/492 of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492 of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492 of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492 of the surgeons provided problematic contextual characteristics. CONCLUSION: This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.

  1. The surgeon's perspective: promoting and discouraging factors for choosing a career in surgery as perceived by surgeons.

    Science.gov (United States)

    Seelandt, Julia C; Kaderli, Reto M; Tschan, Franziska; Businger, Adrian P

    2014-01-01

    The aim of this study was to identify the factors perceived by surgeons that promote surgery as an attractive or unattractive career choice for today's graduates. In addition, it examined whether the perspectives of surgeons in different professional situations converges. The content of work, contextual work conditions, and calling to this job are discussed in the context of choosing surgery as a career. Eight hundred sixty-nine surgeons were asked to answer open-ended questions regarding the factors that promote surgery as an attractive or unattractive career choice for today's graduates. Four hundred ninety-two surgeons participated, and 1,525 statements were analyzed using Mayring's content-analyses method. Chi-square tests were used to analyze the differences among hierarchical positions. With respect to the factors that promote surgery as a profession, 40.8% (209/492) of the surgeons stated that surgery is a calling, 29.1% (149/492) of the surgeons provided at least one argument related to the positive task characteristics, and 12.9% (66/492) of the surgeons provided statements related to the positive contextual factors. With respect to the factors that discourage surgery as a profession, 45.7% (234/492) of the surgeons provided at least one argument related to the discouraging work characteristics, and 67.6% (346/492) of the surgeons provided problematic contextual characteristics. This study emphasizes the importance of the calling to surgery as an important factor for choosing surgery as a career. However, the extensive workload, training, and poor work-family balance have been identified as factors that discourage graduates from choosing surgery as a career. The identified positive factors could be used to attract and maintain graduates in surgical disciplines.

  2. Trust: Implications for the Army Profession

    Science.gov (United States)

    2013-10-01

    Georgia Institute of Technology, a MMAS from the School of Advance Military Studies, and an MSS from the U.S. Army War College. He was the U.S. Army...degrees from the School of Advance Military Studies, the US Army War College, and Webster University. His current research focus is senior military...The Repeal of Don’t Ask, Don’t Tell—1 Year Later,” Center for American Progress, from <http://www.americanprogress.org/issues/ lgbt /report/2012/09

  3. Flood Hazard Management: British and International Perspectives

    Science.gov (United States)

    James, L. Douglas

    This proceedings of an international workshop at the Flood Hazard Research Centre (Queensway, Enfield, Middlesex, U.K.) begins by noting how past British research on flood problems concentrated on refining techniques to implement established policy. In contrast, research covered in North American and Australian publications involved normative issues on policy alternatives and administrative implementation. The workshop's participants included 16 widely recognized scientists, whose origins were about equally divided between Britain and overseas; from this group the workshop's organizers expertly drew ideas for refining British urban riverine flood hazard management and for cultivating links among researchers everywhere. Such intellectual exchange should be of keen interest to flood hazard program managers around the world, to students of comparative institutional performance, to those who make policy on protecting people from hazards, and to hydrologists and other geophysicists who must communicate descriptive information for bureaucratic, political, and public decision- making.

  4. Provincial land use planning in British Columbia

    International Nuclear Information System (INIS)

    Mitchell, W.

    1998-01-01

    The efforts being made to include Aboriginal communities in land use planning in British Columbia are discussed. British Columbia is in the midst of historic changes with respect to land and resource allocation, use and management. Historic trends in land use allocation and management are contrasted with land use planning and resource management of today. The impact of provincial government moves to double park space within the province, and the Protected Areas Strategy initiative will have on the natural gas and petroleum industry is discussed. New efforts being made to include First Nations directly in land use planning discussions in ways that do not prejudice treaty negotiations, are reviewed. Creation of a new Oil and Gas Commission in the Fort St. John area, is cited as the most recent example of the interconnections between First Nations communities and other public and industry stakeholders in land use planning in the province

  5. Experiences within British Steel since 1989

    International Nuclear Information System (INIS)

    Harvey, D.S.

    1999-01-01

    The experience of British steel is that there is a serious and continuing threat of radioactive material being included in scrap delivered to steelworks. All scrap entering the steelworks is monitored for radioactivity. The scrap suppliers and the national authorities have recognized the difficulties caused by the presence of radioactivity in scrap, and are working to minimise the problem. Both domestic and imported scrap has been found to contain radioactivity, but the imported scrap is much more likely to contain radioactivity. If radioactivity is found the Environmental Agency is informed, and established procedures are used to minimise the hazard, and to isolate the radioactivity. Detecting, and isolating radioactive scrap, and preventing it being re-melted in the steelmaking process, is part of the overall commitment of British Steel to work safely, and to provide a safe, good quality, product (author)

  6. British Columbia's untapped wind export potential

    International Nuclear Information System (INIS)

    Kaplan, M.

    2008-01-01

    This presentation discussed wind energy developments in British Columbia (BC). There are currently more than 5000 MW of wind power development activities in British Columbia, but only 325 MW of wind power purchase agreements (PPAs). Various renewable portfolio standards and greenhouse gas (GHG) initiatives are now being use to create demand for additional renewable energy development in the northwestern United States. Studies have demonstrated that BC wind export initiatives have the potential to deliver wind power to markets in the Pacific northwest. Canadian transmission export proposals are now examining methods of bringing renewable energy to areas with high load demands. However, the United States has more than 240,000 MW of proposed wind projects for key markets in the northwestern region. It was concluded that activities in United States wind development are now posing a challenge to Canadian wind energy exporters. Various transmission projects in the United States are now looking at developing renewable energy sources close to BC. tabs., figs

  7. Role of Surgeons in Determining Outcome of Histopathology ...

    African Journals Online (AJOL)

    fixative used, types of specimen containers and appropriate labeling of containers. ... specimen and with wide mouth and tight fitting lid) and adequacy of container .... surgeons in this respect is a reflection of greater availability of prepared ...

  8. Radiation dose to surgeons in theatre | van der Merwe | South ...

    African Journals Online (AJOL)

    Thermoluminescent dosimeter measurements of accumulated dose to specific anatomical regions of a neurosurgeon, gastroenterologist and orthopaedic surgeon performing fluoroscopy on 39 patients undergoing treatment for back pain, 7 for endoscopic retrograde cholangiopancreatography procedures, and 48 for ...

  9. Hepatitis-B Vaccination Status Among Dental Surgeons in Benin ...

    African Journals Online (AJOL)

    hanumantp

    consensus about vaccination rates among dental professionals in the literature as dental surgeons ..... Research Category of the Hatton poster competition in the 3rd. African Middle East ... Community Dent Oral Epidemiol. 1987;15:125-7. 6.

  10. Predictors of pediatric surgeons' career satisfaction: a national survey

    African Journals Online (AJOL)

    Pediatric surgeons were satisfied with professional career. (77%), and 88% would chose the same ... exists between expectations and real income. Ann Pediatr .... single institution employment (no extra job) (P= 0.015432) are factors related to ...

  11. America’s Army: The Strength of the Nation. 2010 Army Posture Statement

    Science.gov (United States)

    2010-02-19

    that the Army Soldier is the best equipped and most re- spected combatant in the world. In order to ex- ecute Army Modernization and ensure the con...Force Traumatic Brain Injury ( TBI ) Unaccompanied Personnel Housing (UPH) Unmanned Aircraft, Raven Small System Unmanned Aircraft, Shadow System Unmanned...Services TBI Traumatic Brain Injury 30 LoyaLty | Duty | Respect | seLfLess seRvice | HonoR | integRity | peRsonaL couRage 2010 Army

  12. Dirty Pop: Contemporary British Painting, Group Exhibition

    OpenAIRE

    Stubbs, Michael

    2013-01-01

    Phil Allen, Peter Ashton Jones, Jake Clark, Richard Clegg, Dan Coombs, Nelson Diplexcito, Nadine Feinson, Mick Finch, Richard Hamilton, Dan Hays, Gavin Lockheart, Andrea Medjesi Jones, David Leeson, Duncan Newton, Sarah Pickstone, Colin Smith, John Stark, Michael Stubbs, James White, Mark Wright.\\ud \\ud Dirty Pop, curated for &Model by Mark Wright, presents twenty contemporary painters whose work connects with Pop Art of the 1960’s, and particularly the legacy of the important British artist ...

  13. Electricity trade: Generating benefits for British Columbians

    International Nuclear Information System (INIS)

    1994-01-01

    Electricity has been traded in British Columbia since the turn of the century. In 1988, the provincial government established the British Columbia Power Exchange Corporation (Powerex) to conduct electricity trade activities in order to make the most efficient use of the electrial system and generate benefits for British Columbians. The trade is made possible by an interconnected system linking producers and consumers in western Canada and the USA. Provincial participants in the trade include British Columbia Hydro, independent power producers, and cogenerators. Benefits of the electricity trade include generation of revenue from sale of surplus power, being able to buy electricity when the mainly hydroelectric provincial system is in a drought condition or when major shutdowns occur, and enabling postponement of development of new power projects. Powerex conducts its trade under provincial and federal permits and licenses. Different types of trade contracts are negotiated depending on the amount and availability of electricity and the kind of trade being conducted. Exchanges and coordination agreements allow transfer and return between utilities with no net export occurring, allowing balancing of loads between different reigons. Surplus electricity is bought or sold on a short- or long-term basis and on firm or non-firm terms. Electricity exports are not subsidized and are only allowed if the electricity is surplus to provincial needs and can be sold at a profit. A new provincial policy allows private industry to export long-term firm electricity; this involves construction of new private-sector generating facilities solely for the purpose of export. 1 fig

  14. Young British readers' engagement with manga

    OpenAIRE

    Tsai, Yi-Shan

    2015-01-01

    This thesis presents young British readers’ engagement with manga regarding literary, aesthetic, social, and cultural dimensions. The study explores young readers’ points of views of their reading preference – manga. I investigated how children interpreted manga, with respect to the artistic techniques, the embedded ideologies, and the cultural elements therein. I also looked into children’s participation in manga fandom and its social meanings. This allowed me to explore what attracted Briti...

  15. British Engineers and Africa 1875-1914

    DEFF Research Database (Denmark)

    Andersen, Casper

    the imperial diasporas, identities and networks that developed as the British engineering profession established connections on the African continent. Using a wide range of primary sources that include correspondence, diaries, technical reports, institutional minutes and periodicals, Andersen reconstructs...... the networks and activities of Britain's engineers while focusing on London as a centre of imperial expansion. By treating Britain and the empire as an interconnected zone heanalyses the ways in whichideas , people and technologies circulated during the critical period....

  16. Self-Esteem: A Cross-Cultural Comparison of British-Chinese, White British and Hong Kong Chinese Children.

    Science.gov (United States)

    Chan, Yiu Man

    2000-01-01

    Evaluates the self-esteem scores of 1303 children, including Chinese children from Britain and Hong Kong and white British children, using the Coopersmith Self-Esteem Inventory. Finds that British Chinese have significantly higher self-esteem than the Hong Kong children, but there is little difference among white British children. (CMK)

  17. Disclosure of Individual Surgeon's Performance Rates During Informed Consent

    Science.gov (United States)

    Burger, Ingrid; Schill, Kathryn; Goodman, Steven

    2007-01-01

    Objective: The purpose of the paper is to examine the ethical arguments for and against disclosing surgeon-specific performance rates to patients during informed consent, and to examine the challenges that generating and using performance rates entail. Methods: Ethical, legal, and statistical theory is explored to approach the question of whether, when, and how surgeons should disclosure their personal performance rates to patients. The main ethical question addressed is what type of information surgeons owe their patients during informed consent. This question comprises 3 related, ethically relevant considerations that are explored in detail: 1) Does surgeon-specific performance information enhance patient decision-making? 2) Do patients want this type of information? 3) How do the potential benefits of disclosure balance against the risks? Results: Calculating individual performance measures requires tradeoffs and involves inherent uncertainty. There is a lack of evidence regarding whether patients want this information, whether it facilitates their decision-making for surgery, and how it is best communicated to them. Disclosure of personal performance rates during informed consent has the potential benefits of enhancing patient autonomy, improving patient decision-making, and improving quality of care. The major risks of disclosure include inaccurate and misleading performance rates, avoidance of high-risk cases, unjust damage to surgeon's reputations, and jeopardized patient trust. Conclusion: At this time, we think that, for most conditions, surgical procedures, and outcomes, the accuracy of surgeon- and patient-specific performance rates is illusory, obviating the ethical obligation to communicate them as part of the informed consent process. Nonetheless, the surgical profession has the duty to develop information systems that allow for performance to be evaluated to a high degree of accuracy. In the meantime, patients should be informed of the quantity of

  18. Surgeons' Emotional Experience of Their Everyday Practice - A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Massimiliano Orri

    Full Text Available Physicians' emotions affect both patient care and personal well-being. Surgeons appear at particularly high risk, as evidenced by the high rate of burnout and the alarming consequences in both their personal lives and professional behavior. The aim of this qualitative study is to explore the emotional experiences of surgeons and their impact on their surgical practice.27 purposively selected liver and pancreatic surgeons from 10 teaching hospitals (23 men, 4 women participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and thematically analyzed independently by 3 researchers (a psychologist, a psychiatrist, and a surgeon. 7 themes emerged from the analysis, categorized in 3 main or superordinate themes, which described surgeons' emotional experience before, during, and after surgery. Burdensome emotions are present throughout all 3 periods (and invade life outside the hospital-surgeons' own emotions, their perception of patients' emotions, and their entwinement. The interviewees described the range of emotional situations they face (with patients, families, colleagues, the influence of the institutional framework (time pressure and fatigue, cultural pressure to satisfy the ideal image of a surgeon, as well as the emotions they feel (including especially anxiety, fear, distress, guilt, and accountability.Emotions are ubiquitous in surgeons' experience, and their exposure to stress is chronic rather than acute. Considering emotions only in terms of their relations to operative errors (as previous studies have done is limiting. Although complications are quite rare events, the concern for possible complications is an oppressive experience, regardless of whether or not they actually occur.

  19. Specialization and the Current Practices of General Surgeons

    Science.gov (United States)

    Decker, Marquita R; Dodgion, Christopher M; Kwok, Alvin C; Hu, Yue-Yung; Havlena, Jeff A; Jiang, Wei; Lipsitz, Stuart R; Kent, K Craig; Greenberg, Caprice C

    2014-01-01

    Background The impact of specialization on the practice of general surgery has not been characterized. Our goal was to assess general surgeons’ operative practices to inform surgical education and workforce planning. Study Design We examined the practices of general surgeons identified in the 2008 State Inpatient and Ambulatory Surgery Databases of the Healthcare Cost and Utilization Project (HCUP) for three US states. Operations were identified using ICD-9 and CPT codes linked to encrypted physician identifiers. For each surgeon, total operative volume and the percentage of practice comprised of their most common operation were calculated. Correlation was measured between general surgeons’ case volume and the number of other specialists in a health service area. Results There were 1,075 general surgeons who performed 240,510 operations in 2008. The mean operative volume for each surgeon was 224 annual procedures. General surgeons performed an average of 23 different types of operations. For the majority of general surgeons, their most common procedure comprised no more than 30% of total practice. The most common operations, ranked by the frequency that they appeared as general surgeons’ top procedure, included: cholecystectomy, colonoscopy, endoscopy, and skin excision. The proportion of general surgery practice comprised of endoscopic procedures inversely correlated with the number of gastroenterologists in the health service area (Rho = - 0.50, p = 0.005). Conclusions Despite trends toward specialization, the current practices of general surgeons remain heterogeneous. This indicates a continued demand for broad-based surgical education to allow future surgeons to tailor their practices to their environment. PMID:24210145

  20. Workload assessment of surgeons: correlation between NASA TLX and blinks.

    Science.gov (United States)

    Zheng, Bin; Jiang, Xianta; Tien, Geoffrey; Meneghetti, Adam; Panton, O Neely M; Atkins, M Stella

    2012-10-01

    Blinks are known as an indicator of visual attention and mental stress. In this study, surgeons' mental workload was evaluated utilizing a paper assessment instrument (National Aeronautics and Space Administration Task Load Index, NASA TLX) and by examining their eye blinks. Correlation between these two assessments was reported. Surgeons' eye motions were video-recorded using a head-mounted eye-tracker while the surgeons performed a laparoscopic procedure on a virtual reality trainer. Blink frequency and duration were computed using computer vision technology. The level of workload experienced during the procedure was reported by surgeons using the NASA TLX. A total of 42 valid videos were recorded from 23 surgeons. After blinks were computed, videos were divided into two groups based on the blink frequency: infrequent group (≤ 6 blinks/min) and frequent group (more than 6 blinks/min). Surgical performance (measured by task time and trajectories of tool tips) was not significantly different between these two groups, but NASA TLX scores were significantly different. Surgeons who blinked infrequently reported a higher level of frustration (46 vs. 34, P = 0.047) and higher overall level of workload (57 vs. 47, P = 0.045) than those who blinked more frequently. The correlation coefficients (Pearson test) between NASA TLX and the blink frequency and duration were -0.17 and 0.446. Reduction of blink frequency and shorter blink duration matched the increasing level of mental workload reported by surgeons. The value of using eye-tracking technology for assessment of surgeon mental workload was shown.

  1. Social networks uncovered: 10 tips every plastic surgeon should know.

    Science.gov (United States)

    Dauwe, Phillip; Heller, Justin B; Unger, Jacob G; Graham, Darrell; Rohrich, Rod J

    2012-11-01

    Understanding online social networks is of critical importance to the plastic surgeon. With knowledge, it becomes apparent that the numerous networks available are similar in their structure, usage, and function. The key is communication between Internet media such that one maximizes exposure to patients. This article focuses on 2 social networking platforms that we feel provide the most utility to plastic surgeons. Ten tips are provided for incorporation of Facebook and Twitter into your practice.

  2. Meta-Analysis of Surgeon Burnout Syndrome and Specialty Differences.

    Science.gov (United States)

    Bartholomew, Alex J; Houk, Anna K; Pulcrano, Marisa; Shara, Nawar M; Kwagyan, John; Jackson, Patrick G; Sosin, Michael

    2018-02-27

    Surgeon burnout compromises the quality of life of physicians and the delivery of care to patients. Burnout rates and interpretation of the Maslach Burnout Inventory (MBI) complicates the interpretation of surgeon burnout. The purpose of this study is to apply a standardized interpretation of severe surgeon burnout termed, "burnout syndrome" to analyze inherent variation within surgical specialties. A systematic literature search was performed using MEDLINE, PsycINFO, and EMBASE to identify studies reporting MBI data by surgical specialty. Data extraction was performed to isolate surgeon specific data. A meta-analysis was performed. A total of 16 cross-sectional studies were included in this meta-analysis, totaling 3581 subjects. A random effects model approximated burnout syndrome at 3.0% (95% CI: 2.0%-5.0%; I 2 = 78.1%). Subscale analysis of emotional exhaustion, depersonalization, and personal accomplishment indicated subscale burnout in 30.0% (CI: 25.0%-36.0%; I 2 = 93.2%), 34.0% (CI: 25.0%-43.0%; I 2 = 96.9%), and 25.0% (CI: 18.0%-32.0%; I 2 = 96.5%) of surgeons, respectively. Significant differences (p burnout termed "burnout syndrome," although surgeon burnout may occur in up to 34% of surgeons, characterized by high burnout in 1 of 3 subscales. Surgical specialties have significantly different rates of burnout subscales. Future burnout studies should target the specialty-specific level to understand inherent differences in an effort to better understand methods of improving surgeon burnout. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Cardiac surgeons and the quality movement: the Michigan experience.

    Science.gov (United States)

    Prager, Richard L; Armenti, Frederick R; Bassett, Joseph S; Bell, Gail F; Drake, Daniel; Hanson, Eric C; Heiser, John C; Johnson, Scott H; Plasman, F B; Shannon, Francis L; Share, David; Theurer, Patty; Williams, Jaelene

    2009-01-01

    The Michigan Society of Thoracic and Cardiovascular Surgeons created a voluntary quality collaborative with all the cardiac surgeons in the state and all hospitals doing adult cardiac surgery. Utilizing this collaborative over the last 3 years and creating a unique relationship with a payor, an approach to processes and outcomes has produced improvements in the quality of care for cardiac patients in the state of Michigan.

  4. Marketing wholesale electricity in British Columbia

    Energy Technology Data Exchange (ETDEWEB)

    Moghadam, B. [Powerex, Vancouver, BC (Canada)

    2002-03-14

    An open access wholesale transmission tariff (WTS) has been in place in British Columbia since 1997, and wholesale electricity can be sold to wholesale purchasers by independent producers located within the province. Customers range from municipalities to British Columbia Hydro (BC Hydro), to Powerex, to UtiliCorp Networks Corporation (UNC). Provided that the necessary approvals and transmission services have been acquired, the energy may be transmitted anywhere in Canada or the United States. The generation and sale of electricity within British Columbia and the United States is subject to government and regulatory approvals. Several buyers and sellers that come together to trade a product are part of a hub. The largest such hub in the Pacific Northwest is called the Mid-Columbia (Mid-C) hub in Washington. The commodity is traded in 25 MW standard blocks. The credit requirements of the purchaser must be satisfied by the generating party. BC Hydro wholesale transmission service can be purchased by any wholesale power marketer or generator to transmit the power to market. It is imperative that scheduling personnel be available at all times. The Western System Coordinating Council (WSCC) insists that an operating reserve of 5 per cent hydro generation and 7 per cent thermal generation to support the electrical system in the face of an emergency be available for the electricity marketed through the hub. Powerex has been successful since 1988 in the marketing of electricity throughout the WSCC. An example was provided to help make the rules a bit easier to comprehend. refs.

  5. The British Model in Britain: Failing slowly

    International Nuclear Information System (INIS)

    Thomas, Steve

    2006-01-01

    In 1990, Britain reorganised its electricity industry to run on competitive lines. The British reforms are widely regarded as successful and the model used provides the basis for reforms of electricity industries worldwide. The main reason for this perception of success is major reductions in the real price of electricity with no reduction in service quality. This paper examines whether the reputation of the British reforms is justified. It concludes that the reputation is not justified and that serious fundamental problems are beginning to emerge. The central question is: have the British reforms resulted in the creation of efficient wholesale and retail markets? On this criterion, the reforms have failed. The wholesale market is dominated by obscure long-term contracts, privileged access to the market and self-dealing within integrated generator/retailers, leaving the spot markets with minimal liquidity and unreliable prices. The failure to develop an efficient wholesale market places the onus on consumers to impose competitive forces on electricity companies by switching regularly. Small consumers will not do this and they are paying too much for their power. For the future, there is a serious risk that the electricity industry will become a weakly regulated oligopoly with a veneer of competition

  6. British Columbia natural gas: Core market policy

    International Nuclear Information System (INIS)

    1988-06-01

    The core market for natural gas in British Columbia is defined as all natural gas consumers in the residential, institutional, commercial, and industrial sectors not currently purchasing natural gas directly and not exempted from the core market by the British Columbia Utilities Commission (BCUC). The intent of the definition is to include all customers who must be protected by contracts which ensure long-term security of supply and stable prices. Core market customers are excluded from direct natural gas purchase and will be served by distribution utilities. A customer may apply to BCUC to leave the core market; such an application may be approved if it is demonstrated that the customer has adequate long-term natural gas supplies or alternative fuel supplies to protect him from supply interruptions. The non-core market is defined as all large industrial customers who elect to make their own natural gas supply arrangements and who can demonstrate to the BCUC sufficient long-term natural gas supply protection or alternative fuel capability to ensure security of the industry. Non-core market customers have full and open access to the competitive natural gas market. The British Columbia government will not apply its core market policy to other jurisdictions through Energy Removal Certificates

  7. Marketing wholesale electricity in British Columbia

    International Nuclear Information System (INIS)

    Moghadam, B.

    2002-01-01

    An open access wholesale transmission tariff (WTS) has been in place in British Columbia since 1997, and wholesale electricity can be sold to wholesale purchasers by independent producers located within the province. Customers range from municipalities to British Columbia Hydro (BC Hydro), to Powerex, to UtiliCorp Networks Corporation (UNC). Provided that the necessary approvals and transmission services have been acquired, the energy may be transmitted anywhere in Canada or the United States. The generation and sale of electricity within British Columbia and the United States is subject to government and regulatory approvals. Several buyers and sellers that come together to trade a product are part of a hub. The largest such hub in the Pacific Northwest is called the Mid-Columbia (Mid-C) hub in Washington. The commodity is traded in 25 MW standard blocks. The credit requirements of the purchaser must be satisfied by the generating party. BC Hydro wholesale transmission service can be purchased by any wholesale power marketer or generator to transmit the power to market. It is imperative that scheduling personnel be available at all times. The Western System Coordinating Council (WSCC) insists that an operating reserve of 5 per cent hydro generation and 7 per cent thermal generation to support the electrical system in the face of an emergency be available for the electricity marketed through the hub. Powerex has been successful since 1988 in the marketing of electricity throughout the WSCC. An example was provided to help make the rules a bit easier to comprehend. refs

  8. Privatisation of the British coal industry

    Energy Technology Data Exchange (ETDEWEB)

    Cowles, R.V. (Norton Rose, London (UK))

    1991-01-01

    The article discusses the possible consequences of the impending privatisation of British Coal. It seems likely that deep mine operations will probably be divided up geographically but opencast mines may be left in single ownership. Freehold ownership of coal is likely to be transferred to the Crown and British Coal's powers to license small mines and opencast sites are likely to be absorbed into a general licensing system under control of the Department of Energy. Possible difficulties of public share issues are discussed - subsidence, environmental problems and also the uncertainty of the future market for British coal are mentioned. As an alternative, a series of contract sales of groups of mine properties could be made. Issues of common concern to future owners of the coal industry may lead to the creation of a new mineowner's trade association. Constraints in the areas of procurement and coal sales are discusssed briefly. Although a gloomy scenario is presented, it is suggested that some mines could become highly profitable. 1 ref.

  9. Developing an Army Market Research Index in Support of Army Recruiting

    National Research Council Canada - National Science Library

    Morath, Ray

    2001-01-01

    .... Generating appropriate market research for the Army requires first cataloguing the existing market research databases and identifying the critical questions that are not answered by current research...

  10. Army Business Transformation: The Utility of Using Corporate Business Models within the Institutional Army

    National Research Council Canada - National Science Library

    Bailer, Jr., John J

    2007-01-01

    .... Through a survey of the literature of published corporate business plans and models, military reports, Army depot case studies, and comparative analysis of emerging computer software technology...

  11. Department of the Army, FY 1999 Amended Budget Estimates, Army Working Capital Fund

    National Research Council Canada - National Science Library

    1998-01-01

    The Department of the Army has historically operated a significant number of its organic commercial and industrial facilities under revolving fund concepts to encourage these activities to function...

  12. The Center for the Army Profession and Ethic (CAPE) Annual Survey of the Army Profession (CASAP FY16)

    Science.gov (United States)

    2016-12-30

    incredibly fatiguing which cuts into my personal time to include mental health, physical health, and emotional well-being.” Understand this...April 2016. Its findings contribute to shared understanding of the State of the Army Profession within the Army Culture of Trust -- informing senior...Army leaders regarding the effectiveness of policies and practices intended to inspire and motivate Army professionals to “live by and uphold the Army

  13. A History of the Army Ground Forces; Study Number 16. The Army Ground Forces History of the Second Army

    Science.gov (United States)

    1945-09-01

    proficiency in conjunction with other arms and services.7 GHQ and Second Army placed great stress on the development of instructors and the proper training of...separate units. This was clearly brought out in a report of iuspection of Second Army units at Ft. Knox, Ky., by Maj. Gen. J. M. Cumins , Commander of the...covered were food and water, hygiene, housing, field sanitation, and contagious and communicable diseases. Physical exercise stressed mass calisthenics

  14. Preventing infection in general surgery: improvements through education of surgeons by surgeons.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-08-01

    Surgical patients are at particular risk of healthcare-associated infection (HCAI) due to the presence of a surgical site leading to surgical site infection (SSI), and because of the need for intravascular access resulting in catheter-related bloodstream infection (CRBSI). A two-year initiative commenced with an initial audit of surgical practice; this was used to inform the development of a targeted educational initiative by surgeons specifically for surgical trainees. Parameters assessed during the initial audit and a further audit after the educational initiative were related to intra- and postoperative aspects of the prevention of SSIs, as well as care of peripheral venous catheters (PVCs) in surgical patients. The proportion of prophylactic antibiotics administered prior to incision across 360 operations increased from 30.0% to 59.1% (P<0.001). Surgical site dressings were observed in 234 patients, and a significant decrease was found in the percentage of dressings that were tampered with during the initial 48h after surgery (16.5% vs 6.2%, P=0.030). In total, 574 PVCs were assessed over the two-year period. Improvements were found in the proportion of unnecessary PVCs in situ (37.9% vs 24.4%, P<0.001), PVCs in situ for >72h (10.6% vs 3.1%, P<0.001) and PVCs covered with clean and intact dressings (87.3% vs 97.6%, P<0.001). Significant improvements in surgical practice were established for the prevention of SSI and CRBSI through a focused educational programme developed by and for surgeons. Potentially, other specific measures may also be warranted to achieve further improvements in infection prevention in surgical practice.

  15. High occupational stress and low career satisfaction of Korean surgeons.

    Science.gov (United States)

    Kang, Sang Hee; Boo, Yoon Jung; Lee, Ji Sung; Han, Hyung Joon; Jung, Cheol Woong; Kim, Chong Suk

    2015-02-01

    Surgery is a demanding and stressful field in Korea. Occupational stress can adversely affect the quality of care, decrease job satisfaction, and potentially increase medical errors. The aim of this study was to investigate the occupational stress and career satisfaction of Korean surgeons. We have conducted an electronic survey of 621 Korean surgeons for the occupational stress. Sixty-five questions were used to assess practical and personal characteristics and occupational stress using the Korean occupational stress scale (KOSS). The mean KOSS score was 49.31, which was higher than the average of Korean occupational stress (45.86) or that of other specialized professions (46.03). Young age, female gender, long working hours, and frequent night duties were significantly related to the higher KOSS score. Having spouse, having hobby and regular exercise decreased the KOSS score. Multiple linear regression analysis showed that long working hours and regular exercise were the independent factors associated with the KOSS score. Less than 50% of surgeons answered that they would become a surgeon again. Most surgeons (82.5%) did not want to recommend their child follow their career. Korean Surgeons have high occupational stress and low level of career satisfaction.

  16. Ergonomics in the operating room: protecting the surgeon.

    Science.gov (United States)

    Rosenblatt, Peter L; McKinney, Jessica; Adams, Sonia R

    2013-01-01

    To review elements of an ergonomic operating room environment and describe common ergonomic errors in surgeon posture during laparoscopic and robotic surgery. Descriptive video based on clinical experience and a review of the literature (Canadian Task Force classification III). Community teaching hospital affiliated with a major teaching hospital. Gynecologic surgeons. Demonstration of surgical ergonomic principles and common errors in surgical ergonomics by a physical therapist and surgeon. The physical nature of surgery necessitates awareness of ergonomic principles. The literature has identified ergonomic awareness to be grossly lacking among practicing surgeons, and video has not been documented as a teaching tool for this population. Taking this into account, we created a video that demonstrates proper positioning of monitors and equipment, and incorrect and correct ergonomic positions during surgery. Also presented are 3 common ergonomic errors in surgeon posture: forward head position, improper shoulder elevation, and pelvic girdle asymmetry. Postural reset and motion strategies are demonstrated to help the surgeon learn techniques to counterbalance the sustained and awkward positions common during surgery that lead to muscle fatigue, pain, and degenerative changes. Correct ergonomics is a learned and practiced behavior. We believe that video is a useful way to facilitate improvement in ergonomic behaviors. We suggest that consideration of operating room setup, proper posture, and practice of postural resets are necessary components for a longer, healthier, and pain-free surgical career. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  17. A Modular Laparoscopic Training Program for Pediatric Surgeons

    Science.gov (United States)

    Wasa, Masafumi; Takiguchi, Shuji; Taniguchi, Eiji; Soh, Hideki; Ohashi, Shuichi; Okada, Akira

    2003-01-01

    Objectives: A structured endoscopic training program for pediatric surgeons has not yet been established. This study was conducted to develop a modular training program (MTP) for pediatric surgeons and to evaluate its effectiveness for surgeons with and without previous experience in laparoscopic surgery. Methods: Nine pediatric surgeons participated in the study. They were divided into 2 groups: group A (n=4), surgeons who had experienced more than 10 cases of laparoscopic surgery prior to MTP; group B (n=5), those who had experienced fewer than 10 cases. They participated in a standardized MTP workshop, which consisted of 2 “see-through” and 3 “laparoscopic” tasks. Each participant's psychomotor skills were evaluated objectively before and after MTP with a computer-generated virtual simulator and were evaluated for precision, efficiency, and speed. Results: In participants, speed was significantly enhanced after MTP. In group A, no differences were observed after MTP, whereas significant improvements were noted in efficiency and speed after MTP in group B. Before MTP, efficiency was significantly higher in group A than in group B; however, no difference remained between the 2 groups after MTP. Conclusions: MTP is effective for nonlaparoscopic pediatric surgeons to become familiar with basic endoscopic skills. PMID:12722996

  18. Army's drinking water surveillance program

    International Nuclear Information System (INIS)

    Sneeringer, P.V.; Belkin, F.; Straffon, N.; Costick, S.A.

    1977-01-01

    In 1976 a total of 827 water sources from Army installations throughout the world were sampled and analyzed for 53 chemical constituents and physical parameters. Medically significant contaminants included radiation measurements, heavy metals, fluoride, nitrate, and pesticides. Radiological activity appeared to vary with geographic location; a majority being from water sources in the western part of the U.S. No results for tritium were found to exceed the health-reference limit. Confirmatory analyses for radium-226 identified 3 groundwater sources as exceeding the limit; one was attributed to natural activity and the other sources are currently being investigated. Of the metals considered to be medically significant, mercury, chromium, lead, cadmium, silver, barium and arsenic were found in amounts within health level limits. Nitrate levels exceeding the health limit were confirmed for 2 drinking water sources

  19. British Energy privatisation - 18 months on

    International Nuclear Information System (INIS)

    McRoberts, Doug

    1998-01-01

    The TV advertisement which launched the privatisation of British Energy in the summer of 1996 - but just how successful has that privatisation been? And who has benefited - shareholders? The nuclear industry? Our own workforce? Last year, as reported to PIME 97 that the privatisation itself had been successfully completed - following the restructuring of the UK nuclear generation industry, and the creation of British Energy, a new name in the UK - and world energy scene. In simple terms, that privatisation has certainly succeeded - our share price since privatisation has more than doubled, from 2 pounds to well over 4 ponds. Over the last year, it has consistently outperformed the UK electricity sector - particularly over the last winter; it has also out-performed the FR Share Index over the same period, and in December British Energy became one of the UK top 100 listed companies, included in the FTSE 100 having started life at around number 130. This in turn has meant that a number of high quality institutions have taken a second look at British Energy and begun to invest in us as part of a portfolio of FTSE 100 companies. Our success as a private sector company could only be built on the solid foundation of successes as a nuclear utility. Over the five years from 1992 to 1997, our output went up by 64 as Sizewell B came on line and the AGRs achieved their design load factors at last. Safety remains our top priority, and while our profitability increased, so did our safety ratings - accident frequency rates came down by 60%, and collective radiation exposure to our workforce came down 58%. As a result of all this achievement, coupled with reduction in our total workforce, our productivity went up by over 100% - surely proof that nuclear can succeed in a competitive, deregulated electricity market. For future, it has been even more important to sustain that initial success to grow and develop British Energy as a company. The results are there for all to see. In the

  20. Army Roof Management and Improvement Opportunities

    National Research Council Canada - National Science Library

    Bailey, David

    1999-01-01

    ... - about $200 million annually. Systemic, integrated solutions offer the Army a great opportunity to save millions of dollars annually in repair and replacement costs, and to avoid incidental costs incurred due to interrupted...

  1. Evaluation of Sierra Army Depot Groundwater Contamination

    National Research Council Canada - National Science Library

    Granetto, Paul

    1997-01-01

    ...), September 28, 1996. The Congressional conferees were concerned about allegations from a group of investors that the Army precipitously and abruptly changed its position on permits and applications to develop water...

  2. US Army Nuclear Burst Detection System (NBDS)

    International Nuclear Information System (INIS)

    Glaser, R.F.

    1980-07-01

    The Nuclear Burst Detection System (NBDS) was developed to meet the Army requirements of an unattended, automatic nuclear burst reporting system. It provides pertinent data for battlefield commanders on a timely basis with high reliability

  3. Accelerated Logistics: Streamlining the Army's Supply Chain

    National Research Council Canada - National Science Library

    Wang, Mark

    2000-01-01

    ...) initiative, the Army has dramatically streamlined its supply chain, cutting order and ship times for repair parts by nearly two-thirds nationwide and over 75 percent at several of the major Forces Command (FORSCOM) installations...

  4. Energy Design Guides for Army Barracks: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Deru, M.; Zhivov, A.; Herron, D.

    2008-08-01

    The U.S. Army Corps of Engineers and NREL are developing target energy budgets and design guides to achieve 30% energy savings. This paper focuses the design guide for one type of barracks called unaccompanied enlisted personal housing.

  5. US Army Cultural Obstacles to Transformational Leadership

    National Research Council Canada - National Science Library

    Combs, Peggy C

    2007-01-01

    ...." Although these words sound like a direct lift of the current 2007 Army Posture statement, which discusses the "pentathlete" leader, they were written by the 33rd CSA, General Dennis Reimer, in 1999...

  6. A Pilotless Army in the Megalopolis

    National Research Council Canada - National Science Library

    Wegner, Robert

    2004-01-01

    This monograph answers the question, "Can unmanned aerial vehicles (UAVs) supplant manned United States Army attack and reconnaissance helicopters in the conduct of future urban operations" and the answer is, "not completely...

  7. Leadership Stability in Army Reserve Component Units

    Science.gov (United States)

    2013-01-01

    OMB control number. 1. REPORT DATE 2013 2. REPORT TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Leadership Stability in...standards for research quality and objectivity. Leadership Stability in Army Reserve Component Units Thomas F. Lippiatt, J. Michael Polich NATIONAL SECURITY...RESEARCH DIVISION Leadership Stability in Army Reserve Component Units Thomas F. Lippiatt, J. Michael Polich Prepared for the Office of the

  8. Democratic civilian control of the Nepalese Army

    Science.gov (United States)

    2013-06-14

    following are recommendations or principles the Army must institutionalize to guide it through the still-evolving civil-military relationship discussions...society. The following are recommendations or principles the Army must institutionalize to guide it through the still-evolving civil-military...hence, the principal–agent framework developed in microeconomics and already used in various political applications can be profitably extended to

  9. Weapons Systems, United States Army 1997.

    Science.gov (United States)

    1997-01-01

    Mexico, Morocco , Philippines, Turkey Co-Production: Korea The Army began fielding the UH-60 in 1978. Between 1978 and 1989 the Army procured UH-60A...Improvement Program ( CSR TEP) to all Area Common User System (ACUS) switch users (except AN/TTC-39-A(V)l). Incorporate Enhanced Switch Operation Program...Finland, Greece, Italy, Kuwait, Morocco , Saudi Arabia National Guard, SHAPE Tech Ctr (NATO), Spain, Special Def Acq Fund (pre-purchased export

  10. Counter - Drug: Mandate for the Army.

    Science.gov (United States)

    1991-03-01

    this comprehensive review will provide a basis for responding to new missions assigned...observations for determining the short-, mid-, and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide...and long-term direction of Army support to the national counter-drug effort. Also, this comprehensive review will provide a basis for responding

  11. The Cultural Dimension of Army Transition

    Science.gov (United States)

    2012-12-06

    by the conveyor belt of training. Instead of spending so much of their time as resource managers, the challenges become those of the operational...adaptability. 19The ARMY 2020 project defined the design of the future Army. A design team lead by...iterations, a design based approach uses systemic analysis to resolve these criteria. 27 Systems thinking reflects a departure from the common

  12. U.S. Army Space Operational Narrative

    Science.gov (United States)

    2012-03-20

    fire, and effects ( MFE ), the operational support (OS), and the functional support division (FSD); it is further divided into many more specialties...cyberspace expertise at the highest levels is a must for the Army. Both ARCYBERCOM and USASMDC/ARSTRAT commands are key positions filled by MFE officers... MFE officers with the majority from infantry and armor (31). The FA, AD, and EN branches will round out the top five.47 Half of the Army branches are

  13. The Army Ethic-Inchoate but Sufficient

    Science.gov (United States)

    2015-06-12

    are constraints imposed by this thesis. Delimitations include the scope, jus ad bellum, cultural relativism , descriptive ethics , and implementation...politicians. Third, this thesis will not look in depth at cultural relativism and how changes in laws and society’s philosophical and ethical ...THE ARMY ETHIC –INCHOATE BUT SUFFICIENT A thesis presented to the Faculty of the U.S. Army Command and General Staff College

  14. US Army Two-Surgeon Teams Operating in Remote Afghanistan - An Evaluation of Split-Based Forward Surgical Team Operations

    Science.gov (United States)

    2009-04-01

    Patient Status ABD (%) Ext (%) Vasc (%) Uro (%) GYN (%) Thor (%) HN (%) Neuro (%) Burn (%) Other (%) Total USF (n 178) 6 (2.6) 125 (54.3) 3 (1.3) 0...Ext, extremity; Vasc, vascular; Uro , urological; GYN, gynecologic; Thor, thoracic; HN, head and neck; Neuro, neurologic. Table 8 Age, Sex, and...Shock Trauma Platoon with a similar patient cohort at Los Angeles County trauma center, found that 12.7% of patients treated by the Surgical Shock

  15. Department of the Army Installation Restoration Program

    International Nuclear Information System (INIS)

    Anderson, A.W.

    1988-01-01

    The Army's Installation Restoration Program (IRP) was established in 1975 in response to regulatory action at several installations where past disposal practices had caused contamination of streams and groundwater. The need to decontaminate excess Army-owned real estate also was considered in early IRP activities. A variety of site types have been discovered on Army installations. The major site types evaluated to date include: contaminated soil areas, landfills, lagoons, buildings, burning grounds, sumps, pits, storage tanks, sewage treatment plants, storage pads, industrial wastewater treatment plants, and salvage yards. Twenty Army installations have been proposed for or listed on the National Priorities List (NPL). The need for taking action at hazardous waste sites, however, is based on threats they pose to human health, welfare or the environment. Sites do not have to be on the SPL in order to be cleaned up through IRP activities. All of the sites that caused Army installations to be proposed for the NPL are being evaluated and cleaned up. In addition, all Army properties have been or will be assessed and where needed they will be addressed by the IRP

  16. Psychophysical workload in the operating room: primary surgeon versus assistant.

    Science.gov (United States)

    Rieger, Annika; Fenger, Sebastian; Neubert, Sebastian; Weippert, Matthias; Kreuzfeld, Steffi; Stoll, Regina

    2015-07-01

    Working in the operating room is characterized by high demands and overall workload of the surgical team. Surgeons often report that they feel more stressed when operating as a primary surgeon than in the function as an assistant which has been confirmed in recent studies. In this study, intra-individual workload was assessed in both intraoperative functions using a multidimensional approach that combined objective and subjective measures in a realistic work setting. Surgeons' intraoperative psychophysiologic workload was assessed through a mobile health system. 25 surgeons agreed to take part in the 24-hour monitoring by giving their written informed consent. The mobile health system contained a sensor electronic module integrated in a chest belt and measuring physiological parameters such as heart rate (HR), breathing rate (BR), and skin temperature. Subjective workload was assessed pre- and postoperatively using an electronic version of the NASA-TLX on a smartphone. The smartphone served as a communication unit and transferred objective and subjective measures to a communication server where data were stored and analyzed. Working as a primary surgeon did not result in higher workload. Neither NASA-TLX ratings nor physiological workload indicators were related to intraoperative function. In contrast, length of surgeries had a significant impact on intraoperative physical demands (p NASA-TLX sum score (p < 0.01; η(2) = 0.287). Intra-individual workload differences do not relate to intraoperative role of surgeons when length of surgery is considered as covariate. An intelligent operating management that considers the length of surgeries by implementing short breaks could contribute to the optimization of intraoperative workload and the preservation of surgeons' health, respectively. The value of mobile health systems for continuous psychophysiologic workload assessment was shown.

  17. Can Access to Data Prevent Army Suicides Identifying Optimal Response Strategies for Army Leaders

    Science.gov (United States)

    2016-01-01

    activities. One shortfall of this approach, however, is the lack of guidance on how Army leaders should interpret and use these data. To address this gap ...records Personal relationships Divorce, Army Community Service records Financial problems Wage garnishment, creditor notification agreed that leaders...endorsed by three panelists. compared, noting that there are significant differences between battalions with respect to age, gender , and rank

  18. Projections of Demand for Cardiovascular Surgery and Supply of Surgeons.

    Science.gov (United States)

    Lee, Jung Jeung; Park, Nam Hee; Lee, Kun Sei; Chee, Hyun Keun; Sim, Sung Bo; Kim, Myo Jeong; Choi, Ji Suk; Kim, Myunghwa; Park, Choon Seon

    2016-12-01

    While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors

  19. Projections of Demand for Cardiovascular Surgery and Supply of Surgeons

    Directory of Open Access Journals (Sweden)

    Jung Jeung Lee

    2016-12-01

    Full Text Available Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040—an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309—an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time

  20. Contemporary use of social media by consultant colorectal surgeons.

    Science.gov (United States)

    McDonald, J J; Bisset, C; Coleman, M G; Speake, D; Brady, R R W

    2015-02-01

    There is evidence of significant growth in the engagement of UK health-care professionals with 'open' social media platforms, such as Twitter and LinkedIn. Social media communication provides many opportunities and benefits for medical education and interaction with patients and colleagues. This study was undertaken to evaluate the uptake of public social media membership and the characteristics of use of such media channels amongst contemporary UK consultant colorectal surgeons. Colorectal surgeons were identified from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) national registry of colorectal mortality outcomes and were cross-referenced with the General Medical Council (GMC) register. Individuals were identified by manual searching on a number of social media platforms. Matching accounts were then examined to confirm ownership and to evaluate key markers of use. Six-hundred and eighteen individual consultant colorectal surgeons from 142 health authorities were studied (79.5% were ACPGBI members and 90.8% were male). Two-hundred and twenty-nine (37.1%) had LinkedIn profiles (37.7% male surgeons, 29.8% female surgeons; P = 0.2530). LinkedIn membership was significantly higher in ACPGBI members (P social media than reported studies from other health-care professional groups. Further education and appropriate guidance on usage may encourage uptake and confidence, particularly in younger consultants. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  1. Practice Patterns and Job Satisfaction of Mohs Surgeons.

    Science.gov (United States)

    Kohli, Nita; Golda, Nicholas

    2018-01-01

    There is a paucity of data on Mohs surgery workforce patterns. To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016. Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of men and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings. Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons-knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.

  2. Burnout syndrome in oral and maxillofacial surgeons: a critical analysis.

    Science.gov (United States)

    Porto, G G; Carneiro, S C; Vasconcelos, B C; Nascimento, M M; Leal, J L F

    2014-07-01

    The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Productivity change of surgeons in an academic year.

    Science.gov (United States)

    Nakata, Yoshinori; Watanabe, Yuichi; Otake, Hiroshi; Nakamura, Toshihito; Oiso, Giichiro; Sawa, Tomohiro

    2015-01-01

    The goal of this study was to calculate total factor productivity of surgeons in an academic year and to evaluate the effect of surgical trainees on their productivity. We analyzed all the surgical procedures performed from April 1 through September 30, 2013 in the Teikyo University Hospital. The nonradial and nonoriented Malmquist model under the variable returns-to-scale assumptions was employed. A decision-making unit is defined as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of physicians who assisted in surgery, and the time of surgical operation from skin incision to skin closure. The output was defined as the surgical fee for each surgery. April is the beginning month of a new academic year in Japan, and we divided the study period into April to June and July to September 2013. We computed each surgeon's Malmquist index, efficiency change, and technical change. We analyzed 2789 surgical procedures that were performed by 105 surgeons. The Malmquist index of all surgeons was significantly greater than 1 (p = 0.0033). The technical change was significantly greater than 1 (p productive in the beginning months of a new academic year. The main factor of this productivity loss is considered to be surgical training. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. Effect of Thoracic Surgeons on Lung Cancer Patients’ Survival

    Directory of Open Access Journals (Sweden)

    Ning LI

    2018-02-01

    Full Text Available Background and objective Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact. Methods A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients. According to different surgeons grouping doctors to compare the basic information of patients, surgical methods, short-term results and long-term survival differences. Results A total of 712 patients treated by 11 experienced thoracic surgeons were included in this study. The patients have nosignificant difference with gender, age, smoking, pathological type between groups. There were significant differences in clinical staging, surgery type, operation time, blood transfusion rate, number of lymph node dissection, palliative resection rate, postoperative complications and perioperative mortality. There was a significant difference in five-year survival rates among patients treated by different doctors. This difference can be seen in all clinical stage analyzes with consistency. In the multivariate analysis, it was suggested that surgeon was an independent factor influencing the prognosis of patients. Conclusion Thoracic surgeon has a significant effect on the therapeutic effect of lung cancer patients.

  5. Postoperative electrolyte management: Current practice patterns of surgeons and residents.

    Science.gov (United States)

    Angarita, Fernando A; Dueck, Andrew D; Azouz, Solomon M

    2015-07-01

    Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents. An online survey was distributed among attending surgeons and surgical residents at the University of Toronto. The survey was designed according to a systematic approach for formulating self-administered questionnaires. Questions addressed workload, decision making in hypothetical clinical scenarios, and improvement strategies. Of 232 surveys distributed, 156 were completed (response rate: 67%). The majority stated that junior residents were responsible for managing electrolytes at 13 University of Toronto-affiliated hospitals. Supervision was carried out predominately by senior residents (75%). Thirteen percent reported management went unsupervised. Approximately 59% of residents were unaware how often attending surgeons assessed patients' electrolytes. Despite the majority of residents (53.7%) reporting they were never given tools or trained in electrolyte replacement, they considered themselves moderately or extremely confident. The management of hypothetical clinical scenarios differed between residents and attending surgeons. The majority (50.5%) of respondents considered that an electrolyte replacement protocol is the most appropriate improvement strategy. Electrolyte replacement represents an important component of surgeons' workload. Despite reporting that formal training in electrolyte management is limited, residents consider themselves competent; however, their practice is highly variable and often differs from pharmacologic-directed recommendations. Optimizing how postoperative electrolytes are managed in surgical wards requires building a framework that improves knowledge, training, and limits unnecessary interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Musculoskeletal pain among surgeons performing minimally invasive surgery

    DEFF Research Database (Denmark)

    Dalager, Tina; Søgaard, Karen; Bech, Katrine Tholstrup

    2017-01-01

    BACKGROUND: Musculoskeletal pain is the most common occupational disease in Europe. Surgeons with awkward and static working postures are no exception. Robotic-assisted laparoscopy has been postulated to be superior to conventional laparoscopy regarding the ergonomic strain for surgeons. In this ......BACKGROUND: Musculoskeletal pain is the most common occupational disease in Europe. Surgeons with awkward and static working postures are no exception. Robotic-assisted laparoscopy has been postulated to be superior to conventional laparoscopy regarding the ergonomic strain for surgeons......, and comparative data on surgeons' physical workload with robotic-assisted laparoscopy and conventional laparoscopy. Studies only describing a single surgical modality were excluded. We applied the checklist, STrengthening the Reporting of OBservational studies in Epidemiology (STROBE), to assess the quality...... fulfilled the criteria of STROBE, with an average score of 13 (range 10-16) out of 18. DISCUSSION: Results, mainly self-reported measures, suggest that robotic-assisted laparoscopy is less strenuous compared with conventional laparoscopy. However, results are limited by the large methodological...

  7. Malaria in inter-war British India.

    Science.gov (United States)

    Bynum, W F

    2000-06-01

    British India was an important site of much important malaria research. Although Ronald Ross left India in 1899, a number of malariologists continued the task of evaluating the incidence and distribution of malaria in the country. Implementing practical solutions was hampered by formidable social and economic problems. This paper examines the Indian situation in the late 1920s, through a retrospective selection of writings chosen by J.A. Sinton for reproduction in an early issue of 'The records of the malaria survey of India', and the analysis of the Indian malaria situation through a visit of the League of Nations Malaria Commission in 1929.

  8. The Labour Party and British Republicanism

    Directory of Open Access Journals (Sweden)

    Kenneth O. MORGAN

    2003-10-01

    Full Text Available The famous detective, Sherlock Holmes, once solved a case by referring to “the dog that did not bark.” In the past 250 years of British history, republicanism is another dog that did not bark. This is particularly true of supposedly our most radical major political party, the Labour Party. Over the monarchy, as over constitutional matters generally, Labour’s instincts have been conservative. Even after 1997, when the party, led by Lord Irvine, has indeed embarked upon major constitutional ref...

  9. Race, history, and black British jazz

    OpenAIRE

    Toynbee, Jason

    2013-01-01

    This article traces the history of black British jazz across five moments from 1920 to the present. It also makes a theoretical argument about the nature of race and its connection both with music and belonging to the nation. Race is indeed a musical-discursive construction, as has been argued in the literature about culture and ethnicity over the last thirty years or so. But it is a social structure too, and the contradictions that result are key to understanding the race-music relationship.

  10. Significance of abolishing British National Oil Corporation

    Energy Technology Data Exchange (ETDEWEB)

    Mabro, R

    1985-04-01

    The decision to abolish British National Oil Corporation has greater significance than any commentator, so far, has cared to admit. Mr. Mabro says the Government has done much more than get rid of an institution it had previously weakened and emasculated; in effect, it had abdicated its responsibilities for the pricing of North Sea oil. He further observes that these moves may be consistent with the tenets of a simplistic free-market ideology: they betray, however, a lack of understanding of the economics of oil, and of the UK economic interest in oil.

  11. Surgeons in Difficulty: An Exploration of Differences in Assistance-Seeking Behaviors between Male and Female Surgeons.

    Science.gov (United States)

    Sanfey, Hilary; Fromson, John; Mellinger, John; Rakinic, Jan; Williams, Michael; Williams, Betsy

    2015-08-01

    Physician burnout is associated with diminished ability to practice with requisite skill and safety. Physicians are often reluctant to seek help for an impaired colleague or for impairment that affects their own ability to practice. To better support surgeons in difficulty, we explored sex differences in assistance-seeking behaviors under stress. Surgeons in 3 national societies completed an IRB-approved anonymous multiple-choice and free-text response survey. Responses were explored with the general linear model using item-specific continuous and categorical methods. Two hundred and twelve surgeons (n = 79 [37.3%] male, n = 133 [63%] female) responded. Although men and women worked similar hours (p > 0.05), women worked more clinical (p work-life balance, as identified by aggregate variables related to emotional/decisional partnership, non-work-related chore support, and personal fulfillment (F = 15.29; df 3/16; p < 0.01), but change jobs less frequently (F = 4.23; df 1/201; p < 0.05). Males are more likely to seek help from colleagues (chi-square 107.5; p < 0.01) or friends (chi-square 123.8; p < 0.01) and women are more likely to seek support from professional counselors (chi-square 146.8; p < 0.01). Almost one-third of surgeons would ignore behaviors that adversely impact well being and could result in potential personal or patient safety. The differences between the assistance-seeking and reporting behaviors of male and female surgeons in distress could have implications for identification and treatment of this population. These findings can be used to develop educational activities to teach surgeons how to effectively handle these challenging situations. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Educating the surgeon-scientist: A qualitative study evaluating challenges and barriers toward becoming an academically successful surgeon.

    Science.gov (United States)

    Kodadek, Lisa M; Kapadia, Muneera R; Changoor, Navin R; Dunn, Kelli Bullard; Are, Chandrakanth; Greenberg, Jacob A; Minter, Rebecca M; Pawlik, Timothy M; Haider, Adil H

    2016-12-01

    The advancement of surgical science relies on educating new generations of surgeon-scientists. Career development awards (K Awards) from the National Institutes of Health, often considered a marker of early academic success, are one way physician-scientists may foster skills through a mentored research experience. This study aimed to develop a conceptual framework to understand institutional support and other factors leading to a K Award. A national, qualitative study was conducted with academic surgeons. Participants included 15 K Awardees and 12 surgery department Chairs. Purposive sampling ensured a diverse range of experiences. Semistructured, in-depth telephone interviews were conducted. Interviews were audio recorded and transcribed verbatim, and 2 reviewers analyzed the transcripts using Grounded Theory methodology. Participants described individual and institutional factors contributing to success. K Awardees cited personal factors such as perseverance and team leadership skills. Chairs described the K Awardee as an institutional "investment" requiring protected time for research, financial support, and mentorship. Both K Awardees and Chairs identified a number of challenges unique to the surgeon-scientist, including financial strains and competing clinical demands. Institutional support for surgeons pursuing K Awards is a complex investment with significant initial costs to the department. Chairs act as stewards of institutional resources and support those surgeon-scientists most likely to be successful. Although the K Award pathway is one way to develop surgeon-scientists, financial burdens and challenges may limit its usefulness. These findings, however, may better prepare young surgeons to develop career plans and identify new mechanisms for academic productivity. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Supervision by a technically qualified surgeon affects the proficiency and safety of laparoscopic colectomy performed by novice surgeons.

    Science.gov (United States)

    Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Kamiizumi, You; Iijima, Hiroaki; Taketomi, Akinobu

    2018-01-01

    The use of laparoscopic colectomy is becoming widespread and acquisition of its technique is challenging. In this study, we investigated whether supervision by a technically qualified surgeon affects the proficiency and safety of laparoscopic colectomy performed by novice surgeons. The outcomes of 23 right colectomies and 19 high anterior resections for colon cancers performed by five novice surgeons (experience level of <10 cases) between 2014 and 2016 were assessed. A laparoscopic surgeon qualified by the Endoscopic Surgical Skill Qualification System (Japan Society for Endoscopic Surgery) participated in surgeries as the teaching assistant. In the right colectomy group, one patient (4.3%) required conversion to open surgery and postoperative morbidities occurred in two cases (8.6%). The operative time moving average gradually decreased from 216 to 150 min, and the blood loss decreased from 128 to 28 mL. In the CUSUM charts, the values for operative time decreased continuously after the 18th case, as compared to the Japanese standard. The values for blood loss also plateaued after the 18th case. In the high anterior resection group, one patient (5.2%) required conversion to open surgery and no postoperative complication occurred in any patient. The operative time moving average gradually decreased from 258 to 228 min, and the blood loss decreased from 33 to 18 mL. The CUSUM charts showed that the values of operative time plateaued after the 18th case, as compared to the Japanese standard. In the CUSUM chart for blood loss, no distinguishing peak or trend was noted. Supervision by a technically qualified surgeon affects the proficiency and safety of laparoscopic colectomy performed by novice surgeons. The trainee's learning curve in this study represents successful mentoring by the laparoscopic surgeon qualified by the Endoscopic Surgical Skill Qualification System.

  14. Towards a model of surgeons' leadership in the operating room.

    Science.gov (United States)

    Henrickson Parker, Sarah; Yule, Steven; Flin, Rhona; McKinley, Aileen

    2011-07-01

    There is widespread recognition that leadership skills are essential for effective performance in the workplace, but the evidence detailing effective leadership behaviours for surgeons during operations is unclear. Boolean searches of four on-line databases and detailed hand search of relevant references were conducted. A four stage screening process was adopted stipulating that articles presented empirical data on surgeons' intraoperative leadership behaviours. Ten relevant articles were identified and organised by method of investigation into (i) observation, (ii) questionnaire and (iii) interview studies. This review summarises the limited literature on surgeons' intraoperative leadership, and proposes a preliminary theoretically based structure for intraoperative leadership behaviours. This structure comprises seven categories with corresponding leadership components and covers two overarching themes related to task- and team-focus. Selected leadership theories which may be applicable to the operating room environment are also discussed. Further research is required to determine effective intraoperative leadership behaviours for safe surgical practice.

  15. [How much business management does a surgeon need?].

    Science.gov (United States)

    Bork, U; Koch, M; Büchler, M W; Weitz, J

    2010-08-01

    The present day healthcare system in Germany is rapidly changing, even more so after the introduction of diagnosis-related groups. The basic requirements for every surgeon remain manual skills, a profound clinical knowledge and the ability for clinical decision-making even in difficult situations. However, these key elements of surgical education no longer fulfill the requirements for today's leaders in surgery. New requirements, consisting of administrative duties, strategic decision-making and department management are too complex to be made only intuitively. Nowadays surgeons also need a profound education in management skills and knowledge of economic mechanisms in order to run an efficient, profitable, patient-oriented surgical department. Every surgeon who aims at obtaining a leadership position should acquire the necessary knowledge and skills.

  16. Was the real Sherlock Holmes a pediatric surgeon?

    Science.gov (United States)

    Raffensperger, John

    2010-07-01

    This article reviews the pioneering efforts of Joseph Bell, the model for Sherlock Holmes, in the surgical care of children during the antiseptic era. I reviewed biographies of Sir Arthur Conan Doyle; the biography of Joseph Bell; his surgical textbook, Edinburgh Medical Journals; and the history of the Royal Edinburgh Hospital for Sick Children. Dr Bell was a colleague of Joseph Lister and one of the first surgeons to apply antiseptic methods to operations involving children. He was the surgeon appointed to the first surgical ward of the Royal Edinburgh Hospital for Sick Children; in that role, he cared for many children with surgical diseases. Dr Joseph Bell, by his compassion for children and his surgical skill, was indeed a pioneer pediatric surgeon. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Cost analysis when open surgeons perform minimally invasive hysterectomy.

    Science.gov (United States)

    Shepherd, Jonathan P; Kantartzis, Kelly L; Ahn, Ki Hoon; Bonidie, Michael J; Lee, Ted

    2014-01-01

    The costs to perform a hysterectomy are widely variable. Our objective was to determine hysterectomy costs by route and whether traditionally open surgeons lower costs when performing laparoscopy versus robotics. Hysterectomy costs including subcategories were collected from 2011 to 2013. Costs were skewed, so 2 statistical transformations were performed. Costs were compared by surgeon classification (open, laparoscopic, or robotic) and surgery route. A total of 4,871 hysterectomies were performed: 34.2% open, 50.7% laparoscopic, and 15.1% robotic. Laparoscopic hysterectomy had the lowest total costs (P depreciation included (P < .001) but similar costs if these variables were excluded. Although laparoscopic hysterectomy had lowest costs overall, robotics may be no more costly than laparoscopic hysterectomy when performed by surgeons who predominantly perform open hysterectomy.

  18. The Effect of Surgeon Empathy and Emotional Intelligence on Patient Satisfaction

    Science.gov (United States)

    Weng, Hui-Ching; Steed, James F.; Yu, Shang-Won; Liu, Yi-Ten; Hsu, Chia-Chang; Yu, Tsan-Jung; Chen, Wency

    2011-01-01

    We investigated the associations of surgeons' emotional intelligence and surgeons' empathy with patient-surgeon relationships, patient perceptions of their health, and patient satisfaction before and after surgical procedures. We used multi-source approaches to survey 50 surgeons and their 549 outpatients during initial and follow-up visits.…

  19. The truth behind british politeness: some misinterpretations

    Directory of Open Access Journals (Sweden)

    Peixoto, Rafael Marcos Tort

    2014-01-01

    Full Text Available The purpose of this paper is to analyse a chart published by the British newspaper The Telegraphabout the most common misunderstandings foreigners face while making use of English as their second language. L2 speakers are said to take every word at face value and therefore making some pragmatic mistakes. Sometimes there can be another meaning behind the spoken words, like it is unsaid for a reason. The pragmatics theories of irony in Attardo (1999 shed light on these translating and intercultural awareness issues by explaining what is behind the misunderstanding which is the secret ofthe so famous British politeness. Some considerations will be made upon the chart so as to understand it, such as an analysis of irony and native speakers’ perspectives on it. In addition to that, we will take into account the opinion of some native speakers of English to unveil some details and clarify how meaningful some sentences may be and if the researched chart is actually accurate

  20. The Ruins of the British Welfare State

    Directory of Open Access Journals (Sweden)

    Tahl Kaminer

    2014-08-01

    Full Text Available The subjects of Owen Hatherley’s A Guide to the New Ruins of Great Britain are architecture and urban development. The book addresses also some broader cultural, political and economic references, as well as personal anecdotes and memories. It includes many encounters with the remnants of the British welfare state.As an extension to his blog postings and a sequel of sorts to his previous Militant Modernism, Hatherley’s antagonist here is the semi-official architecture of New Labour, which he terms ‘pseudomodernism’: an unimaginative, inferior, and, in its own specific way, also tacky architecture of white stucco, steel and glass. He attacks the Faustian bargain of Richard Rogers and his allies with neoliberalism, a pact that produces a modernism devoid of social content, reflected by the unimaginative, speculation-driven architectural design. While Hatherley produces the promised indictment of recent British architecture, the book is, at the end of the day, primarily a eulogy to the disappearing postwar architecture he so evidently loves.

  1. Non-technical skills of surgical trainees and experienced surgeons.

    Science.gov (United States)

    Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G

    2017-05-01

    In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  2. Surgeon Scientists Are Disproportionately Affected by Declining NIH Funding Rates.

    Science.gov (United States)

    Narahari, Adishesh K; Mehaffey, J Hunter; Hawkins, Robert B; Charles, Eric J; Baderdinni, Pranav K; Chandrabhatla, Anirudha S; Kocan, Joseph W; Jones, R Scott; Upchurch, Gilbert R; Kron, Irving L; Kern, John A; Ailawadi, Gorav

    2018-04-01

    Obtaining National Institutes of Health (NIH) funding over the last 10 years has become increasingly difficult due to a decrease in the number of research grants funded and an increase in the number of NIH applications. National Institutes of Health funding amounts and success rates were compared for all disciplines using data from NIH, Federation of American Societies for Experimental Biology (FASEB), and Blue Ridge Medical Institute. Next, all NIH grants (2006 to 2016) with surgeons as principal investigators were identified using the National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results (NIH RePORTER), and a grant impact score was calculated for each grant based on the publication's impact factor per funding amount. Linear regression and one-way ANOVA were used for analysis. The number of NIH grant applications has increased by 18.7% (p = 0.0009), while the numbers of funded grants (p rate of funded grants with surgeons as principal investigators (16.4%) has been significantly lower than the mean NIH funding rate (19.2%) (p = 0.011). Despite receiving only 831 R01s during this time period, surgeon scientists were highly productive, with an average grant impact score of 4.9 per $100,000, which increased over the last 10 years (0.15 ± 0.05/year, p = 0.02). Additionally, the rate of conversion of surgeon scientist-mentored K awards to R01s from 2007 to 2012 was 46%. Despite declining funding over the last 10 years, surgeon scientists have demonstrated increasing productivity as measured by impactful publications and higher success rates in converting early investigator awards to R01s. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Comparing industry compensation of cardiothoracic surgeons and interventional cardiologists.

    Science.gov (United States)

    Parreco, Joshua; Donath, Elie; Kozol, Robert; Faber, Cristiano

    2017-02-01

    The purpose of this study was to compare payment trends between cardiothoracic surgeons and interventional cardiologists using the Open Payments website made available for the public by the Center for Medicare and Medicaid Services. Data were extracted from the second release of the Open Payments database, which includes payments made between August 1, 2013 and December 31, 2014. Total payments to individual physicians were aggregated based on specialty, region of the country, and payment type. The Gini index was calculated for each specialty to measure income disparity. A Gini index of 1 indicates all the payments went to one individual, whereas a Gini index of 0 indicates all individuals received equal payments. During the study period of interest, data were made available for 3587 (80%) cardiothoracic surgeons compared with 2957 (99%) interventional cardiologists. Mean total payments to cardiothoracic surgeons were $7770 (standard deviation, $52,608) compared with a mean of $15,221 (standard deviation, $98,828) for interventional cardiologists. The median total payments to cardiothoracic surgeons was $1050 (interquartile range, $233-$3612) compared with $1851 (interquartile range, $607-$5462) for interventional cardiologists. The overall Gini index was 0.932, whereas the Gini index was 0.862 for interventional cardiologists and 0.860 for cardiothoracic surgeons. The vast majority of interventional cardiologists and cardiothoracic surgeons received payments from drug and device manufacturers. The mean total payments to interventional cardiologists were higher than any other specialty. However, like cardiothoracic surgery, they were among the most equitably distributed compared with other specialties. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

    Science.gov (United States)

    O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

    2012-11-07

    Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

  5. Precocious albion: A new interpretation of the British Industrial Revolution

    OpenAIRE

    Kelly, Morgan; Mokyr, Joel; Ó Gráda, Cormac

    2013-01-01

    Many explanations have been offered for the British Industrial Revolution. This article points to the importance of human capital (broadly defined) and the quality of the British labor force on the eve of the Industrial Revolution. It shows that in terms of both physical quality and mechanical skills, British workers around 1750 were at a much higher level than their continental counterparts. As a result, new inventions—no matter where they originated—were adopted earlier, faster, and on a la...

  6. Glocal routes in British Asian drama: Between adaptation and tradaptation

    OpenAIRE

    Buonanno, Giovanna; Sams, Victoria; Schlote, Christiane

    2011-01-01

    In the context of British Asian theatre and the search for a diasporic theatre aesthetics the practice of adaptation has emerged as a recurring feature. Over the last decades, British Asian theatre has sought to create a language of the theatre that can reflect the cultural heritage of Asians in Britain; this search has taken different directions testified also by the plurality of voices that today make up British Asian theatre and has responded to the need to challenge the conceptual binary ...

  7. Cosmetic surgery in times of recession: macroeconomics for plastic surgeons.

    Science.gov (United States)

    Krieger, Lloyd M

    2002-10-01

    Periods of economic downturn place special demands on the plastic surgeon whose practice involves a large amount of cosmetic surgery. When determining strategy during difficult economic times, it is useful to understand the macroeconomic background of these downturns and to draw lessons from businesses in other service industries. Business cycles and monetary policy determine the overall environment in which plastic surgery is practiced. Plastic surgeons can take both defensive and proactive steps to maintain their profits during recessions and to prepare for the inevitable upturn. Care should also be taken when selecting pricing strategy during economic slowdowns.

  8. Surgeon and Safari: producing valuable bodies in Johannesburg.

    Science.gov (United States)

    Mazzaschi, Andrew

    2011-01-01

    This essay explores how concepts of value and cheapness circulate around the bodies of clients of the Johannesburg-based cosmetic surgery tourism company Surgeon and Safari. I show how the production of a luxurious experience and the mitigation of risk take place within a transnational network enabled by the presence of medical tourism in multiple locales. By placing Surgeon and Safari's activities within the context of the neoliberalization of health care in South Africa, I explore how the division between private versus public health spaces functions as both a technique of valuing clients' bodies and as a process of racialization.

  9. Inventing our future: training the next generation of surgeon innovators.

    Science.gov (United States)

    Krummel, Thomas M; Gertner, Michael; Makower, Josh; Milroy, Craig; Gurtner, Geoff; Woo, Russell; Riskin, Daniel J; Binyamin, Gary; Connor, Jessica Anne; Mery, Carlos M; Shafi, Bilal M; Yock, Paul G

    2006-11-01

    Current surgical care and technology has evolved over the centuries from the interplay between creative surgeons and new technologies. As both fields become more specialized, that interplay is threatened. A 2-year educational fellowship is described which teaches both the process and the discipline of medical/surgical device innovation. Multi-disciplinary teams (surgeons, engineers, business grads) are assembled to educate a generation of translators, who can bridge the gap between scientific and technologic advances and the needs of the physician and the patient.

  10. Patient-specific hip prostheses designed by surgeons

    Directory of Open Access Journals (Sweden)

    Coigny Florian

    2016-09-01

    Full Text Available Patient-specific bone and joint replacement implants lead to better functional and aesthetic results than conventional methods [1], [2], [3]. But extracting 3D shape information from CT Data and designing individual implants is demanding and requires multiple surgeon-to-engineer interactions. For manufacturing purposes, Additive Manufacturing offers various advantages, especially for low volume manufacturing parts, such as patient specific implants. To ease these new approaches and to avoid surgeon-to-engineer interactions a new design software approach is needed which offers highly automated and user friendly planning steps.

  11. American College of Surgeons remains committed to patient safety.

    Science.gov (United States)

    Russell, Thomas R; Jones, R Scott

    2006-11-01

    Since 1913 the American College of Surgeons has addressed patient safety as a top priority, so they are pleased to contribute this article offering the College's perspective on this critical subject. More specifically, this piece reviews the College's perennial efforts to ensure surgeons and hospitals access to scientifically verifiable standards, availability of effective quality improvement tools, and a better understanding of errors in care. Additionally, they examine the cultural changes required within surgery and provide an overview of the College's recent initiatives in research, accreditation, and education.

  12. Army Secure Operating System: Information Security for Real Time Systems

    National Research Council Canada - National Science Library

    Anderson, Eric

    1984-01-01

    The Army Secure Operating System (ASOS) project, under the management of the U.S. Army CECOM organization, will provide real time systems software necessary for fielding modern Battlefield Automation Systems...

  13. The Impact of Irregular Warfare on the US Army

    National Research Council Canada - National Science Library

    McDonald, III, Roger L

    2006-01-01

    Although the U.S. Army has yet to clearly define irregular warfare, it is imperative that the Army take near-term action to enhance the ability of Soldiers and units to operate effectively in an irregular warfare environment...

  14. Assessing Army Professional Forums Metrics for Effectiveness and Impact

    National Research Council Canada - National Science Library

    Cianciolo, Anna T; Heiden, Charles G; Prevou, Michael I

    2006-01-01

    ... meet the challenges brought on by Army transformation. Army professional forums (APFs), powered by advances in collaborative toolsets and multimedia presentation software, provide a means for leader self-development and professional growth...

  15. A Transformed Army in Europe For a Transformed World

    National Research Council Canada - National Science Library

    Brown, James

    2003-01-01

    General Gordon R. Sullivan was the Army Chief of Staff when he wrote, "Ultimately, the Army's objective in leveraging change is to create a "learning organization," one that adapts in ever-quicker response cycles...

  16. 2007 Posture Statement, Army Reserve: An Operational Force

    National Research Council Canada - National Science Library

    Stultz, Jack C

    2007-01-01

    The 2007 Army Reserve Posture Statement describes how the Army Reserve continues to transform from a strategic reserve to an operational force, meeting today's challenges as it better prepares for future uncertainties...

  17. Army Model and Simulation Standards Report FY98

    National Research Council Canada - National Science Library

    1997-01-01

    ...) standards efforts as work progresses towards the objective Army M&S environment. This report specifically documents projects approved for funding through the Army Model and Improvement Program (AMIP...

  18. Nanotechnology Laboratory Collaborates with Army to Develop Botulism Vaccine | FNLCR

    Science.gov (United States)

    The Nanotechnology Characterization Laboratory (NCL) is collaborating with the Army to develop a candidate vaccine against botulism. Under a collaboration agreement between the National Cancer Institute and the U.S. Army Medical Research Institute of

  19. Role Of The Army In Modern Pakistan

    Directory of Open Access Journals (Sweden)

    Vladislav Viktorovich Vorobiev

    2014-01-01

    Full Text Available The article studies the political development of the country in the modern period. Special attention is paid to the position of the army and its role in the Pakistani society. The article explores in detail the processes of gradual distancing of the army from politics and strengthening of civil society institutions. It is the first time in the Pakistani history that the civilian government managed to complete its full five-year constitutional term. Meanwhile, the country has been advancing on the path to democracy even after the elections 2013: a new civilian government has been formed in Pakistan. As compared with the previous phases of the country's development, the status of the army has considerably changed, evolved from "guiding force" to "shadow" guarantee of democratic development. The process has been largely encouraged by popular among officers feeling of tiredness: many of them are not ready to take power into their own hands and committed to their strictly constitutional duties. Despite this recent positive trend, the army continues to enjoy great authority in the society, often brokers political crisis and helps civilian authorities in settling such pressing problems as, for example, fight against extremism. The military will exert influence on government unless civil authorities are able to resist the current challenges and settle the actual problems. The role of "power broker" fully serves the interests of the top army brass.

  20. ROLE OF THE ARMY IN MODERN PAKISTAN

    Directory of Open Access Journals (Sweden)

    Vladislav Viktorovich Vorobiev

    2014-01-01

    Full Text Available The article studies the political development of the country in the modern period. Special attention is paid to the position of the army and its role in the Pakistani society. The article explores in detail the processes of gradual distancing of the army from politics and strengthening of civil society institutions. It is the first time in the Pakistani history that the civilian government managed to complete its full five-year constitutional term. Meanwhile, the country has been advancing on the path to democracy even after the elections 2013: a new civilian government has been formed in Pakistan. As compared with the previous phases of the country's development, the status of the army has considerably changed, evolved from "guiding force" to "shadow" guarantee of democratic development. The process has been largely encouraged by popular among officers feeling of tiredness: many of them are not ready to take power into their own hands and committed to their strictly constitutional duties. Despite this recent positive trend, the army continues to enjoy great authority in the society, often brokers political crisis and helps civilian authorities in settling such pressing problems as, for example, fight against extremism. The military will exert influence on government unless civil authorities are able to resist the current challenges and settle the actual problems. The role of "power broker" fully serves the interests of the top army brass.

  1. The Army Communications Objectives Measurement System (ACOMS) Users’ Manual

    Science.gov (United States)

    1988-07-01

    and analysis system to support Army (1) assessments of advertising program effectiveness; (2) assessments of advertising strategy efficiencies; (3...advertising program effectiveness in a timely fashion; 2 (2) To support Army assessments of advertising strategy in an integrated framework; and (3...ACOMS data to assess the Army’s advertising strategy . ACOMS was designed to be used to examine the extent to which the Army’s intended messages are

  2. A Cross-Sectional Comparison of Army Advertising Attributes

    Science.gov (United States)

    1990-11-01

    ARMY ADVERTISING ATTRIBUTES EXECUTIVE SUMMARY Research Requirement: In order to assess the impact of the Army’s advertising strategy and campaigns...Sample sizes varied from 4,875 to 4,926 for the NRS and from 3,569 to 3,602 for ACOMS. Improvement type themes. This advertising strategy would make...and college. I recommend that the Army focus advertising strategy on the Army as a positive step between high school and college in addition to work

  3. Optimizing the Sustainment of U.S. Army Weapon Systems

    Science.gov (United States)

    2016-03-17

    Dale Carnegie , Fellowship, etc.) NA None of the above OPTIMIZING SUSTAINMENT OF ARMY SYSTEMS 36 Question 11: Army Civilian Education System...Darden, Dale Carnegie , Fellowship, etc.) None of the above 11. Army Civilian Education System (check all that apply) Action Officer Development Course

  4. Body Dysmorphia, the Plastic Surgeon, and the Counselor.

    Science.gov (United States)

    Renshaw, Domeena C.

    2003-01-01

    Misperceived ugliness is called body dysmorphia or dysmorphophobia, often only diagnosed after several discontented return visits to a plastic surgeon who refers the patient for counseling--rarely welcome referrals by the patient when they are convinced the problem is physical and not psychological. Careful listening and patient acceptance are…

  5. Where are general surgeons located in South Africa? | Dell | South ...

    African Journals Online (AJOL)

    South African Journal of Surgery ... Methods: A descriptive analysis of the general surgical workforce in South Africa was performed. The total number of specialist and non-specialist general surgeons working in the public sector in South Africa was documented between the periods from the 1 October 2014 until 31 ...

  6. An audit of nephrectomy by general surgeons | Mungadi | Nigerian ...

    African Journals Online (AJOL)

    ... nephrectomy for non functioning hydronephrotic kidneys. The outcome in the treatment of the congenital renal anomalies, malignant and trauma to the kidney was not satisfactory suggesting the trained urologist will be better equipped to sort things out. Keywords: audit, nephrectomy, general surgeons. Nigerian Journal of ...

  7. Job Hazards Analysis Among A Group Of Surgeons At Zagazig ...

    African Journals Online (AJOL)

    ... 75% respectively. Conclusion: Job hazards analysis model was effective in assessment, evaluation and management of occupational hazards concerning surgeons and should considered as part of hospital wide quality and safety program. Key Words: Job Hazard Analysis, Risk Management, occupational Health Safety.

  8. National survey of surgeons\\' attitudes to laparoscopic surgical ...

    African Journals Online (AJOL)

    Aim. Laparoscopic surgery forms an integral component of modern surgical practice. The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical ...

  9. Practice patterns and career satisfaction of Canadian female general surgeons.

    Science.gov (United States)

    Hebbard, Pamela C; Wirtzfeld, Debrah A

    2009-06-01

    We wanted to study how female general surgeons in Canada manage lifestyle and career demands. All female Canadian general surgeons registered with the Royal College of Physicians and Surgeons of Canada were asked to complete a survey evaluating their practice patterns, personal lives, and levels of satisfaction related to these factors. Eighty-five surveys (66%) were returned. Most respondents work in full-time clinical practices. While it was rare to find women in part-time or shared practices, 35% of women reported interest in these alternative models. Respondents described the necessary factors for a transition into alternative models. Job satisfaction was high (3.8 out of 5), with personal and parenting satisfaction being less highly rated (3.3 and 3.2, respectively). Canadian female general surgeons have active and satisfying careers, although many would like to work in alternative practice models that better conform to their lifestyle demands. This pressure will have a significant impact on the future surgical workforce.

  10. Coaching Surgeons: Is Culture Limiting Our Ability to Improve?

    Science.gov (United States)

    Mutabdzic, Dorotea; Mylopoulos, Maria; Murnaghan, Michael Lucas; Patel, Priyanka; Zilbert, Nathan; Seemann, Natashia; Regehr, Glenn; Moulton, Carol-Anne

    2015-08-01

    To explore surgeons' perceptions of and potential concerns about coaching. There is growing recognition that the traditional model of continuing professional development is suboptimal. This has led to increasing interest in alternative strategies that take place within the actual practice environment such as coaching. However, if coaching is to be a successful strategy for continuing professional development, it will need to be accepted by surgeons. This was a qualitative interview-based study using a constructivist grounded theory approach. Participants included 14 surgeons from University of Toronto-affiliated hospitals. Participants expressed 3 main concerns about coaching: questioning the value of technical improvement ("As you get older if you don't have the stimulation from surgery to get better or to do things that are different and you are so good at so much, why bother [with coaching]?" P009), worry about appearing incompetent ("I think it would be perceived as either a sign of weakness or a sign of inability" P532), and concern about losing autonomy ("To me that would be real coaching where it's self-identified, I'm motivated, I find the person and then they coach me" P086). Coaching faces unique challenges in the context of a powerful surgical culture that values the portrayal of competency and instills the value of surgical autonomy. This study suggests that hanging on to these tightly held values of competency and autonomy is actually limiting the ways, and extent to which, surgeons can improve their practice.

  11. Leadership theory: implications for developing dental surgeons in primary care?

    Science.gov (United States)

    Willcocks, S

    2011-02-12

    The development of leadership in healthcare has been seen as important in recent years, particularly at the clinical level. There have been various specific initiatives focusing on the development of leadership for doctors, nurses and other health care professions: for example, a leadership competency framework for doctors, the LEO programme and the RCN clinical leadership programme for nurses. The NHS has set up a Leadership Council to coordinate further developments. However, there has not been the same focus in dentistry, although the recent review of NHS dental services (Steele review) has proposed a need for leadership initiatives in NHS dentistry as a medium-term action. Central to this will be a need to focus on the leadership role for dental surgeons. Leadership is all the more important in dentistry, given the change of government and the policy of retrenchment, major public sector reform, the emergence of new organisations such as new commissioning consortia, possible changes to the dental contract, new ways of working, and changes to the profession such as the requirements for the revalidation of dental surgeons. The question is: which leadership theory or approach is best for dental surgeons working in primary care? This paper builds on earlier work exploring this question in relation to doctors generally, and GPs, in particular, and planned work on nurses. It will seek to address this question in relation to dental surgeons working in primary care.

  12. Factors Influencing Patient Selection of a Foot and Ankle Surgeon.

    Science.gov (United States)

    Manning, Blaine T; Bohl, Daniel D; Wang, Kevin C; Hamid, Kamran S; Holmes, George B; Lee, Simon

    2017-09-01

    An increasingly consumer-centric health insurance market has empowered patients to select the providers of their choice. There is a lack of studies investigating the rationale by which patients select a foot and ankle surgeon. In the present study, 824 consecutive new patients seeking treatment from 3 foot-ankle surgeons were consecutively administered an anonymous questionnaire prior to their first appointment. It included rating the importance of 15 factors regarding specialist selection on a 1 to 10 scale, with 10 designated " Very important" and 1 designated " Not important at all." The remaining questions were multiple choice regarding patient perspectives on other surgeon aspects (appointment availability, waiting room times, clinic proximity, etc). Of 824 consecutive patients administered the survey, 305 (37%) responded. Patients rated board certification (9.24 ± 1.87) and on-site imaging availability (8.48 ± 2.37)-on a 1 to 10 scale, with 10 designated "Very important- as the 2 most important criteria in choosing a foot and ankle surgeon. Patients rated advertisements as least important. Among the patients, 91% responded that a maximum of 30 minutes should elapse between clinic check-in and seeing their physician; 61% responded that a maximum of 20 minutes should elapse between clinic check-in and seeing their physician. In the context of an increasingly consumer-driven paradigm of health care delivery and reimbursement, it is important to understand patients' preferences in specialist selection. Level III: Prospective questionnaire.

  13. Hypertensive Patient in the Surgical Ward – What the Surgeon ...

    African Journals Online (AJOL)

    Two cases of hypertension are presented to emphasize the need for the surgeons to pay adequate attention to these purely medical conditions that may have a devastating adverse effect on the outcome of surgery. The article also highlights the serious constraints that still characterize the management of these patients in ...

  14. Perspectives of the surgeons, anaesthetists, and pharmacists on ...

    African Journals Online (AJOL)

    Post-operative pain is best managed by a multi-disciplinary team approach. An extensive review of the literature indicated that little is known about the roles of surgeons, anaesthetists, and pharmacists regarding post-operative pain management in Ghana. Therefore, this study was undertaken in order to fully understand ...

  15. Optimal Brain Surgeon on Artificial Neural Networks in

    DEFF Research Database (Denmark)

    Christiansen, Niels Hørbye; Job, Jonas Hultmann; Klyver, Katrine

    2012-01-01

    It is shown how the procedure know as optimal brain surgeon can be used to trim and optimize artificial neural networks in nonlinear structural dynamics. Beside optimizing the neural network, and thereby minimizing computational cost in simulation, the surgery procedure can also serve as a quick...

  16. Safety of the surgeon: 'Double-gloving' during surgical procedures

    African Journals Online (AJOL)

    during exposure to blood and body fluids are now mandatory. Intact surgical gloves can ... HIV/AIDS infection is for the surgeon to 'double-glove' – wear two standard gloves on .... sharp fractured bones or bony structures.[12,16,17] The rate of ...

  17. Perspectives of South African general surgeons regarding their ...

    African Journals Online (AJOL)

    Perspectives of South African general surgeons regarding their postgraduate training. MD Smith. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  18. Professional interpersonal dynamics and burnout in European transplant surgeons.

    Science.gov (United States)

    Jesse, Michelle T; Abouljoud, Marwan; Eshelman, Anne; De Reyck, Chantal; Lerut, Jan

    2017-04-01

    Burnout within the health professions has become an increasingly important topic. Evidence suggests there are differences in burnout across different countries. Research has yet to examine burnout in transplant surgeons throughout Europe. A cross-sectional survey of transplant surgeons across Europe. Survey included sociodemographics, professional characteristics, frequency and discomfort with difficult patient interactions (PI), decisional autonomy, psychological job demands (PJD), support (coworker, supervisor, and hospital administration), and burnout including emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). One hundred and eight transplant surgeons provided data; 33 (30.6%) reported high EE, 19 (17.6%) reported high DP, and 29 (26.9%) reported low PA. Three hierarchical multiple linear regressions examined the burnout subscales as outcomes (EE, DP, and PA), and predictors selected based upon theoretical relationships with the outcomes. Greater PJD, greater discomfort in managing difficult PI, and lower levels of perceived supervisor support (SS) predicted greater EE. Only decisional autonomy significantly predicted DP, accounting for a small proportion of the variance. None of the steps for PA were significant. Given prior research on burnout, there were several surprising findings from this study. For example, the relatively low levels of EE compared to U.S. physicians and surgeons. At this time, we can only hypothesize why this finding occurred but there are multiple possible explanations including cultural effects, response bias, or other factors unknown at this time. Research is needed to attempt to clarify these findings. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Surgeon and nonsurgeon personalities at different career points.

    Science.gov (United States)

    Drosdeck, Joseph M; Osayi, Sylvester N; Peterson, Laura A; Yu, Lianbo; Ellison, Edwin Christopher; Muscarella, Peter

    2015-06-01

    Previous studies have demonstrated correlations between personality traits and job performance and satisfaction. Evidence suggests that personality differences exist between surgeons and nonsurgeons, some of which may develop during medical training. Understanding these personality differences may help optimize job performance and satisfaction among surgical trainees and be used to identify individuals at risk of burnout. This study aims to identify personality traits of surgeons and nonsurgeons at different career points. We used The Big Five Inventory, a 44-item measure of the five factor model. Personality data and demographics were collected from responses to an electronic survey sent to all faculty and house staff in the Departments of Surgery, Medicine, and Family Medicine at The Ohio State University College of Medicine. Data were analyzed to identify differences in personality traits between surgical and nonsurgical specialties according to level of training and to compare surgeons to the general population. One hundred ninety-two house staff and faculty in surgery and medicine completed the survey. Surgeons scored significantly higher on conscientiousness and extraversion but lower on agreeableness compared to nonsurgeons (all P personality differences between surgical and nonsurgical specialties. The use of personality testing may be a useful adjunct in the residency selection process for applicants deciding between surgical and nonsurgical specialties. It may also facilitate early intervention for individuals at high risk for burnout and job dissatisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Can statisticians beat surgeons at the planning of operations?

    NARCIS (Netherlands)

    Joustra, Paul; Meester, Reinier; van Ophem, Hans

    2013-01-01

    The planning of operations in the Academic Medical Center is primarily based on the assessments of the length of the operation by the surgeons. We investigate whether duration models employing the information available at the moment the planning is made, offer a better alternative. Our empirical

  1. Can statisticians beat surgeons at the planning of operations?

    NARCIS (Netherlands)

    Joustra, P.; Meester, R.; van Ophem, H.

    2011-01-01

    The planning of operations in the Academic Medical Center is primarily based on the assessments of the length of the operation by the surgeons. We investigate whether duration models employing the information available at the moment the planning is made, offer a better alternative. Our empirical

  2. Practice activity trends among oral and maxillofacial surgeons in Australia

    Directory of Open Access Journals (Sweden)

    Teusner Dana N

    2004-12-01

    Full Text Available Abstract Background The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. Methods All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. Results Data were available from 79 surgeons from 1990 (response rate = 73.8% and 116 surgeons from 2000 (response rate = 65.1%. The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000, reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000. Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000, while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000. Conclusions The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied.

  3. The paediatric surgeon and his working conditions in Francophone ...

    African Journals Online (AJOL)

    Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA) and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1st May to 30th October 2008. The African Society of paediatric ...

  4. Antimicrobial Stewardship: A Call to Action for Surgeons

    Science.gov (United States)

    Duane, Therese M.; Catena, Fausto; Tessier, Jeffrey M.; Coccolini, Federico; Kao, Lillian S.; De Simone, Belinda; Labricciosa, Francesco M.; May, Addison K.; Ansaloni, Luca; Mazuski, John E.

    2016-01-01

    Abstract Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients. PMID:27828764

  5. Occupational Exposure to the Risk of HIV Infection Among Surgeons ...

    African Journals Online (AJOL)

    The majority (97%) incorrectly estimated the sero-conversion rate with exposure to a patient with HIV. The most popular recommendation was availability of surgical gloves followed by health education to raise the level of awareness of medical personnel. Conclusion: The high rate of needlestick injuries among surgeons in ...

  6. Role of the plastic surgeon in a cancer hospital

    International Nuclear Information System (INIS)

    Sinclair, M.H.

    1979-01-01

    This paper discusses and illustrates the complicated problems faced by the plastic surgeon in a cancer hospital. His patients are often weakened, both physically and psychologically, not only by the cancer itself, but also by extensive ablative surgery. The goal of the plastic surgeon is rehabilitation of the patient after he is cured of cancer. Good planning with the cancer surgeon before the ablative operation is very important, as is immediate repair, whenever possible. The simplest procedure with the fewest stages that can accomplish satisfactory repair in the shortest time should be chosen, as we can never, even after the most extensive cancer operation, be sure that no recurrence will appear. Partial surgical repair and the use of a prosthesis should be considered for complicated defects in old and weak patients. Postoperative radiation therapy, if indicated, can be given after the flap has healed into the defect but before the pedicle is separated. The plastic surgeon should always be aware that his most important goal is speedy and satisfactory rehabilitation of the patient

  7. PREVALENCE OF HEPATITIS B VIRUS MARKERS IN SURGEONS ...

    African Journals Online (AJOL)

    hi-tech

    Objective: To determine the prevalence of hepatitis B virus (HBV) markers in surgeons in a major city in Nigeria. ... Interventions: Blood samples were taken from subjects and analysed for hepatitis B virus markers ( HBsAg, antiHBs and .... Lagos was comparable to those of Romieu et al (10) who found HBsAg seropositivity ...

  8. Computer technology and the surgeon: what the resident needs to ...

    African Journals Online (AJOL)

    Though a compliment to the surgeon, it has its problems including overwhelming information requiring careful scrutiny; computer fraud, hacking and viruses; copyright laws; the 'threat' of a well-informed patient population; and the risk of over dependence. Surgery in Nigeria and most of African is yet to maximize its benefits.

  9. Mentoring the modern African surgeon: A call to arms!

    African Journals Online (AJOL)

    2011-01-16

    Jan 16, 2011 ... Hospital, Nairobi, 2-University of Nairobi, Kenya, 3-King Khalid University, UAE. Correspondence: Dr. Miriam Mutebi, Aga Khan. University Hospital. P.O. Bx 30270 .... Galukande M, Kijjambu S, Luboga S Improving recruitment of surgical trainees and training of surgeons in Uganda. East. Cent Afr J Surg.

  10. Army Energy and Water Reporting System Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Deprez, Peggy C.; Giardinelli, Michael J.; Burke, John S.; Connell, Linda M.

    2011-09-01

    There are many areas of desired improvement for the Army Energy and Water Reporting System. The purpose of system is to serve as a data repository for collecting information from energy managers, which is then compiled into an annual energy report. This document summarizes reported shortcomings of the system and provides several alternative approaches for improving application usability and adding functionality. The U.S. Army has been using Army Energy and Water Reporting System (AEWRS) for many years to collect and compile energy data from installations for facilitating compliance with Federal and Department of Defense energy management program reporting requirements. In this analysis, staff from Pacific Northwest National Laboratory found that substantial opportunities exist to expand AEWRS functions to better assist the Army to effectively manage energy programs. Army leadership must decide if it wants to invest in expanding AEWRS capabilities as a web-based, enterprise-wide tool for improving the Army Energy and Water Management Program or simply maintaining a bottom-up reporting tool. This report looks at both improving system functionality from an operational perspective and increasing user-friendliness, but also as a tool for potential improvements to increase program effectiveness. The authors of this report recommend focusing on making the system easier for energy managers to input accurate data as the top priority for improving AEWRS. The next major focus of improvement would be improved reporting. The AEWRS user interface is dated and not user friendly, and a new system is recommended. While there are relatively minor improvements that could be made to the existing system to make it easier to use, significant improvements will be achieved with a user-friendly interface, new architecture, and a design that permits scalability and reliability. An expanded data set would naturally have need of additional requirements gathering and a focus on integrating

  11. Planning developments in British Nuclear Fuels Ltd

    Energy Technology Data Exchange (ETDEWEB)

    Roper, D A [British Nuclear Fuels Ltd., Risley

    1978-10-01

    The state of the corporate planning art in British Nuclear Fuels Ltd. was described by N.R.Geary (Long Range Planning, September (1973)) just 2 years after Company formation. This article discusses more recent planning developments over the period to date during which the Company adopted a Divisionalized structure (from October 1974) and has been required to submit an annual Company plan to the Department of Energy (from November 1975). Background information on the origin and nature of the BNFL and its business, and the particular features of the Company which reflect into the nature and method of its planning were given in the 1973 article and only a brief introductory updating of the Company position is included here. Subsequently the features and problems of BNFL's operating and development planning system are described. Finally, messages arising from BNFL's planning experience to date which may be of general application and therefore of value to other practitioners of planning are listed.

  12. Metaphyseal osteopathy in a British Shorthair cat.

    Science.gov (United States)

    Adagra, Carl; Spielman, Derek; Adagra, Angela; Foster, Darren J

    2015-04-01

    Metaphyseal osteopathy, otherwise known as hypertrophic osteodystrophy, is a disease that causes pyrexia and lethargy accompanied by pain in the thoracic and pelvic limbs of rapidly growing large-breed dogs. While metaphyseal osteopathy has been descibed in association with slipped capital femoral epiphysis in cats, it has not previously been reported as a cause of limb pain and pyrexia in this species. A 7-month-old British Shorthair cat presented with a 1 month history of pyrexia, lethargy and pain in all limbs. Investigation included radiographs of the limbs and chest, abdominal ultrasound, serum biochemical analysis, haematology, bone biopsy, joint fluid aspiration and cytology. Findings were consistent with a diagnosis of metaphyseal osteopathy. The cat's clinical signs resolved following the administration of prednisolone. Symptoms recurred 1 month after the cessation of prednisolone therapy, but resolved when administration was resumed. © ISFM and AAFP 2014.

  13. British Coal and the energy scene

    Energy Technology Data Exchange (ETDEWEB)

    Cruttenden, M G [British Coal Corporation, London (United Kingdom)

    1992-01-01

    This paper attempts to describe British Coal's (BCC) present position in a rapidly changing UK Energy Market where competition, with imported coal and with other fuels, particularly natural gas is likely to continue to increase. As a relatively high cost coal producer by world standards BCC, while continuing its efforts to improve productivity and lower costs, must work to enhance the value of its product in the market place both by improving quality to more closely match customers individual needs and by offering supporting services which ensure overall customer satisfaction. The paper explores each market sector and describes the steps which the Corporation is taking to improve its competitive position in each market with particular reference to quality standards and supporting services. Finally it attempts to forecast some possible new developments for the future. 3 tabs.

  14. Net metering in British Columbia : white paper

    International Nuclear Information System (INIS)

    Berry, T.

    2003-01-01

    Net metering was described as being the reverse registration of an electricity customer's revenue meter when interconnected with a utility's grid. It is a provincial policy designed to encourage small-distributed renewable power generation such as micro-hydro, solar energy, fuel cells, and larger-scale wind energy. It was noted that interconnection standards for small generation is an important issue that must be addressed. The British Columbia Utilities Commission has asked BC Hydro to prepare a report on the merits of net metering in order to support consultations on a potential net metering tariff application by the utility. This report provides information on net metering with reference to experience in other jurisdictions with net metering, and the possible costs and benefits associated with net metering from both a utility and consumer perspective. Some of the barriers and policy considerations for successful implementation of net metering were also discussed. refs., tabs., figs

  15. Tapering strategies in elite British endurance runners.

    Science.gov (United States)

    Spilsbury, Kate L; Fudge, Barry W; Ingham, Stephen A; Faulkner, Steve H; Nimmo, Myra A

    2015-01-01

    The aim of the study was to explore pre-competition training practices of elite endurance runners. Training details from elite British middle distance (MD; 800 m and 1500 m), long distance (LD; 3000 m steeplechase to 10,000 m) and marathon (MAR) runners were collected by survey for 7 days in a regular training (RT) phase and throughout a pre-competition taper. Taper duration was [median (interquartile range)] 6 (3) days in MD, 6 (1) days in LD and 14 (8) days in MAR runners. Continuous running volume was reduced to 70 (16)%, 71 (24)% and 53 (12)% of regular levels in MD, LD and MAR runners, respectively (P training (MD; 53 (45)%, LD; 67 (23)%, MAR; 64 (34)%, P training intensity was above race speed in LD and MAR runners (112 (27)% and 114 (3)%, respectively, P training undertaken prior to the taper in elite endurance runners is predictive of the tapering strategy implemented before competition.

  16. Wind energy sector in British Columbia

    International Nuclear Information System (INIS)

    2010-01-01

    British Columbia (BC) possesses significant wind energy resources, and many wind energy projects are currently in the planning phase or are already under construction. Wind power policies in the province have been designed to ensure the secure and orderly development of the wind power industry. Policies in the province include a 10-year exemption from participation rents for new projects as well as a policy that has established the maximum permissible noise levels for wind farms located near residential properties. BC's wind power development plan forms part of the province's aim to become electricity self-sufficient by 2016 while ensuring that clean or renewable energy generation accounts for at least 90 per cent of total generation. This guide provided an outline of the province's wind energy sector, and provided a listing of selected wind power operators. Details of new wind power projects were also presented. 11 fig.

  17. British American Tobacco's failure in Turkey.

    Science.gov (United States)

    Lawrence, S

    2009-02-01

    Transnational tobacco companies (TTCs) considered Turkey an important, potential investment market because of its high consumption rates and domestic commitment to tobacco. This paper outlines how British American Tobacco (BAT) attempted to establish a joint venture with the government monopoly TEKEL, while waiting for privatisation and a private tender. Analysis of tobacco industry documents from the Guildford Depository and online tobacco document sources. BAT failed to establish a market share in Turkey until 2000 despite repeated attempts to form a joint venture with Turkey's tobacco monopoly, TEKEL, once the market liberalised in the mid 1980s. BAT's failure in the Turkish market was due to a misguided investment strategy focused solely on acquiring TEKEL and is contrasted with Philip Morris success in Turkey despite both TTCs working within Turkey's unstable and corrupt investing climate.

  18. British standard (BS) 5750--quality assurance?

    Science.gov (United States)

    Pratt, D J

    1995-04-01

    BS5750 is the British Standard on "Quality Systems". Its equivalent in European Standards is EN29000 and in the International Standards Organisation ISO9000. This paper points out that these standards lay down formalised procedures and require documentation but do not ipso facto lead to quality assurance. The author points to the Japanese post-war industrial success as being an example of Total Quality Management within the framework provided by the philosophy of Dr. W. Edwards Deming (1988 and 1993). This philosophy on the management of "systems" to provide high quality products and services is briefly outlined. The author argues that improvement in prosthetic and orthotic services will not be reached through implementation of BS5750 but rather through radical rethinking and the adoption and application of the Deming philosophy.

  19. British torture in the 'war on terror'.

    Science.gov (United States)

    Blakeley, Ruth; Raphael, Sam

    2017-06-01

    Despite long-standing allegations of UK involvement in prisoner abuse during counterterrorism operations as part of the US-led 'war on terror', a consistent narrative emanating from British government officials is that Britain neither uses, condones nor facilitates torture or other cruel, inhuman or degrading treatment and punishment. We argue that such denials are untenable. We have established beyond reasonable doubt that Britain has been deeply involved in post-9/11 prisoner abuse, and we can now provide the most detailed account to date of the depth of this involvement. We argue that it is possible to identify a peculiarly British approach to torture in the 'war on terror', which is particularly well-suited to sustaining a narrative of denial. To explain the nature of UK involvement, we argue that it can be best understood within the context of how law and sovereign power have come to operate during the 'war on terror'. We turn here to the work of Judith Butler, and explore the role of Britain as a 'petty sovereign', operating under the state of exception established by the US executive. UK authorities have not themselves suspended the rule of law so overtly; indeed, they have repeatedly insisted on their commitment to it. Nevertheless, they have been able to construct a rhetorical, legal and policy 'scaffold' that has enabled them to demonstrate at least procedural adherence to human rights norms while, at the same time, allowing UK officials to acquiesce in the arbitrary exercise of sovereignty over individuals who are denied any access to appropriate representation or redress in compliance with the rule of law.

  20. Biodiesel in British Columbia : feasibility study report

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, M.; Murray-Hill, A.; Schaddelee, K. [Wise Energy Co-op, Victoria, BC (Canada)

    2004-05-05

    This report evaluates the potential for biodiesel as a viable fuel in British Columbia. Biodiesel is a non-toxic, biodegradable, renewable fuel produced from recycled bio-oils that can be used to replace conventional petroleum diesel. The report also examines potential feedstock characteristics, output volumes and environmental impacts. Production of biodiesel is increasing globally due to its economic, human and environmental health benefits. Canada's Climate Change Action Plan target of 500 million litres of biodiesel production per year by 2010 will also contribute to biodiesel growth. The use of pure biodiesel as an alternative fuel results in reduced emissions of carbon dioxide, sulphur dioxide, methane, unburned hydrocarbons, carbon monoxide, particulate matter and polycyclic aromatic hydrocarbons. British Columbia's biodiesel feedstock volumes yield a total theoretical capacity of 125 million litres per year of biodiesel, or 4.5 per cent of the province's total annual diesel consumption The feedstock is enough to fuel over 3,700 transit buses annually and significantly reduce greenhouse gas emissions. This report outlines the activities needed to establish commercial biodiesel companies in the province. It also examines standards and regulatory issues; technology availability; cost and processing analysis; potential markets and distribution channels; and environmental impact comparisons. The 4 critical factors that will determine the success or failure of a commercial biodiesel project include: the ability to balance feedstock supplies, processing technology, and market penetration in an integrated system that is reliable and efficient; the ability to form stable strategic alliances with feedstock suppliers, distributors and end users; the ability to deal effectively with competitive pressures; and, the ability to generate a business plan that will attract financing. It was concluded that community-based biodiesel production at a plant scale

  1. US Army primary radiation standards complex

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, S.C. [Radiation Standards and Dosimetry Laboratory, Redstone Arsenal, AL (United States)

    1993-12-31

    This paper describes the U.S. Army Primary Radiation Standards Complex (PRSC) to be constructed at Redstone Arsenal, Alabama. The missions of the organizations to be located in the PRSC are described. The health physics review of the facility design is discussed. The radiation sources to be available in the PRSC and the resulting measurement capabilities of the Army Primary Standards Laboratory Nucleonics section are specified. Influence of the National Voluntary Laboratory Accrediation Program (NVLAP) accreditation criteria on facility design and source selection is illustrated.

  2. Improving surgeon utilization in an orthopedic department using simulation modeling

    Directory of Open Access Journals (Sweden)

    Simwita YW

    2016-10-01

    Full Text Available Yusta W Simwita, Berit I Helgheim Department of Logistics, Molde University College, Molde, Norway Purpose: Worldwide more than two billion people lack appropriate access to surgical services due to mismatch between existing human resource and patient demands. Improving utilization of existing workforce capacity can reduce the existing gap between surgical demand and available workforce capacity. In this paper, the authors use discrete event simulation to explore the care process at an orthopedic department. Our main focus is improving utilization of surgeons while minimizing patient wait time.Methods: The authors collaborated with orthopedic department personnel to map the current operations of orthopedic care process in order to identify factors that influence poor surgeons utilization and high patient waiting time. The authors used an observational approach to collect data. The developed model was validated by comparing the simulation output with the actual patient data that were collected from the studied orthopedic care process. The authors developed a proposal scenario to show how to improve surgeon utilization.Results: The simulation results showed that if ancillary services could be performed before the start of clinic examination services, the orthopedic care process could be highly improved. That is, improved surgeon utilization and reduced patient waiting time. Simulation results demonstrate that with improved surgeon utilizations, up to 55% increase of future demand can be accommodated without patients reaching current waiting time at this clinic, thus, improving patient access to health care services.Conclusion: This study shows how simulation modeling can be used to improve health care processes. This study was limited to a single care process; however the findings can be applied to improve other orthopedic care process with similar operational characteristics. Keywords: waiting time, patient, health care process

  3. Surgeon Experience and Complications of Transvaginal Prolapse Mesh.

    Science.gov (United States)

    Kelly, Erin C; Winick-Ng, Jennifer; Welk, Blayne

    2016-07-01

    To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume. We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5-6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11-14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model. A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0-8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58-2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40-0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation. Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.

  4. Log Books and the Law of Storms: Maritime Meteorology and the British Admiralty in the Nineteenth Century.

    Science.gov (United States)

    Naylor, Simon

    2015-12-01

    This essay contributes to debates about the relationship between science and the military by examining the British Admiralty's participation in meteorological projects in the first half of the nineteenth century. It focuses on attempts to transform Royal Navy log books into standardized meteorological registers that would be of use to both science and the state. The essay begins with a discussion of Admiralty Hydrographer Francis Beaufort, who promoted the use of standardized systems for the observation of the weather at sea. It then examines the application of ships' logs to the science of storms. The essay focuses on the Army engineer William Reid, who studied hurricanes while stationed in Barbados and Bermuda. Reid was instrumental in persuading the Admiralty to implement a naval meteorological policy, something the Admiralty Hydrographer had struggled to achieve. The essay uses the reception and adoption of work on storms at sea to reflect on the means and ends of maritime meteorology in the mid-nineteenth century.

  5. BCASP and the Evolution of School Psychology in British Columbia

    Science.gov (United States)

    Agar, Douglas J.

    2016-01-01

    Since 1992, the British Columbia Association of School Psychologists (BCASP) has been the professional body for school psychologists in British Columbia. In the intervening 24 years, BCASP has been very successful in performing the dual roles of a certifying body and a professional development organization for school psychologists in British…

  6. Britishness as Racist Nativism: A Case of the Unnamed "Other"

    Science.gov (United States)

    Smith, Heather Jane

    2016-01-01

    The construct of Britishness, as with nationalism elsewhere in the world, although amorphous and permeable over time, continues to be used by politicians and the media as a powerful exclusionary force. Moreover in England, fundamental British values (FBV), its most recent and official incarnation, now hold particular currency in education policy…

  7. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  8. The Genesis of Public Relations in British Colonial Practice.

    Science.gov (United States)

    Smyth, Rosaleen

    2001-01-01

    Demonstrates how the British Colonial Office employed public relations strategies as they administered the British colony of Northern Rhodesia before, during, and after World War II. Demonstrates how civil servants in London and colonial officials implemented public relations policies, strategies, and tactics on an ad hoc basis, covering political…

  9. Shakespearean Intertexts and European Identities in Contemporary Black British Fiction

    Science.gov (United States)

    Muñoz-Valdivieso, Sofía

    2012-01-01

    The article analyses the presence of William Shakespeare as intertext in three recent novels by black British writers which deploy the work of the Bard as they explore British and European identities. Caryl Phillips's "The Nature of Blood" recreates an Othello-like figure who in early Modern Venice struggles to come to terms with his…

  10. Addressing Cellulose Acetate Microfilm from a British Library perspective

    Directory of Open Access Journals (Sweden)

    Helen Shenton

    2005-08-01

    Full Text Available This paper is about cellulose acetate microfilm from the British Library perspective. It traces how acetate microfilm became an issue for the British Library and describes cellulose acetate deterioration. This is followed by details of what has already been done about the situation and what action is planned for the future.

  11. Southern Cameroons' financial contributions to British Second World ...

    African Journals Online (AJOL)

    The serious damage done to the British economy during World War II compelled the leaders of the British Government to look for ways of repairing the damage. Hence, they turned to the colonies for help. Inter alia, they needed financial assistance because of their inability to pay for imports from the United States. Imports of ...

  12. British Television and Official Film, 1946-1951.

    Science.gov (United States)

    Wildy, Tom

    1988-01-01

    Discusses the relationships between the British Government's Information Services and both the British Broadcasting Corporation (BBC) and the commercial film trade after the BBC's television service resumed independent broadcasts in 1946. Examines proposals for using television as an alternative outlet for commercial and official films. (GEA)

  13. Do Surgeons React?: A Retrospective Analysis of Surgeons' Response to Harassment of a Colleague During Simulated Operating Theatre Scenarios.

    Science.gov (United States)

    Gostlow, Hannah; Vega, Camila Vega; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    2017-07-24

    To assess and report on surgeons' ability to identify and manage incidences of harassment. The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the workplace. To eradicate these behaviors, it is first critical to understand how the current workforce responds to these actions. A retrospective analysis of video data of an operating theatre simulation was conducted to identify how surgeons, from a range of experience levels, react to instances of harassment. Thematic analysis was used to categorize types of harassment and participant response characteristics. The frequency of these responses was assessed and reported. The type of participant response depended on the nature of harassment being perpetuated and the seniority of the participant. In the 50 instances of scripted harassment, active responses were enacted 52% of the time, acknowledgment responses 16%, and no response enacted in 30%. One senior surgeon also perpetuated the harassment (2%). Trainees were more likely to respond actively compared with consultants. It is apparent that trainees are more aware of instances of harassment, and were more likely to intervene during the simulated scenario. However, a large proportion of harassment was unchallenged. The hierarchical nature of surgical education and the surgical workforce in general needs to enable a culture in which the responsibility to intervene is allowed and respected. Simulation-based education programs could be developed to train in the recognition and intervention of discrimination, bullying, harassment and sexual harassment.

  14. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels

    2015-01-01

    surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all...... of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...... symmetrisation procedures were performed by plastic surgeons. Breast surgeons had sought more specific education, both international observerships and specific courses. In both groups of surgeons, the majority expressed that both tumour removal and reconstruction should be performed by doctors of their own...

  15. 'The Danger of Divided Command': British civil and military disputes ...

    African Journals Online (AJOL)

    Commander-in-Chief of the Indian Army, Lord Kitchener, which culminated in Curzon's ... and the officers commanding forces would have no doubt as to their .... but assuming financial responsibility for its own defence would have been ...

  16. Army Business Transformation: The Utility of Using Corporate Business Models within the Institutional Army

    National Research Council Canada - National Science Library

    Bailer, Jr., John J

    2007-01-01

    .... This study finds that working corporate models, such as Lean Six Sigma (LSS), are available which are already enabling the transformation of a very specific aspect within the institutional Army...

  17. Factors predicting health behaviors among Army Reserve, active duty Army, and civilian hospital employees.

    Science.gov (United States)

    Wynd, Christine A; Ryan-Wenger, Nancy A

    2004-12-01

    This study identified health-risk and health-promoting behaviors in military and civilian personnel employed in hospitals. Intrinsic self-motivation and extrinsic organizational workplace factors were examined as predictors of health behaviors. Because reservists represent a blend of military and civilian lifestyles, descriptive analyses focused on comparing Army Reserve personnel (n = 199) with active duty Army (n = 218) and civilian employees (n = 193), for a total sample of 610. Self-motivation and social support were significant factors contributing to the adoption of health-promoting behaviors; however, organizational workplace cultures were inconsistent predictors of health among the three groups. Only the active Army subgroup identified a hierarchical culture as having an influence on health promotion, possibly because of the Army's mandatory physical fitness and weight control standards. Social support and self-motivation are essential to promoting health among employees, thus hospital commanders and chief executive officers should encourage strategies that enhance and reward these behaviors.

  18. Army ROTC: A Strategy for Developing Tomorrow's Army Leadership in an Era of Diminishing Resources

    National Research Council Canada - National Science Library

    Betoney, Charles

    1997-01-01

    .... This study addresses the need to continue a viable Army ROTC program to produce high quality junior officers as well as maintain a positive, mutually beneficial presence on university and college...

  19. Unchained Interests: American-British-Dutch-Australian Command 1942

    Science.gov (United States)

    2014-05-22

    KNIL Koninklijk Nederlands Indisch Leger (Royal Netherlands East Indies Army) ABDAfloat ABDACOM combined naval forces ABDAair ABDACOM combined and...20Willmott, Empires in the Balance, 15. 21G. Teitler and P. J. Drooglever, De Val van Nederlands -Indië (Dieren: Bataafsche Leeuw, 1982), 82...military presence in the Netherlands East Indies. The armed forces were composed of the Royal Netherlands East Indies Army (Koninklijk Nederlands

  20. 2014 Center for Army Leadership Annual Survey of Army Leadership (CASAL): Military Leader Findings

    Science.gov (United States)

    2015-09-22

    of representativeness across the Army. The respondent sample closely approximated the population of the Army in distribution of component and gender ...standards are types of behaviors that hinder trust by creating climates of perceived inequality . As expected, the display of favoritism is negatively...or ‘favorites’ in lieu of the most qualified personnel, unequal enforcement of standards and discipline, and use of discretion in workplace justice

  1. Evaluating Mobile Device Ownership and Usage in the U.S. Army: Implications for Army Training

    Science.gov (United States)

    2014-07-01

    Mercado University of Central Florida Randall D. Spain U.S. Army Research Institute July 2014 United States Army...NUMBER 633007 6. AUTHOR(S) Joseph E. Mercado ; Randall D. Spain 5c. PROJECT NUMBER A792 5d. TASK NUMBER 5e...13. SUPPLEMENTARY NOTES Subject Matter POC and Subject Matter Expert: Joseph E. Mercado 14. ABSTRACT (Maximum 200 words): As the U.S

  2. Description of Mexican Cleft Surgeons' Experience With Foreign Surgical Volunteer Missions in Mexico.

    Science.gov (United States)

    Schoenbrunner, Anna R; Kelley, Kristen D; Buckstaff, Taylor; McIntyre, Joyce K; Sigler, Alicia; Gosman, Amanda A

    2018-05-01

    Mexican cleft surgeons provide multidisciplinary comprehensive cleft lip and palate care to children in Mexico. Many Mexican cleft surgeons have extensive experience with foreign, visiting surgeons. The purpose of this study was to characterize Mexican cleft surgeons' domestic and volunteer practice and to learn more about Mexican cleft surgeons' experience with visiting surgeons. A cross-sectional validated e-mail survey tool was sent to Mexican cleft surgeons through 2 Mexican plastic surgery societies and the Asociación Mexicana de Labio y Paladar Hendido y Anomalías Craneofaciales, the national cleft palate society that includes plastic and maxillofacial surgeons who specialize in cleft surgery. We utilized validated survey methodology, including neutral fact-based questions and repeated e-mails to survey nonresponders to maximize validity of statistical data; response rate was 30.6% (n = 81). Mexican cleft surgeons performed, on average, 37.7 primary palate repairs per year with an overall complication rate of 2.5%; 34.6% (n = 28) of respondents had direct experience with patients operated on by visiting surgeons; 53.6% of these respondents performed corrective surgery because of complications from visiting surgeons. Respondents rated 48% of the functional outcomes of visiting surgeons as "acceptable," whereas 43% rated aesthetic outcomes of visiting surgeons as "poor"; 73.3% of respondents were never paid for the corrective surgeries they performed. Thirty-three percent of Mexican cleft surgeons believe that there is a role for educational collaboration with visiting surgeons. Mexican cleft surgeons have a high volume of primary cleft palate repairs in their domestic practice with good outcomes. Visiting surgeons may play an important role in Mexican cleft care through educational collaborations that complement the strengths of Mexican cleft surgeons.

  3. The medicolegal landscape of spine surgery: how do surgeons fare?

    Science.gov (United States)

    Makhni, Melvin C; Park, Paul J; Jimenez, Jesus; Saifi, Comron; Caldwell, Jon-Michael; Ha, Alex; Figueroa-Santana, Bianca; Lehman, Ronald A; Weidenbaum, Mark

    2018-02-01

    Because of the limited and confidential nature of most legal data, scarce literature is available to physicians about reasons for litigation in spine surgery. To optimally compensate patients while protecting physicians, further understanding of the medicolegal landscape is needed for high-risk procedures such as spine surgery. Based on these, surgeons can explore ways to better protect both their patients and themselves. To characterize the current medicolegal environment of spine surgery by analyzing a recent dataset of malpractice litigation. A retrospective study. All malpractice cases involving spine surgery available to public query between the years of 2010 and 2014. Case outcome for spine surgery malpractice cases between the years of 2010 and 2014. WestlawNext was used to analyze spine surgery malpractice cases at the state and federal level between the years 2010 and 2014. WestlawNext is a subscription-based, legal search engine that contains publicly available federal and state court records. All monetary values were inflation adjusted for 2016. One hundred three malpractice cases were categorized by case descriptors and outcome measures. Claims were categorized as either intraoperative complaints or preoperative complaints. Rulings in favor of the defendant (surgeon) were noted in 75% (77 of 103) of the cases. Lack of informed consent was cited in 34% of cases. For the 26 cases won by the plaintiff, the average amount in settlement was $2,384,775 versus $3,945,456 in cases brought before a jury. Cases involving consent averaged a compensation of $2,029,884, whereas cases involving only intraoperative complaints averaged a compensation of $3,667,530. A significant correlation was seen between increased compensation for plaintiffs and cases involving orthopedic surgeons (p=.020) or nerve injury (p=.005). Wrong-level surgery may be associated with lower plaintiff compensation (p=.055). The length of cases resulting in defense verdicts averaged 5.51 years

  4. Perceptions of conflict of interest: surgeons, internists, and learners compared.

    Science.gov (United States)

    de Gara, Christopher J; Rennick, Kim C; Hanson, John

    2013-05-01

    Making a conflict of interest declaration is now mandatory at continuing medical education CME accredited events. However, these declarations tend to be largely perfunctory. This study sought to better understand physician perceptions surrounding conflict of interest. The same PowerPoint (Microsoft, Canada) presentation (http://www.youtube.com/watch?v=mQSOvch7Yg0&feature=g-upl) was delivered at multiple University of Alberta and Royal College CME-accredited events to surgeons, internists, and learners. After each talk, the audience was invited to complete an anonymous, pretested, and standardized 5-point Likert scale (strongly disagree to strongly agree) questionnaire. A total of 136 surveys were analyzed from 31 surgeons, 49 internists, and 56 learners. In response to the question regarding whether by simply making a declaration, the speaker had provided adequate proof of any conflicts of interest, 71% of surgeons thought so, whereas only 35% of internists and 39% of learners agreed or strongly agreed (P = .004). Further probing this theme, the audience was asked whether a speaker must declare fees or monies received from industry for consulting, speaking, and research support. Once again there was a variance of opinion, with only 43% of surgeons agreeing or strongly agreeing with this statement; yet, 80% of internists and 71% of learners felt that such a declaration was necessary (P = .013). On the topic of believability (a speaker declaration makes him or her and the presentation more credible), the 3 groups were less polarized: 50% of surgeons, 41% of internists, and 52% of learners (P = .2) felt that this was the case. Although two thirds of surgeons (68%) and learners (66%) and nearly all internists (84%) felt that industry-sponsored research was biased, these differences were not significant (P = .2). Even when they are completely open and honest, conflict of interest declarations do not negate the biases inherent in a speaker's talk or research when it is

  5. 32 CFR 651.5 - Army policies.

    Science.gov (United States)

    2010-07-01

    ... productive, meaningful way from the standpoint of environmental quality. (b) The Army will actively... their NEPA responsibility. Only through alertness, foresight, notification through the chain of command... documentation should incorporate the values of NEPA and: (1) Establish the scope of the analysis through full...

  6. Economic Value of Army Foreign Military Sales

    Science.gov (United States)

    2015-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT ECONOMIC VALUE OF ARMY FOREIGN MILITARY SALES ...this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data...sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden

  7. Army Information Operations Officer Needs Analysis Report

    Science.gov (United States)

    2016-03-01

    helping with formatting the final report iv ARMY INFORMATION OPERATIONS OFFICER NEEDS ANALYSIS REPORT EXECUTIVE SUMMARY Research...time.” One IO officer suggested the IPO try to get a access the database that has all the old APA reports archived as a way to look at assessment

  8. Fostering Creative Thinking in the Institutional Army

    Science.gov (United States)

    2016-06-10

    organizational structure, training, leadership development and education, personnel, facilities, and policies foster creative thinking ? These questions will be...in fostering creative thinking at the organizational level across the US Army. This assumption justifies researching if CGSOC fosters creative...creative thinking . Doctrine and policy and organizational structure and personnel will also be grouped to consolidate analysis. While the researcher will

  9. The Army's Role in Nation Building

    National Research Council Canada - National Science Library

    Edmonds, Mark L

    2009-01-01

    ... should be and how to execute this task. The tasks associated with nation building are part of the Army's core competencies under the auspices of 'Stability Operations', and are now cited in doctrine in the recently published Field Manual 3-07...

  10. Shell Shock and the Kloppe: war neuroses amongst British and Belgian troops during and after the First World War.

    Science.gov (United States)

    Reid, Fiona; Van Everbroeck, Christine

    2014-01-01

    During the First World War combatants of all armies were prey to nervous disorders or psychological breakdown. These war neuroses were a response to the highly-industrialised nature of the warfare as well as to the fatigue engendered over four years of intense conflict. Yet while fear and mental breakdown were universal, national responses varied. A comparison of British and Belgian shell shock indicates that men suffered in very similar ways but that symptoms met with rather different responses: in Britain treatment and diagnostic regimes stressed the importance of class difference and shell shock was often linked to cowardice. These issues were not of overriding importance in the Belgian army. In the longer term shell shock became, and remained, a topic of political and social concern in Britain whereas in Belgium men suffering from kloppe (extreme fear) tended to be forgotten and the topic has not excited much popular interest or scholarly attention. Yet despite these differences one overarching theme remains clear, namely that despite the extensive experience of war neuroses during and after the First World War, there still remains a fierce stigma about the mental wounds of war.

  11. Game theory: applications for surgeons and the operating room environment.

    Science.gov (United States)

    McFadden, David W; Tsai, Mitchell; Kadry, Bassam; Souba, Wiley W

    2012-11-01

    Game theory is an economic system of strategic behavior, often referred to as the "theory of social situations." Very little has been written in the medical literature about game theory or its applications, yet the practice of surgery and the operating room environment clearly involves multiple social situations with both cooperative and non-cooperative behaviors. A comprehensive review was performed of the medical literature on game theory and its medical applications. Definitive resources on the subject were also examined and applied to surgery and the operating room whenever possible. Applications of game theory and its proposed dilemmas abound in the practicing surgeon's world, especially in the operating room environment. The surgeon with a basic understanding of game theory principles is better prepared for understanding and navigating the complex Operating Room system and optimizing cooperative behaviors for the benefit all stakeholders. Copyright © 2012 Mosby, Inc. All rights reserved.

  12. Albert Ross Tilley: The legacy of a Canadian plastic surgeon.

    Science.gov (United States)

    Mowbrey, Kevin

    2013-01-01

    The present article chronicles the career of Dr Albert Ross Tilley, one of the most important Canadian plastic surgeons of the 20th century. Tilley is most well known for his innovations of burn management during World War II and his treatment of a group of burn patients known affectionately as the 'Guinea Pig Club'. In addition to the superb surgical skills he applied to the physical wounds of his patients, Tilley was also a pioneer of caring for the emotional and psychological afflictions suffered by many airmen of World War II. As one of the founding fathers of the Canadian Society of Plastic Surgeons, Tilley's work was instrumental in establishing the specialty and ensured its prosperity for years to come. Serving in the capacity of leader, educator and innovator, Tilley remains one of Canada's most decorated physicians, and his body of work encompasses contributions to the medical field that remain significant and beneficial to patient care to this day.

  13. The veterinary surgeon in natural disasters: Italian legislation in force.

    Science.gov (United States)

    Passantino, A; Di Pietro, C; Fenga, C; Passantino, M

    2003-12-01

    Law No. 225/1992 established a National Service of Civil Protection, with the important role of 'safeguarding life, goods, settlements and the environment from damage deriving from natural disasters, catastrophes and calamities' (art. 1). This law arranges civil protection as a co-ordinated system of responsibilities administrated by the state, local and public authorities, the world of science, charitable organisations, the professional orders and other institutions, and the private sector (art. 6). The President of the Republic's Decree No. 66/1981 'Regulation for the application of Law No. 996/1970, containing norms for relief and assistance to populations hit by natural disasters--Civil Protection' mentions veterinary surgeons among the people that are called upon to intervene. In fact, in natural disasters the intervention of the veterinary surgeon is of great importance. The authors examine these laws and other legislation relating to the National Service of Civil Protection.

  14. Surgeon Design Interface for Patient-Specific Concentric Tube Robots.

    Science.gov (United States)

    Morimoto, Tania K; Greer, Joseph D; Hsieh, Michael H; Okamura, Allison M

    2016-06-01

    Concentric tube robots have potential for use in a wide variety of surgical procedures due to their small size, dexterity, and ability to move in highly curved paths. Unlike most existing clinical robots, the design of these robots can be developed and manufactured on a patient- and procedure-specific basis. The design of concentric tube robots typically requires significant computation and optimization, and it remains unclear how the surgeon should be involved. We propose to use a virtual reality-based design environment for surgeons to easily and intuitively visualize and design a set of concentric tube robots for a specific patient and procedure. In this paper, we describe a novel patient-specific design process in the context of the virtual reality interface. We also show a resulting concentric tube robot design, created by a pediatric urologist to access a kidney stone in a pediatric patient.

  15. Burnout syndrome in dental surgeons from Lima Metropolitan hospitals

    OpenAIRE

    Robles Velásquez, Ronald; Cáceres Gutiérrez, Lita

    2014-01-01

    This research was carried out in a probabilistic randomized sample of 117 dental surgeons who work in hospitals from the Armed Forces, Social Security and the Ministry of Health (MINSA) from Lima and El Callao, during the months of March and April 2008. Its objective was to determine the levels of the Burnout Syndrome in this population and its association with some socio-demographic, labor and general health variables. The Maslash Burnout Inventory questionnaire, as well as a personal data s...

  16. [Pierre Mornard (1883-1929), unrecognized plastic surgeon].

    Science.gov (United States)

    Glicenstein, J

    2017-02-01

    Many operations of aesthetic surgery were described between 1920 and 1930. Several French surgeons are recognized as pioneers of the speciality. Pierre Mornard (1883-1929) published numerous articles of plastic and aesthetic surgery between 1925 and 1929 the date of his death. The articles were illustrated with drawings of surgery he had practiced. He described in 1929 the first abdominoplasty with umbilical transposition. Pierre Mornard can be considered a pioneer of aesthetic surgery. Copyright © 2016. Published by Elsevier Masson SAS.

  17. Surgeon preferences regarding antibiotic prophylaxis for ballistic fractures.

    Science.gov (United States)

    Marecek, Geoffrey S; Earhart, Jeffrey S; Gardner, Michael J; Davis, Jason; Merk, Bradley R

    2016-06-01

    Scant evidence exists to support antibiotic use for low velocity ballistic fractures (LVBF). We therefore sought to define current practice patterns. We hypothesized that most surgeons prescribe antibiotics for LVBF, prescribing is not driven by institutional protocols, and that decisions are based on protocols utilized for blunt trauma. A web-based questionnaire was emailed to the membership of the Orthopaedic Trauma Association (OTA). The questionnaire included demographic information and questions about LVBF treatment practices. Two hundred and twenty surgeons responded. One hundred and fifty-four (70 %) respondents worked at a Level-1 trauma center, 176 (80 %) had received fellowship education in orthopaedic trauma and 104 (47 %) treated at least 10 ballistic fractures annually. Responses were analyzed with SAS 9.3 for Windows (SAS Institute Inc, Cary, NC). One hundred eighty-six respondents (86 %) routinely provide antibiotics for LVBF. Those who did not were more apt to do so for intra-articular fractures (8/16, 50 %) and pelvic fractures with visceral injury (10/16, 63 %). Most surgeons (167, 76 %) do not believe the Gustilo-Anderson classification applies to ballistic fractures, and (20/29, 70 %) do not base their antibiotic choice on the classification system. Few institutions (58, 26 %) have protocols guiding antibiotic use for LVBF. Routine antibiotic use for LVBF is common; however, practice is not dictated by institutional protocol. Although antibiotic use generally follows current blunt trauma guidelines, surgeons do not base their treatment decisions the Gustilo-Anderson classification. Given the high rate of antibiotic use for LVBF, further study should focus on providing evidence-based treatment guidelines.

  18. A basic introduction to statistics for the orthopaedic surgeon.

    Science.gov (United States)

    Bertrand, Catherine; Van Riet, Roger; Verstreken, Frederik; Michielsen, Jef

    2012-02-01

    Orthopaedic surgeons should review the orthopaedic literature in order to keep pace with the latest insights and practices. A good understanding of basic statistical principles is of crucial importance to the ability to read articles critically, to interpret results and to arrive at correct conclusions. This paper explains some of the key concepts in statistics, including hypothesis testing, Type I and Type II errors, testing of normality, sample size and p values.

  19. Surgeon-Based 3D Printing for Microvascular Bone Flaps.

    Science.gov (United States)

    Taylor, Erin M; Iorio, Matthew L

    2017-07-01

    Background  Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods  Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models. These were printed in the surgeon's office as 3D models for the planned reconstruction. Vascularized bone flaps were designed intraoperatively based on the 3D printed models. Results  Three-dimensional models were created for intraoperative use in vascularized bone flaps, including (1) medial femoral trochlea (MFT) flap for scaphoid avascular necrosis and nonunion, (2) MFT flap for lunate avascular necrosis and nonunion, (3) medial femoral condyle (MFC) flap for wrist arthrodesis, and (4) free fibula osteocutaneous flap for distal radius septic nonunion. Templates based on the 3D models allowed for the precise and rapid contouring of well-vascularized bone flaps in situ, prior to ligating the donor pedicle. Conclusions  Surgeon-based 3D printing is a feasible, innovative technology that allows for the precise and rapid contouring of models that can be created in various configurations for pre- and intraoperative planning. The technology is easy to use, convenient, and highly economical as compared with traditional send-out manufacturing. Surgeon-based 3D printing is a useful adjunct in vascularized bone transfer. Level of Evidence  Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Project Muskan : Social responsibility of the plastic surgeon

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

    Full Text Available Although exact statistics are not available, Indian plastic surgeons see around 7,00,000-8,00,000 burn admissions annually with around 10,00,000 cleft patients yet to be operated. In spite of this voluminous load, India does not have national health programs for the various deformities Indian plastic surgeons typically treat. As Plastic Surgeons, it is our social responsibility to treat these patients and bring ′ muskan ′ (smile in Hindi back into their lives. Project Muskan was initiated as an innovative model for targeting these patients and is probably one of its kind in the field of plastic surgery in our country. It is unique because it is a perfect collaboration of government institutions, a Non Government Organization (NGO, and cooperative sectors providing free health care at the doorstep. Identification of the patients was done with the help of the extensive milk dairy network in the state of Gujarat. Provision of transport and other facilities was done by the NGOs and quality health care provision was taken care of by the government hospital. Project Muskan started from a single village but now covers around 3000 villages and tribal areas of Gujarat. It is a system that can be easily reproducible in all hospitals and has reestablished the faith of the common man in government institutes.