WorldWideScience

Sample records for evaluating surgical innovation

  1. An approach to the ethical evaluation of innovative surgical procedures.

    Science.gov (United States)

    Tan, Veronique K M; Chow, Pierce K H

    2011-01-01

    While there is an ethical obligation to improve clinical outcomes by developing better therapies, surgical innovation has largely progressed without the strict regulations required of novel pharmaceutical products. We explore the reasons why new surgical techniques are frequently introduced without the benefit of randomised controlled trials, and present an approach to the ethical evaluation of novel surgical procedures.

  2. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  3. Surgical innovation: the ethical agenda

    Science.gov (United States)

    Broekman, Marike L.; Carrière, Michelle E.; Bredenoord, Annelien L.

    2016-01-01

    care system might particularly enrich the necessary future discussion on surgical innovation: integration of research and practice and a moral emphasis on “learning activities.” Future research should evaluate whether the learning health care system and its adjacent moral framework provides ethical guidance for evidence-based surgery. PMID:27336866

  4. Surgical innovation : The ethical agenda

    NARCIS (Netherlands)

    Broekman, Marike L.|info:eu-repo/dai/nl/343152347; Carrière, Michelle E.; Bredenoord, Annelien L.|info:eu-repo/dai/nl/240834666

    2016-01-01

    The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation. Although the call for evidence-based practice in surgery is increasingly high on

  5. Opportunity cost in the evaluation of surgical innovations: a case study of laparoscopic versus open colectomy.

    Science.gov (United States)

    Chatterjee, Abhishek; Chen, Lilian; Goldenberg, Elie A; Bae, Harold T; Finlayson, Samuel R G

    2010-05-01

    Opportunity cost is the value of an activity forgone for participation in some other activity. With respect to surgery, an innovation incurs an opportunity cost when it uses additional operating time that could otherwise be used in a productive way. This report describes an example of assessing opportunity cost in the transition from open to laparoscopic colectomy using pooled analysis data from the surgical literature and hospital financial data. A MEDLINE literature search was performed between the years 1998 and 2008. Data were pooled from the identified studies used for the statistical analysis of cost and operating room time differences between laparoscopic versus open colectomy. The analysis identified five commonly performed, elective general surgery procedures. The profit margins of these procedures then were determined and divided by their average surgical time to calculate a range of opportunity cost multipliers. Finally, these opportunity cost multipliers were applied to the additional time required for performance of laparoscopic colectomy to demonstrate that procedure's true overall cost. Seven comparative studies were identified. The pooled analysis showed that the operating time was longer for a laparoscopic colectomy by 27.08 min (p costs ($104.67 difference), but this difference was not statistically significant (p = 0.28). The five commonly performed, elective procedures chosen were laparoscopic cholecystectomy, laparoscopic inguinal hernia repair, breast biopsy, partial mastectomy, and total thyroidectomy, and their opportunity cost multipliers ranged from $9 to $26 per minute. Depending on the opportunity cost multiplier used, the opportunity cost of an additional 27.08 min required to perform laparoscopic colectomy ranges from $243.72 to $704.08, which is approximately two to six times greater than the point estimate of the difference in total costs based on published studies. Although frequently overlooked, opportunity cost is a potentially

  6. Responsible Innovation in Children's Surgical Care.

    Science.gov (United States)

    2017-01-01

    Advances in medical care may occur when a change in practice incorporates a new treatment or methodology. In surgery, this may involve the translation of a completely novel concept into a new procedure or device or the adaptation of existing treatment approaches or technology to a new clinical application. Regardless of the specifics, innovation should have, as its primary goal, the enhancement of care leading to improved outcomes from the patient's perspective. This policy statement examines innovation as it pertains to surgical care, focusing on some of the definitions that help differentiate applied innovation or innovative therapy from research. The ethical challenges and the potential for conflict of interest for surgeons or institutions seeking to offer innovative surgical therapy are examined. The importance of engaging patients and families as "innovation partners" to ensure complete transparency of expectations from the patient's and provider's perspectives is also examined, with specific emphasis on cultural competence and mutually respectful approaches. A framework for identifying, evaluating, and safely implementing innovative surgical therapy in children is provided. Copyright © 2017 by the American Academy of Pediatrics.

  7. An innovative method to evaluate the suture compliance in sealing the surgical wound lips

    Science.gov (United States)

    Saleh, Farid; Palmieri, Beniamino; Lodi, Danielle; Al-Sebeih, Khalid

    2008-01-01

    Background and aim: The increasing number of surgical procedures performed with local anesthesia, followed by immediate patient discharge from the hospital, emphasizes the need for a tight waterproof suture that is capable of maintaining its tensile strength in the postoperative phase when the wound tumescence, edema due to the anesthetic drug, and surgical trauma disappear. Moreover, the issue of having an accurate surgical wound closure is very relevant in vivo in order to prevent hemorrhage and exogenous microbial infections. This study aimed at designing a new a lab technique that could be used for evaluating the best surgical material. Using such a technique, we compared the wound-lip-sealing properties of three commonly-used suture threads, namely polyurethane, polypropylene, and polyamide. Materials and methods: The mechanical properties of same-size suture threads made from polyurethane, polypropylene, and polyamide, were compared in order to define the one that possess the best elastic properties by being able to counteract the tension-relaxation process in the first 12 hours following surgery. The tension holding capacity of the suture materials was measured in both in vivo and in vitro experiments. The surface area of the scar associated with the three different suture threads was measured and compared, and the permeability of the three different suture threads was assessed at 0 minute, 2 minute, 4 minute, 6 minute, and 8 minute- interval. Results: Results showed that polyurethane suture threads had significantly (P suture threads. Moreover, polyurethane suture threads were significantly (P suture thread types (polypropylene and polyamide). This impermeability was also associated with a tighter wound-lip-sealing ability, and with significantly (P suturing. This always raises the question about which suture to use to avoid the above problems. This study provides evidence that the new technique developed in our lab could be used to compare the wound

  8. Innovative Evaluation

    Science.gov (United States)

    Maxfield, Margaret

    1974-01-01

    Evaluation procedures meeting the criterion of "facilitating student learning" are discussed. Qualitative reporting with written comments to students is advocated. Other suggestions include giving a quiz during the first week of the course, allowing for retesting, and use of an occasional oral test. Some suggestions for grading are given. (LS)

  9. Surgical innovation: the ethical agenda: A systematic review.

    Science.gov (United States)

    Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

    2016-06-01

    particularly enrich the necessary future discussion on surgical innovation: integration of research and practice and a moral emphasis on "learning activities." Future research should evaluate whether the learning health care system and its adjacent moral framework provides ethical guidance for evidence-based surgery.

  10. [Statement: Requirements for the assessment of surgical innovations].

    Science.gov (United States)

    Seidel, Dörthe; Pieper, Dawid; Neugebauer, Edmund

    2015-01-01

    The term "innovation" refers to new products, but also to the process of developing and distributing new products and procedures. The operative disciplines are often associated with innovations because of their continuous, stepwise adaptation of daily practice to established procedures. Medical devices play a significant role in integrating surgical technology with surgical experience. The success of a surgical innovation and other invasive treatments does not only depend on the surgical procedure, but also on the context of the whole treatment process including the pre- and postoperative phase, the interaction of the surgical team and the setting. High standards have been set for the assessment of surgical innovations in terms of patient safety, efficacy and patient benefit, which will be discussed in the present paper. A stepwise approach to evaluation will be used, split into preclinical development, clinical development (feasibility and safety), evaluation phase (efficacy and patient benefit) and longtime surveillance. Our paper is based on the expert-based consented IDEAL approach as well as the consented recommendations of the European Association of Endoscopic Surgery (EAES). (As supplied by publisher). Copyright © 2015. Published by Elsevier GmbH.

  11. Developing Tomorrow’s Innovative Surgical Solutions

    OpenAIRE

    Breedon, P

    2009-01-01

    Designers are increasingly becoming aware of the potential use and integration of smart materials and technologies within their designs. One of the critical steps towards building innovative surgical solutions will be to link physicians and product designers utilising the appropriate materials and technologies to provide tangible improvements in patient care and treatment.

  12. Developing Tomorrow’s Innovative Surgical Solutions

    Directory of Open Access Journals (Sweden)

    Philip Breedon

    2009-11-01

    Full Text Available Designers are increasingly becoming aware of the potential use and integration of smart materials and technologies within their designs. One of the critical steps towards building innovative surgical solutions will be to link physicians and product designers utilising the appropriate materials and technologies to provide tangible improvements in patient care and treatment.

  13. Evaluation of innovation processes

    Directory of Open Access Journals (Sweden)

    Jakub Tabas

    2012-01-01

    Full Text Available In present, innovations are spoken as an engine of the world economy because the innovations are transforming not only business entities but the whole industries. The innovations have become a necessity for business entities in order to survive on floating challenging markets. This way, innovations are driving force of companies’ performance. The problem which arises here is a question of measurement innovation’s effect on the financial performance of company or selection between two or more possible variants of innovation’s realization. Various authors which are focused on innovations processes are divided into two groups in their attitudes towards the question of influence of innovations on financial performance of companies. One group of the authors present the idea that any reliable measurement is not possible or efficient. The second group of authors present some methods theoretically applicable on this measurement but they base their approaches mostly on the methods of measurement of investments effectiveness or they suggest employment of indicators or ratios which wouldn’t be clearly connected with the outcome of innovation process. The aim of submitted article is to compare different approaches to evaluation of the innovation processes. The authors compare various approaches here and by use of analysis and synthesis, they determine their own method how to measure outcome of innovation process.

  14. [Pioneering surgical innovations in Germany : Part 2: public funding and origins of surgical innovations].

    Science.gov (United States)

    Weber, S; Haverich, A

    2016-05-01

    In recent years research that conforms with evidence-based medicine (EBM) has been demanded even in surgery. Uniform studies were carried out to prove the benefits of new procedures; however, compared to other research sectors, public third party funding for surgical research was significantly cut back. Collation of special features in surgery with respect to external funding of surgical top level research. Examination of the benefits of a continuous promotion and of organizations involved in research. Part one of this investigation presented the methods used to identify and analyze pioneering research in surgery. Out of a total of 15 revolutionary innovations only 3 projects were financed by external funding and 2 projects received indirect financial support as a result of a cooperation with the medical industry. This demonstrates that the majority of projects were neither directly nor indirectly subsidized. Apart from one instance the majority of innovations were generated by university hospitals highly active in research. In effect, the non-existing external funding for outstanding surgical innovations and hospitals suggests that a reformation of surgical research is required. To strengthen the quality of innovations in surgery a concentration of funding to institutions that are highly active in research makes sense. Institutional funding directly linked to a project should form a key component of support particularly in the early stages of development.

  15. A Review of Innovations in Rhegmatogenous Retinal Detachment Surgical Techniques

    Directory of Open Access Journals (Sweden)

    Achia Nemet

    2017-01-01

    Full Text Available Rhegmatogenous retinal detachment (RRD requires surgical intervention for its repair. There are variable techniques used for this purpose, and they are all being continuously refined. In this review, we detail the recent innovations in surgical management of RRD and proliferative vitreoretinopathy (PVR.

  16. Dramatic innovations in modern surgical subspecialties

    National Research Council Canada - National Science Library

    Ball, Chad G; Sutherland, Francis; Kirkpatrick, Andrew W; Dixon, Elijah; Maclean, Anthony R; Mack, Lloyd A; Feliciano, David V; Rajani, Ravi R; Karmy-Jones, Riyad; Buie, W Donald; Temple, Walley J; Rozycki, Grace S; Simeone, Alan

    2010-01-01

    ... in outpatient surgery, sentinel lymph node theory in surgical oncology, endovascular and wire-based skills in vascular and cardiovascular surgery, and the acceptance of abnormal anatomy through damage...

  17. Mandibular Surgical Navigation: An Innovative Guiding Method.

    Science.gov (United States)

    Abbate, Vincenzo; Orabona, Giovanni Dell' Aversana; Solari, Domenico; Bonavolontà, Paola; Iaconetta, Giorgio; Califano, Luigi

    2017-11-01

    Mandibular osteotomies are usually required to treat craniomaxillofacial disorders. Losses of mandibular continuity result in esthetic and functional deficiency. During the past 30 years, the spread of the computer-assisted surgery techniques, rapid prototyping, and surgical navigation technique has improved the reliability and the outcomes of mandibular resections and reconstructions, by providing realtime feedback to surgeon. Recent studies reported the feasibility and the precision of surgical navigation applied to mandibular surgical resection and reconstruction with fibula flap but none of them describes a method to navigate the jaw allowing its full motility during the operation. To our knowledge, this is the first-time description of such a kind of method to navigate the jaw positioning the dynamic reference frame directly on the mandibular branch to maintain the full mobility of the mandible. The method described in our series has allowed an accurate surgical navigation of the jaw without the need of intermaxillary fixation. This technique could greatly facilitate resection and reconstructive surgical procedures of the jaw while ensuring precision and accuracy. The encouraging results obtained in the present report suggest to further investigate the possibilities of this technique to better define the method and its indications.

  18. Impact of surgical innovation on tissue repair in the surgical patient.

    Science.gov (United States)

    Tevlin, R; Atashroo, D; Duscher, D; Mc Ardle, A; Gurtner, G C; Wan, D C; Longaker, M T

    2015-01-01

    Throughout history, surgeons have been prolific innovators, which is hardly surprising as most surgeons innovate daily, tailoring their intervention to the intrinsic uniqueness of each operation, each patient and each disease. Innovation can be defined as the application of better solutions that meet new requirements, unarticulated needs or existing market needs. In the past two decades, surgical innovation has significantly improved patient outcomes, complication rates and length of hospital stay. There is one key area that has great potential to change the face of surgical practice and which is still in its infancy: the realm of regenerative medicine and tissue engineering. A literature review was performed using PubMed; peer-reviewed publications were screened for relevance in order to identify key surgical innovations influencing regenerative medicine, with a focus on osseous, cutaneous and soft tissue reconstruction. This review describes recent advances in regenerative medicine, documenting key innovations in osseous, cutaneous and soft tissue regeneration that have brought regenerative medicine to the forefront of the surgical imagination. Surgical innovation in the emerging field of regenerative medicine has the ability to make a major impact on surgery on a daily basis. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  19. INNOVATIVE TECHNOLOGY EVALUATION REPORT ...

    Science.gov (United States)

    The Split Core Sampler for Submerged Sediments (Split Core Sampler) designed and fabricated by Arts Manufacturing & Supply, Inc., was demonstrated under the U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation Program in April and May 1999 at sites in EPA Regions 1 and 5, respectively. In addition to assessing ease of sampler operation, key objectives of the demonstration included evaluating the samplers ability to (1) consistently collect a given volume of sediment, (2) consistently collect sediment in a given depth interval, (3) collect samples with consistent characteristics from a homogenous layer of sediment, and (4) collect samples under a variety of site conditions. This report describes the demonstration results for the Split Core Sampler and two conventional samplers (the Hand Corer and Vibrocorer) used as reference samplers. During the demonstration, the Split Core Sampler performed as well as or better than the reference samplers. Based on visual observations, both the Split Core Sampler and reference samplers collected partially compressed samples of consolidated and unconsolidated sediments from the sediment surface downward; sample representativeness may be questionable because of core shortening and core compression. Sediment stratification was preserved for both consolidated and unconsolidated sediment samples collected by the Split Core Sampler and reference samplers. No sampler was able to collect samples

  20. A Century of Surgical Innovation at a Boston Hospital.

    Science.gov (United States)

    Swain, JaBaris D; Sharma, Gaurav; Rumma, Rowza T; Fisichella, P Marco; Whang, Edward

    2017-02-01

    Innovation has been a central focus of the Department of Surgery at the Brigham and Women's Hospital since its very inception. Here we review examples of innovations originating in this Department and analyze factors that have been critical to successful innovation. Finally, we discuss challenges to sustainability of innovation in this Department. Narrative review of the literature, interviews, and personal observations. Examples of innovations reviewed here were each dependent on three critical elements: 1) multidisciplinary collaboration among surgical innovators and individuals outside of surgery who offered complementary skills and expertise, 2) a rich institutional environment that sustained a diverse complement of innovators working in close proximity, and 3) Department Chairmen who facilitated the work of innovators and promoted their contributions, rather than seeking personal prestige or financial gain. Contemporary challenges to sustainability of innovation include the prevailing emphasis on clinical efficiency and on cost containment. We have identified factors critical to successful innovation in a Department of Surgery. The relevance of these factors is unlikely to be diminished, even in the changing landscape of modern medicine.

  1. Innovative financing for rural surgical patients: Experience in mission hospitals

    Directory of Open Access Journals (Sweden)

    Gnanaraj Jesudian

    2016-01-01

    Full Text Available In rural India most of the surgical patients become impoverished due to surgical treatment pushing several families below poverty line. We describe the various methods that we tried to help these patients pay for the surgical procedures without becoming impoverished. Some of them were successful and many of them were not so successful. The large turnover and innovative methods helped the mission hospitals to serve the poor and the marginalized. Some of these methods might not be relevant in areas other than Northeast India while many could be used in other areas.

  2. An innovative surgical tool: air jet dissector.

    Science.gov (United States)

    Çelik, Bülent; Orbay, Toygun

    2010-10-01

    This study aims to demonstrate and test a new surgical tool which is designed and manufactured in our institution for neurosurgical operations. The device is referred as 'air jet dissector'. After fabrication of the device, we tested it on 32 New Zealand rabbits. The effectiveness of the device was compared with a well-known ultrasonic aspirator (CUSA) in an experimental design of cranial corticotomies. Dissection quality, intracranial hemorrhage, edema formation and astroglial and microglial reactions were compared for both devices. Regarding post-operative edema formation and intracranial hemorrhage, the air jet dissector was found superior to the CUSA system. Additionally, the pre-operative comfort of the device was also better than the CUSA. In our opinion, this new design has a future in neurosurgical operating rooms. Further refinements and experimental testing is required.

  3. Innovation in pediatric surgery: the surgical innovation continuum and the ETHICAL model.

    Science.gov (United States)

    Schwartz, Jennifer A T

    2014-04-01

    Innovations are indispensable to the practice and advancement of pediatric surgery. Children represent a special type of vulnerable population and must be protected since they do not have legal capacity to consent, and their parent's judgment may be compromised in circumstances when the child is very ill or no adequate therapy exists. In an effort to protect patients, legislators could pass and enforce laws that prohibit or curtail surgical innovations and thus stifle noble advancement of the practice. The goals of this paper are, 1) To clearly define the characteristics of surgical innovation types so interventions may be classified into 1 of 3 distinct categories along a continuum: Practice Variation, Transition Zone, and Experimental Research, and 2) To propose a practical systematic method to guide surgeon decision-making when approaching interventions that fall into the "Transition Zone" category on the Surgical Intervention Continuum. The ETHICAL model allows those that know the intricacies and nuances of pediatric surgery best, the pediatric surgeons and professional pediatric surgical societies, to participate in self-regulation of innovation in a manner that safeguards patients without stifling creativity or unduly hampering surgical progress. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Innovation in surgical technology and techniques: Challenges and ethical issues.

    Science.gov (United States)

    Geiger, James D; Hirschl, Ronald B

    2015-06-01

    The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery.

    Science.gov (United States)

    Garas, George; Cingolani, Isabella; Panzarasa, Pietro; Darzi, Ara; Athanasiou, Thanos

    2017-01-01

    Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations. Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus®) was performed (1974-2014). The virality of each cascade was measured as was innovation value (measured by the innovation index) derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample-NIS®). Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width) were found to correlate closely with the ranking by innovation value (Spearman's rank correlation coefficient = 0.758 (p = 0.01), 0.782 (p = 0.008), 0.624 (p = 0.05), respectively) which in turn matches the ranking based on real world big data from the NIS® (Spearman's coefficient = 0.673;p = 0.033). Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different specialties. The novel surgical innovation metrics developed may

  6. Operability score: an innovative tool for quantitative assessment of operability in comparative studies on surgical anatomy.

    Science.gov (United States)

    Gagliardi, Filippo; Boari, Nicola; Roberti, Fabio; Caputy, Anthony J; Mortini, Pietro

    2014-09-01

    Comparative anatomical studies have proved to be invaluable in the evaluation of advantages and drawbacks of single approaches to access established target areas. Approach-related exposed areas do not necessarily represent useful areas when performing surgical manoeuvres. Accordingly the concept of "operability" has recently been introduced as a qualitative assessment of the ability to execute surgical manoeuvres. The authors propose an innovative model for the quantitative assessment of the operability, defined as "operability score" (OS), which can be effectively and easily applied to comparative studies on surgical anatomy. A microanatomical study was conducted on six cadaveric heads. Morphometric measurements were collected and operability scores in selected target points of the surgical field were calculated. As illustrative example, the operability score was applied to the extradural subtemporal transzygomatic approach (ESTZ). The operability score is effective in grading system of surgical operability, and instruments manipulation capability. It is a useful tool to evaluate, in a single approach, areas that can be exposed, and to quantify how those areas are suitable for surgical manoeuvres. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation.

    Science.gov (United States)

    de Ruijter, V; Halvax, P; Dallemagne, B; Swanström, L; Marescaux, J; Perretta, S

    2015-01-01

    Technological innovation in surgical science and healthcare is vital and calls for close collaboration between engineering and surgery. To meet this objective, BEST was designed as a free sustainable innovative teaching method for young professionals, combining surgery, engineering, and business in a multidisciplinary, high-quality, low-cost, and learning-by-doing philosophy. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions of this innovative educational method. BEST educational method is delivered in two parts: the first component consisting of live streaming or pre-recorded online lectures, with an interdisciplinary profile focused on surgery, engineering, and business. The second component is an annual 5-day on-site course, organized at IRCAD-IHU, France. The program includes workshops in engineering, entrepreneurship team projects, and in-depth hands-on experience in laparoscopy, robotic surgery, interventional radiology, and flexible endoscopy with special emphasis on the interdisciplinary aspect of the training. A panel of surgeons, engineers, well-established entrepreneurs, and scientists assessed the team projects for potential patent application. From November 2011 till September 2013, 803 individual and institutional users from 79 different countries attended the online course. In total, 134 young professionals from 32 different countries applied to the onsite course. Sixty participants were selected each year for the onsite course. In addition, five participants were selected for a web-based team. Thirteen provisional patents were filed for the most promising projects. BEST proved to be a global talent incubator connecting students to high-quality education despite institutional and economical boundaries. Viable and innovative ideas arose from this revolutionary approach which is likely to spin-off significant technology transfer and lead the way for future interdisciplinary hybrid surgical

  8. Evaluating innovation networks in emerging technologies

    NARCIS (Netherlands)

    Valk, T. van der; Chappin, M.M.H.; Gijsbers, G.W.

    2011-01-01

    Interorganisational innovation networks are increasingly important for innovation in emerging technology fields. The performance of such networks can have a large impact on the future development of emerging technologies. A useful framework for the evaluation of innovation networks however does not

  9. Surgical innovation-enhanced quality and the processes that assure patient/provider safety: A surgical conundrum.

    Science.gov (United States)

    Bruny, Jennifer; Ziegler, Moritz

    2015-12-01

    Innovation is a crucial part of surgical history that has led to enhancements in the quality of surgical care. This comprises both changes which are incremental and those which are frankly disruptive in nature. There are situations where innovation is absolutely required in order to achieve quality improvement or process improvement. Alternatively, there are innovations that do not necessarily arise from some need, but simply are a new idea that might be better. All change must assure a significant commitment to patient safety and beneficence. Innovation would ideally enhance patient care quality and disease outcomes, as well stimulate and facilitate further innovation. The tensions between innovative advancement and patient safety, risk and reward, and demonstrated effectiveness versus speculative added value have created a contemporary "surgical conundrum" that must be resolved by a delicate balance assuring optimal patient/provider outcomes. This article will explore this delicate balance and the rules that govern it. Recommendations are made to facilitate surgical innovation through clinical research. In addition, we propose options that investigators and institutions may use to address competing priorities. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Macquarie Surgical Innovation Identification Tool (MSIIT): a study protocol for a usability and pilot test.

    Science.gov (United States)

    Blakely, Brette; Selwood, Amanda; Rogers, Wendy A; Clay-Williams, Robyn

    2016-11-18

    Medicine relies on innovation to continually improve. However, innovation is potentially risky, and not all innovations are successful. Therefore, it is important to identify innovations prospectively and provide support, to make innovation as safe and effective as possible. The Macquarie Surgical Innovation Identification Tool (MSIIT) is a simple checklist designed as a practical tool for hospitals to identify planned surgical innovations. This project aims to test the usability and pilot the use of the MSIIT in a surgical setting. The project will run in two phases at two Australian hospitals, one public and one private. Phase I will involve interviews, focus groups and a survey of hospital administrators and surgical teams to assess the usability and system requirements for the use of the MSIIT. Current practice regarding surgical innovation within participating hospitals will be mapped, and the best implementation strategy for MSIIT completion will be established. Phase II will involve trialling the MSIIT for each surgery within the trial period by various surgical personnel. Follow-up interviews, focus groups and a survey will be conducted with trial participants to collect feedback on their experience of using the MSIIT during the trial period. Comparative data on rates of surgical innovation during the trial period will also be gathered from existing hospital systems and compared to the rates identified by the MSIIT. Ethical approval has been obtained. The results of this study will be presented to interested health services and other stakeholders, presented at conferences and published in a peer-reviewed MEDLINE-indexed journal. 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/.

  11. An overview of pre-surgical evaluation

    Directory of Open Access Journals (Sweden)

    Kurupath Radhakrishnan

    2014-01-01

    Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

  12. IDEAL framework in surgical innovation applied on laparoscopic niche repair.

    Science.gov (United States)

    Nikkels, C; Vervoort, Anke J M W; Mol, Ben Willem; Hehenkamp, Wouter J K; Huirne, Judith A F; Brölmann, Hans A M

    2017-08-01

    The research objective of the current systematic literature review is to classify the laparoscopic niche repair according to the IDEAL framework of 'innovation stages' and to recommend the required research setting to facilitate safe and properly timed implementation of the technique. In doing so, we are also able to evaluate the practical applicability of the IDEAL framework. A systematic search of the available literature on laparoscopic niche repair was performed in PubMed, Embase, and the Wiley/Cochrane library. Articles were classified according to the IDEAL framework and recommendations were given on additional required research before the technique can be safely implemented. Practical applicability of the IDEAL framework was also evaluated. Introduction of laparoscopic niche repair matches Idea (1) and Development (2a), according to the stages of IDEAL framework, although most studies are retrospective and complications have not been registered structurally in a considerable number of the articles. As feasibility and safety have been more or less established and surgery has been further developed we enter stage 2b (Exploration) and need prospective trials preferably comparing the effectiveness of laparoscopic niche repair to expectant management, the current standard care. Available studies were classified with the use of the IDEAL framework, achieving an overall IDEAL stage to be 2a Development. As clinical outcomes, though poorly registered, have been substantially improved, laparoscopic niche repair needs to be carried forward by more advanced study designs. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Statistical innovations in diagnostic device evaluation.

    Science.gov (United States)

    Yu, Tinghui; Li, Qin; Gray, Gerry; Yue, Lilly Q

    2016-01-01

    Due to rapid technological development, innovations in diagnostic devices are proceeding at an extremely fast pace. Accordingly, the needs for adopting innovative statistical methods have emerged in the evaluation of diagnostic devices. Statisticians in the Center for Devices and Radiological Health at the Food and Drug Administration have provided leadership in implementing statistical innovations. The innovations discussed in this article include: the adoption of bootstrap and Jackknife methods, the implementation of appropriate multiple reader multiple case study design, the application of robustness analyses for missing data, and the development of study designs and data analyses for companion diagnostics.

  14. Technological Innovations in Surgical Approach for Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Brian Hung-Hin Lang

    2010-01-01

    Full Text Available Over the last decade, surgeons have witnessed dramatic changes in surgical practice as a result of the introduction of new technological advancement. Some of these changes include refinement of techniques in thyroid cancer surgery. The development of various endoscopic thyroidectomy techniques, the addition of the da Vinci robot, and the use of operative adjuncts in thyroid surgery, such as intraoperative neuromonitoring and quick intraoperative parathyroid hormone, have made thyroid cancer surgery not only safer and better accepted by patients with thyroid cancer but also offer them more surgical treatment options.

  15. Technological innovations in surgical approach for thyroid cancer.

    Science.gov (United States)

    Lang, Brian Hung-Hin; Lo, Chung-Yau

    2010-01-01

    Over the last decade, surgeons have witnessed dramatic changes in surgical practice as a result of the introduction of new technological advancement. Some of these changes include refinement of techniques in thyroid cancer surgery. The development of various endoscopic thyroidectomy techniques, the addition of the da Vinci robot, and the use of operative adjuncts in thyroid surgery, such as intraoperative neuromonitoring and quick intraoperative parathyroid hormone, have made thyroid cancer surgery not only safer and better accepted by patients with thyroid cancer but also offer them more surgical treatment options.

  16. Public Service Innovation And Evaluation Indicators

    OpenAIRE

    Cruz S.; Paulino S.

    2013-01-01

    This paper analyzes innovation in public services with emphasis on the application of evaluation indicators. It considers the clean development mechanism (CDM) projects developed in the Bandeirantes and São João landfills, both located in the city of São Paulo, Brazil. There are two methodological procedures. First, the analysis is based on a multi-agent innovation approach. Second, there is an adaptation of the social carbon methodology (SCM) constructing indicators to assess the social and ...

  17. TEXACO GASIFICATION PROCESS - INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    This report summarizes the evaluation of the Texaco Gasification Process (TGP) conducted under the U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation (SITE) Program. The Texaco Gasification Process was developed by Texaco Inc. The TGP is a comm...

  18. Surgical wound misclassification: a multicenter evaluation.

    Science.gov (United States)

    Levy, Shauna M; Lally, Kevin P; Blakely, Martin L; Calkins, Casey M; Dassinger, Melvin S; Duggan, Eileen; Huang, Eunice Y; Kawaguchi, Akemi L; Lopez, Monica E; Russell, Robert T; St Peter, Shawn D; Streck, Christian J; Vogel, Adam M; Tsao, KuoJen

    2015-03-01

    Surgical wound classification (SWC) is used by hospitals, quality collaboratives, and Centers for Medicare and Medicaid to stratify patients for their risk for surgical site infection. Although these data can be used to compare centers, the validity and reliability of SWC as currently practiced has not been well studied. Our objective was to assess the reliability of SWC in a multicenter fashion. We hypothesized that the concordance rates between SWC in the electronic medical record and SWC determined from the operative note review is low and varies by institution and operation. Surgical wound classification concordance was assessed at 11 participating institutions between SWC from the electronic medical record and SWC from operative note review for 8 common pediatric surgical operations. Cases with concurrent procedures were excluded. A maximum of 25 consecutive cases were selected per operation from each institution. A designated surgeon reviewed the included operative notes from his/her own institution to determine SWC based on a predetermined algorithm. In all, 2,034 cases were reviewed. Overall SWC concordance was 56%, ranging from 47% to 66% across institutions. Inguinal hernia repair had the highest overall median concordance (92%) and appendectomy had the lowest (12%). Electronic medical records and reviewer SWC differed by up to 3 classes for certain cases. Surgical site infection risk stratification by SWC, as currently practiced, is an unreliable methodology to compare patients and institutions. Surgical wound classification should not be used for quality benchmarking. If SWC continues to be used, individual institutions should evaluate their process of assigning SWC to ensure its accuracy and reliability. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Evaluating Colombian SMEs’ technological innovation: Part 1: conceptual basis, evaluation methodology and characterisation of innovative companies

    Directory of Open Access Journals (Sweden)

    Óscar Fernando Castellanos Domínguez

    2007-01-01

    Full Text Available Innovative processes currently constitute one of the most important alternatives for increasing organisations’ levels of competitiveness and productivity. The Colombian state (being conscious of this has generated mechanisms aimed at encouraging technological and innovative development activities in SMEs, as was the case with the Colombian Prize for Entrepreneurial Technological Innovation for SME (Innova 2006. The experience acquired through the technical evaluation of such prize was a valuable element for identifying Colombian MSMSC innovative characteristics and trends. The present article seeks to establish the current state of innovation in SMEs from expe- rience gained when evaluating and awarding the Innova prize; a frame of reference concerning innovation and design, the methodology used for evaluating the prize and some general statistics regarding the results obtained in 2006 are thus presented. A future publication will give the factors influencing innovation taking geographical regions, sectors and impact as reference. Such results revealed innovative initiatives in strategic sectors such as computer science and services, the leadership of cities such as Bogota and MedellIn and the need for producing clear guidelines for incorporating process and product design into being part of the innovative process.

  20. Evaluating Colombian SMEs’ technological innovation: Part 1: conceptual basis, evaluation methodology and characterisation of innovative companies

    Directory of Open Access Journals (Sweden)

    Óscar Fernando Castellanos Domínguez

    2010-04-01

    Full Text Available Innovative processes currently constitute one of the most important alternatives for increasing organisations’ levels of competitiveness and productivity. The Colombian state (being conscious of this has generated mechanisms aimed at encouraging technological and innovative development activities in SMEs, as was the case with the Colombian Prize for Entrepreneurial Technological Innovation for SME (Innova 2006. The experience acquired through the technical evaluation of such prize was a valuable element for identifying Colombian MSMSC innovative characteristics and trends. The present article seeks to establish the current state of innovation in SMEs from expe- rience gained when evaluating and awarding the Innova prize; a frame of reference concerning innovation and design, the methodology used for evaluating the prize and some general statistics regarding the results obtained in 2006 are thus presented. A future publication will give the factors influencing innovation taking geographical regions, sectors and impact as reference. Such results revealed innovative initiatives in strategic sectors such as computer science and services, the leadership of cities such as Bogota and MedellIn and the need for producing clear guidelines for incorporating process and product design into being part of the innovative process.

  1. [Evaluation of technical skills in surgical training].

    Science.gov (United States)

    Kasparian, Andres C; Martinez, A C; JoverClos, R J; Chércoles, R A

    2014-01-01

    technical skills acquisition is considered to be of paramount importance in surgical training. Yet, formal assessment of technical skills is the weakest and less developed area. Currently available resources to evaluate technical skills are largely subjective, and lack of validity and reliability. Direct observation, one of the most frequently used methods, is largely biased by interpersonal subjectivity and personality traits. We propose the creation and use of a new procedure-specific tool for objective assessment of technical skills in surgery to evaluate validity and reliability. laparoscopic cholecystectomy and Lichstenstein's inguinal hernia repair were the chosen procedures. Three groups of comparison were defined according to surgical expertise: initial, intermediate, and experts. Surgeries were videorecorded in real time without identification of the patient or the surgeon. Tapes without any posterior edition were assigned to two expert surgeons in a blind and randomized sequence. A newly proposed procedure-specific rating scale was used for evaluation, as well as Reznick's OSATS global scale. Kruskal-Wallis non-parametric test was used to assess validity. p 0.8 granted reliability. from April 2010 to December 2012 36 laparoscopic cholecystectomies and 31 inguinal hernia repairs were recorded. Significant difference was found among groups of comparison for every item (ptechnical skills in surgery is feasible and useful. The tool we proposed showed construct validity and reliability. Video recording of surgical procedures grants durability over time to an ephemeral phenomenon. The objectivity is based on the explicit statements and quantification of every step to be evaluated, and the blind randomization and anonymous treatment of the sample. Sharing the same quality criteria between evaluators is of paramount importance to reach satisfactory results. The process of evaluation always implies a shortened view of the reality.

  2. The female innovation-generation consumer's evaluation

    African Journals Online (AJOL)

    user

    stimuli as it is important for retailers to understand in order to create integrated marketing strategies that align with these consumers' preferences. The authors therefore focus on the female innovation-generation's evaluation of visual displays in a retail environment communicated through two mediums (a static traditional ...

  3. Financial Evaluation Techniques, Institutions and Innovation

    DEFF Research Database (Denmark)

    Howells, John

    2003-01-01

    This paper reviews the relationship between financial evaluation and control techniques and innovative activity in a range of technological contexts. The relationship is broadly conceived to include both the financial techniques developed and deployed within the firm and theevaluative behaviour...... of financial institutions external to the firm such as venture capital and industrial investment banking. With innovative and investment opportunities tending to vary over time within an industry, it becomes apparent that there can be no permanent solution to the common problem of how to trade off financial...

  4. The Adoption of Surgical Innovations at Academic Versus Nonacademic Health Centers.

    Science.gov (United States)

    Yeo, Heather L; Kaushal, Rainu; Kern, Lisa H

    2017-09-26

    The value of the health care services provided by academic health centers (AHCs) in the United States increasingly is being questioned. AHCs play a prominent role in developing new surgical innovations, including new minimally invasive techniques, which are costly up front but can lead to significant benefits like decreased morbidity and lengths of stays. This study explored the role of AHCs in the adoption of these surgical innovations as a novel measure of their value. The authors combined data from the American Hospital Association and the State Inpatient Databases from California, Florida, Washington State, and New York. They compared the number and percentage of patients who received four new, innovative surgical procedures (vs. those who received the traditional procedures) at Council of Teaching Hospitals (COTH) hospitals to those at non-COTH hospitals from 2009 to 2011. Overall, 61.1% (27,175) of the procedures performed at COTH hospitals used new techniques, compared with 47.2% (41,680) at non-COTH hospitals, across all years (P innovations but they also adopt these new techniques more quickly than other hospitals, and thereby they provide additional benefits to patients. These findings provide an important and understudied perspective on the value of AHCs.

  5. Research on the matters of innovative projects effectiveness evaluation

    OpenAIRE

    Kharisova, Aliya; Puryaev, Aidar

    2013-01-01

    This article describes the concept of innovation and innovative projects. Based on research of domestic and foreign scientists it clarifies the concept of “innovation”. After the analysis of the features of innovative projects the authors concluded that the innovative projects effectiveness evaluation should take into account non-economic indicators such as social, ecological, resource, scientific and technological ones. The algorithm of innovative projects effectiveness evaluation taking int...

  6. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

  7. Cephalometric evaluation of surgical mandibular advancement

    Directory of Open Access Journals (Sweden)

    Eloísa Marcantônio Boeck

    2010-06-01

    Full Text Available The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°. Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm, and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm. It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM or indirectly to it (ANB, AOBO and OJ.

  8. An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring

    Directory of Open Access Journals (Sweden)

    S J Baruah

    2009-01-01

    Full Text Available Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into four groups. Surgical techniques are reserved for the advanced grades (Grades IV and V. We describe an innovative surgical technique, which can be adopted in Grades II and III injuries.

  9. Evaluation matters: lessons learned on the evaluation of surgical teaching.

    Science.gov (United States)

    Woods, Nicole N

    2011-01-01

    The traditional system of academic promotion and tenure can make it difficult to reward those who excel at surgical teaching. A successful faculty evaluation process can provide the objective measures of teaching performance needed for performance appraisals and promotion decisions. Over the course of two decades, an extensive faculty evaluation process has been developed in the Department of Surgery at the University of Toronto. This paper presents some of the non-psychometric characteristics of that system. Faculty awareness of the evaluation process, the consistency of its application, trainee anonymity and the materiality of the results are described key factors of a faculty evaluation system that meets the assessment needs of individual teachers and raises the profile of teaching in surgical departments. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. The model of evaluation of innovative potential of enterprise

    Directory of Open Access Journals (Sweden)

    Ганна Ігорівна Заднєпровська

    2015-06-01

    Full Text Available The basic components of the enterprise’s innovative potential evaluation process are investigated. It is offered the conceptual model of evaluation of the innovative potential that includes: subjects, objects, purpose, provision of information, principles, methods, criteria, indicators. It is noted that the innovative capacity characterizes the transition from the current to the strategic level of innovation potential and, thus, characterizes the composition of objects from position of user

  11. Technical innovations that may facilitate real-time telementoring of damage control surgery in austere environments: a proof of concept comparative evaluation of the importance of surgical experience, telepresence, gravity and mentoring in the conduct of damage control laparotomies.

    Science.gov (United States)

    Kirkpatrick, Andrew W; LaPorta, Anthony; Brien, Susan; Leslie, Tim; Glassberg, Elon; McKee, Jessica; Ball, Chad G; Wright Beatty, Heather E; Keillor, Jocelyn; Roberts, Derek J; Tien, Homer

    2015-06-01

    Bleeding to death is the most preventable cause of posttraumatic death worldwide. Despite the fact that many of these deaths are anatomically salvageable with relatively basic surgical interventions, they remain lethal in actuality in prehospital environments when no facilities and skills exist to contemplate undertaking basic damage control surgery (DCS). With better attention to prehospital control of extremity hemorrhage, intracavitary bleeding (especially intraperitoneal) remains beyond the scope of prehospital providers. However, recent revolutions in the informatics and techniques of telementoring (TMT), DCS and highly realistic accelerated training of motivated first responders suggests that basic lifesaving DCS may have applicability to save bleeding patients in austere environments previously considered unsalvageable. Especially with informatic advances, any provider with Internet connectivity can potentially be supported by highly proficient specialists with content expertise in the index problem. This unprecedented TMT support may allow highly motivated but inexperienced personnel to provide advanced surgical interventions in extreme environments in many austere locations both on and above the planet.

  12. NETWORK ECONOMY INNOVATIVE POTENTIAL EVALUATION METHOD

    Directory of Open Access Journals (Sweden)

    E. V. Loguinova

    2011-01-01

    Full Text Available Existing methodological approaches to assessment of the innovation potential having been analyzed, a network system innovative potential identification and characterization method is proposed that makes it possible to assess the potential’s qualitative and quantitative components and to determine their consistency with national innovative system formation and development objectives. Four stages are recommended and determined to assess the network economy innovative potential. Main structural elements of the network economy innovative potential are the resource, institutional, infrastructural and resulting factor totalities.

  13. Evaluation of surgical gloves for radiation protection

    Energy Technology Data Exchange (ETDEWEB)

    Antolin, E.; Rot, M.J.; Ordonez, J.; Arranz, L.; Sastre, J.M.; Ferrer, N.; Andres, J.C. de [Hospital Ramon y Ca jal, Servicio de Radiofisica y Proteccion Radiologica, Madrid (Spain)

    2006-07-01

    Full text of publication follows: Accumulated doses in hands during interventionist cardiology and radiological procedures can reach high values, and even go beyond legal limits for exposed professionals after years of work, unless they use specific radiation protection methods. An important protection mean for hands is the use of surgical gloves that attenuate the radiation while maintaining the tactile sensitivity demanded by physicians.There is a wide variety of commercialized gloves for radiation protection, with different advantages and disadvantages for various uses. In this paper nine different models of gloves have been evaluated for testing its attenuation capacity for several voltages, the maintenance of tactile sensitivity, its resistance to elongation, and the apparition of pores after successive sterilizing processes. It is very important that they do not lose its initial characteristics after processes of sterilization in order to optimize the product effective cost. The attenuation values have been measured under the voltages of 60, 70, 80 and 90 KVp obtaining very different values at each voltage with different gloves. The values measured range between 34 % before any supplementary sterilization with one model of glove (for 90 KVp), and 57 % after four sterilization processes with another glove (for 60 KVp). Some gloves lose its attenuation capacity after successive sterilizations, having not been found an y significant relation with their composition. The tactile sensitivity, a decisive factor for its users, decreases as its attenuation capacity increases, and remains mostly constant after being sterilized. The tests performed allow to conclude a set of fi nal results that can facilitate the choice of the most suitable gloves according to the practical applications (the priorities being the radiation protection and the tactile sensitivity)

  14. Innovative optical microsystem for static and dynamic tissue diagnosis in minimally invasive surgical operations

    Science.gov (United States)

    Ahmadi, Roozbeh; Packirisamy, Muthukumaran; Dargahi, Javad

    2012-08-01

    During conventional surgical tasks, surgeons use their tactile perception in their finger tips to sense the degree of softness of biological tissues to identify tissue types and to feel for any abnormalities. However, in robotic-assisted surgical systems, surgeons are unable to sense this information because only surgical tools interact with tissues. In order to provide surgeons with such useful tactile perception, therefore, a tactile sensor is required that is capable of simultaneously measuring contact force and resulting tissue deformation. Accordingly, this paper discusses the design, prototyping, testing, and validation of an innovative tactile sensor that is capable of measuring the degree of softness of soft objects such as tissues under both static and dynamic loading conditions and which is also magnetic resonance compatible and electrically passive. These unique characteristics of the proposed sensor would also make it a practical choice for use in robotic-assisted surgical platforms. The prototype version of this sensor was developed by using optical micro-systems technology and, thus far, experimental test results performed on the prototyped sensor have validated its ability to measure the relative softness of artificial tissues.

  15. Adaptation and innovation: a grounded theory study of procedural variation in the academic surgical workplace.

    Science.gov (United States)

    Apramian, Tavis; Watling, Christopher; Lingard, Lorelei; Cristancho, Sayra

    2015-10-01

    Surgical research struggles to describe the relationship between procedural variations in daily practice and traditional conceptualizations of evidence. The problem has resisted simple solutions, in part, because we lack a solid understanding of how surgeons conceptualize and interact around variation, adaptation, innovation, and evidence in daily practice. This grounded theory study aims to describe the social processes that influence how procedural variation is conceptualized in the surgical workplace. Using the constructivist grounded theory methodology, semi-structured interviews with surgeons (n = 19) from four North American academic centres were collected and analysed. Purposive sampling targeted surgeons with experiential knowledge of the role of variations in the workplace. Theoretical sampling was conducted until a theoretical framework representing key processes was conceptually saturated. Surgical procedural variation was influenced by three key processes. Seeking improvement was shaped by having unsolved procedural problems, adapting in the moment, and pursuing personal opportunities. Orienting self and others to variations consisted of sharing stories of variations with others, taking stock of how a variation promoted personal interests, and placing trust in peers. Acting under cultural and material conditions was characterized by being wary, positioning personal image, showing the logic of a variation, and making use of academic resources to do so. Our findings include social processes that influence how adaptations are incubated in surgical practice and mature into innovations. This study offers a language for conceptualizing the sociocultural influences on procedural variations in surgery. Interventions to change how surgeons interact with variations on a day-to-day basis should consider these social processes in their design. © 2015 John Wiley & Sons, Ltd.

  16. Adaptation and innovation: a grounded theory study of procedural variation in the academic surgical workplace

    Science.gov (United States)

    Apramian, Tavis; Watling, Christopher; Lingard, Lorelei; Cristancho, Sayra

    2017-01-01

    Rationale, aims and objectives Surgical research struggles to describe the relationship between procedural variations in daily practice and traditional conceptualizations of evidence. The problem has resisted simple solutions, in part, because we lack a solid understanding of how surgeons conceptualize and interact around variation, adaptation, innovation, and evidence in daily practice. This grounded theory study aims to describe the social processes that influence how procedural variation is conceptualized in the surgical workplace. Method Using the constructivist grounded theory methodology, semi-structured interviews with surgeons (n = 19) from four North American academic centres were collected and analysed. Purposive sampling targeted surgeons with experiential knowledge of the role of variations in the workplace. Theoretical sampling was conducted until a theoretical framework representing key processes was conceptually saturated. Results Surgical procedural variation was influenced by three key processes. Seeking improvement was shaped by having unsolved procedural problems, adapting in the moment, and pursuing personal opportunities. Orienting self and others to variations consisted of sharing stories of variations with others, taking stock of how a variation promoted personal interests, and placing trust in peers. Acting under cultural and material conditions was characterized by being wary, positioning personal image, showing the logic of a variation, and making use of academic resources to do so. Our findings include social processes that influence how adaptations are incubated in surgical practice and mature into innovations. Conclusions This study offers a language for conceptualizing the sociocultural influences on procedural variations in surgery. Interventions to change how surgeons interact with variations on a day-to-day basis should consider these social processes in their design. PMID:26096874

  17. Improving compliance with surgical antibiotic prophylaxis guidelines: A multicenter evaluation.

    Science.gov (United States)

    Schmitt, Cristiane; Lacerda, Rubia Aparecida; Turrini, Ruth Natalia Teresa; Padoveze, Maria Clara

    2017-10-01

    Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics. Six attributes of compliance with SAP guidelines were evaluated; full compliance was defined whenever all these attributes were met. Logistic and linear regressions were used to investigate the association between compliance, patients, and hospital characteristics. Full compliance was 10% and was associated with weekly hours of infection control personnel per intensive care unit bed (95% CI, 0.2-0.1), hospital-wide dissemination of SAP guidelines (95% CI, 1.2-25.1), monitoring (95% CI, 1.2-25.1), and feedback of compliance rates (95% CI, 3.8-25.2). Daytime procedures had greater compliance regarding drug dose (odds ratio [OR], 3.38; 95% confidence interval [CI], 1.72-6.65) and initial time (OR, 2.30; 95% CI, 1.24-4.25). Spinal procedures achieved greater compliance with initial time (OR, 1.83; 95% CI, 1.12-3.01) and duration (OR, 1.59; 95% CI, 1.7-2.16). A low level of compliance was identified, which pointed out the need for an innovative stewardship approach to improve adherence to SAP guidelines. Targeted training programs need to be developed to ensure dissemination of guidelines among surgeons. Monitoring, feedback, and closer interaction between the infection control personnel and the surgical team are key factors for better compliance rates of SAP. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Teaching surgical residents to evaluate scholarly articles: a constructivist approach.

    Science.gov (United States)

    Chichester, Tiffany; Hagglund, Karen; Edhayan, Elango

    2013-03-01

    The ability to critically appraise scholarly journals is an essential skill for surgical residents in their journey to being lifelong learners. Methods to teach evaluation of scholarly articles are scant in the educational literature. Residents completed a pre-test on evaluation of surgical literature. Two lectures on methodology and statistics followed. A board-certified surgeon and residents evaluated 7 articles using a scoring form. A post-test followed. Four additional sessions on evaluating surgical articles were held without the rating form. Residents completed a second post-test. Residents showed improved knowledge and skills on evaluating surgical literature on the first and second post-tests when compared with the pretest ( P constructivist Educational theory. There was a significant improvement in knowledge and the skills of literature evaluation, which persisted after the educational aid was removed. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Evaluation Of Surgical Castration For Prostate Cancer At Nnewi ...

    African Journals Online (AJOL)

    Objective. To evaluate the average time of follow-up of patients with advanced prostate cancer after surgical castration and to assess the difficulties associated with follow-up of patients. Patients and Methods. 89 case notes of patients who had surgical castration for advanced prostate cancer were reviewed. Information on ...

  20. Pre Surgical Evaluation of Scrotal Cystocele by Conventional ...

    African Journals Online (AJOL)

    Urinary bladder is a known content of sliding inguinal hernias but rarely presents as irreducible direct inguinal hernia. As inguinal hernia repair is commonly undertaken even at peripheral surgical centers. Cystogram a simple radiological investigation (picturesque view) is useful for pre-surgical evaluation as it can prevent ...

  1. Evaluating Internal Fixation Skills Using Surgical Simulation.

    Science.gov (United States)

    Burns, Geoffrey T; King, Brandon W; Holmes, James R; Irwin, Todd A

    2017-03-01

    Open reduction and internal fixation (ORIF) is an essential skill for an orthopaedic surgeon, yet teaching its components to surgical residents poses challenges in both complexity and cost. Surgical simulation has demonstrated efficacy and is now a mandated component of residency programs, but the techniques and resources required for effective simulation vary greatly. We hypothesized that simulation of ORIF skills could be accomplished in a cost-effective, quantifiable, and reproducible manner and that this experience coupled with didactic learning would increase skill proficiency and enhance ORIF performance. Sixteen postgraduate-year-1 orthopaedic surgery interns were assessed on performance of ORIF simulation tasks before and after attending a module designed to introduce and practice internal fixation techniques. Simulation tasks addressed drilling accuracy via oblique drilling through polyvinyl chloride (PVC) cylinders and bisecting wooden dowels and plunge control via drilling through layered boards of varying densities. Fracture fixation simulation involved fixing oblique fractures on synthetic ulnae. Task performance was assessed at 3 time points: immediately before the module, 1 week after the module, and 3 months after the module. Fracture fixation was assessed before and after the module via load-to-failure testing. Success rates for the tasks were analyzed using a repeated-measures analysis of variance, and mechanical properties of the fixed ulnar constructs were compared using paired t tests. In all ORIF simulation tasks, pre-module to post-module improvement in success rates was significant (p drill) can be significantly augmented and retained in the short term in surgical residents after exposure to faculty-led lecture and hands-on skills practice using low-cost materials. This study provides evidence for an effective, accessible method of enhancing and assessing surgical skills in training.

  2. Evaluation of tap water for surgical handwashing.

    Science.gov (United States)

    Ohmori, Yukinari; Tonouchi, Hitoshi; Mohri, Yasuhiko; Kobayashi, Minako; Kusunoki, Masato

    2006-01-01

    In Japan, sterile water is used for rinsing in surgical handwashing, whereas in Western countries tap water is generally used. We conducted this study to examine the conditions and the equipment that affect bacterial contamination in tap water and to determine whether the tap water in our institute is suitable for surgical handwashing. First, we examined the water pipes and measured the free chlorine content in the tap water in the operating room. Next, we recruited 40 volunteers and conducted preliminary tests with sterile water. Thirty of these subjects participated in a handwashing test using tap water. The mean free chlorine levels in the tap water and the sterile water were 0.30 +/- 0.05 and 0.07 +/- 0.03 mg/l, respectively. The handwashing test using tap water showed immediate, persistent, and cumulative bacteria activity within the minimum limits set by the Food and Drug Administration (FDA). The free chlorine levels in the tap water in our institute satisfied Japanese health regulations. Moreover, the handwashing test met the criteria of the FDA. Thus, we conclude that this tap water is safe to use for rinsing in surgical handwashing.

  3. Assessing the Effect of an Intensive 2-Week Surgical Training and Innovation Program for High-School Students.

    Science.gov (United States)

    Labadie, Brian; Patel, Roshan M; Gandy Labadie, Jessica; Hwang, Christina; Okhunov, Zhamshid; Landman, Jaime

    2017-06-15

    The summer surgery program (SSP) was founded in 2012 as an educational program for students at the critical juncture between high school and college to engender interest in medicine, science, and innovation. This program has a distinct emphasis on innovation and problem solving based on real-life operative challenges identified by students during surgical observation in the operating room. The effect of the SSP regarding postsecondary education and career goals was evaluated by participants using a follow-up questionnaire. Retrospective cohort study using web-based survey administered to students at least 1 year after participation in the SSP. Associations between demographics and survey responses were made using Fisher's exact test and a Bonferonni correction was used to account for multiple comparisons. Between July 2012 and August 2015, 119 students enrolled in the SSP. We sent a web-based questionnaire link to all participants who completed the program. The questionnaire contained 80 questions assessing the participant's interest in studying medicine or science in college, knowledge of health care, and their appreciation and understanding of innovation. UC Irvine Medical Center, Orange, CA; Institutional tertiary care center. In total, 77 (64.7%) of 119 students who matriculated in the SSP completed the follow-up survey; the mean number of years after the program was 2.09 years. Nearly all students reported the program increased their interest in studying medicine or science in college (97.4%), led them to a better understanding of their own career goals (93.5%) and made them more confident in their ability to succeed in a career in health care (88.3%). The majority indicated the program led them to better understand the training and schooling required of doctors and surgeons (94.8%), and led them to better appreciate the roles of different medical specialties (96.1%). Overall 96% of students reported that the program led them to better understand the

  4. Evaluating Biological Robustness of Innovative Management Alternatives

    NARCIS (Netherlands)

    Bastardie, F.; Baudron, A.; Bilocca, R.; Boje, J.; Bult, T.P.; Garcia, D.; Hintzen, N.T.

    2009-01-01

    The influence of innovative management alternatives (participatory governance, effort management, decision rules) on biological robustness (BR) in various fisheries relevant to the EU (Baltic, Western Shelf, Faroe Islands, North Sea), was investigated with a numerical simulation model developed in

  5. Activation effectiveness evaluation of innovation activity processes of the enterprises

    Directory of Open Access Journals (Sweden)

    Елена Александровна Плахотник

    2016-11-01

    Full Text Available Despite the national importance of innovative activity development in Ukraine, clear relationship to the innovative process has not yet formed. There are a number of outstanding issues concerning the methods for activation effectiveness evaluation of innovative activity of the enterprises, identifying priority allocation of financial resources in the course of innovation. The ways of improving analytical methods for activity effectiveness evaluation of innovative activity of the enterprises in different sectors of the national economy are discussed in the article. They are based on the performances of their economic, social and technological development. The practical aspects of implementation of the methodology for effectiveness evaluation of innovative activity are developed. They can be used as the basis for approaches to the formation and evaluation of the implementation of the state industrial policy of Ukraine. It is proved that economy modernization, based on the formation of high-tech resources in the real economy, and effective participation of innovative activities in economic circulation allows economic growth in the conditions of new economy. Technology can effectively develop only under appropriate forms and methods of institutionalization and socialization. The complex nature of the processes of innovative development of domestic enterprises has predetermined the need for effective implementation of innovation level measurement system based on the definition of the integral performance index of their implementation and related sub-indices in its structure, based on a four-level hierarchical model. Integral performance indicator is a vector with the components of the sub-indices by kinds of influence factors. The proposed approach to the analysis of the activation effectiveness of innovative activity of the enterprises can be the basis for approaches to the development and evaluation of the implementation of the state industrial

  6. [Evaluation of a face model for surgical education].

    Science.gov (United States)

    Schneider, G; Voigt, S; Rettinger, G

    2011-09-01

    The complex anatomy of the human face requires a high degree of experience and skills in surgical dressing of facial soft tissue defects. The previous education contains literature studies and supervision during surgery, according to surgical spectrum of the educating hospital. A structured education including a training of different surgical methods on a model and slow increase of complexity could improve considerably the following education related to the patient.During a cooperative project, the 3 di GmbH and the Department of Otolaryngology at the Friedrich-Schiller-University Jena developed a face model for surgical education that allows the training of surgical interventions in the face. The model was used during the 6th and 8th Jena Workshop for Functional and Aesthetic Surgery as well as a workshop for surgical suturation, and tested and evaluated by the attendees.The attendees mostly rated the work-ability of the models and the possibility to practice on a realistic face model with artificial skin very well and beneficial. This model allows a repeatable and structured education of surgical standards, and is very helpful in preparation for operating facial defects of a patient. Georg Thieme Verlag KG Stuttgart · New York.

  7. EVALUATION CRITERIA OF INNOVATIVE SOCIAL INVESTMENT PROJECTS IN HEALTH CARE

    National Research Council Canada - National Science Library

    Vadim Aleksandrovich Lomazov; Elena Viktorovna Nesterova

    2013-01-01

    Purpose: analysis of key indicators and creation of evaluation criteria of innovative socio-economic investment projects in healthcare, implemented on the basis of public-private partnerships.Methodology...

  8. Evaluation of robotic minimally invasive surgical skills using motion studies.

    Science.gov (United States)

    Jun, Seung-Kook; Sathia Narayanan, Madusudanan; Singhal, Pankaj; Garimella, Sudha; Krovi, Venkat

    2013-09-01

    Robotic Minimally Invasive Surgery, and the engendered computer-integration, offers unique opportunities for quantitative computer-based surgical-performance evaluation. In this work, we examine extension of traditional manipulative skill assessment, having deep roots in performance evaluation in manufacturing industries, for applicability to robotic surgical skill evaluation. This method relies on: defining task-level segmentation of modular sub-tasks/micro-motions called 'Therbligs' that can be combined to perform a given task; and analyzing intra- and inter-user performance variance by studying surgeons' performance over each 'Therbligs'. Any of the performance metrics of macro-motions-from motion-economy, tool motion measurements to handed-symmetry-can now be extended over the micro-motion temporal segments. Evaluation studies were based on video recordings of surgical tasks in two settings: first, we examined performance of two representative manipulation exercises (peg board and pick-and-place) on a da Vinci surgical SKILLS simulator. This affords a relatively-controlled and standardized test-scenarios for surgeons with varied experience-levels. Second, task-sequences from real surgical videos were analyzed with a list of predefined 'Therbligs' in order to investigate its overall usefulness.

  9. Judging surgical research: how should we evaluate performance and measure value?

    Science.gov (United States)

    Souba, W W; Wilmore, D W

    2000-07-01

    To establish criteria to evaluate performance in surgical research, and to suggest strategies to optimize research in the future. Research is an integral component of the academic mission, focusing on important clinical problems, accounting for surgical advances, and providing training and mentoring for young surgeons. With constraints on healthcare resources, there is increasing pressure to generate clinical revenues at the expense of the time and effort devoted to surgical research. An approach that would assess the value of research would allow prioritization of projects. Further, alignment of high-priority research projects with clinical goals would optimize research gains and maximize the clinical enterprise. The authors reviewed performance criteria applied to industrial research and modified these criteria to apply to surgical research. They reviewed several programs that align research objectives with clinical goals. Performance criteria were categorized along several dimensions: internal measures (quality, productivity, innovation, learning, and development), customer satisfaction, market share, and financial indices (cost and profitability). A "report card" was proposed to allow the assessment of research in an individual department or division. The department's business strategy can no longer be divorced from its research strategy. Alignment between research and clinical goals will maximize the department's objectives but will create the need to modify existing hierarchical structures and reward systems. Such alignment appears to be the best way to ensure the success of surgical research in the future.

  10. Development of stereo endoscope system with its innovative master interface for continuous surgical operation.

    Science.gov (United States)

    Kim, Myungjoon; Lee, Chiwon; Hong, Nhayoung; Kim, Yoon Jae; Kim, Sungwan

    2017-06-24

    Although robotic laparoscopic surgery has various benefits when compared with conventional open surgery and minimally invasive surgery, it also has issues to overcome and one of the issues is the discontinuous surgical flow that occurs whenever control is swapped between the endoscope system and the operating robot arm system. This can lead to problems such as collision between surgical instruments, injury to patients, and increased operation time. To achieve continuous surgical operation, a wireless controllable stereo endoscope system is proposed which enables the simultaneous control of the operating robot arm system and the endoscope system. The proposed system consists of two improved novel master interfaces (iNMIs), a four-degrees of freedom (4-DOFs) endoscope control system (ECS), and a simple three-dimensional (3D) endoscope. In order to simultaneously control the proposed system and patient side manipulators of da Vinci research kit (dVRK), the iNMIs are installed to the master tool manipulators of dVRK system. The 4-DOFs ECS consists of four servo motors and employs a two-parallel link structure to provide translational and fulcrum point motion to the simple 3D endoscope. The images acquired by the endoscope undergo stereo calibration and rectification to provide a clear 3D vision to the surgeon as available in clinically used da Vinci surgical robot systems. Tests designed to verify the accuracy, data transfer time, and power consumption of the iNMIs were performed. The workspace was calculated to estimate clinical applicability and a modified peg transfer task was conducted with three novice volunteers. The iNMIs operated for 317 min and moved in accordance with the surgeon's desire with a mean latency of 5 ms. The workspace was calculated to be 20378.3 cm3, which exceeds the reference workspace of 549.5 cm3. The novice volunteers were able to successfully execute the modified peg transfer task designed to evaluate the proposed system's overall

  11. Implications of Frugal Innovations on Sustainable Development: Evaluating Water and Energy Innovations

    Directory of Open Access Journals (Sweden)

    Jarkko Levänen

    2015-12-01

    Full Text Available Frugal innovations are often associated with sustainable development. These connections, however, are based on anecdotal assumptions rather than empirical evidence. This article evaluates the sustainability of four frugal innovations from water and energy sectors. For the purposes of the evaluation, a set of indicators was developed. Indicators are drawn from sustainable development goals by the United Nations and they encompass central dimensions of sustainability: ecological, social and economic. In this article, frugal innovations are compared to solutions that are currently used in similar low-income contexts. Studied frugal innovations were found more sustainable in terms of energy production and water purification capacity than the existing solutions. In terms of social sustainability, larger differences between innovations were found. For example, business models of frugal energy solutions focus on capacity building and the inclusion of marginalized low-income people, whereas business models of water purification solutions focus on more traditional corporate social responsibility activities, such as marketing awareness campaigns and cooperation with non-governmental organizations. Three major sustainability challenges for frugal innovators were identified: (1 the proper integration of material efficiency into product or service systems; (2 the patient promotion of inclusive employment; and (3 the promotion of inclusive and sustainable local industrialization. The article concludes that despite indisputable similarities between frugality and sustainability, it is problematic to equate the two conceptually.

  12. Innovation in Pediatric Surgical Education for General Surgery Residents: A Mobile Web Resource.

    Science.gov (United States)

    Rouch, Joshua D; Wagner, Justin P; Scott, Andrew; Sullins, Veronica F; Chen, David C; DeUgarte, Daniel A; Shew, Stephen B; Tillou, Areti; Dunn, James C Y; Lee, Steven L

    2015-01-01

    General surgery residents lack a standardized educational experience in pediatric surgery. We hypothesized that the development of a mobile educational interface would provide general surgery residents broader access to pediatric surgical education materials. We created an educational mobile website for general surgery residents rotating on pediatric surgery, which included a curriculum, multimedia resources, the Operative Performance Rating Scale (OPRS), and Twitter functionality. Residents were instructed to consult the curriculum. Residents and faculty posted media using the Twitter hashtag, #UCLAPedSurg, and following each surgical procedure reviewed performance via the OPRS. Site visits, Twitter posts, and OPRS submissions were quantified from September 2013 to July 2014. The pediatric surgery mobile website received 257 hits; 108 to the homepage, 107 to multimedia, 28 to the syllabus, and 19 to the OPRS. All eligible residents accessed the content. The Twitter hashtag, #UCLAPedSurg, was assigned to 20 posts; the overall audience reach was 85 individuals. Participants in the mobile OPRS included 11 general surgery residents and 4 pediatric surgery faculty. Pediatric surgical education resources and operative performance evaluations are effectively administered to general surgery residents via a structured mobile platform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. Evaluation of two surveillance methods for surgical site infection

    Directory of Open Access Journals (Sweden)

    M. Haji Abdolbaghi

    2006-08-01

    Full Text Available Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance. Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.

  14. Evaluating the Knowledge Assets of Innovative Companies

    Directory of Open Access Journals (Sweden)

    Maen Al-Hawari

    2002-11-01

    Full Text Available Knowledge has long been recognised as a valuable resource for organisational growth and sustained competitive advantage, especially for organisations competing in an uncertain environment (Miller & Shamsie 1987. In the current post-industrial society, knowledge is recognised as a primary source of a company’s wealth. However knowledge assets are much more difficult to identify and measure than are the physical assets with which we are much more familiar. (Boisot 1998 As a company’s innovative capacity may be dependent upon its ability to take advantage of its knowledge assets, it is important to be able to identify and measure those assets. While large companies can afford extensive knowledge management projects, there is a acute need for a method by which managers in smaller organisations can easily and reliably locate, quantify and compare their knowledge assets in order to maximise their potential for innovation. The paper will begin with an overview of current thinking on the topic of Knowledge Management (KM. It will then introduce the three functions of the knowledge life cycle (Bhatt 2000, Tan 2000, the four modes of conversion between tacit and explicit knowledge (Nonaka 1995 and the five knowledge enablers (Von Krogh 2000. The research, reported here, aims to identify, from the literature, a set of knowledge elements that will give a balanced view of knowledge assets across the four modes and five enablers. An integrated model, which is the result of research to date by the authors, will then be defined. This model combines the functions of the knowledge life cycle and Nonaka’s knowledge creation spiral with the notion of I-Space, which has been used to classify information across three dimensions, to form a new model of K-Space, which can be used to classify the knowledge elements. The paper will present this model and discuss the appropriateness of a set of knowledge elements as a means of measuring the knowledge asset of an

  15. Evaluation of teleoperated surgical robots in an enclosed undersea environment.

    Science.gov (United States)

    Doarn, Charles R; Anvari, Mehran; Low, Thomas; Broderick, Timothy J

    2009-05-01

    The ability to support surgical care in an extreme environment is a significant issue for both military medicine and space medicine. Telemanipulation systems, those that can be remotely operated from a distant site, have been used extensively by the National Aeronautics and Space Administration (NASA) for a number of years. These systems, often called telerobots, have successfully been applied to surgical interventions. A further extension is to operate these robotic systems over data communication networks where robotic slave and master are separated by a great distance. NASA utilizes the National Oceanographic and Atmospheric Administration (NOAA) Aquarius underwater habitat as an analog environment for research and technology evaluation missions, known as NASA Extreme Environment Mission Operations (NEEMO). Three NEEMO missions have provided an opportunity to evaluate teleoperated surgical robotics by astronauts and surgeons. Three robotic systems were deployed to the habitat for evaluation during NEEMO 7, 9, and 12. These systems were linked via a telecommunications link to various sites for remote manipulation. Researchers in the habitat conducted a variety of tests to evaluate performance and applicability in extreme environments. Over three different NEEMO missions, components of the Automated Endoscopic System for Optimal Positioning (AESOP), the M7 Surgical System, and the RAVEN were deployed and evaluated. A number of factors were evaluated, including communication latency and semiautonomous functions. The M7 was modified to permit a remote surgeon the ability to insert a needle into simulated tissue with ultrasound guidance, resulting in the world's first semi-autonomous supervisory-controlled medical task. The deployment and operation of teleoperated surgical systems and semi-autonomous, supervisory-controlled tasks were successfully conducted.

  16. Evaluation of surgical outcome after cataract surgery with lens ...

    African Journals Online (AJOL)

    The objective of this study was to evaluate the surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamber. Design: Retrospective record analysis. Subjects: Record cards of patients operated for cataract at Sakubva Eye Unit, Mutare, Zimbabwe in the period January ...

  17. Evaluation Of Postoperative Facial Swelling Following The Surgical ...

    African Journals Online (AJOL)

    Patients and Methods: Clinical evaluation of facial swelling after the surgical removal of impacted mandibular third molars using a tape measuring technique was ... The tape measuring method is simple, non-invasive, cost effective and time-saving method, which provides numerical data for determination of facial contour ...

  18. Innovation Incubator: Whisker Labs Technical Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Sparn, Bethany F. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Frank, Stephen M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Earle, Lieko [National Renewable Energy Lab. (NREL), Golden, CO (United States); Scheib, Jennifer G. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-08-01

    The Wells Fargo Innovation Incubator (IN2) is a program to foster and accelerate startup companies with commercial building energy-efficiency and demand management technologies. The program is funded by the Wells Fargo Foundation and co-administered by the National Renewable Energy Laboratory (NREL). Whisker Labs, an Oakland, California-based company, was one of four awardees in the first IN2 cohort and was invited to participate in the program because of its novel electrical power sensing technology for circuit breakers. The stick-on Whisker meters install directly on the front face of the circuit breakers in an electrical panel using adhesive, eliminating the need to open the panel and install current transducers (CTs) on the circuit wiring.

  19. An Evaluation of the Role of Simulation Training for Teaching Surgical Skills in Sub-Saharan Africa.

    Science.gov (United States)

    Campain, Nicholas J; Kailavasan, Mithun; Chalwe, Mumba; Gobeze, Aberra A; Teferi, Getaneh; Lane, Robert; Biyani, Chandra Shekhar

    2017-10-11

    An estimated 5 billion people worldwide lack access to any surgical care, whilst surgical conditions account for 11-30% of the global burden of disease. Maximizing the effectiveness of surgical training is imperative to improve access to safe and essential surgical care on a global scale. Innovative methods of surgical training have been used in sub-Saharan Africa to attempt to improve the efficiency of training healthcare workers in surgery. Simulation training may have an important role in up-scaling and improving the efficiency of surgical training and has been widely used in SSA. Though not intended to be a systematic review, the role of simulation for teaching surgical skills in Sub-Saharan Africa was reviewed to assess the evidence for use and outcomes. A systematic search strategy was used to retrieve relevant studies from electronic databases PubMed, Ovid, Medline for pertinent articles published until August 2016. Studies that reported the use of simulation-based training for surgery in Africa were included. In all, 19 articles were included. A variety of innovative surgical training methods using simulation techniques were identified. Few studies reported any outcome data. Compared to the volume of surgical training initiatives that are known to take place in SSA, there is very limited good quality published evidence for the use of simulation training in this context. Simulation training presents an excellent modality to enhance and improve both volume and access to high quality surgical skills training, alongside other learning domains. There is a desperate need to meticulously evaluate the appropriateness and effectiveness of simulation training in SSA, where simulation training could have a large potential beneficial impact. Training programs should attempt to assess and report learner outcomes.

  20. Enhancing surgical innovation through a specialized medical school pathway of excellence in innovation and entrepreneurship: Lessons learned and opportunities for the future.

    Science.gov (United States)

    Cohen, Mark S

    2017-11-01

    The mission of an academic medical center and academic departments of surgery focuses on teaching, scholarship/research, and expertise of clinical care. The standard 4-year medical school curriculum and general surgery residency training are well balanced to expose trainees to these missions in varying degrees, yet the advancement of medicine as a field is predicated on the creation, development, and successful implementation of medical innovations. Surgeons, by virtue of their clinical training, are immersed in medical technology and are continually required to use this technology effectively in combination with their own technical skills and judgment to provide optimal patient care. As such, they routinely face the challenges of current technology and the need for innovation and improvement, leading many to become natural inventors. Having a good idea or innovation to improve patient care, however, is just the starting point of the complex process of implementing that idea in the clinic. Unfortunately, the vast majority of surgeons and medical students have no formal educational training on the innovation process regarding how good ideas can be developed successfully for clinical and commercial implementation. Added to this lack of formal education are the limited resources and time constraints that surgeons, residents, and medical students face in acquiring the educational skill set to adeptly navigate this innovation and entrepreneurial landscape. To address these challenges, the University of Michigan recently created the first pathway of excellence for medical students to focus their passions and interests in medical innovation and entrepreneurship. This program has been transformative for building a new culture of young, motivated medical innovators, many of whom have dedicated their talents already to addressing several key problems in surgical patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Innovation Policy Evaluation – Challenges and Roads Ahead

    DEFF Research Database (Denmark)

    Christensen, Jesper Lindgaard

    2012-01-01

    are that the criteria for evaluating effects should be extended beyond the immediate, observable impact. Results It is found that using traditional evaluation metrics render an underestimation of indirect, hard to measure effects such as transfer of tacit knowledge, reputation effects, long-term benefits from...... networking, training effects in increased abilities to select and manage collaboration projects, and the general increase in connectivity of the innovation system. Value This study contributes to our understanding of how innovation network policies are evaluated. The paper firstly propose what should...

  2. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    Science.gov (United States)

    Gómez-de-Gabriel, Jesús M.; Harwin, William

    2015-01-01

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included. PMID:26516863

  3. Evaluation of Sensor Configurations for Robotic Surgical Instruments.

    Science.gov (United States)

    Gómez-de-Gabriel, Jesús M; Harwin, William

    2015-10-27

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included.

  4. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Jesús M. Gómez-de-Gabriel

    2015-10-01

    Full Text Available Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included.

  5. Innovation

    Science.gov (United States)

    EPA frames innovation as critical to the protection of human health and the environment through initiatives such as sustainable practices, innovative research, prize competitions, innovation awards, partnerships, and community activities.

  6. Cross-platform digital assessment forms for evaluating surgical skills

    Directory of Open Access Journals (Sweden)

    Steven Arild Wuyts Andersen

    2015-04-01

    Full Text Available A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion, digital assessment forms can be used for the structured rating of surgical skills and have the potential to be especially useful in complex assessment situations with multiple raters, repeated assessments in various times and locations, and situations requiring substantial subsequent data processing or complex score calculations.

  7. Cross-platform digital assessment forms for evaluating surgical skills.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts

    2015-01-01

    A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion, digital assessment forms can be used for the structured rating of surgical skills and have the potential to be especially useful in complex assessment situations with multiple raters, repeated assessments in various times and locations, and situations requiring substantial subsequent data processing or complex score calculations.

  8. Surgical Treatment for Refractory Epilepsy: Review of Patient Evaluation and Surgical Options

    Directory of Open Access Journals (Sweden)

    Kristen M. Kelly

    2011-01-01

    Full Text Available Treatment of epilepsy often imposes an exposure to various antiepileptic drugs and requires long-term commitment and compliance from the patient. Although many new medications are now available for the treatment of epilepsy, approximately 30% of epilepsy patients still experience recurrent seizures and many experience undesirable side effects. Treatment of epilepsy requires a multidisciplinary approach. For those patients with medically refractory seizures, surgical treatment has increased in prevalence as techniques and devices improve. With increased utilization, proper patient selection has become crucial in evaluating appropriateness of surgical intervention. Epilepsy syndromes in which surgery has shown to be effective include mesial temporal sclerosis, cortical dysplasia, many pediatric epilepsy syndromes, and vascular malformations. Monitoring in an epilepsy monitoring unit with continuous scalp or intracranial EEG is an important step in localization of seizure focus. MRI is the standard imaging technique for evaluation of anatomy. However, other imaging studies including SPECT and PET have become more widespread, often offering increased diagnostic value in select situations. In addition, as an alternative or adjunct to surgical resection, implantable devices such as vagus nerve stimulators, deep brain stimulators, and direct brain stimulators could be useful in seizure treatment.

  9. Innovative technology transfer of nondestructive evaluation research

    Science.gov (United States)

    Brian Brashaw; Robert J. Ross; Xiping Wang

    2008-01-01

    Technology transfer is often an afterthought for many nondestructive evaluation (NDE) researchers. Effective technology transfer should be considered during the planning and execution of research projects. This paper outlines strategies for using technology transfer in NDE research and presents a wide variety of technology transfer methods used by a cooperative...

  10. EVALUATION OF INNOVATIVE PROJECTS IN CONTROLLING SYSTEM

    Directory of Open Access Journals (Sweden)

    Vladimir P. Bogko

    2013-01-01

    Full Text Available Implementation of the controlling system onto the high-tech enterprises requires the development of specific tools for their evaluation. The models of projects estimation are offered on the article on the basis of the methods of factor analysis, linear regression analysis and fuzzy logic of Mamdani’s algorithm.

  11. Evaluation of a preoperative multimedia information program in surgical oncology.

    Science.gov (United States)

    Evrard, S; Mathoulin-Pelissier, S; Larrue, C; Lapouge, P; Bussieres, E; Tunon De Lara, C

    2005-02-01

    We report on the design, validation and evaluation of a DVD for patient information in a department of surgical oncology. DVDs provided the patient with information about the anatomy, surgical techniques and post-operative complications on digestive cancers, oral cavity and breast tumours. After surgery a questionnaire was sent to the patients in order to evaluate their level of satisfaction and opinion regarding the pre-operative information they had been given. One hundred and eight patients were invited to watch the DVD. Seventy-one percent of the patients considered that viewing the DVD had been positive and encouraging and 83% of all the patients would recommend its use. Among the 14 patients who experienced complications, only 21% declared having been well informed by the DVD and only 12% considered they were better prepared to face those complications. DVD based information systems are valuable and acceptable to patients, but the presentation of complications needs to be improved.

  12. Evaluation of surgically treated breast masses in children.

    Science.gov (United States)

    Doğan, Gül; Soyer, Tutku; Ekinci, Saniye; Karnak, İbrahim; Çiftçi, Arbay Ö; Tanyel, Feridun C

    2017-01-01

    Doğan G, Soyer T, Ekinci S, Karnak İ, Çiftçi AÖ, Tanyel FC. Evaluation of surgically treated breast masses in children. Turk J Pediatr 2017; 59: 177-183. We aimed to define the diagnostic and treatment characteristics of breast masses among female children who had undergone surgical treatment in order to figure out which children should be followed conservatively or treated surgically. We reviewed retrospectively 64 female patients operated for breast masses under the age of 18 years between 1977 and 2013. Patient demographics, symptoms, physical examination findings, size of the mass and its relation with menstrual cycle, follow-up period before and after surgery, diagnostic characteristics, laboratory analysis, diagnosis before and after surgery, indications for surgery, histopathological characteristics of the mass, postoperative complications, and recurrence rate were recorded. Histopathologic investigations among 41 girls with complete hospital records showed that 26 had fibroadenoma (FA; 63.4%). Eleven girls among the other 23 cases with incomplete hospital records but with histopathological results have also had FA (47%). The majority of breast masses in childhood are FA, the frequency and duration of follow up is important. If there is a mass that will not regress, that continues to grow or does not reduce in size during follow up, and for those with family history of breast cancer to definitely exclude the possibility of malignancy, surgical treatment may be appropriate.

  13. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

    Science.gov (United States)

    Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence

  14. Developmental evaluation applying complexity concepts to enhance innovation and use

    CERN Document Server

    Patton, Michael Quinn

    2011-01-01

    Developmental evaluation (DE) offers a powerful approach to monitoring and supporting social innovations by working in partnership with program decision makers. In this book, eminent authority Michael Quinn Patton shows how to conduct evaluations within a DE framework. Patton draws on insights about complex dynamic systems, uncertainty, nonlinearity, and emergence. He illustrates how DE can be used for a range of purposes: ongoing program development, adapting effective principles of practice to local contexts, generating innovations and taking them to scale, and facilitating rapid response in crisis situations. Students and practicing evaluators will appreciate the book's extensive case examples and stories, cartoons, clear writing style, "closer look" sidebars, and summary tables. Provided is essential guidance for making evaluations useful, practical, and credible in support of social change.

  15. [Surgical and nutritional evaluation of children with percutaneous endoscopic gastrostomy].

    Science.gov (United States)

    Limousin, I Tuduri; Velilla, A Gracia; Caro, J González; Azcárate, J Morcillo; Asensio, J C De Agustín

    2009-07-01

    Percutaneous endoscopic gastrostomy (PEG) has suppoused an improvement in the nutritional management of patients with deglution difficulty. Surgical and nutritional aspects have been evaluated in our patients with PEG. A descriptive retrospective study with individual analysis of surgical, nutritional and satisfaction items has been developed. 83 PEG (1994-08) have been implanted in neurological patients (63.8%) followed by cystic fibrosis; Mean age 7 years (4 months-25 years). Two patients have a ventriculo-peritoneal shunt (VPS) and 3 a peritoneal dialysis catheter (PDC). 12% had a mild complication and 3 patients a severe one, with 2 reinterventions performed. 40 patients have the dispositive, 25 were removed after a mean follow-up of 2,5 years and 17 patients dies. Nutrition was done with initial, continuation or specials formulas. Weight evaluation was satisfactory in 96% of patients and biochemical indicators were normalized in 97% of them. Satisfaction is very high among the majority of parents. PEG is a technique that allows nutritional recuperation with few surgical complications. VPS and PDC are not contraindications for the percutaneous gastrostomy. PEG improves children and relatives life quality.

  16. Retrospective analysis of a surgical innovation using the IDEAL framework: radical cystectomy with epidural anaesthesia.

    Science.gov (United States)

    Gerullis, Holger; Ecke, Thorsten H; Barski, Dimitri; Bantel, Carsten; Weyland, Andreas; Uphoff, Jens; Jansen, Thomas; Wawroschek, Friedhelm; Winter, Alexander

    2017-04-01

    Objectives To retrospectively analyse experience of radical cystectomy using spinal/epidural anaesthesia and to classify this method using the IDEAL criteria. Methods Data from patients who had undergone radical cystectomy using spinal/epidural anaesthesia were evaluated retrospectively, focusing on clinical data, intraoperative and perioperative parameters and postoperative complications. Current literature reporting on this technique was reviewed and, together with the present study, evaluated according to the IDEAL recommendations. Results Three male patients aged 66-79 years who had undergone radical cystectomy with epidural anaesthesia were identified. The operating time ranged from 159-261 min and only minor complications occurred. Between 2013 and 2015, three published studies reported experiences with radical cystectomy with epidural/spinal anaesthesia; one was prospective and two were retrospective in nature and they included a total of 55 patients. According to the IDEAL classification, the present study corresponds to stage 1 (idea) and overall the surgical technique can be ranked as stage 2a (development). Conclusions Radical cystectomy with epidural anaesthesia is feasible and applicable for those who are not fit for general anaesthesia. The present study confirmed the functional results of this technique, which can be classified as IDEAL stage 2a on the basis of published studies.

  17. Innovation

    DEFF Research Database (Denmark)

    Nielsen, Janni; Yaganeh, Suzanne; Bloch Rasmussen, Leif

    2013-01-01

    This paper contributes to a theoretical discussion of creation of innovation with participants in, or outside, organisations. We address the creation of innovation with a complex theoretical understanding drawing on the Scandinavian and the Participatory Design tradition introducing two approaches...... to the processes of innovation. We ask if innovation can be initiated and enhanced looking at two collaborative approaches; participatory innovation (PIN) and cooperative innovation (COIN). We invite to dialogue and reflections on PIN’s conflict and creative frictions on one side and COIN’s complexity......, complementarity in diversity and the didactic scaffolding of the innovation process on the other side. Our contribution focuses on the methods and practices for facilitation of co-creating activities between different groups leading to cooperation, and innovation in thinking....

  18. 2016 CAPS ethics session/Ein debate: 1. Regionalization of pediatric surgical care 2. Ethical introduction of surgical innovation 3. Addressing stress in a surgical practice: resiliency, well-being, and burnout.

    Science.gov (United States)

    Bagwell, Charles E; Chiu, Priscilla; Fecteau, Annie; Gow, Kenneth W; Mueller, Claudia M; Price, David; Zigman, Andrew F

    2017-05-01

    The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random. Therefore, the opinions they express within this summary might not reflect their own viewpoints. In the first discussion, arguments for and against the regionalization of pediatric surgical care are discussed, primarily in the context of a case of BA. In the pro argument, the evidence and lessons learned from different European countries are explored as well as different models to provide the best BA care outside of large teaching centers. In the counterargument, the author explains how regionalization of care could be detrimental for the patient, the family, the regional center, and for the health care system in general. In the debate on surgical innovation the authors define surgical innovation. They review the pertinent ethical principles, explore a model for its implementation, and the role of the institution at which the innovation is proposed. In the third section, surgeon well-being is examined, and recent literature on surgeon resiliency and burnout both at the attending and resident level is reviewed. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Evaluation of Augmented Reality Feedback in Surgical Training Environment.

    Science.gov (United States)

    Zahiri, Mohsen; Nelson, Carl A; Oleynikov, Dmitry; Siu, Ka-Chun

    2017-11-01

    Providing computer-based laparoscopic surgical training has several advantages that enhance the training process. Self-evaluation and real-time performance feedback are 2 of these advantages, which avoid dependency of trainees on expert feedback. The goal of this study was to investigate the use of a visual time indicator as real-time feedback correlated with the laparoscopic surgical training. Twenty novices participated in this study working with (and without) different presentations of time indicators. They performed a standard peg transfer task, and their completion times and muscle activity were recorded and compared. Also of interest was whether the use of this type of feedback induced any side effect in terms of motivation or muscle fatigue. Of the 20 participants, 15 (75%) preferred using a time indicator in the training process rather than having no feedback. However, time to task completion showed no significant difference in performance with the time indicator; furthermore, no significant differences in muscle activity or muscle fatigue were detected with/without time feedback. The absence of significant difference between task performance with/without time feedback shows that using visual real-time feedback can be included in surgical training based on user preference. Trainees may benefit from this type of feedback in the form of increased motivation. The extent to which this can influence training frequency leading to performance improvement is a question for further study.

  20. The perioperative surgical home: An innovative, patient-centred and cost-effective perioperative care model.

    Science.gov (United States)

    Desebbe, Olivier; Lanz, Thomas; Kain, Zeev; Cannesson, Maxime

    2016-02-01

    Contrary to the intraoperative period, the current perioperative environment is known to be fragmented and expensive. One of the potential solutions to this problem is the newly proposed perioperative surgical home (PSH) model of care. The PSH is a patient-centred micro healthcare system, which begins at the time the decision for surgery is made, is continuous through the perioperative period and concludes 30 days after discharge from the hospital. The model is based on multidisciplinary involvement: coordination of care, consistent application of best evidence/best practice protocols, full transparency with continuous monitoring and reporting of safety, quality, and cost data to optimize and decrease variation in care practices. To reduce said variation in care, the entire continuum of the perioperative process must evolve into a unique care environment handled by one perioperative team and coordinated by a leader. Anaesthesiologists are ideally positioned to lead this new model and thus significantly contribute to the highest standards in transitional medicine. The unique characteristics that place Anaesthesiologists in this framework include their systematic role in hospitals (as coordinators between patients/medical staff and institutions), the culture of safety and health care metrics innate to the specialty, and a significant role in the preoperative evaluation and counselling process, making them ideal leaders in perioperative medicine. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  1. CLINICAL EVALUATION OF EFFECT OF EARLY EXPOSURE OF WOUNDS AFTER MINOR SURGICAL PROCEDURES

    OpenAIRE

    Annand Bansal; Rajesh Godara; Talo Millo; Rathindra Tripura; Jai Karan

    2015-01-01

    Application of dressings to surgical wounds is a custom as old as history and has become a ritual marking the completion of surgery. Under certain circumstances a surgical dressing might in fact predispose to the development of wound infection. This study evaluates clinical outcome of clean minor surgical wounds without use of surgical dressing. Material and methods: 100 consecutive patients presenting on an outpatient basis for minor soft tissue surgical procedures were studied with respect ...

  2. Critical evaluation of ninhydrin for monitoring surgical instrument decontamination.

    Science.gov (United States)

    Nayuni, N K; Cloutman-Green, E; Hollis, M; Hartley, J; Martin, S; Perrett, D

    2013-06-01

    New Department of Health (England) Choice Framework for Local Policies and Procedures guidance (CFPP 0101) still states that ninhydrin can be used to check for efficient protein removal from surgical instruments processed in sterile services departments (SSDs). With the potential transfer of variant Creutzfeldt-Jakob disease (vCJD) via surgical procedures it is necessary to re-evaluate recommended methods for protein detection. This paper reports studies on the sensitivity and applicability of ninhydrin for detecting proteins in laboratories and SSDs. The efficiency of protein removal by swabbing was also evaluated. Ninhydrin showed poor sensitivity toward proteins. Limits of detection for bovine serum albumin (BSA) in solution were 205 μg/mL compared with arginine 6 μg/mL. A commercial kit could detect neither rat brain homogenate nor BSA at Ninhydrin kits, currently used in SSDs, are ineffective at detecting residual proteins due not only to the insensitivity of ninhydrin towards proteins but also to the poor desorption of adhered proteins by swabbing. Overall ninhydrin, either as a laboratory reagent or as supplied in protein detection kits, does not provide sensitive detection of proteins and generates high numbers of false negatives when used in decontamination practices. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  3. Evaluation von chirurgischem Koordinationstraining [Evaluation of surgical coordination

    Directory of Open Access Journals (Sweden)

    Schneider, Joachim H.

    2007-02-01

    Full Text Available [english] The eye-hand coordination is important in the use of monitors performing successfully diagnostic and therapeutic procedures. It is necessary to interpret the screen on the monitor anatomical correctly in order to coordinate instruments without the intention of depth. The Tübinger Skills Trainer (TST was manufactured not only for great cohorts of students but also to evaluate manual skills without great numbers of controllers. Younger and senor students and younger surgeons were studied. Mistakes and time duration were registered by the PC. In the group of the students mistakes and time durations were decreased in the second trial. Therefore the measuring of the training effect is objective. In the third group the training with both hands showed a diminished time space but an increase of the mistakes. The Tübinger Sills Trainer was fully accepted by students and is reliable to use it for medical education. [german] Die Augen-Hand Koordination ist beim Einsatz von Monitoren in Diagnostik und Therapie von entscheidender Bedeutung für den angestrebten Erfolg. Dabei muss das zweidimensionale Monitorbild anatomisch korrekt interpretiert und der Einsatz von Instrumenten bei fehlender Tiefenwahrnehmung koordiniert werden. Der Tübinger Geschicklichkeitstrainer wurde für große Studentenkohorten nicht nur für ein Basistraining zur Erlangung von manuellen Fertigkeiten entwickelt, sondern auch um diese mit geringem Dozentenaufwand evaluieren zu können. Bei insgesamt 125 Studienteilnehmern wurde ein einhändiges und beidhändiges chirurgisches Basistraining für Medizinstudenten in verschiedenen Ausbildungsstadien und Ärzten in der chirurgischen Weiterbildung durchgeführt. Als Variablen wurden Fehlerquote und Zeitbedarf computergestützt aufgezeichnet. Bei Studenten und PJ Studenten sanken Fehlerzahl und Zeitbedarf beim einhändigen und beidhändigen Training im zweiten Durchgang. Damit konnte ein Trainingserfolg objektiviert werden. In

  4. Social capital, agricultural innovation and the evaluation of agricultural development initiatives

    NARCIS (Netherlands)

    Rijn, van F.C.

    2014-01-01

    In this thesis, I show that social capital has an important role in the evaluation of development initiatives targeting agricultural innovation. Social capital and agricultural innovation are naturally linked from an innovation system perspective in which innovations result from the integration of

  5. Evaluation of urology residents' perception of surgical theater educational environment.

    Science.gov (United States)

    Binsaleh, Saleh; Babaeer, Abdulrahman; Rabah, Danny; Madbouly, Khaled

    2015-01-01

    To evaluate surgical theater learning environment perception in urology residents in Saudi Arabia and to investigate association of learning environment perception and stages of residency program, sectors of health care system, and regions of Saudi Arabia. A cross-sectional survey using the surgical theater educational environment measure (STEEM) inventory. The STEEM inventory was used to measure theater learning environment perception of urology residents in Saudi Arabia. Respondents' perception was compared regarding different residency stages, sectors of the health care system, and regions of Saudi Arabia. Internal reliability of the inventory was assessed using the Cronbach α coefficient. Correlation analysis was done using the Spearman ρ coefficient. Of 72 registered residents, 33 (45.8%) completed the questionnaire. The residents perceived their environment less than acceptable (135.9 ± 16.7, 67.95%). No significant differences in perception were found among residents of different program stages, different sectors of health care system, or different regions in Saudi Arabia. Residents from the eastern region perceived the training and teaching domain better (p = 0.025). The inventory showed a high internal consistency with a Cronbach α of 0.862. STEEM survey is an applicable and reliable instrument for assessing the learning environment and training skills of urology residency program in Saudi Arabia. Urology residents in Saudi Arabia perceived the theater learning environment as less than ideal. The perceptions of theater learning environment did not change significantly among different stages of the program, different sectors of health care system, or different training regions of Saudi Arabia assuring the uniformity of urology training all over Saudi Arabia. The training programs should address significant concerns and pay close attention to areas in surgical theater educational environment, which need development and enhancement, mainly planned fashion

  6. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Surgical Technique.

    Science.gov (United States)

    Cottom, James M; Maker, Jared M

    2016-01-01

    Plantar fasciitis is one the most common pathologies seen by foot and ankle surgeons. When nonoperative therapy fails, surgical intervention is warranted. Various surgical procedures are available for the treatment of recalcitrant plantar fasciitis. The most common surgical management typically consists of open versus endoscopic plantar fascia release. The documented comorbidities associated with the release of the plantar fascia include lateral column overload and metatarsalgia. We present a new technique for this painful condition that is minimally invasive, allows visualization of the plantar fascia, and maintains the integrity of this fascia. Our hypothesis was that the use of endoscopic debridement of the plantar fascia would provide a minimally invasive technique with acceptable patient outcomes. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Methodology evaluation of innovative projects under risk and uncertainty

    Directory of Open Access Journals (Sweden)

    2012-09-01

    Full Text Available This article deals with problems connected with the assessment of innovative projects in the context of risk and uncertainty, topical issues of evaluation of innovative projects at the present stage of development of the Russian economy. By the example of the solution of the "crossing the river" is considering the possibility of using hierarchical models to address it. In what follows, and compares the priorities of different groups of factors are given by calculating the overall costs and benefits. The paper provides a rationale for combined use of four aspects: the beneficial aspects of the decision (the benefits and opportunities and negative (costs and risks that may lead to the decision in question.

  8. Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework.

    Science.gov (United States)

    Beard, David; Hamilton, David; Davies, Loretta; Cook, Jonathan; Hirst, Allison; McCulloch, Peter; Paez, Arsenio

    2018-02-01

    The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. © 2017 American Physical Therapy Association.

  9. Histological evaluation and optimization of surgical vessel sealing systems

    Science.gov (United States)

    Lathrop, Robert; Ryan, Thomas; Gaspredes, Jonathan; Woloszko, Jean; Coad, James E.

    2017-02-01

    Surgical vessel sealing systems are widely used to achieve hemostasis and dissection in open surgery and minimally invasive, laparoscopic surgery. This enabling technology was developed about 17 years ago and continues to evolve with new devices and systems achieving improved outcomes. Histopathological assessment of thermally sealed tissues is a valuable tool for refining and comparing performance among surgical vessel sealing systems. Early work in this field typically assessed seal time, burst rate, and failure rate (in-situ). Later work compared histological staining methods with birefringence to assess the extent of thermal damage to tissues adjacent to the device. Understanding the microscopic architecture of a sealed vessel is crucial to optimizing the performance of power delivery algorithms and device design parameters. Manufacturers rely on these techniques to develop new products. A system for histopathological evaluation of vessels and sealing performance was established, to enable the direct assessment of a treatment's tissue effects. The parameters included the commonly used seal time, pressure burst rate and failure rate, as well as extensions of the assessment to include its likelihood to form steam vacuoles, adjacent thermal effect near the device, and extent of thermally affected tissue extruded back into the vessel lumen. This comprehensive assessment method provides an improved means of assessing the quality of a sealed vessel and understanding the exact mechanisms which create an optimally sealed vessel.

  10. Surgical Termination of Pregnancy: Evaluation of 14,903 Cases

    Directory of Open Access Journals (Sweden)

    Hale Aktun

    2006-09-01

    Conclusion: This study points out that surgical abortion is not a contraceptive method. Most surgical abortions can be prevented by effective usage of modern contraceptive methods. The importance of well-planned contraceptive counseling and education is emphasized. Better family planning counseling and education, and the availability of modern contraceptive methods can easily decrease the incidence of surgical abortions.

  11. Innovation

    DEFF Research Database (Denmark)

    Helms, Niels Henrik

    2012-01-01

    Kravet om innovation og kreativitet er på flere måder en stor og en ny udfordring for voksenuddannelserne. Det udfordrer det didaktiske dilemma, det at vi skal gøres til kompetente og frie mennesker gennem pædagogiske handlinger, som netop pålægger os en ufrihed. – Men hvor denne ufrihed...... innovative, netop er det, vi endnu ikke kender...

  12. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  13. Ergonomic design and evaluation of new surgical scissors.

    Science.gov (United States)

    Shimomura, Yoshihiro; Shirakawa, Hironori; Sekine, Masashi; Katsuura, Tetsuo; Igarashi, Tatsuo

    2015-01-01

    The purpose of this study is to design a new surgical scissors handle and determine its effectiveness with various usability indices. A new scissors handle was designed that retains the professional grip but has the shapes of the eye rings modified to fit the thumb and ring finger and finger rests for the index and little finger. The newly designed scissors and traditional scissors were compared by electromyography, subjective evaluation and task performance in experiments using cutting and peeling tasks. The newly designed scissors reduced muscle load in both hand during cutting by the closing action, and reduced the muscle load in the left hand during peeling by the opening action through active use of the right hand. In evaluation by surgeons, task performance improved in addition to the decrease in muscle load. The newly designed scissors used in this study demonstrated high usability. A new scissors handle was designed that has the eye rings modified to fit the thumb and ring finger. The newly designed scissors reduced muscle load and enabled active use of the right hand. In evaluation by surgeons, task performance improved in addition to the decrease in muscle load.

  14. Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    Directory of Open Access Journals (Sweden)

    Charikleia Triantopoulou

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts. The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm. This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation, the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors’ consistency and way of extension helps to improve radiologists’ diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.

  15. The double-transforaminal lumbar interbody fusion: an innovative one-stage surgical technique for posterior kyphosis correction

    Directory of Open Access Journals (Sweden)

    Marcus Jäger

    2017-06-01

    Full Text Available Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches. Therefore, these established techniques may be contraindicated in elderly or multimorbide patients suffering from concomitant diseases. The authors describe the double transforaminal lumbar interbody fusion (TLIF osteotomy (DTO as an innovative one-stage and low-invasive surgical technique to correct a fixed posttraumatic kyphosis in the thoracolumbar junction. The procedure includes posterior release (laminectomy, facettectomy, nucleotomy combined with two expandable TLIF implants (sandwich technique and posterior instrumentation and is illustrated by a case of a multimorbide 78-year old female.

  16. The Double-Transforaminal Lumbar Interbody Fusion: An Innovative One-Stage Surgical Technique for Posterior Kyphosis Correction

    Science.gov (United States)

    Jäger, Marcus; Tassemeier, Tjark

    2017-01-01

    Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches. Therefore, these established techniques may be contraindicated in elderly or multimorbide patients suffering from concomitant diseases. The authors describe the double transforaminal lumbar interbody fusion (TLIF) osteotomy (DTO) as an innovative one-stage and low-invasive surgical technique to correct a fixed posttraumatic kyphosis in the thoracolumbar junction. The procedure includes posterior release (laminectomy, facettectomy, nucleotomy) combined with two expandable TLIF implants (sandwich technique) and posterior instrumentation and is illustrated by a case of a multimorbide 78-year old female. PMID:28713528

  17. Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

    Science.gov (United States)

    Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

    2015-03-01

    The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

  18. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2015-10-01

    Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

  19. Evaluation of the Community Cataract Surgical Services of a ...

    African Journals Online (AJOL)

    Background: Cataract is the leading cause of blindness in the world. An efficient and effective cataract surgical service is necessary to reduce the backlog of cataract blindness in the community. This study aims to determine the cataract surgical coverage among individuals aged 50 years and above residing in Esie and ...

  20. Innovation

    DEFF Research Database (Denmark)

    Torfing, Jacob; Ricard, Lykke Margot

    2017-01-01

    Innovation i krydsfeltet mellem forskellige styringsparadigmer i offentlige organisationer. New Public Governance gør det muligt at skabe offentlig værdi på nye måder. Men NPG er ingen trylledrik, der fra den ene dag til den anden skaber balance mellem borgernes store forventninger og en trængt...

  1. Innovation

    African Journals Online (AJOL)

    The purpose of Innovation journal of appropriate librarianship and information work in Southern Africa is to publish material on libraries, information supply and other related matters in South and Southern Africa. Vol 45 (2012). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access ...

  2. Innovation

    African Journals Online (AJOL)

    The ends may be competitive advantage as expressed in innovation, increased profit or development of intellectual capital. The second major problem is concerned with how these attributes, actions and characteristics can be measured. Knowledge itself is intangible and ineffable; increased profit presents few problems as ...

  3. Innovation

    African Journals Online (AJOL)

    ... libraries as support for the reading intervention is also an important part of the project. The focus of this article is on the use of family literacy workshops to introduce the reading programme and the fledgling school libraries to parents and the potential role of the school library in supporting reading activities. Innovation Vol.

  4. Innovation

    African Journals Online (AJOL)

    In order to gain experience in scanning of diverse media, projects have deliberately been kept small. It has been found that management of scanned images is as important as the process of scanning. Adequate planning, correct storage procedures and accurate metadata are essential to the success of a project. Innovation ...

  5. Quantifying innovation in surgery.

    Science.gov (United States)

    Hughes-Hallett, Archie; Mayer, Erik K; Marcus, Hani J; Cundy, Thomas P; Pratt, Philip J; Parston, Greg; Vale, Justin A; Darzi, Ara W

    2014-08-01

    The objectives of this study were to assess the applicability of patents and publications as metrics of surgical technology and innovation; evaluate the historical relationship between patents and publications; develop a methodology that can be used to determine the rate of innovation growth in any given health care technology. The study of health care innovation represents an emerging academic field, yet it is limited by a lack of valid scientific methods for quantitative analysis. This article explores and cross-validates 2 innovation metrics using surgical technology as an exemplar. Electronic patenting databases and the MEDLINE database were searched between 1980 and 2010 for "surgeon" OR "surgical" OR "surgery." Resulting patent codes were grouped into technology clusters. Growth curves were plotted for these technology clusters to establish the rate and characteristics of growth. The initial search retrieved 52,046 patents and 1,801,075 publications. The top performing technology cluster of the last 30 years was minimally invasive surgery. Robotic surgery, surgical staplers, and image guidance were the most emergent technology clusters. When examining the growth curves for these clusters they were found to follow an S-shaped pattern of growth, with the emergent technologies lying on the exponential phases of their respective growth curves. In addition, publication and patent counts were closely correlated in areas of technology expansion. This article demonstrates the utility of publically available patent and publication data to quantify innovations within surgical technology and proposes a novel methodology for assessing and forecasting areas of technological innovation.

  6. The Evaluation of University Teaching: Context, Values and Innovation.

    Science.gov (United States)

    Mathias, Haydn

    1984-01-01

    Following an examination of the value, structural, and interpersonal context in which university teaching takes place, an innovation perspective is discussed that explains the process of innovation in terms of the characteristics of the host system. (Author/MLW)

  7. Quality vascular surgical care: the importance of innovation and change in an era of dwindling reimbursement.

    Science.gov (United States)

    Buckley, C J; Patterson, D E; Manning, L G; Lee, S D

    2001-04-01

    Reductions in vascular surgery reimbursement emphasize the need to decrease cost while maintaining quality. Hospital solvency is essential if we are to preserve acceptable levels of nursing/support personnel and acquire new diagnostic and treatment programs. Care processes for patients undergoing carotid, aortic, or dialysis access surgery were retrospectively analyzed and new quality- and cost-oriented treatment algorithms and clinical pathways were developed and implemented using case management principles. Preoperative risk stratification, length of stay, costs, complications, outcomes, and patient satisfaction were compared before and after these revisions in the care process. Statistical analyses were done using the Wilcoxon Rank sum test and Fisher exact test. Significant reductions in length of stay, intensive care use, and cost of treatment and diagnosis were achieved without adversely affecting morbidity, mortality, or patient satisfaction. Use of algorithm, clinical pathway, and case management principles resulted in a marked improvement in the "bottom line" for vascular surgical procedures in our academic medical center.

  8. An Extensive QFD and Evaluation Procedure for Innovative Design

    Directory of Open Access Journals (Sweden)

    Chang-Tzuoh Wu

    2013-01-01

    Full Text Available In this paper, a systematic innovation procedure has been developed based on quality function deployment and extension method. Besides, the evaluation method for design decision making has also been discussed and developed. The major procedure of QFD is to identify the customers’ needs for the product and then convert into appropriate technical measures to fulfill the needs based on the company’s competitive priorities. The priorities of product characteristics can be obtained by translating important technical measures. According to their characteristics, the prior engineering parameters will be identified and selected as the key requirements to redesign. This paper will focus on the integration of QFD and extension method. With the help of “matter element theory and extension method,” customer requirements (CRs can be transferred into product design attributes more comprehensively and deeply. According to the idea of loss function of Taguchi quality design method, the criteria for design decision making have also been developed in this paper. An innovative design case, bicycle, successfully demonstrates that the proposed design process is feasible and efficient.

  9. METHODOLOGY TO EVALUATE THE INNOVATIVE ACTIVITY OF THE MEAT INDUSTRY

    Directory of Open Access Journals (Sweden)

    D. N. Bakaev

    2014-01-01

    Full Text Available The article considers the methods of estimation of innovative activity of the enterprise. Revealed advantages and disadvantages of the proposed techniques in various publications, devoted to the innovative development. Analysis of the works of domestic and foreign authors showed that the existing methods do not provide an adequate assessment of innovative activity of the enterprise. Asked to enter the integral indicator of innovative activity, which is the criterion of the dynamism of innovative activity of the enterprise, as measured by the speed and volume creation, promotion and use of innovations in economic activity of the enterprise. The proposed system of estimation of innovative activity of the enterprise is based on the following indicators: the ratio of personnel development, the growth rate of financial assets directed on conducting innovative activity of the enterprise, the coefficient for mastering new technologies, the growth rate of intellectual property. The assessment matrix integral indicator of innovative activity of the enterprise reflects the relationship of the indicators of innovative potential and innovative activity and includes a group of indicators, which allows the estimation of innovative activity of enterprises in various spheres of business: technological, organizational, marketing. The main advantages of the developed technique of estimation of level of innovative development of the enterprises of the meat industry is: an assessment of the level in dynamics; complex research of a level of innovation development; the possibility of comparison of actual values with the values of the indicators, assessments United experts. A feature of the proposed method is not only able to measure the level of innovation development in General, but diagnosis of individual factors. This allows you to determine which factors-the Torah must be activated to display the meat industry to a higher level of innovation development.

  10. Luxury and innovation: Towards an evaluative framework | Riley ...

    African Journals Online (AJOL)

    ... processes that create new objects and services. The paper argues that, if innovation and creativity are separated from the hegemony of change, then it is possible to devise a set of criteria as to what may be judged to be innovative. A set of seven criteria are postulated. Keywords: innovation, luxury, creativity, design, ...

  11. Evaluating Eco-Innovation of OECD Countries with Data Envelopment Analysis

    Science.gov (United States)

    Mavi, Reza Kiani; Standing, Craig

    2016-01-01

    Government regulations require businesses to improve their processes and products/services in a green and sustainable manner. For being environmentally friendly, businesses should invest more on eco-innovation practices. Firms eco-innovate to promote eco-efficiency and sustainability. This paper evaluates the eco-innovation performance of…

  12. INNOVATION

    DEFF Research Database (Denmark)

    Helms, Niels Henrik

    2012-01-01

    Kravet om innovation og kreativitet er på flere måder en stor og en ny udfordring for voksenuddannelserne. Det udfordrer det didaktiske dilemma, det at vi skal gøres til kompetente og frie mennesker gennem pædagogiske handlinger, som netop pålægger os en ufrihed. – Men hvor denne ufrihed tidligere...... kunne begrundes med, at skolen eller uddannelsen vidste bedre, så er det ikke længere tilfældet. Skolen skal sørge for, at vi lærer noget – og ikke noget andet. Men det kan ikke længere med bestemthed afgøres, hvad det er vi skal lære i skolen, fordi det nye, det kreative og ikke mindst innovative...

  13. Using Innovative Technologies for Manufacturing and Evaluating Rocket Engine Hardware

    Science.gov (United States)

    Betts, Erin M.; Hardin, Andy

    2011-01-01

    Many of the manufacturing and evaluation techniques that are currently used for rocket engine component production are traditional methods that have been proven through years of experience and historical precedence. As we enter into a new space age where new launch vehicles are being designed and propulsion systems are being improved upon, it is sometimes necessary to adopt new and innovative techniques for manufacturing and evaluating hardware. With a heavy emphasis on cost reduction and improvements in manufacturing time, manufacturing techniques such as Direct Metal Laser Sintering (DMLS) and white light scanning are being adopted and evaluated for their use on J-2X, with hopes of employing both technologies on a wide variety of future projects. DMLS has the potential to significantly reduce the processing time and cost of engine hardware, while achieving desirable material properties by using a layered powdered metal manufacturing process in order to produce complex part geometries. The white light technique is a non-invasive method that can be used to inspect for geometric feature alignment. Both the DMLS manufacturing method and the white light scanning technique have proven to be viable options for manufacturing and evaluating rocket engine hardware, and further development and use of these techniques is recommended.

  14. Evaluation and analysis of barriers to the innovation activity in the economy of the region

    OpenAIRE

    D. A. Tomasova

    2017-01-01

    Prospects for the development of the Russian innovative economy largely depend on the successful overcoming of negative factors impeding the effective interaction of institutions in the field of education, science, business, credit and fi nancial sphere regarding the creation, transfer and commercialization of innovations. Deep evaluation of innovative problems needs dynamic analysis of main processes in the spheres accompanying the innovation activity, which determines the topicality of this...

  15. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    National Research Council Canada - National Science Library

    Gómez-de-Gabriel, Jesús M; Harwin, William

    2015-01-01

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization...

  16. A system dynamic and multi-criteria evaluation of innovations in environmental services

    OpenAIRE

    Hyytinen, Kirsi; Ruutu, Sampsa; Nieminen, Mika; Gallouj, FaÏz; Toivonen, Marja

    2015-01-01

    International audience; The purpose of this paper is to study the challenge of evaluation in the context of systemic innovations in which services are a core element. The paper argues that the traditional evaluation methods and measures are not able to capture neither the diversity of innovations in services and systems nor the multifaceted dimensions of performance resulting from these innovations. In order to contribute to a more purposeful evaluation practices and methods, a new combinator...

  17. The Directions of Evaluation of Innovative Products’ Implementation in Construction and Developer Organizations

    Directory of Open Access Journals (Sweden)

    Papelniuk Oksana

    2017-01-01

    Full Text Available The article describes the directions of evaluation of innovative products’ implementation in construction and developer organizations. The author analyzes the effects and offers the criteria for evaluation of efficiency of implementation of an innovative products. It is concluded that this evaluation should include estimation of efficiency of all participants of implementation of an innovative product at all development stages and project implementation during construction and operation of an object, thus the corresponding approach is offered.

  18. Big Data and Machine Learning in Plastic Surgery: A New Frontier in Surgical Innovation.

    Science.gov (United States)

    Kanevsky, Jonathan; Corban, Jason; Gaster, Richard; Kanevsky, Ari; Lin, Samuel; Gilardino, Mirko

    2016-05-01

    Medical decision-making is increasingly based on quantifiable data. From the moment patients come into contact with the health care system, their entire medical history is recorded electronically. Whether a patient is in the operating room or on the hospital ward, technological advancement has facilitated the expedient and reliable measurement of clinically relevant health metrics, all in an effort to guide care and ensure the best possible clinical outcomes. However, as the volume and complexity of biomedical data grow, it becomes challenging to effectively process "big data" using conventional techniques. Physicians and scientists must be prepared to look beyond classic methods of data processing to extract clinically relevant information. The purpose of this article is to introduce the modern plastic surgeon to machine learning and computational interpretation of large data sets. What is machine learning? Machine learning, a subfield of artificial intelligence, can address clinically relevant problems in several domains of plastic surgery, including burn surgery; microsurgery; and craniofacial, peripheral nerve, and aesthetic surgery. This article provides a brief introduction to current research and suggests future projects that will allow plastic surgeons to explore this new frontier of surgical science.

  19. Consumer demand for surgical innovation: a systematic review of public perception of NOTES.

    Science.gov (United States)

    Pucher, Philip H; Sodergren, Mikael H; Lord, Amy C; Teare, Julian; Yang, Guang-Zhong; Darzi, Ara

    2015-04-01

    The full scope of benefits offered by NOTES over traditional laparoscopy, if any, is not yet fully clear. Perceived patient demand for truly "scarless surgery" is often referenced one of the driving factors in the continued development of this relatively new technique. The true scale of patient preference and demand for NOTES as a surgical technique is unknown. This review aims to summarise currently available literature on the topic of patient perceptions of NOTES to guide future development of the technique. A comprehensive search of PubMed and Web of Science electronic databases was performed on 1st Jan 2014. To be considered for inclusion, articles were required to assess and report the perception of NOTES in a sample of laypersons (patients or general public). The primary endpoint assessed was acceptance or preference rates expressed by patients for NOTES procedures. Reasons given for preference or rejection of NOTES were recorded, as well as preferred access routes and any predicting factors of NOTES acceptance. Initial search returned 1,334 results, resulting in 15 articles included in final data synthesis. These polled a total of 4,420 subjects. Acceptance of NOTES ranged between 41 and 84 %. Compared to a laparoscopic approach, preference rates for NOTES ranged from 0 to 78 %. Reasons for preferring NOTES were largely centred on potentially reduced recovery time, complications (particularly with reference to hernias) and postoperative pain. Improved cosmesis also played a role, but was secondary to the above issues. Overall, study quality was poor. This review suggests significant public interest in NOTES and scarless surgery in general. Further research and consideration of differences in public perceptions across regions, countries and cultures are required.

  20. Technology Education in South Africa: Evaluating an Innovative Pilot Project

    Science.gov (United States)

    Stables, Kay; Kimbell, Richard

    2001-02-01

    Researchers from Goldsmiths College were asked to undertake an evaluation of a three year curriculum initiative introducing technology education, through a learner-centred, problem solving and collaborative approach. The program was developed in a group of high schools in the North West Province of South Africa. We visited ten schools involved in the project and ten parallel schools not involved who acted as a control group. We collected data on student capability (demonstrated through an innovative test activity) and on student attitudes towards technology (demonstrated in evaluation questionnaires and in semi-structured interviews). Collectively the data indicate that in areas of knowledge and skill and in certain aspects of procedures (most notably problem solving) the project has had a marked impact. We also illustrate that greater consideration could have been given in the project to developing skills in generating and developing ideas and in graphic communication. Gender differences are noted, particularly in terms of positive attitudes illustrated by both boys and girls from schools involved in the project. Attention is drawn to the critical impact the project has had on transforming the pedagogy of the teachers from a teacher-centred didactic model, to a learner-centred, problem solving model. Some wider implications of the successes of this project are debated.

  1. [Evaluation of surgical simulation sessions of the French society of ophthalmology. A new surgical instruction method].

    Science.gov (United States)

    El Chehab, H; Agard, E; Dot, C

    2017-10-01

    Since 2013, at the French society of ophthalmology (FSO) meetings, two simulators for intraocular surgeries have been available. The goal of this study was to assess the satisfaction of the participants in these organized training sessions. A questionnaire was mailed to participants in the FSO sessions as well as those carried out during the annual congress. This questionnaire collected data on the participants and the practical modalities of the sessions, and assessed participants' feelings and satisfaction with these sessions. The participants in the SFO sessions were young members of the SFO (31.8±12.3 years). 53.8 % were in training, looking to improve a problematic surgical step (capsulorhexis in 51.5 %). They spent nearly 5hours on simulators (4.8hours) and were alone on a simulator 50 % of the time. The sessions held during the annual congress were used by older physicians (41.9±26.4 years) already in practice (66.6 %). The goal of such training was curiosity in a third of the cases (to try the simulators). The majority spent less than an hour on the devices and were at least two participants per machine. Despite these differences, participants cited a role for their surgical learning curve and recommended such training to their colleagues. The participants' enthusiasm for this new training technique is highlighted by the results of this study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Evaluation of surgical training in the era of simulation

    Science.gov (United States)

    Shaharan, Shazrinizam; Neary, Paul

    2014-01-01

    AIM: To assess where we currently stand in relation to simulator-based training within modern surgical training curricula. METHODS: A systematic literature search was performed in PubMed database using keywords “simulation”, “skills assessment” and “surgery”. The studies retrieved were examined according to the inclusion and exclusion criteria. Time period reviewed was 2000 to 2013. The methodology of skills assessment was examined. RESULTS: Five hundred and fifteen articles focussed upon simulator based skills assessment. Fifty-two articles were identified that dealt with technical skills assessment in general surgery. Five articles assessed open skills, 37 assessed laparoscopic skills, 4 articles assessed both open and laparoscopic skills and 6 assessed endoscopic skills. Only 12 articles were found to be integrating simulators in the surgical training curricula. Observational assessment tools, in the form of Objective Structured Assessment of Technical Skills (OSATS) dominated the literature. CONCLUSION: Observational tools such as OSATS remain the top assessment instrument in surgical training especially in open technical skills. Unlike the aviation industry, simulation based assessment has only now begun to cross the threshold of incorporation into mainstream skills training. Over the next decade we expect the promise of simulator-based training to finally take flight and begin an exciting voyage of discovery for surgical trainees. PMID:25228946

  3. IMPROVED METHODS FOR EVALUATING THE EFFECTIVENESS OF INNOVATION DEVELOPMENT IN RUSSIAN CORPORATIONS

    Directory of Open Access Journals (Sweden)

    E. L. Dorzhieva

    2016-01-01

    Full Text Available Objectives. Innovative activity is a key factor in the effective development and growth of competitiveness in the Russian economy. An important role in this process is played by industrial corporations. Against this background, there is an increased need for improving the effectiveness of methods for evaluating the innovation development of Russian corporations. Methods. Formal logic as well as system analysis methods were used in the research, allowing us to consider the corporation as a system that includes a variety of innovational directions (elements. Results. The article discusses various approaches to the determination of the basic definitions of innovation; a classification of innovation is proposed. The attributes of innovative activity of industrial corporations are distinguished together with an outline of the possible causes of various innovative corporate activities; components of the system of indicators of innovation activity are isolated: financial; consumer; process; development and training; risk management. The need for the indices of the innovation activity of the risk component to be included in the composition of the system is substantiated. It is shown how the objectives for each area of innovation may be achieved in tandem with a methodological approach that allows continuous monitoring of the implementation of innovative development strategies. An algorithm for evaluating the implementation of innovative strategies contributing to the development of industrial corporations is presented. Conclusion. Theoretical and methodological development can be used not only to navigate the variety of innovations but also to determine and establish the relationship and interdependence between the various innovations as well as carry out analysis, assessment and forecasting for the effective development of innovative activity of Russian corporations. 

  4. Towards automatic skill evaluation: detection and segmentation of robot-assisted surgical motions.

    Science.gov (United States)

    Lin, Henry C; Shafran, Izhak; Yuh, David; Hager, Gregory D

    2006-09-01

    This paper reports our progress in developing techniques for "parsing" raw motion data from a simple surgical task into a labeled sequence of surgical gestures. The ability to automatically detect and segment surgical motion can be useful in evaluating surgical skill, providing surgical training feedback, or documenting essential aspects of a procedure. If processed online, the information can be used to provide context-specific information or motion enhancements to the surgeon. However, in every case, the key step is to relate recorded motion data to a model of the procedure being performed. Robotic surgical systems such as the da Vinci system from Intuitive Surgical provide a rich source of motion and video data from surgical procedures. The application programming interface (API) of the da Vinci outputs 192 kinematics values at 10 Hz. Through a series of feature-processing steps, tailored to this task, the highly redundant features are projected to a compact and discriminative space. The resulting classifier is simple and effective.Cross-validation experiments show that the proposed approach can achieve accuracies higher than 90% when segmenting gestures in a 4-throw suturing task, for both expert and intermediate surgeons. These preliminary results suggest that gesture-specific features can be extracted to provide highly accurate surgical skill evaluation.

  5. Cross-platform digital assessment forms for evaluating surgical skills

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts

    2015-01-01

    assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database...... containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were...... developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion...

  6. A prospective study on an innovative online forum for peer reviewing of surgical science.

    Directory of Open Access Journals (Sweden)

    Martin Almquist

    Full Text Available Peer review is important to the scientific process. However, the present system has been criticised and accused of bias, lack of transparency, failure to detect significant breakthrough and error. At the British Journal of Surgery (BJS, after surveying authors' and reviewers' opinions on peer review, we piloted an open online forum with the aim of improving the peer review process.In December 2014, a web-based survey assessing attitudes towards open online review was sent to reviewers with a BJS account in Scholar One. From April to June 2015, authors were invited to allow their manuscripts to undergo online peer review in addition to the standard peer review process. The quality of each review was evaluated by editors and editorial assistants using a validated instrument based on a Likert scale.The survey was sent to 6635 reviewers. In all, 1454 (21.9% responded. Support for online peer review was strong, with only 10% stating that they would not subject their manuscripts to online peer review. The most prevalent concern was about intellectual property, being highlighted in 118 of 284 comments (41.5%. Out of 265 eligible manuscripts, 110 were included in the online peer review trial. Around 7000 potential reviewers were invited to review each manuscript. In all, 44 of 110 manuscripts (40% received 100 reviews from 59 reviewers, alongside 115 conventional reviews. The quality of the open forum reviews was lower than for conventional reviews (2.13 (± 0.75 versus 2.84 (± 0.71, P<0.001.Open online peer review is feasible in this setting, but it attracts few reviews, of lower quality than conventional peer reviews.

  7. The surgical manegement of metastases to humerus-clinical evaluation.

    Science.gov (United States)

    Chrobok, Adam; Spindel, Jerzy; Miszczyk, Leszek; Koczy, Bogdan; Pilecki, Bogdan; Jarosz, Adam; Mrozek, Tomasz

    2003-06-30

    Background. The humerus is a common localisation of cancer metastases. The restoration of anatomical order and tumor resection within humerus is important for patients quality of everyday life and for their pain relief. The surgical treatment is one of the most important part of the whole oncological ways of tratment. The study objective was a clinical assesment of tumor resection and reconstruction within humerus according to matastasis localisation and the choice of surgical technique. Material and methods. In the years 1999-2002 19 patients underwent surgery due to pathological fracture or/and cancer metastasis within humerus. The shaft localisation of the tumor was found in 8 cases and in 11 patients the metastatic foci were found in proximnal diaphysis. In patients with proximal diaphysis localisation of the tumor the partial resection with subsequent joint exchange procedure was made. The humeral shaft metastatic cancer changes were treated by the segmental resection with subsequent surgical cement filling or auto/allogenical bone grafting combined with intramedullary nail or AO/ASIF plate stabilisation. The average follow-up period was 8,5 months. Results. In patients after resection with shoulder joint alloplasty according to the Enneking test a very good result was found in 7 and very good in 4 cases. In patients with femoral shaft metastatic tumor locaslisation, 6 good and 2 fair results were found. In 1 patient after 2 months rehabilitation a reoperation was needed due to the mechanical destabilisation. The best results were found in patients after intramedullary nailing.An acute soft tissue inflamation requiering surgical treatment was found in 1 patient after shoulder joint replacement. Conclusions. After clinical analysis of the material we highly recomend the partial humeral bone resection with subsequent shoulder alloplasty in patients with proximal humeral diaphysis metastatic localisation. In cases with shaft localisation a better results were

  8. Radiation injury of the rectum: Evaluation of surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Anseline, P.F.; Lavery, I.C.; Fazio, V.W.; Jagelman, D.G.; Weakley, F.L.

    1981-12-01

    One hundred four patients, 80 women and 24 men, with radiation injury of the rectum following treatment for gynecologic and urologic malignancy were studied. In 50 patients, the rectal injury was treated surgically; 54 patients were treated conservatively. The age and sex distributions were the same in each group. In 63 patients, symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical patients, 23 had associated small bowel injury. The indications for surgery for the rectal injury were 1) proctitis unresponsive to conservative measures in 14 patients, 2) rectal stricture or fistula or both in 32, and 3) rectosigmoid perforation in four. Forty-one patients had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for proctitis unresponsive to medical measures. Nineteen patients did not undergo colostomy closure, although symptoms were greatly improved. Diversion alone was insufficient treatment in the remaining 11 patients. Twenty-six patients died. The 12 deaths in the surgical group comprised four due to residual malignancy, four from post-operative complications, and four from unrelated causes. Of the 14 deaths in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and proctitis unresponsive to medical measures. Intestinal resection resulted in a sharp rise in the morbidity and mortality rates.

  9. Radiation injury of the rectum: evaluation of surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Anseline, P.F.; Lavery, I.C.; Fazio, V.W.; Jagelman, D.G.; Weakley, F.L.

    1981-12-01

    One hundred four patients, 80 women and 24 men, with radiation injury of the rectum following treatment for gynecologic and urologic malignancy were studied. In 50 patients, the rectal injury was treated surgically; 54 patients were treated conservatively. The age and sex distributions were the same in each group. In 63 patients, symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical patients, 23 had associated small bowel injury. The indications for surgery for the rectal injury were 1) proctitis unresponsive to conservative measures in 14 patients, 2) rectal stricture or fistula or both in 32, and 3) rectosigmoid perforation in four. Forty-one patients had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for proctitis unresponsive to medical measures. Nineteen patients did not undergo colostomy closure, although symptoms wer greatly improved. Diversion alone was insufficient treatment in the remaining 11 patients. Twenty-six patients died. The 12 deaths in the surgical group comprised four due to residual malignancy, four from postoperative complications, and four from unrelated causes. Of the 14 deaths in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and proctitis unresponsive to medical measures. Intestinal resection resulted in sharp rise in the morbidity and mortality rates.

  10. SANDIA NATIONAL LABORATORIES IN SITU ELECTROKINETIC EXTRACTION TECHNOLOGY; INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As a part of the Superfund Innovative Technology Evaluation (SITE) Program, the U.S. Environmental Protection Agency evaluated the In-Situ Electrokinetic Extraction (ISEE) system at Sandia National Laboratories, Albuquerque, New Mexico.The SITE demonstration results show ...

  11. Intraocular robotic interventional surgical system (IRISS): Mechanical design, evaluation, and master-slave manipulation.

    Science.gov (United States)

    Wilson, Jason T; Gerber, Matthew J; Prince, Stephen W; Chen, Cheng-Wei; Schwartz, Steven D; Hubschman, Jean-Pierre; Tsao, Tsu-Chin

    2018-02-01

    Since the advent of robotic-assisted surgery, the value of using robotic systems to assist in surgical procedures has been repeatedly demonstrated. However, existing technologies are unable to perform complete, multi-step procedures from start to finish. Many intraocular surgical steps continue to be manually performed. An intraocular robotic interventional surgical system (IRISS) capable of performing various intraocular surgical procedures was designed, fabricated, and evaluated. Methods were developed to evaluate the performance of the remote centers of motion (RCMs) using a stereo-camera setup and to assess the accuracy and precision of positioning the tool tip using an optical coherence tomography (OCT) system. The IRISS can simultaneously manipulate multiple surgical instruments, change between mounted tools using an onboard tool-change mechanism, and visualize the otherwise invisible RCMs to facilitate alignment of the RCM to the surgical incision. The accuracy of positioning the tool tip was measured to be 0.205±0.003 mm. The IRISS was evaluated by trained surgeons in a remote surgical theatre using post-mortem pig eyes and shown to be effective in completing many key steps in a variety of intraocular surgical procedures as well as being capable of performing an entire cataract extraction from start to finish. The IRISS represents a necessary step towards fully automated intraocular surgery and demonstrated accurate and precise master-slave manipulation for cataract removal and-through visual feedback-retinal vein cannulation. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Evaluation of an Innovative Digital Assessment Tool in Dental Anatomy.

    Science.gov (United States)

    Lam, Matt T; Kwon, So Ran; Qian, Fang; Denehy, Gerald E

    2015-05-01

    The E4D Compare software is an innovative tool that provides immediate feedback to students' projects and competencies. It should provide consistent scores even when different scanners are used which may have inherent subtle differences in calibration. This study aimed to evaluate potential discrepancies in evaluation using the E4D Compare software based on four different NEVO scanners in dental anatomy projects. Additionally, correlation between digital and visual scores was evaluated. Thirty-five projects of maxillary left central incisors were evaluated. Among these, thirty wax-ups were performed by four operators and five consisted of standard dentoform teeth. Five scores were obtained for each project: one from an instructor that visually graded the project and from four different NEVO scanners. A faculty involved in teaching the dental anatomy course blindly scored the 35 projects. One operator scanned all projects to four NEVO scanners (D4D Technologies, Richardson, TX, USA). The images were aligned to the gold standard, and tolerance set at 0.3 mm to generate a score. The score reflected percentage match between the project and the gold standard. One-way ANOVA with repeated measures was used to determine whether there was a significant difference in scores among the four NEVO scanners. Paired-sample t-test was used to detect any difference between visual scores and the average scores of the four NEVO scanners. Pearson's correlation test was used to assess the relationship between visual and average scores of NEVO scanners. There was no significant difference in mean scores among four different NEVO scanners [F(3, 102) = 2.27, p = 0.0852 one-way ANOVA with repeated measures]. Moreover, the data provided strong evidence that a significant difference existed between visual and digital scores (p = 0.0217; a paired - sample t-test). Mean visual scores were significantly lower than digital scores (72.4 vs 75.1). Pearson's correlation coefficient of 0.85 indicated

  13. Impact of measurement and evaluation on innovation level

    DEFF Research Database (Denmark)

    Jakobsen, Henning Sejer; Gertsen, Frank; Goduscheit, René Chester

    This article explores the situation in which an innovation project fails to achieve its full potential because the goal is lowered during the process. When the gap between measured/perceived progress and goals/aspirations of an innovation project becomes too large, the goals will be lowered...... and opportunities will be lost. The hypothetical explanation suggested here, is that the progress is often perceived to be linear whereas the actual progress is often exponential and that this makes the gap between actual achievement and expected progress much larger. The hypothesis is explored by means of a single...... case study of a network-based innovation in the energy sector. The case supports the hypothesis, but further research is needed in order to conclude that the perception of progress in innovation projects should be exponential, not linear....

  14. Innovation

    African Journals Online (AJOL)

    evaluate anti-apartheid initiatives from within the Afrikaans community. The publishing history of a significantly important anti-apartheid print culture institution, the independent anti-apartheid publishing house Taurus (1975-1991), is reconstructed.

  15. Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

    Science.gov (United States)

    Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien

    2016-05-01

    Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  16. Improved patient specific seizure detection during pre-surgical evaluation.

    LENUS (Irish Health Repository)

    Chua, Eric C-P

    2011-04-01

    There is considerable interest in improved off-line automated seizure detection methods that will decrease the workload of EEG monitoring units. Subject-specific approaches have been demonstrated to perform better than subject-independent ones. However, for pre-surgical diagnostics, the traditional method of obtaining a priori data to train subject-specific classifiers is not practical. We present an alternative method that works by adapting the threshold of a subject-independent to a specific subject based on feedback from the user.

  17. The Evaluation of Innovation in the IT Service Sector: Methodological and Empirical Aspects

    Directory of Open Access Journals (Sweden)

    Eglė Kazlauskienė

    2013-08-01

    Full Text Available Purpose — Nowadays services are comprehended as the key factor for economic activity, growth and employment. Developed economies are service-dominated though little is known about the innovation details in the service sector and this study field has been neglected for a while. The innovation in service sector activities needs to be thoroughly evaluated because innovation is an interconnected process and cannot be defined using one or few indicators. IT services are an integral part of contemporary life, particularly for business. It can be introduced and implemented in all fields, especially when the world is becoming more multidimensional. Innovation performance in the IT sector has been under-researched, despite the fact that IT service sector plays the innovation disseminator role in other sectors by appliance of IT products. Design/methodology/approach — Based on scientific literature and methodological aspects analyses, an empirical research methodology was designed and the qualitative research on innovation in information technology service sector was accomplished. Findings — The article presents methodological aspects of innovation evaluation in service sector and empirical aspects on innovation implementation and development in the IT service companies in Lithuania. Research limitations/implications — For more comprehensive understanding of innovation in service sector, especially in IT services, the theory of service innovation is necessary. Deeper understanding and perspectives on how innovation benefits the information technology sector should be revealed in further researches and the multi-country analysis is needed. Practical implications — The finding of the paper can be used to improve the development of innovation in information technology service companies and create a model for more exhaustive multi-country empirical researches. Originality/value — The impact of innovation and its development in information

  18. Innovation

    African Journals Online (AJOL)

    This article traces the history of record keeping in Zimbabwe and discusses the ethical considerations that go with the whole process. It tracks down the various archives within the country and abroad and evaluates their utility and accessibility to local and foreign researchers. Attention is given to efforts by the National ...

  19. Using Hybrid Model to Evaluate Performance of Innovation and Technology Professionals in Marine Logistics Industry

    Directory of Open Access Journals (Sweden)

    Qunzhen Qu

    2015-01-01

    Full Text Available With the development of marine logistics industry to grow, the government and corporate more and more attach importance to the performance evaluation of innovation and technology professionals. Combine the characteristics of marine logistics industry and innovative technology professionals to design a performance evaluation index of marine logistics industry in innovation and technology professionals, with the Analytic Hierarchy Process (AHP to determine the weights of the various performance indicatorsf and through the establishment of fuzzy comprehensive evaluation model to make the problems of complex performance evaluation quantification and then come to their performance evaluation results, and provide reference methods and recommendations for innovation and technology professionals in performance evaluation theory and practice of marine logistics industry.

  20. Wind Technology: A Framework for the Evaluation of Innovations¿ Impacts on the Diffusion Potential

    NARCIS (Netherlands)

    Dinica, V.

    2010-01-01

    This paper proposes a framework based on which innovations in wind power technologies can be evaluated from the standpoint of their contribution to diffusion expansion. The framework helps build up a missing link between the technical literature on innovations and policy-oriented contributions

  1. Innovation management and performance evaluation: structured process of literature review

    Directory of Open Access Journals (Sweden)

    Julieta Scheidt Dienstmann

    2014-03-01

    Full Text Available This article aims to provide a process for the construction of knowledge demanded by researchers at the initial stage of their work on innovation management. To meet this need, the process adopted was the ProKnow-C (Knowledge Development Process - Constructivist, which proposes the construction of researchers knowledge considering their perceptions on the subject, and the recognition of scientific articles analyzed. The knowledge generated in the researcher means, for this article, knowing what are the main journals, articles, authors and keywords associated with 15 articles with scientific recognition and aligned with the perception of the researcher on innovation management, with focus on results. Through this application, the process ProKnow-C is presented demonstrating how it can be used by researchers to meet their initial demands of building knowledge about innovation management and aims to instill future works  based on structured processes for selecting a theoretical framework in this field of knowledge.

  2. Diffusion of Innovations: Evaluation of the Sustainability of the ...

    African Journals Online (AJOL)

    Reported therapeutic coverage is high (the lowest TCR is 73 percent), but CDD motivation is low and turnover high (fifty percent in Ganye LGA) and this is viewed in this report as a serious threat to programme sustainability. Viewed as a new innovation in community health care delivery system. An understanding of the ...

  3. The female innovation-generation consumer's evaluation of ...

    African Journals Online (AJOL)

    Using virtual displays in South African clothing retail outlets could be a marketing communication strategy that attracted consumers to products or the actual stores. ... The innovation-generation consumer segment is the largest and foremost global consumer segment to date, with massive buying power, and this group's ...

  4. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  5. Use of a formal assessment instrument for evaluation of veterinary student surgical skills.

    Science.gov (United States)

    Schnabel, Lauren V; Maza, Paul S; Williams, Kimberly M; Irby, Nita L; McDaniel, Carolyn M; Collins, Brian G

    2013-05-01

    To (1) evaluate the design and use of a global rating scale assessment instrument in veterinary medical education and; (2) examine the effectiveness of 2 surgical techniques courses for improving the surgical skills of veterinary students. Instrument development; observational; survey-based. Students (n = 16) registered for 2 elective surgical techniques courses were enrolled on a volunteer basis. A 5-point global rating scale instrument was designed for the evaluation of 12 basic surgical skills by faculty evaluators and used to obtain student start and end scores during the courses. Upon conclusion of the courses, students completed a survey from which their opinions on their improvement as well as their desire for feedback were obtained. All authors agreed the instrument was easy to use. As groups, 3rd year students, 4th year students, and all students combined had significantly higher total skill scores at the end of the courses compared to the start of the courses. Individually, 10 students (63%) had significant improvement in surgical skills as a result of their participation in the courses: 4 (100%) 3rd year and 6 (50%) 4th year students. Student survey responses revealed a strong desire for feedback as well as support of formal assessment methods. Only weak agreement was found between student opinions on their improvement and the authors' assessment scores. Assessment instruments are useful for (1) student evaluation and (2) for providing students with feedback on their surgical skills. © Copyright 2013 by The American College of Veterinary Surgeons.

  6. An evaluation of Irish general surgical research publications from 2000 to 2009.

    LENUS (Irish Health Repository)

    Robertson, I J

    2010-12-01

    Maintaining a high standard of research, and being competitive in the funding application process requires a coordinated and focused research strategy. The first step in the formulation of such a strategy is the identification of those centres, and specifically those areas of study, in which Irish surgical research has previously performed strongly. The aim of this paper was to evaluate all surgical research produced in the Republic of Ireland in the first ten years of the new millennium.

  7. Evaluation of operation and death statistics at surgical procedures by using attribute control charts

    OpenAIRE

    Tomak, Leman; Bek, Yülsel

    2018-01-01

    Statistical Process Control (SPC) is a technique that enables the quality controllerto monitor, analyze, predict, control, and improve a production processthrough control charts. So to use of SPC in medical field is very important.The cases were obtained at the Ondokuz Mayis University Faculty of medicinedepartments of surgical sciences within two year were evaluated. The outcomesof the operations in these departments were followed throughout twenty-fourmonths. For a surgical procedure has tw...

  8. [Clinico-surgical evaluation of dental elements in bone inclusions].

    Science.gov (United States)

    Berrone, S; Gallesio, C; Modica, F; Benech, A

    1989-01-01

    Dental inclusions are assessed on the basis of clinical and operating statistics relating to the years 1981-1985 and comprising 815 patients and 1445 treated teeth. The results confirm the predominance of inclusions among female patients and the prevalence of the mandibular site; the most frequently included teeth are the lower eighths followed by the upper eighths, the upper canines and the second lower premolars. Inclusions are bilateral in most cases. These findings are in substantial agreement with the epidemiological data recorded in the literature. The operating series shows that the type of surgical treatment varies with the localisation of the tooth (anterior or posterior), its relationship with contigous teeth and with the surrounding anatomical structures and the age of the patient. Teeth in the posterior sector are usually extracted. At young age, germectomy is carried out for orthodontic purposes; at mature age, teeth are extracted to prevent the formation of periodontal pockets and the aggravation of caries and their complications. On the other hand, for teeth in the anterior sector, surgery is usually merely the first stage in treatment and is followed by treatment of orthodontic type with traction, in view of the important aesthetic and functional role of the labial teeth.

  9. Innovation evaluation model for macro-construction sector companies: A study in Spain.

    Science.gov (United States)

    Zubizarreta, Mikel; Cuadrado, Jesús; Iradi, Jon; García, Harkaitz; Orbe, Aimar

    2017-04-01

    The innovativeness of the traditional construction sector, composed of construction companies or contractors, is not one of its strong points. Likewise, its poor productivity in comparison with other sectors, such as manufacturing, has historically been criticized. Similar features are found in the Spanish traditional construction sector, which it has been described as not very innovative. However, certain characteristics of the sector may explain this behavior; the companies invest in R+D less than in other sectors and release fewer patents, so traditional innovation evaluation indicators do not reflect the true extent of its innovative activity. While previous research has focused on general innovation evaluation models, limited research has been done regarding innovation evaluation in the macro-construction sector, which includes, apart from the traditional construction companies or contractors, all companies related to the infrastructure life-cycle. Therefore, in this research an innovation evaluation model has been developed for macro-construction sector companies and is applied in the Spanish case. The model may be applied to the macro-construction sector companies in other countries, requiring the adaption of the model to the specific characteristics of the sector in that country, in consultation with a panel of experts at a national level. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. A method to evaluate the role of stakeholder dynamics in IT based innovation adoption processes.

    Science.gov (United States)

    Postema, Tim

    2010-01-01

    The introduction of new information technology in organizations seems to lead to mixed results in practice. Innovation adoption success is dependent on user commitment and absorption of the innovation in work processes. For that reason, much can be gained in insights in the role of stakeholders during innovation adoption. In this article we are presenting an evaluation method for stakeholder dynamics during the IT based innovation journey in relation to innovation adoption predictors. The method covers two evaluation elements of these stakeholder dynamics; (a) the changing nature of stakeholder salience and changing role involvements of stakeholders on the one hand, and (b) the changing nature of stakeholder-innovation interaction during the adoption processes on the other. It is argued that a stakeholder's capacity and intentions together determine his role involvement and influence on innovation adoption and thus its decision making unit membership. To further enhance usability of the described method, we propose the use of structured implementation activities and their effect during different phases of the innovation journey on the decision making unit as constructed through stakeholder analysis.

  11. Innovative Startup-Projects: Experience, Evaluation, Implementation Contradictions

    Directory of Open Access Journals (Sweden)

    Inshakov Maksim Olegovich

    2015-09-01

    Full Text Available Innovative companies in the conditions of global post-crisis economic recovery and increased economic activity become again a promising area for investments of large investment and venture capital funds, venture divisions of large transnational corporations, business angels and other private investors. This is confirmed by the data on the increase in the volume of venture capital market in the US and Europe and on a significant increase in the cost of the leading foreign and Russian start-up companies which are rated as of 2014 in the present article. The comparative analysis of the leading Russian and foreign start-ups showed the prevalence of companies engaged in the field of IT-Internet-Mobile and focused on the provision of various kinds of innovative services to consumers among the foreign participants of the rating. Among Russian startups-winners the companies of technological orientation (biological, medical, and “clean” technologies dominate. They reflect the increasing importance of start-ups in the innovative development of the Russian economy. Participation in such competitions and ratings is a favorable factor of promoting start-ups, increasing awareness of potential investors and consumers of start-up products. The importance of start-ups formation and the development of effective regional and national innovation systems update the studies related to the identification of the fundamental contradictions in the activities of Russian start-ups and to the development of recommendations for their resolution. The article identifies the key issues of economic, organizational, informational and marketing character causing the collapse of start-up projects in the Russian economy in modern conditions.

  12. Functional evaluation of patients with surgically treated terrible triad of the elbow

    Science.gov (United States)

    Brigato, Rafael Mulatti; Mouraria, Guilherme Grisi; Kikuta, Fernando Kenji; Coelho, Sérgio de Paula; Cruz, Márcio Alves; Zoppi, Américo

    2015-01-01

    OBJECTIVES: To evaluate the functional outcome of patients with surgically treated terrible triad of the elbow. METHODS: A retrospective evaluation was performed using the MEPS score (Mayo Elbow Performance Score) of patients diagnosed with terrible triad of the elbow who underwent surgical treatment. RESULTS: 14 patients (nine men and five women) and 15 elbows (one bilateral case) were evaluated. A MEPS average score of 78 points and 86% good and excellent results was obtained. As complications, we had one case of infection and three of neuropraxia of the ulnar nerve. CONCLUSION: The patients had stable elbow with good function, however with reduced range of motion. Level of Evidence IV, Case Series. PMID:26207090

  13. The impact of innovation support programmes on SME innovation in traditional manufacturing industries: an evaluation for seven EU regions

    NARCIS (Netherlands)

    Radicic, D.; Pugh, G.; Hollanders, H.J.G.M.; Wintjes, R.J.M.

    2014-01-01

    This study investigates the impact of innovation support programmes on SME innovation in traditional manufacturing industries in seven EU regions. Recent literature identifying sources of potential government failure in innovation policy suggests that the effects of public support measures to

  14. Multimedia data capture and management for surgical events: Evaluation of a system.

    Science.gov (United States)

    Cone, Stephen W; Leung, Anna; Mora, Francisco; Rafiq, Azhar; Merrell, Ronald C

    2006-06-01

    The objective of this study was to design an electronic form of documentation of surgical procedures, which would include audio and video recording of the entire surgical procedure. Video clips have shown promise for teaching surgical procedures. To date, no systems have been described to fully record video and audio of all events during a surgical procedure. Much as such systems have aided the airline industry, surgical safety, documentation, and education could benefit from comprehensive, multimedia documentation systems. Four camcorders provided views of: (1) anesthetic monitors, (2) laparoscopic images, (3) room view, and (4) surgical field view. All video and audio were combined with real-time written documentation of events within a simple, inexpensive database for archiving, review, and evaluation. Electronic records provided answers to more than 90% of the structured review questions, leaving only 6% unanswered, versus 92% unanswerable based on the traditional paper records. This electronic documentation system provides a much more comprehensive and easily mined means of surgical documentation than traditional paper records.

  15. Gross intraoperative evaluation (GIE): a reliable method for the evaluation of surgical margins at partial nephrectomy.

    Science.gov (United States)

    Yilmaz, Hasan; Ciftci, Seyfettin; Ozkan, Levend; Saribacak, Ali; Yildiz, Kursat; Dillioglugil, Ozdal

    2014-01-01

    To determine the efficacy of a new method called by us as "gross intra-operative evaluation (GIE)" for the assessment of surgical margin (SM) status. A total of 26 consecutive patients operated with cT1a-b renal tumors at a single center were included in this study. After the excision, the tumors were uniformly divided into two halves in the longitudinal axis ex vivo. In this way, margins were exposed for GIE for the evaluation of the safety of SMs. Findings of GIE were compared with the permanent section analysis in terms of SM status. Mean patient age, tumor size and margin thickness was 59 (38-79), 3.1 (1.5-6) cm and 3.7 (0.1-12) mm, respectively. In all patients, GIE showed intact margins and none of the patients had positive SM in the final pathological examination. There was no evidence of local recurrence or distant metastasis with a mean follow-up of 25 (4-104) months. All patients are alive. GIE of resected specimen without FS analysis is a safe and effective method for the evaluation of SMs in partial nephrectomy patients.

  16. EVALUATION OF THE IMPACT OF INNOVATIVE PROJECTS ON THE COMPETITIVENESS OF AGRICULTURAL HOLDINGS IN SLOVAK REPUBLIC

    Directory of Open Access Journals (Sweden)

    Ľubica RUMANOVSKÁ

    2013-01-01

    Full Text Available The scientific paper evaluates the impact of innovative projects on the competitiveness of agricultural holdings in SR. Evaluation of the impact of innovative projects on competitiveness of agricultural holdings was realized on the selected holdings in Nitra and Trnava region. For the evaluation was used RCR coefficient. With the use of RCR coefficient could be confirmed the scientific hypothesis - The innovative projects realized through Program for rural development SR 2007-2013 have positive impact on competitiveness of agricultural holdings. The possibilities for EU financial support for innovative projects in SR represent important source for introduction of new innovative technologies into production process and in future they can significantly contribute to the growth of competitiveness of agricultural subjects. Therefore, to increase competitiveness of agricultural holdings it is important to focus on modernization of machinery and buildings, use of natural sources for energy production, but also to increase the education and the flow of information between rural inhabitants, mainly farmers. In competitive area of EU agricultural sector it is necessary that agricultural holdings will innovate, not only to create independent flow of innovative products and knowledge, but also to increase its value on internal market. Agricultural holdings –receivers of financial support – have expressed the opinion that financial support realized through PRD SR 2007-2013 had definitely allowed them to implement new processes and products.

  17. Evaluation of Noninvasive Hemoglobin Monitoring in Surgical Critical Care Patients.

    Science.gov (United States)

    Xu, Tim; Yang, Ting; Kim, Joseph B; Romig, Mark C; Sapirstein, Adam; Winters, Bradford D

    2016-06-01

    To assess the clinical utility of noninvasive hemoglobin monitoring based on pulse cooximetry in the ICU setting. A total of 358 surgical patients from a large urban, academic hospital had the noninvasive hemoglobin monitoring pulse cooximeter placed at admission to the ICU. Core and stat laboratory hemoglobin measurements were taken at the discretion of the clinicians, who were blinded to noninvasive hemoglobin monitoring values. There was a poor correlation between the 2,465 time-matched noninvasive hemoglobin monitoring and laboratory hemoglobin measurements (r = 0.29). Bland-Altman analysis showed a positive bias of 1.0 g/dL and limits of agreement of -2.5 to 4.6 g/dL. Accuracy was best at laboratory values of 10.5-14.5 g/dL and least at laboratory values of 6.5-8 g/dL. At hemoglobin values that would ordinarily identify a patient as requiring a transfusion (monitoring consistently overestimated the patient's true hemoglobin. When sequential laboratory values declined below 8 g/dL (n = 102) and 7 g/dL (n = 13), the sensitivity and specificity of noninvasive hemoglobin monitoring at identifying these events were 27% and 7%, respectively. At a threshold of 8 g/dL, continuous noninvasive hemoglobin monitoring values reached the threshold before the labs in 45 of 102 instances (44%) and at 7 g/dL, noninvasive hemoglobin monitoring did so in three of 13 instances (23%). Noninvasive hemoglobin monitoring minus laboratory hemoglobin differences showed an intraclass correlation coefficient of 0.47 within individual patients. Longer length of stay and higher All Patient Refined Diagnostic-Related Groups severity of illness were associated with poor noninvasive hemoglobin monitoring accuracy. Although noninvasive hemoglobin monitoring technology holds promise, it is not yet an acceptable substitute for laboratory hemoglobin measurements. Noninvasive hemoglobin monitoring performs most poorly in the lower hemoglobin ranges that include commonly used

  18. EVALUATION OF TWO SURGICAL TREATMENTS OF PRIMARY VESICOURETERAL REFLUX AMONG CHILDREN: A 15 YEARS EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Memeti Shaban

    2016-07-01

    Full Text Available Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters with an open surgical technique and 32 patients (47 ureters with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. A good result was considered when reduction of VUR by 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days. All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and

  19. The use of the balanced scorecard in evaluating the results of the innovations implemented in metallurgical companies

    Directory of Open Access Journals (Sweden)

    L. Blacha

    2016-10-01

    Full Text Available Implementation of innovations is the main factor of development of companies’ competitiveness and effectiveness. Innovations result in creation of a value for both the client and the company. The article presents a method of evaluating the innovations implemented in industry which emphasises, on the background of qualitative changes, the measurable (quantitative effects of various types of innovations. For the purpose of measuring the results of implemented innovations the Balanced Scorecard was used. The method developed by the authors of the paper was used to evaluate results of the innovations implemented in metallurgical companies.

  20. Dig into Learning: A Program Evaluation of an Agricultural Literacy Innovation

    Science.gov (United States)

    Edwards, Erica Brown

    2016-01-01

    This study is a mixed-methods program evaluation of an agricultural literacy innovation in a local school district in rural eastern North Carolina. This evaluation describes the use of a theory-based framework, the Concerns-Based Adoption Model (CBAM), in accordance with Stufflebeam's Context, Input, Process, Product (CIPP) model by evaluating the…

  1. Evaluation of the US Department of Energy Weatherization Innovation Pilot Program (2010-2014)

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, Bruce Edward [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rose, Erin M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hawkins, Beth A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-05-01

    This report contains results from analysis conducted on each of the Weatherization Innovation Pilot Program (WIPP) grants awarded to 16 organizations by the US Department of Energy (DOE) in 2010. The purpose of WIPP was to explore the potential adoptability or replicability of innovative processes or technologies for the enhancement of DOE’s Weatherization Assistance Program (WAP). DOE initiated the WIPP grant to accelerate effective innovations in home energy efficiency and other WAP mission-related goals for income-qualifying households of low socioeconomic status. This study was performed alongside a broader, national evaluation of WAP conducted by Oak Ridge National Laboratory (ORNL) for DOE.

  2. Perioperative Evaluation of Pregnant Surgical Patients: A Review

    Directory of Open Access Journals (Sweden)

    Manu Gupta

    2016-06-01

    Full Text Available Pregnant Females require special perioperative consideration as females react differently to treatment from physiologic and behavioural standpoints. Thus a standard perioperative assessment plays a crucial role for successful accomplishment of intraoperative and postoperative phase as well as to resist complications due to pregnancy. Each physiologic system is affected in such a way that may or may not have clinical significance for the surgeons. Thus affect of Pregnancy on cardiovascular, respiratory, gastrointestinal, renal and endocrinal system have been reviewed. Moreover to decrease the hazards to the developing child, impact of surgery/treatment on the fetus has also been discussed. It was concluded that the goal of the perioperative evaluation of pregnant females is to identify its physiological effects on various systems and provide for the best efficacious perioperative treatment algorithm that shall minimize the patient morbidity.

  3. Prospective evaluation of daily performance metrics to reduce emergency department length of stay for surgical consults.

    Science.gov (United States)

    Horng, Steven; Pezzella, Lina; Tibbles, Carrie D; Wolfe, Richard E; Hurst, James M; Nathanson, Larry A

    2013-02-01

    As part of a quality improvement initiative to reduce Emergency Department (ED) length of stay (LOS) for surgical consult patients, we e-mailed performance metrics to key stakeholders on a daily basis. ED and Surgery leadership used these daily metrics to identify and remedy contributing factors for increased ED LOS in patients who received surgical consults. To evaluate whether a quality improvement process driven by a daily performance metric e-mail would be associated with a change in ED LOS for surgical consult patients. Prospective before-after study looking at ED LOS for surgical consult patients after an e-mail intervention at a tertiary academic teaching hospital. All consecutive adult ED patients between July 1, 2010 and October 1, 2010 who received a general surgical consult were enrolled. The primary outcome measure was ED LOS, and secondary outcome measure was time to consultation. There were 916 patients who had surgical consults placed during the study period; 459 patients presented before the intervention and 457 patients presented after the intervention. The median LOS decreased 54 min, from 463 min (interquartile range [IQR] 326-617) before the intervention to 409 min (IQR 294.5-528.5) after the intervention (p metric e-mails. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

    Science.gov (United States)

    Saluja, Saurabh; Silverstein, Allison; Mukhopadhyay, Swagoto; Lin, Yihan; Raykar, Nakul; Keshavjee, Salmaan; Samad, Lubna; Meara, John G

    2017-01-01

    The Lancet Commission on Global Surgery defined six surgical indicators and a framework for a national surgical plan that aimed to incorporate surgical care as a part of global public health. Multiple countries have since begun national surgical planning; each faces unique challenges in doing so. Implementation science can be used to more systematically explain this heterogeneous process, guide implementation efforts and ultimately evaluate progress. We describe our intervention using the Consolidated Framework for Implementation Research. This framework requires identifying characteristics of the intervention, the individuals involved, the inner and outer setting of the intervention, and finally describing implementation processes. By hosting a consultative symposium with clinicians and policy makers from around the world, we are able to specify key aspects of each element of this framework. We define our intervention as the incorporation of surgical care into public health planning, identify local champions as the key individuals involved, and describe elements of the inner and outer settings. Ultimately we describe top-down and bottom-up models that are distinct implementation processes. With the Consolidated Framework for Implementation Research, we are able to identify specific strategic models that can be used by implementers in various settings. While the integration of surgical care into public health throughout the world may seem like an insurmountable challenge, this work adds to a growing effort that seeks to find a way forward.

  5. Innovation in urban agriculture: Evaluation data of a participatory approach (ROIR).

    Science.gov (United States)

    Zoll, Felix; Specht, Kathrin; Siebert, Rosemarie

    2016-06-01

    The data in this article represent an evaluation of a participatory process called Regional Open Innovation Roadmapping (ROIR). The approach aims at the promotion of regional development. In this case, it was carried out to develop a specific innovation in the field of 'Zero-acreage farming' (ZFarming), which is a building-related subtype of urban agriculture. For the evaluation of the process, an online survey was sent to the 58 participants of the ROIR on March 4, 2014. The survey ended on April 8, 2014, and a response rate of 53.54% resulted in a sample size of 31 respondents. The survey was divided into seven different blocks. We analyzed the ROIR process׳s contribution to knowledge generation, the establishment of networks among the participants, the implementation of new projects related to ZFarming, and the increase of acceptance of ZFarming and the selected ZFarming innovation. Furthermore, other remarks, and personal information were collected. Hence, the objective of the survey was to assess whether ROIR is a useful tool to promote the aforementioned innovation drivers, and thereby, the selected innovation, which was developed throughout the process. The data were used in the research article "Application and evaluation of a participatory "open innovation" approach (ROIR): the case of introducing zero-acreage farming in Berlin" (Specht et al., 2016) [1].

  6. Radiofrequency-Based Identification Medical Device: An Evaluable Solution for Surgical Sponge Retrieval?

    Science.gov (United States)

    Lazzaro, Alessandra; Corona, Arianna; Iezzi, Luca; Quaresima, Silvia; Armisi, Luca; Piccolo, Ilaria; Medaglia, Carlo Maria; Sbrenni, Sergio; Sileri, Pierpaolo; Rosato, Nicola; Gaspari, Achille Lucio; Di Lorenzo, Nicola

    2017-06-01

    A retained surgical item in patients (gossypiboma) is a persisting problem, despite consistent improvements and existing guidelines in counting instruments and sponges. Previous experiences with radiofrequency identification technology (RFID) tracking sponges show that it could represent an innovation, in order to reduce the criticism and increase the effectiveness during surgical procedures. We present an automated system that allows reduction of errors and improves safety in the operating room. The system consists of 3 antennas, surgical sponges containing RFID tags, and dedicated software applications, with Wi-Fi real-time communication between devices. The first antenna provides the initial count of gauzes; the second a real-time counting during surgery, including the sponges thrown into the kick-bucket; and the third can be used in the event of uneven sponge count. The software allows management at all stages of the process. In vitro and in vivo tests were performed: the system provided excellent results in detecting sponges in patients' body. Hundred percent retained sponges were detected correctly, even when they were overlapped. No false positive or false negative was recorded. The counting procedure turned out to be more streamlined and efficient and it could save time in a standard procedure. The RFID system for sponge tracking was shown to be experimentally a reliable and feasible method to track sponges with a full detection accuracy in the operating room. The results indicate the system to be safe and effective with acceptable cost-effective parameters.

  7. Evaluation of four suture materials for surgical incision closure in Siberian sturgeon

    Science.gov (United States)

    Boone, S. Shaun; Hernandez, Sonia M.; Camus, Alvin C.; Peterson, Douglas C.; Jennings, Cecil A.; Shelton, James L.; Divers, Stephen J.

    2015-01-01

    The visual and microscopic tissue reactions to the absorbable monofilament Monocryl, absorbable monofilament triclosan-coated Monocryl-Plus, absorbable multifilament Vicryl, and nonabsorbable monofilament Prolene were evaluated for their use of surgical closure in Siberian Sturgeon Acipenser baerii. Postoperative assessments were conducted at 1, 2, 8, 12, and 26 and 55 weeks to visually evaluate the surgical incision for suture retention, incision healing, erythema, and swelling. Incisions were also assessed microscopically at 1, 2, and 8 weeks for necrosis, inflammation, hemorrhage, and fibroplasia. The results indicated that incisions closed with either Vicryl or Prolene suture materials were more likely to exhibit more erythema or incomplete healing compared with those closed with Monocryl or Monocryl-Plus. The surgical implantation of a transmitter in the coelomic cavity did not significantly affect the response variables among the four suture materials. Monocryl or Monocryl-Plus were equally effective and superior to other suture materials used for closing surgical incisions in Siberian Sturgeon or closely related species of sturgeon. Furthermore, Monocryl or Monocryl-Plus may decrease the risk of transmitter expulsion through the incision, as surgical wounds appear to heal faster and exhibit less erythema compared with those closed with Vicryl.

  8. Surgical robotics. Evaluation of the Computer Motion AESOP 3000 robotic endoscope holder.

    Science.gov (United States)

    2002-07-01

    The use of robots to manipulate surgical instruments inside the patient has already moved from the world of fiction to fact. While the widespread use of full-function surgical robots is still many years away, less sophisticated robots that perform very specific surgical functions are already at a stage where the typical hospital can consider their use. Currently, the most affordable and commonly used type of "surgical-assist" robot is the robotic endoscope holder, which is used to hold and position rigid endoscopes during minimally invasive surgery. In this study, we introduce readers to the topic of surgical robotics, focusing specifically on robotic endoscope holders. The study includes a Technology Management Guide, in which we discuss who should and who shouldn't consider implementing such robots, and it includes our evaluation protocol and findings for one such robot, the Computer Motion AESOP 3000. We judged the evaluated system based on its performance relative to the human scope holders it is designed to replace, as well as its safety and ease of use. While we found the AESOP 3000 to be an acceptable, and sometimes preferred, alternative to the use of a human scope holder, we caution that many healthcare facilities won't see sufficient clinical benefit to warrant its purchase at this time.

  9. Innovation and evaluation. Proposals for improving cross-project training university students in Education

    Directory of Open Access Journals (Sweden)

    Antonio Romero Muñoz

    2010-10-01

    Full Text Available This article reflects the results of the evaluation in the educational innovation project called "City of Rainbows", that has been developed at the University of Huelva since the academic year 2002/03.The experience, aims, tools and the process of evaluation followed are briefly described in it, focusing especially on evaluation an proposals for improvement which the various participants (faculty lecturer, students of Education, and actual teachers make on the impact of this innovation project to train the students of the Faculty of Education

  10. Evaluation of a new wound closure device for linear surgical incisions: 3M Steri-Strip S Surgical Skin Closure versus subcuticular closure.

    Science.gov (United States)

    Kerrigan, Carolyn L; Homa, Karen

    2010-01-01

    Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions. Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test. Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p Strip S versus suture for the abdomen was faster (p Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings. Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.

  11. Investigation and evaluation of key success factors in technological innovation development based on BWM

    Directory of Open Access Journals (Sweden)

    Sina Ghaffari

    2017-06-01

    Full Text Available Developing innovation, based on knowledge and technology, as a driving force of the economy, is necessary for survival and is required in having strong interactions within the globalized world of business. Innovation and technology development require an intertwined network of organizational interactions between public and private sector. The activities and interactions of these firms are the reasons for innovation development in the framework of innovation systems. Following strategies is of crucial necessity and importance in industries such as aerospace and remotely-piloted helicopters (RPH with their complex characteristics, costly and time-consuming processes. Understanding the business environment and identifying the success factors is a significant step towards adopting innovative strategies and planning for technology development. The aim of this article is to evaluate the key success factors in technological innovation development of remotely-piloted helicopters (RPH industry. The methodology used in this article is Best-Worst method which is considered as one of the most prominent and effective MCDM methods. Based on a case study and by reviewing the extant and relevant literature, the key success factors of technological innovation development of remotely-piloted helicopters (RPH industry in Iran were identified. Then by applying the “Best-Worst” method and the experts’ opinions, the key success factors were analyzed and prioritized. Finally, some suggestions are made by considering the results of the study.

  12. Process Evaluation of an Innovative Healthy Eating Website Promoting the Mediterranean Diet

    Science.gov (United States)

    Papadaki, A.; Scott, J. A.

    2006-01-01

    The Internet offers a promising medium for delivering nutrition education. This study aimed to evaluate user perceptions and usage patterns of an innovative healthy eating website promoting the Mediterranean diet. The website was evaluated over a 6-month period by female employees of University of Glasgow, aged 25-55 years. User satisfaction with…

  13. COMPOST-FREE BIOREACTOR TREATMENT OF ACID ROCK DRAINAGE LEVIATHAN MINE, CALIFORNIA INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As part of the Superfund Innovative Technology Evaluation (SITE) program, an evaluation of the compost-free bioreactor treatment of acid rock drainage (ARD) from the Aspen Seep was conducted at the Leviathan Mine Superfund site located in a remote, high altitude area of Alpine Co...

  14. A COMPARATIVE STUDY OF INDIGENOUS MODEL-ASSISTED INNOVATIVE AND CONVENTIONAL SURGICAL TEACHING IN A TERTIARY HEALTHCARE CENTRE

    Directory of Open Access Journals (Sweden)

    Sudhir Kumar Jain

    2016-09-01

    Full Text Available BACKGROUND Surgical teaching and learning needs lots of practical exposure and hands on training. It often becomes difficult to demonstrate practically hundreds of medical student’s steps of surgical examination, various surgical minor or major procedures on living patients. Three-dimensional demonstration of theoretical topics helps in easy understanding of the subject. On many occasions, theory classes using lectures and slide projection techniques become cumbersome and monotonous for both teachers and students leading to failure to achieve fruitful results. Computer and 3D simulator-assisted teaching may help in some cases, but yet to become available in many developing countries. Without proper practical knowledge when a surgical action is attempted on a living patient, there is always a chance of error. Keeping all these facts in view and the limited teaching resources available, over hundred self-made inexpensive teaching models are developed out of scrap materials and are used to teach medical students in medical colleges of Assam and the results compared with conventional teaching. MATERIALS AND METHODS In this study, the efficacy and effectiveness of the model-assisted teaching is compared with that of conventional teaching over a span of two years. RESULTS Some of the shortcomings of conventional teaching can be overcome by model-assisted teaching in terms of overall student attendance in the classes and the acceptance and understanding of the topic concerned. CONCLUSION These models help in filling the voids in surgical learning and can be used as an effective adjunct to conventional surgical teaching.

  15. Post-Occupancy Evaluation of a Mental Healthcare Facility Based on Staff Perceptions of Design Innovations.

    Science.gov (United States)

    Kalantari, Saleh; Snell, Robin

    2017-07-01

    This study was a post-occupancy evaluation (POE) to examine the effectiveness of three specific design innovations in a mental healthcare facility. In addition to collecting data about the impact of these specific designs, the study provides a model for the broader implementation of POE approaches in the mental healthcare context. POEs in general healthcare settings have been shown to lead to better work environments and better outcomes for patients. Despite growing evidence of the value provided by POE studies, the industry has been somewhat slow to adopt their regular use, in part due to unfamiliarity with the POE process. This is particularly true in mental healthcare contexts, where POE studies remain virtually nonexistent. In-depth interviews and a widely distributed, anonymous survey were used to collect hospital staff perceptions and feedback regarding the impact of specific design features. The hospital staff were quite enthusiastic about two of the design innovations studied here (a new wayfinding strategy and the use of vibrant colors in specific areas of the facility). The third innovation, open-style communication centers, elicited more mixed evaluations. The results include extensive hypothesis testing about the effects of each innovation as well as narrative discussions of their pros and cons. The study generated new knowledge about three specific mental healthcare design innovations and provides a model for the practical implementation of a POE approach in mental healthcare contexts. The results are particularly relevant for designers who are considering innovative strategies in future mental healthcare facilities.

  16. INNOVATION CAPITAL – A POSSIBLE APPROACH IN EVALUATION THE INTANGIBLES ASSETS

    Directory of Open Access Journals (Sweden)

    Dan C. DURAN

    2014-12-01

    Full Text Available In an era of knowledge are many aspects to operating a successful business, things like hard work and perseverance are fairly obvious but other less tangible resources like creativity and innovation are also paramount to the long-term success of most modern organizations. Over the last few years many companies have begun looking beyond the traditional idea of what makes a company innovative and have started to explore a kind of mix and match approach to applying various creative methodologies within their organizations in the attempt to inspire innovation.The aim of the paper is is twofold. Firstly is presents a new evaluation model of innovation capital. Secondly, the proposed model is tested and validated in a company. This model helps managers to focus their attention on the increase of the value of innovation–related intangibles assets.

  17. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure

    Directory of Open Access Journals (Sweden)

    Kiran Kumar Ganji

    2012-01-01

    Full Text Available Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20 patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening and adjacent sites: Plaque and Gingival Indices (PI & (GI, Position of Gingival Margin from reference Stent (PGMRS, Probing depth (PD, and Biologic Width (BW. Statistical Analysis Used. Student “t” Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group and 1.95 mm (Ostectomy procedure B2 Group and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  18. Innovation and invention in Finland. Strategies for networking. An international evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zegveld, W.; McCarthy, S.; Lemola, T.

    1998-12-31

    The objective of the evaluation was to come up with recommendations on how the Finnish systems for promoting independent inventions and their commercialisation could be most appropriately developed. In practice, the evaluation was expected to address at least the following aspects of the promotion: The role of the public sector; The role of the private sector (inventors, financiers, companies); The evaluation of the Finnish Foundation for Inventions (FFI); The strengths and weaknesses of the present system for promoting inventions and their commercialisation. In effect, the evaluation proved to be the evaluation of a subsystem integrated within the overall Finnish National System of Innovation with its many players from the public and private sectors. An effort was made to evaluate the relationship between the different actors in this system and closer cooperation is recommended in many areas. Interviews were held with 130 individuals from 70 organisations. The evaluators address the following nine issues: (1) Improving the balance between r and d and the promotion of inventiveness/innovation; (2) Increased coherence between the different organisations; (3) The responsibility of inventors and research organisations in inventive activities and the role of support organisations; (4) A gradual shift towards private services; (5) The development of the role of FFI; (6) Improving the competence in the area of intellectual property rights; (7) Financial incentives for inventors; (8) Increasing the awareness on invention and innovation; (9) The requirement to broaden the concept of inventiveness and innovation. (orig.)

  19. Evaluation of surgical margins according to the histological type of basal cell carcinoma.

    Science.gov (United States)

    Godoy, Charles Antonio Pires de; Neta, Alice Lima de Oliveira; Leão, Sofia Silveira de Souza; Dantas, Raul Lima; Carvalho, Valeska Oliveira Fonseca; Silva, Samuel Freire da

    2017-01-01

    Basal cell carcinoma is the most common skin cancer in the world. The aim of this study was to evaluate the surgical margin of basal cell carcinoma and correlate this with its histologic subtype. A retrospective analysis of pathology laboratory records from 1990 to 2000 was performed and the following data was collected: age, sex, race, anatomical location, histological type, and state of the excision margins in 1,428 histopathological reports of basal cell carcinoma. Ages ranged from 6 to 99 years, with an average of 57. There was a slight predominance of lesions in white women patients, and the most common histological subtype was the nodular, followed by the superficial. The most common locations were in the head and neck, with highest prevalence appeared in the nose. Surgical margins revealed a lateral involvement of 20.14% and a deep involvement of 12.47%. The fibrosing basal cell carcinoma is the histological type that most often presented positive surgical margins.

  20. Evaluation of the surgical apgar score in patients undergoing Ivor-Lewis esophagectomy.

    Science.gov (United States)

    Strøyer, Simon; Mantoni, Teit; Svendsen, Lars Bo

    2017-02-01

    The Surgical Apgar Score is a simple outcome score based on intraoperative parameters. The scoring system is recently validated in patients undergoing esophagectomy but without comparable results. This study evaluated the ability of the original and modified Surgical Apgar Scores to predict major complications in a patient population undergoing Ivor-Lewis esophagectomy. We retrospectively examined 234 patients who successfully underwent Ivor-Lewis esophagectomy at Rigshospitalet, Copenhagen from November 23, 2011 till November 23, 2014. Major complications were defined as Clavien-Dindo grade IIIa or higher within 30 days after surgery. Univariate and multivariate analyses were performed to assess factors associated with major complications. Receiver operating characteristics were performed for determination of the predictive value of the Surgical Apgar Score scoring systems. There were 64 (27.4%) patients with at least one major complication and 4 (1.7%) deaths. The original and modified versions of the Surgical Apgar Score were not associated with major complications and the scoring systems showed no significant predictive value when receiver operating characteristics were performed. The original or modified versions of the Surgical Apgar Score could possibly be useful in some subgroups of esophagectomy patients, but should not be considered to have a general predictive value. J. Surg. Oncol. 2017;115:186-191. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. Evaluation of a portable image overlay projector for the visualisation of surgical navigation data: phantom studies.

    Science.gov (United States)

    Gavaghan, K; Oliveira-Santos, T; Peterhans, M; Reyes, M; Kim, H; Anderegg, S; Weber, S

    2012-07-01

    Presenting visual feedback for image-guided surgery on a monitor requires the surgeon to perform time-consuming comparisons and diversion of sight and attention away from the patient. Deficiencies in previously developed augmented reality systems for image-guided surgery have, however, prevented the general acceptance of any one technique as a viable alternative to monitor displays. This work presents an evaluation of the feasibility and versatility of a novel augmented reality approach for the visualisation of surgical planning and navigation data. The approach, which utilises a portable image overlay device, was evaluated during integration into existing surgical navigation systems and during application within simulated navigated surgery scenarios. A range of anatomical models, surgical planning data and guidance information taken from liver surgery, cranio-maxillofacial surgery, orthopaedic surgery and biopsy were displayed on patient-specific phantoms, directly on to the patient's skin and on to cadaver tissue. The feasibility of employing the proposed augmented reality visualisation approach in each of the four tested clinical applications was qualitatively assessed for usability, visibility, workspace, line of sight and obtrusiveness. The visualisation approach was found to assist in spatial understanding and reduced the need for sight diversion throughout the simulated surgical procedures. The approach enabled structures to be identified and targeted quickly and intuitively. All validated augmented reality scenes were easily visible and were implemented with minimal overhead. The device showed sufficient workspace for each of the presented applications, and the approach was minimally intrusiveness to the surgical scene. The presented visualisation approach proved to be versatile and applicable to a range of image-guided surgery applications, overcoming many of the deficiencies of previously described AR approaches. The approach presents an initial step

  2. [What and how to evaluate clinical-surgical competence. The resident and staff surgeon perspective].

    Science.gov (United States)

    Cervantes-Sánchez, Carlos Roberto; Chávez-Vizcarra, Paola; Barragán-Ávila, María Cristina; Parra-Acosta, Haydee; Herrera-Mendoza, Renzo Eduardo

    2016-01-01

    Evaluation is a means for significant and rigorous improvement of the educational process. Therefore, competence evaluation should allow assessing the complex activity of medical care, as well as improving the training process. This is the case in the evaluation process of clinical-surgical competences. A cross-sectional study was designed to measure knowledge about the evaluation of clinical-surgical competences for the General Surgery residency program at the Faculty of Medicine, Universidad Autónoma de Chihuahua (UACH). A 55-item questionnaire divided into six sections was used (perception, planning, practice, function, instruments and strategies, and overall evaluation), with a six level Likert scale, performing a descriptive, correlation and comparative analysis, with a significance level of 0.001. In both groups perception of evaluation was considered as a further qualification. As regards tools, the best known was the written examination. As regards function, evaluation was considered as a further administrative requirement. In the correlation analysis, evaluation was perceived as qualification and was significantly associated with measurement, assessment and accreditation. In the comparative analysis between residents and staff surgeons, a significant difference was found as regards the perception of the evaluation as a measurement of knowledge (Student t test: p=0.04). The results provide information about the concept we have about the evaluation of clinical-surgical competences, considering it as a measure of learning achievement for a socially required certification. There is confusion as regards the perception of evaluation, its function, goals and scopes as benefit for those evaluated. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  3. Innovation in urban agriculture: Evaluation data of a participatory approach (ROIR

    Directory of Open Access Journals (Sweden)

    Felix Zoll

    2016-06-01

    Full Text Available The data in this article represent an evaluation of a participatory process called Regional Open Innovation Roadmapping (ROIR. The approach aims at the promotion of regional development. In this case, it was carried out to develop a specific innovation in the field of ‘Zero-acreage farming’ (ZFarming, which is a building-related subtype of urban agriculture. For the evaluation of the process, an online survey was sent to the 58 participants of the ROIR on March 4, 2014. The survey ended on April 8, 2014, and a response rate of 53.54% resulted in a sample size of 31 respondents. The survey was divided into seven different blocks. We analyzed the ROIR process׳s contribution to knowledge generation, the establishment of networks among the participants, the implementation of new projects related to ZFarming, and the increase of acceptance of ZFarming and the selected ZFarming innovation. Furthermore, other remarks, and personal information were collected. Hence, the objective of the survey was to assess whether ROIR is a useful tool to promote the aforementioned innovation drivers, and thereby, the selected innovation, which was developed throughout the process. The data were used in the research article “Application and evaluation of a participatory “open innovation” approach (ROIR: the case of introducing zero-acreage farming in Berlin” (Specht et al., 2016 [1].

  4. An Evaluation of Preparedness, Delivery and Impact of Surgical and Anesthesia Care in Madagascar: A Framework for a National Surgical Plan.

    Science.gov (United States)

    Bruno, Emily; White, Michelle C; Baxter, Linden S; Ravelojaona, Vaonandianina Agnès; Rakotoarison, Hasiniaina Narindria; Andriamanjato, Hery Harimanitra; Close, Kristin L; Herbert, Alison; Raykar, Nakul; Saluja, Saurabh; Shrime, Mark G

    2017-05-01

    The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar. Data collection was by semi-structured interviews with ministerial, medical, laboratory, pharmacy, and administrative representatives in each region. Microsimulation modeling was used to calculate values for financial indicators. In Madagascar, 29% of the population can access a surgical facility within 2 h. Surgical workforce density is 0.78 providers per 100,000 and annual surgical volume is 135-191 procedures per 100,000 with a perioperative mortality rate of 2.5-3.3%. Patients requiring surgery have a 77.4-86.3 and 78.8-95.1% risk of incurring impoverishing and catastrophic expenditure, respectively. Of the six LCoGS indicator targets, Madagascar meets one, the reporting of perioperative mortality rate. Compared to the LCoGS targets, Madagascar has deficits in surgical access, workforce, volume, and the ability to offer financial risk protection to surgical patients. Its perioperative mortality rate, however, appears better than in comparable countries. The government is committed to improvement, and key stakeholder meetings to create a national surgical plan have begun.

  5. Big Data as Innovative Approach for Usability Evaluations of Buildings

    OpenAIRE

    Olsson, Nils; Bull-Berg, Heidi; Junghans, Antje

    2014-01-01

    Purpose: The purpose of this paper is to investigate how Big Data can add a new dimension to usability evaluations of buildings. Background: There is a tremendous growth in the volume of available data, creating the “Big Data” trend. Industries such as IT, retail and transportation can present a number of examples of successful applications of Big Data. Usability has traditionally been analysed by qualitative research methods, and Big Data gives an opportunity to add quantitative data in s...

  6. Bias in surgical research.

    Science.gov (United States)

    Paradis, Carmen

    2008-08-01

    The aim is to discuss the various forms of bias in surgical research, including how it impacts validity and how to recognize and avoid it. The various factors affecting bias in surgical research's design, execution, and reporting were explored. The impact of these factors on internal and external validity in both observational and randomized controlled trials was examined, and recommendations were made for ameliorating the various biases. Identifying bias when interpreting a trial enables surgeons to assess surgical research's internal and external validity. Avoiding bias and/or using methods that minimize bias helps surgeons design and conduct trials with enhanced validity, which can be reliably translated into practice. To accomplish this, surgeons need to be cognizant of susceptibility bias, the applicability of surrogate endpoints, and the use of inappropriate comparators in trial design. They must also be aware of detection, ascertainment, performance and transfer bias in trial execution, and of citation bias in trial reporting. Familiarity with clinical trials' potential biases helps surgeons assess the believability and applicability of research results. Though these biases may sometimes be ameliorated by randomization, blinding, and intervention standardization, these remedies can present distinctive problems to surgical research. This poses a unique need and opportunity for innovation in surgical research design and evaluation. It necessitates that further research be done on methods to improve not only the internal and external validity of surgical trials but also their assessment.

  7. The evaluation of knowledge claims in an innovation project : A case study

    NARCIS (Netherlands)

    Peters, K.; Jorna, R.J.J.M.; Maruster, L.

    2011-01-01

    Understanding how an organization determines what knowledge is valid leads to new insights about how firms cope with innovation. Although the evaluation of knowledge is a relevant topic in the field of knowledge management, the existing literature does not provide substantial contributions. Nonaka

  8. An Evaluation of an Innovative Drug Education Program: First Year Results.

    Science.gov (United States)

    Schaps, Eric; And Others

    An innovative drug education course was taught to seventh and eighth graders and evaluated in a true experiment. Students learned Lasswell's framework for understanding human needs and motives, a systematic decision-making procedure, and information about the pharmacological, psychological, and social consequences of licit and illicit drug use.…

  9. Innovative Access Programme for Young Mothers Wishing to Train in Childbirth Education: From Concept to Evaluation

    Science.gov (United States)

    Nolan, Mary L.

    2008-01-01

    This paper describes the conception, planning, implementation and evaluation of an access programme arising out of an innovative collaboration between two charities, Straight Talking and the National Childbirth Trust. The access programme was designed at the request of a group of young mothers who had finished compulsory education and subsequently…

  10. Strategic Management and Innovation: A Checklist for Readiness Evaluation of AACSB Standards

    Science.gov (United States)

    Kundu, Goutam Kumar; Bairi, Jayachandra

    2016-01-01

    Purpose: The purpose of this paper is to introduce the concept of a checklist, focusing on the detailed analysis of the requirement of the Association to Advance Collegiate Schools of Business (AACSB) standards related to strategic management and innovation area, for evaluation of implementation readiness in a business school setting.…

  11. Student Evaluation of Teaching Effectiveness of a Nationwide Innovative Education Program on Image Display Technology

    Science.gov (United States)

    Yueh, Hsiu-Ping; Chen, Tzy-Ling; Chiu, Li-An; Lee, San-Liang; Wang, An-Bang

    2012-01-01

    The study presented here explored a student evaluation of the teaching effectiveness of a nationwide innovative education program on image display technology in Taiwan. Using survey data collected through an online questionnaire system, covering 165 classes across 30 colleges and universities in Taiwan, the study aimed to understand the teaching…

  12. Evaluation of an Innovative Sand Filter for Small System Drinking Water Treatment

    Science.gov (United States)

    Results of evaluation of an innovative sand filter that uses the concepts of both slow and rapid sand filtration are presented in this article. The system uses a low-cost “Drum Sand Filter” (DSF) that consists of a 55-gallon drum filled with layers of sand of varying size. A low-...

  13. Using Developmental Evaluation as a Design Thinking Tool for Curriculum Innovation in Professional Higher Education

    Science.gov (United States)

    Leonard, Simon N.; Fitzgerald, Robert N.; Riordan, Geoffrey

    2016-01-01

    This paper argues for the use of "developmental" evaluation as a design-based research tool for sustainable curriculum innovation in professional higher education. Professional education is multi-faceted and complex with diverse views from researchers, professional practitioners, employers and the world of politics leaving little…

  14. Innovative procedures to evaluate corn silage for milk yield

    Directory of Open Access Journals (Sweden)

    C. Zanfi

    2010-01-01

    Full Text Available Corn silage is the main ingredient of diets for dairy cattle (around 40% of diet DM in Italy and, therefore, an accurate estimation of its nutritive value is essential to describe the whole diet. Given the low, and fairly stable protein, lipid and ash contents in corn silage (e.g. a total of around 15% DM, the critical point to evaluate its energy value is the amount and availability of the two main carbohydrate fractions (NDF and non fiber carbohydrates, NFC.

  15. Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons.

    Science.gov (United States)

    Rosser, J C; Rosser, L E; Savalgi, R S

    1998-06-01

    Laparoscopic surgery adapts poorly to apprenticeship models for general surgical training. Standardized skill acquisition and validation programs, targeted performance goals, and a supervised, enforced, skill-based curriculum that readily can be shared between trainee and instructor must replace the observation and incremental skill-acquisition model used in an open surgical environment. The Yale Laparoscopic Skills and Suturing Program was used to develop a data bank for objective evaluation of dexterity and suturing skills for laparoscopic surgical training. The current study compares trainee and senior surgeon performance in this standardized training program. To compare objectively evaluated laparoscopic surgical skills and suturing capability of senior surgeons and of residents after they have completed the same standardized training regimen. Two hundred ninety-one trained surgeons performed 8730 standardized laparoscopic dexterity drills and 2910 intracorporeal suturing exercises in the Yale Laparoscopic Skills and Suturing Program. Their performance was supervised by an instructor who recorded performance and timing of the tasks in a 2 1/2-day program. Ninety-nine residents performed the same drills and exercises the same number of times and followed the same technique for intracorporeal suturing. Percentile graphs were prepared for each type of drill and suturing exercise to allow comparison of levels of achievement among different training groups. The performance of the residents was the same as that of trained surgeons for the rope pass drill and the suturing exercise. Residents in comparison with trained surgeons performed the triangle transfer drill faster and the new cup drop drill and old cup drop drill more slowly. There was no significant difference in performance between male and female residents. Basic skills relevant to laparoscopic performance can be acquired with a high level of competence in a brief course unrelated to prior surgical

  16. Impact Evaluation of a Program of Public Funding of Private Innovation Activities. An Econometric Study of FONTAR in Argentina

    OpenAIRE

    Andrés López; Ana María Reynoso; Martín Rossi

    2010-01-01

    This report contains an evaluation of the Argentinean Technological Fund (FONTAR), whose main objective is to fund projects presented by private firms which aim at improving their competitive performance through technological innovation activities. The main goal of this evaluation is to analyze the impact of FONTAR's programs on the innovation activities of granted firms. The authors also try to ascertain whether FONTAR contributed to improve supported firms' innovative outputs and productive...

  17. Environment and innovation. An evaluation of EU strategies and policies; Umwelt und Innovation. Eine Evaluation von EU-Strategien und Politiken

    Energy Technology Data Exchange (ETDEWEB)

    Hertin, Julia; Jacob, Klaus; Kahlenborn, Walter

    2008-03-15

    This study outlines the methodology and results of the research project: ''Umwelt, Innovation und Beschaeftigung in einem europaeischen Kontext: Europaeische Strategien als ein Motor fuer oekeffiziente Technologien und Wettbewerbsfaehigkeit'', funded by the BMU and UBA and carried out jointly by the Forschungsstelle fuer Umweltpolitik of Freie Universitaet Berlin and Adelphi Consult. The project was carried out with the intention to evaluate inhowfar current EU policies follow and implement goals that can be classified as ''ecological industrial policy''. In the definition of the BMU, this concept means a political strategy which enhances eco-efficient innovations beyond the traditional approaches of environmental and R + D policy. A strategy of this type is to influence the innovation behaviour and also influence the marketing conditions for generic technologies. As the strategy intends to effect both a reduction of the ecological burden and an enhancement of the economic and competitive standing, it can recur to a two-fold foundation. The current investigation attempted to identify political measures at EU level that are suited for enhancing fast development and propagation of eco-efficient technologies. (orig.)

  18. Evaluation life quality of oral anticoagulated patients following oral surgical interventions

    OpenAIRE

    Dimova, Cena; Zdravkovska, Milka

    2016-01-01

    INTRODUCTION. The aim of this study was to evaluate patients on oral anticoagulants about their experience of life quality following different oral surgery interventions. MATERIAL AND METHOD. The study consisted of 260 patients referred for oral surgical treatment. An equal number of patients were assigned to each group (60 individuals). Group 1 was with deep venous thrombosis, Group 2 was with myocardial infarct, Group 3 with cerebrovascular insult and Group 4 with artificial heart valve...

  19. Life quality evaluation of oral anti-coagulated patients following oral surgical interventions

    OpenAIRE

    Dimova, Cena; Zdravkovska, Milka

    2015-01-01

    INTRODUCTION. The aim of this study was to evaluate patients on oral anticoagulants about their experience of life quality following different oral surgery interventions. MATERIAL AND METHOD. The study consisted of 260 patients referred for oral surgical treatment.. An equal number of patients were assigned to each group (60 individuals). Group 1 was with deep venous thrombosis, Group 2 was with myocardial infarct, Group 3 with cerebrovascular insult and Group 4 with artificial heart valv...

  20. Surgical, functional and audiological evaluation of new Baha? Attract system implantations

    OpenAIRE

    Gaw?cki, Wojciech; Stieler, Olgierd Maciej; Balcerowiak, Andrzej; Komar, Dariusz; Gibasiewicz, Renata; Karlik, Micha?; Szyfter-Harris, Joanna; Wr?bel, Maciej

    2016-01-01

    Bone-anchored hearing aids are well-established solutions for treatment of hearing-impaired patients. However, classical systems with percutaneous abutments have disadvantages concerning aesthetics, hygiene and adverse soft tissue reactions. The study aimed to evaluate surgical, functional and audiological results of a new Baha? Attract system, in which the sound processor is attached by magnetic force. Twenty patients implanted with a Baha? Attract system were divided into two groups: A?bila...

  1. Evaluation of cost and length of stay, linked to complications associated with major surgical procedures.

    Science.gov (United States)

    Pirson, M; Dehanne, F; Van den Bulcke, J; Leclercq, P; Martins, D; De Wever, A

    2017-06-19

    A lot of studies have demonstrated the possibility of reducing the number of post-operative complications in the domain of major surgical procedures with the use of medical preventive techniques. However, complications following surgical procedures are unfortunately frequent and are a major problem, not only because of the impact for the patient, but also because of economic consequences that they provoke. The aim of the present study is to evaluate the extra length of stay and the extra cost, born by the hospital and the social security, linked to complications, incurring after major surgical procedures. Study based on the data from 13 Belgian hospitals for the year 2012. Complications were extracted through medical discharge summaries. The cost born by the social security was assessed on the basis of the billing data, hospital cost are taken from cost accounting studies. The rate of complication for all the hospitals is 6.6%. About 30.3% of inpatient stays having a major or extreme severity of index had a complication during the stay, 1.8% of stays with a minor or moderate severity of index had a complication. The extra length of stay is 19.38 days when the stay has had a complication (p field of major surgical procedures having caused complications. Results should encourage Belgian authorities to propose and finance preventive measures in order to reduce these complications, which represent major economic impacts, not only for authorities but also for hospitals.

  2. PRE-MARKET CLINICAL EVALUATIONS OF INNOVATIVE HIGH-RISK MEDICAL DEVICES IN EUROPE

    DEFF Research Database (Denmark)

    Hulstaert, F.; Neyt, M.; Vinck, I.

    2012-01-01

    data are available? We studied the premarket clinical evaluation of innovative high-risk medical devices in Europe compared with the US, and with medicines, where appropriate. Methods: The literature and regulatory documents were checked. Representatives from industry, Competent Authorities, Notified...... of premarket trials in Europe and number of patients exposed, but failed as this information is not made public. Furthermore, the Helsinki Declaration is not followed with respect to the registration and publication of premarket trials. Conclusions: For innovative high-risk devices, new EU legislation should...

  3. Evaluating the impact of farm scale innovation at catchment scale

    Science.gov (United States)

    van Breda, Phelia; De Clercq, Willem; Vlok, Pieter; Querner, Erik

    2014-05-01

    Hydrological modelling lends itself to other disciplines very well, normally as a process based system that acts as a catalogue of events taking place. These hydrological models are spatial-temporal in their design and are generally well suited for what-if situations in other disciplines. Scaling should therefore be a function of the purpose of the modelling. Process is always linked with scale or support but the temporal resolution can affect the results if the spatial scale is not suitable. The use of hydrological response units tends to lump area around physical features but disregards farm boundaries. Farm boundaries are often the more crucial uppermost resolution needed to gain more value from hydrological modelling. In the Letaba Catchment of South Africa, we find a generous portion of landuses, different models of ownership, different farming systems ranging from large commercial farms to small subsistence farming. All of these have the same basic right to water but water distribution in the catchment is somewhat of a problem. Since water quantity is also a problem, the water supply systems need to take into account that valuable production areas not be left without water. Clearly hydrological modelling should therefore be sensitive to specific landuse. As a measure of productivity, a system of small farmer production evaluation was designed. This activity presents a dynamic system outside hydrological modelling that is generally not being considered inside hydrological modelling but depends on hydrological modelling. For sustainable development, a number of important concepts needed to be aligned with activities in this region, and the regulatory actions also need to be adhered to. This study aimed at aligning the activities in a region to the vision and objectives of the regulatory authorities. South Africa's system of socio-economic development planning is complex and mostly ineffective. There are many regulatory authorities involved, often with unclear

  4. Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia

    Directory of Open Access Journals (Sweden)

    Marco Felipe Francisco Honorato Barros

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate. MATERIAL AND METHODS: This was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure. RESULTS: The DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01. In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia. CONCLUSION: Use of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

  5. Usefulness of gadolinium in MRI evaluation of non surgically treated herniated disk.

    Science.gov (United States)

    Motta, E; Boniotti, V; Miserocchi, L; Caudana, R

    2005-01-01

    The rationale for the use of Gadolinium (Gd) in the MRI evaluation of non surgically treated herniated disk is based on the known presence of inflammatory granulation tissue and neoangiogenesis which plays an important role in both pain and the spontaneous resorption of the hernia. of this study was to determine the usefulness of Gd in MRI examination for detecting the inflammatory reaction around the discal hernia. Thirty-eight patients (mean age 45 years; range 20-70 years) with non surgically treated herniated disk were evaluated with MRI between January 2000 and July 2004. T2w-FAST-SE sagittal and T1w-SE transaxial and sagittal images were acquired before and after the administration of Gd. Twenty out of 22 patients with acute sciatic pain (symptoms =/discal hernia in the spinal canal. In the remaining 16 with chronic sciatic pain (symptoms > 6 months) the discal hernia did not show peri-hernial enhancement. In MRI evaluation of the herniated disk, peri-hernial enhancement is correlated with inflammatory reaction around the hernia which is associated with acute symptoms. The absence of peri-hernial enhancement in chronic herniated disk is due to the poorly vascular fibrotic tissue. Therefore, peri-hernial enhancement facilitates the differential diagnosis in uncertain cases and represents a reliable prognostic index of response to non-surgical therapy and of the possible spontaneous resorption of discal hernia.

  6. Laparoscopic-Assisted Tension-free Vaginal Mesh: An Innovative Approach to Placing Synthetic Mesh Transvaginally for Surgical Correction of Pelvic Organ Prolapse

    OpenAIRE

    Watanabe, Toyohiko; Inoue, Miyabi; Ishii, Ayano; Yamato, Toyoko; Yamamoto, Masumi; Sasaki, Katsumi; Kobayashi, Yasuyuki; Araki, Motoo; Uehara, Shinya; Saika, Takashi; Kumon, Hiromi

    2012-01-01

    Polypropylene mesh implants for the correction of pelvic organ prolapse (POP) are now available in Japan. We developed an innovative approach for correcting POP by placing polypropylene mesh transvaginally with laparoscopic assistance. From June 2007 through March 2010, sixteen consecutive patients with symptomatic stage 2 or 3 pelvic organ prolapse underwent the laparoscopic-assisted tension-free vaginal mesh procedure at Okayama University Hospital. All patients were evaluated before and at...

  7. The Future of the Space Age or how to Evaluate Innovative Ideas

    Science.gov (United States)

    Vollerthun, A.; Fricke, E.

    2002-05-01

    Based on an initiative of the German Aerospace Industry Association to foster a more transparent and structured funding of German commercial-oriented space projects a three-phased approach is suggested in this paper, to stepwise improve and evaluate proposed concepts for space-related innovations. The objective of this concept was to develop a transparent, structured, and reproducible process to select the right innovative project in terms of political, economical, and technical objectives for funding by e.g. a governmental agency. A stepwise process and related methods, that cover technical as well as economical aspects (and related sensitivities) are proposed. Based on the special needs and requirements of space industry the proposals are compared to a set of predefined top level objectives/requirements. Using an initial trades analysis with the criteria company, technology, product, and market, an initial business case is analyzed. The alternative innovative concepts are in the third process step subject to a very detailed analysis. The full economical and technical scale of the projects is evaluated and metrics for e.g. the 'Return on Investment' or 'Break Even Point' are determined, to compare the various innovations. Risks related to time, cost, and quality are considered, when performing sensitivity analysis by varying the most important factors of the project. Before discussing critical aspects of the proposed process, space-related examples will be presented to show how the process could be applied, and how different concepts should be evaluated.

  8. THE PRACTICE OF EVALUATING THE ECONOMIC EFFICIENCY OF THE INNOVATIVE PROJECT

    Directory of Open Access Journals (Sweden)

    I. A. Vorobiev

    2013-01-01

    Full Text Available At the present stage of development of the society of scientific and technical activities is the most important factor in the intensification of production and the growth of its economic performance. It is therefore important now gets to determine the effectiveness of research and development activities, improving the measurement methods of economic evaluation of innovative projects and innovation. For informed decision-making requires a deep study and objective assessment of the real situation. This is due to changes in economic relations between the producers and consumers of scientific and technical products. Earlier in this activity involved only state scientific institution and the enterprise, then now they are gradually joining financial institutions, commercial and non-profit organizations. The adoption of innovative solutions should be preceded by thorough and comprehensive analysis of the economic feasibility of the innovative project. In this paper we propose to consider how business is costing innovative projects and determine their effectiveness for the enterprise business hotel.

  9. The use of an essay examination in evaluating medical students during the surgical clerkship.

    Science.gov (United States)

    Smart, Blair J; Rinewalt, Daniel; Daly, Shaun C; Janssen, Imke; Luu, Minh B; Myers, Jonathan A

    2016-01-01

    Third-year medical students are graded according to subjective performance evaluations and standardized tests written by the National Board of Medical Examiners (NBME). Many "poor" standardized test takers believe the heavily weighted NBME does not evaluate their true fund of knowledge and would prefer a more open-ended forum to display their individualized learning experiences. Our study examined the use of an essay examination as part of the surgical clerkship evaluation. We retrospectively examined the final surgical clerkship grades of 781 consecutive medical students enrolled in a large urban academic medical center from 2005 to 2011. We examined final grades with and without the inclusion of the essay examination for all students using a paired t test and then sought any relationship between the essay and NBME using Pearson correlations. Final average with and without the essay examination was 72.2% vs 71.3% (P essay examination increasing average scores by .4, 1.8, and 2.5 for those receiving high pass, pass, and fail, respectively. The essay decreased the average score for those earning an honors by .4. Essay scores were found to overall positively correlate with the NBME (r = .32, P essay examination as part of the third-year surgical core clerkship final did increase the final grade a modest degree, especially for those with lower scores who may identify themselves as "poor" standardized test takers. A more open-ended forum may allow these students an opportunity to overcome this deficiency and reveal their true fund of surgical knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Patient-Centred Innovations for Persons with Multimorbidity: funded evaluation protocol.

    Science.gov (United States)

    Stewart, Moira; Fortin, Martin

    2017-05-09

    The high prevalence of multimorbidity necessitates rethinking of the health care system. The overarching goal of the Patient-Centred Innovations for Persons with Multimorbidity program is to build on existing structures and find and evaluate patient-centred innovations relevant to multimorbidity. We describe the protocol for a proposed multijurisdictional (Quebec and Ontario) concurrent triangulation mixed-methods study. In both provinces, a qualitative descriptive study will be used to explore innovations in patient-centred multimorbidity care. Two randomized controlled trials, 1 in either province, will evaluate the innovations in a wait-list-controlled design using patient-reported outcomes. An additional control group, matched on age, sex, enrolment/index date (± 3 mo) and propensity score, will be created with the use of health administrative data. Patients will be 18-80 years of age and will have 3 or more chronic conditions. The innovations will have elements of relevance to multimorbidity care, patient-centred partnerships and integration of care. The primary outcome measures will be 2 patient-reported outcomes: patient education and self-efficacy. Secondary outcomes will include patient-reported health status, quality of life, psychological distress and health behaviours, and costs of care. This protocol describes a mixed-method study in 2 jurisdictions. The studies will answer the questions of what innovations work and how they work for patients, health care professionals and policy-makers. Trial registration: ClinicalTrials.gov, no NCT02789800 (Quebec Trial), NCT02742597 (Ontario Trial). Copyright 2017, Joule Inc. or its licensors.

  11. Evaluation and analysis of barriers to the innovation activity in the economy of the region

    Directory of Open Access Journals (Sweden)

    D. A. Tomasova

    2017-01-01

    Full Text Available Prospects for the development of the Russian innovative economy largely depend on the successful overcoming of negative factors impeding the effective interaction of institutions in the field of education, science, business, credit and fi nancial sphere regarding the creation, transfer and commercialization of innovations. Deep evaluation of innovative problems needs dynamic analysis of main processes in the spheres accompanying the innovation activity, which determines the topicality of this article. The aim of research consists in elaborating a dynamic approach to complex estimation of problems and barriers to the innovative development of Russia, including their structure and change. In order to do that, this article reviews the main barriers to the development of innovation activity in the region, builds a detailed classifi cation of parameters of innovative economic environment, and analyses their dynamics. The algorithm of innovation barriers assessment is based on economic statistics methods and fuzzy sets theory. This algorithm is determined on the basis of linguistic variables according to the matrix principle and linguistic identifi cation of economic objects. The estimation is based on a dynamic approach, that is, each analyzed indicator represents a rate of growth of one or another factor associated with the level of barriers to the innovation activity and therefore reflects the degree of reduction or strengthening in such barrier for the period under review. The minimax normalization allows providing comparability of all indicators under review. Macroeconomic data and indices of Russian enterprises operation, presented in statistical collections were used as the input data for analysis and estimation. As a result, we evaluated the level of overcoming barriers to innovative development during the past three years on the basis of analyzing research human potential, of development of innovative infrastructure

  12. Economic evaluation of surgically trained assistant medical officers in performing major obstetric surgery in Mozambique.

    Science.gov (United States)

    Kruk, M E; Pereira, C; Vaz, F; Bergström, S; Galea, S

    2007-10-01

    To compare the training and deployment costs and surgical productivity of surgically trained assistant medical officers (técnicos de cirurgia) and specialist physicians (surgeons and obstetrician/gynaecologists) in Mozambique in order to inform health human resource planning in a developing country with low availability of obstetric care and severe physician shortages. Técnicos de cirurgia have been previously shown to have quality of care outcomes comparable to physicians. Economic evaluation of costs and productivity of surgically trained assistant medical officers and specialist physicians. Hospitals and health science training institutions in Mozambique. Surgically trained assistants, medical officers, surgeons and obstetrician/gynaecologists in Mozambique. The costs of training and deploying the two cadres of health workers were derived from a review of budgets, annual expenditure reports, enrolment registers, and accounting statements from training institutions and interviews with directors and administrators. Productivity estimates were based on a hospital survey of physicians and técnicos de cirurgia. Cost per major obstetric surgical procedure over 30 years in 2006 US dollars. The 30-year cost per major obstetric surgery was $38.9 for técnicos de cirurgia and $144.1 for surgeons and obstetrician/gynaecologists. Doubling the salaries of técnicos de cirurgia resulted in a smaller but still substantial difference in cost per surgery between the groups ($60.3 versus $144.1 per procedure). One-way sensitivity analysis to test the impact of varying other inputs did not substantially change the magnitude of the cost advantage of técnicos de cirurgia. Training more mid-level health workers in surgery can be part of the response to the health worker shortage, which today threatens the achievement of the health Millennium Development Goals in developing countries.

  13. Several Methods for Evaluating the Investment Attractiveness of Small Innovation Enterprises

    Directory of Open Access Journals (Sweden)

    Ignatova Iuliia V.

    2017-04-01

    Full Text Available An important factor of impact on the development and living abilities of small and medium-sized innovation enterprises, including startups, is the opportunity to evaluate their investment attractiveness. The main reason for the «failure» of such enterprises is the lack of instrumentarium to forecast the potential number of their customers, and therefore their financial results. The article suggests the number of projected customers as an indicator for evaluation of the investment attractiveness of small innovation enterprises. The authors propose to use a number of mathematical models on the basis of the instrumentarium of descriptive statistics and simulation modeling. The proposed models are built on the basis of the hypothesis of normality of the distribution law of random amounts of income clients and allow forecasting with high accuracy in relation to the day of week, and therefore evaluating the investment risks for potential investors.

  14. Ultrasonographic Evaluation of Uterine Scar Niche before and after Laparoscopic Surgical Repair: A Case Report

    Directory of Open Access Journals (Sweden)

    Olivier Drouin

    2014-11-01

    Full Text Available Context - Uterine scar defects or scar niche are relatively common after cesarean delivery. An association has been observed between the severity of scar defect, also known as isthmocele, some gynecologic symptoms, and the risk of uterine scar dehiscence at the next delivery. It has been suggested that surgical repair of scar defect could improve the gynecological symptoms, but it remains unclear whether such surgery mends the uterine scar itself. Case Report - We report the case of a woman with uterine scar defect in whom laparoscopic repair significantly improved the gynecological symptoms without affecting the uterine scar, evaluated by hysterosonography. Conclusion - This case highlights the significant dearth of knowledge surrounding the diagnosis, consequences, and benefits of surgical repair of uterine scar defect after cesarean.

  15. Secondary correction of nasal deformities in cleft lip and palate patients: surgical technique and outcome evaluation.

    Science.gov (United States)

    Vass, Gabor; Mohos, Gabor; Bere, Zsofia; Ivan, Laszlo; Varga, Janos; Piffko, Jozsef; Rovo, Laszlo

    2016-12-01

    Nasal deformity associated with cleft lip and palate is a highly challenging reconstructive problem in rhinoplasty. In the literature, several operative solutions and evaluation methods have been described, however these do not offer a standard procedure for the surgeon. Our aim was to standardize our surgical technique-as much as the uniqueness of each case allowed it-based on the most frequent deformities we had faced; and to evaluate our results via a postoperative patient satisfaction questionnaire. Between 2012 and 2014 12 consecutive patients with combined cleft lip and palate deformities underwent secondary nasal and septal correction surgery with the same method by the same surgeon. The indications of surgery were, on one hand, difficult nasal breathing and altered nasal function (tendency for chronic rhinosinusitis) and on the other hand the aesthetic look of the nose. No exclusion criteria were stated. In our follow-up study we evaluated our results by using a modified Rhinoplasty Outcome Evaluation (ROE) questionnaire: patients answered the same four questions pre- and postoperatively. Data were statistically analyzed by t-test. Based on the questionnaire, all patients experienced improvement of nasal breathing function, improved appearance of the nose and less stigmatization from the society. According to the t-test, all scores of the four questions improved significantly in the postoperative 4-6 months, compared with the preoperative scores. In our opinion with our standardized surgical steps satisfactory aesthetic and functional results can be achieved. We think the modified ROE questionnaire is an adequate and simple method for the evaluation of our surgical results.

  16. Surgical resident technical skill self-evaluation: increased precision with training progression.

    Science.gov (United States)

    Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L

    2017-10-01

    Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines.

    Science.gov (United States)

    Goodnough, L T; Maniatis, A; Earnshaw, P; Benoni, G; Beris, P; Bisbe, E; Fergusson, D A; Gombotz, H; Habler, O; Monk, T G; Ozier, Y; Slappendel, R; Szpalski, M

    2011-01-01

    Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes.

  18. Evaluating teaching methods of cataract surgery: validation of an evaluation tool for assessing surgical technique of capsulorhexis.

    Science.gov (United States)

    Smith, Ronald J; McCannel, Colin A; Gordon, Lynn K; Hollander, David A; Giaconi, JoAnn A; Stelzner, Sadiqa K; Devgan, Uday; Bartlett, John; Mondino, Bartly J

    2012-05-01

    To develop and assess the validity of an evaluation tool to quantitatively assess the capsulorhexis portion of cataract surgery performed by residents. University of California at Los Angeles (UCLA), Department of Ophthalmology, Jules Stein Eye Institute, Los Angeles, California, USA. Masked prospective case series. Ophthalmology faculty members at UCLA were surveyed and literature was reviewed to develop a grading tool comprising 12 questions to evaluate surgical technique, including 4 from the Global Rating Assessment of Skills in Intraocular Surgery and 2 from the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric. Video clips of continuous curvilinear capsulorhexis (CCC) performed by 2 postgraduate year (PGY) 3 residents, 2 PGY 4 residents, and 2 advanced surgeons were independently graded in a masked fashion by a 7-member faculty panel. Four questions had low interobserver variability and a significant correlation with surgical skill level (intraclass correlation coefficient >0.75; Pteaching interventions. No author has a financial or proprietary interest in any material or method mentioned. Published by Elsevier Inc.

  19. EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS

    Directory of Open Access Journals (Sweden)

    Nagaraju

    2015-02-01

    Full Text Available INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is based on available levator function and also other factors like etiology, severity, Bell’s phenomenon etc. If such varied procedure s are performed in a group of patients based on standard criteria and results are evaluated systematically we can determine what works best for a given patient . AIM : Evaluation of outcome of various surgical procedures for upper eyelid ptosis . METHODOLOGY : 25 eyelids of 20 patients who presented to a tertiary centre in south India with complaint of drooping of upper lid were considered. All subjects underwent complete ocular examination corrected visual acuity and detailed ptosis evaluation with particular emphasis on measurement of levator muscle function, MRD1 (margin reflex distance - 1, palpebral fissure width in different gazes and margin crease distance. The effect of various factors like MRD1, MCD, levator function were assessed, the amount of correction required and appropriate surgical procedure was chosen. Surgical procedure of Levator resection, frontalis sling operation, anterior levator aponeurosis advancement, o r other ptosis correction procedures under appropriate anaesthesia were performed. Post - operative evaluation in terms of visual acuity, MRD, Interpalpebral fissure height, lid symmetry, lagophthalmos and complications (if any was done. RESULTS : Levator muscle resection was done in 28% of eyelids, frontal sling surgery in 60% of eyelids, Levator muscle plication in 8% eyelids and levator muscle disinsertion with frontal sling surgery in 4% eyes. Undercorrection was seen in about 44% of eyelids in varying degrees. 56% of the eyes had optimal correction. Symmetric correction was achieved in 76% of eyelids. CONCLUSION: The influence of various preoperative factors on the

  20. Evaluating Surgical Residents' Patient-Centered Communication Skills: Practical Alternatives to the "Apprenticeship Model".

    Science.gov (United States)

    Newcomb, Anna; Trickey, Amber W; Lita, Elena; Dort, Jonathan

    2017-10-06

    The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to assess communication skills and provide feedback to residents. We aimed to develop a feasible data collection process that generates objective clinical performance information to guide training activities, inform ACGME milestone evaluations, and validate assessment instruments. Residents care for patients in the surgical clinic and in the hospital, and participate in a communication curriculum providing practice with standardized patients (SPs). We measured perception of resident communication using the 14-item Communication Assessment Tool (CAT), collecting data from patients at the surgery clinic and surgical wards in the hospital, and from SP encounters during simulated training scenarios. We developed a handout of CAT example behaviors to guide patients completing the communication assessment. Independent academic medical center. General surgery residents. The primary outcome is the percentage of total items patients rated "excellent;" we collected data on 24 of 25 residents. Outpatient evaluations resulted in significantly higher scores (mean 84.5% vs. 68.6%, p < 0.001), and female patients provided nearly statistically significantly higher ratings (mean 85.2% vs. 76.7%, p = 0.084). In multivariate analysis, after controlling for patient gender, visit reason, and race, (1) residents' CAT scores from SPs in simulation were independently associated with communication assessments in their concurrent patient population (p = 0.017), and (2) receiving CAT example instructions was associated with a lower percentage of excellent ratings by 9.3% (p = 0.047). Our data collection process provides a model for obtaining meaningful information about resident communication proficiency. CAT evaluations of surgical residents by the inpatient population had not previously been described in the literature; our results provide important insight into relationships between the

  1. Use of Performance Measures to Evaluate, Document Competence and Deterioration of Advanced Surgical Skills Exposure for Trauma (ASSET) Surgical Skills

    Science.gov (United States)

    2014-03-01

    Financial Overview Lisa Gettings, STAR ORC 4 3:50 – 4:00 pm Study Coordination Karen Murdock, STAR ORC 4:00 – 4:15 pm Timeline and...Telecommunication from Wright State University) + other, Catriona Miller, Chang, Julie Bosch, Karen Murdock, Lisa Gettings , George Hagegeorge, Ronn...in surgical resident education. J Trauma 2001;50:1015-1019. 30. Clarke DL, Allorto NL, Thomson SR. An audit of failed non-operative management of

  2. Evaluating Additionality of an Innovation Subsidy Program Targeted at SMEs: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Sonja Radas

    2013-04-01

    Full Text Available This paper explores the effectiveness of a recently introduced innovation subsidy program targeted at SMEs in Croatia. Three aspects of program additionality were evaluated: input, output and behavioral aspects. Both qualitative and survey research was employed, and four case studies with selected recipient companies were conducted. This study is a response to the policy-makers’ need for early program assessment. It attempts to show that even with early evaluation and small population of recipients it is possible to gain insight into program effectiveness. The analysis suggests that the effects of programs targeted at innovative SMEs might need to be evaluated differently than general subsidies. This is especially evident in the evaluation of input additionality. The analysis indicates that SMEs which started with a higher R&D capability tend to increase R&D intensity while participating in the program. The program raised R&D and innovation capability of the participating SMEs, but commercialization of project results remains a concern.

  3. Creation and Evaluation of New Porcine Model for Investigation of Treatments of Surgical Site Infection.

    Science.gov (United States)

    Mohiti-Asli, Mahsa; Risselada, Marije; Jacob, Megan; Pourdeyhimi, Behnam; Loboa, Elizabeth G

    2017-11-01

    Surgical site infection (SSI) is the most common cause of surgical failure, increasing the risks of postoperative mortality and morbidity. Recently, it has been reported that the use of antimicrobial dressings at the incision site help with prevention of SSI. Despite the increased body of research on the development of different types of antimicrobial dressings for this application, to our knowledge, nobody has reported a reliable large animal model to evaluate the efficacy of developed materials in a preclinical SSI model. In this study, we developed a porcine full-thickness incision model to investigate SSI caused by methicillin-resistant Staphylococcus aureus (MRSA), the leading cause of SSI in the United States. Using this model, we then evaluated the efficacy of our newly developed silver releasing nanofibrous dressings for preventing and inhibiting MRSA infection. Our results confirmed the ease and practicality of a new porcine model as an in vivo platform for evaluation of biomaterials for SSI. Using this model, we found that our silver releasing scaffolds significantly reduced bacterial growth in wounds inoculated with MRSA relative to nontreated controls and to wounds treated with the gold standard, silver sulfadiazine, without causing inflammation at the wound site. Findings from this study confirm the potential of our silver-releasing nanofibrous scaffolds for treatment/prevention of SSI, and introduce a new porcine model for in vivo evaluation of additional SSI treatment approaches.

  4. Innovative procedure for computer-assisted genioplasty: three-dimensional cephalometry, rapid-prototyping model and surgical splint.

    Science.gov (United States)

    Olszewski, R; Tranduy, K; Reychler, H

    2010-07-01

    The authors present a new procedure of computer-assisted genioplasty. They determined the anterior, posterior and inferior limits of the chin in relation to the skull and face with the newly developed and validated three-dimensional cephalometric planar analysis (ACRO 3D). Virtual planning of the osteotomy lines was carried out with Mimics (Materialize) software. The authors built a three-dimensional rapid-prototyping multi-position model of the chin area from a medical low-dose CT scan. The transfer of virtual information to the operating room consisted of two elements. First, the titanium plates on the 3D RP model were pre-bent. Second, a surgical guide for the transfer of the osteotomy lines and the positions of the screws to the operating room was manufactured. The authors present the first case of the use of this model on a patient. The postoperative results are promising, and the technique is fast and easy-to-use. More patients are needed for a definitive clinical validation of this procedure. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Giving tranexamic acid to reduce surgical bleeding in sub-Saharan Africa: an economic evaluation

    Directory of Open Access Journals (Sweden)

    Perel Pablo

    2010-02-01

    Full Text Available Abstract Background The identification of safe and effective alternatives to blood transfusion is a public health priority. In sub-Saharan Africa, blood shortage is a cause of mortality and morbidity. Blood transfusion can also transmit viral infections. Giving tranexamic acid (TXA to bleeding surgical patients has been shown to reduce both the number of blood transfusions and the volume of blood transfused. The objective of this study is to investigate whether routinely administering TXA to bleeding elective surgical patients is cost effective by both averting deaths occurring from the shortage of blood, and by preventing infections from blood transfusions. Methods A decision tree was constructed to evaluate the cost-effectiveness of providing TXA compared with no TXA in patients with surgical bleeding in four African countries with different human immunodeficiency virus (HIV prevalence and blood donation rates (Kenya, South Africa, Tanzania and Botswana. The principal outcome measures were cost per life saved and cost per infection averted (HIV, Hepatitis B, Hepatitis C averted in 2007 International dollars ($. The probability of receiving a blood transfusion with and without TXA and the risk of blood borne viral infection were estimated. The impact of uncertainty in model parameters was explored using one-way deterministic sensitivity analyses. Probabilistic sensitivity analysis was performed using Monte Carlo simulation. Results The incremental cost per life saved is $87 for Kenya and $93 for Tanzania. In Botswana and South Africa, TXA administration is not life saving but is highly cost saving since fewer units of blood are transfused. Further, in Botswana the administration of TXA averts one case of HIV and four cases of Hepatitis B (HBV per 1,000 surgical patients. In South Africa, one case of HBV is averted per 1,000 surgical patients. Probabilistic sensitivity analyses confirmed the robustness of the model. Conclusion An economic

  6. Biomechanical evaluation of three surgical scenarios of posterior lumbar interbody fusion by finite element analysis

    Directory of Open Access Journals (Sweden)

    Xiao Zhitao

    2012-06-01

    Full Text Available Abstract Background For the treatment of low back pain, the following three scenarios of posterior lumbar interbody fusion (PLIF were usually used, i.e., PLIF procedure with autogenous iliac bone (PAIB model, PLIF with cages made of PEEK (PCP model or titanium (Ti (PCT model materiel. But the benefits or adverse effects among the three surgical scenarios were still not fully understood. Method Finite element analysis (FEA, as an efficient tool for the analysis of lumbar diseases, was used to establish a three-dimensional nonlinear L1-S1 FE model (intact model with the ligaments of solid elements. Then it was modified to simulate the three scenarios of PLIF. 10 Nm moments with 400 N preload were applied to the upper L1 vertebral body under the loading conditions of extension, flexion, lateral bending and torsion, respectively. Results Different mechanical parameters were calculated to evaluate the differences among the three surgical models. The lowest stresses on the bone grafts and the greatest stresses on endplate were found in the PCT model. The PCP model obtained considerable stresses on the bone grafts and less stresses on ligaments. But the changes of stresses on the adjacent discs and endplate were minimal in the PAIB model. Conclusions The PCT model was inferior to the other two models. Both the PCP and PAIB models had their own relative merits. The findings provide theoretical basis for the choice of a suitable surgical scenario for different patients.

  7. Safer paediatric surgical teams: A 5-year evaluation of crew resource management implementation and outcomes.

    Science.gov (United States)

    Savage, Carl; Gaffney, F Andrew; Hussain-Alkhateeb, Laith; Olsson Ackheim, Pia; Henricson, Gunilla; Antoniadou, Irini; Hedsköld, Mats; Pukk Härenstam, Karin

    2017-10-01

    Evaluate longitudinal changes in technical and non-technical skills (teamwork, situation monitoring, communication and leadership), safety culture, and clinical outcomes before and after implementation of a crew resource management (CRM) safety program. A multi-level prospective single case study in accordance with the SQUIRE-guidelines for reporting quality improvement efforts. Large university paediatric surgical service. All 153 managers and staff. Training of staff in CRM, systematic risk assessments, and the redesign of work practices captured and reinforced through the development, implementation and refinement of SOPs. Data were collected related to: 1) Relevance of CRM training (survey), 2) Safety culture (survey), 3) Team behaviours in clinical practice (non-participatory observations with MedPACT protocol) and 4) Effects on perioperative care for laparoscopic appendectomies-a representative and frequently performed surgical procedure (electronic medical records and administrative data for length of stay, unplanned readmissions and returns to the Operating Room). Non-technical skills, the use of safety tools, as well as adherence to guidelines for appendectomies all improved significantly over time. Significant safety culture improvements were found in teamwork across and within units, supervisors' expectations and actions, non-punitive response to adverse events, and perceptions of overall patient safety. Unplanned readmissions following appendectomy declined significantly. Implementation of a comprehensive CRM program including associated safety tools created sustained adherence to new work practices and improved non-technical and technical skills, surgical outcomes and safety culture.

  8. EVALUATION OF COMPLICATOINS AND BENEFITS OF HISTOACRYL TISSUE GLUE IN SURGICAL WOUNDS

    Directory of Open Access Journals (Sweden)

    M. R. Zafarghandy

    1999-07-01

    Full Text Available - Healing of surgical wounds and their complications such as infection or scar formation are of major concern in surgery. Tissue glues are advanced to reduce these problems. In a prospective study, we have evaluated surgical wound healing in 76 patients whose surgical wounds were repaired by tissue glues (Histoacryl. This study was performed in four leaching hospitals (Sina, Shariaty, Shohada, Razi. The major parameters co/isidered for this study were complete wound healing in the first postoperative week, early wound complications, late wound complications, and their relation with some other factors such as wound size and glue application techniques. In our study, complete wound healing in less than one week was seen in 81.9% of patients, whereas 18.1% had a longer course. Early complications consisted of (5.6% infection and (2.8% hematoma. Late complications included hypertrophy (O.48% and widening (18.1% of scars. Tliere was a significant correlation between wound size and healing time (P<0.05, but not between faulty techniques and scar formation. 

  9. Development and Evaluation of Innovative Peer-Led Physical Activity Programs for Mental Health Service Users.

    Science.gov (United States)

    Graham, Candida R; Larstone, Roseann; Griffiths, Brenda; de Leeuw, Sarah; Anderson, Lesley; Powell-Hellyer, Stephanie; Long, Nansi

    2017-09-25

    Mental health service users (MHSUs) have elevated rates of cardiometabolic disturbance. Improvements occur with physical activity (PA) programs. We report the development and evaluation of three innovative peer-developed and peer-led PA programs: 1) walking; 2) fitness; and 3) yoga. Qualitative evaluation with 33 MHSUs in British Columbia, Canada, occurred. These programs yielded improvements for participants, highlighted by powerful narratives of health improvement, and improved social connections. The feasibility and acceptability of innovative peer-developed and peer-led programs were shown. Analyses revealed concepts related to engagement and change. Relating core categories, we theorize effective engagement of MHSUs requires accessibility on three levels (geographic, cost, and program flexibility) and health behavior change occurs within co-constituent relationships (to self, to peers, and to the wider community). This study highlights the benefits of peer involvement in developing and implementing PA programs and provides a theoretical framework of understanding engagement and behavior change in health programs for MHSUs.

  10. Using evaluation to create "provisional stabilities": bridging innovation in Higher Education change process

    OpenAIRE

    Saunders, Murray; Charlier, Bernadette; Bonamy, Joël

    2005-01-01

    International audience; This paper will report on the evaluation experience in two SOCRATES (European Union funding mechanism designed to support innovation in teaching and learning) projects focused on change in Higher Education. The projects were international in scope involving 6 countries and 10 institutions within the last four years. The paper reflects on change in institutions specifically, especially those introduced by the use of ICT (Information and Communication Technologies) and i...

  11. Evaluating the dynamics of project strategy in innovative enterprises : Case: Standard Chartered Bank Nigeria (SCBN) Limited

    OpenAIRE

    Oladepo, O. Emmanuel

    2013-01-01

    This research evaluates the dynamics of project strategy in innovative enterprises. More particularly, this research deploys the concepts of project autonomy and multiplicity of stakeholders as determinants of successful project strategy. From the theoretical point of view, this research defines and explains the significance of the concepts of project strategy in a single project’s environment. The main objective of this research is to contribute to the existing project management studies by ...

  12. Development of Innovative Aerogel Based Plasters: Preliminary Thermal and Acoustic Performance Evaluation

    OpenAIRE

    Cinzia Buratti; Elisa Moretti; Elisa Belloni; Fabrizio Agosti

    2014-01-01

    The thermal and acoustic properties of innovative insulating systems used as building coatings were investigated: Granular silica aerogel was mixed with natural plaster in different percentages. This coating solution is transpiring and insulating, thanks to the use of a natural lime coat and aerogel, a highly porous light material with very low thermal conductivity. The thermal conductivity of the proposed solution was evaluated by means of a Heat Flow meter apparatus (EN ISO 12667), consider...

  13. Evaluating the enhancement and improvement of China's technology and financial services platform innovation strategy.

    Science.gov (United States)

    Wu, Ching-Sung; Hu, Kuang-Hua; Chen, Fu-Hsiang

    2016-01-01

    The development of high-tech industry has been prosperous around the world in past decades, while technology and finance have already become the most significant issues in the information era. While high-tech firms are a major force behind a country's economic development, it requires a lot of money for the development process, as well as the financing difficulties for its potential problems, thus, how to evaluate and establish appropriate technology and financial services platforms innovation strategy has become one of the most critical and difficult issues. Moreover, how the chosen intertwined financial environment can be optimized in order that high-tech firms financing problems can be decided has seldom been addressed. Thus, this research aims to establish a technology and financial services platform innovation strategy improvement model, as based on the hybrid MADM model, which addresses the main causal factors and amended priorities in order to strengthen ongoing planning. A DEMATEL technique, as based on Analytic Network Process, as well as modified VIKOR, will be proposed for selecting and re-configuring the aspired technology and financial services platform. An empirical study, as based on China's technology and financial services platform innovation strategy, will be provided for verifying the effectiveness of this proposed methodology. Based on expert interviews, technology and financial services platforms innovation strategy improvement should be made in the following order: credit guarantee platform ( C )_credit rating platform ( B )_investment and finance platform ( A ).

  14. Consistent evaluation of an ultrasound-guided surgical navigation system by utilizing an active validation platform

    Science.gov (United States)

    Kim, Younsu; Kim, Sungmin; Boctor, Emad M.

    2017-03-01

    An ultrasound image-guided needle tracking systems have been widely used due to their cost-effectiveness and nonionizing radiation properties. Various surgical navigation systems have been developed by utilizing state-of-the-art sensor technologies. However, ultrasound transmission beam thickness causes unfair initial evaluation conditions due to inconsistent placement of the target with respect to the ultrasound probe. This inconsistency also brings high uncertainty and results in large standard deviations for each measurement when we compare accuracy with and without the guidance. To resolve this problem, we designed a complete evaluation platform by utilizing our mid-plane detection and time of flight measurement systems. The evaluating system uses a PZT element target and an ultrasound transmitting needle. In this paper, we evaluated an optical tracker-based surgical ultrasound-guided navigation system whereby the optical tracker tracks marker frames attached on the ultrasound probe and the needle. We performed ten needle trials of guidance experiment with a mid-plane adjustment algorithm and with a B-mode segmentation method. With the midplane adjustment, the result showed a mean error of 1.62+/-0.72mm. The mean error increased to 3.58+/-2.07mm without the mid-plane adjustment. Our evaluation system can reduce the effect of the beam-thickness problem, and measure ultrasound image-guided technologies consistently with a minimal standard deviation. Using our novel evaluation system, ultrasound image-guided technologies can be compared under equal initial conditions. Therefore, the error can be evaluated more accurately, and the system provides better analysis on the error sources such as ultrasound beam thickness.

  15. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kontopodis, Nikolaos, E-mail: kontopodisn@yahoo.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece); Metaxa, Eleni, E-mail: emmetaxa@gmail.com [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Papaharilaou, Yannis, E-mail: yannisp@iacm.forth.gr [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Georgakarakos, Efstratios, E-mail: efstratiosgeorg@gmail.com [Vascular Surgery Department, “Demokritus” University of Thrace Medical School, Alexandroupolis (Greece); Tsetis, Dimitris, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, University of Crete Medical School, Heraklion, Crete (Greece); Ioannou, Christos V., E-mail: ioannou@med.uoc.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece)

    2014-07-15

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness.

  16. Developing an educational research framework for evaluating rural training of health professionals: a case for innovation.

    Science.gov (United States)

    van Schalkwyk, S; Bezuidenhout, J; Burch, V C; Clarke, M; Conradie, H; van Heerden, B; De Villiers, M

    2012-01-01

    World-wide, rural clinical training of undergraduate medical students is looking to transform learning experiences, calling for the adoption of innovative approaches that create spaces for curriculum renewal and new ways of thinking. In order for these teaching models to gain acceptance and credibility among the relevant academic communities, it is critical that they be studied and evaluated. This article describes an innovative rural education intervention and a concomitant, intentional process that was adopted to establish a research framework within which the intervention will be evaluated. Key role-players participated in a one-day workshop aimed at developing the framework. A collaborative, structured process that moved through three phases of deliberation and reflection was followed. The documentation and raw data generated during the workshop was used to generate the framework that will serve as a blueprint for ensuring the study and evaluation of the educational innovation. Establishing an educational research framework, by adopting a consultative and collaborative process, provides a vehicle for encouraging a culture of critical accountability that seeks to discern evidence of good practice in the training of health care workers in a rural context.

  17. Advanced Visualization and Interactive Display Rapid Innovation and Discovery Evaluation Research (VISRIDER) Program Task 6: Point Cloud Visualization Techniques for Desktop and Web Platforms

    Science.gov (United States)

    2017-04-01

    ADVANCED VISUALIZATION AND INTERACTIVE DISPLAY RAPID INNOVATION AND DISCOVERY EVALUATION RESEARCH (VISRIDER) PROGRAM TASK 6: POINT CLOUD...To) OCT 2013 – SEP 2014 4. TITLE AND SUBTITLE ADVANCED VISUALIZATION AND INTERACTIVE DISPLAY RAPID INNOVATION AND DISCOVERY EVALUATION RESEARCH

  18. Performance evaluation of haptic hand-controllers in a robot-assisted surgical system.

    Science.gov (United States)

    Zareinia, Kourosh; Maddahi, Yaser; Ng, Canaan; Sepehri, Nariman; Sutherland, Garnette R

    2015-12-01

    This paper presents the experimental evaluation of three commercially available haptic hand-controllers to evaluate which was more suitable to the participants. Two surgeons and seven engineers performed two peg-in-hole tasks with different levels of difficulty. Each operator guided the end-effector of a Kuka manipulator that held surgical forceps and was equipped with a surgical microscope. Sigma 7, HD(2) and PHANToM Premium 3.0 hand-controllers were compared. Ten measures were adopted to evaluate operators' performances with respect to effort, speed and accuracy in completing a task, operator improvement during the tests, and the force applied by each haptic device. The best performance was observed with the Premium 3.0; the hand-piece was able to be held in a similar way to that used by surgeons to hold conventional tools. Hand-controllers with a linkage structure similar to the human upper extremity take advantage of the inherent human brain connectome, resulting in improved surgeon performance during robotic-assisted surgery. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Clinical and surgical evaluation of the indication of postoperative antibiotic prescription in third molar surgery.

    Science.gov (United States)

    Adde, Carlos Alberto; Soares, Mário Sérgio; Romano, Marcelo Munhóes; Carnaval, Talita Girio; Sampaio, Roberta Moura; Aldarvis, Fernanda Palone; Federico, Luiz Renato Tobias de Aguiar

    2012-11-01

    The aim of this study was to evaluate the need for antibiotic prescription in third molar surgery. A double-blind randomized study was carried out with 71 patients from CODONT (Dentistry Center of the Police of São Paulo). Amoxicillin, clindamycin, or no medication was administered for 7 days immediately after surgery. The participants evaluated the presence of pain, edema, interincisal distance (ID), presence of infection, Pell and Gregory classification, rescue analgesia, osteotomy, and odontosection. There was no difference (P < .05) between antibiotics and control over the surgery duration, dose, visual analog scale (VAS), ID, and edema, yet significant differences were seen over time for VAS, edema, and ID. Antibiotic prescription should not be indicated in all clinical conditions, yet it is necessary to correctly evaluate factors such as systemic condition of the patient, skill of the operator, and contamination of the surgical environment. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. The Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE): Construct and Content Validation Using a Modified Delphi Method.

    Science.gov (United States)

    Paquette-Warren, Jann; Tyler, Marie; Fournie, Meghan; Harris, Stewart B

    2017-06-01

    In order to scale-up successful innovations, more evidence is needed to evaluate programs that attempt to address the rising prevalence of diabetes and the associated burdens on patients and the healthcare system. This study aimed to assess the construct and content validity of the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE), a tool developed to guide the evaluation, design and implementation with built-in knowledge translation principles. A modified Delphi method, including 3 individual rounds (questionnaire with 7-point agreement/importance Likert scales and/or open-ended questions) and 1 group round (open discussion) were conducted. Twelve experts in diabetes, research, knowledge translation, evaluation and policy from Canada (Ontario, Quebec and British Columbia) and Australia participated. Quantitative consensus criteria were an interquartile range of ≤1. Qualitative data were analyzed thematically and confirmed by participants. An importance scale was used to determine a priority multi-level indicator set. Items rated very or extremely important by 80% or more of the experts were reviewed in the final group round to build the final set. Participants reached consensus on the content and construct validity of DEFINE, including its title, overall goal, 5-step evaluation approach, medical and nonmedical determinants of health schematics, full list of indicators and associated measurement tools, priority multi-level indicator set and next steps in DEFINE's development. Validated by experts, DEFINE has the right theoretic components to evaluate comprehensively diabetes prevention and management programs and to support acquisition of evidence that could influence the knowledge translation of innovations to reduce the burden of diabetes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Evaluation of a countrywide implementation of the world health organisation surgical safety checklist in Madagascar

    Science.gov (United States)

    White, Michelle C.; Baxter, Linden S.; Close, Kristin L.; Ravelojaona, Vaonandianina A.; Rakotoarison, Hasiniaina N.; Bruno, Emily; Herbert, Alison; Andean, Vanessa; Callahan, James; Andriamanjato, Hery H.; Shrime, Mark G.

    2018-01-01

    Background The 2009 World Health Organisation (WHO) surgical safety checklist significantly reduces surgical mortality and morbidity (up to 47%). Yet in 2016, only 25% of East African anesthetists regularly use the checklist. Nationwide implementation of the checklist is reported in high-income countries, but in low- and middle-income countries (LMICs) reports of successful implementations are sparse, limited to single institutions and require intensive support. Since checklist use leads to the biggest improvements in outcomes in LMICs, methods of wide-scale implementation are needed. We hypothesized that, using a three-day course, successful wide-scale implementation of the checklist could be achieved, as measured by at least 50% compliance with six basic safety processes at three to four months. We also aimed to determine predictors for checklist utilization. Materials and methods Using a blended educational implementation strategy based on prior pilot studies we designed a three-day dynamic educational course to facilitate widespread implementation of the WHO checklist. The course utilized lectures, film, small group breakouts, participant feedback and simulation to teach the knowledge, skills and behavior changes needed to implement the checklist. In collaboration with the Ministry of Health and local hospital leadership, the course was delivered to 427 multi-disciplinary staff at 21 hospitals located in 19 of 22 regions of Madagascar between September 2015 and March 2016. We evaluated implementation at three to four months using questionnaires (with a 5-point Likert scale) and focus groups. Multivariate linear regression was used to test predictors of checklist utilization. Results At three to four months, 65% of respondents reported always using the checklist, with another 13% using it in part. Participant’s years in practice, hospital size, or surgical volume did not predict checklist use. Checklist use was associated with counting instruments (pchecklist

  2. Toward a Framework for Resource Efficiency Evaluation in Industry: Recommendations for Research and Innovation Projects

    Directory of Open Access Journals (Sweden)

    Sophie Sfez

    2017-01-01

    Full Text Available The world is facing a tremendous resource supply challenge. One strategy of regions and nations to address this issue is to encourage research and innovation through funding programs. Most of the time, these programs require that research and innovation projects quantify potential increases in resource efficiency achieved by the projects. However, no consensus exists on how to calculate resource efficiency; therefore, a wide range of approaches is followed. As a result, resource efficiency results are not comparable between projects, and because no rules or guidelines exist to help project developers, the approach followed is not always appropriate. This paper aims to discuss the existing approaches and methods used to evaluate resource efficiency. In this context, resource efficiency is defined as the ratio between the benefits obtained from resources and the impact or amount of resources used. The most challenging step is the determination of this ratio’s denominator because a wide range of methods to quantify resource consumption exist and are being used. They can be classified as gate-to-gate or life cycle based methods and can be subdivided into accounting methods and impact assessment methods. Each method considers different aspects of resources; thus, no single method aims to answer the same research questions. Therefore, project developers must make a well informed choice about which method to use. This paper provides recommendations to support this choice, as well as the overall evaluation and the valorization of the resource efficiency ratio in the framework of research and innovation programs.

  3. Evaluation of the Market introduction Energy Innovations (MEI) subsidy scheme; Evaluatie van de MEI-regeling

    Energy Technology Data Exchange (ETDEWEB)

    Wetzels, W.; Smekens, K.; Lako, P. [ECN Beleidsstudies, Petten (Netherlands); Warmenhoven, H. [De Gemeynt, Klarenbeek (Netherlands)

    2012-11-15

    This report contains the outcomes of an evaluation study of the Market introduction Energy Innovations (MEI) subsidy scheme. This scheme is targeted to the horticultural sector and aims to stimulate and accelerate the early market introduction of innovative energy systems in greenhouses. The subsidy scheme was initiated in 2007 and has provided subsidies twice a year since then. Based on project and data analysis, stakeholder interviews and a workshop, the evaluation concludes that the MEI scheme has made a positive contribution to the innovation process in the sector, but that the scheme could have been implemented more efficiently [Dutch] De regeling Marktintroductie energie-innovaties (MEI) is in 2007 ingesteld door het toenmalige Ministerie van Landbouw, Natuur en Voedselkwaliteit. Het doel van de MEI-regeling is het stimuleren en versnellen van de vroege marktintroductie van innovatieve energiesystemen in de glastuinbouw. ECN en De Gemeynt hebben een evaluatie uitgevoerd van de MEI-regeling. De centrale conclusie is dat de regeling een positieve bijdrage heeft geleverd aan het innovatieproces in de glastuinbouwsector.

  4. Endoscopic Management of Cavernous Carotid Surgical Complications: Evaluation of a Simulated Perfusion Model.

    Science.gov (United States)

    Ciporen, Jeremy N; Lucke-Wold, Brandon; Mendez, Gustavo; Cameron, William E; McCartney, Shirley

    2017-02-01

    Endoscopic surgical treatment of pituitary tumors, lateral invading tumors, or aneurysms requires surgeons to operate adjacent to the cavernous sinus. During these endoscopic endonasal procedures, the carotid artery is vulnerable to surgical injury at its genu. The objective of this simulation model was to evaluate trainees regarding management of a potentially life-threatening vascular injury. Cadaveric heads were prepared in accordance with the Oregon Health & Science University body donation program. An endoscopic endonasal approach was used, and a perfusion pump with a catheter was placed in the ipsilateral common carotid artery at its origin in the neck. Learners used a muscle graft to establish vascular control and were evaluated over 3 training sessions. Simulation assessment, blood loss during sessions, and performance metric data were collected for learners. Vascular control was obtained at a mean arterial pressure of 65 mm Hg using a muscle graft correctly positioned at the arteriotomy site. Learners improved over the course of training, with senior residents (n = 4) performing better across all simulation categories (situation awareness, decision making, communications and teamwork, and leadership); the largest mean difference was in communication and teamwork. Additionally, learner performance concerning blood loss improved between sessions (t = 3.667, P management that transcend this model. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Evaluation of spinopelvic balance among patients undergoing surgical treatment for lumbar disk hernia

    Directory of Open Access Journals (Sweden)

    Rafael de Paiva Oliveira

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate spinopelvic balance using the pelvic incidence, sacral slope and pelvic tilt among patients with lumbar disk hernias who underwent surgical treatment.METHODS: thirty patients at the spinal services of Hospital Santa Casa de Misericórdia de Vitória and Hospital Vila Velha were evaluated by measuring their spinopelvic balance from the angles of pelvic tilt, sacral slope and pelvic incidence, with their respective means, on simple lateral-view lumbopelvic radiographs that needed to encompass the lumbar spine, sacrum and proximal third of the femur.RESULTS: the spinopelvic balance measurements obtained from the mean angles of the population studied, for pelvic incidence, sacral slope and pelvic tilt, were 45◦ , 36.9◦ and 8.1◦ , respectively. The confidence interval for the mean pelvic incidence was from 41.9 to 48.1 (95% CI, thus including a reference value that characterized it as low, for an asymptomatic population, thus confirming that the sample was extracted from a population with this characteristic.CONCLUSION: among these patients with lumbar disk hernias who underwent surgical treatment, the average spinopelvic balance was found to have pelvic incidence lower than what has been reported in the literature for an asymptomatic population.

  6. A comparative evaluation: Oral leukoplakia surgical management using diode laser, CO2 laser, and cryosurgery.

    Science.gov (United States)

    Natekar, Madhukar; Raghuveer, Hosahallli-Puttaiah; Rayapati, Dilip-Kumar; Shobha, Eshwara-Singh; Prashanth, Nagesh-Tavane; Rangan, Vinod; Panicker, Archana G

    2017-06-01

    The comparatively evaluate the three surgical treatment modalities namely cryosurgery, diode and CO2 laser surgery in terms of healing outcomes on the day of surgery, first and second week post operatively and recurrence at the end of 18 months was assessed. Thirty selected patients were divided randomly into three groups. Each group comprising of ten patients were subjected to one of the three modalities of treatment namely cryosurgery, diode laser or CO2 laser surgery for ablation of OL. Obtained data was analyzed using mainly using Chi-square and Anova tests. Study showed statistical significant differences (p > 0.05) for evaluation parameters like pain, edema and scar. The parameters like infection, recurrence, bleeding showed no statistical significance. Pain was significantly higher in CO2 laser surgery group as compared with diode laser group. There was no recurrence observed at the end of the 6 months follow up period in all the three study groups. Observations from the study highlights that all three surgical modalities used in this study were effective for treatment of OL, and the overall summation of the results of the study showed that laser therapy (CO2 and Diode) seems to offer better clinically significant results than cryotherapy. Key words:Oral premalignant lesion, leukoplakia, cryosurgery, CO2 laser surgery, diode laser surgery.

  7. Nostril Morphometry Evaluation before and after Cleft Lip Surgical Correction: Clinical Evidence

    Science.gov (United States)

    Feijo, Mario Jorge Frassy; Brandão, Stella Ramos; Pereira, Rui Manoel Rodrigues; Santos, Mariana Batista de Souza; Justino da Silva, Hilton

    2014-01-01

    Introduction The purpose to this work is to review systematically the morphological changes of the nostrils of patients undergoing surgery for correction of cleft lip and identify in the literature the issues involved in the evaluation of surgical results in this population. Review of Literature A review was conducted, searching for clinical evidence from MEDLINE. The search occurred in January 2012. Selection criteria included original articles and research articles on individual subjects with cleft lip or cleft palate with unilateral nostril anthropometric measurements before and after surgical correction of cleft lip and measurements of soft tissues. There were 1,343 articles from the search descriptors and free terms. Of these, five articles were selected. Discussion Most studies in this review evaluated children in Eastern countries, using different measurement techniques but with the aid of computers, and showed improved nostril asymmetry postoperatively compared with preoperatively. Conclusion There is a reduction of the total nasal width postoperatively compared with preoperative measurements in patients with cleft lip. PMID:25992089

  8. Relative Hidden Markov Models for Video-Based Evaluation of Motion Skills in Surgical Training.

    Science.gov (United States)

    Zhang, Qiang; Li, Baoxin

    2015-06-01

    A proper temporal model is essential to analysis tasks involving sequential data. In computer-assisted surgical training, which is the focus of this study, obtaining accurate temporal models is a key step towards automated skill-rating. Conventional learning approaches can have only limited success in this domain due to insufficient amount of data with accurate labels. We propose a novel formulation termed Relative Hidden Markov Model and develop algorithms for obtaining a solution under this formulation. The method requires only relative ranking between input pairs, which are readily available from training sessions in the target application, hence alleviating the requirement on data labeling. The proposed algorithm learns a model from the training data so that the attribute under consideration is linked to the likelihood of the input, hence supporting comparing new sequences. For evaluation, synthetic data are first used to assess the performance of the approach, and then we experiment with real videos from a widely-adopted surgical training platform. Experimental results suggest that the proposed approach provides a promising solution to video-based motion skill evaluation. To further illustrate the potential of generalizing the method to other applications of temporal analysis, we also report experiments on using our model on speech-based emotion recognition.

  9. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    Science.gov (United States)

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  10. Journal of Surgical Technique and Case Report

    African Journals Online (AJOL)

    The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques and illustrative surgical cases on various surgical disciplines. The journal encourages authoritative synthesis of current surgical literature ...

  11. Innovation contests to promote sexual health in China: a qualitative evaluation.

    Science.gov (United States)

    Zhang, Wei; Schaffer, David; Tso, Lai Sze; Tang, Songyuan; Tang, Weiming; Huang, Shujie; Yang, Bin; Tucker, Joseph D

    2017-01-14

    Innovation contests call on non-experts to help solve problems. While these contests have been used extensively in the private sector to increase engagement between organizations and clients, there is little data on the role of innovation contests to promote health campaigns. We implemented an innovation contest in China to increase sexual health awareness among youth and evaluated community engagement in the contest. The sexual health image contest consisted of an open call for sexual health images, contest promotion activities, judging of entries, and celebrating contributions. Contest promotion activities included in-person and social media feedback, classroom didactics, and community-driven activities. We conducted 19 semi-structured interviews with a purposive sample to ensure a range of participant scores, experts and non-expert participants, submitters and non-submitters. Transcripts of each interview were coded with Atlas.ti and evaluated by three reviewers. We identified stages of community engagement in the contest which contributed to public health impact. Community engagement progressed across a continuum from passive, moderate, active, and finally strong engagement. Engagement was a dynamic process that appeared to have little relationship with formally submitting an image to the contest. Among non-expert participants, contest engagement increased knowledge, healthy attitudes, and empowered participants to share ideas about safe sex with others outside of the contest. Among experts who helped organize the contest, the process of implementing the contest fostered multi-sectoral collaboration and re-oriented public health leadership towards more patient-centered public health campaigns. The results of this study suggest that innovation contests may be a useful tool for public health promotion by enhancing community engagement and re-orienting health campaigns to make them more patient-centered.

  12. Hydrogen Release Compound (HRC®) Barrier Application At The North Of Basin F Site, Rocky Mountain Arsenal; Innovative Technology Evaluation Report

    Science.gov (United States)

    This Innovative Technology Evaluation Report documents the results of a demonstration of the hydrogen release compound (HRC®) barrier technology developed by Regenesis Bioremediation Products, Inc., of San Clemente, California. HRC® is a proprietary, food-q...

  13. HISTORY AND ACCOMPLISHMENTS OF THE US EPA'S SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION (SITE) MONITORING AND MEASUREMENT (MMT) PROGRAM

    Science.gov (United States)

    This manuscript presents the history and evolution of the U.S. Environmental Protection Agency's (EPA) Superfund Innovative Technology Evaluation (SITE) Monitoring and Measurement Technology (MMT) Program. This includes a discussion of how the fundamental concepts of a performanc...

  14. Healing of surgical castration wounds: a description and an evaluation of flunixin.

    Science.gov (United States)

    Mintline, E M; Varga, A; Banuelos, J; Walker, K A; Hoar, B; Drake, Daniel; Weary, D M; Coetzee, J F; Stock, M L; Tucker, C B

    2014-12-01

    Previous studies have shown that surgical castration wounds take between 10 and 61 d to heal. The objectives of this work were to describe healing, inflammation, lying behavior, and serum concentration of substance P after surgical castration in beef calves and to evaluate the effect of a possible intervention, a single injection of flunixin meglumine (1.1 mg/kg IV, a NSAID), on the healing process. Calves (mean±SE: 25±2.0 d of age; 54±1.4 kg BW) were surgically castrated with or without an injection of flunixin immediately before the procedure (n=24/treatment). Healing was measured with a 5-point scale (1=fresh wound, 5=no visible incision or inflammation) as well as weight gain, scrotal size, and scrotal surface temperature, on d 1, 2, 3, 7, 14, 21, 28, 35, 49, and 63 after castration. Serum concentration of substance P was recorded on all d, including d 0, but not d 63. Lying behavior was recorded with loggers from 2 d before to 29 d after castration. Inflammation, as measured by scrotal size, peaked on d 2 and 3 after the procedure (e.g., 51±1.0 mm on d 2 versus 28±1.3 mm before castration) and then declined with time (Pflunixin had more lying bouts than those that received saline (flunixin by time interaction; P=0.052), but this pattern emerged on and after d 8, well after the 3 to 8 h half-life of this NSAID. In conclusion, castration caused inflammation in the days that followed, and the wounds required a minimum of 4 wk to heal. Provision of an NSAID had no effect on these outcomes.

  15. Evaluation of the Unit Rod surgical instrumentation in Duchenne scoliosis. A retrospective study.

    Science.gov (United States)

    Nedelcu, T; Georgescu, I

    2016-01-01

    The article represents a retrospective clinical and radiological study. Objectives. Evaluating the safety and efficiency of the surgical treatment by using the Unit Rod for scoliosis in adolescents and children presenting Duchenne's muscular dystrophy. Summary. Surgical management of myopathic scoliosis still causes controversies regarding the timing of surgery (patient's age), the pelvic inclusion in the arthrodesis or the advantages of surgery over the conservatory treatment. The patients are very fragile and a long surgery with massive blood loss could lead to serious complications. Unit Rod instrumentation is simple, confers excellent stability and has a low rate of complications. Methods. This is a retrospective clinical and radiological study with a medium follow-up of 6.9 years including 13 patients diagnosed with Duchenne myopathy. All investigated patients were non-ambulatory at the time of surgery and have been treated by the Unit Rod technique at the University Hospital of Rouen between 2002 and 2008. Spinal fusion was, in all cases, realized from T2 to pelvis. Galveston technique of pelvic fixation and Luque's sublaminar wire instrumentation of the spine were used. Results. The results obtained with this treatment and post-surgery complications were analyzed and compared with those from literature. The advantages of this technique consist mostly in a good and stable pelvic fixation, a short interventional time, a minimal blood loss and few complications. Cobb angle correction is similar to that obtained by other surgical procedures. Conclusions. Using the Unit Rod instrumentation of scoliosis in Duchenne's muscular dystrophy is safe, has excellent outcomes, brings post-surgery improvements, and has minor intra and post-surgery complications. The low cost of this treatment could make it a first choice for medical health systems with financial problems.

  16. The evaluation and surgical management of cyclodialysis clefts that have failed to respond to conservative management

    Science.gov (United States)

    Ioannidis, Alexander S; Bunce, Catey; Barton, Keith

    2014-01-01

    Purpose To investigate factors that may influence successful correction of hypotony in a consecutive series of patients with cyclodialysis clefts repaired surgically over a 10-year period. Design Retrospective interventional case series. Methods Interventional case series of consecutive patients with cyclodialysis clefts and hypotony treated surgically after failure of conservative treatment. Results Eighteen patients (18 eyes) of mean (SD) age 48.3 (15.8) years at the time of surgery were included (16 male, 2 female). All were diagnosed using gonioscopy, usually assisted with intracameral viscoelastic injection. Imaging used in three cases was not found to be sufficiently precise to plan surgical intervention, without prior gonioscopic cleft visualisation. The intraocular pressure (IOP) was restored in nine cases (50%) after one procedure with a postoperative IOP (mean±SD) of 13.6±4.5 mm Hg (6/11 who had cyclopexy as a first procedure and 3/6 who had cryopexy). 2–3 procedures were required in the remaining nine patients. There was a trend towards the use of cyclopexy for larger clefts and cryopexy for smaller clefts (NS). We observed a trend for a lower likelihood of successful closure of larger clefts after one intervention. Two eyes that had cyclopexy required later IOP-lowering surgery to achieve IOP control. Conclusions Most clefts were closed with one procedure. A trend towards larger cleft size as a preoperative risk factor for failure to achieve closure with one procedure was observed. In this series, imaging was not found to be sufficiently precise to replace viscoelastic-assisted gonioscopy in the diagnosis and evaluation of cyclodialysis clefts. PMID:24457370

  17. Expert evaluation of innovation projects of mining enterprises on the basis of methods of system analysis and fuzzy logics

    Directory of Open Access Journals (Sweden)

    Pimonov Alexander

    2017-01-01

    Full Text Available This paper presents the multipurpose approach to evaluation of research and innovation projects based on the method of analysis of hierarchies and fuzzy logics for the mining industry. The approach, implemented as part of a decision support system, can reduce the degree of subjectivity during examinations by taking into account both quantitative and qualitative characteristics of the compared innovative alternatives; it does not depend on specific conditions of examination and allows engagement of experts of various fields of knowledge. The system includes the mechanism of coordination of several experts’ views. Using of fuzzy logics allows evaluating the qualitative characteristics of innovations in the form of formalized logical conclusions.

  18. Evaluation capacity assessment of the transport sector in South Africa: An innovative approach

    Directory of Open Access Journals (Sweden)

    Basia D. Bless

    2017-04-01

    Full Text Available Background: This article was based on the study on the assessment of evaluation capacity in the transport sector in South Africa. The purpose of the study was to test the Six Sphere Framework (SSF, which is an innovative evaluation capacity diagnostic tool developed by the Centre for Learning on Evaluation and Results (CLEAR-AA based in South Africa.Objectives: The article presents the findings emanating from the study and new knowledge on how evaluation capacity assessments can be conducted in the transport sector in South Africa.Method: A variety of methods including a survey, semi-structured interviews, document review and focus group discussions were used to collect data from primary and secondary sources. In all the cases, research questions were structured around the six components of the framework. Similarly, the presentation of the findings was arranged in themes that mirror these components.Results: The article locates the SSF within the current evaluation capacity development literature and argues that existing evaluation capacity assessment tools are inadequate to understand pertinent issues affecting the use of evidence in the transport sector in South Africa.Conclusion: In this regard, the framework is recommended as an innovative tool to assist evaluation practitioners and scholars to better understand evaluation capacity constraints within a broader context that involves logistical, technical, contextual, social and political dimensions. It also offers an important insight on how these components interfaced to shape the organisational value system that impacts the use of evidence in the transport sector in South Africa.

  19. In vitro evaluation of decellularized ECM-derived surgical scaffold biomaterials.

    Science.gov (United States)

    Luo, Xiao; Kulig, Katherine M; Finkelstein, Eric B; Nicholson, Margaret F; Liu, Xiang-Hong; Goldman, Scott M; Vacanti, Joseph P; Grottkau, Brian E; Pomerantseva, Irina; Sundback, Cathryn A; Neville, Craig M

    2017-04-01

    Decellularized extracellular matrix (ECM) biomaterials are increasingly used in regenerative medicine for abdominal tissue repair. Emerging ECM biomaterials with greater compliance target surgical procedures like breast and craniofacial reconstruction to enhance aesthetic outcome. Clinical studies report improved outcomes with newly designed ECM scaffolds, but their comparative biological characteristics have received less attention. In this study, we investigated scaffolds derived from dermis (AlloDerm Regenerative Tissue Matrix), small intestinal submucosa (Surgisis 4-layer Tissue Graft and OASIS Wound Matrix), and mesothelium (Meso BioMatrix Surgical Mesh and Veritas Collagen Matrix) and evaluated biological properties that modulate cellular responses and recruitment. An assay panel was utilized to assess the ECM scaffold effects upon cells. Results of the material-conditioned media study demonstrated Meso BioMatrix and OASIS best supported cell proliferation. Meso BioMatrix promoted the greatest migration and chemotaxis signaling, followed by Veritas and OASIS; OASIS had superior suppression of cell apoptosis. The direct adhesion assay indicated that AlloDerm, Meso BioMatrix, Surgisis, and Veritas had sidedness that affected cell-material interactions. In the chick chorioallantoic membrane assay, Meso BioMatrix and OASIS best supported cell infiltration. Among tested materials, Meso BioMatrix and OASIS demonstrated characteristics that facilitate scaffold incorporation, making them promising choices for many clinical applications. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 585-593, 2017. © 2015 Wiley Periodicals, Inc.

  20. Endoscopic evaluation of surgically altered bowel in patients with inflammatory bowel diseases.

    Science.gov (United States)

    Sinh, Preetika; Shen, Bo

    2015-06-01

    Patients with inflammatory bowel diseases often undergo surgical procedures for medically refractory disease or colitis associated dysplasia. Endoscopic evaluation of the surgically altered bowel is often needed to assess for disease recurrence, its severity, and for therapy. It is important to obtain and review the operative report and abdominal imaging before performing the endoscopy. Diagnostic and therapeutic endoscopy can be safely performed in most patients with inflammatory bowel disease with altered bowel anatomy under conscious sedation without fluoroscopy. Carefully planned stricture therapy with balloon dilation or needle knife stricturotomy can be performed for simple, short, and fibrotic strictures. A multidisciplinary approach involving a team of endoscopist, endoscopy nurse, colorectal surgeon, gastrointestinal pathologist, and gastrointestinal radiologist is important for a safe and effective endoscopy. We attempt to review the aspects that need consideration before the endoscopy, the technique of endoscopy, and briefly the therapies that can be performed during endoscopy of the bowel through an ileostomy, a colostomy, in the diverted large bowel or ileal pouch, and small bowel after stricturoplasty and bowel bypass surgery in patients with inflammatory bowel diseases.

  1. Augmentation mastopexy after bariatric surgery: evaluation of patient satisfaction and surgical results.

    Science.gov (United States)

    Junior, Wilson Cintra; Modolin, Miguel Luiz Antonio; Rocha, Rodrigo Itocazo; Gemperli, Rolf

    2016-01-01

    to evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. we conducted a prospective study of 20 consecutive female patients with a mean age of 39.9 years, submitted to augmentation mastopexy. We applied semi-directed psychological interviews pre and postoperatively. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. We evaluated surgical results through photographic analysis of three independent plastic surgeons, in the pre and postoperative periods, when scores were attributed to the following items: breasts shape, breasts volume, breasts symmetry, nipple-areolar complex position, and scar quality and extent. nineteen patients (95%) referred satisfaction with the surgical results attained (pimplantes mamários. estudo prospectivo com 20 pacientes consecutivas do sexo feminino, com média etária de 39,9 anos, que foram submetidas à mastopexia de aumento. Foram aplicadas entrevistas psicológicas semidirigidas nos períodos pré e pós-operatórios e cujas respostas foram tabuladas, divididas em categorias, e possibilitaram a avaliação da satisfação das pacientes. Foi realizada avaliação dos resultados cirúrgicos através da análise fotográfica por três cirurgiões plásticos independentes, nos períodos pré e pós-operatórios, que atribuíram notas aos seguintes itens: forma da mama, volume da mama, simetria entre as mamas, posicionamento do complexo aréolo-papilar e qualidade e extensão das cicatrizes. dezenove pacientes (95%) referiram satisfação com o resultado cirúrgico obtido (p<0,001). A média das somatórias das notas atribuídas pelos três cirurgiões, referentes a cada paciente, variou entre 4,7 e 10, sendo a média geral de 7,28. Os resultados foram considerados bons ou ótimos para 65% da amostra e pobres para 8,4%. houve satisfação de 95% das pacientes com os resultados obtidos pela mastopexia de aumento. A análise fotogr

  2. Rationale and design of the INNOVATE Trial: an international cooperative study on surgical versus conservative treatment for odontoid fractures in the elderly.

    Science.gov (United States)

    Huybregts, Jeroen G J; Jacobs, Wilco C H; Peul, Wilco C; Vleggeert-Lankamp, Carmen L A

    2014-01-08

    Fractures of the odontoid process of the axis are the most common fractures of the geriatric cervical spine. As the population ages, their incidence is expected to increase progressively, as is the number of very old patients (>80 years) with an odontoid fracture. No consensus exists on the optimal treatment (surgical or conservative) and the most relevant outcome parameter (osseous union, fracture stability or clinical outcome). The aim of the INNOVATE (INterNational study on Odontoid frActure Treatment in the Elderly) Trial is to prospectively assess fracture healing and clinical outcome after surgical and conservative treatment for odontoid fractures in the elderly patient, with a specific focus on the very old patient. The trial is an observational study in which eleven centres in five European countries are involved. All patients admitted to one of these centres who meet the selection criteria (≥55 years, acute (

  3. Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

    Science.gov (United States)

    Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

    2015-03-10

    In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross

  4. Strategical integration and prior evaluation of science and innovation projects in Ecuadorians sports organizations.

    Directory of Open Access Journals (Sweden)

    Gloria Barroso Rodríguez

    2015-09-01

    Full Text Available This work shows the design of a procedure for evaluating the strategical integration of science and innovation projects level in the physical and sport sphere, and its validation through expert criteria for application to Ecuadorian sports organizations. As a result, it was possible to demonstrate the validity of the procedure designed, so it will be possible to be used to facilitate decision-making in relation to the execution of such projects considering, as a value judgment, the level of their essential components integration for the achievement of objectives aligned to the strategic priorities of the Ecuadorians sports organizations.  

  5. Phantom-based evaluation method for surgical assistance devices in minimally invasive cochlear implantation

    Science.gov (United States)

    Lexow, G. Jakob; Kluge, Marcel; Majdani, Omid; Lenarz, Thomas; Rau, Thomas S.

    2017-03-01

    Several research groups have proposed individual solutions for surgical assistance devices to perform minimally invasive cochlear implantation. The main challenge is the drilling of a small bore hole from the surface of the skull to the inner ear at submillimetric accuracy. Each group tested the accuracy of their device in their respective test bench or in a small number of temporal bone specimens. This complicates the comparison of the different approaches. Thus, a simple and inexpensive phantom based evaluation method is proposed which resembles clinical conditions. The method is based on half-skull phantoms made of bone-substitute material - optionally equipped with an artificial skin replica to include skin incision within the evaluation procedure. Anatomical structures of the temporal bone derived from segmentations using clinical imaging data are registered into a computer tomographic scan of the skull phantom and used for the planning of the drill trajectory. Drilling is performed with the respective device under conditions close to the intraoperative setting. Evaluation of accuracy can either be performed through postoperative imaging or by means of added targets on the inside of the skull model. Two different targets are proposed: simple reference marks only for measuring the accuracy of the device and a target containing a scala tympani model for evaluation of the complete workflow including the insertion of the electrode carrier. Experiments using the presented method take place under reproducible conditions thus allowing the comparison of the different approaches. In addition, artificial phantoms are easier to obtain and handle than human specimens.

  6. Stereophotogrammetric Evaluation of Labial Symmetry After Surgical Treatment of a Lymphatic Malformation.

    Science.gov (United States)

    Pucciarelli, Valentina; Tarabbia, Filippo; Codari, Marina; Guidugli, Giulia Andrea; Colletti, Giacomo; Dell'Aversana Orabona, Giovanni; Bianchi, Bernardo; Sforza, Chiarella; Biglioli, Federico

    2017-06-01

    Lymphatic malformations (LMs) are rare, nonmalignant masses, frequently involving the head and neck, potentially causing impairment to the surrounding anatomical structures. Major LMs frequently cause facial disfigurement with obvious consequences on self-esteem and social functioning. The attempt to restore symmetry is thus one of the main goals of treatment. In this study, the authors present a not-invasive method to objectively quantify the symmetry of the labial area before and after surgical treatment of a LM, affecting a 16-year-old woman. This was done with sequential three-dimensional stereophotogrammetric imaging and morphometric measurements. The method showed a high reproducibility and supplied quantitative indicators of the local degree of symmetry, helping clinicians in its objective assessment, and facilitating treatment planning and evaluation. A quantitative appraisal of the results can additionally improve patient adherence to a usually multistage therapy.

  7. A Mobile Framework for Competence Evaluation: Innovation Assessment Using Mobile Information Systems

    Directory of Open Access Journals (Sweden)

    Marcos Ruano Mayoral

    2007-09-01

    Full Text Available The environment surrounding organizations is characterized by an increasing necessity of competent personnel but with finite competence level. From the scope of the management of those human resources, one of the most crucial aspects is to be able to measure the competence level of each professional as quickly and precisely as possible. This paper introduces a tool, based on HR-XML standard, to feed competence evaluation with data or evidences that help to fit performance evaluations to the actual performance of the employees. Mobility capabilities in performance evaluation, particularly in the innovation field, involve an inventive contribution to current Competence Management Systems that, due to their lack of flexibility, hinder the full development of the capability to include evidences wherever they may take place, whether it is at work, at client’s office or in a recruitment interview.

  8. Comparative evaluation of plasma ROM levels in chronic periodontitis patients before and after non-surgical and surgical periodontal therapy: A clinical trial

    Science.gov (United States)

    Chaudhary, Sohini; Gowda, Triveni M.; Mehta, Dhoom S.; Kumar, Tarun A. B.

    2014-01-01

    Objective: Chronic periodontitis (CP) is associated with increased levels of blood reactive oxygen species (ROS). So, treatment of CP may lead to decrease in blood ROS. However, not much literature is available comparing the effect of surgical and non-surgical periodontal treatment on blood ROS levels. Reactive oxygen metabolites (ROMs) are a useful measure of blood ROS. The aim of this study was to investigate the effect of periodontal treatment on plasma ROM levels in CP patients. Materials and Methods: Thirty CP patients and 15 controls were monitored. Plasma samples were collected at baseline and the clinical parameters were recorded. The CP patients were randomly divided into two groups: Scaling and root planing (Group II) and periodontal flap surgery (Group III). Both groups were re-evaluated 1 and 2 months after therapy. Clinical parameters were reviewed, plasma samples collected, and ROM levels were determined using a spectrophotometric technique. Results: At baseline, the ROM levels for Group II and Group III were 519.8 ± 62.4 and 513.4 ± 74.7 CARR U, respectively, which were higher than Group I value (282.9 ± 23.9, P Periodontal treatment in CP patients resulted in improvement of clinical parameters and a highly significant reduction in plasma ROM level (P periodontal treatment was more effective in lowering the plasma ROM levels than when non-surgical periodontal treatment was performed alone and, therefore, may be more beneficial in reducing systemic oxidative stress. PMID:24872618

  9. Comparative evaluation of plasma ROM levels in chronic periodontitis patients before and after non-surgical and surgical periodontal therapy: A clinical trial.

    Science.gov (United States)

    Chaudhary, Sohini; Gowda, Triveni M; Mehta, Dhoom S; Kumar, Tarun A B

    2014-03-01

    Chronic periodontitis (CP) is associated with increased levels of blood reactive oxygen species (ROS). So, treatment of CP may lead to decrease in blood ROS. However, not much literature is available comparing the effect of surgical and non-surgical periodontal treatment on blood ROS levels. Reactive oxygen metabolites (ROMs) are a useful measure of blood ROS. The aim of this study was to investigate the effect of periodontal treatment on plasma ROM levels in CP patients. Thirty CP patients and 15 controls were monitored. Plasma samples were collected at baseline and the clinical parameters were recorded. The CP patients were randomly divided into two groups: Scaling and root planing (Group II) and periodontal flap surgery (Group III). Both groups were re-evaluated 1 and 2 months after therapy. Clinical parameters were reviewed, plasma samples collected, and ROM levels were determined using a spectrophotometric technique. At baseline, the ROM levels for Group II and Group III were 519.8 ± 62.4 and 513.4 ± 74.7 CARR U, respectively, which were higher than Group I value (282.9 ± 23.9, P ROM level (P ROM levels in Group III as compared to Group II (P ROM levels than when non-surgical periodontal treatment was performed alone and, therefore, may be more beneficial in reducing systemic oxidative stress.

  10. Evaluation of the Effect of Surgical Crown Lengthening on Periodontal Parameters

    Directory of Open Access Journals (Sweden)

    Farzane Vaziri

    2015-09-01

    Full Text Available Background: Surgical crown lengthening is needed for teeth with subgingival caries, fractured teeth, insufficient crown length, and deep subgingival margin of failed restorations. Since there is no agreement on the effects of crown lengthening surgery on gingival parameters, the purpose of this study was to evaluate periodontal parameters in patients who needed crown lengthening surgery. Methods: Twenty patients who had healthy periodontium and needed surgical crown lengthening were included in this study. After professional dental cleaning, gingival parameters including gingival index (GI, probing depth (PD, bone level (BL, and transsulcular probing (TSP were recorded in interproximal and keratinized gingiva (KG in mid buccal portion. The patients were evaluated one and three months after the surgery. Results: After one and three months of the surgery, the amount of PD reduced from 2.32 mm to 1.25 mm and 1.17 mm, respectively (P=0.001. The mean of BL reduction was 0.88 mm after one month (P=0.001, but there was no reduction between 1 month and 3 months. Amounts of KG at baseline andone month later were 4.2 mm and 2.9 mm, respectively (P=0.001, and remained at the same level up to three months. TSP significantly reduced (from 3.67 mm at baseline to 2.62 mm after 1 month, and to 2.27 mm after 3 months (P=0.001, P=0.005. Conclusion: The present  study suggests that in the presence of good oral hygiene, except BW (biological width, other parameters including PD, BL, KG, and TSP had significant changes after crown lengthening surgery in the period of 1 month and 3 months (P

  11. Evaluation of the Prevalence of Different Treatment Failure Modes after Crown Lengthening Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2016-07-01

    Full Text Available Introduction: Preservation of the health of periodontium is very important for the long-term success of restored teeth and a balance should always be created between the patients’ esthetic requirements and the periodontal health. Failures of crown lengthening procedures are classified into early and late failures. The aim of this study was to evaluate the prevalence of early failures of crown leathering surgical procedures. Materials and methods: In this descriptive/cross-sectional study, 96 patients were selected from those referring to the Department of Periodontitis, Tabriz Faculty of Dentistry, who required crown lengthening procedures. The particulars of these patients were recorded in special forms and the reasons for the failure of surgical procedures were separately determined at 2- and 6-week intervals. In addition, the frequencies of the reasons for failures were determined in percentages and absolute frequencies. Data were analyzed with descriptive statistics (frequencies and percentages using SPSS 21. Statistical significance was set at P<0.05. Results: Evaluation of patients 6 weeks after surgery showed a failure rate of 14.5% for crown lengthening procedures in patients referring to the Department of Periodontics, Tabriz Faculty of Dentistry. The most common reasons for such early failures in the 6th week, in descending order, were a lack of sufficient keratinized gingiva around in tooth in question, fracture of the tooth structure after surgery, inadequate surgery (not creating a proper distance between the healthy margin and the crest and the coronal returning of the gingival tissue on the tooth. A lack of sufficient keratinized gingiva around the tooth was the most frequent reason for the early failure of crown lengthening procedure at both study intervals. Conclusion: It can be concluded from the results of the present study that during the 6th postoperative week the crown lengthening procedures exhibited a 14.5% failure rate

  12. SU-F-T-03: Radiobiological Evaluation of a Directional Brachytherapy Device Surgically Implanted Following EBRT

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, MJ [Tufts University School of Medicine, Boston, MA (United States); Emrich, JG; Poli, J [Drexel University College of Medicine, Philadelphia, PA (United States)

    2016-06-15

    Purpose: Preceding surgical implantation following external-beam radiotherapy (EBRT) delivery, a radiobiological evaluation was performed for a new LDR Pd-103 directional brachytherapy device (CivaSheet). As this was the first case with the device used in combination with EBRT, there was concern to determine the appropriate prescription dose. Methods: The radiobiological model of Dale (1985, 1989) was used for a permanent LDR implant including radioactive decay. The biological effective dose (BED) was converted to the equivalent dose in 2 Gy fractions (EQD2) for comparison with EBRT prescription expectations. Given IMRT delivery of 50.4 Gy, an LDR brachytherapy dose of approximately 15–20 Gy EQD2 was desired. To be specific to the treatment site (leiomyosarcoma T2bN0M0, grade 2 with R1 surgical margin), the radiobiological model required several radiobiological parameters with values taken from the literature. A sensitivity analysis was performed to determine their relative importance on the calculated BED and subsequent EQD2. The Pd-103 decay constant (λ=0.0017 h{sup −1}) was also used. DVHs were prepared for pre- and post-surgical geometries to glean the possible and realized implant geometric configuration. DVHs prepared in VariSeed9 were converted to BEDVHs and subsequently EQD2 values for each volume-element. Results: For a physical dose of 28 Gy to a 0.5 cm depth, BED=21.7 Gy and EQD2=17.6 Gy, which was near the center of the desired EQD2 range. Tumor bed (CTV=4 cm{sup 3}) coverage was 99.2% with 48 sources implanted. In order of decreasing importance from the sensitivity analysis, the radiobiological parameters were α=0.25 Gy{sup −1}, T{sub POT}=23 days, α/β=8.6 Gy, and T=1.5 h. Percentage variations in these values produced EQD2 variations of 40%, 20%, 18%, and 1%, respectively. Conclusion: This radiobiological evaluation indicated that prescription dose may be determined for comparison with the desired EQD2, and that radiobiologicalparameter

  13. [Evaluation of efficiency of the sonotherapy in enhancement of venous leg ulcer healing in patients after surgical and conservative treatment].

    Science.gov (United States)

    Franek, Andrzej; Brzezińska-Wcisło, Ligia; Cierpka, Lech; Chmielewska, Daria; Dolibog, Patrycja; Błaszczak, Edward; Taradaj, Jakub

    2008-07-01

    The aim of the study was to evaluate the application of sonotherapy in enhancement venous leg ulcer healing after conservative and surgical therapy. The 60 patients were included into the study. The 30 patients, who agreed on operation and were accepted by medical team to the surgical treatment, had been included to A and B group. The others, 30 patients were treated conservatively, and had been included to C and D group. The patients in group A and C were additionally treated in use of sonotherapy. The evaluated factors were to estimate the sonotherapy promotes total wound closure and causes any changes of the relative surface, longest and widest dimensions, and volume of tissue defect, pus and granulation degree. After study in all groups, we noticed a therapeutic effect. Treatment was more efficient in patients after surgical operation than in patients after conservative methods. Beneficial effects of sonotherapy in conservative enhancement of ulcer healing were observed. No impact of sonotherapy after surgical procedure was noticed. The sonotherapy is useful and efficient method only in enhancement of venous leg ulcer healing after conservative treatment. In surgically treated patients is not efficient method, because there is no accelerating impact on wound healing. As well conducted surgical operation more efficiently enhance a healing process than conservative pharmacological procedures.

  14. Real-time monitoring for detection of retained surgical sponges and team motion in the surgical operation room using radio-frequency-identification (RFID) technology: a preclinical evaluation.

    Science.gov (United States)

    Kranzfelder, Michael; Zywitza, Dorit; Jell, Thomas; Schneider, Armin; Gillen, Sonja; Friess, Helmut; Feussner, Hubertus

    2012-06-15

    Technical progress in the surgical operating room (OR) increases constantly, facilitating the development of intelligent OR systems functioning as "safety backup" in the background of surgery. Precondition is comprehensive data retrieval to identify imminent risky situations and inaugurate adequate security mechanisms. Radio-frequency-identification (RFID) technology may have the potential to meet these demands. We set up a pilot study investigating feasibility and appliance reliability of a stationary RFID system for real-time surgical sponge monitoring (passive tagged sponges, position monitoring: mayo-stand/abdominal situs/waste bucket) and OR team tracking (active transponders, position monitoring: right/left side of OR table). In vitro: 20/20 sponges (100%) were detected on the mayo-stand and within the OR-phantom, however, real-time detection accuracy declined to 7/20 (33%) when the tags were moved simultaneously. All retained sponges were detected correctly. In vivo (animal): 7-10/10 sterilized sponges (70%-100%) were detected correctly within the abdominal cavity. OR-team: detection accuracy within the OR (surveillance antenna) and on both sides of the OR table (sector antenna) was 100%. Mean detection time for position change (left to right side and contrariwise) was 30-60 s. No transponder failure was noted. This is the first combined RFID system that has been developed for stationary use in the surgical OR. Preclinical evaluation revealed a reliable sponge tracking and correct detection of retained textiles (passive RFID) but also demonstrated feasibility of comprehensive data acquisition of team motion (active RFID). However, detection accuracy needs to be further improved before implementation into the surgical OR. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Evaluation of Quality Metrics for Surgically Treated Laryngeal Squamous Cell Carcinoma.

    Science.gov (United States)

    Graboyes, Evan M; Townsend, Melanie E; Kallogjeri, Dorina; Piccirillo, Jay F; Nussenbaum, Brian

    2016-12-01

    for all patients (OS aHR, 0.51; 95% CI, 0.29-0.88; DFS aHR, 0.50, 95% CI, 0.32-0.80) and elective neck dissection yield of 18 lymph nodes or more (DFS aHR, 0.36; 95% CI, 0.14-0.99) were associated with improved survival on multivariable Cox proportional hazards analysis. In this cohort of patients with surgically treated laryngeal SCC, multidisciplinary evaluation and elective neck dissection yield of 18 lymph nodes or more are associated with improved survival. Development of better quality metrics is necessary because increased compliance with metrics described by the AHNS and NCCN is not associated with improved survival. Previously described metrics for surgically treated oral cavity cancer are not prognostic for surgically treated laryngeal SCC. Future multi-institutional collaboration will be required to validate these findings, develop better quality metrics, and evaluate whether quality metrics for head and neck cancer are site specific.

  16. Evaluation of accuracy of virtual surgical planning for patient-specific pre-contoured plate in acetabular fracture fixation.

    Science.gov (United States)

    Maini, Lalit; Verma, Tarun; Sharma, Amit; Sharma, Ankur; Mishra, Abhishek; Jha, Sunil

    2018-01-24

    Acetabular fractures are amongst the most challenging fractures to treat because of complex anatomy. Open reduction and internal fixation remains the standard treatment for displaced acetabular fractures to achieve anatomical reduction as in any other intra-articular fracture. Patient-specific pre-contoured reconstruction plate template made by a pre-operative virtual surgical planning can be useful to respect patient's morphology, reduce surgical invasiveness and simplify the surgical procedure. Proper evaluation and surgical planning is necessary to achieve these goals. The goal of this study was to evaluate the outcomes of using virtual surgical planning and virtually pre-contoured plate template in comparison with the conventional method of intra-operative contouring of reconstruction plate for acetabular fracture fixation. Twenty-five patients were categorized into group A and B by computerized randomization. In group A (12 patients), CT-based virtual surgical planning was done using Mimics and 3-Matic software to form virtually pre-contoured plates, which were 3D printed to act as templates over which 3.5 mm reconstruction plates were manually contoured pre-operatively and used for fixation. In group B (13 patient), conventional method of intra-operative contouring to adapt the plate to the fracture region was followed. Blood loss, surgical time, reduction on X-rays and post-operative computed tomography were compared between two groups. Duration of surgery and total blood loss were found to be less while reduction was found to satisfactory/anatomical in higher percentage of Group A than Group B patients. Virtual surgical planning, patient-specific virtually pre-contoured plate template and 3D printing technology improve the outcomes of acetabular fracture surgery by reducing duration and invasiveness of surgery and improving the quality of reduction. However, studies with larger sample size are required to further validate it.

  17. An evaluation of a surgical telepresence system for an intrahospital local area network.

    Science.gov (United States)

    Schneider, A; Wilhelm, D; Bohn, U; Wichert, A; Feussner, H

    2005-01-01

    We evaluated a digital telepresence system in an operating theatre (OR) environment which enabled a consultant to join the surgical team from a remote site by audiovisual communication. The system is based on video transmission using a streaming technique, with a server and a client connected via a local area network (LAN). Two cameras can be remotely controlled: one camera is built into the OR lamp and a second, laparoscopic camera is mounted on a robotic arm. Another feature of the system is teledemonstration, which permits the remote consultant to demonstrate points of particular interest. We evaluated the system clinically in 237 cases. In 28 cases (12%), telepresence could not be established for various reasons, mainly human failure. In 42 cases (18%), the full potential of telepresence was used. Technical evaluation showed that a data rate of 2 Mbit/s provides sufficient audio and video quality, as well as reliable teledemonstration. The data transmission delay was acceptable for clinical purposes (video 0.92 s, audio 0.6 s from OR to client, audio 0.7 s from client to OR). The study showed that telepresence is a promising means of providing highly specialized expertise within the OR.

  18. Evaluation of surgical treatment for ruptured Achilles tendon in 31 athletes.

    Science.gov (United States)

    Jallageas, R; Bordes, J; Daviet, J-C; Mabit, C; Coste, C

    2013-09-01

    In the past few decades, the incidence of Achilles tendon rupture has increased in parallel with increased sports participation. Although the optimal treatment remains controversial, there is a trend towards surgical treatment in athletes. Surgical repair of ruptured Achilles tendon in athlete results in good functional and objective recovery, irrespective of the type of surgery performed. Subsidiarily, are the results different between percutaneous surgery (PS) and standard open surgery (OS)? This was a cross-sectional study of 31 patients who presented with a ruptured Achilles tendon that occurred during sports participation. Percutaneous surgery was performed in 16 patients and open surgery in 15 patients between 2005 and 2009. The objective recovery status was evaluated by open chain goniometry, measurement of leg muscle atrophy and assessment of isokinetic strength. The functional analysis was based on the delay, level of sports upon return, AOFAS and VAS for pain. Our series of Achilles tendon rupture patients consisted of 88% men and 12% women, with an average age of 38 years. In 71% of cases, the rupture occurred during eccentric loading. After a follow-up of 15 months, the muscle atrophy was 13 mm after PS and 24 mm after OS (P=0.01). A strength deficit of 19% in the plantar flexors was found in the two groups. No patient experienced a rerupture. The return to sports occurred at 130 days after PS and 178 days after OS (P=0.005). The average AOFAS score was 94 and the VAS was 0.5. There were no differences in ankle range of motion between the two groups. The majority (77%) of patients had returned to their preinjury level of sports activity. The return to activities of daily living was slower in our study than in studies based in Anglo-Saxon countries; this can be explained by the different sick leave coverage systems. Percutaneous surgery resulted in a faster return to sports (about 130 days) and less muscle atrophy than open surgery. Our results for

  19. Evaluation of surgical performance with standard rigid and flexible-tip laparoscopes.

    Science.gov (United States)

    Perrone, J M; Ames, C D; Yan, Y; Landman, J

    2005-10-01

    Flexible-tip laparoscopes have recently been introduced into clinical practice, with the goal of improving surgeon performance during complex laparoscopic procedures. We used objective and subjective performance parameters to compare standard rigid 0 degrees and 30 degrees lens laparoscopes two flexible-tip laparoscopes in an in vitro model. Twenty-nine subjects with varied levels of surgical experience performed complex laparoscopic tasks in three different models simulating (a) prostate dissection from the rectum, (b) cystic duct clipping, and (c) distal posterior rectum dissection. Each task was performed using two Storz rigid laparoscopes (0 degrees and 30 degrees) and two flexible-tip laparoscopes, the Olympus LTF-V3 and the Fujinon EL2-TF310. The sequence of application of the two flexible-tip laparoscopes was randomized. In each case, an experienced laparoscopic camera driver controlled the field of vision. Time to complete each task, operative precision, and subjective surgeon rating scores were compared. Statistical analysis was performed with analysis of variance (ANOVA) and a two-sided fisher's exact test. In all three models, the flexible laparoscopes offered no advantage in terms of procedure time, surgical precision, or subjective surgeon rating score when compared with the 30 degrees lens rigid laparoscope. The 30 degrees rigid lens laparoscope and the two flexible-tip laparoscopes were superior to the 0 degrees lens rigid laparoscope for all parameters evaluated, with the exception of subjective rating in the cystic duct model and procedure time in the colorectal model. In this in vitro experimental model, the flexible-tip laparoscopes found to have no advantage over the standard rigid 30 degrees lens laparoscope. These models were validated, as the 0 degrees lens rigid laparoscope was surpassed by the 30 degrees lens rigid laparoscope and the flexible-tip laparoscopes. Both flexible-tip laparoscopes produced similar results and excellent image

  20. Evaluation of Inferior Oblique Muscle Overaction Existence Time and Surgical Outcomes in Infantile Esotropia

    Directory of Open Access Journals (Sweden)

    Mehmet Ragıp Ekmen

    2013-12-01

    Full Text Available Purpose: Evaluation of inferior oblique muscle overaction (IOOA existence time and surgical outcomes in infantile esotropia. Material and Method: A total of 100 patients who underwent operation for infantile esotropia (IE were included in the study. Full ophthalmic assessment, including ocular motility, best-corrected visual acuity, cycloplegic refraction, any of alternant prism cover test or Hirschberg/Krimsky test, was performed. Results: Forty-nine patients (49% were male and (51% were female. The mean age at IE diagnosis was 23.2±18.6 months. The mean follow-up time was 43.7±18.0 months. The mean horizontal deviation - corrected and uncorrected - was 36.75±10.45 PD and 40.05±8.39 PD, respectively. We found that there was no statistically significant relationship between existence time of IOOA and the age at IE diagnosis (p: 0.486, p: 0.251. IOOA was detected in 69 patients. Inferior oblique (IO muscle weakening procedures were performed in 45 of 69 patients. In 45 patients who had undergone surgery for IOOA, 24 (53.3% had bilateral IO recession, 10 (22.2% had bilateral IO tenotomy, 8 (17.7% had unilateral IO tenotomy, 1(2.2% had unilateral myectomy, 1 (2.2% had bilateral myectomy, and 1 (2.2% had bilateral anteroposition. IOOA degrees after IO recession and tenotomy surgery were found to be significantly lower than the preoperative values (p=0.0586, p=0.7258. Discussion: There was no statistically significant relationship between the existence time of IOOA and the age of IE diagnosis. We concluded that IO tenotomy and IO recession surgical techniques are effective and safe procedures for cases which have IOOA associated with IE. (Turk J Ophthalmol 2013; 43: 419-23

  1. Brain spect in the pre-surgical evaluation of epileptic patients preliminary results

    Directory of Open Access Journals (Sweden)

    Carlos A. Buchpiguel

    1992-03-01

    Full Text Available Pre-surgical evaluation of epileptic patients consists of neurological examination, intensive electroencephalographic (EEG monitoring and anatomical studies (CT and MRI. Functional methods such as PET and SPECT imaging are now used more frequently. We have studied pre-operatively 15 adult epileptic patients (8 female, 7 male using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99mTc_HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas. In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions. Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hyperperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: (a in 4, SPECT findings correlated well with the anatomical findings; (b in 5 instances, SPECT was able to disclose additional functional deficits; (c in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10 SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and hete-rogenicity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic patients who are candidates for epilepsy surgery.

  2. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Pecina, Hrvoje Ivan; Boric, Igor [Clinical Hospital ' ' Sestre Milosrdnice' ' , Department of Radiology, Zagreb (Croatia); Smoljanovic, Tomislav; Pecina, Marko [University of Zagreb, Department of Orthopedic Surgery, School of Medicine, Zagreb (Croatia); Duvancic, Davor [Outpatients Clinic and Clinic for Diagnostic Procedures, Zagreb (Croatia)

    2008-11-15

    The objective of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of the piriformis muscle syndrome (PMS). In ten patients, seven female and three male, with a long history of clinical symptoms of the PMS, an MRI was performed as the last preoperative diagnostic tool. All patients were imaged using 2T MR system (Elscint, Haifa, Israel). Axial and coronal spin-echo, fast spin-echo (FSE), and fat-suppressed FSE-weighted images were made through the pelvic region with 3-mm section thickness and a 0.5-mm gap to show the whole piriformis muscle and the course of sciatic nerve on its way out of the pelvis. A routine examination also included axial fast spin-echo T2, three-dimensional gradient echo. In seven cases, an MRI abnormality for the PMS was found. In two women, the MRI demonstrated a bigastric appearance of the piriformis muscle with a tendinous portion between the muscle heads and the course of the common peroneal nerve through the muscle between the tendinous portions of the muscle. In one female patient, the common peroneal nerve passed through the hypertrophied piriformis muscle. In four patients, the MRI showed a hypertrophied aspect of the piriformis muscle and an anteriorly displaced sciatic nerve. All MRI findings were confirmed surgically. In three patients, no apparent abnormalities could be observed, but after a surgical treatment, i.e., a tenotomy of the piriformis muscle and neurolysis of the sciatic nerve, all symptoms disappeared. In piriformis muscle syndrome, MRI may demonstrate signal abnormalities of the sciatic nerve as well as its relationship with the normal and abnormal piriformis muscle. (orig.)

  3. [Effects of malnutrition on infective morbidity in the surgical treatment of portal hypertension (prospective evaluation)].

    Science.gov (United States)

    Herrera, M F; Hoyos, C; Prado, E; Orozco, H

    1991-01-01

    With the aim of investigating the preoperative frequency of undernutrition and its impact on the infectious morbidity in patients without malignant disease, we studied prospectively 41 patients operated because of portal hypertension between 1987 and 1989 at the Instituto Nacional de la Nutrición. All patients were evaluated through anthropometric analysis and biochemical markers one week before the surgical procedure. A standard scheme of antibiotic profilaxis was used during surgery and the preoperative complications were registered up to discharge from the hospital. Undernutrition was considered when the serum albumin was less than 3 mg/dL or the total lymphocyte count was under 900, associated with a 10% weight loss in six months and reduction of one or more anthropometric parameters below the 30th percentile of the normal value. The group consisted of 17 males and 24 females with a mean age of 48 +/- 14 years old. 35 were Child A, four Child B and two Child C. Ten patients had a distal splenorenal shunt, seven esophageal devascularization and 24 gastric desvascularization with splenectomy. Twenty eight patients were well nourished and 13 undernourished. The two groups were comparable in all parameters except for the nutritional status. In the first group seven patients developed 10 complications and in the undernourished group eight patients had 14 complications (p less than 0.05 chi 2). There was no significant difference in the mortality rate. Infections occurred more frequently in: urinary tract, surgical wound, lung and pleura, and esophageal fistulae was an additional complication. The univariate analysis of the anthropometric parameters did not show significant differences between both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Implementation and Benefit Evaluation of Recommendations for Patient Safety in Ambulatory Surgical Care.

    Science.gov (United States)

    Monaca, C; Buchmann, M; Manser, T

    2016-09-01

    Objective: The aim of this study was to evaluate the degree of implementation of recommendations for patient safety in ambulatory surgical care and their benefit as perceived by surgeons in the ambulatory sector. Based on 2 practice recommendations issued by the Association of Statutory Health Insurance Physicians in Westphalia-Lippe, recommendations were formulated specifically for ambulatory surgery and distributed in 2013 to all physicians licensed to conduct ambulatory surgery in Westphalia-Lippe. Methods: We conducted a written survey covering all safety measures addressed by the 2 practice recommendations and assessed the degree of implementation and the perceived benefit for each of these measures as well as the strengths of the recommendations and the challenges of implementing them. The survey was distributed in late 2014 to 2 454 surgeons in the ambulatory setting. The survey period was 7 weeks. The analysis of the quantitative data was mainly descriptive and we conducted thematic summaries of free text answers to open-ended questions. Results: The participation rate was 17% (n=405). The recommendations were known to 86% of the respondents. The majority of recommended safety measures had been implemented systemically in more than 50% of the participating institutions. An increased interprofessional awareness of patient safety measurements was reported as the main impact of the recommendations. Respondents indicated further need for information and practice recommendations concerning the following topics: risk and error management, implementation of the Medical Devices Act, hygiene in medical practice and processing of instruments. Conclusion: This study highlights the valuable contribution practice recommendations can make to patient safety improvement in ambulatory surgical care. Their dissemination to other regions as well as to other ambulatory care settings such as family practice can therefore be recommended. © Georg Thieme Verlag KG Stuttgart

  5. Evaluation of Spinacia oleracea L. leaves mucilage as an innovative suspending agent.

    Science.gov (United States)

    Nayak, Amit Kumar; Pal, Dilipkumar; Pany, Dipti Ranjan; Mohanty, Biswaranjan

    2010-07-01

    The present study was undertaken to evaluate the mucilage isolated from Spinacia oleracea L. leaves, commonly named spinach (family: Amaranthaceae) as an innovative suspending agent. Zinc oxide suspensions (20% w/v) were prepared using the mucilage of S. oleracea L. leaves as a suspending agent, and it was evaluated for its stability by using parameters like, sedimentation profile, degree of flocculation, and redispersibility. The effect of the tested mucilage on the suspension was compared with various commonly used suspending agents, such as, tragacanth, bentonite, and sodium carboxymethyl cellulose (NaCMC) at concentrations of 0.5, 1.0, and 2.0% w/v. The results obtained indicated that the mucilage of S. oleracea L. leaves could be used as a suspending agent, and the performance was found to be superior to both tragacanth and bentonite.

  6. Evaluation of Spinacia oleracea L. leaves mucilage as an innovative suspending agent

    Directory of Open Access Journals (Sweden)

    Amit Kumar Nayak

    2010-01-01

    Full Text Available The present study was undertaken to evaluate the mucilage isolated from Spinacia oleracea L. leaves, commonly named spinach (family: Amaranthaceae as an innovative suspending agent. Zinc oxide suspensions (20% w/v were prepared using the mucilage of S. oleracea L. leaves as a suspending agent, and it was evaluated for its stability by using parameters like, sedimentation profile, degree of flocculation, and redispersibility. The effect of the tested mucilage on the suspension was compared with various commonly used suspending agents, such as, tragacanth, bentonite, and sodium carboxymethyl cellulose (NaCMC at concentrations of 0.5, 1.0, and 2.0% w/v. The results obtained indicated that the mucilage of S. oleracea L. leaves could be used as a suspending agent, and the performance was found to be superior to both tragacanth and bentonite.

  7. Evaluating the Role and Contribution of Innovation to Health and Wealth in the UK: A Review of Innovation, Health and Wealth: Phase 1 Final Report.

    Science.gov (United States)

    Bienkowska-Gibbs, Teresa; Exley, Josephine; Saunders, Catherine L; Marjanovic, Sonja; Chataway, Joanna; MacLure, Calum; McDonald, Ruth; Ling, Tom

    2016-06-20

    The Department of Health's Innovation, Health and Wealth (IHW) strategy aimed to introduce a more strategic approach to the spread of innovation across the NHS. This study represents the first phase of a three-year evaluation and aims to map progress towards the IHW strategy and its component actions. This evaluation used a combination of quantitative and qualitative methods: document review, key informant interviews and stakeholder survey. This study also forms the basis for selecting case studies for phase two of the evaluation. Our findings from the interviews and survey suggest broad stakeholder support for the overarching ambitions of the IHW strategy. However, we found variable progress towards the overarching objectives of the eight IHW themes and an ambiguous relationship between many of the themes' objectives and their actions. It was difficult to assess progress on IHW's actions as commitment to the actions, implementation guidance and expected outcomes of the actions were not clearly articulated. The Academic Health Science Networks (AHSNs) and the Small Business Research Initiative (SBRI) were reported to be working well, which may be attributed to their clear structures of accountability and earmarked budgets. However, survey respondents and interviewees raised concerns that budgetary pressures may limit the impact of both AHSNs and the SBRI. The main challenges identified for ongoing action were the resources available for their implementation (e.g. Medtech Briefings), lack of awareness of the initiative (e.g. the NICE Implementation Collaborative) and the design of the actions (e.g. the Innovation Scorecard, web portal and High Impact Innovations).

  8. What and How Are We Evaluating? Meta-Evaluation Study of the NASA Innovations in Climate Education (NICE) Portfolio

    Science.gov (United States)

    Martin, A. M.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.

    2013-12-01

    As part of NASA's Minority University Research and Education Program (MUREP), the NASA Innovations in Climate Education (NICE) project at Langley Research Center has funded 71 climate education initiatives since 2008. The funded initiatives span across the nation and contribute to the development of a climate-literate public and the preparation of a climate-related STEM workforce through research experiences, professional development opportunities, development of data access and modeling tools, and educational opportunities in both K-12 and higher education. Each of the funded projects proposes and carries out its own evaluation plan, in collaboration with external or internal evaluation experts. Using this portfolio as an exemplar case, NICE has undertaken a systematic meta-evaluation of these plans, focused primarily on evaluation questions, approaches, and methods. This meta-evaluation study seeks to understand the range of evaluations represented in the NICE portfolio, including descriptive information (what evaluations, questions, designs, approaches, and methods are applied?) and questions of value (do these evaluations meet the needs of projects and their staff, and of NASA/NICE?). In the current climate, as federal funders of climate change and STEM education projects seek to better understand and incorporate evaluation into their decisions, evaluators and project leaders are also seeking to build robust understanding of program effectiveness. Meta-evaluations like this provide some baseline understanding of the current status quo and the kinds of evaluations carried out within such funding portfolios. These explorations are needed to understand the common ground between evaluative best practices, limited resources, and agencies' desires, capacity, and requirements. When NASA asks for evaluation of funded projects, what happens? Which questions are asked and answered, using which tools? To what extent do the evaluations meet the needs of projects and

  9. Wireless live streaming video of surgical operations: an evaluation of communication quality.

    Science.gov (United States)

    Schneider, Armin; Wilhelm, Dirk; Doll, Dietrich; Rauschenbach, Uwe; Finkenzeller, Michael; Wirnhier, Helga; Illgner, Klaus; Feussner, Hubertus

    2007-01-01

    We evaluated a mobile video system for surgical teleconsultation. A video streaming server in the operating room transmitted video and audio to a hand-held computer (personal digital assistant [PDA]) over a wireless local area network. Two groups of 20 surgeons (each with 12 qualified surgeons and eight surgeons between the 2nd and the 4th year of training) participated in the tests. For voice transmission, correct understanding of numbers was achieved in 100% of the cases (n = 1000) and 98% of medical terms (n = 400). The quality of the video displayed on the PDA was assessed by the recognition of different operating room scenarios. Only 62% (SD 17) of the structures were identified clearly on the hand-held device (n = 400). The accuracy improved to 78% (SD 15) (n = 400) if the same scenario was observed on a larger (50 cm) video screen (p < 0.001). Accuracy was significantly better if audio conversation was possible. The quality evaluation by the consultants showed that the PDA display size and quality were sufficient for clinical use.

  10. Particulate bioglass in the regeneration of alveolar bone in dogs: clinical, surgical and radiographic evaluations

    Directory of Open Access Journals (Sweden)

    Alexandre Couto Tsiomis

    2011-04-01

    Full Text Available Bone loss, either by trauma or other diseases, generates an increasing need for substitutes of this tissue. This study evaluated Bioglass as a bone substitute in the regeneration of the alveolar bone in mandibles of dogs by clinical, surgical and radiological analysis. Twenty-eight adult dogs were randomly separated into two equal groups. In each animal, a bone defect was created on the vestibular surface of the alveolar bone between the roots of the fourth right premolar tooth. In the treated group, the defect was immediately filled with bioglass, while in the control, it remained unfilled. Clinical evaluations were performed daily for a week, as well as x-rays immediately after surgery and at 8, 14, 21, 42, 60, 90 and 120 days post-operative. Most animals in both groups showed no signs of inflammation and wound healing was similar. Radiographic examination revealed a gradual increase of radiopacity in the region of the defect in the control group. In the treated group, initial radiopacity was higher than that of adjacent bone, decreasing until 21 days after surgery. Then it gradually increased until 120 days after surgery, when the defect became undetectable. The results showed that Bioglass integrates into bone tissue, is biocompatible and reduced the period for complete bone regeneration.

  11. A Sensitivity Analysis and Opportunity Cost Evaluation of the Surgical Council on Resident Education Curriculum.

    Science.gov (United States)

    Falcone, John L; Feinn, Richard S

    2016-01-01

    The study purpose is to evaluate the Surgical Council on Resident Education (SCORE) Curriculum regarding American Board of Surgery Qualifying Examination (ABS QE) outcomes. The goal is to perform effect size analyses, sensitivity analyses, and sample size analyses with opportunity cost estimates required to favor the SCORE Curriculum subscription regarding ABS QE outcomes. Published data were used to construct 2 × 2 matrices regarding ABS QE outcome (pass/fail) and SCORE subscription status (subscriber/nonsubscriber). Post hoc analyses of effect sizes and sample sizes, with opportunity cost estimates, were performed to evaluate ABS QE outcomes favoring SCORE subscription (2-tailed and 1-tailed tests) using an α = 0.05. The absolute risk increase of SCORE subscription on ABS QE outcome was 1.6% (number needed to treat = 63). Sensitivity analyses showed that a pass rate difference of 4.9% to 7.5% was required to favor SCORE subscription (all p opportunity cost of $6.0 to $13.5 million ($30,000-$67,000/program), not adjusting for inflation. The number needed to treat and pass rate differences required to favor SCORE subscription are large. The opportunity costs of SCORE subscription are substantial. Residency programs with more limited resources should determine if the subscription costs are financially sound. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Unlocking the "black box" of practice improvement strategies to implement surgical safety checklists: a process evaluation.

    Science.gov (United States)

    Gillespie, Brigid M; Hamilton, Kyra; Ball, Dianne; Lavin, Joanne; Gardiner, Therese; Withers, Teresa K; Marshall, Andrea P

    2017-01-01

    Compliance with surgical safety checklists (SSCs) has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve. The objective of this study was to undertake a process evaluation of four knowledge translation (KT) strategies used to implement the Pass the Baton (PTB) intervention which was designed to improve utilization of the SSC. As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well) in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently implemented. Of the 220 staff working in the department, that is, nurses, anesthetists, and surgeons, 160 (72.7%) knew about the PTB strategies. Qualitative analysis revealed that implementation was generally feasible and acceptable. A barrier to feasibility was physician engagement. An impediment to acceptability was participants' skepticism about the ability of the KT strategies to effect behavioral change. Overall, results of this evaluation suggest that success of implementation was moderate. Given the probable impact of contextual factors, that is, team culture and the characteristics of participants, the KT strategies may need modification prior to widespread implementation.

  13. PHIRE (Public Health Innovation and Research in Europe): methods, structures and evaluation

    NARCIS (Netherlands)

    Barnboorn, F; McCarthy, M.; Devillé, W.; Alexanderson, K.; Voss, M.; Conceição, C.

    2013-01-01

    INTRODUCTION: Public Health Innovation and Research in Europe (PHIRE), building on previous European collaborative projects, was developed to assess national uptake and impacts of European public health innovations, to describe national public health research programmes, strategies and structures

  14. Evaluating Progress in the Global Surgical Crisis: Contrasting Access to Emergency and Essential Surgery and Safe Anesthesia Around the World.

    Science.gov (United States)

    Merchant, Amina; Hendel, Simon; Shockley, Ross; Schlesinger, Joseph; Vansell, Hilary; McQueen, Kelly

    2015-11-01

    Since 2007, observations reveal that low- and middle-income countries (LICs and LMICs) experience similar surgical access and safety issues, though the etiology of these challenges varies by country. The collective voice of surveys completed to date has pushed the agenda for the inclusion of safe surgery and anesthesia within global health discussions. Comparison of four countries across the world shows similar basic progress as well as ongoing surgical and anesthesia needs in resource-challenged countries. By studying these common needs, a comprehensive plan to provide infrastructure and personnel support can work in multiple austere settings. A standardized survey tool published, designed, and developed initially by the Harvard Humanitarian Initiative and modified at Vanderbilt University was completed in Guatemala, Guyana, Laos, and Mozambique. The survey assessed eight key areas of essential surgical care: access to and availability of surgical services, access to human resources, essential infrastructure (including access to water, electricity, sanitation, blood products, and essential medicines including supplemental oxygen), surgical outcomes, operating room information and procedures, equipment, International Organization, and Non-Government Organization provision of surgical care. These results were compared and contrasted to evaluate resource challenges and assets in each country. A total of 49 hospitals were surveyed in this comparison cohort. The results reveal common needs for emergency and essential surgery in each country, but some differences in human and capital resources exist. While minimal resources exist, all surgical sites provided running water, electricity, and oxygen-assets not seen in previous surveys as recent as 2011. The most basic needs to provide essential surgery are now present in LICs and LMICs. Many more resources are needed to ensure access to safe surgery and anesthesia. The next steps to provide essential surgery must include

  15. Impact of an Innovative Classroom-Based Lecture Series on Residents’ Evaluations of an Anesthesiology Rotation

    Directory of Open Access Journals (Sweden)

    Pedro Tanaka

    2016-01-01

    Full Text Available Introduction. Millennial resident learners may benefit from innovative instructional methods. The goal of this study is to assess the impact of a new daily, 15 minutes on one anesthesia keyword, lecture series given by faculty member each weekday on resident postrotation evaluation scores. Methods. A quasi-experimental study design was implemented with the residents’ rotation evaluations for the 24-month period ending by 7/30/2013 before the new lecture series was implemented which was compared to the 14-month period after the lecture series began on 8/1/2013. The primary endpoint was “overall teaching quality of this rotation.” We also collected survey data from residents at clinical rotations at two other different institutions during the same two evaluation periods that did not have the education intervention. Results. One hundred and thirty-one residents were eligible to participate in the study. Completed surveys ranged from 77 to 87% for the eight-question evaluation instrument. On a 5-point Likert-type scale the mean score on “overall teaching quality of this rotation” increased significantly from 3.9 (SD 0.8 to 4.2 (SD 0.7 after addition of the lecture series, whereas the scores decreased slightly at the comparison sites. Conclusion. Rotation evaluation scores for overall teaching quality improved with implementation of a new structured slide daily lectures series.

  16. An Innovative Method for Evaluating Strategic Goals in a Public Agency: Conservation Leadership in the U.S. Forest Service

    Science.gov (United States)

    David N. Bengston; David P. Fan

    1999-01-01

    This article presents an innovative methodology for evaluating strategic planning goals in a public agency. Computer-coded content analysis was used to evaluate attitudes expressed in about 28,000 on-line news media stories about the U.S. Department of Agriculture Forest Service and its strategic goal of conservation leadership. Three dimensions of conservation...

  17. Laparoscopic-assisted tension-free vaginal mesh: an innovative approach to placing synthetic mesh: transvaginally for surgical correction of pelvic organ prolapse.

    Science.gov (United States)

    Watanabe, Toyohiko; Inoue, Miyabi; Ishii, Ayano; Yamato, Toyoko; Yamamoto, Masumi; Sasaki, Katsumi; Kobayashi, Yasuyuki; Araki, Motoo; Uehara, Shinya; Saika, Takashi; Kumon, Hiromi

    2012-01-01

    Polypropylene mesh implants for the correction of pelvic organ prolapse (POP) are now available in Japan. We developed an innovative approach for correcting POP by placing polypropylene mesh transvaginally with laparoscopic assistance. From June 2007 through March 2010, sixteen consecutive patients with symptomatic stage 2 or 3 pelvic organ prolapse underwent the laparoscopic-assisted tension-free vaginal mesh procedure at Okayama University Hospital. All patients were evaluated before and at 1, 3, 6, and 12 months after surgery. Female sexual function was also evaluated with the Female Sexual Function Index (FSFI). The procedure was performed successfully without significant complications. Fifteen of 16 patients were considered anatomically cured (93.8%) at 12 months postoperatively. One patient with a recurrent stage 3 vaginal vault prolapse required sacral colpopexy six months postoperatively. Total FSFI scores improved significantly from 10.3 ± 1.3 at baseline to 18.0 ± 1.2 at 12 months after surgery. The laparoscopic-assisted trans-vaginal mesh is a safe, effective, and simple procedure for POP repairs. The procedure not only restores anatomic relationships but also improves sexual function.

  18. MRI-based multiscale models for the hemodynamic and structural evaluation of surgically reconstructed aortic arches

    DEFF Research Database (Denmark)

    Pittaccio, S; Migliavacca, F; Balossino, R

    2007-01-01

    The surgical reconstruction of the aortic arch is necessary in pediatric patients suffering from different types of congenital heart malformations, in particular, coarctation of the aorta. Among the reconstruction techniques used in surgical practice end-to-end anastomosis (E/E), Gore-tex graft i...... on the subject's left side of the vessel, particularly in the frontal area. There was a concentration of stress at the suture lines. All surgical techniques performed equally well in restoring physiological pressures.......The surgical reconstruction of the aortic arch is necessary in pediatric patients suffering from different types of congenital heart malformations, in particular, coarctation of the aorta. Among the reconstruction techniques used in surgical practice end-to-end anastomosis (E/E), Gore-tex graft...

  19. Innovative Hyperspectral Imaging-Based Techniques for Quality Evaluation of Fruits and Vegetables: A Review

    Directory of Open Access Journals (Sweden)

    Yuzhen Lu

    2017-02-01

    Full Text Available New, non-destructive sensing techniques for fast and more effective quality assessment of fruits and vegetables are needed to meet the ever-increasing consumer demand for better, more consistent and safer food products. Over the past 15 years, hyperspectral imaging has emerged as a new generation of sensing technology for non-destructive food quality and safety evaluation, because it integrates the major features of imaging and spectroscopy, thus enabling the acquisition of both spectral and spatial information from an object simultaneously. This paper first provides a brief overview of hyperspectral imaging configurations and common sensing modes used for food quality and safety evaluation. The paper is, however, focused on the three innovative hyperspectral imaging-based techniques or sensing platforms, i.e., spectral scattering, integrated reflectance and transmittance, and spatially-resolved spectroscopy, which have been developed in our laboratory for property and quality evaluation of fruits, vegetables and other food products. The basic principle and instrumentation of each technique are described, followed by the mathematical methods for processing and extracting critical information from the acquired data. Applications of these techniques for property and quality evaluation of fruits and vegetables are then presented. Finally, concluding remarks are given on future research needs to move forward these hyperspectral imaging techniques.

  20. Collaborative Evaluation and Market Research Converge: An Innovative Model Agricultural Development Program Evaluation in Southern Sudan

    Science.gov (United States)

    O'Sullivan, John M.; O'Sullivan, Rita

    2012-01-01

    In June and July 2006 a team of outside experts arrived in Yei, Southern Sudan through an AID project to provide support to a local agricultural development project. The team brought evaluation, agricultural marketing and financial management expertise to the in-country partners looking at steps to rebuild the economy of the war ravaged region. A…

  1. Evaluation and Optimization of an Innovative Low-Cost Photovoltaic Solar Concentrator

    Directory of Open Access Journals (Sweden)

    Franco Cotana

    2011-01-01

    Full Text Available Many researches showed that the cost of the energy produced by photovoltaic (PV concentrators is strongly reduced with respect to flat panels, especially in those countries that have a high solar irradiation. The cost drop comes from the reduction of the expensive high-efficiency photovoltaic surface through the use of optical concentrators of the solar radiation. In this paper, an experimental innovative PV low-concentration system is analysed. Numerical simulations were performed to determine the possible reasons of energy losses in the prototype, primarily due to geometrical factors. In particular, the effect of the shadows produced from the mirrors on the prototype performances was analysed: shadows are often neglected in the design phase of such systems. The study demonstrates that shadows may affect the performances of a hypothetical optimized PV low-concentration system up to 15%. Finally, an economical evaluation was carried out comparing the proposed optimized system to a traditional flat PV panel.

  2. Evaluation of surgical therapy for syringomyelia by means of magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Toshiaki; Yatsuzuka, Hitoshi; Nishida, Shin; Suzuki, Takashi; Nakamura, Norio; Ida, Masahiro

    1988-12-01

    Magnetic resonance imaging (MRI) was performed to evaluate surgical therapy in 18 patients with syringomyelia. Fourteen patients had a Chiari I-syringomyelia complex, ten of whom underwent Gardner's operation - suboccipital craniectomy, upper cervical laminectomy, arachnoid dissection around the foramen Magendie, dural plasty, and plugging of the obex. Postoperative MRI studies revealed a collapse of the syringomyelic cavity in the 10 patients; and an enlargement of the cisterna magna, with an upward displacement of the cerebellar tonsiles, an increase in the size of the anterior-posterior diameter of the medulla, and a widering of the lower part of the fourth ventricle in 9 patients. These MR findings were comparable with clinical improvement and the cessation of neurologic deterioration in patients with syringomyelia. Using cine MR images, the flow of cerebral spinal fluid (CSF) was analyzed in 6 patients. The turbulent flow of CSF in the cisterna magna was not detected before surgery. There was an active flow inside the syrinx in all the preoperative patients, but it was much less active in the patients who had undergone Gardner's operation, although they had a residual syrinx inside the spinal cord. This suggested that the pulsatile flow inside the syrinx might be transmitted from the fourth ventricle through the patent central canal. (Namekawa, K).

  3. Histologic evaluation of effectiveness of Enamel Matrix Derivative in surgical defect of sheep tooth

    Directory of Open Access Journals (Sweden)

    Pak Nejad M.

    2001-09-01

    Full Text Available "nAbstract: The aim of the present study was the histological evaluation of Enamel Matrix Derivative (EMD effectiveness for regeneration of periodontal defects. EMD activates cementum synthesis, PDL and bone during the maturation stage of follicole. In this research, EMD was used in surgical defects of premolar teeth in four adult sheep. Muccoperiosteal flap was reflected in buccal site of teeth. The buccal bone plate was removed from mesial to distal in 4 mm depth. After eliminating the cementum by bur and its etching, EMD was applied on exposed dentine and flap was sutured. In opposite sites of those teeth (control sites the same process was performed without etching. After 100 days, sheep were sacrificed and histological study through light microscopic was performed on black sections of operation sites. The results showed that in test sites, regeneration of cementum and bone was 62/5% and 42/5-50% respectively. But in control sites regeneration of cementum and bone was 37.5% and 32/5-42/5% respectively. Also the migration of junctional epithelium in control sites was 8-10% more than test sites. The important point is that in test sites, cementum was completely attached to undermining dentine. But, in control sites, the gap between cementum and dentine was visible. As a result, this study suggests that EMD promotes periodontal regeneration, and EMD application is a successful achievement in regenerative periodontal therapy.

  4. Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study

    Directory of Open Access Journals (Sweden)

    Shobha K

    2010-01-01

    Full Text Available Background and Objectives: The purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown-lengthening in human subjects. Materials and Methods: A clinical trial study involving 15 patients was carried out for a period of 6 months. Sites were divided into 3 groups: treated (TT sites, adjacent (AD sites and nonadjacent (NAD sites. Free gingival margin [FGM], attachment level, pocket depth, bone level, biological width [BW] were recorded at baseline, 1, 3 and 6 months. Direct bone level after flap reflection was recorded before and after osseous resection at baseline only. Level of osseous crest was lowered based on BW, and supracrestal tooth structure needed using a combination of rotary and hand instruments. Statistical Analysis: Student t test and ANOVA were used. Results: Overall, apical displacement of FGM at TT, AD and NAD sites was statistically significant compared to baseline. The apical displacement of FGM at TT site was more when compared to that at AD and NAD sites at 3 and 6 months. The BW at the TT site was smaller at 1, 3 and 6 months compared to that at baseline. However, at all sites, BW was reestablished to the baseline value at the end of 6 months. Interpretation and Conclusion: The BW at TT sites was reestablished to its original vertical dimension by 6 months. In addition, a consistent 2-mm gain of coronal tooth structure was observed at the 1, 3 and 6-month examinations.

  5. Development of Innovative Aerogel Based Plasters: Preliminary Thermal and Acoustic Performance Evaluation

    Directory of Open Access Journals (Sweden)

    Cinzia Buratti

    2014-09-01

    Full Text Available The thermal and acoustic properties of innovative insulating systems used as building coatings were investigated: Granular silica aerogel was mixed with natural plaster in different percentages. This coating solution is transpiring and insulating, thanks to the use of a natural lime coat and aerogel, a highly porous light material with very low thermal conductivity. The thermal conductivity of the proposed solution was evaluated by means of a Heat Flow meter apparatus (EN ISO 12667, considering different percentages of aerogel. The natural plaster without aerogel has a thermal conductivity of about 0.50 W/m K; considering a percentage of granular aerogel of about 90% in volume, the thermal conductivity of the insulating natural coating falls to 0.050 W/m K. Increasing the percentage of granular aerogel, a value of about 0.018–0.020 W/m K can be reached. The acoustic properties were also evaluated in terms of the acoustic absorption coefficient, measured by means of a Kundt’s Tube (ISO 10534-2. Two samples composed by a plasterboard support, an insulation plaster with aerogel (thicknesses 10 mm and 30 mm respectively and a final coat were assembled. The results showed that the absorption coefficient strongly depends on the final coat, so the aerogel-based plaster layer moderately influences the final value. The application of this innovative solution can be a useful tool for new buildings, but also for the refurbishment of existing ones. This material is in development: until now, the best value of the thermal conductivity obtained from manufacturers is about 0.015 W/m K.

  6. On the evaluation of social innovations and social enterprises: Recognizing and integrating two solitudes in the empirical knowledge base.

    Science.gov (United States)

    Szijarto, Barbara; Milley, Peter; Svensson, Kate; Cousins, J Bradley

    2018-02-01

    Social innovation (SI) is billed as a new way to address complex social problems. Interest in SI has intensified rapidly in the last decade, making it an important area of practice for evaluators, but a difficult one to navigate. Learning from developments in SI and evaluation approaches applied in SI contexts is challenging because of 'fuzzy' concepts and silos of activity and knowledge within SI communities. This study presents findings from a systematic review and integration of 41 empirical studies on evaluation in SI contexts. We identify two isolated conversations: one about 'social enterprises' (SEs) and the other about non-SE 'social innovations'. These conversations diverge in key areas, including engagement with evaluation scholarship, and in the reported purposes, approaches and use of evaluation. We identified striking differences with respect to degree of interest in collaborative approaches and facilitation of evaluation use. The findings speak to trends and debates in our field, for example how evaluation might reconcile divergent information needs in multilevel, cross-sectoral collaborations and respond to fluidity and change in innovative settings. Implications for practitioners and commissioners of evaluation include how evaluation is used in different contexts and the voice of evaluators (and the evaluation profession) in these conversations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens.

    Science.gov (United States)

    Ahn, Soomin; Lee, Junghye; Cho, Min-Sun; Park, Sanghui; Sung, Sun Hee

    2017-11-16

    - The Ki-67 index is strongly prognostic and is used as a surrogate marker to distinguish luminal A from luminal B breast cancer types. - To investigate differences in Ki-67 index between core needle biopsy samples and matched surgical samples in breast cancer. - We included patients with invasive breast cancer who did not receive neoadjuvant therapy. A total of 89 pairs of core needle biopsies and surgical specimens were collected, and the Ki-67 index was assessed in hot spot areas using an image analyzer. We applied a 14% Ki-67 index to define low versus high groups. - The Ki-67 index was significantly higher in core needle biopsies than in surgical specimens (P biopsies but a low Ki-67 index in surgical samples. There were 10 cases (11.2%) that showed discordant luminal A/B types between core needle biopsy and the matched surgical specimen. The reasons for the discordance were poor staining of MIB1 accompanied by fixation issues and intratumoral heterogeneity of the Ki-67 index. - A significant difference in the Ki-67 index between core biopsy and surgical specimens was observed. Our findings indicate that it may be better to perform the Ki-67 assay on the core needle biopsy and the surgical specimen than on only one sample.

  8. Carpal valgus in llamas and alpacas: Retrospective evaluation of patient characteristics, radiographic features and outcomes following surgical treatment

    Science.gov (United States)

    Hunter, Barbara; Duesterdieck-Zellmer, Katja F.; Huber, Michael J.; Parker, Jill E.; Semevolos, Stacy A.

    2014-01-01

    This study evaluated outcomes of surgical treatment for carpal valgus in New World camelids and correlated successful outcome (absence of carpal valgus determined by a veterinarian) with patient characteristics and radiographic features. Univariable and multivariable analyses of retrospective case data in 19 camelids (33 limbs) treated for carpal valgus between 1987 and 2010 revealed that procedures incorporating a distal radial transphyseal bridge were more likely (P = 0.03) to result in success after a single surgical procedure. A greater degree of angulation (> 19°, P = 0.02) and younger age at surgery (< 4 months, P = 0.03) were associated with unsuccessful outcome. Overall, 74% of limbs straightened, 15% overcorrected, and 11% had persistent valgus following surgical intervention. To straighten, 22% of limbs required multiple procedures, not including implant removal. According to owners, valgus returned following implant removal in 4 limbs that had straightened after surgery. PMID:25477542

  9. Surgical, functional and audiological evaluation of new Baha(®) Attract system implantations.

    Science.gov (United States)

    Gawęcki, Wojciech; Stieler, Olgierd Maciej; Balcerowiak, Andrzej; Komar, Dariusz; Gibasiewicz, Renata; Karlik, Michał; Szyfter-Harris, Joanna; Wróbel, Maciej

    2016-10-01

    Bone-anchored hearing aids are well-established solutions for treatment of hearing-impaired patients. However, classical systems with percutaneous abutments have disadvantages concerning aesthetics, hygiene and adverse soft tissue reactions. The study aimed to evaluate surgical, functional and audiological results of a new Baha(®) Attract system, in which the sound processor is attached by magnetic force. Twenty patients implanted with a Baha(®) Attract system were divided into two groups: A-bilateral mixed and conductive hearing loss, B-single-sided deafness, and evaluated during a 6-month follow-up. Parameters analysed comprised: (1) surgery and wound healing, (2) postoperative functional results (GBI, APHAB and BAHU questionnaires), (3) audiological results (free field speech in noise audiometry in two situations: with signal from implant side and from contralateral side). Obtained results revealed: mean time of surgery-44 min, soft tissue reduction-30 %, bone polishing-20 %, haematoma-10 %. Functional results showed: GBI total score-29.6 points, APHAB global score mean gain-23.5 %, BAHU 'good or very good' score for: aesthetic-85 %, hygiene-100 %, ease of placing the processor-100 %, stability of attraction-75 %. Audiological results-mean gain for the two analysed situations: 32.9 % (group A-36.5 %, group B-27.5 %). To conclude, the data obtained prove the safety and effectiveness of the Baha(®) Attract system in patients with conductive and mixed hearing loss as well as in patients with single-sided deafness. Cosmetic aspects are highly acceptable and the idea of Attract itself is important for patients with limited manual dexterity.

  10. Decision Dissonance: Evaluating an Approach to Measuring the Quality of Surgical Decision Making

    Science.gov (United States)

    Fowler, Floyd J.; Gallagher, Patricia M.; Drake, Keith M.; Sepucha, Karen R.

    2013-01-01

    Background Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. Methods For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail survey of selected patients was carried out about one year after the procedures. Patients’ goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A Decision Dissonance Score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the Decision Dissonance Score was then assessed. Results When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. Conclusions Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. PMID:23516764

  11. Evaluation of the results from surgical treatment of the terrible triad of the elbow,

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2014-06-01

    Full Text Available OBJECTIVE: to evaluate the results from surgical treatment of the terrible triad of the elbow (fracture of the radial head, fracture of the coronoid process and elbow dislocation and its complications.METHODS: between August 2002 and August 2010, 15 patients (15 elbows with the terrible triad were treated by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Nine (60% were male and six (40% were female; their ages ranged from 21 to 66 years, with a mean of 41 years. With the exception of one case that underwent arthroscopic surgery, all the patients underwent open surgery. The fracture of the coronoid process was fixed in 10 patients (66.7%. The fracture of the radial head was treated by means of internal osteosynthesis in 11 cases (73.3%; in three cases (20%, the radial head was resected; and in one case, only the fragment of the fracture was resected. The collateral ligaments, except for one case, were repaired whenever they were found to be injured; ten cases (66.7% of medial collateral injury and 15 (100% of lateral collateral injury were found. The mean length of the postoperative follow-up was 62 months, with a minimum of 12 months. The postoperative evaluation was done by means of the Bruce score.RESULTS: more than 80% of the patients recovered their functional ranges of motion but, according to the Bruce score, only 26% of the patients achieved results that were considered satisfactory.CONCLUSION: despite the unsatisfactory results, the functional ranges of motion and elbow function could be restored.

  12. [Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia].

    Science.gov (United States)

    Mozharovskiy, V V; Tsyganov, A A; Mozharovskiy, K V; Tarasov, A A

    To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

  13. Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study

    Science.gov (United States)

    Bakutra, Gaurav; Shankarapillai, Rajesh; Mathur, Lalit; Manohar, Balaji

    2017-01-01

    Introduction: There are various treatment modalities to remove the black patches of melanin pigmentation. The aim of the study is to clinically compare the diode laser ablation and surgical stripping technique for gingival depigmentation and to evaluate their effect on the histological changes in melanocyte activity. Materials and Methods: A total of 40 sites of 20 patients with bilateral melanin hyperpigmentation were treated with the surgical stripping and diode laser ablation technique. Change in Hedin index score, change in area of pigmentation using image analyzing software, pain perception, patient preference of treatment were recorded. All 40 sites were selected for immunohistochemical analysis using HMB-45 immunohistochemical marker. Results: At 12 months post-operative visit, in all sites, repigmentation was observed with different grades of Hedin index. Paired t-test, analysis of variance, and Chi-square tests were used for statistical analysis. Repigmentation in surgical stripping is significantly lesser compared to laser ablation. Lesser numbers of melanocytes were found on immunohistological examination at 12 months postoperatively. Comparison for patient preference and pain indices give statistically significant values for diode laser techniques. Conclusion: Gingival hyperpigmentation is effectively managed by diode laser ablation technique and surgical stripping method. In this study, surgical stripping technique found to be better compared to diode laser ablation. PMID:28539864

  14. Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study.

    Science.gov (United States)

    Bakutra, Gaurav; Shankarapillai, Rajesh; Mathur, Lalit; Manohar, Balaji

    2017-01-01

    There are various treatment modalities to remove the black patches of melanin pigmentation. The aim of the study is to clinically compare the diode laser ablation and surgical stripping technique for gingival depigmentation and to evaluate their effect on the histological changes in melanocyte activity. A total of 40 sites of 20 patients with bilateral melanin hyperpigmentation were treated with the surgical stripping and diode laser ablation technique. Change in Hedin index score, change in area of pigmentation using image analyzing software, pain perception, patient preference of treatment were recorded. All 40 sites were selected for immunohistochemical analysis using HMB-45 immunohistochemical marker. At 12 months post-operative visit, in all sites, repigmentation was observed with different grades of Hedin index. Paired t-test, analysis of variance, and Chi-square tests were used for statistical analysis. Repigmentation in surgical stripping is significantly lesser compared to laser ablation. Lesser numbers of melanocytes were found on immunohistological examination at 12 months postoperatively. Comparison for patient preference and pain indices give statistically significant values for diode laser techniques. Gingival hyperpigmentation is effectively managed by diode laser ablation technique and surgical stripping method. In this study, surgical stripping technique found to be better compared to diode laser ablation.

  15. The challenge pathway: A mixed methods evaluation of an innovative care model for the palliative and end-of-life care of people with dementia (Innovative practice).

    Science.gov (United States)

    Harrop, Emily; Nelson, Annmarie; Rees, Helen; Harris, Dylan; Noble, Simon

    2018-02-01

    An innovative service for the palliative and end-of-life care of people with dementia was introduced at a UK hospice. This evaluation involved analysis of audit data, semi-structured interviews with project staff (n=3) and surveys of family carers (n=15) and professionals (n=20). The service has increased access to palliative, end-of-life care and other services. Improvements were reported in the knowledge, confidence and care skills of family carers and professionals. Carers felt better supported and it was perceived that the service enabled more patients to be cared for at home or in their usual place of care.

  16. Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

    Science.gov (United States)

    Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

    2016-10-01

    Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  17. Validation of a Unilateral Cleft Lip Surgical Outcomes Evaluation Scale for Surgeons and Laypersons

    Directory of Open Access Journals (Sweden)

    Alex Campbell, MD

    2017-09-01

    Conclusions:. Surgeon and layperson raters can reliably use the SOE to assess the aesthetics results after surgical repair of UCL/N, and improved reliability and reproducibility is achieved by averaging the scores of multiple reviewers.

  18. Instant replay: Evaluation of instant video feedback in surgical novices for a laparoscopic gallbladder dissection.

    Science.gov (United States)

    Farooq, Ameer; Reso, Artan; Harvey, Adrian

    2018-01-25

    Athletes often use video to improve their technique. We hypothesized that surgical novices given feedback using video-replay would outperform surgical novices given verbal feedback in the performance of a laparoscopic task. Our study used a prospective, randomized control design. The surgical task involved the laparoscopic dissection of a pig gallbladder. Our participants performed a dissection, pre- and post-traditional or video feedback. Each recording was independently scored by two staff surgeons using the previously validated rating tools. There was no significant difference between video feedback or traditional feedback groups in their mean overall or task specific scores. Both traditional and video-feedback groups had a trend towards improved performance post-feedback. No significant difference in performance by both our global assessment metrics or task-specific metrics was observed. Video feedback requires further study to investigate its impact on surgical training. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. CLINICAL EVALUATION OF THE HEALING PROCESS OF ORAL SOFT TISSUE SURGICAL WOUNDS STIMULATED BY LOW-LEVEL LASER THERAPY.

    Directory of Open Access Journals (Sweden)

    Hristina Lalabonova

    2013-03-01

    Full Text Available During the past decades laser therapy gained much popularity in clinical practice. Low-level lasers offer alternative solutions to numerous problems in oral surgery.Purpose: The purpose of the present study is to evaluate clinically the healing process of soft tissue surgical wounds in the oral cavity stimulated by low-level laser therapy (LLLT.Materials and methods: One hundred and twenty surgical wounds were assigned to three groups: Group I included 40 patients who underwent red spectrum LLLT with wavelength (λ of 658 nm;Group ІІ – 40 patients treated with infra-red LLLT with λ of 904 nm;Group ІІІ (control group - 40 patients without LLLT. In Group І and ІІ the LLLT procedures were applied 1 day before, in the day of and 1 day after the operation. Distant emission with a focused beam through an angled conical probe 3 mm in diameter (ø3mm was used. The irradiated area is 0,5 cm2. The area of impact is the surgical wound zone and the neighboring 0,5-1,0 cm of the adjacent oral mucosa.Results and discussion: The evaluation of the healing process included the following criteria: pain, edema, hyperemia, time for wound closure, postoperative complications.Conclusions: LLLT applied with the offered treatment modality accelerates the healing process of soft tissue surgical wounds in the oral cavity, reduces treatment time and restores patients’ comfort.

  20. Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study.

    Science.gov (United States)

    Fitchett, Joseph R; Bhatta, Surya; Sherpa, Tenzing Y; Malla, Bishwo S; A Fitchett, Elizabeth J; Samen, Arlene; Kristensen, Sibylle

    2015-12-01

    Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. Prospective monitoring and evaluation study of a new public health programme. Baglung district, rural Nepal. Women with gynaecological symptoms of POP. Risk factors for disease progression were assessed using Fisher's exact test, Pearson's χ(2)-test and logistic regression analysis. Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal.

  1. Public support to firm level innovation: an evaluation of the FONTEC Program

    OpenAIRE

    Benavente, Jose Miguel; Crespi, Gustavo; Maffioli, Alessandro

    2012-01-01

    Latin American Governments have frequently adopted Technology Development Funds (TDF) to provide financial support for innovation activities of firms. In this paper, we analyzed the effectiveness of a Chilean TDF, the FONTEC program. We found that FONTEC’s subsidies increased firm innovation investments in intangible assets (in particular R&D) and they also improved the linkages among actors in the innovation system. However, although we did not find any evidence of crowding-out effects, neit...

  2. Evaluation of the Accuracy and Precision of a Next Generation Computer-Assisted Surgical System.

    Science.gov (United States)

    Angibaud, Laurent D; Dai, Yifei; Liebelt, Ralph A; Gao, Bo; Gulbransen, Scott W; Silver, Xeve S

    2015-06-01

    Computer-assisted orthopaedic surgery (CAOS) improves accuracy and reduces outliers in total knee arthroplasty (TKA). However, during the evaluation of CAOS systems, the error generated by the guidance system (hardware and software) has been generally overlooked. Limited information is available on the accuracy and precision of specific CAOS systems with regard to intraoperative final resection measurements. The purpose of this study was to assess the accuracy and precision of a next generation CAOS system and investigate the impact of extra-articular deformity on the system-level errors generated during intraoperative resection measurement. TKA surgeries were performed on twenty-eight artificial knee inserts with various types of extra-articular deformity (12 neutral, 12 varus, and 4 valgus). Surgical resection parameters (resection depths and alignment angles) were compared between postoperative three-dimensional (3D) scan-based measurements and intraoperative CAOS measurements. Using the 3D scan-based measurements as control, the accuracy (mean error) and precision (associated standard deviation) of the CAOS system were assessed. The impact of extra-articular deformity on the CAOS system measurement errors was also investigated. The pooled mean unsigned errors generated by the CAOS system were equal or less than 0.61 mm and 0.64° for resection depths and alignment angles, respectively. No clinically meaningful biases were found in the measurements of resection depths (system investigated. This study presented a set of methodology and workflow to assess the system-level accuracy and precision of CAOS systems. The data demonstrated that the CAOS system investigated can offer accurate and precise intraoperative measurements of TKA resection parameters, regardless of the presence of extra-articular deformity in the knee.

  3. Evaluation of two dental registration-splint techniques for surgical navigation in cranio-maxillofacial surgery.

    Science.gov (United States)

    Venosta, Dominik; Sun, Yi; Matthews, Felix; Kruse, Astrid L; Lanzer, Martin; Gander, Thomas; Grätz, Klaus W; Lübbers, Heinz-Theo

    2014-07-01

    Surgical navigation requires precise registration of the pre-operative image dataset to the patient in the operation theatre. Different marker-based and marker-free registration techniques are available, each of them with advantages and disadvantages regarding precision and clinical handling. In this model study, the precision of two dental splint techniques for marker-based registration is analyzed. A synthetic full-size human skull was registered with its cone beam computed tomography dataset using (a) a dentally-mounted "rapid" occlusal splint with five titanium screws directly attached to the splint, (b) an "extender", a dentally-mounted occlusal splint with similar fiducials fixed to an extension of the splint. The target registration error was measured for 170 landmarks distributed over the viscero- and neurocranium in 10 repeats per splint type using the Vector Vision2 (BrainLAB AG, Heimstetten, Germany) navigation system. Statistical and graphical evaluations were performed per anatomical region. In the periorbital region, the rapid splint, with an average deviation of 1.50 mm (SD = 0.439) showed greater accuracy than the extender with 1.76 mm (SD = 0.525). The viscerocranial results for both splints were similar (extender 1.84 mm, SD = 0.559, rapid occlusal splint 1.86 mm, SD = 0.686). In the cranial vault region, registration with the extender (2.33 mm, SD = 0.685) proved to be more precise than with the rapid splint (2.86 mm, SD = 0.929). Due to the more compact dimension of the rapid occlusal splint, errors close to the splint were smaller compared to the extender technique. The advantage of greater distances between the registration fiducials on the extender is particularly important in areas such as the orbital roof, the cranial vault, and the lateral skull base. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Evaluation of primary stability of innovated orthodontic miniscrew system (STS): An ex-vivo study.

    Science.gov (United States)

    Seifi, Massoud; Matini, Negin-Sadat

    2016-07-01

    Stability is determined as one of the requirements in use of Temporary Anchorage Devices (TAD) in orthodontics. Miniscrew has been a widely used Bone Anchor. Compared with mini-implant that necessitates osseointegration; mechanical retention is a determining factor for primary stability of miniscrew. Studies investigated various ways to increase primary stability. The aim of this study is to introduce a new configuration of miniscrew system which is believed to obtain more primary stability. Freshly ovine mandibles were cut in blocks. Twenty-seven miniscrews (diameter 1.6 × 8 mm; G2, Dual Top Anchor System, Jeil Medical, Seoul, Korea) were inserted in the blocks and divided in 2 experimental groups: single miniscrew and the innovated design "Seifi Twin Screw (STS)". Primary stability was evaluated by Periotest "M"® device. Independent t-test showed a significant difference between 2 experimental groups in periotest evaluation (pstability due to its mechanical configuration and design. The STS provides higher primary stability and was found to be effective in increased success rate of miniscrew systems from the standpoint of primary stability. Anchorage procedures, anchorage techniques, orthodontic anchorage procedures, miniscrews, temporary anchorage device.

  5. Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education.

    Science.gov (United States)

    Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan

    2015-06-01

    Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

  6. Evaluation of innovative arsenic treatment technologies :the arsenic water technology partnership vendors forums summary report.

    Energy Technology Data Exchange (ETDEWEB)

    Everett, Randy L.; Siegel, Malcolm Dean; McConnell, Paul E.; Kirby, Carolyn (Comforce Technical Services, Inc.)

    2006-09-01

    The lowering of the drinking water standard (MCL) for arsenic from 50 {micro}g/L to 10 {micro}g/L in January 2006 could lead to significant increases in the cost of water for many rural systems throughout the United States. The Arsenic Water Technology Partnership (AWTP), a collaborative effort of Sandia National Laboratories, the Awwa Research Foundation (AwwaRF) and WERC: A Consortium for Environmental Education and Technology Development, was formed to address this problem by developing and testing novel treatment technologies that could potentially reduce the costs of arsenic treatment. As a member of the AWTP, Sandia National Laboratories evaluated cutting-edge commercial products in three annual Arsenic Treatment Technology Vendors Forums held during the annual New Mexico Environmental Health Conferences (NMEHC) in 2003, 2004 and 2005. The Forums were comprised of two parts. At the first session, open to all conference attendees, commercial developers of innovative treatment technologies gave 15-minute talks that described project histories demonstrating the effectiveness of their products. During the second part, these same technologies were evaluated and ranked in closed sessions by independent technical experts for possible use in pilot-scale field demonstrations being conducted by Sandia National Laboratories. The results of the evaluations including numerical rankings of the products, links to company websites and copies of presentations made by the representatives of the companies are posted on the project website at http://www.sandia.gov/water/arsenic.htm. This report summarizes the contents of the website by providing brief descriptions of the technologies represented at the Forums and the results of the evaluations.

  7. Technology-Enhanced Physics Programme for Community-Based Science Learning: Innovative Design and Programme Evaluation in a Theme Park

    Science.gov (United States)

    Tho, Siew Wei; Chan, Ka Wing; Yeung, Yau Yuen

    2015-01-01

    In this study, a new physics education programme is specifically developed for a famous theme park in Hong Kong to provide community-based science learning to her visitors, involving her three newly constructed rides. We make innovative use of digital technologies in this programme and incorporate a rigorous evaluation of the learning…

  8. SURGICAL EMBRYOLOGY '

    African Journals Online (AJOL)

    SURGICAL EMBRYOLOGY ' t. Foetal alcohol syndrome: an osteometric evaluation in the wistar rat animal model. S. S. Adebisi. Department of Human Anatomy, Faculty of Medicine, Ahmadu Bello University, Zaria,. Nigeria. Reprint requests to: Dr. S. S. Adebisi. E—mail.' .s'runln'si@tzlgu.adultg,. Abstract. Background: ...

  9. Knowledge evaluation : A new aim for knowledge management to enhance sustainable innovation

    NARCIS (Netherlands)

    Peters, K.; Maruster, L.; Jorna, R.J.J.M.; Remenyi, D

    2007-01-01

    Sustainability is a topic that presently forces organizations to strive for innovation. Sustainable innovation relates to organizational measures to gain more sustainable outcomes and processes from a social and ecological point of view (People, Planet 8 Profit, i.e. the three Ps, Elkington 1997).

  10. Evaluation of implementation of the strategy of the economy innovation-oriented development in Russian regions

    Directory of Open Access Journals (Sweden)

    Yuliya Semenovna Toktamysheva

    2015-06-01

    Full Text Available Objective to develop methods for analyzing and determining the level of socioeconomic development of the Russian Federation subjects towards innovations. Methods dialectical and systemic approaches to the consideration of economic phenomena and facts processing and synthesis of information using statistical and graphical methods of analysis. Results it was determined that the transition to intensive economic growth as a vital in the longterm strategy for accelerated economic development is not implemented in all regions of Russia. There are disparities in the level of innovation activity and investment performance. Scientific novelty the method used for estimating the efficiency of implementing and realization of the potential of innovationoriented development in the Russian Federation regions was the method of ranking based on information on the key indicators labour productivity capital productivity sustainability of the regional economy production of innovative goods works and services expenditure on research and development investment in technological innovation in the region. Practical value financing and implementation of innovative projects industrial production and technical innovation special economic zones technology parks etc. proved their efficient impact on the growth and performance of the entire regionrsquos economy. The highest positions in the ranking of innovative development are occupied by the regions with high innovative attractivity and welldeveloped energy and raw materials industry. nbsp

  11. Protocols for Teaching Students How to Search for, Discover, and Evaluate Innovations

    Science.gov (United States)

    Norton, William I., Jr.; Hale, Dena H.

    2011-01-01

    The authors introduce and develop protocols to guide aspiring entrepreneurs' behaviors in searching for and discovering innovative ideas that may have commercial potential. Systematic search has emerged as a theory-based, prescriptive framework to guide innovative behavior. Grounded in Fiet's theory of search and discovery, this article provides…

  12. Cutting through the Hype: Evaluating the Innovative Potential of New Educational Technologies through Business Model Analysis

    Science.gov (United States)

    Kalman, Yoram M.

    2016-01-01

    In an era when novel educational technologies are constantly introduced to the marketplace, often accompanied by hyperbolic claims that these ground-breaking innovations will transform the educational landscape, decision makers in educational institutions need a methodological approach for examining the innovative potential of new educational…

  13. Promoting Entrepreneurship in a Tribal Context: Evaluation of the First Innovations Course Sequence

    Science.gov (United States)

    Walters, Fonda

    2012-01-01

    In the First Innovations Initiative at Arizona State University students are exposed to the culture of innovation and the entrepreneurial process through two courses situated intentionally within an American Indian sustainability context. In this action research dissertation, a summer field practicum was designed and implemented to complement the…

  14. Evaluation of Efficacy of Surgical Periodontal Therapy with the Use of Bone Graft in the Treatment of Periodontal Intrabony Defects.

    Science.gov (United States)

    Gojkov-Vukelic, Mirjana; Hadzic, Sanja; Pasic, Enes

    2017-06-01

    One of the most important goals of periodontitis therapy is the elimination of deep periodontal pockets. In regenerative periodontal therapy, different types of bone grafts, membranes, growth factors, etc. are used to improve regeneration of lost periodontal tissue. The aim of this study was to evaluate the effect of surgical therapy supported by the use of bone replacement material in the treatment of deep intrabony pockets, compared to surgical treatment (flap surgery) without the use of bone replacement in advanced periodontitis. The study included 50 patients of both sexes with advanced periodontitis, divided into two groups. After initial periodontal therapy was performed, plaque index (PI), papillary bleeding index (PBI) were verified, and depth of periodontal pockets was measured in both groups. One group (group 1) of the patients underwent surgical therapy, open flap surgery, while the other group (group 2) underwent the same surgical treatment method (open flap surgery), during which bone defects were filled with bone replacement material. The results showed that both group 1 and group 2 experienced improvements after periodontal surgical therapy. In group 1, there are no statistically significant changes in all three plaque index measurements (PI), while there has been a significant reduction in PI in group 2 following the surgery. For the PBI index, it was determined that there were statistically significant changes in values in group 1, both after surgical procedures and six months later, as well as in group 2. Statistical analysis of the results of the probing depth of pockets has shown that there are significant changes in the measurement of the depth of periodontal pocket one month after the surgery, as well as six months later, meaning that there has been a significant reduction in the depth of the periodontal pocket one month following the surgery as well as six months later, for both groups. However, we did not determine a statistically

  15. Innovative prospects evaluation as a tool of managerial efficiency increase for complicated technical systems creation

    Directory of Open Access Journals (Sweden)

    Vorotnikov Vitalii Anatolievich

    2016-02-01

    Full Text Available The article deals with problems of management for the complicated technical systems creation according to the competitiveness criteria. It is proposed to form an analytical apparatus using the expert-analytical tools of project management, technological forecasting, investment planning, innovation management and marketing. The concept of using forecasting innovation component step to assess the competitiveness of the integral index is based on the fact that through the use of patent-innovative parameters can compensate for the lack of technical and economic. The approach, which allows on the basis of conceptual patents of the R&D project to generate indicators of novelty, technological level, the degree of legal protection and linking it with the degree of feasibility in the group indicator of innovative competitiveness. Methodology linking patent-innovation and technical and economic parameters requires a high correlation of their group competitiveness indicators, which in turn leads to a correlation with the integral indicator.

  16. TRANSITION TO INNOVATIVE ECONOMICS ON THE BASIS OF «ROAD CARD»: EXAMINATION, EVALUATION, PROSPECTS

    Directory of Open Access Journals (Sweden)

    A. O. Baklanov

    2011-01-01

    Full Text Available The innovative economics model is examined in its interaction with the environment that includes such components as science, society, state, education, business and market as well as safety and court systems. Three main RF economics innovative and active development strategies are suggested and discussed: «resource-export», «resource-science» and «resource-innovation» strategies. Preference is given to the resourceinnovation strategy characteristic with multiple effect resulting from innovations used to update domestic technologies and to restructure the processing and manufacturing industries. An instrument called «Road map» is developed as a set and succession of measures required for Russia to transit to innovative economy.

  17. Prospective evaluation of surgical palliative care immersion training for general surgery residents.

    Science.gov (United States)

    Raoof, Mustafa; O'Neill, Lisa; Neumayer, Leigh; Fain, Mindy; Krouse, Robert

    2017-08-01

    Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework. The training format was modeled after the highly successful University of Arizona Center on Aging's Interprofessional Chief Resident Immersion Training (IP-CRIT) Program to teach palliative care competencies to general surgery residents. Objective and self-assessments were performed at baseline, immediately post training and 5-months after training. For all pre-test, post-test comparisons on Likert scale, Wilcoxon Signed Rank Test was used. For aggregate scores a repeated-measures analysis of variance was used. Forty of the forty-eight residents (83%) completed the learner's needs assessment survey. Thirty-four (71%) of the forty-eight residents in the residency program participated in the SPCIT. Significant improvement was noted in objective assessment of post-test aggregate scores (Mean difference 2.15, 95% CI 0.52-3.77, p = 0.0083). There was a significant increase in proportion of residents who felt confident in discussing palliative care options (96.5% vs. 27.5%, p support (79.2% vs. 45%, p = 0.0059) with patient/families after the SPCIT. The newly developed SPCIT program drastically improves knowledge, attitudes and perceived skills of general surgery residents. Similar training can be implemented in other surgical residency programs. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Design, testing and validation of an innovative web-based instrument to evaluate school meal quality.

    Science.gov (United States)

    Patterson, Emma; Quetel, Anna-Karin; Lilja, Karin; Simma, Marit; Olsson, Linnea; Elinder, Liselotte Schäfer

    2013-06-01

    To develop a feasible, valid, reliable web-based instrument to objectively evaluate school meal quality in Swedish primary schools. The construct 'school meal quality' was operationalized by an expert panel into six domains, one of which was nutritional quality. An instrument was drafted and pilot-tested. Face validity was evaluated by the panel. Feasibility was established via a large national study. Food-based criteria to predict the nutritional adequacy of school meals in terms of fat quality, iron, vitamin D and fibre content were developed. Predictive validity was evaluated by comparing the nutritional adequacy of school menus based on these criteria with the results from a nutritional analysis. Inter-rater reliability was also assessed. The instrument was developed between 2010 and 2012. It is designed for use in all primary schools by school catering and/or management representatives. A pilot-test of eighty schools in Stockholm (autumn 2010) and a further test of feasibility in 191 schools nationally (spring 2011). The four nutrient-specific food-based criteria predicted nutritional adequacy with sensitivity ranging from 0.85 to 1.0, specificity from 0.45 to 1.0 and accuracy from 0.67 to 1.0. The sample in the national study was statistically representative and the majority of users rated the questionnaire positively, suggesting the instrument is feasible. The inter-rater reliability was fair to almost perfect for continuous variables and agreement was ≥ 67 % for categorical variables. An innovative web-based system to comprehensively monitor school meal quality across several domains, with validated questions in the nutritional domain, is available in Sweden for the first time.

  19. Building Rural Surgical Networks: An Evidence-Based Approach to Service Delivery and Evaluation.

    Science.gov (United States)

    Kornelsen, Jude; Friesen, Randy

    2016-08-01

    Formalized rural health service delivery networks are emerging as an over-arching response to the attrition of rural surgical and maternity services in Canada. In effective networks, there is strong collaborative leadership, form follows function, core network elements are identified and site-specific variations are accommodated to meet the surgical needs of the population in each geographic catchment. The network catchment must reflect the natural alliances that already exist among health professionals, policy makers, health administrators, academic institutions and communities. Although each key stakeholder plays a key role in determining success, value is added through the synergistic interplay of all participants. Copyright © 2016 Longwoods Publishing.

  20. A hybrid MCDM framework combined with DEMATEL-based ANP to evaluate enterprise technological innovation capabilities assessment

    Directory of Open Access Journals (Sweden)

    Meng-Jong Kuan

    2014-08-01

    Full Text Available The efficient evaluation of technological innovation capabilities of enterprises is an important factor to enhance competitiveness. This paper aims to assess and to rank technological innovation evaluation criteria in order to provide a practical insight of systematic analysis by gathering the qualified experts’ opinions combined with three methods of multi-criteria decision making approach. A framework is proposed and uses a novel hybrid multiple criteria decision-making (MCDM model to address the dependence relationships of criteria with the aid of the Decision-Making Trial and Evaluation Laboratory (DEMATEL, analytical network process (ANP and VIKOR (VlseKriterijumska Optimizacija I Kompromisno Resenje. The study reports that the interaction between criteria is essential and influences technological innovation capabilities; furthermore, this ranking development of technological innovation capabilities assessment is also one of key management tools for managements of other related high- tech enterprises. Managers can then judge the need to improve and determine which criteria provide the most effective direction towards improvement.

  1. EVITA: a tool for the early evaluation of pharmaceutical innovations with regard to therapeutic advantage.

    Science.gov (United States)

    Püntmann, Isabel; Schmacke, Norbert; Melander, Arne; Lindberg, Gunnar; Mühlbauer, Bernd

    2010-03-16

    New drugs are generally claimed to represent a therapeutic innovation. However, scientific evidence of a substantial clinical advantage is often lacking. This may be the result of using inadequate control groups or surrogate outcomes only in the clinical trials. In view of this, EVITA was developed as a user-friendly transparent tool for the early evaluation of the additional therapeutic value of a new drug. EVITA does not evaluate a new compound per se but in an approved indication in comparison with existing therapeutic strategies. Placebo as a comparator is accepted only in the absence of an established therapy or if employed in an add-on strategy on top. The evaluation attributes rating points to the drug in question, taking into consideration both therapeutic benefit and risk profile. The compound scores positive points for superiority in efficiency and/or adverse effects as demonstrated in randomized controlled trials (RCTs), whilst negative points are awarded for inferiority and/or an unfavorable risk profile. The evaluation follows an algorithm considering the clinical relevance of the outcomes, the strength of the therapeutic effect and the number of RCTs performed. Categories for therapeutic aim and disease severity, although essential parts of the EVITA assessment, are attributed but do not influence the EVITA score which is presented as a color-coded bar graph. In case the available data were unsuitable for an EVITA calculation, a traffic-type yield sign is assigned instead to criticize such practice. The results are presented online http://www.evita-report.de together with all RCTs considered as well as the reasons for excluding a given RCT from the evaluation. This allows for immediate revision in response to justified criticism and simplifies the inclusion of new data. As examples, four compounds which received approval within the last years were evaluated for one of their clinical indications: lenalidomide, pioglitazone, bupropion and zoledronic

  2. Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation.

    Science.gov (United States)

    Hongo, Hiroki; Inoue, Tomohiro; Tamura, Akira; Saito, Isamu

    2017-01-01

    Extracranial carotid artery aneurysm (ECAA) is a rare clinical entity, and no standard treatment strategy has been established for this condition. Data from three patients who underwent surgical treatment of enlarging giant ECAAs were retrospectively reviewed. Based on the collateral status, as evaluated by preoperative digital subtraction angiography (DSA), surgical strategy was stratified into (1) high flow bypass followed by cervical ICA (internal carotid artery) ligation, when the collateral status was judged as poor/fair or (2) direct cervical repair with patch application after aneurysmal wall resection when the collateral status was judged as robust. Postoperative results were evaluated by magnetic resonance imaging (MRI). Postoperative follow-up (day 0 to 1, as well as midterm at approximately 6 months) confirmed completely trapped aneurysm with successful robust bypass and robust anterograde flow of the reconstructed cervical carotid artery on magnetic resonance angiography with no additional ischemic lesions on diffusion weighted imaging and T2-weighted imaging when compared with preoperative imaging in all three patients. Postoperatively, there was no stroke event during the midterm follow-up at 6 months. Clinical results of ECAAs treated by a surgical strategy stratified based on collateral status, as evaluated by preoperative DSA, were favorable, without postoperative ischemic event, and with satisfactory mid-term MRI results.

  3. Functional evaluation of patients with injury of the distal insertion of the biceps brachii muscle treated surgically,

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2014-04-01

    Full Text Available OBJECTIVE: to functionally evaluate patients with injury of the distal insertion of the biceps brachii muscle that was treated surgically.METHODS: between April 2002 and June 2011, 15 elbows of 14 patients underwent surgical treatment performed by the Shoulder and Elbow Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. The minimum follow-up was six months, with a mean of 28 months. The patients' ages ranged from 28 to 62 years, with a mean age of 40 years. All the patients were male and the dominant arm was affected in 64.2%. The clinical evaluation on the results was conducted using the criteria of the American Medical Association (AMA, as modified by Bruce, with evaluation of the joint range of motion (flexion-extension and pronosupination, the presence of pain and the patient's degree of satisfaction.RESULTS: from the AMA criteria, as modified by Bruce, we obtained 100% satisfactory results, of which 85.7% were considered to be excellent and 14.3% good. We observed that when distal injuries of the biceps brachii muscle affected young and active patients, surgical treatment was a good option.

  4. Echocardiographic evaluation of right ventricular systolic function: The traditional and innovative approach.

    Science.gov (United States)

    Smolarek, Dorota; Gruchała, Marcin; Sobiczewski, Wojciech

    2017-01-01

    Estimation of right ventricular (RV) performance still remains technically challenging due to its anatomical and functional distinctiveness. The current guidelines for the echocardiographic quantification of RV function recommend using multiple indices to describe the RV in a thorough and comprehensive manner, such as RV index of myocardial performance, tricuspid annular plane systolic excursion, fractional area change, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S'-wave), three-dimensional RV ejection fraction (3D RVEF), RV longitudinal strain (RVLS)/strain rate by speckle- tracking echocardiography (STE). Among these, the last one mentioned here is an innovative and a particularly promising tool that yields more precise information about complex regional and global RV mechanics. STE was initially designed to evaluate left ventricular function, but recently it has been introduced to assess RV performance, which is difficult due to its unique structure and physiology. Many studies have shown that both free wall and 6-segment RVLS present a stronger correlation with the RVEF assessed by cardiac magnetic resonance than conventional parameters and seem to be more sensitive in detecting myocardial dysfunction at an earlier, subclinical stage.

  5. Performance evaluation of a full-scale innovative swine waste-to-energy system.

    Science.gov (United States)

    Xu, Jiele; Adair, Charles W; Deshusses, Marc A

    2016-09-01

    Intensive monitoring was carried out to evaluate the performance of a full-scale innovative swine waste-to-energy system at a commercial swine farm with 8640 heads of swine. Detailed mass balances over each unit of the system showed that the system, which includes a 7600m(3) anaerobic digester, a 65-kW microturbine, and a 4200m(3) aeration basin, was able to remove up to 92% of the chemical oxygen demand (COD), 99% of the biological oxygen demand (BOD), 77% of the total nitrogen (TN), and 82% of the total phosphorous (TP) discharged into the system as fresh pig waste. The overall biogas yield based on the COD input was 64% of the maximum theoretical, a value that indicates that even greater environmental benefits could be obtained with process optimization. Overall, the characterization of the materials fluxes in the system provides a greater understanding of the fate of organics and nutrients in large scale animal waste management systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Transcallosal approach to tumors of the third ventricle. Surgical results and neuropsychological evaluation.

    Science.gov (United States)

    Villani, R; Papagno, C; Tomei, G; Grimoldi, N; Spagnoli, D; Bello, L

    1997-03-01

    A series of 34 patients with tumours of the third ventricle were operated on by a transcallosal route. Basal extrinsic lesions compressing or invading the ventricle as well as tumours located in the pineal area were excluded from this review. Tumours were approached by a transforaminal entry in 16 cases (47%), by an interforniceal route in 11 (32%), by a subchoroidal entry in 4 (14%) and by a combined transforaminal and subchoroidal entry in 3 (9%). Four out of 34 patients were submitted to a second operation, through the same approach corridor: 2 for an incomplete removal of an intrinsic tumour and 2 for a late regrowth. Postoperative mortality rate accounted for 5.8% (2 patients). Major post operative complications were hemiparesis (4 patients) and diabetes insipidus (4 patients), that were transient in 3. Akinetic mutism like status was observed in only 1 patient. Postoperative psychic disturbances were noticed in 5 cases. Nine out of 21 patients (62%) with preoperative hydrocephalus required a permanent CSF shunt. Histology revealed that 21 tumours (62%) were intraaxial (4 pilocitic astrocytoma, 10 low grade glioma, 1 giant cell astrocytoma, 1 subependymoma, 4 ependymoma/ependymoblastoma, 1 neurocitoma) and 13 (38%) were extraaxial (8 colloid cyst, 2 craniopharingioma, 1 ectopic pituitary adenoma, 1 lymphocytic hypophysitis and 1 metastasis). Total excision of third ventricle tumours was achieved in all patients with extraaxial tumours and in 62% and 71% of intraaxial tumours with the first and second surgical procedure respectively. Ten out of 34 patients of this series were submitted to a complete neuropsychological evaluation at an interval of 2-9 years after surgery. Memory tests were pathological in 2. Disconnection signs were constantly absent. Control function were preserved. Transcallosal approach remains the best microsurgical method of third ventricle tumours treatment. This route provides the capability for a superior visualization of the entire

  7. A mechanical evaluation of implants placed with different surgical techniques into the trabecular bone of goats.

    NARCIS (Netherlands)

    Shalabi, M.M.; Wolke, J.G.C.; Ruijter, A.J. de; Jansen, J.A.

    2007-01-01

    The aim of the study was to assess the effects of surgical technique and implant surface roughness on implant fixation. A total of 48 screw implants with machined or etched surface topographies were placed into the femoral condyles of goats. The implant sites were prepared by a conventional

  8. The laparoscopic surgical skills programme : Preliminary evaluation of grade I Level 1 courses by trainees

    NARCIS (Netherlands)

    Buzink, S.N.; Soltes, M.; Radonak, J.; Fingerhutt, A.; Hanna, G.; Jakimowicz, J.J.

    2012-01-01

    Introduction: New training models are needed to maintain safety and quality of surgical performance. A simulated setting using virtual reality, synthetic, and/or organic models should precede traditional supervised training in the operating room. Aim: The aim of the paper is to describe the

  9. Surgical strategy for giant pituitary adenoma based on evaluation of fine feeding system and angioarchitecture

    Directory of Open Access Journals (Sweden)

    Yoshikazu Ogawa, M.D., Ph.D.

    2017-06-01

    Conclusion: Major blood supply was different from the normal supply to the anterior pituitary gland and did not necessarily correspond to tumor shape and extension. Surgical strategy should be established based on the tumor feeding systems and hemodynamics in giant pituitary adenomas.

  10. In Vivo Evaluation of Bacterial Infection Involving Morphologically Different Surgical Meshes

    NARCIS (Netherlands)

    Engelsman, Anton F.; van Dam, Gooitzen M.; van der Mei, Henny C.; Busscher, Henk J.; Ploeg, Rutger J.

    Objective: To study the influence of morphology of surgical meshes on the course of bacterial infection under the influence of the host immune system in an in vivo chronic bacterial infection model. Background: The use of prosthetic meshes has increased dramatically the last decades in abdominal

  11. Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

    Science.gov (United States)

    Duclos, A; Peix, J L; Piriou, V; Occelli, P; Denis, A; Bourdy, S; Carty, M J; Gawande, A A; Debouck, F; Vacca, C; Lifante, J C; Colin, C

    2016-12-01

    The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals. Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  12. Use and Evaluation of a Cooling Aid in Laser-Assisted Dental Surgery: An Innovative Study.

    Science.gov (United States)

    Bernardi, Sara; Mummolo, Stefano; Zeka, Keti; Pajewski, Leonardo; Continenza, Maria Adelaide; Marzo, Giuseppe

    2016-06-01

    The aim of this study was to evaluate the beneficial effect of NeoHeal during laser-assisted oral surgery. Laser-assisted surgery is a less invasive technique than conventional surgery using a blade; however, the heat produced by the laser can damage tissue proximal to the treated area. We hypothesized the hydrogel NeoHeal could be applied during oral surgery and have similar benefits as those already described for dermatological surgery. In our randomized controlled trial, we first selected 30 patients who were to undergo laser surgical intervention using a diode laser. Both at the end of intervention and at follow-up, each patient filled out a questionnaire comprising two questions. The answers to the questions were statistically analyzed with regard to frequency of each response, and validated by the Wilcoxon test with a p value <0.05 being considered significant. The use of NeoHeal significantly reduced the pain experienced by patients both during the intervention and at the 7-day follow-up. NeoHeal clearly reduces surgery-related pain experienced by patients. The results show positive feedback from the patients, demonstrating how the hydrogel pads are necessary, useful, and effective as a cooling aid in laser-assisted dental surgery.

  13. Platelet function changes in different cardiac surgery subgroups as evaluated with an innovative technology.

    Science.gov (United States)

    Gerrah, Rabin; Brill, Alex; Varon, David

    2007-07-01

    : During cardiac surgery, platelets undergo substantial changes. The purpose of this study was to assess platelet function and compare these changes between different cardiac operations using an innovative technology. : Perioperative platelet function was evaluated by the Impact test [cone and plate(let) analyzer (CPA)]. The Impact test yields 2 parameters for platelet function: average size (AS, the mean size of the platelet aggregates) and surface coverage (SC, the percentage of the surface covered by the platelet aggregates), which correspond to platelet aggregation and adhesion. The study groups were compared for platelet function results in various surgery stages and correlation with bleeding. : A significant decrease in surface coverage was detected on establishment of cardiopulmonary bypass, with an increase up to preoperative values at the end of the surgery in all groups. In contrast to operations performed on bypass, in patients operated without cardiopulmonary bypass, the postoperative AS and SC were higher than the preoperative values, 30.4 ± 8.1 μmol versus 23.3 ± 6.9 μmol, P = 0.02 in AS, and 7.6 ± 3.6% versus 5.2 ± 1.8%, P = 0.04 in SC. Preoperative AS and SC were the only parameters significantly (P = 0.01) and linearly (r = 0.6) related to postoperative bleeding. : Preoperative platelet function, as evaluated by the CPA, is an independent risk factor determining postoperative bleeding. The off-pump patients presented an increased platelet function at the end of surgery, a finding that can imply a higher risk of thrombosis. The impact test appears to be a useful tool to determine perioperative platelet function and help in prediction of postoperative bleeding.

  14. Development and In Vitro Evaluation of an Innovative “Dietary Flavonoid Supplement” on Osteoarthritis Process

    Science.gov (United States)

    Panico, Anna Maria; Puglisi, Giovanni

    2017-01-01

    The aim of this study was to evaluate the antidegenerative effect in osteoarthritis damage of eriocitrin alone and eriocitrin formulated as innovative “dietary flavonoid supplement.” A complexation between eriocitrin and hydroxypropyl β-cyclodextrin by solubilization/freeze-drying method was performed. The complex in solution was evaluated by phase solubility studies and the optimal 1 : 2 flavanone/cyclodextrin molar ratio was selected. Hydroxypropyl β-cyclodextrin was able to complex eriocitrin as confirmed by UV-Vis absorption, DSC, and FTIR studies. The complex formed increased the eriocitrin water solubility (from 4.1 ± 0.2 g·L−1 to 11.0 ± 0.1 g·L−1) and dissolution rate (from 37.0% to 100%) in 30 min. The in vitro studies exhibit the notion that eriocitrin and its complex inhibit AGEs in a similar manner because hydroxypropyl β-cyclodextrin does not interfere with the flavanone intrinsic property. Instead, the presence of cyclodextrin improves eriocitrin antioxidant stability maintaining a high fluorescence value until 8 hours with respect to the pure materials. Moreover, hydroxypropyl β-cyclodextrin showed moderate GAGs restoration acting synergistically with the complexed compound to maintain the structural chondrocytes integrity. The results point out that ERT/HP-betaCD complex possesses technological and biological characteristics able to obtain an easily soluble nutraceutical product, which reduces the degenerative and oxidative damage which occurs in osteoarthritis, and improve the patient compliance. PMID:28367273

  15. Development and In Vitro Evaluation of an Innovative “Dietary Flavonoid Supplement” on Osteoarthritis Process

    Directory of Open Access Journals (Sweden)

    Maria Rosaria Lauro

    2017-01-01

    Full Text Available The aim of this study was to evaluate the antidegenerative effect in osteoarthritis damage of eriocitrin alone and eriocitrin formulated as innovative “dietary flavonoid supplement.” A complexation between eriocitrin and hydroxypropyl β-cyclodextrin by solubilization/freeze-drying method was performed. The complex in solution was evaluated by phase solubility studies and the optimal 1 : 2 flavanone/cyclodextrin molar ratio was selected. Hydroxypropyl β-cyclodextrin was able to complex eriocitrin as confirmed by UV-Vis absorption, DSC, and FTIR studies. The complex formed increased the eriocitrin water solubility (from 4.1±0.2 g·L−1 to 11.0±0.1 g·L−1 and dissolution rate (from 37.0% to 100% in 30 min. The in vitro studies exhibit the notion that eriocitrin and its complex inhibit AGEs in a similar manner because hydroxypropyl β-cyclodextrin does not interfere with the flavanone intrinsic property. Instead, the presence of cyclodextrin improves eriocitrin antioxidant stability maintaining a high fluorescence value until 8 hours with respect to the pure materials. Moreover, hydroxypropyl β-cyclodextrin showed moderate GAGs restoration acting synergistically with the complexed compound to maintain the structural chondrocytes integrity. The results point out that ERT/HP-betaCD complex possesses technological and biological characteristics able to obtain an easily soluble nutraceutical product, which reduces the degenerative and oxidative damage which occurs in osteoarthritis, and improve the patient compliance.

  16. Evaluation of innovative strategies in the organization of Primary Health Care.

    Science.gov (United States)

    Onocko-Campos, Rosana Teresa; Campos, Gastão Wagner de Sousa; Ferrer, Ana Luiza; Corrêa, Carlos Roberto Silveira; Madureira, Paulo Roberto de; Gama, Carlos Alberto Pegolo da; Dantas, Deivisson Vianna; Nascimento, Roberta

    2012-02-01

    To compare the performance of Primary Care Units according to the implementation of new arrangements and strategies in primary care and mental health. Evaluative research with triangulation of methods and theoretical framework of critical hermeneutics, carried out at six Primary Care Units of the two most populous health districts of the city of Campinas (Southeastern Brazil) in 2007. The Primary Care Units were analyzed according to clinical resolution, articulation between the primary care and mental health networks and implementation of health promotion strategies. Two groups were defined by cluster analysis: one with higher and another one with lower degree of implementation of the actions. The groups were compared based on the improvement in clinical follow-up, given by the occurrence of cerebral vascular accident; evaluation of dispensation of psychiatric medicines; focal groups with workers, users and community health agents; and interviews with users and relatives. Inclusive and participatory research strategies were employed. There were no pure models, but a mosaic of organizational proposals. Positive advances were identified in the group with higher implementation of innovative strategies in relation to better integration of the community agents in the Units' teams; to the workers' and agents' perception of improvement in the assistance; and to the facility for referrals and assistance of mental health cases. The difficulties identified in both groups were: communication among the levels of care and within the teams, in the implementation of matrix support, and incipient health promotion actions. The development and implementation of mechanisms to fix professionals in Primary Care in large cities are necessary. The community health agents are fundamental to perform the territorial work proposed by the Family Health Strategy, using mechanisms to integrate the community health agents into the healthcare teams in order to counterbalance the tendency to

  17. Performance Evaluation of An Innovative-Vapor- Compression-Desalination System

    Directory of Open Access Journals (Sweden)

    Mirna R. Lubis

    2012-04-01

    Full Text Available Two dominant desalination methods are reverse osmosis (RO and multi-stage flash (MSF. RO requires large capital investment and maintenance, whereas MSF is too energy-intensive. Innovative system of vapor compression desalination is proposed in this study. Comprehensive mathematics model for evaporator is also described. From literature study, it is indicated that very high overall-heat-transfer coefficient for evaporator can be obtained at specific condition by using dropwise condensation in the steam side, and pool boiling in the liquid side. Smooth titanium surface is selected in order to increase dropwise condensation, and resist corrosion. To maximize energy efficiency, a cogeneration scheme of a combined cycle consisting of gas turbine, boiler heat recovery, and steam turbine that drivescompressor is used. The resource for combined cycle is relatively too high for the compressor requirement. Excess power can be used to generate electricity for internal and/or externalconsumptions, and sold to open market. Four evaporator stages are used. Evaporator is fed by seawater, with assumption of 3.5% salt contents. Boiling brine (7% salt is boiled in low pressure side of the heat exchanger, and condensed vapor is condensed in high pressure side of the heat exchanger. Condensed steam flows at velocity of 1.52 m/s, so that it maximize the heat transfer coefficient. This unit is designed in order to produce 10 million gallon/day, and assumed it is financed with 5%, 30 years of passive obligation. Three cases are evaluated in order to determine recommended condition to obtain the lowest fixed capital investment. Based on the evaluation, it is possible to establish four-stage unit of mechanical vapor compression distillation with capital $31,723,885.

  18. [Comparative clinical multicenter study to evaluate analgesic effectiveness of intramuscular etofenamate and diclofenac in patients with post-surgical pain].

    Science.gov (United States)

    Guevara-López, Uriah; Uscanga-Sánchez, Santos; Márquez, José; Bárcenas-Olivares, Juan; Martínez-Arenas, Angeles; Palma-Aguirre, José Antonio

    2004-01-01

    The analgesic efficacy of intramuscular etofenamate (1 g/day) and intramuscular diclofenac (75 mg/day) was assessed in post-surgical pain relief during a period of 3 days. One hundred ten hospitalized patients undergoing elective surgery were evaluated in an open-label, comparative, randomized, parallel-group, multicenter study. Fifty five patients received etofenamate and 55 patients diclofenac, 1 h before surgery. The doses were administered after 24 and 48 h. Baseline evaluations were carried out 30 min after anesthesia recovery and the clinical efficacy variables were assessed at 1, 6, 12, 24, 36, 48, 60 and 72 h. The efficacy variables were Pain Visual-Analogue Scale (VAS), Pain Analogous Verbal Scale (AVERS), and Well-Being Scale. Adverse events were documented. Patients in both groups showed similar values in post-surgical pain relief (VAS, AVERS). According to VAS, etofenamate at 24 h had a better analgesic action than diclofenac even though it was not statistically significant. Both drugs demonstrated to be safe. Patients in both groups reported nausea, vomiting, flatulence, and pain at injection site. We find that both etofenamate and diclofenac were safe, tolerable, and effective treatments for the relief of post-surgical pain.

  19. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  20. Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study

    Science.gov (United States)

    Fitchett, Joseph R; Bhatta, Surya; Sherpa, Tenzing Y; Malla, Bishwo S; A Fitchett, Elizabeth J; Samen, Arlene

    2015-01-01

    Objectives Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. Design Prospective monitoring and evaluation study of a new public health programme. Setting Baglung district, rural Nepal. Participants Women with gynaecological symptoms of POP. Main outcome measures Risk factors for disease progression were assessed using Fisher’s exact test, Pearson’s χ2-test and logistic regression analysis. Results Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. Conclusions Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal. PMID:26664731

  1. Evaluation of the ROSA™ Spine robot for minimally invasive surgical procedures.

    Science.gov (United States)

    Lefranc, M; Peltier, J

    2016-10-01

    The ROSA® robot (Medtech, Montpellier, France) is a new medical device designed to assist the surgeon during minimally invasive spine procedures. The device comprises a patient-side cart (bearing the robotic arm and a workstation) and an optical navigation camera. The ROSA® Spine robot enables accurate pedicle screw placement. Thanks to its robotic arm and navigation abilities, the robot monitors movements of the spine throughout the entire surgical procedure and thus enables accurate, safe arthrodesis for the treatment of degenerative lumbar disc diseases, exactly as planned by the surgeon. Development perspectives include (i) assistance at all levels of the spine, (ii) improved planning abilities (virtualization of the entire surgical procedure) and (iii) use for almost any percutaneous spinal procedures not limited in screw positioning such as percutaneous endoscopic lumbar discectomy, intracorporeal implant positioning, over te top laminectomy or radiofrequency ablation.

  2. Evaluation of lid speculum with a drape (LiDrape?) for preventing surgical-field contamination

    OpenAIRE

    Urano T; Kasaoka M; Sagawa K; Yamakawa R

    2015-01-01

    Toru Urano,1 Masataka Kasaoka,1 Kimitaka Sagawa,2 Ryoji Yamakawa1 1Department of Ophthalmology, Kurume University School of Medicine, 2Department of Laboratory Medicine, Kurume University Hospital, Kurume, Japan Purpose: To compare the degree of surgical-field contamination in cataract surgeries between a new draping method using a lid speculum with a drape (LiDrape®) and a conventional draping method. Methods: Cataract surgery was performed on 21 eyes using LiDrape® (LiDrap...

  3. Load evaluation of the da Vinci surgical system for transoral robotic surgery.

    Science.gov (United States)

    Fujiwara, Kazunori; Fukuhara, Takahiro; Niimi, Koji; Sato, Takahiro; Kitano, Hiroya

    2015-12-01

    Transoral robotic surgery, performed with the da Vinci surgical system (da Vinci), is a surgical approach for benign and malignant lesions of the oral cavity and laryngopharynx. It provides several unique advantages, which include a 3-dimensional magnified view and ability to see and work around curves or angles. However, the current da Vinci surgical system does not provide haptic feedback. This is problematic because the potential risks specific to the transoral use of the da Vinci include tooth injury, mucosal laceration, ocular injury and mandibular fracture. To assess the potential for intraoperative injuries, we measured the load of the endoscope and the instrument of the da Vinci Si surgical system. We pressed the endoscope and instrument of the da Vinci Si against Load cell six times each and measured the dynamic load and the time-to-maximum load. We also struck the da Vinci Si endoscope and instrument against the Load cell six times each and measured the impact load. The maximum dynamic load was 7.27 ± 1.31 kg for the endoscope and 1.90 ± 0.72 for the instrument. The corresponding time-to-maximum loads were 1.72 ± 0.22 and 1.29 ± 0.34 s, but the impact loads were significantly lower than the dynamic load. It remains possible that a major load is exerted on adjacent structures by continuous contact with the endoscope and instrument of da Vinci Si. However, there is a minor delay in reaching the maximum load. Careful monitoring by an on-site assistant may, therefore, help prevent contiguous injury.

  4. [Discussion on efficacy evaluation thought and method for innovation medicine of Chinese herbal compound formula based on clinical application characteristics].

    Science.gov (United States)

    Sun, Jian-Ning; Sun, Wen-Yan; Dong, Shi-Fen

    2017-03-01

    The Chinese herbal compound formula preparation was made based on theory of Chinese medicine, which was confirmed by long period clinical application, and with multi-compound and multi-target characteristics. During the exploitation process of innovation medicine of Chinese herbal compound formula, selecting and speeding up the research development of drugs with clinical value shall be paid more attention, and as request of rules involved in new drug research and development, the whole process management should be carried out, including project evaluation, manufacturing process determination, establishment of quality control standards, evaluation for pharmacological and toxic effect, as well as new drug application process. This reviews was aimed to give some proposals for pharmacodynamics research methods involved in exploration of Chinese herbal compound formula preparation, including: ①the endpoint criteria should meet the clinical attribution of new drugs; ②the pre-clinical pharmacodynamics evaluation should be carried on appropriate animal models according to the characteristics of diagnosis and therapy of Chinese medicine and observation indexes; ③during the innovation of drug for infants and children, information on drug action conforming to physiological characteristics of infants and children should be supplied, and the pharmacodynamics and toxicology research shall be conducted in immature rats according to the body weight of children. In a summary, the clinical application characteristics are the important criteria for evaluation of pharmacological effect of innovation medicine of Chinese herbal compound formula. Copyright© by the Chinese Pharmaceutical Association.

  5. Surgical hand antisepsis in veterinary practice: evaluation of soap scrubs and alcohol based rub techniques.

    Science.gov (United States)

    Verwilghen, Denis R; Mainil, Jacques; Mastrocicco, Emilie; Hamaide, Annick; Detilleux, Johann; van Galen, Gaby; Serteyn, Didier; Grulke, Sigrid

    2011-12-01

    Recent studies have shown that hydro-alcoholic solutions are more efficient than traditional medicated soaps in the pre-surgical hand antisepsis of human surgeons but there is little veterinary literature on the subject. The aim of this study was to compare the efficiency of medicated soaps and a hydro-alcoholic solution prior to surgery using an in-use testing method in a veterinary setting. A preliminary trial was performed that compared the mean log(10) number of bacterial colony forming units (CFU) and the reduction factors (RF) between two 5-min hand-scrubbing sessions using different soaps, namely, povidone iodine (PVP) and chlorhexidine gluconate (CHX), and the 1.5-min application of a hydro-alcoholic rub. A clinical in-use trial was then used to compare the hydro-alcoholic rub and CHX in a surgical setting. Sampling was performed using finger printing on agar plates. The hydro-alcoholic rub and CHX had a similar immediate effect, although the sustained effect was significantly better for the hydro-alcoholic rub, while PVP had a significantly lower immediate and sustained effect. The hydro-alcoholic rub showed good efficiency in the clinical trial and could be considered as a useful alternative method for veterinary surgical hand antisepsis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Cervical spine degenerative diseases: An evaluation of clinical and imaging features in surgical decisions

    Energy Technology Data Exchange (ETDEWEB)

    Soo, M.; Tran-Dinh, H.D.; Quach, T.; Downey, J.; Pohlmann, S. [Westmead Hospital, Westmead, NSW (Australia). Department of Radiology; Dorsch, N.W.C. [Westmead Hospital, Westmead, NSW (Australia). Department of Neurosurgery

    1997-11-01

    In clinically severe cervical spondylosis, imaging plays a vital role in surgical decisions. A prime factor is acquired canal stenosis with cord compression. To validate this concept, the clinical and imaging features of 20 patients with spondylitic myelopathy and 24 with radiculopathy were retrospectively reviewed. All had computed tomographic myelography (CTM) as part of their clinical work-up. The patients` clinical severity was graded as mild, moderate and severe; the age, length of illness and a history of eventual surgery or otherwise were recorded. At the level of maximum compression the following parameters were obtained from the axial CTM images: surface area and ratio of the anteroposterior to the transverse diameter of the cord; subarachnoid space and vertebral canal areas. Data were statistically analysed. A significant association exists between surgery and increasing severity of symptoms (P=0.04), and advancing age (P=0.01). These associations hold true for myelopathy and radiculopathy. A strong association is present between surgery and the surface area of the cord (P=0.01), being applicable to myelopathy only. The other parameters show no association with surgical decisions. It is concluded that with myelopathy a narrow cord area at the level of maximum compression, and moderate-severe functional impairment are indicators for surgical intervention. (authors). 22 refs., 3 tabs., 3 figs.

  7. Application of molecular diagnostics to the evaluation of the surgical approach to thyroid cancer.

    Science.gov (United States)

    Miccoli, Paolo

    2014-06-01

    Recent important studies that include long-term follow-up have shown that BRAF and RAS mutations can have negative implications for disease recurrence and survival. BRAF positivity has been shown to be associated with decreased survival and is an independent predictor of poor prognosis. Reliable pre-operative identification of high-risk papillary thyroid cancer (PTC) patients may productively guide initial surgical management since reoperative neck surgery is associated with increased morbidity. However, it is probably too early to conclude that at present it is possible to tailor surgical therapy patient by patient only on the basis of their mutational status. Other important parameters, not including molecular testing, represented by some specific morphological aspects, still play an important role, probably still more significant than molecular diagnostics, such as neck ultrasonography. Pre-operative knowledge of BRAF-positive PTC could alter the initial surgical treatment for at least 20% of patients and can potentially prevent the increased morbidity associated with reoperative neck exploration. However, additional multi-institutional and randomized studies will be needed to further define the role of the pre-operative identification of BRAF positivity to guide not only the initial extent of total thyroidectomy (TT) but also the need for and extent of lymphadenectomy.

  8. Surgical dislocation of the hip for reduction of acetabular fracture and evaluation of chondral damage.

    Science.gov (United States)

    Maini, Lalit; Batra, Sahil; Arora, Sumit; Singh, Shailendra; Kumar, Santosh; Gautam, V K

    2014-04-01

    To assess the outcome of open reduction and internal fixation combined with surgical dislocation of the hip for displaced acetabular fractures. 20 men and 2 women aged 20 to 55 (mean, 28) years underwent open reduction and internal fixation combined with surgical dislocation of the hip for displaced acetabular fracture. The most common fracture pattern was bicolumnar (n=12), followed by transverse (n=6) and T-type (n=4). Femoral head chondral lesions were classified as grade 0 (no defect) to grade 4 (osteochondral defect). Fracture fragments were fixed with titanium plates and screws, and the femoral head was redislocated to inspect for intraarticular screws. The association between functional status and acetabular fracture pattern and femoral head chondral lesions was explored. Nine patients had chondral lesions in the femoral head (mostly in the anterosuperior zone), but none in the acetabulum. All femoral heads were viable. Reduction was anatomic in 6 patients and satisfactory in 16. Functional outcome was very good in 6 patients, good in 13, medium in 2, and fair in one. No patient developed avascular necrosis of the femoral head. Four patients had iatrogenic sciatic nerve palsy. One patient developed early degenerative hip arthritis and underwent total hip arthroplasty 14 months later. Surgical dislocation of the hip facilitated anatomic reduction and inspection of any chondral lesions. It did not result in avascular necrosis of the femoral head.

  9. Revolutionizing volunteer interpreter services: an evaluation of an innovative medical interpreter education program.

    Science.gov (United States)

    Hasbún Avalos, Oswaldo; Pennington, Kaylin; Osterberg, Lars

    2013-12-01

    In our ever-increasingly multicultural, multilingual society, medical interpreters serve an important role in the provision of care. Though it is known that using untrained interpreters leads to decreased quality of care for limited English proficiency patients, because of a short supply of professionals and a lack of formalized, feasible education programs for volunteers, community health centers and internal medicine practices continue to rely on untrained interpreters. To develop and formally evaluate a novel medical interpreter education program that encompasses major tenets of interpretation, tailored to the needs of volunteer medical interpreters. One-armed, quasi-experimental retro-pre-post study using survey ratings and feedback correlated by assessment scores to determine educational intervention effects. Thirty-eight students; 24 Spanish, nine Mandarin, and five Vietnamese. The majority had prior interpreting experience but no formal medical interpreter training. Students completed retrospective pre-test and post-test surveys measuring confidence in and perceived knowledge of key skills of interpretation. Primary outcome measures were a 10-point Likert scale for survey questions of knowledge, skills, and confidence, written and oral assessments of interpreter skills, and qualitative evidence of newfound knowledge in written reflections. Analyses showed a statistically significant (P  0.8). The second half of the program was also quantitatively and qualitatively shown to be a vital learning experience, resulting in 18 % more students passing the oral assessments; a 19 % increase in mean scores for written assessments; and a newfound understanding of interpreter roles and ways to navigate them. This innovative program was successful in increasing volunteer interpreters' skills and knowledge of interpretation, as well as confidence in own abilities. Additionally, the program effectively taught how to navigate the roles of the interpreter to maintain

  10. Innovation & evaluation of tangible direct manipulation digital drawing pens for children.

    Science.gov (United States)

    Lee, Tai-Hua; Wu, Fong-Gong; Chen, Huei-Tsz

    2017-04-01

    Focusing on the theme of direct manipulation, in this study, we proposed a new and innovative tangible user interface (TUI) design concept for a manipulative digital drawing pen. Based on interviews with focus groups brainstorming and experts and the results of a field survey, we selected the most suitable tangible user interface for children between 4 and 7 years of age. Using the new tangible user interface, children could choose between the brush tools after touching and feeling the various patterns. The thickness of the brush could be adjusted by changing the tilt angle. In a subsequent experimental process we compared the differences in performance and subjective user satisfaction. A total of sixteen children, aged 4-7 years participated in the experiment. Two operating system experiments (the new designed tangible digital drawing pen and traditional visual interface-icon-clicking digital drawing pens) were performed at random and in turns. We assessed their manipulation performance, accuracy, brush stroke richness and subjective evaluations. During the experimental process we found that operating functions using the direct manipulation method, and adding shapes and semantic models to explain the purpose of each function, enabled the children to perform stroke switches relatively smoothly. By using direct manipulation digital pens, the children could improve their stroke-switching performance for digital drawing. Additionally, by using various patterns to represent different brushes or tools, the children were able to make selections using their sense of touch, thereby reducing the time required to move along the drawing pens and select icons (The significant differences (p = 0.000, p drawing thick lines using the crayon function of the two (new and old) drawing pens (new 5.8750 drawing operations enhanced the drawing results, thereby increasing the children's enjoyment of drawing with tangible digital drawing pens. Copyright © 2016 Elsevier Ltd. All

  11. Retrospective evaluation of the long-term outcome of non-surgical management of 74 dogs with clinical hip dysplasia.

    Science.gov (United States)

    Farrell, M; Clements, D N; Mellor, D; Gemmill, T; Clarke, S P; Arnott, J L; Bennett, D; Carmichael, S

    2007-04-14

    The long-term outcome for dogs treated non-surgically for clinical signs of canine hip dysplasia were evaluated retrospectively; 74 dogs were evaluated by a postal questionnaire sent to their owners, and 24 of these were also evaluated by a veterinary clinical examination. A total of 11 outcome variables were evaluated. Depending on the variable assessed, between 31 (41.9 per cent) and 49 (66.2 per cent) of the dogs remained clinically affected according to their owner's assessment, and between 17 (70.8 per cent) and 23 (95.8 per cent) of the 24 dogs had abnormalities attributed to hip osteoarthritis according to the veterinary assessment. Orthopaedic abnormalities other than hip dysplasia affected 17 of the 24 dogs. Long-term medications had been prescribed for the treatment of clinical signs associated with hip dysplasia in 41 of the 74 dogs.

  12. An Evaluation of the Accuracy of Peer to Peer Surgical Teaching and the Role of the Peer Review Process

    Directory of Open Access Journals (Sweden)

    Sheila Oh

    2014-06-01

    Full Text Available Background: Peer to peer learning is a well-established learning modality which has been shown to improve learning outcomes, with positive implications for clinical practice. Surgical students from across Ireland were invited to upload learning points daily while paired with their peers in a peer-reviewing process. This study was designed to assess content accuracy and evaluate the benefit of the review process. Method: A reflective content sample was selected from the database representing all gastrointestinal (GI surgical entries. All questions and answers were double corrected by four examiners, blinded to the “review” status of the entries. Statistical analysis was performed to compare accuracy between “reviewed” and “non-reviewed” entries. Results: There were 15,569 individual entries from 2009–2013, 2977 were GI surgery entries; 678 (23% were peer reviewed. Marked out of 5, accuracy in the reviewed group was 4.24 and 4.14 in the non-reviewed group. This was not statistically different (p = 0.11. Accuracy did not differ between universities or grade of tutors. Conclusion: The system of student uploaded data is accurate and was not improved further through peer review. This represents an easy, valuable and safe method of capturing surgical oral ward based teaching.

  13. RISK VIP: Evaluation of Flood Risk on the French Railway Network Using an Innovative GIS Approach

    Directory of Open Access Journals (Sweden)

    Cheetham Mark

    2016-01-01

    Full Text Available Flooding can have significant direct and indirect negative effects on a railway network affecting both infrastructure and rail operations. Such impacts include the delaying or cancelling of train services, damage to railway structures or the implementation of costly maintenance and monitoring programs to ensure the safety and performance of the railway system. Identifying sections of railway line at risk from flooding allows appropriate actions to be targeted at specific areas and contributes to an effective asset management plan. Flooding of railway infrastructure can have numerous sources including surface water run-off, insufficient capacity of hydraulic structures or the inundation of embankments located in floodplains. Consequences of flooding include the destabilisation of structures (surface erosion of embankments or the undermining of bridge foundations, differential settlement of structures and damage to the track structure. This paper details an innovative approach developed at the SNCF using a Geographic Information System (GIS model to identify zones of the railway network at risk of different types of flooding. The GIS model RiskVIP has been constructed through the assessment of three distinct components of risk: “Vulnerability” (assessment of the susceptibility of the railway infrastructure to flood conditions, Intensity’ (capacity of a catchment to generate a flood flow, Probability’ (probability of a rainfall event.Through the application of decision trees, the component ‘Intensity’ has been characterised in the model by the physical properties of the catchment intercepted by the railway line (surface area of the catchment, slope and land cover characteristics and “Vulnerability” by the infrastructure itself (type, geometry and the presence of hydraulic structures. In order to evaluate its efficiency at identifying sites at risk of flooding, the model has been tested in the region of Languedoc-Roussillon in France

  14. Identifying Opportunities for Virtual Reality Simulation in Surgical Education: A Review of the Proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) Conference: VR Surgery.

    Science.gov (United States)

    Olasky, Jaisa; Sankaranarayanan, Ganesh; Seymour, Neal E; Magee, J Harvey; Enquobahrie, Andinet; Lin, Ming C; Aggarwal, Rajesh; Brunt, L Michael; Schwaitzberg, Steven D; Cao, Caroline G L; De, Suvranu; Jones, Daniel B

    2015-10-01

    To conduct a review of the state of virtual reality (VR) simulation technology, to identify areas of surgical education that have the greatest potential to benefit from it, and to identify challenges to implementation. Simulation is an increasingly important part of surgical training. VR is a developing platform for using simulation to teach technical skills, behavioral skills, and entire procedures to trainees and practicing surgeons worldwide. Questions exist regarding the science behind the technology and most effective usage of VR simulation. A symposium was held to address these issues. Engineers, educators, and surgeons held a conference in November 2013 both to review the background science behind simulation technology and to create guidelines for its use in teaching and credentialing trainees and surgeons in practice. Several technologic challenges were identified that must be overcome in order for VR simulation to be useful in surgery. Specific areas of student, resident, and practicing surgeon training and testing that would likely benefit from VR were identified: technical skills, team training and decision-making skills, and patient safety, such as in use of electrosurgical equipment. VR simulation has the potential to become an essential piece of surgical education curriculum but depends heavily on the establishment of an agreed upon set of goals. Researchers and clinicians must collaborate to allocate funding toward projects that help achieve these goals. The recommendations outlined here should guide further study and implementation of VR simulation. © The Author(s) 2015.

  15. Changes in professionals' beliefs following a palliative care implementation programme at a surgical department: a qualitative evaluation.

    Science.gov (United States)

    Hahne, Pia; Lundström, Staffan; Leveälahti, Helena; Winnhed, Janet; Öhlén, Joakim

    2017-12-28

    One ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to implement palliative care. The aim of this study is to evaluate how the implementation of palliative care, using a combination of integration and consultation strategies, can change beliefs regarding palliative care among professionals in a surgical department. In order to explore professionals' experiential outcome of an educational implementation strategy, a before-after qualitative design was used. The study was based on three focus group discussions. Two discussions were conducted before introducing the implementation strategy and one was conducted after. The participants consisted of five nurses and two specialist surgeons from a surgical department in Sweden. The focus group discussions revealed a variety of different attitudes and beliefs, which were analysed using qualitative systematic text condensation. Beliefs regarding palliative care were identified in seven areas; the importance of palliative care, working methods in palliative care, team collaboration in palliative care, collegial support, discussions about diagnosis, symptoms at the end of life, and families of patients in palliative care. Changes in beliefs were seen in all areas except one: team collaboration in palliative care. It is possible to change the beliefs of health care professionals in a surgical department regarding palliative care through the implementation of palliative knowledge. Beliefs were changed from an individual to a collective development where the group initiated a shared palliative working method. The changes observed were palliative care being described as more complex and participants differentiating between surgical care and palliative care.

  16. Utility of postoperative radiographs for cervical spine fusion: a comprehensive evaluation of operative technique, surgical indication, and duration since surgery.

    Science.gov (United States)

    Shau, David N; Bible, Jesse E; Samade, Richard; Gadomski, Stephen P; Mushtaq, Bushra; Wallace, Ato; McGirt, Matthew J; O'Neill, Kevin R; Devin, Clinton J

    2012-11-15

    A retrospective study. To assess the utility of postoperative radiographs in patients across a spectrum of cervical fusion procedures, surgical indication, and time since surgery. Postoperative radiographs are routinely obtained after cervical spine fusion despite lack of evidence supporting such practice. Studies assessing postoperative radiographical utility in the cervical spine have been limited. To date, no study has comprehensively evaluated the utility of obtaining such radiographs across multiple cervical fusion procedures. A total of 972 clinic notes from 301 patients during a 10-year period at a single institution were retrospectively reviewed. Patients in this study underwent an anterior cervical discectomy and fusion, anterior corpectomy and fusion, a combined anterior cervical discectomy and fusion and anterior corpectomy and fusion (hybrid), posterior spine fusion, or 360° fusion. All postoperative clinic notes and radiographs were reviewed for abnormalities and changes in treatment course. It was determined whether an abnormal radiograph alone led to a change in treatment course among the various operative techniques, surgical indication, or time since surgery. No statistical significant difference in radiograph utility between anterior cervical discectomy and fusion (0 changes in treatment course due to radiograph alone out of 332 clinic notes), anterior corpectomy and fusion (0 of 140), hybrid procedure (1 of 72), posterior spine fusion (5 of 357), and 360° fusion (0 of 71) was found. Surgical indication (trauma vs. degeneration) and duration from surgery yielded no statistical significant difference in radiograph utility. The overall sensitivity, specificity, and positive and negative predictive values of radiographs were 33.8%, 87.6%, 19.0%, and 93.9%, respectively. Regardless of operative techniques performed, surgical indication, and time since surgery, routine postoperative radiographs provide low utility in guiding treatment course in

  17. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki

    2016-03-01

    Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

  18. In vitro evaluation of novel antimicrobial coatings for surgical sutures using octenidine.

    Science.gov (United States)

    Obermeier, A; Schneider, J; Föhr, P; Wehner, S; Kühn, K-D; Stemberger, A; Schieker, M; Burgkart, R

    2015-09-24

    Sutures colonized by bacteria represent a challenge in surgery due to their potential to cause surgical site infections. In order to reduce these type of infections antimicrobially coated surgical sutures are currently under development. In this study, we investigated the antimicrobial drug octenidine as a coating agent for surgical sutures. To achieve high antimicrobial efficacy and required biocompatibility for medical devices, we focused on optimizing octenidine coatings based on fatty acids. For this purpose, antimicrobial sutures were prepared with either octenidine-laurate or octenidine-palmitate at 11, 22, and 33 μg/cm drug concentration normalized per length of sutures. Octenidine containing sutures were compared to the commercial triclosan-coated suture Vicryl® Plus. The release of octenidine into aqueous solution was analyzed and long-term antimicrobial efficacy was assessed via agar diffusion tests using Staphylococcus aureus. For determining biocompatibility, cytotoxicity assays (WST-1) were performed using L-929 mouse fibroblasts. In a 7 days elution experiment, octenidine-palmitate coated sutures demonstrated much slower drug release (11 μg/cm: 7%; 22 μg/cm: 5%; 33 μg/cm: 33%) than octenidine-laurate sutures (11 μg/cm: 82%; 22 μg/cm: 88%; 33 μg/cm: 87%). Furthermore sutures at 11 μg/cm drug content were associated with acceptable cytotoxicity according to ISO 10993-5 standard and showed, similar to Vicryl® Plus, relevant efficacy to inhibit surrounding bacterial growth for up to 9 days. Octenidine coated sutures with a concentration of 11 μg/cm revealed high antimicrobial efficacy and biocompatibility. Due to their delayed release, palmitate carriers should be preferred. Such coatings are candidates for clinical testing in regard to their safety and efficacy.

  19. Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

    Science.gov (United States)

    Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

    2016-10-01

    Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

  20. Clinical evaluation and surgical decision making for patients with lumbar discogenic pain and facet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Tessitore, Enrico, E-mail: enrico.tessitore@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Molliqaj, Granit, E-mail: granitmolliqaj@gmail.com [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Schatlo, Bawarjan, E-mail: schatlo@gmail.com [Department of Neurosurgery, Georg-August University, University of Medicine Gottingen, 37075 Gottingen (Germany); Schaller, Karl, E-mail: karl.schaller@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland)

    2015-05-15

    In industrialized countries, more than two thirds of the population suffers from low back pain (LBP) in their lifetime. LBP associated with lumbar disc herniation, stenosis, and instability is a well-known and documented entity. On the other hand, the lumbar discogenic pain and facet syndrome are difficult to be clearly identified, and they are not always detectable by imaging. This article describes the causes of these painful syndromes, which are typically without radicular component, explains the modern diagnostic procedures, and provides guidelines for surgical decision making.

  1. Comparative Evaluation of Cephalosporin Injectable Product Manufactured by Generic and Innovator Company

    OpenAIRE

    GIRISH PAI K; Vamshi Krishna T; Lalit Kumar; Anup Naha; M Sreeenivasa Reddy

    2013-01-01

    The main purpose of the study was to compare few physical parameters of the marketed products of Ceftriaxone Sodium for injection 1g manufactured by generic and innovator company nearing the expiry date. The marketed samples of generic and innovator company were tested for physical parameters like Appearance, pH, clarity, reconstitution time and primary packing quality. All the samples were reconstituted and pH was determined using calibrated pH meter. From the results it was found that few p...

  2. Explore-create-share study: An evaluation of teachers as curriculum innovators in engineering education

    Science.gov (United States)

    Berry, Ayora

    included twenty-six teachers and data was collected pre-, mid-, and post-program using teacher surveys and a curriculum analysis instrument. The second study evaluated teachers' perceptions of the ECS model as a curriculum authoring tool and the quality of the curriculum units they developed. The study included sixty-two participants and data was collected post-program using teacher surveys and a curriculum analysis instrument. The third study evaluated teachers' experiences implementing ECS units in the classroom with a focus on identifying the benefits, challenges and solutions associated with project-based engineering in the classroom. The study included thirty-one participants and data was collected using an open-ended survey instrument after teachers completed implementation of the ECS curriculum unit. Results of these three studies indicate that teachers can be prepared to integrate engineering in the classroom using a CDB professional development model. Teachers reported an increase in engineering content knowledge, improved their self-efficacy in curriculum planning, and developed high quality instructional units that were aligned to engineering design practices and STEM educational standards. The ECS instructional model was acknowledged as a valuable tool for developing and implementing engineering education in the classroom. Teachers reported that ECS curriculum design aligned with their teaching goals, provided a framework to integrate engineering with other subject-area concepts, and incorporated innovative teaching strategies. After implementing ECS units in the classroom, teachers reported that the ECS model engaged students in engineering design challenges that were situated in a real world context and required the application of interdisciplinary content knowledge and skills. Teachers also reported a number of challenges related to scheduling, content alignment, and access to resources. In the face of these obstacles, teachers presented a number of

  3. Quantitative evaluation of surgical task performance by remote-access endoscopic telemanipulation.

    Science.gov (United States)

    Li, R; Jensen, J; Hill, J; Bowersox, J C

    2000-05-01

    The performance limitations inherent in minimally invasive surgery may be overcome by using an interface that provides intuitive orientation for video display and tool manipulation. A prototype remote-access endoscopic telemanipulator was designed to fulfill these requirements and used for a surgical anastomosis task. A remote-access telemanipulator system, employing remote center-of-motion geometry, was used to complete distant in vitro tubular anastomoses. The performance of four surgeons using this system was compared with that achieved in completing the same anastomosis task in an open environment using open surgical techniques and in a minimally invasive environment using standard laparoscopic methods. The average performance times for completion of the anastomosis task was 1448 +/- 130 s using the telemanipulator system compared with 2108 +/- 291 s with laparoscopic instruments and 296 +/- 25 s with conventional techniques. Leakage rates from the tubular anastomoses were 5.2 +/- 1.4 ml/s in the telemanipulator group, 6.9 +/- 2.0 ml/s in the laparoscopic group, and 3.2 +/- 0.9 ml/s in the conventional methods group. All experimental subjects were able to complete the assigned task in each experimental condition successfully without complications. Our results in this pilot study suggest that remote-access endoscopic telemanipulation can execute complex three-dimensional manipulations, and that the intuitive orientation of the surgeon's workstation may contribute to easier task completion.

  4. New understanding of dorsal dysraphism with lipoma (lipomyeloschisis): radiologic evaluation and surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Naidich, T.P. (Northwestern Univ., Chicago, IL); McLone, D.G.; Mutluer, S.

    1983-06-01

    The spinal anomaly designated dorsal dysraphism with lipoma (lipomyeloschisis) consists of skin-covered, focal spina bifida; focal partial clefting of the dorsal half of the spinal cord; continuity of the dorsal cleft with the central canal of the cord above (and occasionally below) the cleft; deficiency of the dura underlying the spina bifida; deep extension of subcutaneous lipoma through the spina bifida and the dural deficiency to insert directly into the cleft on the dorsal half of the cord; variable cephalic extension of lipoma into the contiguous central canal of the cord; and variable ballooning of the subarachnoid space to form an associated meningocele. The variable individual expressions of the anomaly are best understood by reference to their archetypal concept. Careful analysis of radiographic and surgical findings in human lipomyeloschisis and correlation with an animal model of lipomyeloschisis indicate that plain spine radiographs and high-resolution metrizamide computed tomographic myelography successfully delineate the precise anatomic derangements associated with lipomyeloschisis and provide the proper basis for planning surgical therapy of this condition.

  5. Surgical sterilization: an underutilized procedure for evaluating the merits of induced sterility

    Science.gov (United States)

    Kennelly, James J.; Converse, Kathryn A.

    1993-01-01

    Despite more than 4 decades of effort, development of effective wildlife damage control programs based on sterilization of target species has met with limited success. This is partly due to the fact that investigators have assumed, rather than empirically tested, whether the reproductive strategies of the target populations were vulnerable to the planned treatment. Equally important, methods selected to include sterility usually involve a chemical agent that can affect sociosexual behaviors of the nuisance population. In this report, we illustrate how surgically induced sterility circumvents both problems--how the concept without the potentially confounding secondary effects of a chemical. We assessed the merits of initiating research to develop a male chemosterilant for Norway rats, red-winged blackbirds, beaver, and Canada geese by inducing sterility surgically. The infidelity of many red-winged females to their polygynous territorial male was surprising and argued against searching for a male sterilant. On the other hand, beaver and Canada goose studies confirmed previous reports that both form par-bonds and are monogamous. Both should be vulnerable to a male chemosterilant approach, and research toward this goal is justified.

  6. Evaluation of an innovative radiographic technique - parallel profile radiography - to determine the dimensions of dentogingival unit

    Directory of Open Access Journals (Sweden)

    Sushama R Galgali

    2011-01-01

    Full Text Available Background: Maintenance of gingival health is a key factor for longevity of the teeth as well as of restorations. The physiologic dentogingival unit (DGU, which is composed of the epithelial and connective tissue attachments of the gingiva, functions as a barrier against microbial entry into the periodontium. Invasion of this space triggers inflammation and causes periodontal destruction. Despite the clinical relevance of the determination of the length and width of the DGU, there is no standardized technique. The length of the DGU can be either determined by histologic preparations or by transgingival probing. Although width can also be assessed by transgingival probing or with an ultrasound device, they are either invasive or expensive Aims: This study sought to evaluate an innovative radiographic exploration technique - parallel profile radiography - for measuring the dimensions of the DGU on the labial surfaces of anterior teeth. Materials and Methods: Two radiographs were made using the long-cone parallel technique in ten individuals, one in frontal projection, while the second radiograph was a parallel profile radiograph obtained from a lateral position. The length and width of the DGU was measured using computer software. Transgingival probing (trans-sulcular was done for these same patients and length of the DGU was measured. The values obtained by the two methods were compared. Pearson product correlation coefficient was calculated to examine the agreement between the values obtained by PPRx and transgingival probing. Results: The mean biologic width by the parallel profile radiography (PPRx technique was 1.72 mm (range 0.94-2.11 mm, while the mean thickness of the gingiva was 1.38 mm (range 0.92-1.77 mm. The mean biologic width by trans-gingival probing was 1.6 mm (range 0.8-2.2mm. Pearson product correlation coefficient (r for the above values was 0.914; thus, a high degree of agreement exists between the PPRx and TGP techniques

  7. 75 FR 8043 - National Medal of Technology and Innovation Nomination Evaluation Committee

    Science.gov (United States)

    2010-02-23

    ... Technology and Innovation; presidents or distinguished faculty of universities; or senior executives of non... intimate knowledge of the forces determining future directions for their organizations and industries. The... process. The United States Patent and Trademark Office is committed to equal opportunity in the workplace...

  8. Evaluating IT innovations in a business-to-government context: Frameworks its applications

    NARCIS (Netherlands)

    Liu, J.; Raus, M.; Kipp, A.

    2010-01-01

    This paper highlights the challenges of assessing the value of business-to-government IT innovations for both private and public stakeholders. Due to the different backgrounds of inhomogeneous stakeholders, potential adopters of business-to-government systems have varying requirements; in

  9. An Evaluation of an Innovative Drug Education Program: Follow-Up Results.

    Science.gov (United States)

    Moskowitz, Joel M.; And Others

    This study provides a follow-up assessment of an innovative drug education program for seventh and eighth graders. Students learned Lasswell's framework for understanding human needs and motives, a systematic decision-making procedure, and information about the pharmacological, psychological, and social consequences of licit and illicit drug use.…

  10. [Hospital-based health technology assessment in France: how to proceed to evaluate innovative medical devices?].

    Science.gov (United States)

    Martelli, N; van den Brink, H; Denies, F; Dervaux, B; Germe, A F; Prognon, P; Pineau, J

    2014-01-01

    Innovative medical devices offer solutions to medical problems and greatly improve patients' outcomes. Like National Health Technology Assessment (HTA) agencies, hospitals face numerous requests for innovative and costly medical devices. To help local decision-makers, different approaches of hospital-based HTA (HB-HTA) have been adopted worldwide. The objective of the present paper is to explore HB-HTA models for adopting innovative medical devices in France and elsewhere. Four different models have been conceptualized: "ambassador" model, "mini-HTA" model, "HTA unit" model and "internal committee". Apparently, "HTA unit" and "internal committee" (or a mixture of both models) are the prevailing HB-HTA models in France. Nevertheless, some weaknesses of these models have been pointed out in previous works. Only few examples involving hospital pharmacists have been found abroad, except in France and in Italy. Finally, the harmonization of the assessment of innovative medical devices in France needs a better understanding of HB-HTA practices. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  11. Dynamic Tensions: Early Reflections from MDRC's Evaluation of the Innovative Professional Development Challenge

    Science.gov (United States)

    MDRC, 2015

    2015-01-01

    In the Innovative Professional Development (iPD) Challenge, the Bill & Melinda Gates Foundation has invested in helping school districts and networks redesign their instructional support systems to better support educators in increasing student success. This Issue Focus, the second in a series, presents early reflections from MDRC's evaluation…

  12. Innovations in climate policy: the politics of invention, diffusion, and evaluation

    NARCIS (Netherlands)

    Jordan, A.; Huitema, D.

    2014-01-01

    The governance of climate change is in flux. In the understandable rush to explore what is filling the governance gaps created by gridlock in the international regime, scholars risk under-appreciating the capacity of states to engage in policy innovation at national and sub-national levels. Based on

  13. Design Research as a Mechanism for Consultants to Facilitate and Evaluate Educational Innovations

    Science.gov (United States)

    Castillo, Jose M.; Dorman, Clark; Gaunt, Brian; Hardcastle, Beth; Justice, Kelly; March, Amanda L.

    2016-01-01

    Schools across the nation are implementing innovative practices; however, questions remain regarding how to facilitate quality implementation. Research designs that emphasize high degrees of control over independent variables result in findings with internal validity, but that may not generalize to complex, dynamic educational systems. The purpose…

  14. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups.

    Science.gov (United States)

    Yap, Tracey L; Kennerly, Susan; Corazzini, Kirsten; Porter, Kristie; Toles, Mark; Anderson, Ruth A

    2014-07-25

    The purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI) model guided staff interviews about their perceptions of the intervention's characteristics, outcomes, and sustainability. This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members). One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. The a priori codes (observability, trialability, compatibility, relative advantage and complexity) described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled "brainstormed ideas", focusing on strategies for improving the innovation. Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  15. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups

    Directory of Open Access Journals (Sweden)

    Tracey L. Yap

    2014-07-01

    Full Text Available The purpose of the manuscript is to describe long-term care (LTC staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI model guided staff interviews about their perceptions of the intervention’s characteristics, outcomes, and sustainability. Methods: This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members. One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. Results: The a priori codes (observability, trialability, compatibility, relative advantage and complexity described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled “brainstormed ideas”, focusing on strategies for improving the innovation. Implications: Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  16. 76 FR 80901 - National Medal of Technology and Innovation Nomination Evaluation Committee

    Science.gov (United States)

    2011-12-27

    ... to the review and selection of finalists for the National Medal of Technology and Innovation, and must uphold the confidential nature of an independent peer review and competitive selection process... the following SPECIAL EMPHASIS areas are particularly sought: Microbiology, Medical Science, Energy...

  17. Multicriteria evaluation of innovative IPM systems in pome fruit in Europe

    NARCIS (Netherlands)

    Caffi, T.; Helsen, H.H.M.; Rossi, V.; Holb, I.J.; Strassemeyer, J.; Buurma, J.S.; Capowiez, Y.; Simon, S.; Alaphilippe, A.

    2017-01-01

    Pesticides represent the major input in pome fruit across Europe. They are mainly used on a calendar-based approach in order to control a large number of pests and diseases causing both direct and indirect losses. This situation has stimulated research for innovative tools and methods for pest

  18. Delayed Presentation of Traumatic Diaphragmatic Hernia: The Evaluation of Surgical Treatment Results

    Directory of Open Access Journals (Sweden)

    Ali Sadrizadeh

    2015-06-01

    Full Text Available Introduction: Diaphragmatic hernia could be caused by congenital disorders, blunt trauma or penetrating injuries. The diagnosis of traumatic diaphragmatic hernia is normally neglected during the first presentation leading to late complications and considerably increased mortality and morbidity among the patients. Materials and Methods: In this retrospective, descriptive study, we reviewed the medical records of patients presented with traumatic diaphragmatic hernia who had undergone surgical operations between 1982-2015 in Ghaem Hospital and Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran. The studied variables included age, gender, clinical symptoms, location of hernia, involved organs, type of imaging modalities, surgical techniques, length of hospital stay, mortality rate and surgical complications. Results: In this study, 38 patients were diagnosed with traumatic diaphragmatic hernia consisting of 28 men and 10 women. In total, 79% and 21% of the patients suffered from penetrating trauma and blunt trauma, respectively. In addition, left-sided, right-sided and bilateral hernias were present in 33%, 4% and 1% of the patients, respectively. The most frequently herniated organ was the stomach, and the most common clinical symptoms were abdominal pain (84% and dyspnea (53%. Initially, chest radiographs were performed on all the patients, and thoracotomy was performed to repair diaphragmatic tears in all the cases (100%. In this study, 3 patients had previously undergone Hartmann’s operation for gangrenous herniated colon, and devolvulation of gastric volvulus had also been performed on 3 patients. The main post-operative complications were reported to be pneumonia and respiratory insufficiency (2 cases, and the mean length of hospital stay was 6 days (5-8 days which was longer (1-2 months in patients with gangrenous bowel (3 patients. Furthermore, no mortality was reported during the course of hospitalization in these

  19. A broadly applicable surgical teaching method: evaluation of a stepwise introduction to cataract surgery.

    Science.gov (United States)

    Kloek, Carolyn E; Borboli-Gerogiannis, Sheila; Chang, Kenneth; Kuperwaser, Mark; Newman, Lori R; Lane, Anne Marie; Loewenstein, John I

    2014-01-01

    Although cataract surgery is one of the most commonly performed surgeries in the country, it is a microsurgical procedure that is difficult to learn and to teach. This study aims to assess the effectiveness of a new method for introducing postgraduate year (PGY)-3 ophthalmology residents to cataract surgery. Hospital-based ophthalmology residency program. Retrospective cohort study. PGY-3 and PGY-4 residents of the Harvard Medical School Ophthalmology Residency from graduating years 2010 to 2012. In July 2009, a new method of teaching PGY-3 ophthalmology residents cataract surgery was introduced, which was termed "the stepwise introduction to cataract surgery." This curriculum aimed to train residents to perform steps of cataract surgery by deliberately practicing each of the steps of surgery under a structured curriculum with faculty feedback. Assessment methods included surveys administered to the PGY-4 residents who graduated before the implementation of these measures (n = 7), the residents who participated in the first and second years of the new curriculum (n = 16), faculty who teach PGY-4 residents cataract surgery (n = 8), and review of resident Accreditation Council for Graduate Medical Education surgical logs. Resident survey response rate was 100%. Residents who participated in the new curriculum performed more of each step of cataract surgery in the operating room, spent more time practicing each step of cataract surgery on a cataract surgery simulator during the PGY-3 year, and performed more primary cataract surgeries during the PGY-3 year than those who did not. Faculty survey response rate was 63%. Faculty noted an increase in resident preparedness following implementation of the new curriculum. There was no statistical difference between the precurriculum and postcurriculum groups in the percentage turnover of cataracts for the first 2 cataract surgery rotations of the PGY-4 year of training. The introduction of cataract surgery to PGY-3 residents

  20. SCIENTIFIC AND INNOVATIVE APPROACH TO PROBLEM PERTAINING TO EVALUATION AND MONITORING OF ENVIRONMENT QUALITY IN REPUBLIC OF BELARUS

    Directory of Open Access Journals (Sweden)

    I. V. Voytov

    2009-01-01

    Full Text Available The paper proposes a scientific and innovative approach to solution of an important problem in the field of rational nature management and ecology which presupposes realization of evaluation, analysis and monitoring of environment  quality  (EQ in Belarus.  This  approach is based on methods and  facilities  of  administrative-command  and  partially  automatic-control  management.   The  main components of the innovative approach are an automatic  system for  evaluation and monitoring of EQ including estimation and formation of nature-resource potential within 11 cadaster and other data base, general principles on evaluation and monitoring of EQ, structural and algorithmic schemes for evaluation of ecological state of administrative territories, calculation of generalized indices of nature-territorial complexes and solution of nature protection problems in respect of EQ monitoring. A system of equation calculation for the analysis and evaluation of technogenic load on main nature components of the environment (free air, water objects, soil cover, realization of monitoring function in respect of EQ and ecological state of local and urban territories, nature resources  and enterprises, pollution and state of some recipients and also data resources for execution of analytical calculations and functions directed on monitoring quality of nature components of the environment is advanced in the paper.

  1. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients......Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications...... surgery, skull-base surgery, and foreign body removal were the areas of interests. Results: The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign...

  2. COMPARATIVE EVALUATION OF SURGICAL CORRECTION METHODS OF VESICO-URETERIC REFLUX IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. P. Yatsyk

    2014-01-01

    Full Text Available Background: To compare different surgical correction methods of vesico-ureteric reflux in children using both open surgery and endoluminal (intraluminal treatment options of this pathology. Patients and methods: 166 patients aged from 4 months to 13 were examined and treated. All children underwent X-ray urological examination through cystography and ultrasound examination of kidneys and urocyst. Cohen's operation, STING procedure involving endoscopic injection of bulking agents was performed. Treatment results were assessed 6 months later through control cystography. Conclusion: Endoscopic correction of vesico-ureteric reflux is an effective and minimally invasive treatment method for this pathology. Maximum treatment effect after biodegradable bulking agents application should be expected in younger age group. Treatment rates of endoluminal correction of vesico-ureteric reflux with the use of sterile viscous gel as a fixing agent are higher than with the use of bovine collagen.

  3. Healing and evaluating guinea pig skin incision after surgical suture and laser tissue by welding using in vivo Raman spectroscopy

    Science.gov (United States)

    Alimova, A.; Sriramoju, V.; Chakraverty, R.; Muthukattil, R.; Alfano, R. R.

    2010-02-01

    Changes in collagen in the wound during the healing process of guinea pig skin following surgical incisions and LTW was evaluated using in vivo, using Raman spectroscopy. Raman spectroscopy provided information regarding the internal structure of the proteins. After the incisions were closed either by suturing or by LTW the ratio of the Raman peaks of the amide III (1247 cm-1) band to a peak at 1326 cm-1 used to evaluate the progression of collagen deposition. Histopathology was used as the gold standard. LTW skin demonstrated better healing than sutured skin, exhibiting minimal hyperkeratosis, minimal collagen deposition, near-normal surface contour, and minimal loss of dermal appendages. This work is important to plastic surgery.

  4. Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures.

    Science.gov (United States)

    Reynolds, Kellin; Barnhill, Danny; Sias, Jamie; Young, Amy; Polite, Florencia Greer

    2014-12-01

    A portable electronic method of providing instructional feedback and recording an evaluation of resident competency immediately following surgical procedures has not previously been documented in obstetrics and gynecology. This report presents a unique electronic format that documents resident competency and encourages verbal communication between faculty and residents immediately following operative procedures. The Microsoft Tag system and SurveyMonkey platform were linked by a 2-D QR code using Microsoft QR code generator. Each resident was given a unique code (TAG) embedded onto an ID card. An evaluation form was attached to each resident's file in SurveyMonkey. Postoperatively, supervising faculty scanned the resident's TAG with a smartphone and completed the brief evaluation using the phone's screen. The evaluation was reviewed with the resident and automatically submitted to the resident's educational file. The evaluation system was quickly accepted by residents and faculty. Of 43 residents and faculty in the study, 38 (88%) responded to a survey 8 weeks after institution of the electronic evaluation system. Thirty (79%) of the 38 indicated it was superior to the previously used handwritten format. The electronic system demonstrated improved utilization compared with paper evaluations, with a mean of 23 electronic evaluations submitted per resident during a 6-month period versus 14 paper assessments per resident during an earlier period of 6 months. This streamlined portable electronic evaluation is an effective tool for direct, formative feedback for residents, and it creates a longitudinal record of resident progress. Satisfaction with, and use of, this evaluation system was high.

  5. Public support to firm level innovation: an evaluation of the FONTEC Program

    Directory of Open Access Journals (Sweden)

    Alessandro Maffioli

    2012-07-01

    Full Text Available Os governos latino-americanos recorrem frequentemente aos Fundos de Desenvolvimento Tecnológico (FDT para apoiar financeiramente as atividades inovadoras das empresas. Neste estudo analisamos a eficácia do um FDT chileno, o programa FONTEC. Constatamos que os subsídios do FONTEC provocaram um aumento dos investimentos inovadores das empresas em ativos intangíveis (principalmente P&D, além de melhorarem as articulações entre atores no sistema de inovação. Entretanto, embora não tenhamos detectado indícios de crowding out (inibição, tampouco encontramos quaisquer evidências de aumento do financiamento privado da inovação devido aos subsídios (crowding in. Em termos de adicionalidade de resultados (output additionality, o FONTEC de fato aumentou a geração de emprego e a produtividade das empresas beneficiárias. As conclusões quanto a habilidades foram mais mistas, mas isso pode ter sido afetado pela baixa qualidade da variável habilidades na enquete.Latin American Governments have frequently adopted Technology Development Funds (TDF to provide financial support for innovation activities of firms. In this paper, we analyzed the effectiveness of a Chilean TDF, the FONTEC program. We found that FONTEC’s subsidies increased firm innovation investments in intangible assets (in particular R&D and they also improved the linkages among actors in the innovation system. However, although we did not find any evidence of crowding-out effects, neither did we find any evidence of the leveraging of private financing for innovation (crowding-in. In terms of output additionality, FONTEC did significantly increase the employment and productivity of beneficiary firms. The findings with regards to skills are more mixed, but this could be affected by the poor quality of the skills variable in the survey.

  6. INNOVATIVE METHODS TO EVALUATE THE RELIABILITY OF INFORMATION CONSOLIDATED FINANCIAL STATEMENTS

    Directory of Open Access Journals (Sweden)

    Irina P. Kurochkina

    2014-01-01

    Full Text Available The article explores the possibility of using foreign innovative methods to assess the reliabilityof information consolidated fi nancial statements of Russian companies. Recommendations aremade under their adaptation and applicationinto commercial organizations. Banish methodindicators are implemented in one of the world’s largest vertically integrated steel and miningcompanies. Audit firms are proposed to usemethods of assessing the reliability of information in the practical application of ISA.

  7. Evaluation of lid speculum with a drape (LiDrape® for preventing surgical-field contamination

    Directory of Open Access Journals (Sweden)

    Urano T

    2015-07-01

    Full Text Available Toru Urano,1 Masataka Kasaoka,1 Kimitaka Sagawa,2 Ryoji Yamakawa1 1Department of Ophthalmology, Kurume University School of Medicine, 2Department of Laboratory Medicine, Kurume University Hospital, Kurume, Japan Purpose: To compare the degree of surgical-field contamination in cataract surgeries between a new draping method using a lid speculum with a drape (LiDrape® and a conventional draping method. Methods: Cataract surgery was performed on 21 eyes using LiDrape® (LiDrape® group and on 22 eyes using a conventional draping method (conventional group. Contamination was evaluated by bacterial culture of conjunctival sac scrapings and ocular surface irrigation fluid. Conjunctival sac scrapings were collected before and after application of preoperative antibiotics. Ocular surface irrigation fluid was collected before incision placement and during surgery. Bacterial detection rate and types of organisms isolated at these four time points were examined. Results: Bacterial detection rates were significantly decreased in the LiDrape® group at all time points after the application of antibiotics compared with preapplication. Regarding between-group comparisons, the bacterial detection rate in the LiDrape® group was only significantly lower than that in the conventional group in the intraoperative sample. Propionibacterium acnes was the most common organism isolated from ocular surface irrigation fluid. The number of P. acnes in the intraoperative sample was significantly lower in the LiDrape® group compared with the conventional group. There were no significant differences in detection rates for other bacteria between the groups. Conclusion: LiDrape® was as effective as conventional draping for preventing surgical-field contamination. The number of P. acnes during surgery was significantly lower in the LiDrape® group compared with the conventional group, suggesting that LiDrape® may contribute to the prevention of postoperative infection

  8. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-06-01

    Full Text Available OBJECTIVES: To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over.METHODS: Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65-69 years (49.1%, 70-74 (26.4% and 75 years and over (24.5%. Their mean age was 71 years (range: 65-83. There were 63 male patients (38.7%. The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months. Sixty-two patients (38% reported histories of trauma and 26 (16% reported that their pain worsened through exertion.RESULTS: From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001 between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027 with the postoperative results: the longer this time was, the worse the results were.CONCLUSION: Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were.

  9. Evaluation of Students' Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs.

    Science.gov (United States)

    Joshi, Anuradha; Ganjiwale, Jaishree

    2015-07-01

    Various studies in medical education have shown that active learning strategies should be incorporated into the teaching-learning process to make learning more effective, efficient and meaningful. The aim of this study was to evaluate student's perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student's perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Descriptive analysis. Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on "Autobiography of Drugs" was taken as a positive learning experience by students. Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes.

  10. Innovative learning for innovation

    NARCIS (Netherlands)

    Dr.Ir. Hay Geraedts

    2010-01-01

    Introduction Innovation is crucial for companies who have to react to constantly changing markets. Several national and European research institutes stress the importance of developing innovation for small and medium size enterprises (SMEs). This was a trigger to design a minor on strategic

  11. Evaluation and comparison of laser surgery and surgical blade in the treatment of epulis fissuratum

    Directory of Open Access Journals (Sweden)

    Mahmood Hashemi H

    2005-07-01

    Full Text Available Background and Aim: The treatment of epulis fissuratum is surgery, but a new proposed modality is laser surgery. The aim of this study was the comparison between laser and blade surgery in the treatment of epulis fissuratum. Materials and Methods: In this clinical trial, 12 patients with epulis fissuratum were selected. The lesions were divided into two parts. One part was resected by laser and the other by surgical blade randomly and single blinded. The time of surgery, bleeding, wound repairment as well as the depth of vestibule were measured. Data were analyzed using Wilcoxon sign test and Paired t test with P<0.05 as the limit of significance. Results: The wound of laser surgery healed sooner and the depth of vestibule in laser side was deeper comparing with blade surgery. Also the time of surgery was less than blade. Conclusion: Based on the results of this study, we suggest that laser surgery is a more useful technique for the treatment of epulis fissuratum.

  12. Secondary Cleft Nasolabial Deformities: A New Classification System for Evaluation and Surgical Revision.

    Science.gov (United States)

    Sittah, Ghassan Abu; Ghanem, Odette Abou; Hamdan, Usama; Ramia, Paul; Zgheib, Elias

    2017-01-17

      Secondary or residual cleft lip and nasal deformities following primary unilateral or bilateral cleft lip repair are common. Many classification systems have been proposed to describe congenital cleft lip and palate deformities before repair. This article proposes a one-of-a-kind classification system for residual cleft deformities and describes its application to 136 cleft lip revision cases from cleft outreach missions worldwide.   Patients' demographics and deformities were classified preoperatively, and a database of the classification was created. Postoperatively, the type of surgery performed was added to the database and comparison was done using an independent t test.   Kappa coefficient was 0.92 and showed excellent agreement between the type assigned preoperatively to the patient and the type of procedure done.   This system proves to provide good descriptions of the deformities, is user friendly, facilitates the planning of the corrective surgical procedure, and enhances the communicative lingo between surgeons and members of cleft multidisciplinary care teams. It is broadly applicable in outreach missions with limited resources and cleft referral centers with considerable load.

  13. [Evaluation of surgical skills in medical students using a virtual simulator].

    Science.gov (United States)

    Sabench Pereferrer, Fàtima; Hernández González, Mercè; Muñoz García, Andrés; Cabrera Vilanova, Arantxa; Del Castillo Déjardin, Daniel

    2013-03-01

    The use of virtual simulators together with hospital practicals during undergraduate training can improve basic surgical skills, and may even be an important motivating focal point. The aim of this work is to determine the endoscopy skill level and its learning curve in three stages within the Medical degree (second, fourth, and sixth year) using a virtual simulator. The Lapsim simulator with 7 basic modular exercises was used. Twenty four students (8 second, 8 fourth, and 8 sixth year) were subjected to a training program (basic test plus 3 sessions), and an examination at 30 days. A control group (n=24) from each year were subjected to 2 examinations with an interval of 30 days. All the groups improved significantly after training, and this was maintained in all the exercises after a "wash out" period of 30 days. All the groups achieved lower baseline scores in the "Cutting" and "Lifting and grasping" exercises, considered of intermediate level than any of the others. However, after the training process, they were the only exercises that the sixth year students demonstrated that they were clearly superior to the rest of the years: "Cutting" (94.5%±11 vs 81%±7) (PSurgical skills during this phase should be reinforced by means of new teaching challenges, such as simulation programs in the framework of skills laboratories. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  14. Comprehensive evaluation of 11 cytokines in premature infants with surgical necrotizing enterocolitis.

    Directory of Open Access Journals (Sweden)

    Thomas Benkoe

    Full Text Available OBJECTIVE: A prospective study to investigate the pattern of pro- and anti-inflammatory cytokine responses in neonates with surgical necrotizing enterocolitis (NEC and identify those cytokines being the most promising for future research. METHODS: A panel of 11 different cytokines were measured in 9 infants with proven NEC and compared with 18 age-matched healthy neonates. RESULTS: The serum concentrations of the interleukins (IL-6, IL-8, and IL-10 were significantly (32-fold to 56-fold higher in NEC infants compared with controls. In contrast, IL-5, IFN gamma, IL-4 and IL-2 showed slightly (1.4-fold to 5.9-fold lower levels in the NEC samples. However, these cytokines showed a very low absolute concentration in infants with NEC and in controls. The sum of the serum concentrations of IL-6, IL-8 and IL-10 was able to clearly separate infants with NEC from control samples. IL-1 beta and TNF-alpha showed no statistically different levels. The serum levels of TNF-beta and IL-12p70 were below the detection limit in more than 50% of all samples per group. CONCLUSION: In spite of strong local inflammation only three out of eleven cytokines (IL-6, IL-8, and IL-10 showed strongly increased serum levels indicating an important role of them in the pathogenesis of NEC. At least two of these three cytokines were elevated in every single NEC patient. Thus, longitudinal monitoring of combined IL-8, IL-6, and IL-10 levels could reveal their potency in being clinical relevant markers in NEC.

  15. Hargreaves does not evaluate nociception following a surgical laparotomy in Xenopus leavis frogs.

    Science.gov (United States)

    Vachon, P

    2014-10-01

    The present study was performed to determine the effectiveness of the Hargreaves test for the evaluation of nociception in frogs, more precisely to determine if cutaneous thresholds to a radiant heat stimulus would increase with analgesics following an abdominal laparotomy performed under general anaesthesia. Non breeding female Xenopus leavis frogs (3 groups (non-anaesthetized, anaesthetized with tricaine methanesulfonate (MS222), with or without an abdominal laparotomy) were used to evaluate the effectiveness of the Hargreaves test. Cutaneous thresholds were evaluated at baseline and following anaesthetic recovery (over 8 h) at six different body locations. Increased reaction times were observed in the gular area only at 1 h post-recovery following a MS222 bath immersion in frogs with (p nociception induced by an abdominal laparotomy and consequently cannot be used to evaluate analgesics in X. leavis frogs. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  16. The cement-augmented transiliacal internal fixator (caTIFI): an innovative surgical technique for stabilization of fragility fractures of the pelvis.

    Science.gov (United States)

    Schmitz, Paul; Baumann, Florian; Grechenig, Stephan; Gaensslen, Axel; Nerlich, Michael; Müller, Michael B

    2015-10-01

    Analyzing the different age groups in a population who suffered a pelvic ring fracture it becomes obvious that there are important differences between the pelvic ring lesions of an elderly patient compared to a young adult concerning trauma mechanism, fracture pattern and therapeutic options. In the elderly patient it is very important to achieve maximum of stability if surgery is necessary in order to avoid early failure of the ostheosynthesis under mobilization with full weight bearing. 15 patients (14 female) with fragility fractures of the pelvis that required surgical stabilization were eligible to participate in this study from December 2012 to December 2014. Such details were documented and analysed as patient demographics, mechanism of injury, fracture classification, operative treatment and postoperative radiological parameters of achieved bone-implant interface. The average age of the patients was 79.9 years (SD 9.0 years). According to Rommens five patients had a fragility fracture of the pelvis Type II-c, one a Type III-c, six a Type IV-b and three a Type IV-c. Four patients were treated by a cement augmented transiliac internal fixation (caTIFI). Seven patients received a cement augmented iliolumbar fixation. In all these patients the Schanz screws applied to the ilium were placed in an oblique dorsoventral direction into the supraacetabular bone canal (mean length of screws 100 ± 20mm, max. 135 mm, min. 70 mm). Even though in four patients the iliosacral joint was hit tangential and one cortex perforation without any cement leakage appeared no revision surgery was necessary. Overall the clinical findings including mobilisation with full weight bearing showed a sufficient mechanically stability in all patients. The focus of this study was to describe the modified surgical technique of the caTIFI with placing the Schanz screws from the posterior superior iliac spine to the anterior inferior iliac spine into the supraacetabular bone canal. Usage of

  17. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  18. EVALUATION OF DIFFERENTIATION OF SOCIO-ECONOMIC DEVELOPMENT OF REGIONS IN INNOVATIVE STRATEGY OF RUSSIA

    Directory of Open Access Journals (Sweden)

    Marina Buyanova

    2018-01-01

    Full Text Available The problem of asymmetry, uneven development has been the most important problem of the state for a long time. The concept of asymmetry is multifaceted, and can manifest itself in various aspects of the development of the region. The article identifies the prerequisites for differentiation, asymmetry, which are diverse and related both to natural and climatic, as well as to historical, political, and economic conditions. Each constituent entity of the federation, developing its own strategy of innovative development, should take into account both state priorities and the opportunities and specifics of regional development and their competitive advantages in specific science-intensive industries. Among the main prerequisites objectively contributing to the disproportion of the socioeconomic status of the subjects of the South of Russia are the following: area size, demography (number and density of population, geolocation, etc. As a result of the study of the differentiation of the socio-economic development of the regions of the Southern Federal District, the authors note a certain tendency: for several years inequality in the explored development of regions exists, but it is not dynamic. The graduation of the regions, with respect to practically every indicators considered, remains unchanged. The dynamics is observed only relative to the base value of the indicator for each of the subjects of the district, without violating the overall degree of differentiation. Consequently, the existence of strategies for socio-economic development of the regions is not yet a guarantee that development in these regions will reach a new trajectory. Many external and internal factors can influence it. Nevertheless, it is necessary to know the guidelines of innovative development and to look for ways out of the existing imbalance in this development. Thus, developing their own strategy of innovative development, regions need to create starting conditions for

  19. Counterfactual Impact Evaluation of Public Funding of Innovation, Investment and R&D.

    OpenAIRE

    Bondonio, Daniele; BIAGI FEDERICO; STANCIK JURAJ

    2015-01-01

    This report uses data from Efige and from Bureau Van Dijk’s Amadeus and Orbis to estimate the effect of funding from the EU and national programmes on firms’ employment, sales, added value, productivity and innovativeness. It also looks at the impact of subsidies to investment and R&D (irrespective of the source of funding) on the same variables. In the first part of the report we use only the Efige dataset (covering the years 2007- 2009) and we look at (contemporaneous) correlation betwe...

  20. Surgical lighting

    OpenAIRE

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago, the last decades only minor developments have been made. This lack of significant development suggests that the current state of surgical lighting is perfectly developed and functions without any fla...

  1. The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer

    Science.gov (United States)

    Elibol, Funda Dinç; Obuz, Funda; Sökmen, Selman; Terzi, Cem; Canda, Aras Emre; Sağol, Özgül; Sarıoğlu, Sülen

    2016-01-01

    PURPOSE We aimed to evaluate preoperative T and N staging and retroperitoneal surgical margin (RSM) involvement in colon cancer using multidetector computed tomography (MDCT). METHODS In this retrospective study, preoperative MDCTs of 141 patients with colon adenocarcinoma were evaluated in terms of T and N staging and retroperitoneal surgical margin involvement by two observers. Results were compared with histopathology. RESULTS In determining extramural invasion, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MDCT were 81%, 50%, 95%, 26%, and 81% for observer 1 and 87%, 75%, 97%, 27%, and 84% for observer 2, respectively. Moderate interobserver agreement was observed (κ=0.425). In determining T stage of the tumor, accuracy of MDCT was 55% for observer 1 and 51% for observer 2. In the detection of lymph node metastasis, sensitivity, specificity, PPV, NPV, and accuracy of MDCT were 84%, 46%, 60%, 74% and 64% for observer 1 and 84%, 56%, 65%, 78%, and 70% for observer 2, respectively. Interobserver agreement was substantial (κ=0.650). RSM was involved in six cases (4.7%). When only retroperitoneal colon segments were considered, 1.6% of subjects demonstrated RSM involvement. Four of the six RSM-positive tumors were located on sigmoid colon and one tumor was on transverse colon and caecum. Considering all colon tumors, in the detection of RSM involvement, sensitivity and specificity of MDCT were 33% and 81% for observer 1 and 50% and 80% for observer 2. Interobserver agreement was moderate (κ=0.518). CONCLUSION MDCT is a promising technique with moderate interobserver agreement in detection of extramural invasion, lymph node metastases, and RSM involvement in colon carcinomas. PMID:26611110

  2. The role of multidetector CT in local staging and evaluation of retroperitoneal surgical margin involvement in colon cancer.

    Science.gov (United States)

    Elibol, Funda Dinç; Obuz, Funda; Sökmen, Selman; Terzi, Cem; Canda, Aras Emre; Sağol, Özgül; Sarıoğlu, Sülen

    2016-01-01

    We aimed to evaluate preoperative T and N staging and retroperitoneal surgical margin (RSM) involvement in colon cancer using multidetector computed tomography (MDCT). In this retrospective study, preoperative MDCTs of 141 patients with colon adenocarcinoma were evaluated in terms of T and N staging and retroperitoneal surgical margin involvement by two observers. Results were compared with histopathology. In determining extramural invasion, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MDCT were 81%, 50%, 95%, 26%, and 81% for observer 1 and 87%, 75%, 97%, 27%, and 84% for observer 2, respectively. Moderate interobserver agreement was observed (ĸ=0.425). In determining T stage of the tumor, accuracy of MDCT was 55% for observer 1 and 51% for observer 2. In the detection of lymph node metastasis, sensitivity, specificity, PPV, NPV, and accuracy of MDCT were 84%, 46%, 60%, 74% and 64% for observer 1 and 84%, 56%, 65%, 78%, and 70% for observer 2, respectively. Interobserver agreement was substantial (ĸ=0.650). RSM was involved in six cases (4.7%). When only retroperitoneal colon segments were considered, 1.6% of subjects demonstrated RSM involvement. Four of the six RSM-positive tumors were located on sigmoid colon and one tumor was on transverse colon and caecum. Considering all colon tumors, in the detection of RSM involvement, sensitivity and specificity of MDCT were 33% and 81% for observer 1 and 50% and 80% for observer 2. Interobserver agreement was moderate (ĸ=0.518). MDCT is a promising technique with moderate interobserver agreement in detection of extramural invasion, lymph node metastases, and RSM involvement in colon carcinomas.

  3. Unlocking the “black box” of practice improvement strategies to implement surgical safety checklists: a process evaluation

    Directory of Open Access Journals (Sweden)

    Gillespie BM

    2017-04-01

    Full Text Available Brigid M Gillespie,1–3 Kyra Hamilton,4 Dianne Ball,5 Joanne Lavin,6 Therese Gardiner,6 Teresa K Withers,7 Andrea P Marshall1–3 1School of Nursing & Midwifery, Griffith University, Gold Coast, 2Gold Coast University Hospital and Health Service, Southport, 3Nursing & Midwifery Education & Research Unit (NMERU, National Centre of Research Excellence in Nursing, Menzies Health Institute of Queensland, Griffith University, Gold Coast, 4School of Applied Psychology, Griffith University, Mt Gravatt, 5Communio Pty Ltd, Sydney, 6Nursing & Midwifery Education & Research Unit, 7Surgical and Procedural Services, Gold Coast University Hospital and Health Service, Southport, Australia Background: Compliance with surgical safety checklists (SSCs has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve.Objectives: The objective of this study was to undertake a process evaluation of four knowledge translation (KT strategies used to implement the Pass the Baton (PTB intervention which was designed to improve utilization of the SSC. Methods: As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Results: Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently

  4. Teaching innovation.

    Science.gov (United States)

    Lachman, Vicki D; Glasgow, Mary Ellen Smith; Donnelly, Gloria F

    2009-01-01

    Innovation in healthcare is essential to solve the "wicked problems" currently facing healthcare. This article focuses on nature of innovation and how it operates, how innovators think and view problems, how the theory and practice of innovation can be taught in novel ways, and how organizational cultures foster or suppress innovation. Examples of teaching strategies and nurse-driven innovation illustrate the theory and practice of innovation.

  5. Usefulness of computed tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality.

    Science.gov (United States)

    Toso, Francesco; Zuiani, Chiara; Vergendo, Maurizio; Salvo, Iolanda; Robiony, Massimo; Politi, Massimo; Bazzocchi, Massimo

    2005-01-01

    To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomic and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients after simulation of the procedure on the stereolithographyc model. The solid prototypes constructed in the difficult cases were sufficiently detailed despite problems related to the artefacts generated by dental fillings an d prostheses. In the remaining cases the MPR/3D images were sufficiently detailed for surgical planning. The surgical results were excellent in all patients who underwent surgery, and the surgeons were satisfied with the improvement in quality and the reduction in time required for the procedure. MDCT enables rapid prototyping using solid replication, which was very helpful in maxillo-facial surgery, despite problems related to artifacts due to dental fillings and prosthesis within the acquisition field; solutions for this problem are work in progress. The protocol used for communication between the different laboratories was valid and reproducible.

  6. Safety and Efficacy Evaluation of Pulsed Dye Laser Treatment, CO2 Ablative Fractional Resurfacing, and Combined Treatment for Surgical Scar Clearance.

    Science.gov (United States)

    Cohen, Joel L; Geronemus, Roy

    2016-11-01

    Surgical scars are an unwanted sequela following surgical procedures. Several different treatment modalities and approaches are currently being employed to improve the cosmesis of surgical scars with each having varying degrees of success. The objective of this study was to assess the ef cacy and safety pulsed dye laser treatment, CO2 ablative fractional resurfacing, and a combined treatment with these two modalities for the cosmetic improvement of surgical scarring that occurred following the surgical removal of skin cancer from different anatomic areas. Twenty-five patients with surgical scarring most frequently on the face following recent surgical excision of skin cancer with Mohs surgery were included in this multicenter, prospective clinical study. Patients were randomized into 4 treatment arms, namely, pulsed dye laser alone, CO2 laser alone, a combined treatment with these two modalities, and CO2 ablative fractional resurfacing on the same day of surgery to half of the scar, followed by a combined treatment with the two modalities to that half of the scar. Patients in each study arm received a total of 3-4 treatments, while those patients in Arm 4 underwent an additional treatment with CO2 laser immediately after surgery. Patients were followed up at 1 and 3 months after the final treatment session. No adverse events were seen. Significant improvements in the appearance of scars were achieved in all study arms, as as- sessed by the Vancouver Scar Scale and Global Evaluation Response scales, with the best clinical outcomes seen in those scars that underwent a combination treatment. All patients reported very high satisfaction from treatment. Both pulsed dye laser treatment and CO2 ablative fractional resurfacing, when used as a monotherapy, are safe and effective in the treatment and improvement of recent surgical scarring. When both of these modalities are used in combination, however, they appear to potentially have a synergistic effect and an accelerated

  7. Bone SPECT/CT of the Spine, Foot, and Ankle: Evaluation of Surgical Patients.

    Science.gov (United States)

    Waldman, Leah E; Scharf, Stephen C

    2017-11-01

    Radionuclide bone scanning has been used routinely in the evaluation of bone pathology for decades. The greatest strength of the procedure is its extreme sensitivity for bone metabolism, allowing it to distinguish between active and inactive bony abnormalities. The downside of this reliance on abnormal bone turnover is the relative lack of anatomical detail compared with ever-improving CT and MRI technology. Fusion imaging using SPECT/CT (SCT), PET/CT, and PET/MRI offers an opportunity to combine the sensitivity of nuclear medicine examinations with the anatomical detail of CT and MRI. This fusion of technologies is especially important in situations where anatomical imaging modalities alone provide insufficient diagnostic information. In this review, we highlight the utility of SPECT/CT bone imaging in the pre- and postoperative evaluation of patients undergoing procedures of the spine, foot, and ankle. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. [Evaluation of short-term surgical outcomes in facial paralysis patients treated by trigeminal neurotization].

    Science.gov (United States)

    Zotov, A V; Rzayev, D A; Dmitriev, A B; Chernov, S V; Moysak, G I

    The management of patients with facial nerve palsy is a challenge of modern neurosurgery. The study purpose was to evaluate the degree of facial nerve function recovery, following trigeminal neurotization. Trigeminal neurotization was performed in 23 patients within 1 to 10 months after the development of facial paralysis. In most cases, the cause of facial paralysis was surgery for space-occupying lesions of the cerebellopontine angle (95.6%). Outcomes of trigeminal neurotization were evaluated in 17 (73.9%) patients who were followed-up for more than 6 months. In 16 (94.1%) patients, the facial nerve function was recovered to a House-Brackmann grade III-IV. Given the surgery we can say that trigeminal neurotization is one of the effective treatments for facial paralysis. In most cases, this technique has provided good outcomes without additional complications, which is important for this group of patients.

  9. Use of Performance Measures to Evaluate, Document Competence and Deterioration of ASSET Surgical Skills

    Science.gov (United States)

    2016-05-01

    years after training) showed a large variety of interval experience since taking the ASSET course ( orthopedic , pediatric, plastic, general surgeons...loud” by the 10 experts, several key points became apparent that were then noted and included in possible discriminators. A consensus meeting of the...after ASSET training; Group 2: 35 practicing surgeons (pediatric, plastic, orthopedic , general or critical care surgeons) evaluated 2-4 years after

  10. The role of molecular strategies in the evaluation of surgical margins in oropharyngeal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Anastasios N. Kanatas

    2011-12-01

    Full Text Available The recurrence of a tumour at the resection margins in head and neck squamous cell carcinoma (HNSCC has profound implications on the morbidity and mortality of the patient. At present HNSCC does not undergo any form of molecular analysis to aid treatment strategy and prognosticate for those individuals at higher risk of recurrence. This article aims to review current research into molecular strategies for tumour evaluation, highlighting conflicting evidence and possible novel concepts for further exploration.

  11. SOFT TISSUE RECONSTRUCTION OF THE LOWER EXTREMITY: EVALUATION OF SURGICAL RESULTS IN 15 PATIENTS

    OpenAIRE

    Fatemi, M.J.; M Baghaei; M Soroush

    2003-01-01

    Introduction: There are general guidelines for reconstruction of complex wounds of the Lower extremity. The goal in treatment of these wounds is to preserve a limb that will be more functional than an amputation. Material & Methods: In this study, we evaluate our results in 15 patients with extensive wounds in lower extremities (April - 1998 to march - 2001). Results: The average age of the patients was 31.20 with an age range between 9 to 61 years. Majority of the patients were...

  12. An Innovative Tool for Intraoperative Electron Beam Radiotherapy Simulation and Planning: Description and Initial Evaluation by Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Pascau, Javier, E-mail: jpascau@mce.hggm.es [Unidad de Medicina y Cirugia Experimental, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Departamento de Bioingenieria e Ingenieria Aeroespacial, Universidad Carlos III de Madrid, Madrid (Spain); Santos Miranda, Juan Antonio [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Calvo, Felipe A. [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Departamento de Oncologia, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Bouche, Ana; Morillo, Virgina [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); Gonzalez-San Segundo, Carmen [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Ferrer, Carlos; Lopez Tarjuelo, Juan [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); and others

    2012-06-01

    Purpose: Intraoperative electron beam radiation therapy (IOERT) involves a modified strategy of conventional radiation therapy and surgery. The lack of specific planning tools limits the spread of this technique. The purpose of the present study is to describe a new simulation and planning tool and its initial evaluation by clinical users. Methods and Materials: The tool works on a preoperative computed tomography scan. A physician contours regions to be treated and protected and simulates applicator positioning, calculating isodoses and the corresponding dose-volume histograms depending on the selected electron energy. Three radiation oncologists evaluated data from 15 IOERT patients, including different tumor locations. Segmentation masks, applicator positions, and treatment parameters were compared. Results: High parameter agreement was found in the following cases: three breast and three rectal cancer, retroperitoneal sarcoma, and rectal and ovary monotopic recurrences. All radiation oncologists performed similar segmentations of tumors and high-risk areas. The average applicator position difference was 1.2 {+-} 0.95 cm. The remaining cancer sites showed higher deviations because of differences in the criteria for segmenting high-risk areas (one rectal, one pancreas) and different surgical access simulated (two rectal, one Ewing sarcoma). Conclusions: The results show that this new tool can be used to simulate IOERT cases involving different anatomic locations, and that preplanning has to be carried out with specialized surgical input.

  13. Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults

    Directory of Open Access Journals (Sweden)

    Maffulli Nicola

    2009-11-01

    Full Text Available Abstract Background Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory. In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision. Methods/Design We aim to undertake a pragmatic UK-based multi-centre randomised controlled trial evaluating the effectiveness and cost-effectiveness of surgical versus standard non-surgical treatment for adults with an acute closed displaced fracture of the proximal humerus with involvement of the surgical neck. The choice of surgical intervention is left to the surgeon, who must use techniques that they are fully experienced with. This will avoid 'learning curve' problems. We will promote good standards of non-surgical care, similarly insisting on care-provider competence, and emphasize the need for comparable provision of rehabilitation for both groups of patients. We aim to recruit 250 patients from a minimum of 18 NHS trauma centres throughout the UK. These patients will be followed-up for 2 years. The primary outcome is the Oxford Shoulder Score, which will be collected via questionnaires completed by the trial participants at 6, 12 and 24 months. This is a 12-item condition-specific questionnaire providing a total score based on the person's subjective assessment of pain and activities of daily living impairment. We will also collect data for other outcomes, including general health measures and complications, and for an economic evaluation. Additionally, we plan a systematic collection of reasons for non-inclusion of eligible patients who were not recruited into the trial, and their baseline

  14. Building an immune-mediated coagulopathy consensus: early recognition and evaluation to enhance post-surgical patient safety

    Directory of Open Access Journals (Sweden)

    Voils Stacy A

    2009-05-01

    Full Text Available Abstract Topical hemostats, fibrin sealants, and surgical adhesives are regularly used in a variety of surgical procedures involving multiple disciplines. Generally, these adjuncts to surgical hemostasis are valuable means for improving wound visualization, reducing blood loss or adding tissue adherence; however, some of these agents are responsible for under-recognized adverse reactions and outcomes. Bovine thrombin, for example, is a topical hemostat with a long history of clinical application that is widely used alone or in combination with other hemostatic agents. Hematologists and coagulation experts are aware that these agents can lead to development of an immune-mediated coagulopathy (IMC. A paucity of data on the incidence of IMC contributes to under-recognition and leaves many surgeons unaware that this clinical entity, originating from normal immune responses to foreign antigen exposure, requires enhanced post-operative vigilance and judicious clinical judgment to achieve best outcomes. Postoperative bleeding may result from issues such as loosened ties or clips or the occurrence of a coagulopathy due to hemodilution, vitamin K deficiency, disseminated intravascular coagulation (DIC or post-transfusion, post-shock coagulopathic states. Other causes, such as liver disease, may be ruled out by a careful patient history and common pre-operative liver function tests. Less common are coagulopathies secondary to pathologic immune responses. Such coagulopathies include those that may result from inherent patient problems such as patients with an immune dysfunction related to systemic lupus erythrematosus (SLE or lymphoma that can invoke antibodies against native coagulation factors. Medical interventions may also provoke antibody formation in the form of self-directed anti-coagulation factor antibodies, that result in problematic bleeding; it is these iatrogenic post-operative coagulopathies, including those associated with bovine thrombin

  15. [Postpyloric feeding tubes for surgical intensive care patients. Pilot series to evaluate two methods for bedside placement].

    Science.gov (United States)

    Schröder, S; van Hülst, S; Claussen, M; Petersen, K; Pich, B; Bein, B; von Spiegel, T

    2011-03-01

    Bedside placement of postpyloric feeding tubes in surgical intensive care patients: a pilot series to evaluate two methods. Early enteral feeding is thought to be a key factor in maintaining the integrity of the gastrointestinal tract mucosal barrier associated with less bacterial translocation and decreased stimulation of the systemic inflammatory response and subsequent improved outcome in intensive care patients. Thus enteral feeding by nasogastric tubes is the preferred route of nutritional support for most surgical intensive care patients. However, intensive care patients with delayed gastric emptying and poor intestinal motility may not tolerate gastric feeding and may therefore benefit from postpyloric feeding. Postpyloric feeding tube placement may be achieved by endoscopic procedures or different bedside techniques with variable success. In the present study two feeding tubes for bedside postpyloric placement without endoscopic assistance were compared. The time to successful positioning was compared for jejunal feeding tubes from the companies Cook (Tiger 2™) and PortaMedical (Corflo-Tube®). The description for the Tiger 2™ states that because of its design slight residual peristalsis can cause it to migrate from the stomach to the jejunum. The Corflo-Tube® is also positioned at the bedside with the help of a detector and a monitor which maps the movements of the magnetic tip of the mandrin as it is pushed forward. Patients receiving early enteral nutrition through a gastric tube and exhibiting enhanced reflux, in spite of the head of the bed being raised and the administration of prokinetics randomly received either a Tiger 2™ or a Corflo-Tube®. The study included 41 patients from an intensive care ward for surgical patients and 13 out of 20 Tiger 2™-Tubes (65%) and 16 out of 21 Corflo-Tubes® (76%) were successfully positioned (p>0.05). The median time to successful positioning with the Corflo-Tubes® was 0.83 h (range 0.06-2.5 h), which was

  16. Evaluating the quality of life of patients with Cushing’s syndrome in surgical and conservative treatment

    Directory of Open Access Journals (Sweden)

    G.D. Narimova

    2017-03-01

    Full Text Available Research aim — to study the quality of life of patients with Cushing’s syndrome (CS depending on the disease duration and applied methods of treatment. Materials and methods. The features of quality of life were studied in 60 patients with CS applied for infertility. The average age of patients was 33.9 ± 12.5 years. The duration of disease was from 3 months to 5 years. The spectrum of researches included clinical, biochemical studies, radioimmune hormonal methods of analysis of the blood, ultrasonic densitometry, which were used in all patients. In all patients, we performed magnetic resonance imaging of the pituitary gland and computed tomography of adrenals. An oral glucose tolerance test was used, if necessary. To evaluate the quality of life of patients, the short version of health questionnaire was used (MOS 36-Item Short-Form Health Survey — MOS SF-36. 36 points of questionnaire were grouped in eight scales. Indexes of every scale vary between 0 and 100, where 100 presents the complete health. Results. Before the treatment, women with СS in the subgroup with complications reported the reliable increase of basal values of adrenocorticotropic hormone (ACTH, cortisol, prolactin on the background of hyperandrogenemia and ovarian insufficiency. In patients with СS from the second subgroup (without complications, against the background of significant increase of basal values of cortisol, prolactin, hyperandrogenemia, there was marked unreliable decline of estradiol and progesterone levels. In patients with СS with surgical treatment in the subgroup with complications, 1 month after the surgery the normalization of levels of ACTH and cortisol was marked, and through 6 months this state was saved. In patients with СS with surgical treatment in subgroup 2 (without complications 1 month after the operation, the normalization of levels of ACTH and cortisol was marked, and through 6 months the state remained former. Conclusions. Six months

  17. Preoperative evaluation, surgical procedure, follow up and results of 150 cochlear implantations.

    Science.gov (United States)

    Kyriafinis, G; Vital, V; Psifidis, A; Constantinidis, J; Nikolaou, A; Hitoglou-Antoniadou, M; Kouloulas, A

    2007-04-01

    The cochlear implantation is among the most important achievements of medicine and biotechnology in the last 20 years, because it allows individuals who had never heard or had lost their hearing to perceive sound and improve their quality of life. Selection criteria for candidates are strict and are evaluated in each individual by a scientific committee specially trained for implantations which includes Ear Nose and Throat (ENT) surgeon, audiologist, psychiatrist and speech therapist. In our department, the first cochlear implantation was performed in 1995. During the last ten years more than 250 individuals have been evaluated due to profound hearing loss and 170 of them were found to be suitable candidates for cochlear implantation. One hundred and fifty (150) have already been operated and most of them are children with congenital hearing loss. No major or permanent complications were recorded in any of our 150 patients. Activation and fitting/mapping of the cochlear implant is initiated three weeks post-operatively. Regular follow-up and mapping of the implant are held, more frequently in children, along with specialized speech therapy. Each new mapping is evaluated according to the record of the patient with regard to the acoustic perception of sounds and speech and the discrimination of individual elements of phonation based on a protocol that we have created for the needs of Greek language. Speech discrimination (AHEPA Hospital protocol), before the Implantation, at the activation of the cochlear implant and till 4 years of the follow-up showed that in our patients, we obtained better and faster results in post-speech acquisition adults with recent or chronic deafness and in children with congenital deafness operated before the 5th year of age, who underwent special preoperative speech therapy programme, fact which is in agreement with current literature. Patient satisfaction evaluated by "Sanders" psychometrics tests, was achieved in accordance to pre

  18. Evaluation of Students’ Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs

    Science.gov (United States)

    Ganjiwale, Jaishree

    2015-01-01

    Introduction Various studies in medical education have shown that active learning strategies should be incorporated into the teaching–learning process to make learning more effective, efficient and meaningful. Objectives The aim of this study was to evaluate student’s perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Settings and Design Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Materials and Methods Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student’s perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Statistical analysis used Descriptive analysis. Results Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on “Autobiography of Drugs” was taken as a positive learning experience by students. Conclusions Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes. PMID:26393138

  19. The adverse effects of inferior innovations

    Directory of Open Access Journals (Sweden)

    Chang Joseph W.

    2017-09-01

    Full Text Available This research advances brand innovation research by examining the adverse effects of inferior innovative extensions on the brand innovability of own parent brands. Brand innovability conceptually consists of brand quality and innovativeness. The results reveal that radical and incremental inferior innovations exert asymmetric adverse effects on brand quality and innovability. For brand quality, inferior radical innovations exert more negative impacts on the quality of pioneer brands than on the quality of follower brands. However, inferior incremental innovations exert identical negative impacts on the quality of both pioneer and follower brands. For brand innovability, both inferior radical and incremental innovations exert more negative impacts on the innovability of pioneer brands than on the innovability of follower brands. In comparison, brand innovability is less susceptible than brand quality to inferior innovation information. The findings suggest that it is more justified to evaluate innovative brands with brand innovability, instead of brand quality, for two reasons. Firstly, brand innovability is more realistic than brand quality because brand innovability is more relevant than brand quality to profits. Secondly, brand innovability is inclusive of brand innovativeness, which ameliorates adverse effects when innovative extensions are inferior. The threat of inferior innovative extensions is less horrible than expectation if the adverse effects on the innovative brands are assessed with brand innovability, instead of brand quality. However, being innovative is like a double-edged sword. On the one hand, it helps generating more profits. On the other hand, it endangers innovative brands to be more susceptible to inferior innovative extensions. Therefore, for marketing implications, pioneer brands are more obliged than follower brands to ensure the success of radical innovations in order to avoid the possible adverse effects of inferior

  20. Hepatic MR imaging using ferumoxides: prospective evaluation with surgical and intraoperative sonographic confirmation in 25 cases.

    Science.gov (United States)

    Raman, S S; Lu, D S; Chen, S C; Sayre, J; Eilber, F; Economou, J

    2001-10-01

    The purpose of our study was to evaluate the sensitivity and accuracy of ferumoxides-enhanced MR imaging in comparison with surgery and intraoperative sonography. We prospectively evaluated 25 consecutive studies in 24 patients who underwent ferumoxides-enhanced hepatic MR imaging before surgery and intraoperative sonography. Both 1.5-T scanners (13 cases) and 0.2-T scanners (12 cases) were used. Turbo spin-echo T2-weighted sequences were performed before and after the administration of ferumoxides and the images were compared. Lesions were classified as solid or nonsolid and tabulated on standard liver maps. The liver maps from MR imaging were compared with those from surgery and intraoperative sonography. For lesions greater than 1 cm, the regions of interest were measured and contrast-to-noise ratio was calculated. Of 93 solid lesions found at surgery, 69 were seen on unenhanced MR imaging (sensitivity, 74.2%) and 87 were seen on ferumoxides-enhanced MR imaging (sensitivity, 93.5%) (p assessment.

  1. Evaluation of masseter muscle electromyography after surgical extraction of third molar.

    Science.gov (United States)

    Kim, Chan-Woo; Kim, Seong-Gon; Park, Sung-Wook; Chee, Young-Joon

    2015-03-01

    The aims of this study were to evaluate the results of electromyographies (EMGs) of the masseter muscle after mandibular third molar surgery and to determine the relationships between clinical variables and EMG results. Seventy patients were included in the study. The parameters of the patients' masseter muscles were measured using EMG prior to operation and 7 and 21 days post-operation. Clinical variables were also recorded before and after the third molar surgeries. When the masseter muscle EMG results from the tooth-extracted side were compared with those from the non-extracted (control) side, significant differences in the areas of voltage, power spectral densities and median frequencies (p = 0.011, 0.017 and 0.041, respectively) were found 7 days postoperatively. Additionally, there were significant associations between some clinical variables (i.e. postoperative swelling, bone reduction and pericoronitis) and the EMG results 7 days postoperatively, (p evaluate postoperative changes in masseter muscle activity.

  2. Magnetic resonance imaging for stress incontinence: evaluation of patients before and after surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Perk, Hakki E-mail: hakkiperk@yahoo.com; Oral, Baha; Yesildag, Ahmet; Serel, T. Ahmet; Oezsoy, Mesut; Turgut, Tayfun

    2002-10-01

    Objective: The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the pre and postoperative assessment of stress urinary incontinence. Methods: Fifteen female patients with clinical evidence of stress urinary incontinence were included in this prospective study. All the patients underwent MRI in the supine position both preoperatively and postoperatively. For imaging, we used a 1.0 T magnet, T2-weighted images were obtained in the midline sagittal plane with patients at rest. Images were evaluated for anatomical stress urinary incontinence alterations, such as the increased distance between the pubococcygeal line and the bladder base and the posterior urethro-vesical angle and the urethral inclination angle changes. Wilcoxon signed rank test allowed comparisons of pre and postoperative results. Results: Compared with postoperative measurements, the bladder base was lowered significantly by an average of 9.4{+-}4.0 mm (P<0.01), posterior urethro-vesical angle was significantly increased by an average of 127.8{+-}11.4 deg. (P<0.01), and the urethral inclination angle was significantly increased by an average of 54.9{+-}10.1 deg. (P<0.01) preoperatively. Conclusion: Our results suggest that MRI can play a major role in the preoperative and postoperative assessment of stress urinary incontinence. It can reliably detect anatomical urinary incontinence alterations. MRI should be considered in failed surgery, complex prolapse, and in differentiating genuine stress incontinence resulting from malposition of the bladder neck from stress incontinence due to intrinsic urethral damage.

  3. Preparing Nurse Leaders to Innovate: Iowa's Innovation Seminar.

    Science.gov (United States)

    Joseph, M Lindell; Rhodes, Ann; Watson, Carol A

    2016-02-01

    Currently, no doctoral guidelines to teach innovation exist. Using Christensen's theory of disruptive innovation, the five discovery skills used by disruptive innovators provide the framework for designing a leadership development approach to enable and support a mindset to innovate. Executive leadership students were provided with didactic content on innovation, were assigned to non-healthcare settings for an anthropological dig to uncover innovative activities, and were provided with reflective prompts to enable a new context for innovation. Faculty collaborated with other fields and took risks to provide new contexts to innovate. Students identified and proposed innovations for current health care issues. Some of the innovations included processes, evaluation methods, data analytics for care design, and patient engagement solutions. Faculty crossed borders for field experiences, as well as disciplinary borders. This collaborative seminar demonstrated that it is possible to develop executive nurse leaders to innovate. Copyright 2016, SLACK Incorporated.

  4. Preoperative evaluation and surgical technique of functional and cosmetic aspects in zygomatic complex fracture patients.

    Science.gov (United States)

    Lin, Q; Hong, X Y; Zhang, D; Jin, H J

    2017-01-01

    The zygomatico-maxillary complex functions as the principle buttress of the face and is the cornerstone to an individual’s aesthetic appearance. Its fracture not only creates cosmetic deformities owing to its position and facial contour, but can also cause disruption of ocular and mandibular functions. The aim of this study was to evaluate the quality, efficacy and impact of internal fixation of zygomatic complex fractures on functional and cosmetic outcomes. A prospective study was carried out on 100 patients who were divided according to the classification and the severity of injury. Subjective evaluation was submitted based on the patient’s perception of signs and symptoms in the preoperative and postoperative periods. Intraoperative and postoperative assessment of bone reduction quality was made according to the type of the fracture and related difficulties; also, the difference between these groups was observed as functional and esthetic outcome. To optimize the treatment of zygomatic bone fractures, a pre-designed questionnaire was used for subjective evaluation of symptoms and treatment outcome. In 70% of cases, ophthalmologic consultation was taken and was most common in type VII fractures (100% cases). Neurosensory disturbance was the most common finding (60%), followed by diplopia (56R%), pain upon mouth opening (54%) and malar depression (50%). Out of all possible 400 fracture sites in 100 patients of zygomatic complex fractures, 266 (66.5%) fractures were detected by clinical examination, in contrast to 330 (82.5%) on radiological examination, which were highest at zygomatic-maxillary buttress (93%) followed by infraorbital rim (91%) and almost equal among fronto-zygomatic site (72%) and zygomatic arch (74%). The scores from the questionnaire for annoyance were significantly higher for paraesthesia (23%) than for trismus (10%), pain (8.5%), or deformity (8.25%). Residual deformity and pain significantly influenced the total satisfaction. Conclusively

  5. Evaluation of a blended learning surgical skills course for rural surgeons.

    Science.gov (United States)

    Halverson, Amy L; DaRosa, Debra A; Borgstrom, David C; Caropreso, Philip R; Hughes, Tyler G; Hoyt, David B; Sachdeva, Ajit K

    2014-07-01

    Rural surgeons have unique learning needs not easily met by traditional continuing medical education courses. A multidisciplinary team developed and implemented a skills curriculum focused on leadership and communication, advanced endoscopy, emergency urology, emergency gynecology, facial plastic surgery, ultrasound, and management of fingertip amputations. Twenty-five of 30 (89%) rural surgeons who completed a follow-up course evaluation reported that the knowledge acquired during the course had improved their practice and/or the quality of patient care, particularly by refining commonly used skills and expanding the care options they could offer to their patients. The surgeons reported incorporating changes in their communication and interaction with colleagues. This course was successful, from participants' perspectives, in providing hands-on mentored training for a variety of skills that reflect the broad scope of practice of surgeons in rural areas. Attendees felt that their participation resulted in important behavior and practice changes. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Do soft skills predict surgical performance?: a single-center randomized controlled trial evaluating predictors of skill acquisition in virtual reality laparoscopy.

    Science.gov (United States)

    Maschuw, K; Schlosser, K; Kupietz, E; Slater, E P; Weyers, P; Hassan, I

    2011-03-01

    Virtual reality (VR) training in minimal invasive surgery (MIS) is feasible in surgical residency and beneficial for the performance of MIS by surgical trainees. Research on stress-coping of surgical trainees indicates the additional impact of soft skills on VR performance in the surgical curriculum. The aim of this study was to evaluate the impact of structured VR training and soft skills on VR performance of trainees. The study was designed as a single-center randomized controlled trial. Fifty first-year surgical residents with limited experience in MIS ("camera navigation" in laparoscopic cholecystectomy only) were randomized for either 3 months of VR training or no training. Basic VR performance and defined soft skills (self-efficacy, stress-coping, and motivation) were assessed prior to randomization using basic modules of the VR simulator LapSim(®) and standardized psychological questionnaires. Three months after randomization VR performance was reassessed. Outcome measurement was based on the results derived from the most complex of the basic VR modules ("diathermy cutting") as the primary end point. A correlation analysis of the VR end-point performance and the psychological scores was done in both groups. Structured VR training enhanced VR performance of surgical trainees. An additional correlation to high motivational states (P 0.05). Low self-efficacy and negative stress-coping strategies seem to predict poor VR performance. However, structured training along with high motivational states is likely to balance out this impairment.

  7. Consumer-based technology for distribution of surgical videos for objective evaluation.

    Science.gov (United States)

    Gonzalez, Ray; Martinez, Jose M; Lo Menzo, Emanuele; Iglesias, Alberto R; Ro, Charles Y; Madan, Atul K

    2012-08-01

    The Global Operative Assessment of Laparoscopic Skill (GOALS) is one validated metric utilized to grade laparoscopic skills and has been utilized to score recorded operative videos. To facilitate easier viewing of these recorded videos, we are developing novel techniques to enable surgeons to view these videos. The objective of this study is to determine the feasibility of utilizing widespread current consumer-based technology to assist in distributing appropriate videos for objective evaluation. Videos from residents were recorded via a direct connection from the camera processor via an S-video output via a cable into a hub to connect to a standard laptop computer via a universal serial bus (USB) port. A standard consumer-based video editing program was utilized to capture the video and record in appropriate format. We utilized mp4 format, and depending on the size of the file, the videos were scaled down (compressed), their format changed (using a standard video editing program), or sliced into multiple videos. Standard available consumer-based programs were utilized to convert the video into a more appropriate format for handheld personal digital assistants. In addition, the videos were uploaded to a social networking website and video sharing websites. Recorded cases of laparoscopic cholecystectomy in a porcine model were utilized. Compression was required for all formats. All formats were accessed from home computers, work computers, and iPhones without difficulty. Qualitative analyses by four surgeons demonstrated appropriate quality to grade for these formats. Our preliminary results show promise that, utilizing consumer-based technology, videos can be easily distributed to surgeons to grade via GOALS via various methods. Easy accessibility may help make evaluation of resident videos less complicated and cumbersome.

  8. A CLINICAL STUDY ON SURGICAL MANAGEMENT OF TIBIAL PLATEAU FRACTURES - FUNCTIONAL AND RADIOLOGICAL EVALUATION

    Directory of Open Access Journals (Sweden)

    Bhavani

    2015-10-01

    Full Text Available BACKGROUND: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. AIM OF STUDY: This study is to analyze the functional outcome of CRIF or ORIF with or without bone grafting in tibial plateau fractures in adults. MATERIALS AND METHODS: 30 cases of tibial plateau fractures treated by various modalities were studied from 1 - 8 - 2012 to 31 - 1 - 2014 at our institution and followed for a minimum of 6 months. Fractures were evaluated using Modified Rasmussen’s Clinical, Radiological grading system. RESULTS : The selected patients were evaluated thoroughly and after the relevant investigations, were taken for surgery. The fractures were classified as per the SCHATZKER’S types and operated accordingly with CRIF with Percutaneous cannulated cancellous screws, ORIF with buttress plate/LCP with or without bone grafting. Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6 - 8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union . The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory, knee stiffness in 3 cases , wound dehiscence and infection in 1 case and non - union in none of our cases was noted. CONCLUSION: Functional outcome is better in operatively treated tibial plateau fractures in adults, because it gives excellent anatomical reduction and rigid fixation to restore articular congruity and early motion thereby preventing knee stiffness.

  9. Surgical pathology and the patient: a systematic review evaluating the primary audience of pathology reports.

    Science.gov (United States)

    Mossanen, Matthew; True, Lawrence D; Wright, Jonathan L; Vakar-Lopez, Funda; Lavallee, Danielle; Gore, John L

    2014-11-01

    The pathology report is a critical document that helps guide the management of patients with cancer. More and more patients read their reports, intending to participate in decisions about their care. However, a substantial subset of patients may lack the ability to comprehend this often technical and complex document. We hypothesized that most literature on pathology reports discusses reports from the perspective of other physicians and not from the perspective of patients. An expert panel of physicians developed a list of search criteria, which we used to identify articles on PubMed, MEDLINE, Cochrane Reviews, and Google Scholar databases. Two reviewers independently evaluated all articles to identify for detailed review those that met search criteria. We identified the primary audience of the selected articles and the degree to which these articles addressed clarity of communication of pathology reports with patients. Of 801 articles identified in our search, 25 involved the formatting of pathology reports for clarity of communication. Recurrent themes in proposed improvements in reports included content standardization, variation in terminology, clarity of communication, and quality improvement. No articles discussed patients as their target audience. No study evaluated the health literacy level required of patients to comprehend pathology reports. In summary, there is a scarcity of patient-centered approaches to improve pathology reports. The literature on pathology reports does not include patients as a target audience. Limited resources are available to help patients comprehend their reports. Efforts to improve patient-centered communication are desirable to address this overlooked aspect of patient care. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Measuring New Product Portfolio Innovativeness: How Differences in Scale Width and Evaluator Perspectives Affect its Relationship with Performance

    DEFF Research Database (Denmark)

    Schultz, Carsten; Salomo, Søren; Talke, Katrin

    2013-01-01

    Portfolio innovativeness is a central variable in innovation management. However, the impact of portfolio innovativeness on new product development (NPD) performance is unclear, which may partly be due to the construct’s multifaceted nature. Different facets may reflect different degrees...... of innovativeness and may have different relationships with performance. In addition, firm members with different functional backgrounds may perceive and thus assess these facets differently, which again may influence the performance effect of portfolio innovativeness. Based on a sample of 746 CEOs and marketing...... as well as technology professionals from 117 firms and using Item Response Theory (IRT), a multifaceted scale of portfolio innovativeness, whose facets are able to cover the entire innovativeness spectrum, is developed. In addition, it is shown that the performance impact of portfolio innovativeness...

  11. Innovation af innovation

    DEFF Research Database (Denmark)

    Harste, Gorm

    2009-01-01

    , at innovation af innovationen forsøges gennemført på en måde, hvor tiden kræves at forholde sig til sin egen tidslighed i form af fremtid, nutid, fortid og ikke mindst i form af samtidighed. I tiden skal vi iagttage, hvordan vi iagttager tiden. Vi dobbelt-koder tiden på samme måde, som forskning forsker i...... organisationssystemerne. De to typer systemer kan noget helt bestemt med fænomenet tid. De kan synkronisere. Analyseres organisationssystemer ser vi, imidlertid at innovation kræver ro. Stærkt innovative systemer er militærsystemet og kunstsystemet, der også inddrages, og hvor vi ser paradokset mellem innovation og...... involution. Tid er med et medium og ikke et lufttomt rum. Tid er end ikke en gasart, men udgør et solidt fluidum, som samfundet bader i og flyder i, konstant i bevægelse. Reformer forudsætter former, og innovation forudsætter involution. Kun sådan muliggøres evolution....

  12. Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

    Directory of Open Access Journals (Sweden)

    Gurkirat Sandhu

    2017-01-01

    Full Text Available Context: Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. Aim: The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA during lengthy periodontal surgical procedures. Settings and Design: This was a randomized, split-mouth, cross-over study. Materials and Methods: A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Statistical Analysis Used: Paired t-test and repeated measure ANOVA. Results: The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Conclusion: Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

  13. An intuitionistic fuzzy set–based hybrid approach to the innovative design evaluation mode for green products

    Directory of Open Access Journals (Sweden)

    Ching-Hsin Wang

    2016-04-01

    Full Text Available As technology vigorously develops and the awareness of environmental protection rises, green industry has been gradually valued by government and consumers. Customers’ needs can be satisfied with effective resource strategies as well as innovative technology of green products. Importance–performance analysis is a method incorporating the voices of customers and resource strategies of green design into the product development as well as management performance assessment by means of “importance” and “performance.” Quality function deployment can turn the voices of customers into product development and technical requirement, in order to ensure that the product can meet customers’ satisfaction. The present companies take not only customers’ demand but also their own technical limits into account. Hence, data envelopment analysis can offer firms the priority order when they carry out their improvement in the green product design. Nevertheless, many uncertainties and semantic ambiguity appear in the process of information collection for the product design. Consequently, this study comes up with importance–performance analysis, analytical network process, quality function deployment, and data envelopment analysis, to construct an evaluation mode of innovative design for green products based on intuitionistic fuzzy sets offering enterprises a practical reference for their green product design.

  14. Unlocking the “black box” of practice improvement strategies to implement surgical safety checklists: a process evaluation

    Science.gov (United States)

    Gillespie, Brigid M; Hamilton, Kyra; Ball, Dianne; Lavin, Joanne; Gardiner, Therese; Withers, Teresa K; Marshall, Andrea P

    2017-01-01

    Background Compliance with surgical safety checklists (SSCs) has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve. Objectives The objective of this study was to undertake a process evaluation of four knowledge translation (KT) strategies used to implement the Pass the Baton (PTB) intervention which was designed to improve utilization of the SSC. Methods As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well) in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Results Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently implemented. Of the 220 staff working in the department, that is, nurses, anesthetists, and surgeons, 160 (72.7%) knew about the PTB strategies. Qualitative analysis revealed that implementation was generally feasible and acceptable. A barrier to feasibility was physician engagement. An impediment to acceptability was participants’ skepticism about the ability of the KT strategies to effect behavioral change. Conclusion Overall, results of this evaluation suggest that success of implementation was moderate. Given the probable impact of contextual factors, that is, team culture and the characteristics of participants, the KT strategies may need modification prior to widespread implementation. PMID

  15. Logistic innovations in transport

    Directory of Open Access Journals (Sweden)

    Mirosław Antonowicz

    2014-03-01

    Full Text Available Introduction: The article discusses the issue of logistic innovations in transport. The essentials of logistic innovations in transport together with some examples of specific innovations are presented. The role of the client's needs in transport innovations is indicated. The most vital postulates affecting the innovativeness of shipping companies and derived from the author's experience as well as scholarly publications, are time, safety, reliability as well as comprehensiveness of service offer. Following the analysis of the issue, and on the grounds of Kaizen's and Lean's method, the concept of continuous innovations is suggested as very useful for the development of transport. The potential of clusters as the source of logistic innovations in transport is emphasised. Methods: The discussion of the issue was preceded by the author's analysis of written sources on innovativeness, the evaluation of ratings of innovativeness as well as the analysis of rewarded innovative solutions in transport subsequent to the businesses participation in the programme of innovative solutions in transport. The role of innovation practical business operations is argued following the analysis of some strategic documents such as: 2011 White Paper and the Strategy for the Development of Transport by 2020 adopted by the Polish government in 2013. Aim: The aim of the article is to present the role and significance of the issue of logistic innovations in transport and to cite instances of practical solutions implemented by shipping companies, the solutions which resulted in measurable effects. Following the author's observation of the instances of innovative solutions as well as his analysis of the ratings of innovativeness, the article aims to present the conclusions as for the specific kinds of activities which are indispensable to foster innovativeness in transport. Conclusions: The conclusions derived from the author's analyses and observations show that logistic

  16. Surgical Technologists

    Science.gov (United States)

    ... State & Area Data Explore resources for employment and wages by state and area for surgical technologists. Similar Occupations Compare the job duties, education, job growth, and pay of surgical technologists with ...

  17. A Potential Solution to Minimally Invasive Device for Oral Surgery: Evaluation of Surgical Outcomes in Rat

    Directory of Open Access Journals (Sweden)

    Keng-Liang Ou

    2015-01-01

    Full Text Available The objective of the present research was to investigate the thermal injury in the brain after minimally invasive electrosurgery using instruments with copper-doped diamond-like carbon (DLC-Cu surface coating. The surface morphologies of DLC-Cu thin films were characterized using scanning electron microscopy and atomic force microscopy. Three-dimensional brain models were reconstructed using magnetic resonance imaging to simulate the electrosurgical operation. In adult rats, a monopolar electrosurgical instrument coated with the DLC-Cu thin film was used to generate lesions in the brain. Animals were sacrificed for evaluations on postoperative days 0, 2, 7, and 28. Data indicated that the temperature decreased significantly when minimally invasive electrosurgical instruments with nanostructure DLC-Cu thin films were used and continued to decrease with increasing film thickness. On the other hand, the DLC-Cu-treated device created a relatively small thermal injury area and lateral thermal effect in the brain tissues. These results indicated that the DLC-Cu thin film minimized excessive thermal injury and uniformly distributed the temperature in the brain. Taken together, our study results suggest that the DLC-Cu film on copper electrode substrates is an effective means for improving the performance of electrosurgical instruments.

  18. Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia.

    Science.gov (United States)

    Calheiros-Trigo, Francisca; Linhares, Paulo

    2014-01-01

    Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia. Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported. Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  19. [Evaluation of the safety of innovative drugs against viruses and infectious agents].

    Science.gov (United States)

    Kobayashi, Tetsu; Yusa, Keisuke; Kawasaki, Nana

    2013-01-01

    Recently, several novel cellular therapy products and biological drugs are being developed to treat various previously untreatable diseases. One of the most important issues regarding these innovations is how to ensure safety over infectious agents, including viruses and prions, in the earliest treatments with these products. The object of this study is a risk assessment of cases of human infectious with the agents and to present a sample risk management plan based on a collaboration among the National Institute of Health Sciences, universities, marketing authorization holders, and scientific societies. There are three subjects of study: (1) the viral safety of cellular therapy products, (2) the viral safety of biological drugs, and (3) the safety of prions. In this report, we describe the objects of the study, the project members, the study plan outline, and the ongoing plans. The results of the viral risk identification and the risk analysis of cellular therapy products will also be described, based on a review of the literature and case reports obtained during the first year of this project.

  20. The evaluation of innovative production to ensure quality in sustainable buildings

    Directory of Open Access Journals (Sweden)

    Antonella Postorino

    2013-08-01

    Full Text Available The LaboReg has spent years to focus on the purpose of internal research on practical application of the achieved  results and the involvement in all phases of business, governments and local entrepreneurs in order to anticipate times and procedures to make a decision towards sustainable solutions. The synergy created between the academic world, the local government and the businesses has put together a research whose main objective is oriented towards the implementation of the productive sectors of the local construction materials to be used in the restoration and rehabilitation of historic buildings and new green building measures in the prospective of environmental sustainability and energy conservation. Within the research programme, interesting results have emerged in the field of experiments called “New Historical Materials.” In this field of ​​activity a research has emerged on the implementation of a prototype of a “new town photovoltaic roof tiles”. The study has provided a first significant result, that is the development of a model of assessment and control of production processes, and some innovative materials.

  1. DISCUSSION OF SOME CRITERIA OF FINANCIAL EVALUATION IN THE DECISION OF INNOVATION PROJECTS IN PROCESSES

    Directory of Open Access Journals (Sweden)

    Jair Sbaraini

    2014-06-01

    Full Text Available One of the greatest challenges for small companies is to administer scarce resources, because, they represent the means by which companies accomplish their operations. These resources - materials, financial, human, administrative or of market - managed in a harmonious way, are responsible for maintaining the competitiveness level of the company. Besides the proper administration of their resources, innovation is extremely important in the context of maintaining and improving the competitive advantages of these companies. Nowadays with the speed of information, lots of ideas appear in the companies intending to improve processes, increase productivity, and reduce costs, among other proposals. However a small portion of these ideas have effective implementation potential and do not reach their goals. The higher the assertiveness the better is the result. As there is a great dispute of resources in the companies, it is necessary to decide appropriately which ideas have better chance for obtaining success, and, for such, it is very important to properly quantify the financial return.

  2. Using optical coherence tomography to evaluate macular changes after surgical management for rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Kai-Chun Cheng

    2016-05-01

    Full Text Available Incomplete visual recovery, color vision defects, or persistent metamorphopsia may persist even after successful surgery for rhegmatogenous retinal detachment (RRD, especially in cases of RD with macula off, suggesting microstructural macular damage that standard fundus biomicroscopy could not detect. We compared spectral-domain optical coherence tomography imaging with preoperative and postoperative visual acuity to evaluate the relationship between morphological changes in the outer retina and visual outcome after successful repair of RRD with macula on or off. We enrolled 43 patients (43 eyes with successful repair of RRD and a minimum 6-month follow up after surgery in this retrospective research. Patients accepted spectral-domain optical coherence tomography postoperatively and visual acuity examination preoperatively and postoperatively. The mean age of the patients was 48.74 ± 12.68 years (range: 16–77 years. The mean visual acuity (logarithm of minimal angle of resolution before surgery was 0.87 ± 0.70. Disrupted ellipsoid zone was noted in one of 11 eyes in the macula-on group (9.1% and 19 of 32 eyes in the macula-off group (59.4%. Disrupted external limiting membrane (ELM was noted in no eye in the macula-on group (0% and 11 of 32 eyes in the macula-off group (34.4%. The macula-off group was associated with better postoperative visual gains than the macula-on group (p = 0.013. Patients with integrity of the ellipsoid zone and ELM were associated with significant visual improvement than patients with disruption of the ellipsoid zone or ELM.

  3. SOFT TISSUE RECONSTRUCTION OF THE LOWER EXTREMITY: EVALUATION OF SURGICAL RESULTS IN 15 PATIENTS

    Directory of Open Access Journals (Sweden)

    M.J FATEMI

    2003-03-01

    Full Text Available Introduction: There are general guidelines for reconstruction of complex wounds of the Lower extremity. The goal in treatment of these wounds is to preserve a limb that will be more functional than an amputation. Material & Methods: In this study, we evaluate our results in 15 patients with extensive wounds in lower extremities (April - 1998 to march - 2001. Results: The average age of the patients was 31.20 with an age range between 9 to 61 years. Majority of the patients were victims of motor vehicle accident, except two, which developed wounds due to war injury. Distal third of leg was the most common site of trauma and 7 patients had bone fractures, mostly Gustillo III-B. Wound coverage was the most common indication for surgery and free tissue transplantation performed for majority of the patients. Transfer of latissimus dorsi muscle or myocutaneous flap was the most common procedure. One free flap and one fasciocutaneous flap necrosed due to infection and poor technique respectively. Discussion: Our results revealed that the options for reconstruction of significant soft tissue wounds of the upper and lower thigh are included skin graft, local flap and rarely free tissue transfer. The gastrocnemius muscle or myocutaneous flap serve well for supra-patellar, knee and proximal tibial wounds. The soleus muscle flape is probably the most useful flap in middle tibia However, frequently; wounds of this part are best satisfied by micro vascular tissue transplantation. Soft tissue reconstruction in distal tibia and foot is viewed by many as the most challenging of all lower extremity areas. The vast majority of these wounds are best satisfied by micro vascular tissue transfer. Meanwhile, in cases with a modest skin defect, there is the opportunity to utilize either proximally or distally based fasciocutaneous flaps.

  4. Comparative evaluation of gingival depigmentation by tetrafluroethane cryosurgery and surgical scalpel technique. A randomized clinical study

    Directory of Open Access Journals (Sweden)

    Suraj D Narayankar

    2017-01-01

    Full Text Available Introduction: Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique. Method: A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI for pigmentation and Visual Analoug Scale (VAS for pain was evaluated for both test (Cryosurgery and control sites (Scalpel technique at baseline, 1month, 3months and 6 months. Results: GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P=0.0691. This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P<0.001. Conclusion: It can be concluded that cryosurgery can be effectively and efficiently used for depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

  5. Comparative Evaluation of Gingival Depigmentation by Tetrafluroethane Cryosurgery and Surgical Scalpel Technique. A Randomized Clinical Study.

    Science.gov (United States)

    Narayankar, Suraj D; Deshpande, Neeraj C; Dave, Deepak H; Thakkar, Dhaval J

    2017-01-01

    Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique. A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI) for pigmentation and Visual Analoug Scale (VAS) for pain was evaluated for both test (Cryosurgery) and control sites (Scalpel technique) at baseline, 1month, 3months and 6 months. GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P =0.0691). This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

  6. Linking User and Staff Perspectives in the Evaluation of Innovative Transition Projects for Youth with Disabilities

    Science.gov (United States)

    McAnaney, Donal F.; Wynne, Richard F.

    2016-01-01

    A key challenge in formative evaluation is to gather appropriate evidence to inform the continuous improvement of initiatives. In the absence of outcome data, the programme evaluator often must rely on the perceptions of beneficiaries and staff in generating insight into what is making a difference. The article describes the approach adopted in an…

  7. Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis.

    NARCIS (Netherlands)

    Kasteren, M.E.E. van; Mannien, J.; Kullberg, B.J.; Boer, A.S. de; Nagelkerke, N.J.; Ridderhof, M.; Wille, J.C.; Gyssens, I.C.J.

    2005-01-01

    OBJECTIVES: Misuse of antibiotics in surgical prophylaxis is still quite common. The objectives of this study were to reduce the quantity and improve the quality of surgical prophylaxis and to reduce costs. METHODS: Prospective multi-site study of elective procedures in 13 Dutch hospitals. The