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Sample records for optimizing microsurgical skills

  1. Optimizing microsurgical skills with EEG neurofeedback

    Directory of Open Access Journals (Sweden)

    Benjamin Larry

    2009-07-01

    Full Text Available Abstract Background By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. Results National Health Service trainee ophthalmic microsurgeons (N = 20 were randomly assigned to either Sensory Motor Rhythm-Theta (SMR or Alpha-Theta (AT groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8. Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1 the expert ratings: overall technique (d = 0.6, p Conclusion SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

  2. Easy, Efficient, and Mobile Way to Train Microsurgical Skills During Busy Life of Neurosurgical Residency in Resource-Challenged Environment.

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    Huotarinen, Antti; Niemelä, Mika; Jahromi, Behnam Rezai

    2017-11-01

    Residents' lives are hectic-it is hard to find a place and time for training basic and advanced microsurgical skills. Surgical instruments and sutures can be purchased (or loaned from another department), but the most expensive and space-occupying device is the microscope. In developing countries, microscopes are used where they are needed most, in operating rooms. Furthermore, a conventional microscope is not portable. For all of these reasons, the availability of microscopes for training microsurgery is limited. We used a coffee cup and smartphone (CCS) as a training device instead of a microscope. The coffee cup was the base, and the smartphone functioned to magnify, illuminate, and visualize objects. We measured 2 residents' performance on end-to-end artificial bypass before and after 5 days of CCS-based training. We were able to quickly set up the environment for practicing microsurgical skills in any surrounding. After 5 days of training with CCS we could see significant development of microsurgical performance with a conventional microscope as well. The learning curve was dependent on baseline performance. CCS is efficient, mobile, and easy to set up. Even though our smartphone-based training was in 2 dimensions, we could improve our microsurgical performance with conventional microscopes, which have 3-dimensional capability. CCS also provides an easy method to record one's microsurgical training. CCS improved both of the subjects' microsurgical performance, making it a good alternative for a traditional microscope. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  4. Optimal skill distribution under convex skill costs

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    Tin Cheuk Leung

    2018-03-01

    Full Text Available This paper studies optimal distribution of skills in an optimal income tax framework with convex skill constraints. The problem is cast as a social planning problem where a redistributive planner chooses how to distribute a given amount of aggregate skills across people. We find that optimal skill distribution is either perfectly equal or perfectly unequal, but an interior level of skill inequality is never optimal.

  5. A didactic and hands-on module enhances resident microsurgical knowledge and technical skill.

    Science.gov (United States)

    El Ahmadieh, Tarek Y; Aoun, Salah G; El Tecle, Najib E; Nanney, Allan D; Daou, Marc R; Harrop, James; Batjer, Hunt H; Bendok, Bernard R

    2013-10-01

    Simulation has been adopted as a powerful training tool in many areas of health care. However, it has not yet been systematically embraced in neurosurgery because of the absence of validated tools, assessment scales, and curricula. To use our validated microanastomosis module and scale to evaluate the effects of an educational intervention on the performance of neurosurgery residents at the 2012 Congress of Neurological Surgeons Annual Meeting. The module consisted of an end-to-end microanastomosis of a 3-mm vessel and was divided into 3 phases: (1) a cognitive and microsuture prelecture testing phase, (2) a didactic lecture, and (3) a cognitive and microsuture postlecture testing phase. We compared resident knowledge and technical proficiency from the pretesting and posttesting phases. One neurosurgeon and 7 neurosurgery residents participated in the study. None had previous experience in microsurgery. The average score on the microsuture prelecture and postlecture tests, as measured by our assessment scale, was 32.50 and 39.75, respectively (P = .001). The number of completed sutures at the end of each procedure was higher for 75% of participants in the postlecture testing phase (P = .03). The average score on the cognitive postlecture test (12.75) was significantly better than that of the cognitive prelecture test (8.38; P = .001). Simulation has the potential to enhance resident education and to elevate proficiency levels. Our data suggest that a focused microsurgical module that incorporates a didactic component and a technical component can enhance resident knowledge and technical proficiency in microsurgical anastomosis.

  6. Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era.

    Science.gov (United States)

    Sanai, Nader; Caldwell, Nolan; Englot, Dario J; Lawton, Michael T

    2012-08-01

    Many neurosurgeons feel competent clipping posterior communicating artery (PCoA) aneurysms and include this lesion in their practice. However, endovascular therapy removes simple aneurysms that would have been easiest to clip with the best results. What remains are aneurysms with complex anatomy and technical challenges that are not well described. A contemporary surgical series with PCoA aneurysms is reviewed to define the patients, microsurgical techniques, and outcomes in current practice. A total of 218 patients had 218 PCoA aneurysms that were treated microsurgically during an 11-year period. Complexities influencing aneurysm management included (1) large/giant size; (2) fetal posterior cerebral artery; (3) previous coiling; (4) anterior clinoidectomy; (5) adherence of the anterior choroidal artery (AChA); (6) intraoperative aneurysm rupture; (7) complex clipping; and (8) atherosclerotic calcification. Simple PCoA aneurysms were encountered in 113 patients (51.8%) and complex aneurysms in 105 (48.2%). Adherent AChA (13.8%) and intraoperative rupture (11.5%) were the most common complexities. Simple aneurysms had favorable outcomes in 86.6% of patients, whereas aneurysms with 1 or multiple complexities had favorable outcomes in 78.2% and 75.0%, respectively. Intraoperative rupture (P PCoA aneurysms requires advanced techniques including clinoidectomy, AChA microdissection, complex clipping, and facility with intraoperative rupture. Microsurgery is recommended for recurrent aneurysms after coiling, complex branches, aneurysms causing oculomotor nerve palsy, multiple aneurysms, and patients with hematomas.

  7. The Effects of Music on Microsurgical Technique and Performance: A Motion Analysis Study.

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    Shakir, Afaaf; Chattopadhyay, Arhana; Paek, Laurence S; McGoldrick, Rory B; Chetta, Matthew D; Hui, Kenneth; Lee, Gordon K

    2017-05-01

    Music is commonly played in operating rooms (ORs) throughout the country. If a preferred genre of music is played, surgeons have been shown to perform surgical tasks quicker and with greater accuracy. However, there are currently no studies investigating the effects of music on microsurgical technique. Motion analysis technology has recently been validated in the objective assessment of plastic surgery trainees' performance of microanastomoses. Here, we aimed to examine the effects of music on microsurgical skills using motion analysis technology as a primary objective assessment tool. Residents and fellows in the Plastic and Reconstructive Surgery program were recruited to complete a demographic survey and participate in microsurgical tasks. Each participant completed 2 arterial microanastomoses on a chicken foot model, one with music playing, and the other without music playing. Participants were blinded to the study objectives and encouraged to perform their best. The order of music and no music was randomized. Microanastomoses were video recorded using a digitalized S-video system and deidentified. Video segments were analyzed using ProAnalyst motion analysis software for automatic noncontact markerless video tracking of the needle driver tip. Nine residents and 3 plastic surgery fellows were tested. Reported microsurgical experience ranged from 1 to 10 arterial anastomoses performed (n = 2), 11 to 100 anastomoses (n = 9), and 101 to 500 anastomoses (n = 1). Mean age was 33 years (range, 29-36 years), with 11 participants right-handed and 1 ambidextrous. Of the 12 subjects tested, 11 (92%) preferred music in the OR. Composite instrument motion analysis scores significantly improved with playing preferred music during testing versus no music (paired t test, P music was significant even after stratifying scores by order in which variables were tested (music first vs no music first), postgraduate year, and number of anastomoses (analysis of variance, P music in

  8. Microsurgical Composite Tissue Transplantation

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    Serafin, Donald; Georgiade, Nicholas G.

    1978-01-01

    Since 1974, 69 patients with extensive defects have undergone reconstruction by microsurgical composite tissue transplantation. Using this method, donor composite tissue is isolated on its blood supply, removed to a distant recipient site, and the continuity of blood flow re-established by microvascular anastomoses. In this series, 56 patients (81%) were completely successful. There have been eight (12%) failures, primarily in the extremities. There have been five (7%) partial successes, (i.e., a microvascular flap in which a portion was lost requiring a secondary procedure such as a split thickness graft). In those patients with a severely injured lower extremity, the failure rate was the greatest. Most of these were arterial (six of seven). These failures occurred early in the series and were thought to be related to a severely damaged recipient vasculature. This problem has been circumvented by an autogenous interpositional vein graft, permitting more mobility of flap placement. In the upper extremity, all but one case were successful. Early motion was permitted, preventing joint capsular contractures and loss of function. Twenty-three cases in the head and neck region were successful (one partial success). This included two composite rib grafts to the mandible. Prolonged delays in reconstruction following extirpation of a malignancy were avoided. A rapid return to society following complete reconstruction was ensured. Nine patients presented for reconstruction of the breast and thorax following radical mastectomy. All were successfully reconstructed with this new technique except one patient. Its many advantages include immediate reconstruction without delayed procedures and no secondary deformity of the donor site. Healthy, well vascularized tissue can now be transferred to a previously irradiated area with no tissue loss. This new method offers many advantages to older methods of reconstruction. Length of hospital stay and immobilization are reduced. The

  9. Microsurgical training model for residents to approach to the orbit and the optic nerve in fresh cadaveric sheep cranium

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    M Emre Altunrende

    2014-01-01

    Full Text Available Background: Neurosurgery and ophthalmology residents need many years to improve microsurgical skills. Laboratory training models are very important for developing surgical skills before clinical application of microsurgery. A simple simulation model is needed for residents to learn how to handle microsurgical instruments and to perform safe dissection of intracranial or intraorbital nerves, vessels, and other structures. Materials and Methods: The simulation material consists of a one-year-old fresh cadaveric sheep cranium. Two parts (Part 1 and Part 2 were designed to approach structures of the orbit. Part 1 consisted of a 2-step approach to dissect intraorbital structures, and Part 2 consisted of a 3-step approach to dissect the optic nerve intracranially. Results: The model simulates standard microsurgical techniques using a variety of approaches to structures in and around the orbit and the optic nerve. Conclusions: This laboratory training model enables trainees to gain experience with an operating microscope, microsurgical instruments and orbital structures.

  10. Discussion of skill improvement in marine ecosystem dynamic models based on parameter optimization and skill assessment

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    Shen, Chengcheng; Shi, Honghua; Liu, Yongzhi; Li, Fen; Ding, Dewen

    2016-07-01

    Marine ecosystem dynamic models (MEDMs) are important tools for the simulation and prediction of marine ecosystems. This article summarizes the methods and strategies used for the improvement and assessment of MEDM skill, and it attempts to establish a technical framework to inspire further ideas concerning MEDM skill improvement. The skill of MEDMs can be improved by parameter optimization (PO), which is an important step in model calibration. An efficient approach to solve the problem of PO constrained by MEDMs is the global treatment of both sensitivity analysis and PO. Model validation is an essential step following PO, which validates the efficiency of model calibration by analyzing and estimating the goodness-of-fit of the optimized model. Additionally, by focusing on the degree of impact of various factors on model skill, model uncertainty analysis can supply model users with a quantitative assessment of model confidence. Research on MEDMs is ongoing; however, improvement in model skill still lacks global treatments and its assessment is not integrated. Thus, the predictive performance of MEDMs is not strong and model uncertainties lack quantitative descriptions, limiting their application. Therefore, a large number of case studies concerning model skill should be performed to promote the development of a scientific and normative technical framework for the improvement of MEDM skill.

  11. Successful microsurgical replantation of an amputated penis

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    Sanchit Garg

    2016-01-01

    Full Text Available Penile amputation is an uncommon injury for which immediate surgical replantation is warranted. Microsurgical replantation is the “standard” method for penile replantation. Early replantation yields a high success and low complication rate. We report a case of a 34-year-old male who presented with amputation at the proximal penile shaft which was successfully replanted using microsurgical techniques. Minor skin necrosis was noted post-operatively which was debrided and covered with skin graft. Follow-up at 6 months showed satisfactory cosmetic appearance, normal voiding, return of sensations and erectile function. The level of evidence was V.

  12. Mastectomy skin necrosis after microsurgical breast reconstruction.

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    Vargas, Christina R; Koolen, Pieter G; Anderson, Katarina E; Paul, Marek A; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

    2015-10-01

    Mastectomy skin necrosis represents a significant clinical morbidity after immediate breast reconstruction. In addition to aesthetic deformity, necrosis of the native mastectomy skin may require debridement, additional reconstruction, or prolonged wound care and potentially delay oncologic treatment. This study aims to evaluate patient and procedural characteristics to identify predictors of mastectomy skin necrosis after microsurgical breast reconstruction. A retrospective review was performed of all immediate microsurgical breast reconstructions performed at a single academic center. Patient records were queried for age, diabetes, active smoking, previous breast surgery, preoperative radiation, preoperative chemotherapy, body mass index, mastectomy type, mastectomy weight, flap type, autologous flap type, and postoperative mastectomy skin flap necrosis. There were 746 immediate autologous microsurgical flaps performed by three plastic surgeons at our institution during the study period. The incidence of mastectomy skin flap necrosis was 13.4%. Univariate analysis revealed a significantly higher incidence of mastectomy skin necrosis in patients with higher mastectomy weight (P mastectomy type. Multivariate analysis demonstrated statistically significant associations between mastectomy skin necrosis and both increasing mastectomy weight (odds ratio 1.348 per quartile increase, P = 0.009) and diabetes (odds ratio 2.356, P = 0.011). Increasing mastectomy weight and coexisting diabetes are significantly associated with postoperative mastectomy skin necrosis after microsurgical reconstruction. These characteristics should be considered during patient counseling, procedure selection, operative planning, and intraoperative tissue viability assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. [Destruction of microsurgical devices by sterilisation].

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    Berto, Raphaela; Strutz, Jürgen

    2017-11-01

    Hospital facilities issue numerous risk announcements on corrosion, deformation or premature wearout of medical devices every year. As there is yet little data on the impact of reprocessing on the quality and durability of microsurgical instruments, this paper aims at evaluating the effects of the reprocessing on microsurgical instruments. Material and Methods 22 brand new microsurgical instruments for stapes surgery were being reprocessed 30 times without being used for surgery or other purposes in the interim time. After each reprocessing the instruments were examined macroscopicly and microscopicly. The results were portrayed in a photo documentation and analysed on that basis. Results Almost all devices showed mechanical damage caused by the reprocessing procedure. The increasing deterioration was often associated with missing protective caps. Furthermore contaminations and stains were apparent in several cases. Conclusions The findings illustrate that careful handling of delicate surgical devices during reprocessing is vital. They also highlight problems of protective caps. As an alternative going forward it should be considered to store microsurgical instruments statically in special racks. Georg Thieme Verlag KG Stuttgart · New York.

  14. Virtual Reality Glasses and "Eye-Hands Blind Technique" for Microsurgical Training in Neurosurgery.

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    Choque-Velasquez, Joham; Colasanti, Roberto; Collan, Juhani; Kinnunen, Riina; Rezai Jahromi, Behnam; Hernesniemi, Juha

    2018-04-01

    Microsurgical skills and eye-hand coordination need continuous training to be developed and refined. However, well-equipped microsurgical laboratories are not so widespread as their setup is expensive. Herein, we present a novel microsurgical training system that requires a high-resolution personal computer screen, smartphones, and virtual reality glasses. A smartphone placed on a holder at a height of about 15-20 cm from the surgical target field is used as the webcam of the computer. A specific software is used to duplicate the video camera image. The video may be transferred from the computer to another smartphone, which may be connected to virtual reality glasses. Using the previously described training model, we progressively performed more and more complex microsurgical exercises. It did not take long to set up our system, thus saving time for the training sessions. Our proposed training model may represent an affordable and efficient system to improve eye-hand coordination and dexterity in using not only the operating microscope but also endoscopes and exoscopes. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Microsurgical techniques in temporal lobe epilepsy.

    Science.gov (United States)

    Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

    2017-04-01

    Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  16. Microsurgical reconstruction of extensive oncological scalp defects

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    Ole eGoertz

    2015-09-01

    Full Text Available While most small to medium defects of the scalp can be covered by local flaps, large defects or complicating factors like a history of radiotherapy often require a microsurgical reconstruction.Several factors need to be considered in such procedures. A sufficient preoperative planning is based on adequate imaging of the malignancy and a multi-disciplinary concept. Several flaps are available for such reconstructions, of which the latissimus dorsi and anterior lateral thigh flaps are the most commonly used ones.In very large defects, combined flaps such as a parascapular / latissimus dorsi flaps can be highly useful or necessary. The most commonly used recipient vessels for microsurgical scalp reconstructions are the superficial temporal vessels, but various other feasible choices exist. If the concomitant veins are not sufficient, the jugular veins represent a safe backup alternative but require a vessel interposition or long pedicle. Postoperative care and patient positioning can be difficult in these patients but can be facilitated by various devices. Overall, microsurgical reconstruction of large scalp defects is a feasible undertaking if the mentioned key factors are taken into account.

  17. Off-the-job microsurgical training on dry models: Siberian experience.

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    Belykh, Evgenii; Byvaltsev, Vadim

    2014-01-01

    Microsurgical training has become an obligatory part of many neurosurgical training programs. To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models. A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910. Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Data-driven warehouse optimization : Deploying skills of order pickers

    NARCIS (Netherlands)

    M. Matusiak (Marek); M.B.M. de Koster (René); J. Saarinen (Jari)

    2015-01-01

    textabstractBatching orders and routing order pickers is a commonly studied problem in many picker-to-parts warehouses. The impact of individual differences in picking skills on performance has received little attention. In this paper, we show that taking into account differences in the skills of

  19. Optimizing the Long-Term Retention of Skills: Structural and Analytic Approaches to Skill Maintenance

    National Research Council Canada - National Science Library

    Healy, Alice

    1997-01-01

    Progress has been made on the topics of tank gunner skills, Morse code reception, color naming, instrument panel scanning, tests of the procedural reinstatement framework, mental calculation, memory...

  20. Utility of a Validated Rating Scale for Self-Assessment in Microsurgical Training.

    Science.gov (United States)

    Grant, Aaron L; Temple-Oberle, Claire

    The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale. Self-assessment and preceptor scores were compared using the Pearson correlation coefficient (PCC). There was a significant agreement noted between the 32 preceptor assessments and 36 self-assessments that were completed. Correlation between scores for the knot-tying (PCC = 0.62) and anastomosis modules (PCC = 0.77) was good and excellent, respectively. Preceptor scores and self-scores improved over the duration of the course: for preceptors, knot-tying scores increased from 58% on day 1 to 78% on day 5 (p = 0.02) and anastomosis scores improved from 56% to 82% (p = 0.004); for self-scores, knot-tying scores increased from 44% to 81% (p = 0.001) and anastomosis scores from 49% to 84% (p = 0.001). Learners with greater experience (higher postgraduate year level) tended to have higher self as well as preceptor ratings, albeit not statistically significant. Self-assessment using the University of Western Ontario Microsurgical Acquisition/Assessment instrument has good to excellent agreement with preceptor-assessment scores suggesting good interrater reliability. Self-assessment using such tools may, therefore, be used along with preceptor supervision and assessment to potentially improve self-directed learning during these courses. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. An Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-Training Laboratory.

    Science.gov (United States)

    Chung, Sang-Bong; Ryu, Jiwook; Chung, Yeongu; Lee, Sung Ho; Choi, Seok Keun

    2017-09-01

    To provide detailed information about how to realize a self-training laboratory with cost-effective microsurgical instruments, especially pertinent for the novice trainee. Our training model is designed to allow the practice of the microsurgery skills in an efficient and cost-effective manner. A used stereoscopic microscope is prepared for microsurgical training. A sufficient working distance for microsurgical practice is obtained by attaching an auxiliary objective lens. The minimum instrument list includes 2 jeweler's forceps, iris scissors, and alligator clips. The iris scissors and alligator clip provide good alternatives to micro-scissors and microvascular clamp. The short time needed to set up the microscope and suture the gauze with micro-forceps makes the training model suitable for daily practice. It takes about 15 minutes to suture 10 neighboring fibers of the gauze with 10-0 nylon; thus, training can be completed more quickly. We have developed an inexpensive and efficient micro-anastomosis training system using a stereoscopic microscope and minimal micro-instruments. Especially useful for novice trainees, this system provides high accessibility for microsurgical training. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Robotic instrumentation: Evolution and microsurgical applications

    Directory of Open Access Journals (Sweden)

    Sijo J Parekattil

    2010-01-01

    Full Text Available This article presents a review of the history and evolution of robotic instrumentation and its applications in urology. A timeline for the evolution of robotic instrumentation is presented to better facilitate an understanding of our current-day applications. Some new directions including robotic microsurgical applications (robotic assisted denervation of the spermatic cord for chronic orchialgia and robotic assisted vasectomy reversal are presented. There is a paucity of prospective comparative effectiveness studies for a number of robotic applications. However, right or wrong, human nature has always led to our infatuation with the concept of using tools to meet our needs. This chapter is a brief tribute to where we have come from and where we may be potentially heading in the field of robotic assisted urologic surgery.

  3. Automated Motor Skills Training Optimized for Individual Differences.

    Science.gov (United States)

    1980-11-01

    Several preliminary applications of adaptive training to I complex synthetic flight trainers have been attempted (Loses, I ,5 I Ellis, Norman , and Matheny...Association, San Francisco, 1976. Lowes, A. H., Ellis, N. C., Norman , D. A., and Matheny, W. 3. Improving piloting skills in turbulent air using a self...intercept observer. Orlando, Florida: Naval Training Equipment Center, NAVTRAEQUIPCEN 71-C-6219-1, 1973. Smallwood , R. D. A decision structure for

  4. Microsurgical tubal recanalization: A hope for the hopeless

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    Jain M

    2003-01-01

    Full Text Available Objective: To analyse the various factors affecting pregnancy rate after microsurgical tubal recanalisation. Design: Prospective study, follow-up of 5 years in patients treated with tubal microsurgery. Setting: Referral Tertiary Care Hospital. Patients: Fifty women underwent microsurgical tubal recanalisation procedure. Principles of microsurgery were followed throughout the procedure meticulously. Interventions: Microsurgical tubal recanalisation. Main outcome measure: Pregnancy rate. Results: With microsurgery, an overall 60% pregnancy rate was achieved. In these patients, pregnancy outcome was in form of intrauterine pregnancy (96.66%, ectopic pregnancy (3.33%, term viable pregnancy (96.55% and spontaneous abortion (3.45%. Conclusions: The important factors for determining the success of operation were age of the patient, time interval between sterilization and reversal, site of ligation, method used for previous ligation & the remaining length of the tube after recanalisation. The microsurgical technique should be available at specialized centres to improve the success of family planning services.

  5. Optimizing students’ scientific communication skills through higher order thinking virtual laboratory (HOTVL)

    Science.gov (United States)

    Sapriadil, S.; Setiawan, A.; Suhandi, A.; Malik, A.; Safitri, D.; Lisdiani, S. A. S.; Hermita, N.

    2018-05-01

    Communication skill is one skill that is very needed in this 21st century. Preparing and teaching this skill in teaching physics is relatively important. The focus of this research is to optimizing of students’ scientific communication skills after the applied higher order thinking virtual laboratory (HOTVL) on topic electric circuit. This research then employed experimental study particularly posttest-only control group design. The subject in this research involved thirty senior high school students which were taken using purposive sampling. A sample of seventy (70) students participated in the research. An equivalent number of thirty five (35) students were assigned to the control and experimental group. The results of this study found that students using higher order thinking virtual laboratory (HOTVL) in laboratory activities had higher scientific communication skills than students who used the verification virtual lab.

  6. Adaptive Virtual Reality Training to Optimize Military Medical Skills Acquisition and Retention.

    Science.gov (United States)

    Siu, Ka-Chun; Best, Bradley J; Kim, Jong Wook; Oleynikov, Dmitry; Ritter, Frank E

    2016-05-01

    The Department of Defense has pursued the integration of virtual reality simulation into medical training and applications to fulfill the need to train 100,000 military health care personnel annually. Medical personnel transitions, both when entering an operational area and returning to the civilian theater, are characterized by the need to rapidly reacquire skills that are essential but have decayed through disuse or infrequent use. Improved efficiency in reacquiring such skills is critical to avoid the likelihood of mistakes that may result in mortality and morbidity. We focus here on a study testing a theory of how the skills required for minimally invasive surgery for military surgeons are learned and retained. Our adaptive virtual reality surgical training system will incorporate an intelligent mechanism for tracking performance that will recognize skill deficiencies and generate an optimal adaptive training schedule. Our design is modeling skill acquisition based on a skill retention theory. The complexity of appropriate training tasks is adjusted according to the level of retention and/or surgical experience. Based on preliminary work, our system will improve the capability to interactively assess the level of skills learning and decay, optimizes skill relearning across levels of surgical experience, and positively impact skill maintenance. Our system could eventually reduce mortality and morbidity by providing trainees with the reexperience they need to help make a transition between operating theaters. This article reports some data that will support adaptive tutoring of minimally invasive surgery and similar surgical skills. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  7. Microsurgical Bypass Training Rat Model: Part 2-Anastomosis Configurations.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Yousef, Sonia; Mokhtari, Pooneh; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Mastery of microsurgical anastomosis is key to achieving good outcomes in cerebrovascular bypass procedures. Animal models (especially rodents) provide an optimal preclinical bypass training platform. However, the existing models for practicing different anastomosis configurations have several limitations. We sought to optimize the use of the rat's abdominal aorta and common iliac arteries (CIA) for practicing the 3 main anastomosis configurations commonly used in cerebrovascular surgery. Thirteen male Sprague-Dawley rats underwent inhalant anesthesia. The abdominal aorta and the CIAs were exposed. The distances between the major branches of the aorta were measured to find the optimal location for an end-to-end anastomosis. Also, the feasibility of performing side-to-side and end-to-side anastomoses between the CIAs was assessed. All bypass configurations could be performed between the left renal artery and the CIA bifurcation. The longest segments of the aorta without major branches were 1) between the left renal and left iliolumbar arteries (16.9 mm ± 4.6), and 2) between the right iliolumbar artery and the aortic bifurcation (9.7 mm ± 4.7). The CIAs could be juxtaposed for an average length of 7.6 mm ± 1.3, for a side-to-side anastomosis. The left CIA could be successfully reimplanted on to the right CIA at an average distance of 9.1 mm ± 1.6 from the aortic bifurcation. Our results show that rat's abdominal aorta and CIAs may be effectively used for all the anastomosis configurations used in cerebral revascularization procedures. We also provide technical nuances and anatomic descriptions to plan for practicing each bypass configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Microsurgical anatomy of the abducens nerve.

    Science.gov (United States)

    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

    2012-11-01

    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. Copyright © 2012 Wiley Periodicals, Inc.

  9. A Cognitive Skill Classification Based On Multi Objective Optimization Using Learning Vector Quantization for Serious Games

    Directory of Open Access Journals (Sweden)

    Moh. Aries Syufagi

    2011-12-01

    Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments using 33 respondent players demonstrates that 61% of players have high trial and error cognitive skill, 21% have high carefully cognitive skill, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. Players have a high interest to finish the game if the player is emotionally stable. Interests in the players strongly support the procedural learning in a serious game.

  10. [Microsurgical removal of olfactory groove meningiomas].

    Science.gov (United States)

    Liang, Ri-Sheng; Zhou, Liang-Fu; Mao, Ying; Zhang, Rong; Yang, Wei-Zhong

    2011-01-01

    To explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas. Sixty seven cases of olfactory groove meningiomas were treated by microneurosurgery, among which fifty seven were de novo cases, eight were recurrent tumors and the other two re-recurrent cases. Modified Derome approach was used in 12 cases, bilateral subfrontal approach in 28 cases, modified pterional approach in 21 cases and unilateral subfrontal approach in six cases. Tumors were resected microsurgically with radical removal of invaded dura, bone, and paranasal sinus mucosa. Reconstruction was performed in patients with skull base defect. Simpson grade I removal was accomplished in 59 cases, grade II in seven cases and grade IV in one case. Among 57 patients with de novo tumor, Simpson I resection was accomplished in 54 cases. Postoperative rhinorrhea and intracranial infection occurred in one case and was cured after temporal lumbar CSF drainage and antibiotic therapy. Two patients (2.9%) died within one month after operation, i.e.one aged patient of heart failure and the other of severe hypothalamus complication. Forty seven patients (72.3%) were followed up from one to ten years with an average of five years and four months. With the exception of two cases died, among the alive 45 patients, there were only three patients with tumor recurrence, which had undergone Simpson II or IV tumor resection. No recurrence was found in cases with Simpson I tumor removal. Previous blurred vision was not improved in three patients, hemiparalysis in two patients, and the other patients recovered well, resuming previous jobs or being able to take care themselves. Total tumor removal (Simpson I) should be the surgical goal for treatment of olfactory groove meningiomas, especially for de novo cases. An appropriate approach is fundamental in the effort to remove an OGM totally. Appropriate anterior skull base reconstruction with vascularized material is

  11. Microsurgical anatomy of the central lobe.

    Science.gov (United States)

    Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

    2015-03-01

    The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

  12. Video game practice optimizes executive control skills in dual-task and task switching situations.

    Science.gov (United States)

    Strobach, Tilo; Frensch, Peter A; Schubert, Torsten

    2012-05-01

    We examined the relation of action video game practice and the optimization of executive control skills that are needed to coordinate two different tasks. As action video games are similar to real life situations and complex in nature, and include numerous concurrent actions, they may generate an ideal environment for practicing these skills (Green & Bavelier, 2008). For two types of experimental paradigms, dual-task and task switching respectively; we obtained performance advantages for experienced video gamers compared to non-gamers in situations in which two different tasks were processed simultaneously or sequentially. This advantage was absent in single-task situations. These findings indicate optimized executive control skills in video gamers. Similar findings in non-gamers after 15 h of action video game practice when compared to non-gamers with practice on a puzzle game clarified the causal relation between video game practice and the optimization of executive control skills. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. A Cognitive Skill Classification Based on Multi Objective Optimization Using Learning Vector Quantization for Serious Games

    Directory of Open Access Journals (Sweden)

    Moh. Aries Syufagi

    2013-09-01

    Full Text Available Nowadays, serious games and game technology are poised to transform the way of educating and training students at all levels. However, pedagogical value in games do not help novice students learn, too many memorizing and reduce learning process due to no information of player’s ability. To asses the cognitive level of player ability, we propose a Cognitive Skill Game (CSG. CSG improves this cognitive concept to monitor how players interact with the game. This game employs Learning Vector Quantization (LVQ for optimizing the cognitive skill input classification of the player. CSG is using teacher’s data to obtain the neuron vector of cognitive skill pattern supervise. Three clusters multi objective XE "multi objective"  target will be classified as; trial and error, carefully and, expert cognitive skill. In the game play experiments employ 33 respondent players demonstrates that 61% of players have high trial and error, 21% have high carefully, and 18% have high expert cognitive skill. CSG may provide information to game engine when a player needs help or when wanting a formidable challenge. The game engine will provide the appropriate tasks according to players’ ability. CSG will help balance the emotions of players, so players do not get bored and frustrated. 

  14. Optimize scientific communication skills on work and energy concept with implementation of interactive conceptual instruction and multi representation approach

    Science.gov (United States)

    Patriot, E. A.; Suhandi, A.; Chandra, D. T.

    2018-05-01

    The ultimate goal of learning in the curriculum 2013 is that learning must improve and balance between soft skills and hard skills of learners. In addition to the knowledge aspect, one of the other skills to be trained in the learning process using a scientific approach is communication skills. This study aims to get an overview of the implementation of interactive conceptual instruction with multi representation to optimize the achievement of students’ scientific communication skills on work and energy concept. The scientific communication skills contains the sub-skills were searching the information, scientific writing, group discussion and knowledge presentation. This study was descriptive research with observation method. Subjects in this study were 35 students of class X in Senior High School at Sumedang. The results indicate an achievement of optimal scientific communication skills. The greatest achievement of KKI based on observation is at fourth meeting of KKI-3, which is a sub-skill of resume writing of 89%. Allmost students responded positively to the implication of interactive conceptual instruction with multi representation approach. It can be concluded that the implication of interactive conceptual instruction with multi representation approach can optimize the achievement of students’ scientific communication skill on work and energy concept.

  15. Optimizing the number of steps in learning tasks for complex skills.

    Science.gov (United States)

    Nadolski, Rob J; Kirschner, Paul A; van Merriënboer, Jeroen J G

    2005-06-01

    Carrying out whole tasks is often too difficult for novice learners attempting to acquire complex skills. The common solution is to split up the tasks into a number of smaller steps. The number of steps must be optimized for efficient and effective learning. The aim of the study is to investigate the relation between the number of steps provided to learners and the quality of their learning of complex skills. It is hypothesized that students receiving an optimized number of steps will learn better than those receiving either the whole task in only one step or those receiving a large number of steps. Participants were 35 sophomore law students studying at Dutch universities, mean age=22.8 years (SD=3.5), 63% were female. Participants were randomly assigned to 1 of 3 computer-delivered versions of a multimedia programme on how to prepare and carry out a law plea. The versions differed only in the number of learning steps provided. Videotaped plea-performance results were determined, various related learning measures were acquired and all computer actions were logged and analyzed. Participants exposed to an intermediate (i.e. optimized) number of steps outperformed all others on the compulsory learning task. No differences in performance on a transfer task were found. A high number of steps proved to be less efficient for carrying out the learning task. An intermediate number of steps is the most effective, proving that the number of steps can be optimized for improving learning.

  16. Japanese Neurosurgeons and Microsurgical Anatomy: A Historical Review

    Science.gov (United States)

    MATSUSHIMA, Toshio; KAWASHIMA, Masatou; MATSUSHIMA, Ken; WANIBUCHI, Masahiko

    2015-01-01

    Research in microneurosurgical anatomy has contributed to great advances in neurosurgery in the last 40 years. Many Japanese neurosurgeons have traveled abroad to study microsurgical anatomy and played major roles in advancing and spreading the knowledge of anatomy, overcoming their disadvantage that the cadaver study has been strictly limited inside Japan. In Japan, they initiated an educational system for surgical anatomy that has contributed to the development and standardization of Japanese neurosurgery. For example, the Japanese Society for Microsurgical Anatomy started an annual educational meeting in the middle of 1980s and published its proceedings in Japanese every year for approximately 20 years. These are some of the achievements that bring worldwide credit to Japanese neurosurgeons. Not only should Japanese neurosurgeons improve their educational system but they should also contribute to the international education in this field, particularly in Asia. PMID:25797782

  17. Microsurgical training on an in vitro chicken wing infusion model.

    Science.gov (United States)

    Olabe, Jon; Olabe, Javier

    2009-12-01

    Microneurovascular anastomosis and aneurysm clipping require extensive training before mastering the technique and are a surgical challenge. We developed the "infused chicken wing method" to provide a simple but realistic training method minimizing animal use and need for special facilities for animal care and anesthesia. Fresh chicken wings were used in this model. The main brachial artery was cannulated, and water was infused at 140 mm Hg followed by anatomical neurovascular dissection. Multiple microsurgical training exercises were performed under microscope vision including terminoterminal, lateroterminal, laterolateral vascular anastomosis, and nerve anastomosis. Different complexity aneurysms were created using venous patches, clipping, rupture, and vascular reconstruction techniques were performed. This novel training model is inexpensive, easily obtainable, and no live animals are required. The diameter and characteristics of arteries and veins used are similar to those of the human brain. Great microsurgical technique progress may be obtained. The infused chicken wing artery model presents a realistic microvascular training method. It is inexpensive and easy to set up. Such simplicity provides the adequate environment for developing microsurgical technique. Copyright 2009 Elsevier Inc. All rights reserved.

  18. Microsurgical replantation of a small segment of thumb volar skin.

    Science.gov (United States)

    Akyürek, Mustafa; Safak, Tunç

    2004-06-01

    This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

  19. Examining Length of Hospital Stay after Microsurgical Breast Reconstruction: Evaluation in a Case-Control Study

    Directory of Open Access Journals (Sweden)

    Jordan D. Frey, MD

    2017-12-01

    Conclusions:. Multiple patient-specific, intra-operative, and post-operative outcomes factors are associated with increased length of stay with immediate and delayed microsurgical breast reconstruction.

  20. Optimizing the Timing of Expert Feedback During Simulation-Based Spaced Practice of Endourologic Skills.

    Science.gov (United States)

    Lee, Jason Young; McDougall, Elspeth M; Lineberry, Matthew; Tekian, Ara

    2016-08-01

    Provision of expert feedback is widely acknowledged to be an essential component of simulation-based training. However, little is known about the most effective and efficient ways to provide feedback to novices. Optimizing the timing of expert feedback may improve outcomes while reducing resource requirements. The main objective of this study was to determine the impact of providing early versus late expert feedback to novice learners engaged in a flexible ureteroscopy (fURS) training curriculum. Senior medical students were recruited to participate in this study. Each student participated in a comprehensive fURS training curriculum that included 3 deliberate, independent practice sessions. Baseline and postcourse fURS skill was assessed for each student using a standardized fURS test task. Each student was randomized to either an early feedback group (EFG) or late feedback group (LFG). The EFG participants were provided expert feedback immediately after the baseline skill test, whereas LFG participants were given feedback before their final deliberate, independent practice session. Eighteen senior medical students completed the study (9 EFG and 9 LFG participants). There were no discernible demographic differences between the groups at baseline. When controlling for pretest performance, early rather than late feedback was associated with both shorter postcourse time to completion of the task (19.2 vs. 21.5 minutes, P feedback when learning a novel skill. Further study is required.

  1. A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft.

    Science.gov (United States)

    Kim, K S; Eo, S R; Kim, D Y; Lee, S Y; Cho, B H

    2001-01-01

    Many methods have been used to reattach amputated fingertips. Of these methods, microsurgery has been accepted as the procedure of choice because the defining characteristic of a microsurgically replanted finger is that its surival in the recipient bed is predicated on functioning intravascular circulation. Although considerable progress has been made in the techniques for microvascular replantation of amputated fingers, the replantation of an amputated fingertip is difficult because digital arteries branch into small arteries. This is in addition to digital veins that run from both sides of the nail bed to the median dorsal sides, which are difficult to separate from the immobile soft tissue. Furthermore, even with the most technically skilled microsurgeon, replantation failure often occurs, especially in severe injury cases. Therefore, the technique is not the only protection against failure, and a new strategy of fingertip reattachment is needed. From March of 1997 to December of 1999, 12 fingers of 11 patients with zone 1 or zone 2 fingertip amputations that were reattached microsurgically but were compromised were deepithelialized, reattached, and then inserted into the abdominal pocket. All had been complete amputations with crushing injuries. Approximately 3 weeks later, the fingers were depocketed and covered with a skin graft. Of the 12 fingers, 7 survived completely and 3 had partial necrosis on less than one-third the volume of the amputated part. The complete survival rate was approximately 58 percent. The results of the above 10 fingers were satisfactory from both functional and cosmetic aspects. The authors believe that this high success rate was achieved because the deepithelialized finger pulp was placed in direct contact with the deep abdominal fascia, which was equipped with plentiful vascularity, not subcutaneous fat. In addition, the pocketing was performed promptly before necrosis of the compromised fingertip occurred. From the results of this

  2. Predictability of a Coupled Model of ENSO Using Singular Vector Analysis: Optimal Growth and Forecast Skill.

    Science.gov (United States)

    Xue, Yan

    The optimal growth and its relationship with the forecast skill of the Zebiak and Cane model are studied using a simple statistical model best fit to the original nonlinear model and local linear tangent models about idealized climatic states (the mean background and ENSO cycles in a long model run), and the actual forecast states, including two sets of runs using two different initialization procedures. The seasonally varying Markov model best fit to a suite of 3-year forecasts in a reduced EOF space (18 EOFs) fits the original nonlinear model reasonably well and has comparable or better forecast skill. The initial error growth in a linear evolution operator A is governed by the eigenvalues of A^{T}A, and the square roots of eigenvalues and eigenvectors of A^{T}A are named singular values and singular vectors. One dominant growing singular vector is found, and the optimal 6 month growth rate is largest for a (boreal) spring start and smallest for a fall start. Most of the variation in the optimal growth rate of the two forecasts is seasonal, attributable to the seasonal variations in the mean background, except that in the cold events it is substantially suppressed. It is found that the mean background (zero anomaly) is the most unstable state, and the "forecast IC states" are more unstable than the "coupled model states". One dominant growing singular vector is found, characterized by north-south and east -west dipoles, convergent winds on the equator in the eastern Pacific and a deepened thermocline in the whole equatorial belt. This singular vector is insensitive to initial time and optimization time, but its final pattern is a strong function of initial states. The ENSO system is inherently unpredictable for the dominant singular vector can amplify 5-fold to 24-fold in 6 months and evolve into the large scales characteristic of ENSO. However, the inherent ENSO predictability is only a secondary factor, while the mismatches between the model and data is a

  3. Teaching laryngeal endoscopy skills to speech and language therapists: applying learning theory to optimize practical skills mastery.

    Science.gov (United States)

    Robinson, H Fiona; Dennick, Reg

    2015-06-01

    This review was carried out to highlight relevant learning theory and its application to the teaching of endoscopic skills to speech and language therapists (SLTs). This article explains the most relevant models from Constructivist, Experiential and Humanistic Learning Theory, a combination that has been described as Constructive Experience, and describes the relevance and the benefits of applying educational frameworks in course design. This approach has been formally used to design and deliver practical skills teaching in medicine. SLTs carry out endoscopic evaluation of the larynx (EEL) to provide information for evaluation and rehabilitation of voice and swallowing disorders. These are essential procedures in ear, nose and throat, voice and swallowing specialist centres. Training in endoscopy skills for SLTs working in the ear, nose and throat specialist centres in the United Kingdom has traditionally been provided external to the local clinic environment as 1 or 2-day courses. In one survey in the United Kingdom, 79% of SLTs reported that they did not acquire the depth of skill required to carry out EEL autonomously after attending such courses. Course development to teach practical skills should be underpinned by educational theory. One EEL course in the United Kingdom is described, wherein sessions are interactive and experiential, promoting deep learning, constructive feedback and reflection, enriched by the completion of logs and portfolios. From course evaluations, all the learners met the learning objectives, developing and applying skills to become confident endoscopists in autonomous clinical practice.

  4. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Science.gov (United States)

    2010-04-01

    ... laser. 874.4500 Section 874.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  5. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

    2018-01-26

    OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

  6. Biliary fibrosis in microsurgical extrahepatic cholestasis in the rat.

    Science.gov (United States)

    Sánchez-Patán, Fernando; Anchuelo, Raquel; Corcuera, María-Teresa; Casado, Isabel; Gómez-Aguado, Fernando; Aller, María-Angeles; Cruz, Arturo; Alonso, María-José; Arias, Jaime

    2008-01-01

    A new model of extrahepatic cholestasis, using a microsurgical technique, is performed as an alternative to the traditional model of the bile duct ligated-rat, in order to study the stage of fibrosis in the long-term. Male Wistar rats were divided into two groups: I (Sham-operated, n = 9) and II [Microsurgical Cholestasis (MC), n = 10]. After 4 weeks, portal pressure, types of portosystemic collateral circulation, mesenteric venous vasculopathy, hepatic function test, and liver histopathology were studied by using the Knodell index and fibrosis was determined by reticulin and Sirius red stains. The animals with MC presented portal hypertension with extrahepatic portosistemic collateral circulation, associated with mesenteric venous vasculopathy and increased plasma levels of bilirubin (6.30 +/- 1.80 vs. 0.22 +/- 0.37 mg/dL; P = 0.0001), alkaline phosphatase (293.00 +/- 82.40 vs. 126.30 +/- 33.42 U/L; P = 0.001), AST (380.00 +/- 78.50 vs. 68.33 +/- 11.74 IU/L; P = 0.0001), ALT (87.60 +/- 22.32 vs. 42.22 +/- 7.89 IU/L; P = 0.0001), and LDH (697.76 +/- 75.13 vs. 384.80 +/- 100.03 IU/L; P = 0.0001). On the contrary, plasma levels of albumin decreased (2.72 +/- 0.12 mg/dl vs. 2.99 +/- 0.10; P = 0.001). The microsurgical resection of the extrahepatic biliary tract in the rat produces an experimental model of hepatic inflammation, characterized by a high Knodell hepatic activity index (4), bile proliferation, and fibrosis.

  7. Microsurgical spinothalamic chordotomy in the treatment of cancer pain.

    Science.gov (United States)

    Slavik, E; Ivanović, S; Grujisić, D; Djurović, B; Nikolić, I

    2005-01-01

    Advances in cancer treatment continue to lengthen survival among cancer patients. As patients live longer, the need for effective pain control has gained increased importance for improving quality of life. In patients who do not respond to all available conservative methods of therapy for cancer pain, surgical methods have been applied; one of them is the open high thoracic spinothalamic chordotomy. We present a group of 86 patients suffering from nociceptive cancer pain, caused by compression of lumbosacral plexus. All patients were treated by microsurgical open high thoracic spinothalamic chordotomy. These patients did not respond to any available conservative treatment. Immediately after surgery 68 (79%) patients had total pain relief. Of the remaining 18 (21%) patients, significant pain relief was achieved in 9 (10%), while in the remaining 9 patients this procedure had no effect. After a 6-month follow-up, total pain relief remained in 62 (72%) and significant pain relief in 10 (17%) of the patients. From 62 of patients with well-defined unilateral pain treated by "moderately deep" chordotomy, total pain relief was achieved in 53 (85%), lasting for 6 months in 49 (79%) of them. These results show that microsurgical chordotomy can achieve total control of intractable cancer pain in the majority (79%) of patients, especially in those with well-defined unilateral pain (85%), indicating the usefullness of this surgical approach in the treatment of nociceptive cancer pain.

  8. The role of community sports coaches in creating optimal social conditions for life skill development and transferability - a salutogenic perspective

    NARCIS (Netherlands)

    Super, S.; Verkooijen, K.T.; Koelen, M.A.

    2018-01-01

    Sport is widely recognised as having the potential to enhance the personal development of socially vulnerable youth, yet there is very limited knowledge on how community sports coaches can create optimal social conditions for life skill development and transferability. We adopt a salutogenic

  9. Cerebellar anatomy as applied to cerebellar microsurgical resections

    Directory of Open Access Journals (Sweden)

    Alejandro Ramos

    2012-06-01

    Full Text Available OBJECTIVE: To define the anatomy of dentate nucleus and cerebellar peduncles, demonstrating the surgical application of anatomic landmarks in cerebellar resections. METHODS: Twenty cerebellar hemispheres were studied. RESULTS: The majority of dentate nucleus and cerebellar peduncles had demonstrated constant relationship to other cerebellar structures, which provided landmarks for surgical approaching. The lateral border is separated from the midline by 19.5 mm in both hemispheres. The posterior border of the cortex is separated 23.3 mm from the posterior segment of the dentate nucleus; the lateral one is separated 26 mm from the lateral border of the nucleus; and the posterior segment of the dentate nucleus is separated 25.4 mm from the posterolateral angle formed by the junction of lateral and posterior borders of cerebellar hemisphere. CONCLUSIONS: Microsurgical anatomy has provided important landmarks that could be applied to cerebellar surgical resections.

  10. Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Ching-Jen Chen

    2016-01-01

    Full Text Available Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.

  11. The efficacy of the enhanced Aussie Optimism Positive Thinking Skills Program in improving social and emotional learning in middle childhood

    OpenAIRE

    Myles-Pallister, Jacqueline D.; Hassan, Sharinaz; Rooney, Rosanna M.; Kane, Robert T.

    2014-01-01

    The aim of the current study was to investigate the effects of the modified and enhanced Aussie Optimism Positive Thinking Skills Program (AO-PTS) on Year 4 and 5 children's social and emotional learning (SEL) skills. AO-PTS is a universal-school based program that is implemented by class teachers as part of regular school curricula and was developed for the prevention of depression and anxiety. The study comprised a total of 683 Year 4 and 5 students from 10 private primary schools in Wester...

  12. Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients.

    Science.gov (United States)

    Guo, Fuyou; Wang, Guoqing; Suresh, Vigneyshwar; Xu, Dingkang; Zhang, Xiaoyang; Feng, Mengzhao; Wang, Fang; Liu, Xianzhi; Song, Laijun

    2018-04-01

    The optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases. Clinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed. Gross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p  0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05). Present findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Optimal training design for procedural motor skills: a review and application to laparoscopic surgery

    NARCIS (Netherlands)

    Spruit, E.N.; Band, G.P.H.; Hamming, J.F.; Ridderinkhof, K.R.

    2014-01-01

    This literature review covers the choices to consider in training complex procedural, perceptual and motor skills. In particular, we focus on laparoscopic surgery. An overview is provided of important training factors modulating the acquisition, durability, transfer, and efficiency of trained

  14. Use of autologous and microsurgical breast reconstruction by U.S. plastic surgeons.

    Science.gov (United States)

    Kulkarni, Anita R; Sears, Erika Davis; Atisha, Dunya M; Alderman, Amy K

    2013-09-01

    Concern exists that plastic surgeons are performing fewer autologous and microsurgical breast reconstructions, despite superior long-term outcomes. The authors describe the proportion of U.S. plastic surgeons performing these procedures and evaluate motivating factors and perceived barriers. A random national sample of American Society of Plastic Surgeons members was surveyed (n = 325; response rate, 76 percent). Surgeon and practice characteristics were assessed, and two multiple logistic regression models were created to evaluate factors associated with (1) high-volume autologous providers and (2) microsurgical providers. Qualitative assessments of motivating factors and barriers to microsurgery were also performed. Fewer than one-fifth of plastic surgeons perform autologous procedures for more than 50 percent of their breast cancer patients, and only one-quarter perform any microsurgical breast reconstruction. Independent predictors of a high-volume autologous practice include involvement with resident education (odds ratio, 2.57; 95 percent CI, 1.26 to 5.24) and a microsurgical fellowship (odds ratio, 2.09; 95 percent CI, 1.04 to 4.27). Predictors of microsurgical breast reconstruction include involvement with resident education (odds ratio, 6.8; 95 percent CI, 3.32 to 13.91), microsurgical fellowship (odds ratio, 2.4; 95 percent CI, 1.16 to 4.95), and high breast reconstruction volume (odds ratio, 6.68; 95 percent CI, 1.76 to 25.27). The primary motivator for microsurgery is superior outcomes, and the primary deterrents are time and reimbursement. The proportion of U.S. plastic surgeons with a high-volume autologous or microsurgical breast reconstruction practice is low. Involvement with resident education appears to facilitate both, whereas time constraints and reimbursement are primary deterrents. Future efforts should focus on improving the feasibility and accessibility of all types of breast reconstruction.

  15. Microsurgical tunica albuginea transplantation in an animal model

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    Salvatore Sansalone

    2017-01-01

    Full Text Available Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at −80°C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.

  16. Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

    Science.gov (United States)

    Corradino, Bartolo; Di Lorenzo, Sara; Mossuto, Carmela; Costa, Renato Patrizio; Moschella, Francesco

    2010-01-01

    Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during the healing stage. During the preoperative stage, 20 patients with oral cavity carcinoma who were candidates for microsurgical reconstruction underwent sialoscintigraphy and a quantitative measurement of the salivary secretion. Injection of botulinum toxin was carried out in the salivary glands 4 days before surgery. The saliva quantitative measurement was repeated 3 and 8 days after infiltration, sialoscintigraphy after 15 days. In all cases, the saliva quantitative measurement revealed a reduction of 50% and 70% of the salivary secretion after 72 h and 8 days, respectively. A lower rate of local complications was observed.

  17. Predictive Factors for Natural Pregnancy after Microsurgical Reconstruction in Patients with Primary Epididymal Obstructive Azoospermia

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    Mihai Harza

    2014-01-01

    Full Text Available Primary epididymal obstructive azoospermia (OA is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34±4.5 years (range 24–46 years. Median follow-up time was 15 [IQR 12–21] months. The total patency rate was 77.7% (n=28. During follow-up, 8 (22.2% natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052–0.88; P=0.032 and higher total motile sperm count (TMSC (HR: 1.001; 95% CI 1–1.001; P=0.012 were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  18. Predictive factors for natural pregnancy after microsurgical reconstruction in patients with primary epididymal obstructive azoospermia.

    Science.gov (United States)

    Harza, Mihai; Voinea, Sebastian; Ismail, Gener; Gagiu, Cristian; Baston, Catalin; Preda, Adrian; Manea, Ioan; Priporeanu, Tiberiu; Sinescu, Ioanel

    2014-01-01

    Primary epididymal obstructive azoospermia (OA) is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34 ± 4.5 years (range 24-46 years). Median follow-up time was 15 [IQR 12-21] months. The total patency rate was 77.7% (n = 28). During follow-up, 8 (22.2%) natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052-0.88; P = 0.032) and higher total motile sperm count (TMSC) (HR: 1.001; 95% CI 1-1.001; P = 0.012) were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

  19. Optimizing the number of steps in learning tasks for complex skills.

    NARCIS (Netherlands)

    Nadolski, Rob; Kirschner, Paul A.; Van Merriënboer, Jeroen

    2007-01-01

    Background. Carrying out whole tasks is often too difficult for novice learners attempting to acquire complex skills. The common solution is to split up the tasks into a number of smaller steps. The number of steps must be optimised for efficient and effective learning. Aim. The aim of the study is

  20. Microsurgical Resection of Suprasellar Craniopharyngioma-Technical Purview.

    Science.gov (United States)

    Nanda, Anil; Narayan, Vinayak; Mohammed, Nasser; Savardekar, Amey R; Patra, Devi Prasad

    2018-04-01

    Objectives  Complete surgical resection is an important prognostic factor for recurrence and is the best management for craniopharyngioma. This operative video demonstrates the technical nuances in achieving complete resection of a suprasellar craniopharyngioma. Design and Setting  The surgery was performed in a middle-aged lady who presented with the history of progressive bitemporal hemianopia and excessive sleepiness over 8 months. On imaging, suprasellar craniopharyngioma was identified. The tumor was approached through opticocarotid cistern and lamina terminalis. Exposure of bilateral optic nerves, right internal carotid artery, anterior cerebral artery, and its perforator branches was then afforded and the tumor was gross totally resected. Results  The author demonstrates step-by-step technique of microsurgical resection of suprasellar craniopharyngioma. The narrow corridor to deeper structures, intricacies of multiple perforator vessels, and the technique of arachnoid and capsule dissection are the main challenging factors for the gross total resection of craniopharyngioma. The tumor portion which lies under the ipsilateral optic nerve is a blind spot region with a high chance of leaving residual tumor. Mobilization of optic nerve may endanger visual function too. The use of handheld mirror ['mirror-technique'] helps in better visualization of this blind spot and achieve complete excision. Conclusions  The technical pearls of craniopharyngioma surgery include the optimum utilization of translamina terminalis route, wide opening of the cisterns, meticulous separation of deep perforator vessels, capsular mobilization/traction avoidance, and the use of "mirror-technique" for blind-spot visualization. These surgical strategies help to achieve complete resection without causing neurological deficit. The link to the video can be found at: https://youtu.be/9wHJ4AUpG50 .

  1. Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

    Energy Technology Data Exchange (ETDEWEB)

    Meij, B. P. [Utrecht University, Utrecht (Netherlands); Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H. A.W.; Verlaat, J.W. van ' t

    1997-07-15

    Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons.

  2. Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

    International Nuclear Information System (INIS)

    Meij, B.P.; Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H.A.W.; Verlaat, J.W. van 't

    1997-01-01

    Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons

  3. [Microsurgical anatomy importance of A1-anterior communicating artery complex].

    Science.gov (United States)

    Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

    2013-01-01

    The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

  4. Microsurgical principles and postoperative adhesions: lessons from the past.

    Science.gov (United States)

    Gomel, Victor; Koninckx, Philippe R

    2016-10-01

    "Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Postoperative adhesion formation being a major cause of failure in fertility surgery, the concept of microsurgery predominantly addresses prevention of postoperative adhesions. In this concept, magnification with a microscope or laparoscope plays a minor role as technical facilitator. Not surprisingly, the principles to prevent adhesion formation are strikingly similar to our actual understanding: gentle tissue handling, avoiding desiccation, irrigation at room temperature, shielding abdominal contents from ambient air, meticulous hemostasis and lavage, avoiding foreign body contamination and infection, administration of dexamethasone postoperatively, and even the concept of keeping denuded areas separated by temporary adnexal or ovarian suspension. The actual concepts of peritoneal conditioning during surgery and use of dexamethasone and a barrier at the end of surgery thus confirm without exception the tenets of microsurgery. Although recent research helped to clarify the pathophysiology of adhesion formation, refined its prevention and the relative importance of each factor, the clinical end point of improvement of fertility rates remains demonstrated for only the microsurgical tenets as a whole. In conclusion, the principles of microsurgery remain fully valid as the cornerstones of reproductive microsurgery, whether performed by means of open access or laparoscopy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Utility of the Lone Star Retractor System in Microsurgical Carotid Endarterectomy.

    Science.gov (United States)

    Toyota, Shingo; Kumagai, Tetsuya; Goto, Tetsu; Mori, Kanji; Taki, Takuyu

    2017-05-01

    The retractor system is an important device in carotid endarterectomy (CEA). We applied the Lone Star (LS) Retractor System, which is a self-retaining retractor originally designed for improved visualization in many other surgical fields, in microsurgical CEA. The LS disposal retractor (14.1 cm × 14.1 cm) and LS elastic stays (5-mm sharp hook) were used as a retractor system in 38 consecutive CEAs. Using the LS retractor system, a shallow operative field could be obtained by lifting up the connective tissue surrounding the deep structures hooked by the LS elastic stays. The LS elastic stays were quick and easy to handle in the microsurgical operative field. There were no complications using the LS retractor system. The application of the LS retractor system in microsurgical CEA is feasible. An additional merit is that it is single use. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Structuring collaboration scripts for mastership skills: Optimizing online group play on classroom dilemmas in teacher education

    NARCIS (Netherlands)

    Hummel, Hans; Geerts, Walter; Slootmaker, Aad; Kuipers, Derek; Westera, Wim

    2014-01-01

    Serious games can facilitate workplace learning, for instance when collaboration on solving professional problems is involved. The optimal structure in collaboration scripts for such games has appeared to be a key success factor. Free collaboration does not systematically produce effective

  7. Optimization of preparation of skilled wrestlers by perfection of method of the special preparation

    Directory of Open Access Journals (Sweden)

    Ogar' G.O.

    2009-12-01

    Full Text Available The author method of the special physical preparation of skilled fighters is presented. A method carries stage-by-stage character. On the first stage effectively to conduct the accented power training. On the second stage - to perfect explosive force. Tasks of the third stage are perfection of speed force and lactate component of energy supply. On the fourth stage the special is perfected speed-power endurance. The fifth stage coincides with beginning of competition period of macrocycle.

  8. Changes in gray matter volume after microsurgical lumbar discectomy: A longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Michael eLuchtmann

    2015-02-01

    Full Text Available People around the world suffer chronic lower back pain. Because spine imaging often does not explain the degree of perceived pain reported by patients, the role of the processing of nociceptor signals in the brain as the basis of pain perception is gaining increased attention. Modern neuroimaging techniques (including functional and morphometric methods have produced results that suggest which brain areas may play a crucial role in the perception of acute and chronic pain. In this study, we examined twelve patients with chronic low back pain and sciatica, both resulting from lumbar disc herniation. Structural magnetic resonance imaging (MRI of the brain was performed one day prior to and about four weeks after microsurgical lumbar discectomy. The subsequent MRI revealed an increase in gray matter volume in the basal ganglia but a decrease in volume in the hippocampus, which suggests the complexity of the network that involves movement, pain processing, and aspects of memory. Interestingly, volume changes in the hippocampus were significantly correlated to preoperative pain intensity but not to the duration of chronic pain. Mapping structural changes of the brain that result from lumbar disc herniation has the potential to enhance our understanding of the neuropathology of chronic low back pain and sciatica and therefore may help to optimize the decisions we make about conservative and surgical treatments in the future. The possibility of illuminating more of the details of central pain processing in lumbar disc herniation, as well as the accompanying personal and economic impact of pain relief worldwide, calls for future large-scale clinical studies.

  9. Optimizing engagement in goal pursuit with youth with physical disabilities attending life skills and transition programs: an exploratory study.

    Science.gov (United States)

    Smart, Eric; Aulakh, Adeeta; McDougall, Carolyn; Rigby, Patty; King, Gillian

    2017-10-01

    Identify strategies youth perceive will optimize their engagement in goal pursuit in life skills and transition programs using an engagement framework involving affective, cognitive, and behavioral components. A qualitative descriptive design was used. Two semi-structured interviews were conducted with seven youth. The first was informed by a prior observation session, and the second occurred after the program ended and explored youths' perceptions of whether and how their engagement changed. Data were analyzed using thematic analysis. The analysis generated eight strategies youth considered effective. These were categorized under the three components of engagement. Affective strategies: (1) building a relationship on familiarity and reciprocity; and (2) guiding the program using youths' preferences and strengths. Cognitive strategies: (3) assisting youth to envision meaningful change; (4) utilizing youths' learning styles; and (5) promoting awareness of goal progress. Behavioral strategies: (6) ensuring youth access to a resource network; (7) providing youth multiple decision opportunities; and (8) enabling youth to showcase capabilities. Service providers together with youth are encouraged to consider the role of context and self-determination needs in order to optimize youth engagement in goal pursuit. Systematic approaches to studying engagement are necessary to learn how to maximize rehabilitation potential. Implications for Rehabilitation Service providers are encouraged to be aware of the nature of engagement strategies identified by youth. Comprehensive frameworks of engagement are essential to generate knowledge on the range of strategies service providers can use to engage clients in rehabilitation services. Strategies perceived by youth to optimize their engagement in goal pursuit in life skills and transition programs have subtle yet significant differences with strategies used in other rehabilitation settings like mental health and adult healthcare

  10. The Efficacy of the Enhanced Aussie Optimism Positive Thinking Skills Program in Improving Social and Emotional Learning in Middle Childhood

    Directory of Open Access Journals (Sweden)

    Jacqueline D Myles-Pallister

    2014-08-01

    Full Text Available The aim of the current study was to investigate the effects of the modified and enhanced Aussie Optimism Positive Thinking Skills Program (AO-PTS on Year 4 and 5 children’s social and emotional learning (SEL skills. AO-PTS is a universal-school based program that is implemented by class teachers as part of regular school curricula and was developed for the prevention of depression and anxiety. The study comprised a total of 683 Year 4 and 5 students from 10 private primary schools in Western Australia. Students were assessed on two subscales of emotional attribution at school whilst parents reported on their children’s externalizing and internalizing problems outside of school and at home. Two analyses were conducted: seven intervention schools were assessed at pre- and post-test (Analysis 1 and pre-post change in three intervention schools were compared to pre-post change in three matched control schools (Analysis 2. Results from Analysis 1 showed that the intervention children had increased in their overall emotional attribution accuracy and decreased in total difficulties and hyperactivity; Results from Analysis 2 revealed no intervention effect on emotional attribution accuracy or internalizing or externalizing problems. These findings suggest that the enhanced AO-PTS’s effects on SEL were not evident in the short-term period after intervention. The non-significant findings and future directions for AO-PTS research and program modification were discussed.

  11. Microsurgical and Endoscopic Anatomy for Intradural Temporal Bone Drilling and Applications of the Electromagnetic Navigation System: Various Extensions of the Retrosigmoid Approach.

    Science.gov (United States)

    Matsushima, Ken; Komune, Noritaka; Matsuo, Satoshi; Kohno, Michihiro

    2017-07-01

    The use of the retrosigmoid approach has recently been expanded by several modifications, including the suprameatal, transmeatal, suprajugular, and inframeatal extensions. Intradural temporal bone drilling without damaging vital structures inside or beside the bone, such as the internal carotid artery and jugular bulb, is a key step for these extensions. This study aimed to examine the microsurgical and endoscopic anatomy of the extensions of the retrosigmoid approach and to evaluate the clinical feasibility of an electromagnetic navigation system during intradural temporal bone drilling. Five temporal bones and 8 cadaveric cerebellopontine angles were examined to clarify the anatomy of retrosigmoid intradural temporal bone drilling. Twenty additional cerebellopontine angles were dissected in a clinical setting with an electromagnetic navigation system while measuring the target registration errors at 8 surgical landmarks on and inside the temporal bone. Retrosigmoid intradural temporal bone drilling expanded the surgical exposure to allow access to the petroclival and parasellar regions (suprameatal), internal acoustic meatus (transmeatal), upper jugular foramen (suprajugular), and petrous apex (inframeatal). The electromagnetic navigation continuously guided the drilling without line of sight limitation, and its small devices were easily manipulated in the deep and narrow surgical field in the posterior fossa. Mean target registration error was less than 0.50 mm during these procedures. The combination of endoscopic and microsurgical techniques aids in achieving optimal exposure for retrosigmoid intradural temporal bone drilling. The electromagnetic navigation system had clear advantages with acceptable accuracy including the usability of small devices without line of sight limitation. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Optimizing human-system interface automation design based on a skill-rule-knowledge framework

    International Nuclear Information System (INIS)

    Lin, Chiuhsiang Joe; Yenn, T.-C.; Yang, C.-W.

    2010-01-01

    This study considers the technological change that has occurred in complex systems within the past 30 years. The role of human operators in controlling and interacting with complex systems following the technological change was also investigated. Modernization of instrumentation and control systems and components leads to a new issue of human-automation interaction, in which human operational performance must be considered in automated systems. The human-automation interaction can differ in its types and levels. A system design issue is usually realized: given these technical capabilities, which system functions should be automated and to what extent? A good automation design can be achieved by making an appropriate human-automation function allocation. To our knowledge, only a few studies have been published on how to achieve appropriate automation design with a systematic procedure. Further, there is a surprising lack of information on examining and validating the influences of levels of automation (LOAs) on instrumentation and control systems in the advanced control room (ACR). The study we present in this paper proposed a systematic framework to help in making an appropriate decision towards types of automation (TOA) and LOAs based on a 'Skill-Rule-Knowledge' (SRK) model. From the evaluating results, it was shown that the use of either automatic mode or semiautomatic mode is insufficient to prevent human errors. For preventing the occurrences of human errors and ensuring the safety in ACR, the proposed framework can be valuable for making decisions in human-automation allocation.

  13. The Role of Community Sports Coaches in Creating Optimal Social Conditions for Life Skill Development and Transferability--A Salutogenic Perspective

    Science.gov (United States)

    Super, Sabina; Verkooijen, Kirsten; Koelen, Maria

    2018-01-01

    Sport is widely recognised as having the potential to enhance the personal development of socially vulnerable youth, yet there is very limited knowledge on how community sports coaches can create optimal social conditions for life skill development and transferability. We adopt a salutogenic approach in order to study whether and how community…

  14. Treatment of fingertip amputation: comparison of results between microsurgical replantation and pocket principle.

    Science.gov (United States)

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

    2012-05-01

    In this article, a comparison of replantation using microsurgical replantation (replantation) and the Brent method and its modification (pocket principle) in the treatment of fingertip amputation is reported. As a classification of amputation level, we used Ishikawa's subzone classification of fingertip amputation, and the cases of amputations only in subzone 2 were included in this study. Between these two groups, there was no statistical difference in survival rate, postoperative atrophy, or postoperative range of motion. In terms of sensory recovery, some records were lost and exact study was difficult. But there was no obvious difference between these cases. In our comparison of microsurgical replantation versus the pocket principle in treatment of subzone 2 fingertip amputation, there was no difference in postoperative results. Each method has pros and cons, and the surgeon should choose which technique to use based on his or her understanding of the characteristics of both methods. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Stereotaxic microsurgical procedures of cerebral intracranial tumors guided by image and attended by computer

    International Nuclear Information System (INIS)

    Lopez Flores, Gerardo; Guerra Figueredo, Eritk; Ochoa Zaldivar, Luis

    2000-01-01

    It is reported that spatial guidance during microsurgery is an essential element. This application of stereotaxic surgery is shown at the International Center of Neurological Restoration (Cirene) from May, 1994, to February, 1998, on describing the performance of 65 microsurgical procedures under stereotaxic conditions among 62 patients with cerebral intracranial tumors. The procedure was divided into 3 stages: image acquisition, Cat, surgical planning , with Stasis planning system, and microsurgical procedures that included the Leksell, Micromar and Esteroflex stereotaxic systems. 27 of the total of patients presented glial tumors; 33, non-glial; and only 2 non-neoplastic lesions of diverse localization and size. 30 total resections We're made. Surgical morbidity was minimum and there was no surgical mortality. The main advantages of this method are: exact localization of the craniotomy, easy spatial guidance, and the opportunity to distinguish the limits between the tumor and the sound tissue. The possibility to apply Esteroflex to cerebral microsurgery was demonstrated

  16. Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics.

    Science.gov (United States)

    Sitbon, Y; Attathom, T

    2014-05-01

    Different aspects of treatment for periodontal diseases or gingival problems require rigorous diagnostics. Magnification tools and microsurgical instruments, combined with minimally invasive techniques can provide the best solutions in such cases. Relevance of treatments, duration of healing, reduction of pain and post-operative scarring have the potential to be improved for patients through such techniques. This article presents an overview of the use of microscopy in periodontics, still in the early stages of development.

  17. Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique.

    Science.gov (United States)

    Lee, Ka-Wo; Chiang, Feng-Yu

    2009-12-01

    Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions. These techniques include conventional incision or dissection, bimanual retraction and cutting, microflap technique and the CO2 laser. Until recently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can precisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. Instead of using conventional vertically opening microinstruments, this microsurgical pressing excision technique (MPET) utilized two pairs of custom-made horizontally left-opening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (G0) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure. This could be a well tolerated and precise microsurgical technique.

  18. Supraorbital Keyhole Microsurgical Fenestration of Symptomatic Temporal Arachnoid Cysts in Children: Advantages and Limitations.

    Science.gov (United States)

    Elkheshin, Sherif; Soliman, Ahmed

    2017-01-01

    To investigate the impact of endoscope-assisted microsurgical fenestration on temporal arachnoid cysts, and to determine the advantages and limitations of the technique. Twenty-five children with symptomatic temporal arachnoid cysts were operated via eyebrow supraorbital keyhole microsurgical fenestration targeting the medial cyst wall. Preoperative magnetic resonance imaging (MRI) of the brain was done for all patients. Preoperative clinical presentation of the patients included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%), motor weakness in the form of right-sided hemiparesis (12%) and cranial nerve palsy. Postoperative complete subsidence of headache was noted in 50%, while 20% remained unchanged. Drug resistant epilepsy improved in 69% of the patients. Postoperative MRI showed initial decrease in cyst volume as early as 3 months, only in a range of 5-12% volume reduction, and the late follow-up done at 6 and 18 months continued to show further reduction reported to be significant (p CSF) collection was the most common complication (20%). Only 1 patient experienced CSF leak mandating cysto-peritoneal shunting. Conclusıon: Eyebrow supraorbital keyhole microsurgical fenestration for temporal arachnoid cysts can be performed with a fairly low risk of complications and yields a favorable improvement in clinical and neuroimaging outcomes.

  19. Nasolabial facial artery and vein as recipient vessels for midface microsurgical reconstruction.

    Science.gov (United States)

    Oh, Suk Joon; Jeon, Man Kyung; Koh, Sung Hoon

    2011-05-01

    Although free flap transfer is commonly performed to reconstruct facial defects, the submandibular facial artery and vein have historically been considered as adequate recipient vessels for microsurgical reconstruction. If the vascular pedicles of the free flap are short, vein grafts are necessary. The purpose of this study was to determine the indications for and effectiveness of using the nasolabial facial vessels for midfacial reconstruction. A retrospective chart review of 6 patients undergoing microsurgical reconstruction for defects of the face revealed 6 free tissue transfers in which the nasolabial facial artery and vein were considered for use as recipient vessels. Flap success rates were evaluated. Six patients (5 men and 1 woman) underwent 6 free flap transfers. Five anterior helix free flaps were used for the reconstruction of defects in the lower third of the nose. Nasal defects were due to trauma in 4 patients and squamous cell carcinoma in 1 patient. In 1 neurofibromatosis type 1 case, a radial forearm flap was used for reconstruction of the left orbital defect. The facial artery and vein in the nasolabial fold were used as the recipient artery and vein in every case. The mean length of follow-up was 5.8 years. All flaps survived. All patients were satisfied with the degree of aesthetic improvement after surgery.Use of the facial artery and vein in the nasolabial fold for facial reconstruction is reliable and safe. The nasolabial facial artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the midface.

  20. Designing evidence-based medicine training to optimize the transfer of skills from the classroom to clinical practice: applying the four component instructional design model.

    Science.gov (United States)

    Maggio, Lauren A; Cate, Olle Ten; Irby, David M; O'Brien, Bridget C

    2015-11-01

    Evidence-based medicine (EBM) skills, although taught in medical schools around the world, are not optimally practiced in clinical environments because of multiple barriers, including learners' difficulty transferring EBM skills learned in the classroom to clinical practice. This lack of skill transfer may be partially due to the design of EBM training. To facilitate the transfer of EBM skills from the classroom to clinical practice, the authors explore one instructional approach, called the Four Component Instructional Design (4C/ID) model, to guide the design of EBM training. On the basis of current cognitive psychology, including cognitive load theory, the premise of the 4C/ID model is that complex skills training, such as EBM training, should include four components: learning tasks, supportive information, procedural information, and part-task practice. The combination of these four components can inform the creation of complex skills training that is designed to avoid overloading learners' cognitive abilities; to facilitate the integration of the knowledge, skills, and attitudes needed to execute a complex task; and to increase the transfer of knowledge to new situations. The authors begin by introducing the 4C/ID model and describing the benefits of its four components to guide the design of EBM training. They include illustrative examples of educational practices that are consistent with each component and that can be applied to teaching EBM. They conclude by suggesting that medical educators consider adopting the 4C/ID model to design, modify, and/or implement EBM training in classroom and clinical settings.

  1. Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases.

    Science.gov (United States)

    Lang, Min; Moore, Nina Z; Witek, Alex M; Kshettry, Varun R; Bain, Mark D

    2017-09-01

    Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage. Angiography revealed chronic right M1 occlusion and a 3-mm spherical lenticulostriate aneurysm. The frontal lobe hematoma was evacuated to reveal the aneurysm, which was safely cauterized and resected by coagulating and dividing the lenticulostriate parent vessel. The procedure was carried out with neuronavigation guidance and intraoperative neuromonitoring. The patient was discharged with no neurologic deficits. The second patient was a 53-year-old woman who presented with subarachnoid and intracerebral hemorrhage. Computed tomography angiogram showed a 2-mm saccular MCA aneurysm. Emergency left decompressive hemicraniectomy and hematoma evacuation were performed. The aneurysm, arising from a small collateral type vessel, was safely clipped without complications. Postoperative angiography revealed absence of the superior MCA trunk with a dense network of collateral vessels at the site of the clipped aneurysm. The patient recovered well and was ambulating independently 6 months postoperatively. No rebleeding occurred in the 2 patients. Our experience suggests that patients with MCA occlusion can harbor associated aneurysms related to flow through collateral vessels and can present with hemorrhage. Microsurgical repair of these aneurysms can be performed safely to prevent rebleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Microsurgical free flap reconstructions of head and neck region in 406 cases: a 13-year experience.

    Science.gov (United States)

    Gerressen, Marcus; Pastaschek, Claudia Inge; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

    2013-03-01

    The reconstruction of extended soft tissue and bony defects in the maxillofacial region with microsurgical flaps is considered to be the therapy of first choice. The aim of this retrospective study was to detect different influencing factors concerning flap survival. We examined the data of 406 patient cases (121 female and 285 male cases; mean age, 57 years) undergoing reconstruction with a microsurgical flap in our facility between 1998 and 2010. In these cases 326 soft tissue flaps (radial forearm flap, scapula flap, latissimus dorsi flap, anterolateral thigh flap, lateral arm flap, and jejunum flap) and 80 bony flaps (fibula flap and deep circumflex iliac artery flap) were examined. Evaluated parameters were, among others, the timing of reconstruction, defect localization, and recipient vessels used (external vs internal jugular system), as well as anticoagulative management. We statistically analyzed data by means of a χ(2) test, taking account of the odds ratio with P < .05, which was deemed significant. The overall flap survival rate was approximately 92%, without any gender- or age-specific differences. Primary reconstructions proceeded distinctly more successfully than secondary reconstructions (P < .01). Likewise, the defect localization exerted a significant effect on the survival rate (P = .01), with a more caudal localization affecting flap survival positively. Finally, neither the anticoagulation regimen nor the choice of recipient vein system exercised an influence on the survival rate. Microsurgical tissue transfer is a convenient and reliable method in maxillofacial surgery, provided that one is aware of the determining factors for success. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Microsurgical replantation and postoperative leech treatment of a large severed nasal segment

    DEFF Research Database (Denmark)

    Stemann Andersen, Peter; Elberg, Jens Jørgen

    2012-01-01

    The survival of a microsurgically replanted segment of nose in a 41-year-old woman was facilitated by the assistance of the medicinal leech Hirudo medicinalis. An arterial microanastomosis was made to a severed partial segment of nose with no possibility of recreating a venous anastomosis. The re....... The resulting venous congestion was treated with nine days of treatment with a medical leech until venous neovascularisation had been achieved. At follow-up six months after discharge there was a well-heeled nasal segment and a satisfying functional - as well as cosmetic - result....

  4. [Microsurgical drezotomy for the treatment of spasticity of the lower limbs].

    Science.gov (United States)

    Mertens, P; Sindou, M

    1998-09-01

    Ablative functional neurosurgery can be useful in some selected patients for the treatment of harmful spasticity in the lower limbs. Microsurgical drezotomy was introduced in 1972, on the basis of anatomical studies of the human dorsal root entry zone (DREZ) showing a topographical segregation of the afferent fibers according to their size and thus functional destinations. It consists of a 3 mm deep microsurgical lesion directed at a 45 degree angle in the postero-lateral sulcus, penetrating the DREZ in its ventro-lateral aspect, at the level of all the rootlets considered as involved in spasticity (and pain). It destroys mainly the lateral (nociceptive) and central (myotatic) afferent fibers as well as the facilitatory medial part of the Lissauer tract, whilst sparing most of the medial (lemniscal) fibers and the inhibitor lateral part of the Lissauer tract. We report a series of 121 bedridden patients suffering from harmful spasticity in one (15) or both (106) lower limbs and treated with microsurgical drezotomy. Surgery was decided on because of abnormal postures in flexion in two-thirds of the patients and in hyperextension in one-third, additional pain in 75 of them, and hyperactive bladder in 38 cases. The post-operative results were evaluated after a mean follow-up time of 5 years and 6 months. Both spasticity and spasms were significantly decreased or suppressed respectively in 78% and 88% of the patients. When present, pain was relieved without abolition of sensation in 82%. These benefits resulted in either disappearance or marked reduction of the abnormal postures and articular limitation in 90% of the patients. When present preoperatively, urinary leakage disappeared in 85% of the cases. Mild to severe complications occurred in 32 patients and precipitated or were responsible for death in 6 cases (5%). This is explained by the fact that most of the patients, especially those affected by multiple sclerosis, were in very precarious general and

  5. The results of surgical treatment of oviductal infertility with use of microsurgical technique

    International Nuclear Information System (INIS)

    Cislo, M.; Murawski, M.; Palczynski, B.

    1993-01-01

    40 women were operated on infertility due to oviductal factor. This kind of infertility has been previously diagnosed by hysterosalpingography examination and then verified in 22 cases (55%) by laparoscopy combined with chromotubation. The operations were carried out with use of microsurgical technique and instruments. At the same time the prophylactics of postoperative intraperitoneal adhesions was applied. Seven pregnancies were obtained, that makes 17.5% of success. It is an outcome comparable with results presented by many other world centers of gynecological microsurgery. (author)

  6. Microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches

    Directory of Open Access Journals (Sweden)

    Hong-guang WANG

    2016-08-01

    Full Text Available Objective To investigate surgical strategies, clinical effects and complications of microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches.  Methods Review clinical data of 18 cases with anterior circulation mirror aneurysms who underwent one-stage clipping via bilateral frontolateral approaches from July 2010 to July 2015 admitted to Department of Neurosurgery in Tianjin Huanhu Hospital. The operative efficacy was evaluated according to postoperative Glasgow Outcome Scale (GOS.  Results The 36 aneurysms in 18 patients were successfully clipped via bilateral frontolateral approaches at one-stage, including 18 posterior communicating artery (PCoA mirror aneurysms in 9 cases and 18 middle cerebral artery (MCA mirror aneurysms in 9 cases. GOS score of 5 was discovered in 16 cases, and 4 was discovered in 2 cases after operation. One case underwent ventriculoperitoneal shunting (VPS due to communicating hydrocephalus, one case got postoperative pulmonary infection and no death occurred. Intracranial CTA at 6 months postoperatively showed aneurysms of 18 patients were clipped completely, the parent artery blood flow was smooth, and no recurrence was found.  Conclusions Microsurgical one-stage clipping via bilateral frontolateral approaches for treating intracranial mirror aneurysms is a sugrical method with small incision, fitting surgical field, high safety, satisfactory effect and good prognosis, which is a new minimally invasive neurosurgical technique. DOI: 10.3969/j.issn.1672-6731.2016.08.012

  7. Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide.

    Science.gov (United States)

    Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen

    2015-10-01

    Microvascular surgery following tumor resection has become an important field of oral maxillofacial surgery (OMFS). Following the surveys on current reconstructive practice in German-speaking countries and Europe, this paper presents the third phase of the project when the survey was conducted globally. The DOESAK questionnaire has been developed via a multicenter approach with maxillofacial surgeons from 19 different hospitals in Germany, Austria and Switzerland. It was distributed in three different phases to a growing number of maxillofacial units in German-speaking clinics, over Europe and then worldwide. Thirty-eight units from Germany, Austria and Switzerland, 65 remaining European OMFS-departments and 226 units worldwide responded to the survey. There is wide agreement on the most commonly used flaps, intraoperative rapid sections and a trend towards primary bony reconstruction. No uniform concepts can be identified concerning osteosynthesis of bone transplants, microsurgical techniques, administration of supportive medication and postoperative monitoring protocols. Microsurgical reconstruction is the gold standard for the majority of oncologic cases in Europe, but worldwide, only every second unit has access to this technique. The DOESAK questionnaire has proven to be a valid and well accepted tool for gathering information about current practice in reconstructive OMFS surgery. The questionnaire has been able to demonstrate similarities, differences and global inequalities. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

    Directory of Open Access Journals (Sweden)

    Toba N. Niazi

    2012-01-01

    Full Text Available Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

  9. Microsurgical Resection of a Common Peroneal Nerve Schwannoma: A 3-Dimensional Operative Video.

    Science.gov (United States)

    Budohoski, Karol P; Guilfoyle, Mathew R; Kenyon, Olivia; Barone, Damiano G; Santarius, Thomas; Trivedi, Rikin A

    2018-01-01

    Peripheral nerve sheath tumors are benign entities that manifest with pain or neurological deficits from mass effect. Treatment is mostly surgical, however, the aggressiveness of treatment needs to be carefully considered with respect to preserving function. We present a case of a 62-year-old male with a 2-year history of left lower extremity pain radiating toward the dorsolateral foot. There was a tender and palpable mass in the lateral popliteal fossa with imaging consistent with Schwannoma of the common peroneal nerve. The patient was counseled for surgery and informed consent was obtained. Microsurgical resection was undertaken and gross total resection was achieved without compromise of function. We demonstrate the placement of neurophysiological monitoring electrodes in all 3 compartment of the calf as well as the use of stimulation to identify a nonfunctioning area for entering the nerve sheath. Anatomy of the popliteal fossa and microsurgical technique for resection of nerve sheath tumors are discussed. When dealing with these pathologies, it is important to use intraoperative neurophysiology as well as careful technique in order to achieve maximal resection without compromising neurological function. Copyright © 2017 by the Congress of Neurological Surgeons.

  10. New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits

    NARCIS (Netherlands)

    Vrijhof, Eric J.; de Bruine, Adriaan; Zwinderman, Aeilko; Lycklama à Nijeholt, August A. B.; Koole, Leo

    2005-01-01

    To investigate whether a newly designed nonabsorbable polymeric stent for the reconstruction of the vas deferens provided less stricturing at the site of the anastomosis in comparison with the conventional microsurgical reconstruction of the vas deferens. Prospective randomized study in 26 rabbits,

  11. Case Report: Microsurgical excision of grade 5 cerebral AVM [version 2; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2016-07-01

    Full Text Available In this case report, we discuss the microsurgical management of a Spetzler-Martin grade 5 arteriovenous malformation (AVM in a young boy who presented with a hemorrhagic episode and had a high calculated risk of rebleeding. We also outline the rationale for choosing the management option.

  12. Developing the Model for Optimal Learning and Transfer (MOLT) Following an Evaluation of Outdoor Groupwork Skills Programmes

    Science.gov (United States)

    Cooley, Sam Joseph; Cumming, Jennifer; Holland, Mark J. G.; Burns, Victoria E.

    2015-01-01

    Purpose: This paper aims to evaluate the perceived efficacy of outdoor groupwork skills programmes for the undergraduate and postgraduate students, and the factors that influence its success. It also illustrates the use of Kirkpatrick's (1994) 4-level model of training evaluation as a framework for qualitative investigation of learning and…

  13. Improving outcomes in microsurgical breast reconstruction: lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon.

    Science.gov (United States)

    Damen, Tim H C; Morritt, Andrew N; Zhong, Toni; Ahmad, Jamil; Hofer, Stefan O P

    2013-08-01

    Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative (406 Consecutive free flap microsurgical breast reconstructions (164 unilateral and 121 bilateral) were performed in 285 patients over the study period. Deep inferior epigastric artery perforator (DIEP) flaps (88%, n=359) were used most commonly followed by muscle-sparing transverse rectus abdominis musculocutaneous (MS-TRAM) flaps (11%, n=44), and fascial-sparing TRAM (FS-TRAM) flaps (0.7%, n=3). One-hundred-seventy-one (48%) DIEP flaps were based on a single perforator while 188 (52%) had multiple perforators. The internal mammary (IM) artery and vein were used as the recipient vessels for 99% (n=403) of flaps. A second venous anastomosis was required for 11.8 percent (n=48) of flaps. Partial flap failure occurred in nine (2.2%) flaps while total flap failure occurred in two flaps (0.5%). Minimum follow-up was three months. Incorporating a number of algorithms into our practice has enabled us to simplify the decision-making processes involved in microsurgical breast reconstruction and to consistently obtain successful surgical outcomes. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

    Science.gov (United States)

    Santamaria, Eric; de la Concha, Erika

    2016-10-01

    Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Successful microsurgical penile replantation following self amputation in a schizophrenic patient

    Directory of Open Access Journals (Sweden)

    Saurabh Gyan

    2010-01-01

    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient .The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  16. Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2014-01-01

    Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

  17. Microsurgical resection of incompletely obliterated intracranial arteriovenous malformations following stereotactic radiosurgery

    International Nuclear Information System (INIS)

    Chang, S.D.; Steinberg, G.K.; Levy, R.P.; Marks, M.P.; Frankel, K.A.; Shuster, D.L.; Marcellus, M.L.

    1998-01-01

    Radiosurgery is effective in obliterating small arteriovenous malformations (AVMs), but less successful in thrombosing larger AVMs. This study reviewed patients who underwent surgical resection of their large AVMs following failed radiosurgical obliteration. AVMs from 36 patients (aged 7 to 64 years, mean 29.9) were surgically resected 1 to 11 years after radiosurgery. Initial AVM volumes were 0.7 to 117 cm 3 (mean 21.6 cm 3 ), and radiosurgical doses ranged from 4.6 to 45 Gray equivalent (GyE) (mean 21.1 GyE). Thirty AVMs (83%) were located in eloquent tissue. Venous drainage was deep (14), superficial (13), or both (9). Spetzler grades were II (2), III (12), IV (18), and V (4). Nine patients suffered rehemorrhage after radiosurgery but prior to surgery, while three patients developed radiation necrosis. Twenty-seven patients underwent endovascular embolization prior to surgery. During microsurgical resection, the AVMs were found to be significantly less vascular and more easily resected, compared to AVMs in patients who had not received radiosurgery. Histology showed endothelial proliferation with hyaline and mineralization in vessel walls. Partial or complete thrombosis of some AVM vessels, and evidence of vessel and brain necrosis were noted in many cases. Clinical outcome was excellent or good in 34 cases, with two patients dying of rebleeding from residual AVM. Five patients were neurologically worse following microsurgical resection. Final outcome was largely related to the pretreatment grade. Radiosurgery several years prior to surgical resection appears useful in treating unusually large and complex AVMs. (author)

  18. Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study.

    Science.gov (United States)

    Micko, Alexander; Knopp, Karoline; Knosp, Engelbert; Wolfsberger, Stefan

    2017-10-01

    In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing, and excessive force on tissue were evaluated. In addition, vital parameters and self-assessment were analyzed. After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = 0.048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > 0.05) for both students and residents. Excessive force decreased in both groups during the stress test for the nondominant hand (P = 0.05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = 0.05). In contrast to their results, participants of both groups assessed their performance worse during the stress test. In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Optimizing life success through residential immersive life skills programs for youth with disabilities: study protocol of a mixed-methods, prospective, comparative cohort study.

    Science.gov (United States)

    McPherson, Amy C; King, Gillian; Rudzik, Alanna; Kingsnorth, Shauna; Gorter, Jan Willem

    2016-09-06

    Young people with disabilities often lag behind their typically developing peers in the achievement of adult roles, which has been attributed to a lack of opportunities to develop critical life skills. Residential Immersive Life Skills (RILS) programs provide situated learning opportunities to develop life skills alongside peers and away from home in real-world settings. Retrospective research suggests that attending RILS programs is a transformative experience that empowers youth, provides parental hope, and increases service provider expertise. However, prospective, comparative research is needed to determine longer term benefits of these programs on youth life trajectories, in addition to exploring the program features and participant experiences that optimize program success. This protocol describes a 5-year, multi-site prospective study examining the effects of RILS programs for youth with disabilities. The study involves RILS programs at three sites in Ontario, Canada. Cohorts of treatment and control groups will receive the study protocol over 3 successive years. Thirty English-speaking participants aged 14-21 years with a child-onset disability and the cognitive capacity to engage in goal setting will be recruited every year for 3 years in the following groups: youth attending a RILS program (Group A); a deferred RILS control group of youth (Group B); a control group of youth attending a non-residential life skills program (Group C); and a control group matched on age, diagnoses, and cognitive capacity not receiving any life skills intervention (Group D). All participants will complete measures of self-determination and self-efficacy at four time points. Program opportunities and experiences will also be assessed in-the-moment at the RILS programs. Qualitative interviews pre-program and at 3- and 12-months post-program will be undertaken with a sub-sample of youth and parents to explore their expectations and experiences. This study will address key gaps

  20. Transplantation and microsurgical anastomosis of free omental grafts: experimental animal model of a new operative technique in dogs.

    Science.gov (United States)

    Pap-Szekeres, Jozsef; Cserni, Gabor; Furka, Istvan; Svebis, Mihaly; Cserni, Tamas; Brath, Endre; Nemeth, Norbert; Miko, Iren

    2003-01-01

    Our objective was the elaboration of a new animal model for the free transplantation of an omental flap and the examination of its viability in dogs. The cooled omental flap from the abdomen was freely transplanted to the lateral cervical region, and its blood supply was established with microsurgical anastomoses. The technique was developed in 5 dogs, and short-term survival examinations were later carried out in 3 cases by means of this method. Postoperative viability was assessed by angiography, methylene blue testing, and histology. Of the 3 transplanted grafts, 2 still survived 1 week after the operation. For technical reasons, 1 flap thrombotized. For determination of the viability of the transplanted graft, histology proved best. Vital reactions, including granulation tissue and angiogenesis, were present on the histological slides. The short-term survival of an omental flap can be ensured with microsurgical transplantation in dogs. Copyright 2003 Wiley-Liss, Inc.

  1. Music Training Program: A Method Based on Language Development and Principles of Neuroscience to Optimize Speech and Language Skills in Hearing-Impaired Children

    Directory of Open Access Journals (Sweden)

    Samaneh Sadat Dastgheib

    2013-03-01

    Full Text Available Introduction: In recent years, music has been employed in many intervention and rehabilitation program to enhance cognitive abilities in patients. Numerous researches show that music therapy can help improving language skills in patients including hearing impaired. In this study, a new method of music training is introduced based on principles of neuroscience and capabilities of Persian language to optimize language development in deaf children after implantation.    Materials and Methods: The candidate children are classified in three groups according to their hearing age and language development. The music training program is established and centered on four principles, as follows: hearing and listening to music (with special attention to boost hearing, singing, rhythmic movements with music and playing musical instruments.   Results: Recently much research has demonstrated that even after cochlear implant operation, a child cannot acquire language to the same level of detail as a normal child. As a result of this study music could compensate this developmental delay .It is known that the greater the area of the brain that is activated, the more synaptic learning and plasticity changes occur in that specific area. According to the principles of neural plasticity, music could improve language skills by activating the same areas for language processing in the brain.   Conclusion:  In conclusion, the effects of music on the human brain seem to be very promising and therapeutic in various types of disorders and conditions, including cochlear implantation.

  2. Orbitopterional Approach for the Resection of a Suprasellar Craniopharyngioma: Adapting the Strategy to the Microsurgical and Pathologic Anatomy.

    Science.gov (United States)

    Nguyen, Vincent; Basma, Jaafar; Klimo, Paul; Sorenson, Jeffrey; Michael, L Madison

    2018-04-01

    Objectives  To describe the orbitopterional approach for the resection of a suprasellar craniopharyngioma with emphasis on the microsurgical and pathological anatomy of such lesions. Design  After completing the orbitopterional craniotomy in one piece including a supraorbital ridge osteotomy, the Sylvian fissure was split in a distal to proximal direction. The ipsilateral optic nerve and internal carotid artery were identified. Establishing a corridor to the tumor through both the opticocarotid and optic cisterns allowed for a wide angle of attack. Using both corridors, a microsurgical gross total resection was achieved. A radical resection required transection of the stalk at the level of the hypothalamus. Photographs of the region are borrowed from Dr Rhoton's laboratory to illustrate the microsurgical anatomy. Understanding the cisternal and topographic relationships of the optic nerve, optic chiasm, and internal carotid artery is critical to achieving gross total resection while preserving normal anatomy. Participants  The surgery was performed by the senior author assisted by Dr. Jaafar Basma. The video was edited by Dr. Vincent Nguyen. Outcome Measures  Outcome was assessed with extent of resection and postoperative visual function. Results  A gross total resection of the tumor was achieved. The patient had resolution of her bitemporal hemianopsia. She had diabetes insipidus with normal anterior pituitary function. Conclusions  Understanding the microsurgical anatomy of the suprasellar region and the pathological anatomy of craniopharyngiomas is necessary to achieve a good resection of these tumors. The orbitopterional approach provides the appropriate access for such endeavor. The link to the video can be found at: https://youtu.be/Be6dtYIGqfs .

  3. Preoperative Prediction of the Necessity for Anterior Clinoidectomy During Microsurgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Burkhardt, Jan-Karl; Tabani, Halima; Safaee, Michael M; Lawton, Michael T

    2018-01-01

    Although most posterior communicating artery (PCoA) aneurysms can be clipped easily with excellent results, some require anterior clinoidectomy for safe and complete clipping. To review our microsurgical series of ruptured PCoA aneurysms and identify the preoperative predictors for anterior clinoidectomy during microsurgical clipping for PCoA aneurysms. Results from microsurgical clipping of 104 patients with ruptured PCoA aneurysms were reviewed retrospectively. Distances and angles were obtained from computed tomographic angiography and compared between the anterior and nonanterior clinoidectomy groups. Anterior clinoidectomy was required in 19 of the 104 cases (18%). None developed surgical complications due to anterior clinoid process (ACP) resection, including postoperative visual deficit. Univariate and multivariate analyses revealed that the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were statistically significant predictive factors for the need of anterior clinoidectomy. Based on a receiver operating characteristic analysis, the distances from the ACP tip to the aneurysmal proximal neck PCoA aneurysm surgery, the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were both found to be useful predictors of whether anterior clinoidectomy was required. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach: The Padua Experience.

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    Di Stadio, Arianna; Colangeli, Roberta; Dipietro, Laura; Martini, Alessandro; Parrino, Daniela; Nardello, Ennio; D'Avella, Domenico; Zanoletti, Elisabetta

    2018-05-01

    The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. Three patients with disabling tinnitus resulting from a loop in the internal auditory canal were evaluated with magnetic resonance imaging and tests of pure tone auditory, tinnitus, and auditory brain response (ABR) to identify the features of the cochlear nerve involvement. We observed a loop with a caliber greater than 0.8 mm in all patients. Patients were treated via an endoscope-assisted retrosigmoid microsurgical decompression. After surgery, none of the patients reported short-term or long-term complications. After surgery, tinnitus resolved immediately in 2 patients, whereas in the other patient symptoms persisted although they improved; in all patients, hearing was preserved and ABR improved. Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. [Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study].

    Science.gov (United States)

    Zarghooni, Kourosh; Beyer, Frank; Papadaki, Joanna; Boese, Christoph Kolja; Siewe, Jan; Schiffer, Gereon; Eysel, Peer; Bredow, Jan

    2017-08-01

    Introduction Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango). Methods 36 patients were included in this single-center, prospective, observational study from January 2013 to June 2014. Data were collected from the Spine Tango or DWG Register. The core outcome measure index (COMI), Oswestry Disability Index (ODI), and the quality of life questionnaire EuroQoL-5D were used. Data were collected prior to surgery as well as six weeks, six months, and twelve months after the operation. Results The patient cohort comprised 13 females and 23 males (36.1 and 63.9 %). Complete 12-month follow-up data on 21 patients were available for analysis. Compared to preoperative measures, the COMI score increased 8.1 ± 1.5 over the entire follow up, with 4.5 ± 3.1 at 6 weeks (p < 0.001), 4.8 ± 3.1 at 6 months, and 3.8 ± 3.2 at 12 months. ODI scores, measuring spinal function impairment, were significantly better than preoperative values overall (47.5 ± 17.3) and after 6 weeks (29.1 ± 22.4; p < 0.005), 6 months (30.0 ± 19.3), and 12 months (23.8 ± 18.2). Quality of life measures improved in a similar manner (preoperative: 0.36 ± 0.38; 6 weeks: 0.57 ± 0.34 (p < 0.019); 6 months: 0.62 ± 0.28; 12 months: 0.67 ± 0.31). Conclusion Our study shows that LSS patients without previous surgery and neurologic deficits can expect significant pain relief and improved quality of life already six weeks after undergoing stabilizing decompression. There was an increase in positive postoperative effects over 12 months. The DWG

  6. Clinical study on microsurgical treatment of lumbar disc herniation assisted by METRx system

    Directory of Open Access Journals (Sweden)

    Xin-gang ZHAO

    2016-04-01

    Full Text Available Objective To explore the techniques and curative effect of microsurgical procedures assisted by minimal exposure tubular retractor system (METRx in the treatment of lumbar disc herniation (LDH.  Methods A total of 51 LDH patients, including 24 patients with L4-5 herniation and 27 patients with L5-S1 herniation, underwent discectomy assisted by METRx system. The operation time, intraoperative blood loss, postoperative complications and hospital stay were recorded. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of low back pain before operation, one week, 3 months after operation, and in the last follow-up. Lumbar MRI was used to evaluate the decompression of spinal canal.  Results The success rate of operations in 51 cases was 98.04% (50/51. The average operation time was 125 min, the average intraoperative blood loss was 50 ml, the mean hospital stay was 5 d, all patients were followed up for 6-48 months (average 24 months. Compared with preoperation, both VAS and ODI scores decreased significantly one week after operation (P = 0.036, 0.029, 3 months after operation (P = 0.018, 0.023 and in the last follow-up (P = 0.007, 0.013. The improvement rate of ODI was 35.37% in the last follow-up. No infection, postoperative cerebrospinal fluid (CSF fistula, neurological defects or incision infection was found. One patient presented acute abdominalgia on the 2nd day after operation, and was diagnosed as annexitis. One patient showed nerve root irritation symptoms after operation caused by thick nerve root during the surgery. They were cured after symptomatic treatment.  Conclusions Microsurgical procedures for treating LDH assisted by METRx system can effectively relieve nerve root compression, protect the dural sac and nerve roots, and reduce surgical complications. DOI: 10.3969/j.issn.1672-6731.2016.04.008

  7. Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

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    Wilson F. Busato Junior

    2007-12-01

    Full Text Available OBJECTIVE: Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery. The objective of this study is to reach the same results with reduced operative time. MATERIALS AND METHODS: Male adults Wistar rats were divided into 3 groups: I 20 rats in control group, II 20 with conventional one-layer microsuture and III 20 with fibrin glue. After four weeks each rat was left for two weeks with two female rats. RESULTS: The fertility rates were 80% in group I, 70% in group II and 65% in group III (p > 0.05. In group II granuloma was found in 75% of the rats, while in group III in 85% (p 0.05. Overall operative time was 41.7 ± 2.49 and 28.55 ± 1.14 minutes in groups II and III (p < 0.05 and the time to anastomosis of 24.6 ± 1.8 and 9.35 ± 0.78 minutes (p < 0.05, respectively. CONCLUSIONS: We can conclude that vasovasostomy with fibrin adhesive has the same results of the conventional microsurgery technique but with a reduced operative time and a simplified procedure.

  8. Robot-assisted microsurgical forceps with haptic feedback for transoral laser microsurgery.

    Science.gov (United States)

    Deshpande, Nikhil; Chauhan, Manish; Pacchierotti, Claudio; Prattichizzo, Domenico; Caldwell, Darwin G; Mattos, Leonardo S

    2016-08-01

    In this paper, a novel, motorized, multi-degrees-of-freedom (DoF), microsurgical forceps tool is presented, which is based on a master-slave teleoperation architecture. The slave device is a 7-DoF manipulator with: (i) 6-DoF positioning and orientation, (ii) 1 open/close gripper DoF; and (iii) an integrated force/torque sensor for tissue grip-force measurement. The master device is a 7-DoF haptic interface which teleoperates the slave device, and provides haptic feedback in its gripper interface. The combination of the device and the surgeon interface replaces the manual, hand-held device providing easy-to-use and ergonomic tissue control, simplifying the surgical tasks. This makes the system suitable to real surgical scenarios in the operating room (OR). The performance of the system was analysed through the evaluation of teleoperation control and characterization of gripping force. The new system offers an overall positioning error of less than 400 μm demonstrating its safety and accuracy. Improved system precision, usability, and ergonomics point to the potential suitability of the device for the OR and its ability to advance haptic-feedback-enhanced transoral laser microsurgeries.

  9. Microsurgical and Tractographic Anatomy of the Supplementary Motor Area Complex in Humans.

    Science.gov (United States)

    Bozkurt, Baran; Yagmurlu, Kaan; Middlebrooks, Erik H; Karadag, Ali; Ovalioglu, Talat Cem; Jagadeesan, Bharathi; Sandhu, Gauravjot; Tanriover, Necmettin; Grande, Andrew W

    2016-11-01

    To evaluate the microsurgical anatomy of the fiber tract connections of the supplementary motor area (SMA) and pre-SMA, and examine its potential functional role with reference to clinical trials in the literature. Ten postmortem formalin-fixed human brains (20 sides) and 1 cadaveric head were prepared following Klingler's method. The fiber dissection was performed in a stepwise fashion, from lateral to medial and also from medial to lateral, under an operating microscope, with 3D images captured at each stage. Our findings were supported by in vivo magnetic resonance imaging tractography in 2 healthy subjects. The connections of the SMA complex, composed of the pre-SMA and the SMA proper, are composed of short "U" association fibers and the superior longitudinal fasciculus I, cingulum, claustrocortical fibers, callosal fibers, corticospinal tract, frontal aslant tract, and frontostriatal tract. The claustrocortical fibers may play an important role in the integration of motor, language, and limbic functions of the SMA complex. The frontostriatal tract connects the pre-SMA to the putamen and caudate nucleus, and also forms parts of both the internal capsule and the dorsal external capsule. The SMA complex has numerous connections throughout the cerebrum. An understanding of these connections is important for presurgical planning for lesions in the frontal lobe and helps explain symptoms related to SMA injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Technical Nuances of Exposing Rat Common Carotid Arteries for Practicing Microsurgical Anastomosis.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Aklinski, Joseph; Gandhi, Sirin; Lawton, Michael T; Preul, Mark C

    2018-04-17

    Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. However, technical nuances of exposing rat CCAs have been understudied. The purpose of this study is to describe nuances of technique for safely and efficiently exposing rat CCAs in preparation for a vascular anastomosis. Bilateral CCAs were exposed and prepared for anastomosis in 10 anesthetized Sprague-Dawley rats through a midline cervical incision. The exposed length of the CCA was measured. Additionally, technical nuances of exposure and surgically relevant anatomic details were recorded. The CCAs were exposed from the sternoclavicular joint to their bifurcation (average length, 19.1 ± 2.8 mm). Tenets important for a safe and efficient exposure of the CCAs included 1) generous subcutaneous dissection to expose the external jugular veins (EJVs), 2) avoiding injury to or compression of the EJVs, 3) superior mobilization of the salivary glands, 4) division of internal jugular veins, 5) opening the carotid sheath at its midlevel and from medial to lateral, and 6) avoiding injury to the vagus nerve or sympathetic trunk. Using the principles introduced in this study, trainees may safely and efficiently expose rat CCAs in preparation for a bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Modern use of smartphone applications in the perioperative management in microsurgical breast reconstruction

    Science.gov (United States)

    Rozen, Warren Matthew; Marsh, Daniel; Chow, Whitney T.H.; Vickers, Tobias; Khan, Lubna; Miller, George S.; Hunter-Smith, David J.; Ramakrishnan, Venkat V.

    2016-01-01

    Background Advances in mobile telecommunication, improved mobile internet and affordability have led to a significant increase in smartphone use within medicine. The capability of instant messaging, photography, videography, word processing, drawing and internet access allow significant potential in this small portable device. Smartphone use within medicine has grown tremendously worldwide given its affordability, improved internet and capabilities. Methods We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. Results The useful apps have been subdivided: (I) communication apps—multimedia messaging, WhatsApp, PicSafeMedi: allow efficient communication via text, picture and video messages leading to earlier assessment and definitive management of free flaps; (II) storage apps—Notability, Elogbook: electronic storage of patient notes and logbooks of case which can be shared with others if required; (III) educational apps—FlapApp, Touch Surgery, PubMed on tap: step by step guides to surgical procedures to aid learning and medical journal database; (IV) flap monitoring app—SilpaRamanitor: free flap monitoring app based on photographic analysis for earlier detection of compromised flaps. Conclusions There has been remarkable growth in smartphones use among surgeons. Apps are being developed for every conceivable use. The future will be in wearable smart devices that allow continuous monitoring with the potential to instigate change should deviations from the norm occur. The smart watch is the start of this digital revolution. PMID:27047783

  12. Validation of Reverse-Engineered and Additive-Manufactured Microsurgical Instrument Prototype.

    Science.gov (United States)

    Singh, Ramandeep; Suri, Ashish; Anand, Sneh; Baby, Britty

    2016-12-01

    With advancements in imaging techniques, neurosurgical procedures are becoming highly precise and minimally invasive, thus demanding development of new ergonomically aesthetic instruments. Conventionally, neurosurgical instruments are manufactured using subtractive manufacturing methods. Such a process is complex, time-consuming, and impractical for prototype development and validation of new designs. Therefore, an alternative design process has been used utilizing blue light scanning, computer-aided designing, and additive manufacturing direct metal laser sintering (DMLS) for microsurgical instrument prototype development. Deviations of DMLS-fabricated instrument were studied by superimposing scan data of fabricated instrument with the computer-aided designing model. Content and concurrent validity of the fabricated prototypes was done by a group of 15 neurosurgeons by performing sciatic nerve anastomosis in small laboratory animals. Comparative scoring was obtained for the control and study instrument. T test was applied to the individual parameters and P values for force (P direct application of these additive-manufactured instruments in the operating room requires further validation. © The Author(s) 2016.

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with quality, comprehensive education. The standardized interactive program has been ...

  15. Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology.

    Science.gov (United States)

    Ng, Ivan; Hwang, Peter Y K; Kumar, Dinesh; Lee, Cheng Kiang; Kockro, Ralf A; Sitoh, Y Y

    2009-05-01

    To evaluate the feasibility of surgical planning using a virtual reality platform workstation in the treatment of cerebral arterio-venous malformations (AVMs) Patient-specific data of multiple imaging modalities were co-registered, fused and displayed as a 3D stereoscopic object on the Dextroscope, a virtual reality surgical planning platform. This system allows for manipulation of 3D data and for the user to evaluate and appreciate the angio-architecture of the nidus with regards to position and spatial relationships of critical feeders and draining veins. We evaluated the ability of the Dextroscope to influence surgical planning by providing a better understanding of the angio-architecture as well as its impact on the surgeon's pre- and intra-operative confidence and ability to tackle these lesions. Twenty four patients were studied. The mean age was 29.65 years. Following pre-surgical planning on the Dextroscope, 23 patients underwent microsurgical resection after pre-surgical virtual reality planning, during which all had documented complete resection of the AVM. Planning on the virtual reality platform allowed for identification of critical feeders and draining vessels in all patients. The appreciation of the complex patient specific angio-architecture to establish a surgical plan was found to be invaluable in the conduct of the procedure and was found to enhance the surgeon's confidence significantly. Surgical planning of resection of an AVM with a virtual reality system allowed detailed and comprehensive analysis of 3D multi-modality imaging data and, in our experience, proved very helpful in establishing a good surgical strategy, enhancing intra-operative spatial orientation and increasing surgeon's confidence.

  16. Microsurgical head and neck tissue repair by visceral mini-autografting

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available Objective. To minimize surgical trauma in patients with head and neck tumors during microsurgical plasty with visceral autografts.Subjects and methods. Clinical experience has been gained in the treatment of 53 patients with locally advanced craniofascial (n = 27 and oropharyngeal (n = 36 cancers. Abdominal organs were used for plastic closure of extensive defects after surgical resection. Paraumbilical incision allowing for an adequate approach into the abdominal cavity with minimal external trauma in the anterior abdominal wall was chosen as an access procedure. Video-assisted techniques were used to excise the midline aponeurosis. Donor organs, such as the omentum, greater curvature of the stomach, transverse colon, small intestine were taken through a mini-laparotomic incision to the anterior abdominal wall, then the vascular pedicle was exposed and a visceral autograft was made. After forming and cutting off the autograft, organ anastomoses were created extracorporeally.Results. Mini-access surgery could be completed in 50 of the 53 cases (4 patients had previously undergone abdominal interventions. Omental (n = 26, colo-omental (n = 15, gastro-omental (n = 7, and entero-omental (n = 5 flaps were made and prepared for autografting. No intra- or postoperative abdominal complications were found.Conclusion. Minimally invasive technologies used to create visceral authografts for head and neck tissue repair can minimize surgical trauma and reduce treatment duration. The indications for this access are the debilitating state of a cancer patient or the young age of a patient who does not wish to have an additional scar in the donor region.

  17. Progression of vestibular schawnnoma after GammaKnife radiosurgery: A challenge for microsurgical resection.

    Science.gov (United States)

    Aboukaïs, Rabih; Bonne, Nicolas-Xavier; Touzet, Gustavo; Vincent, Christophe; Reyns, Nicolas; Lejeune, Jean-Paul

    2018-05-01

    We aimed to evaluate the outcome of patients who underwent salvage microsurgery for vestibular schwannoma (VS) that failed primary Gammaknife radiosurgery (GKS). Among the 1098 patients who received GKS for the treatment of VS in our center between January 2004 and December 2012, the follow-up was organized in our institution for 290 patients who lived in our recruitment area. Tumor progression was noted in 23 patients. A salvage microsurgical resection was performed in 11 patients, who were included in our study. Grading of facial function was done according to the House & Brackman scale. The mean age at diagnosis was 50.2 years (19-68 years) and the mean follow-up was 9.4 years (4-13 years). The mean dose was 11.8 Gy (11-12 Gy) and the mean volume was 922 mm3 (208-2500 mm3). The mean period between GKS and diagnosis of tumor progression was 32 months (18-72 months). Concerning salvage microsurgery, complete resection was obtained in 8 patients. Small residual tumor on the facial nerve was deliberately left in 3 patients and no tumor progression was noted with a mean follow-up of 26 months. At last follow-up, facial nerve function was grade 1 in 4 patients, grade 2 in 3 patients, grade 3 in 1 patient and grade 4 in 3 patients. Salvage surgery of recurrent vestibular schwannoma after failed initial GKS remains a good treatment. However, facial nerve preservation is more challenging in this case and small tumor remnant could be sometimes deliberately left. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Novel mouse model for simulating microsurgical tumor excision with facial nerve preservation.

    Science.gov (United States)

    Lim, Jae H; Boyle, Glen M; Panizza, Benedict

    2016-01-01

    To determine the feasibility of using a mouse tumor model as a microsurgical training tool for otolaryngology-head and neck surgery (OHNS) trainees. Animal study. We injected athymic nude mice with human cutaneous squamous cell carcinoma (A431 cell line) deep to the parotid region overlying the masseter muscle. We sacrificed the animals 1 to 3 weeks postinjection, once a visible tumor growth was confirmed. We then asked 10 OHNS trainees to excise the tumor with preservation of the facial nerves under a high-magnification dissecting microscope. The trainees graded the tasks in several areas of specific measures using a visual analogue scale (VAS) including 1) tumor texture, 2) surgical realism, 3) usefulness, and 4) difficulty of the task. Noticeable tumor growth occurred within 5 days following A431 cell injection and reached measureable size (0.5-1.5 cm) within 1 to 3 weeks. The tumor displaced the facial nerve laterally and medially, with few demonstrating infiltration of the nerve. VAS scores (± standard deviation) were 8.1 (± 1.7), 7.7 (± 2.5), 9.0 (± 0.9) and 6.6 (± 1.9) for tumor texture, surgical realism, usefulness, and the difficulty of the task, respectively. We demonstrate a novel, reliable and cost-effective mouse model for simulating tumor extirpation microsurgery with preservation of important neural structures. OHNS trainees have found this simulation model to be realistic, useful, and appropriately challenging. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  19. A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

    Directory of Open Access Journals (Sweden)

    Rodrigo Ramos-Zúñiga

    2015-01-01

    Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

  20. Prevention of Internalising Disorders in 9-10 year old children: Efficacy of the Aussie Optimism Positive Thinking Skills Program at 30-month follow-up

    Directory of Open Access Journals (Sweden)

    David eMorrison

    2013-12-01

    Full Text Available The Aussie Optimism: Positive Thinking Skills Program (AOPTP is a school-based prevention program aimed at addressing anxious and depressive symptoms in children aged 9-10 years. Nine-hundred and ten students from 22 Australian primary schools situated in low socio-economic areas were randomly assigned to either an intervention or control group, and assessed at a 30-month follow up. Those in the intervention group received the AOPTP program, where the control group continued to receive the regular health education course. Students completed self-report measures regarding their levels of depression, anxiety, and attribution style. Parents also reported on their children’s externalising and internalising problems outside of school. There were no significant differences between groups in regard to anxiety or depression, as well as no significant differences in attributional styles. Parents reported significantly less hyperactive behaviours from children in the intervention group. This finding suggests that AOP-PTS has the capacity to treat externalising problems at a medium term effect. The decrease in the externalising problems provides evidence of a partial medium term intervention effect. Future studies should continue to evaluate the program at a long term follow up.

  1. The Enhanced Aussie Optimism Positive Thinking Skills Program: Assessing the relationship between internalising symptoms and family functioning in children aged 9-11 years of age

    Directory of Open Access Journals (Sweden)

    Patricia eKennedy

    2015-04-01

    Full Text Available The family context plays a critical role in the health of the child. This was the first study to examine the usefulness of the General Functioning subscale of the Family Assessment Device (FAD-GF in assessing family functioning and its relationship to internalising symptoms in school-aged children aged between 9 and 11 years of age. Eight hundred and forty-seven Year 4 and 5 students from 13 schools (607 intervention students, and 240 control students participated in the Aussie Optimism Positive Thinking Skills Program (AO-PTS - a universal school-based program targeting internalising symptoms. Students rated how ‘healthy’ they perceived their family to be at pre-test and at 6-month follow-up. Although some aspects of validity and reliability could be improved, results indicated that perceptions of family functioning at pre-test were predictive of internalising symptoms at the 6-month follow-up. The FAD-GF therefore showed promise as a potential measure of family functioning for children as young as nine years old. Regardless of children’s pre-test levels of perceived family functioning, no intervention effects were found on the anxiety and depression scales; this finding suggests that child perceptions of family functioning may act as a general protective factor against internalising symptomology.

  2. Prevention of Depression and Anxiety Symptoms in Adolescents: 42 and 54 Months Follow-Up of the Aussie Optimism Program-Positive Thinking Skills.

    Directory of Open Access Journals (Sweden)

    Julie eJohnstone

    2014-05-01

    Full Text Available Anxiety and depression are the most commonly reported mental health problems amongst Australian children and adolescents. The Aussie Optimism Program: Positive Thinking Skills (AOP- PTS is a universal intervention program based on cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9-10 years old. 370 students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow – up study. The intervention group received the AOP-PTS 10-week program and the control group received the regular Health Education curriculum. Students were assessed on anxiety, depression and attribution style at school whilst parents reported on their child’s externalizing and internalising problems at home. Results showed there were no significant reduction across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up. These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the desirable outcomes in a longitudinal study are discussed.

  3. Monitoring in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants.

    Science.gov (United States)

    Jonas, René; Schaal, Thomas; Krimmel, Michael; Gülicher, Dirk; Reinert, Siegmar; Hoffmann, Jürgen

    2013-06-01

    In a prospective study, the characteristics and benefit of an invasive measurement of oxygen partial pressure (pO(2)) with the aid of a polarographic sensor were investigated in 125 microsurgical reconstructions of the head and neck area over a period of 45 months. Measurements were performed over 96 h in eight different types of microsurgically revascularized flaps for extra- and intraoral reconstructions and were evaluated separately for each flap type. Of 125 reconstructions the system indicated malperfusion in 18 cases. Salvage surgery was performed in 17 cases due to venous thrombosis (6 cases), arterial thrombosis (3 cases), a combination of arterial and venous thrombosis (2 cases), rheological problems (3 cases), venous insufficiency by hematoma (2 cases) and kinking of vessels (1 case). In 10 cases salvage surgery was successful, 7 flaps were lost despite salvage surgery. In all these cases, the polarographic probe indicated the necessity of salvage surgery correctly. After 96 h no malperfusion was seen. Postoperatively, a common and characteristic development of the oxygen partial pressure in different types of flaps was seen. Initially, a clear increase of pO(2) could be measured. During 96 h, a slow decrease of pO(2) was observed. In conclusion polarographic measurement of pO(2) can be an excellent apparative supplement for the postoperative clinical control of microsurgically revascularized transplants. In buried flaps, this technique represents the only reliable method for transplant monitoring. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Microsurgical DREZotomy in the treatment of chronic pain due to spinal cord and cauda equina injuries: 2 cases report and related literature review

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    LIU Qing-jun

    2013-10-01

    Full Text Available Objective The dorsal root entry zone (DREZ is a hyperactive focus in neuropathic pain (NP syndromes, and DREZotomy has been used in selective cases of NP. This study aims to investigate the therapeutic effect of microsurgical DREZotomy in chronic pain due to spinal cord and cauda equina injuries. Methods Two patients suffered with chronic pain due to spinal cord and cauda equina injuries were treated with microsurgical DREZotomy, and postoperative therapeutic effect and complications were observed. Results One patient had great pain, and the pain was alleviated 2 weeks after surgery, while carbamazepine (300 mg/d was administered continously. Another patient was completely free of pain 2 weeks after surgery, and no recurrence occurred during 3-year follow up. No severe complications were found in the 2 patients. Conclusion Microsurgical DREZotomy is an effective approach in treating chronic pain due to spinal cord and cauda equina injuries.

  5. [The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)].

    Science.gov (United States)

    Weigert, M; Mellerowicz, H; Werhahn, C

    1975-10-01

    Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

  6. [The use of a microsurgical precision technic for applying a gastroduodenal anastomosis in a Billroth-I gastric resection].

    Science.gov (United States)

    Galkin, R A; Makarov, I V

    1998-01-01

    Advantages of the formation of gastroduodenal anastomosis using the microsurgical precision technique as compared to the two-row interrupted Albert-Lembert suture and the one-row suture of Pirogov-Mateshuk were established in an experimental investigation in 63 dogs. The article describes the precision suture technique proposed by the authors which was used in Billroth-I resection of the stomach in 15 patients. It was shown that the use of the precision suture resulted in healing by the first intention type, without motor evacuatory disorders and with shorter time of hospital treatment.

  7. Diploid, but not haploid, human embryonic stem cells can be derived from microsurgically repaired tripronuclear human zygotes

    Science.gov (United States)

    Fan, Yong; Li, Rong; Huang, Jin; Yu, Yang; Qiao, Jie

    2013-01-01

    Human embryonic stem cells have shown tremendous potential in regenerative medicine, and the recent progress in haploid embryonic stem cells provides new insights for future applications of embryonic stem cells. Disruption of normal fertilized embryos remains controversial; thus, the development of a new source for human embryonic stem cells is important for their usefulness. Here, we investigated the feasibility of haploid and diploid embryo reconstruction and embryonic stem cell derivation using microsurgically repaired tripronuclear human zygotes. Diploid and haploid zygotes were successfully reconstructed, but a large proportion of them still had a tripolar spindle assembly. The reconstructed embryos developed to the blastocyst stage, although the loss of chromosomes was observed in these zygotes. Finally, triploid and diploid human embryonic stem cells were derived from tripronuclear and reconstructed zygotes (from which only one pronucleus was removed), but haploid human embryonic stem cells were not successfully derived from the reconstructed zygotes when two pronuclei were removed. Both triploid and diploid human embryonic stem cells showed the general characteristics of human embryonic stem cells. These results indicate that the lower embryo quality resulting from abnormal spindle assembly contributed to the failure of the haploid embryonic stem cell derivation. However, the successful derivation of diploid embryonic stem cells demonstrated that microsurgical tripronuclear zygotes are an alternative source of human embryonic stem cells. In the future, improving spindle assembly will facilitate the application of triploid zygotes to the field of haploid embryonic stem cells. PMID:23255130

  8. Open Tibia Shaft Fractures and Soft-Tissue Coverage: The Effects of Management by an Orthopaedic Microsurgical Team.

    Science.gov (United States)

    VandenBerg, James; Osei, Daniel; Boyer, Martin I; Gardner, Michael J; Ricci, William M; Spraggs-Hughes, Amanda; McAndrew, Christopher M

    2017-06-01

    To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team. Retrospective cohort study. A single level 1 trauma center. Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015. Flap coverage for open tibia shaft fractures treated before ("preintegration") and after ("postintegration") implementation of an integrated orthopaedic trauma/microsurgical team. Time from index injury to flap coverage. The unadjusted median time to coverage was 7 days (95% confidence interval, 5.9-8.1) preintegration, and 6 days (95% confidence interval, 4.6-7.4) postintegration (P = 0.48). For preintegration, 9 (69%) of the patients experienced complications, compared with 7 (47%) postintegration (P = 0.23). After formation of an integrated orthopaedic trauma/microsurgery team, we observed a 1-day decrease in median days to coverage from index injury. Complications overall were lowered in the postintegration group, although statistically insignificant. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  9. Prediction of the microsurgical window for skull-base tumors by advanced three-dimensional multi-fusion volumetric imaging

    International Nuclear Information System (INIS)

    Oishi, Makoto; Fukuda, Masafumi; Saito, Akihiko; Hiraishi, Tetsuya; Fujii, Yukihiko; Ishida, Go

    2011-01-01

    The surgery of skull base tumors (SBTs) is difficult due to the complex and narrow surgical window that is restricted by the cranium and important structures. The utility of three-dimensional multi-fusion volumetric imaging (3-D MFVI) for visualizing the predicted window for SBTs was evaluated. Presurgical simulation using 3-D MFVI was performed in 32 patients with SBTs. Imaging data were collected from computed tomography, magnetic resonance imaging, and digital subtraction angiography. Skull data was processed to imitate actual bone resection and integrated with various structures extracted from appropriate imaging modalities by image-analyzing software. The simulated views were compared with the views obtained during surgery. All craniotomies and bone resections except opening of the acoustic canal in 2 patients were performed as simulated. The simulated window allowed observation of the expected microsurgical anatomies including tumors, vasculatures, and cranial nerves, through the predicted operative window. We could not achieve the planned tumor removal in only 3 patients. 3-D MFVI afforded high quality images of the relevant microsurgical anatomies during the surgery of SBTs. The intraoperative deja-vu effect of the simulation increased the confidence of the surgeon in the planned surgical procedures. (author)

  10. Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

    Science.gov (United States)

    Kivelev, Juri; Koskela, Elina; Setälä, Kirsi; Niemelä, Mika; Hernesniemi, Juha

    2012-08-01

    Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3-59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5-14 years). All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Surgical removal of occipital cavernomas may carry a

  11. Microsurgical resection of ventral foramen magnum meningiomas via a far-lateral suboccipital approach

    Institute of Scientific and Technical Information of China (English)

    Zhihua Cheng; Zhilin Guo; Meixiu Ding

    2006-01-01

    BACKGROUND: In recent years some reports have been published propagating microsurgical resection of ventral foramen magnum meningiomas (VFMMs). Operative approaches to these lesions have been studied by various authors, but remain controversial.OBJECTIVE: To discuss the operative technique and outcome in patients with VFMMs who had been treatedvia a far lateral suboccipital approach.DESIGN: Retrospectively clinic case investigation. SElrING: Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University.PARTICIPANTS: Between January 1997 and June 2003, 10 patients were treated surgically with VFMMs in Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University. In the series of 10 patients, ages ranged from 37 to 72 years, mean (53±10) years, were consisted of 6 males and 4 females. All the subjects were informed of the treatment plan and agreed to join the experiment. Early symptoms included headache and upper cervical pain. The time between the first occurrence of symptoms and the diagnosis ranged from 6 months to 17 months, mean (10.3±3.4) months. Main presenting symptoms were unilateral upper extremity sensory and motor deficits in 6 cases, swallowing difficulties in 2 and spastic quadriparesis in 2. VFMMs were demonstrated as round by the computed tomographic (CT) scan and magnetic resonance imaging (MRI) in all patients. The maximum diameter of tumors ranged from 2 to 4 cm,mean (2.55±0.57) cm, including 2 cm in one case, 2.0-3.0 cm in six and 3.0-4.0 cm in three.METHODS: ①All tumors were removed via the far lateral suboccipital approach. Resection of the posterior 5 mm of the condyle was necessary in one patient whose tumors' diameter were 2 cm. The patient was situated in the lateral decubitus position. The head was fixed in a Mayfield headrest. A C-shaped incision made behind the ear 2 cm medial to the mastoid process, turning vertically down to the level C4, to

  12. Leadership Skills.

    Science.gov (United States)

    Hutchison, Cathleen; And Others

    1988-01-01

    Lists skills identified by the Leadership Development Task Force as being critical skills for a leader. Discussion focuses on information managing skills, including problem solving, decision making, setting goals and objectives; project management; and people managing skills, including interpersonal communications, conflict management, motivation,…

  13. Optimal Training Systems STTR

    National Research Council Canada - National Science Library

    Best, Brad; Lovett, Marsha

    2005-01-01

    .... Using an optimal model of task performance subject to human constraints may be a more efficient way to develop models of skilled human performance for use in training, especially since optimal models...

  14. Evaluating a Skills Management System

    International Nuclear Information System (INIS)

    Largier, A.

    2013-01-01

    In order to anticipate the large number of people due to retire in the next few years, and to optimize the workforce contribution, IRSN (Institute for radiation protection and nuclear safety) is setting up skill management. This poster presents the IRSN's skill management system. The skill management system is based on a 4 step approach: -) identifying and listing the necessary skills, -) assessing the skills available, -) defining and setting up solutions: training, recruitment, out-sourcing), and -) feedback about the efficiency of the system. It appears that it is important to take into account the way the organization considers individual ability in order to favour collective proficiency

  15. Impact of a Vascular Neurosurgery Simulation-Based Course on Cognitive Knowledge and Technical Skills in European Neurosurgical Trainees.

    Science.gov (United States)

    Zammar, Samer G; El Tecle, Najib E; El Ahmadieh, Tarek Y; Adelson, P David; Veznedaroglu, Erol; Surdell, Daniel L; Harrop, James S; Benes, Vladimir; Rezai, Ali R; Resnick, Daniel K; Bendok, Bernard R

    2015-08-01

    To assess microsurgical and diagnostic cerebral angiography modules and their corresponding objective assessment scales as educational tools for European neurosurgical residents at the European Association of Neurosurgical Societies Resident Vascular Neurosurgery course, which was held in Prague, Czech Republic, on September 2013. Microsurgical skills and cerebral angiography are fundamental skills in vascular neurosurgery. There is a need to develop a simulation-based curriculum focusing on these skills for neurosurgical trainees worldwide. The course consisted of 2 modules: microanastomosis and diagnostic cerebral angiography. In addition to an initial screening survey, each module was divided into 3 components: 1) a before didactic cognitive knowledge and technical skills testing, 2) a didactic lecture, and 3) an after didactic cognitive knowledge and technical skills testing. We compared the trainees' cognitive and technical scores from the before and after testing phases. Wilcoxon sum rank test was used to test statistical significance. The knowledge test median scores increased from 63% and 68% to 80% and 88% (P technical proficiency. Copyright © 2015. Published by Elsevier Inc.

  16. Interpersonal Skills

    Directory of Open Access Journals (Sweden)

    Barakat NG

    2007-01-01

    Full Text Available INTRODUCTIONInterpersonal skills are becoming more and more a necessity in the medical profession. The expectation from health care professionals is beyond just knowledge of the medical facts. To practice medicine effectively, doctors need to develop interpersonal skills in communication, leadership, management, teaching and time management. All of these are vital tools and are becoming increasingly essential subjects in teaching both undergraduate students and postgraduate doctors. However, a degree of self-motivation and personal initiative is needed to develop these skills. In this article, I will give an overview on interpersonal skills and will be follow this by a series of articles, in future issues, dealing with these skills.

  17. Optimization modeling with spreadsheets

    CERN Document Server

    Baker, Kenneth R

    2015-01-01

    An accessible introduction to optimization analysis using spreadsheets Updated and revised, Optimization Modeling with Spreadsheets, Third Edition emphasizes model building skills in optimization analysis. By emphasizing both spreadsheet modeling and optimization tools in the freely available Microsoft® Office Excel® Solver, the book illustrates how to find solutions to real-world optimization problems without needing additional specialized software. The Third Edition includes many practical applications of optimization models as well as a systematic framework that il

  18. Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

    Science.gov (United States)

    Yang, Yun-fa; Xu, Zhong-he; Zhang, Guang-ming; Wang, Jian-wei; Hu, Si-wang; Hou, Zhi-qi; Xu, Da-chuan

    2013-11-01

    Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study. They were classified into four types on the basis of the conditions of the bone defects, soft tissue defects, and injured limb length, including Type A (without soft tissue defects), Type B (with soft tissue defects of 10 × 20 cm or less), Type C (with soft tissue defects of 10 × 20 cm or more), and Type D (with the limb shortening of 3 cm or more). Four types of single-stage microsurgical repair protocols were planned accordingly and implemented respectively. These protocols included the following: Protocol A, where vascularized fibular graft was implemented for Type A; Protocol B, where vascularized fibular osteoseptocutaneous graft was implemented for Type B; Protocol C, where vascularized fibular graft and anterior lateral thigh flap were used for Type C; and Protocol D, where limb lengthening and Protocols A, B, or C were used for Type D. There were 12, 33, 4, and 2 cases of Types A, B, C, and D, respectively, according to this classification. During the surgery, three cases of planned Protocol B had to be shifted into Protocol C; however, all microsurgical repairs were completed. With reference to Johner-Wruhs evaluation method, the total percentage of excellent and good results was 82.35% after 6 to 41 months of follow-up. It was concluded that posttraumatic massive bone defects could be accurately classified into four types on the basis of the conditions of bone defects, soft tissue coverage, and injured limb length, and successfully repaired with the single-stage repair protocols after thorough debridement. Thieme Medical

  19. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  20. Microsurgical management of cerebral aneurysms based in CT angiography with three-dimensional reconstruction (3D-CTA) and without preoperative cerebral angiography

    International Nuclear Information System (INIS)

    Gonzalez-Darder, J.M.; Pesudo-Martinez, J.V.; Feliu-Tatay, R.A.

    2001-01-01

    Objective. To study the possibilities of the microsurgical management of ruptured intracranial aneurysms with the sole preoperative information provided by computed tomography angiography with three-dimensional reconstruction (3D-CTA). Methods. Patients were studied with 3D-CTA after diagnosis of subarachnoid hemorrhage. If the study had an adequate quality and revealed an aneurysm congruent with the clinical findings or neurological examination and/or with the location of the bleeding on computed tomography (CT) scan an early microsurgical clipping of the lesion was done. When the quality of the 3D-CTA study was not adequate or the quality being adequate displayed no lesions or the findings were not accurate enough to warrant direct microsurgical treatment, the patient was studied with cerebral digital substraction (DS) angiography. A total of 44 consecutive patients harboring a total of 47 intracranial aneurysms diagnosed by 3D-CTA and without preoperative DS angiography were submitted to microsurgical clipping and included in the study. Results. The overall mortality was 15.9 % and the favorable results evaluated 6 months after discharge by means of the Glasgow outcome scale reached 70.4 %. All lesions were successfully clipped. Surgery was done a mean of 4.1 days after the admission bleeding. A total of four microlesions undiagnosed by 3D-CTA were found at surgery and clipped. Postoperative DS angiography and necropsy findings were also used as control of the 3D-CTA findings but no additional information was provided excepting the finding in DS angiography of an asymptomatic intracavemous aneurysm. Therefore the sensitivity of the 3D-CTA for diagnosis of symtomatic aneurysms was 100 % and the overall sensitivity 90.4 %. Conclusions. We have reached similar results in patients operated on with or without preoperative angiography. 3D-CTA provides very valuable anatomical information, which has an additional value in the microsurgical treatment of aneurysms of the

  1. Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.

    Science.gov (United States)

    Morita, Akio; Sora, Shigeo; Mitsuishi, Mamoru; Warisawa, Shinichi; Suruman, Katopo; Asai, Daisuke; Arata, Junpei; Baba, Shoichi; Takahashi, Hidechika; Mochizuki, Ryo; Kirino, Takaaki

    2005-08-01

    To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper. The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space. Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.

  2. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Rat allotransplantation of epigastric microsurgical flaps: a study of rejection and the immunosuppressive effect of cyclosporin A

    Directory of Open Access Journals (Sweden)

    Carramaschi Fábio R.

    2000-01-01

    Full Text Available The rejection of allotransplantation of epigastric microsurgical flaps and the effect of immunosuppression have been studied in 58 rats. Three sets of experiments were planned: (1 Wistar Furth isogenic donors and receptors (control set; (2 Brown Norway donors and Wistar Furth receptors (rejection set; and (3 Brown Norway donors and Wistar Furth immunosuppressed receptors (cyclosporin A set. Cyclosporin A (10 mg/kg/d treated rats had a transplantation survival rate of up to 30 days: 83.3% among isogenic animals and 60% among allogeneic. There was 100% rejection by the 9th day after the transplantation in allogeneic non-immunosuppressed rats. Biopsies embedded with historesin were taken from the flap and normal contralateral skin (used as control on the 3rd, 7th, 15th, and 30th days after the surgery. A quantitative study of infiltrating lymphocytes in the flaps, with and without cyclosporin A, was done by evaluating the local inflammatory infiltrate. A significant increase in the number of lymphocytes among the rejection and immunosuppressed groups was seen, as compared to the isogenic set. Local lymphocytosis in allogeneic non-immunosuppressed transplantations reached its highest level on the 3rd day after surgery, before gross findings of rejection, which could only be seen by naked eye on the 5th or 6th day. Therefore, we conclude that cyclosporin A is effective in preserving allogenic transplantation in rats. Biopsies of transplanted areas may contribute to earlier diagnosis of the need for immunosuppressive therapy.

  4. A deficit in optimizing task solution but robust and well-retained speed and accuracy gains in complex skill acquisition in Parkinson׳s disease: multi-session training on the Tower of Hanoi Puzzle.

    Science.gov (United States)

    Vakil, Eli; Hassin-Baer, Sharon; Karni, Avi

    2014-05-01

    There are inconsistent results in the research literature relating to whether a procedural memory dysfunction exists as a core deficit in Parkinson׳s disease (PD). To address this issue, we examined the acquisition and long-term retention of a cognitive skill in patients with moderately severe PD. To this end, we used a computerized version of the Tower of Hanoi Puzzle. Sixteen patients with PD (11 males, age 60.9±10.26 years, education 13.8±3.5 years, disease duration 8.6±4.7 years, UPDRS III "On" score 16±5.3) were compared with 20 healthy individuals matched for age, gender, education and MMSE scores. The patients were assessed while taking their anti-Parkinsonian medication. All participants underwent three consecutive practice sessions, 24-48h apart, and a retention-test session six months later. A computerized version of the Tower of Hanoi Puzzle, with four disks, was used for training. Participants completed the task 18 times in each session. Number of moves (Nom) to solution, and time per move (Tpm), were used as measures of acquisition and retention of the learned skill. Robust learning, a significant reduction in Nom and a concurrent decrease in Tpm, were found across all three training sessions, in both groups. Moreover, both patients and controls showed significant savings for both measures at six months post-training. However, while their Tpm was no slower than that of controls, patients with PD required more Nom (in 3rd and 4th sessions) and tended to stabilize on less-than-optimal solutions. The results do not support the notion of a core deficit in gaining speed (fluency) or generating procedural memory in PD. However, PD patients settled on less-than-optimal solutions of the task, i.e., less efficient task solving process. The results are consistent with animal studies of the effects of dopamine depletion on task exploration. Thus, patients with PD may have a problem in exploring for optimal task solution rather than in skill acquisition and

  5. Skills core

    Science.gov (United States)

    Lawson, Laura

    Constantly changing technology and increasing competition mean that private companies are aggressively seeking new employees with high levels of technological literacy, good judgment, and communication and team-building skills. Industry also needs workers educated in science, math, engineering, and technology. But which of these skills are most important? Researchers at Indian River Community College at Fort Pierce, Fla., will attempt to answer that question with an NSF grant of nearly $1 million.

  6. Soft skills and Moodle

    Directory of Open Access Journals (Sweden)

    Ivanova Veronica

    2017-01-01

    Full Text Available At present, technical university graduates are expected to acquire a set of not only hard skills but soft ones as well, which are in the first instance communication skills that can be developed through active and interactive methods during in-class learning. The issue related to communicative skills development is being discussed in different countries throughout the world. This problem is faced by university graduates from Europe, the US and Russia, and in the East. The learning process exploits a variety of electronic platforms, which, on the one hand, significantly increase the pool of students, but, on the other hand, hinder the development of communicative skills. This poses the question about blended learning which combines active and interactive teaching methods with e-learning. Consider a good example of these two types of combined student activity obtained using interactive methods in the Moodle course “Professional training in English” designed for the Bachelor's Degree Programs, Tomsk Polytechnic University (Tomsk, Russia. This paper considers the main types of tasks used in the e-course. It is shown that the teacher’s first aim is to be not a scientific knowledge translator, but to foster a creative educational environment by selecting an optimal teaching strategy through modern educational technology; an e-course is a good teaching aid to build hard and soft skills.

  7. Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy.

    Science.gov (United States)

    Mooney, Michael A; Hendricks, Benjamin; Sarris, Christina E; Spetzler, Robert F; Almefty, Kaith K; Porter, Randall W

    2018-06-01

    Objectives  This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design  A retrospective review. Setting  Single-institution cohort. Participants  Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures  Incidence, House-Brackmann grade. Results  Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1-4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House-Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions  Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

  8. Microsurgical Clipping of an Anterior Communicating Artery Aneurysm Using a Novel Robotic Visualization Tool in Lieu of the Binocular Operating Microscope: Operative Video.

    Science.gov (United States)

    Klinger, Daniel R; Reinard, Kevin A; Ajayi, Olaide O; Delashaw, Johnny B

    2018-01-01

    The binocular operating microscope has been the visualization instrument of choice for microsurgical clipping of intracranial aneurysms for many decades. To discuss recent technological advances that have provided novel visualization tools, which may prove to be superior to the binocular operating microscope in many regards. We present an operative video and our operative experience with the BrightMatterTM Servo System (Synaptive Medical, Toronto, Ontario, Canada) during the microsurgical clipping of an anterior communicating artery aneurysm. To the best of our knowledge, the use of this device for the microsurgical clipping of an intracranial aneurysm has never been described in the literature. The BrightMatterTM Servo System (Synaptive Medical) is a surgical exoscope which avoids many of the ergonomic constraints of the binocular operating microscope, but is associated with a steep learning curve. The BrightMatterTM Servo System (Synaptive Medical) is a maneuverable surgical exoscope that is positioned with a directional aiming device and a surgeon-controlled foot pedal. While utilizing this device comes with a steep learning curve typical of any new technology, the BrightMatterTM Servo System (Synaptive Medical) has several advantages over the conventional surgical microscope, which include a relatively unobstructed surgical field, provision of high-definition images, and visualization of difficult angles/trajectories. This device can easily be utilized as a visualization tool for a variety of cranial and spinal procedures in lieu of the binocular operating microscope. We anticipate that this technology will soon become an integral part of the neurosurgeon's armamentarium. Copyright © 2017 by the Congress of Neurological Surgeons

  9. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    Science.gov (United States)

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.

  10. Communication skills in palliative surgery: skill and effort are key.

    Science.gov (United States)

    Miner, Thomas J

    2011-04-01

    Excellence as a surgeon requires not only the technical and intellectual ability to effectively take care of surgical disease but also an ability to respond to the needs and questions of patients. This article provides an overview of the importance of communication skills in optimal surgical palliation and offers suggestions for a multidisciplinary team approach, using the palliative triangle as the ideal model of communication and interpersonal skills. This article also discusses guidelines for advanced surgical decision making and outlines methods to improve communication skills. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Modern Microsurgical Resection of Olfactory Groove Meningiomas by Classical Bicoronal Subfrontal Approach without Orbital Osteotomies.

    Science.gov (United States)

    Farooq, Ghulam; Rehman, Lal; Bokhari, Irum; Rizvi, Syed Raza Hussain

    2018-01-01

    The olfactory groove meningioma has always been surgically challenging. The common microscopic surgical procedures exercised involve modification of pterional or sub-frontal approaches with or without orbital osteotomies. However, we believe that orbital osteotomies are not mandatory to achieve gross total resection. Hence, this study was performed to evaluate the surgical outcomes of olfactory groove meningioma with bicoronal sub frontal approach but without orbital osteotomies. The study was performed by reviewing the medical charts, neuroimaging data, and follow-up data of 19 patients who were treated micro surgically for olfactory groove meningioma without orbital osteotomies in our department. Mean overall follow up period of our study was 5 years. Statistical analysis was done by means of IBM SPSS Software version 19. Nineteen patients (1 male and 18 female patients, with an age range of 35-67 years; average age of patients' 51±7.5 years) of OGM were managed in our department. All patients were evaluated by MRI Brain with and without Gadolinium, CTA, CT Scan both axial and Coronal sequences. Most common symptom reported was head ache (80%), others include; urinary incontinence (26%), seizures (78%), decreased visual acuity (79%), papilledema (74%), personality changes (68%) and olfactory loss was reported in 57% of the patients. Post-operative complications include; CSF accumulation (5%), hematoma at tumor bed (10%), skin infection (5%) and mild post-operative brain edema (26%). Mortality rate was 5%. During 5 years of follow-up, we recorded one recurrence which was after 26 months and successfully removed in reoperation. Bi-coronal sub frontal approach appears to be an excellent technique for Olfactory Meningioma removal as practiced by most neurosurgeons. Nevertheless, it is not mandatory to carry out orbital osteotomy to acquire optimal surgical outcome as is advocated by some Authors.

  12. Preoperative simulation for the planning of microsurgical clipping of intracranial aneurysms.

    Science.gov (United States)

    Marinho, Paulo; Vermandel, Maximilien; Bourgeois, Philippe; Lejeune, Jean-Paul; Mordon, Serge; Thines, Laurent

    2014-12-01

    The safety and success of intracranial aneurysm (IA) surgery could be improved through the dedicated application of simulation covering the procedure from the 3-dimensional (3D) description of the surgical scene to the visual representation of the clip application. We aimed in this study to validate the technical feasibility and clinical relevance of such a protocol. All patients preoperatively underwent 3D magnetic resonance imaging and 3D computed tomography angiography to build 3D reconstructions of the brain, cerebral arteries, and surrounding cranial bone. These 3D models were segmented and merged using Osirix, a DICOM image processing application. This provided the surgical scene that was subsequently imported into Blender, a modeling platform for 3D animation. Digitized clips and appliers could then be manipulated in the virtual operative environment, allowing the visual simulation of clipping. This simulation protocol was assessed in a series of 10 IAs by 2 neurosurgeons. The protocol was feasible in all patients. The visual similarity between the surgical scene and the operative view was excellent in 100% of the cases, and the identification of the vascular structures was accurate in 90% of the cases. The neurosurgeons found the simulation helpful for planning the surgical approach (ie, the bone flap, cisternal opening, and arterial tree exposure) in 100% of the cases. The correct number of final clip(s) needed was predicted from the simulation in 90% of the cases. The preoperatively expected characteristics of the optimal clip(s) (ie, their number, shape, size, and orientation) were validated during surgery in 80% of the cases. This study confirmed that visual simulation of IA clipping based on the processing of high-resolution 3D imaging can be effective. This is a new and important step toward the development of a more sophisticated integrated simulation platform dedicated to cerebrovascular surgery.

  13. Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.

    Science.gov (United States)

    Jablonka, Eric M; Lamelas, Andreas M; Kim, Julie N; Molina, Bianca; Molina, Nathan; Okwali, Michelle; Samson, William; Sultan, Mark R; Dayan, Joseph H; Smith, Mark L

    2017-08-01

    Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge. A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade. During this period, the use of locoregional analgesia evolved from none (control), to continuous bupivacaine infusion transversus abdominis plane and catheters, to single-dose transversus abdominis plane blockade with liposomal bupivacaine solution. Demographic factors, length of stay, inpatient opioid consumption, and complications were reported for all three groups. One hundred twenty-eight consecutive patients (182 flaps) were identified. Forty patients (62 flaps) were in the infusion-liposomal bupivacaine group, 48 (66 flaps) were in the single-dose blockade-catheter group, and 40 (54 flaps) were in the control group. The infusion-liposomal bupivacaine patients had a significantly shorter hospital stay compared with the single-dose blockade-catheter group (2.65 ± 0.66 versus 3.52 ± 0.92 days; p plane blocks performed with single injections of liposomal bupivacaine help facilitate early hospital discharge after abdominally based microsurgical breast reconstruction. A trend toward consistent discharge by postoperative day 2 was seen. This could result in significant cost savings for health care systems. Therapeutic, III.

  14. Meta-heuristic ant colony optimization technique to forecast the amount of summer monsoon rainfall: skill comparison with Markov chain model

    Science.gov (United States)

    Chaudhuri, Sutapa; Goswami, Sayantika; Das, Debanjana; Middey, Anirban

    2014-05-01

    Forecasting summer monsoon rainfall with precision becomes crucial for the farmers to plan for harvesting in a country like India where the national economy is mostly based on regional agriculture. The forecast of monsoon rainfall based on artificial neural network is a well-researched problem. In the present study, the meta-heuristic ant colony optimization (ACO) technique is implemented to forecast the amount of summer monsoon rainfall for the next day over Kolkata (22.6°N, 88.4°E), India. The ACO technique belongs to swarm intelligence and simulates the decision-making processes of ant colony similar to other adaptive learning techniques. ACO technique takes inspiration from the foraging behaviour of some ant species. The ants deposit pheromone on the ground in order to mark a favourable path that should be followed by other members of the colony. A range of rainfall amount replicating the pheromone concentration is evaluated during the summer monsoon season. The maximum amount of rainfall during summer monsoon season (June—September) is observed to be within the range of 7.5-35 mm during the period from 1998 to 2007, which is in the range 4 category set by the India Meteorological Department (IMD). The result reveals that the accuracy in forecasting the amount of rainfall for the next day during the summer monsoon season using ACO technique is 95 % where as the forecast accuracy is 83 % with Markov chain model (MCM). The forecast through ACO and MCM are compared with other existing models and validated with IMD observations from 2008 to 2012.

  15. Forecasting Skill

    Science.gov (United States)

    1981-01-01

    for the third and fourth day precipitation forecasts. A marked improvement was shown for the consensus 24 hour precipitation forecast, and small... Zuckerberg (1980) found a small long term skill increase in forecasts of heavy snow events for nine eastern cities. Other National Weather Service...and maximum temperature) are each awarded marks 2, 1, or 0 according to whether the forecast is correct, 8 - *- -**■*- ———"—- - -■ t0m 1 MM—IB I

  16. Direct costs of microsurgical management of radiosurgically amenable intracranial pathology in Germany: an analysis of meningiomas, acoustic neuromas, metastases and arteriovenous malformations of less than 3 cm in diameter

    International Nuclear Information System (INIS)

    Wellis, G.; Nagel, R.; Vollmar, C.; Steiger, H.-J.

    2003-01-01

    The purpose of the analysis was to appreciate and compare the effective direct costs of microsurgical treatment of intracranial pathology potentially amenable to radiosurgery as they arose in 1998-99. Treatment costs of 127 microsurgically treated patients harboring an arteriovenous malformation (AVM), acoustic neuroma, meningioma or brain metastasis potentially amenable to radiosurgery were reviewed. Costs for the surgical procedure, ICU rare, medical and nursing care on the ward, interclinical bills (ICB) for services provided by other departments and the overhead for basic hotel service were added. For comparison gamma knife costs were calculated by dividing the global operating cost of the gamma knife centre by the number of patients treated in 1999. Average hospitalization time for the entire microsurgical patients was 15.4 + 8.6 days. The patients spent an average of 1.2 ± 2.8 days on ICU. Average operating time for all patients, including preparation, was 393 ± 118 minutes. Average costs for the microsurgical therapy were Eur 10814 ± 6108. These consisted of Eur 1417 ± 426 for the surgical procedure, Eur 1188 ± 2658 for ICU care, Eur 2333 ± 1582 for medical and nursing care on the ward, Eur 1671 ± 1433 for interclinical bills and Eur 4204 ± 2338 for basic hotel service (overhead, Eur 273 per day). 70 % of the microsurgically treated patients needed ancillary inpatient rehabilitation or radiotherapy resulting in an average additional cost for all patients of Eur 2744. Furthermore 20 % of the microsurgically treated patients required an unplanned readmission after discharge, resulting in an average additional costs for all patients of Eur 1684. Average overall costs per patient including ancillary therapy and unplanned read-missions amounted to Eur 15242. For comparison, gamma knife treatment costs per patient amounted to Eur 7920 in 1999. The current analysis showed that for established radiosurgical indications the primary costs of microsurgery

  17. Skill and strategy in games

    NARCIS (Netherlands)

    Dreef, M.R.M.

    2005-01-01

    This thesis consists of two parts. Part I deals with relative skill and the role of random factors in games. Part II is devoted to the computation of optimal strategies in two interesting classes of games: poker and take-and-guess games.

  18. Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

    Science.gov (United States)

    Sindou, Marc; Georgoulis, George

    2016-01-01

    Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

  19. Soft skills, hard skills, and individual innovativeness

    DEFF Research Database (Denmark)

    Hendarman, Achmad Fajar; Cantner, Uwe

    2018-01-01

    of Indonesian firms from different industries are used from an online survey on manager and worker perceptions related to individual innovation performance on the one hand and individual skills on the other hand. The results show that soft skills and hard skills are significantly and positively associated...... with individual level innovativeness. However, no complementarity (positive interaction effect) is found between soft skills and hard skills....

  20. Adult congenital heart disease nurse coordination: Essential skills and role in optimizing team-based care a position statement from the International Society for Adult Congenital Heart Disease (ISACHD).

    Science.gov (United States)

    Sillman, Christina; Morin, Joanne; Thomet, Corina; Barber, Deena; Mizuno, Yoshiko; Yang, Hsiao-Ling; Malpas, Theresa; Flocco, Serena Francesca; Finlay, Clare; Chen, Chi-Wen; Balon, Yvonne; Fernandes, Susan M

    2017-02-15

    Founded in 1992, the International Society for Adult Congenital Heart Disease (ISACHD) is the leading global organization of professionals dedicated to pursuing excellence in the care of adults with congenital heart disease (CHD) worldwide. Among ISACHD's objectives is to "promote a holistic team-based approach to the care of the adult with CHD that is comprehensive, patient-centered, and interdisciplinary" (http://www.isachd.org). This emphasis on team-based care reflects the fact that adults with CHD constitute a heterogeneous population with a wide spectrum of disease complexity, frequent association with other organ involvement, and varied co-morbidities and psychosocial issues. Recognizing the vital role of the adult CHD (ACHD) nurse coordinator (ACHD-NC) in optimizing team-based care, ISACHD established a task force to elucidate and provide guidance on the roles and responsibilities of the ACHD-NC. Acknowledging that nursing roles can vary widely from region to region based on factors such as credentials, scopes of practice, regulations, and local culture and tradition, an international panel was assembled with experts from North America, Europe, East Asia, and Oceania. The writing committee was tasked with reviewing key aspects of the ACHD-NC's role in team-based ACHD care. The resulting ISACHD position statement addresses the ACHD-NC's role and skills required in organizing, coordinating, and facilitating the care of adults with CHD, holistic assessment of the ACHD patient, patient education and counseling, and support for self-care management and self-advocacy. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  1. Depression in adolescence:testing a social skills deficit theory

    NARCIS (Netherlands)

    van Beek, Y.|info:eu-repo/dai/nl/107292300

    2017-01-01

    C145. DEPRESSION IN ADOLESCENCE:TESTING A SOCIAL SKILLS DEFICIT THEORYVan Beek, Y. Utrecht University, NetherlandsThe Social Skill Deficit Model for depression suggeststhat less optimal social skills lead to negativefeedback of others, which in turn results in negativeself-views and depression.

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education ... Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Overview The skills kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Careers at ACS Careers at ACS About ACS Career Types Working at ACS ... American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills ...

  5. Ostomy Home Skills Program

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    Full Text Available ... ACS Careers at ACS About ACS Career Types Working at ACS ... Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy ...

  6. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    OpenAIRE

    Mert Çalış; Zeynep Öz; Hakan Uzun; Burçe Özgen; Alp Çetin3; Ali Emre Aksu

    2017-01-01

    Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospita...

  7. Ostomy Home Skills Program

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    Full Text Available ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and Emergency ...

  8. Skill level, Cognitive Ability, Unemployment and Welfare

    DEFF Research Database (Denmark)

    Larsen, Birthe

    2004-01-01

    -biasedtechnological shocks increase unemployment, this may explain why themarket it-self cannot respond to this by making it sufficiently attractiveto acquire skills. Consequently, the trade-off in-between subsidizing educationand thereby reducing unemployment and optimizing welfare maybe eliminated. We analyse this issue...... in a simple educational model andnext in a search equilibrium model including a skill choice decision.Keywords: Education, subsidies, efficiency, unemployment.JEL codes: I20, J64....

  9. A laser microsurgical method of cell wall removal allows detection of large-conductance ion channels in the guard cell plasma membrane

    Science.gov (United States)

    Miedema, H.; Henriksen, G. H.; Assmann, S. M.; Evans, M. L. (Principal Investigator)

    1999-01-01

    Application of patch clamp techniques to higher-plant cells has been subject to the limitation that the requisite contact of the patch electrode with the cell membrane necessitates prior enzymatic removal of the plant cell wall. Because the wall is an integral component of plant cells, and because cell-wall-degrading enzymes can disrupt membrane properties, such enzymatic treatments may alter ion channel behavior. We compared ion channel activity in enzymatically isolated protoplasts of Vicia faba guard cells with that found in membranes exposed by a laser microsurgical technique in which only a tiny portion of the cell wall is removed while the rest of the cell remains intact within its tissue environment. "Laser-assisted" patch clamping reveals a new category of high-conductance (130 to 361 pS) ion channels not previously reported in patch clamp studies on plant plasma membranes. These data indicate that ion channels are present in plant membranes that are not detected by conventional patch clamp techniques involving the production of individual plant protoplasts isolated from their tissue environment by enzymatic digestion of the cell wall. Given the large conductances of the channels revealed by laser-assisted patch clamping, we hypothesize that these channels play a significant role in the regulation of ion content and electrical signalling in guard cells.

  10. [Intraoperative magnetic resonance imaging-guided functional neuronavigation plus intraoperative neurophysiological monitoring for microsurgical resection of lesions involving hand motor area].

    Science.gov (United States)

    Miao, Xing-lu; Chen, Zhi-juan; Yang, Wei-dong; Wang, Zeng-guang; Yu, Qing; Yue, Shu-yuan; Zhang, Jian-ning

    2013-01-15

    To explore the methods and applications of intraoperative magnetic resonance imaging (iMRI)-guided functional neuronavigation plus intraoperative neurophysiological monitoring (IONM) for microsurgical resection of lesions involving hand motor area. A total of 16 patients with brain lesions adjacent to hand motor area were recruited from January 2011 to April 2012. All of them underwent neuronavigator-assisted microsurgery. Also IONM was conducted to further map hand motor area and epileptogenic focus. High-field iMRI was employed to update the anatomical and functional imaging date and verify the extent of lesion resection. Brain shifting during the functional neuronavigation was corrected by iMRI in 5 patients. Finally, total lesion resection was achieved in 13 cases and subtotal resection in 3 cases. At Months 3-12 post-operation, hand motor function improved (n = 10) or remained unchanged (n = 6). None of them had persistent neurological deficit. The postoperative seizure improvement achieved Enge II level or above in 9 cases of brain lesions complicated with secondary epilepsy. Intraoperative MRI, functional neuronavigation and neurophysiological monitoring technique are complementary in microsurgery of brain lesions involving hand motor area. Combined use of these techniques can obtain precise location of lesions and hand motor functional structures and allow a maximum resection of lesion and minimization of postoperative neurological deficits.

  11. Cognitive Load in Mastoidectomy Skills Training

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts; Mikkelsen, Peter Trier; Konge, Lars

    2016-01-01

    OBJECTIVE: The cognitive load (CL) theoretical framework suggests that working memory is limited, which has implications for learning and skills acquisition. Complex learning situations such as surgical skills training can potentially induce a cognitive overload, inhibiting learning. This study...... aims to compare CL in traditional cadaveric dissection training and virtual reality (VR) simulation training of mastoidectomy. DESIGN: A prospective, crossover study. Participants performed cadaveric dissection before VR simulation of the procedure or vice versa. CL was estimated by secondary...... surgical skills can be a challenge for the novice and mastoidectomy skills training could potentially be optimized by employing VR simulation training first because of the lower CL. Traditional dissection training could then be used to supplement skills training after basic competencies have been acquired...

  12. Optimization and Optimal Control

    CERN Document Server

    Chinchuluun, Altannar; Enkhbat, Rentsen; Tseveendorj, Ider

    2010-01-01

    During the last four decades there has been a remarkable development in optimization and optimal control. Due to its wide variety of applications, many scientists and researchers have paid attention to fields of optimization and optimal control. A huge number of new theoretical, algorithmic, and computational results have been observed in the last few years. This book gives the latest advances, and due to the rapid development of these fields, there are no other recent publications on the same topics. Key features: Provides a collection of selected contributions giving a state-of-the-art accou

  13. Optimally Stopped Optimization

    Science.gov (United States)

    Vinci, Walter; Lidar, Daniel

    We combine the fields of heuristic optimization and optimal stopping. We propose a strategy for benchmarking randomized optimization algorithms that minimizes the expected total cost for obtaining a good solution with an optimal number of calls to the solver. To do so, rather than letting the objective function alone define a cost to be minimized, we introduce a further cost-per-call of the algorithm. We show that this problem can be formulated using optimal stopping theory. The expected cost is a flexible figure of merit for benchmarking probabilistic solvers that can be computed when the optimal solution is not known, and that avoids the biases and arbitrariness that affect other measures. The optimal stopping formulation of benchmarking directly leads to a real-time, optimal-utilization strategy for probabilistic optimizers with practical impact. We apply our formulation to benchmark the performance of a D-Wave 2X quantum annealer and the HFS solver, a specialized classical heuristic algorithm designed for low tree-width graphs. On a set of frustrated-loop instances with planted solutions defined on up to N = 1098 variables, the D-Wave device is between one to two orders of magnitude faster than the HFS solver.

  14. Optimal admission to higher education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    2016-01-01

    that documents the relevance of theory and illustrates how to apply optimal admission procedures. Indirect gains from optimal admission procedures include the potential for increasing entire cohorts of students' probability of graduating with a higher education degree, thereby increasing the skill level...

  15. IMPLEMENTASI TQM BERORIENTASI HARD SKILL DAN SOFT SKILL DALAM PEMBELAJARAN SEJARAH SMA DI KOTA SEMARANG

    Directory of Open Access Journals (Sweden)

    Cahyo Budi Utomo

    2011-10-01

    Full Text Available This study aims to introduce the implementation of hardskill and softskill oriented TQM in teacher’s learning of history in Senior High School in Semarang. The research model are structural fit model and significance of relationship between TQM implementation model, PDSA cycle, the model analysis of fish bone, continuous improvement , hard skills and soft skills and qualified history learning is the main target of research. Data was obtained from field studies using Likert scale questionnaire developed from the constructs and theoretical construct indicator. Analysis performed using software models SmartPLS. Implementation of PDSA cycle correlated 0879 to the implementation of fish bone analysis, correlates 0830 PDSA cycle to continuously improvement , while continuously improvement  correlated 0441 and 0749 against the hard skills to soft skills. Soft skills to hard skills correlate of 0329, while the correlation of hard skills to qualified history learning is at 0673. The developed qualityfied history learning need support from  the realization of the continuous (continuously improvement and optimal orientation of hard skills. Keywords: model, TQM, PDSA, the analysis of fish bone, hard skills, soft skills, learning the history of quality  Kajian ini bertujuan mengenalkan model implementasi TQM yang berorientasi pada hardskill dan softskill dalam pembelajaran sejarah di sekolah atas Semarang pada para guru. Sebagai model penelitian, model struktural fit dan signifikasi  dari korelasi antara model implementasi TQM, siklus PDSA, model analisis tulang ikan, perbaikan terus-menerus, hard skill dan soft skill, dan pembelajaran sejarah bermutu (PSB menjadi target utama penelitian. Data didapatkan dari studi lapangan menggunakan angket skala Likert yang dikembangkan dari konstruk dan indicator konstruk teoretis. Analisis menggunakan program SmartPLS. Implementasi siklus PDSA berkorelasi 0879 terhadap implementasi model analisis

  16. Ostomy Home Skills Program

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    Full Text Available ... Congress Educational Program Events and Special Activities Resources Housing and Travel Exhibitors Media Information Clinical Congress 2017 ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

  17. Ostomy Home Skills Program

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    Full Text Available ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... at ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  19. Ostomy Home Skills Program

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    Full Text Available ... JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and Emergency ...

  2. Ostomy Home Skills Program

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    Full Text Available ... Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Stay Up to Date with ACS Association Management Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  5. Acquiring Psychomotor Skills.

    Science.gov (United States)

    Padelford, Harold E.

    1984-01-01

    The author discusses levels of psychomotor skill acquisition: perceiving, motivating, imitating, performing, adapting, and innovating. How these skills interact and how they affect the learner's ability to learn are examined. (CT)

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Specific Registry Surgeon Specific Registry News and Updates Account Setup Resources and FAQs Features of the SSR ... Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Up to Date with ACS Association Management JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking ...

  10. Livebirth and utero-placental insufficiency in Papio hamadryas baboons with uterus angiosome perfused by bilateral utero-ovarian microsurgical anastomoses alone.

    Science.gov (United States)

    Beran, B; Arnolds, K; Shockley, M; Rivas, K; Medina, M; Escobar, P F; Tzakis, A; Falcone, T; Sprague, M L; Zimberg, S

    2017-09-01

    Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy. In an attempt to avoid the time-consuming dissection of the uterine vein, our group has previously shown maintenance of baboon uterine menstrual function after ligation of the uterine vein and after ligation of both the uterine artery and uterine vein. In a 19-month timespan, three baboons underwent laparotomy to surgically alter uterine perfusion, and pregnancy outcomes were monitored after spontaneous mating in a breeding colony. Three nulligravid female Papio hamadryas baboons in a breeding colony underwent laparotomy to ligate uterine arteries and veins along with colpotomy and cervico-vaginal anastomosis. During the same surgery, the utero-ovarian arteries and veins were microsurgically transected and re-anastomosed to themselves. Intraoperative organ perfusion was confirmed with laser angiography. After a recovery period, monitoring of menstrual cycling via menstrual blood flow and sex-skin cycling occurred, as well as uterine viability via sonography and cervical biopsy. Each baboon was released to the breeding colony for spontaneous mating and pregnancies dated by menstrual calendar and compared with early ultrasound. Delivery outcomes were monitored in each including neonate weight and placental pathology. In the event of a stillbirth, the animal was returned to the breeding colony for repeat mating attempts. After achieving a livebirth, the maternal baboon was removed from the study. Each baboon in the trial underwent successful surgery with all uteri demonstrating viability and return of menstrual function within 10 weeks of surgery. Pregnancies occurred

  11. Transversus abdominis plane block reduces morphine consumption in the early postoperative period following microsurgical abdominal tissue breast reconstruction: a double-blind, placebo-controlled, randomized trial.

    Science.gov (United States)

    Zhong, Toni; Ojha, M; Bagher, Shaghayegh; Butler, Kate; Srinivas, Coimbatore; McCluskey, Stuart A; Clarke, Hance; O'Neill, Anne C; Novak, Christine B; Hofer, Stefan O P

    2014-11-01

    The analgesic efficacy of the transversus abdominis plane peripheral nerve block following abdominal tissue breast reconstruction has not been studied in a randomized controlled trial. The authors conducted a double-blind, placebo-controlled, 1:1 allocation, two-arm parallel group, superiority design, randomized controlled trial in patients undergoing microsurgical abdominally based breast reconstruction. Intraoperatively, epidural catheters were inserted under direct vision through the triangle of Petit on both sides of the abdomen into the transversus abdominis plane just before rectus fascial closure. Patients received either bupivacaine (study group) or saline (placebo group) through the catheters for 2 postoperative days. All patients received hydromorphone by means of a patient-controlled analgesic pump. The primary outcome was the difference in the parenteral opioid consumption on each postoperative day between the groups. The secondary outcome measures included the following: total in-hospital opioid; antinausea medication; pain, nausea, and sedation scores; Quality of Recovery Score; time to ambulation; and hospital stay duration. Between September of 2011 and June of 2013, 93 patients were enrolled: 49 received bupivacaine and 44 received saline. There were 11 postoperative complications (13 percent); none were related to the catheter. Primary outcomes were completed by 85 of 93 patients (91.3 percent); the mean parenteral morphine consumption was significantly reduced on postoperative day 1 in the bupivacaine group (20.7±20.1 mg) compared with 30.0±19.1 mg in the control group (p=0.02). There were no significant differences in secondary outcomes. Following abdominally based breast reconstruction, transversus abdominis plane peripheral nerve block is safe and significantly reduces morphine consumption in the early postoperative period. Therapeutic, II.

  12. Prospective double-blind preoperative pain clinic screening before microsurgical denervation of the spermatic cord in patients with testicular pain syndrome.

    Science.gov (United States)

    Oomen, Robert J A; Witjens, Annemijke C; van Wijck, Albert J M; Grobbee, Diederik E; Lock, Tycho M T W

    2014-09-01

    Testicular pain syndrome (TPS), defined as an intermittent or constant pain in one or both testicles for at least 3 months, resulting in significant reduction of daily activities, is common. Microsurgical denervation of the spermatic cord (MDSC) has been suggested as an effective treatment option. The study population comprised 180 TPS patients admitted to our outpatient urology clinic between 1999 and 2011. On 3 different occasions, patients were offered a double-blind, placebo-controlled temporary blockade of the spermatic cord. A single blockade consisted of 10 mL 2% lidocaine, 10 mL 0.25% bupivacaine, or 10 mL 0.9% sodium chloride. If the results of these blockades were positive, MDSC was offered. All MDSCs were performed by a single urologist (M.T.W.T.L.) using an inguinal approach. Pain reduction was determined at prospective follow-up. This study evaluated 180 patients. Most patients (61.1%) had undergone a scrotal or inguinal procedure. Patients had complaints during sexual activities (51.7%), sitting (37.5%), and/or cycling (36.7%); 189 randomized blockades were offered to all patients. There was a positive response in 37% and a negative response in 51%. MDSC was performed on 58 testicular units, including 3 patients with a negative outcome of the blockades. At mean follow-up of 42.8 months, 86.2% had a ≥ 50% reduction of pain and 51.7% were completely pain free. MDSC is a valuable treatment option for TPS patients because in this study 86.2% experienced a ≥ 50% reduction of pain. To prevent superfluous diagnostics and treatment, it is mandatory to follow a systematic protocol in the treatment of TPS. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  13. Different Recipient Vessels for Free Microsurgical Fibula Flaps in the Treatment of Avascular Necrosis of the Femoral Head: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Tu, Yiji; Chen, Zenggan; Lineaweaver, William Charles; Zhang, Feng

    2017-12-01

    Several recipient vessels can be used in free microsurgical fibula flaps (MFFs) for the treatment of avascular necrosis of the femoral head (ANFH). Few articles investigate the influence of different recipient vessels on outcomes of MFF for ANFH. A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related studies. The Medical Subject Headings used were "femur head necrosis" and "bone transplantation." The relevant words in title or abstract included but not limited to "fibula flap," "fibular flap," "vascularized fibula," "vascularized fibular," "free fibula," "free fibular," "femoral head necrosis," "avascular necrosis of femoral head," and "ischemic necrosis of femoral head." The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Finally, 15 studies encompassing a total of 1267 patients (1603 hips) with ANFH were pooled in the overall analysis. Recipient vessels for MFF included the ascending branch of the lateral circumflex femoral artery and vein in 8 studies, descending branch of the lateral circumflex femoral artery and vein in 2 studies, second perforating branch of the deep femoral artery and vein in 4 studies, and inferior gluteal artery and vein in 1 study. Preoperative and postoperative average Harris hip score and pooled analyses of the rate of conversion, radiographic progression, and hip surgery-related complications showed no significant difference on the outcomes of MFF on ANFH between using different recipient vessels. Different recipient vessels did not affect outcomes in MFF procedures for ANFH. High-quality randomized controlled trials and prospective studies would be necessary to clarify reliable advantages and disadvantages between different recipient vessels. Until then, surgeons are justified in using ascending branch of the lateral circumflex femoral artery and vein, descending branch of the lateral

  14. Endoscopic-assisted interhemispheric parieto-occipital transtentorial approach for microsurgical resection of a pineal region tumor: operative video and technical nuances.

    Science.gov (United States)

    Liu, James K

    2016-01-01

    The angle of the straight sinus and tentorium cerebelli can often influence the choice of surgical approach to the pineal region. The supracerebellar infratentorial approach can be technically challenging and a relative contraindication in cases where the angle of the straight sinus and tentorium is very steep. Similarly, an occipital transtentorial approach, which uses a low occipital craniotomy at the junction of the superior sagittal sinus and transverse sinus, may not provide the best trajectory to the pineal region in patients with a steep tentorium. In addition, this approach often necessitates retraction on the occipital lobe to access the tentorial incisura and pineal region, which can increase the risk of visual compromise. In this operative video, the author demonstrates an alternative route using an endoscopic-assisted interhemispheric parieto-occipital transtentorial approach to a pineal region tumor in a patient with a steep straight sinus and tentorium. The approach provided a shorter route and more direct trajectory to the tumor at the tentorial incisura, and avoided direct fixed retraction on the occipital lobe when performed using the lateral position, thereby minimizing visual complications. This video atlas demonstrates the operative technique and surgical nuances, including the application of endoscopic-assisted microsurgical resection and operative pearls for preservation of the deep cerebral veins. In summary, the parieto-occipital transtentorial approach with endoscopic assistance is an important approach in the armamentarium for surgical management of pineal region tumors. The video can be found here: https://youtu.be/Ph4veG14aTk .

  15. Perspectives of employability skills

    OpenAIRE

    ANNE LOUISE NEWTON

    2017-01-01

    The study investigated the different perspectives held by young people, employers and policy makers around Employability Skills and it examined how young people learnt these skills. This study draws young peoples’ perspectives into the research around Employability Skills and highlights the way in which social and cultural capital mediate their development. The research points to a model to re-vision employability skills which recognises the many ways in which they are learnt, over time a...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  17. School Leadership Skill Development

    Science.gov (United States)

    Weigel, Richard A.

    2013-01-01

    The purpose of this study was to investigate the relationship between what is currently understood about skills for school leadership and the need for a greater understanding of those skills. The importance of developing leadership skills to improve school performance and effectiveness is great. In the field of school leadership, most leaders…

  18. Teaching Organizational Skills

    Science.gov (United States)

    Bakunas, Boris; Holley, William

    2004-01-01

    Kerr and Zigmond (1986) found that 67 percent of all high school teachers surveyed viewed organizational skills as crucial for student success in school. How can teachers get their students to agree? One way is to teach organizational skills just as they would teach writing or computation skills. Explain and demonstrate what students are to do,…

  19. Functional flexibility good for skills development

    NARCIS (Netherlands)

    Goudswaard, A.

    2004-01-01

    Making optimal use of the employee’s capacity to perform different tasks (‘functional flexibility’) is positively related to skills development and involvement in decision-making. It may lead to emotional exhaustion, however, if an imbalance exists, such as high job demands combined with a lack of

  20. Functional flexibility good for skills development

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    Functional flexibility, making optimal use of the employee’s capacity to perform different tasks, is positively related to skills development and involvement in decision-making. It may lead to emotional exhaustion, however, if an imbalance exists, such as high job demands combined with a lack of

  1. Promoting Team Leadership Skills in Doctoral Candidates

    Science.gov (United States)

    Suleiman, Mahmoud; Whetton, Danny

    2014-01-01

    Doctoral programs can serve as an optimal opportunity for candidates to engage in tasks and activities to transform them and their schools. The paradigm shifts in such preparation involve moving from sitting and getting to making and taking. Most importantly, it requires building leadership skills and styles necessary to bring about desired change…

  2. Pharmacists' and general practitioners' pharmacology knowledge and pharmacotherapy skills

    NARCIS (Netherlands)

    Keijsers, Carolina J P W; Leendertse, Anne J; Faber, Adrianne; Brouwers, Jacobus R B J; de Wildt, Dick J; Jansen, Paul A F

    Understanding differences in the pharmacology knowledge and pharmacotherapy skills of pharmacists and physicians is vital to optimizing interprofessional collaboration and education. This study investigated these differences and the potential influence of work experience. The pharmacology knowledge

  3. Elments constintute teachers’ teaching skills

    OpenAIRE

    Hoa, H.; Lам, P.

    2014-01-01

    Teachers’ pedagogical activities are constituted by many skills such as teaching skills, education skills, and skills of performing varied pedagogical ac- tivities. Each skill is formed from a variety of specifi c skills. Approaching teachers’ teaching skills based on pedagogical operation base can help us establish methods and develop skills for teachers. By doing so, we can assist teachers to enhance their teaching competence contributing to teaching quality improvement in schools

  4. Soft skills and dental education

    OpenAIRE

    Gonzalez, M. A. G.; Abu Kasim, N. H.; Naimie, Z.

    2014-01-01

    Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses ...

  5. Teaching and Assessing Communication Skills in Medical Undergraduate Training.

    Science.gov (United States)

    Modi, Jyoti Nath; Anshu, -; Chhatwal, Jugesh; Gupta, Piyush; Singh, Tejinder

    2016-06-08

    Good communication skills are essential for an optimal doctor-patient relationship, and also contribute to improved health outcomes. Although the need for training in communication skills is stated as a requirement in the 1997 Graduate Medical Education Regulations of the Medical Council of India, formal training in these skills has been fragmentary and non-uniform in most Indian curricula. The Vision 2015 document of the Medical Council of India reaffirms the need to include training in communication skills in the MBBS curriculum. Training in communication skills needs approaches which are different from that of teaching other clinical subjects. It is also a challenge to ensure that students not only imbibe the nuances of communication and interpersonal skills, but adhere to them throughout their careers. This article addresses the possible ways of standardizing teaching and assessment of communication skills and integrating them into the existing curriculum.

  6. Cognitive Skill in Medicine: An Introduction

    NARCIS (Netherlands)

    Cnossen, Fokie; Lanzer, Peter

    2015-01-01

    Cognition encompasses all processes from perception to action including attention and memory, reasoning, and decision making. Therefore, all skills (perceptual skills, motor skills, diagnosing skill, medical skills) are cognitive skills. Cognitive skills are supported by two types of knowledge:

  7. Skills and Competencies

    Directory of Open Access Journals (Sweden)

    Nasios Orinos

    2013-07-01

    Full Text Available This article presents the results of a study aimed to investigate the requirements of the business sector in light of the skills and competencies students should have in order to be recruited. In this fashion, the study intended to measure the importance of the skills and competencies sought by the business world, revealing ways through which students can develop such skills. This project portrayed that, some of the required classes will certainly give students a strong theoretical background but they will neither completely prepare this student with all possible skills or competencies nor provide the student with any practical experience that will enable him/her to be more competitive when entering the business market. In some classes, however, like Public Speaking, which is designed to teach presentation skills, successful students are able to build good communication and interpersonal skills. Additionally, an English writing class will certainly attempt to provide them with strong writing skills, and a business class will possibly demand reading skills. Moreover, a calculus and a statistics class will provide basic arithmetic/mathematical skills. However, through this project it is proven that all of these classes will neglect the indoctrination of creative thinking in students, or make students believe in their own self-worth (self-esteem skills; the courses will also fail to develop the sense of urgency, drive and determination that students should possess not just to compete but also to survive in a business world.

  8. Skills, Franchise and Industrialization

    OpenAIRE

    Boschini, Anne

    2003-01-01

    In this paper the skill distribution is proposed as being fundamental for technological transitions, besides the economic and political variables normally considered. The setting is an endogenous growth model with non-overlapping generations, where agents are heterogeneous with respect to wealth, skills and political power. It is shown that the skill distributionis as imporant as the initial wealth distribution and the type of political regime in determining the subsequent economic developmen...

  9. Communication skills in context: trends and perspectives.

    Science.gov (United States)

    van Dalen, Jan

    2013-09-01

    Doctor-patient communication has been well researched. Less is known about the educational background of communication skills training. Do we aim for optimal performance of skills, or rather attempt to help students become skilled communicators? An overview is given of the current view on optimal doctor-patient communication. Next we focus on recent literature on how people acquire skills. These two topics are integrated in the next chapter, in which we discuss the optimal training conditions. A longitudinal training design has more lasting results than incidental training. Assessment must be in line with the intended learning outcomes. For transfer, doctor-patient communication must be addressed in all stages of health professions training. Elementary insights from medical education are far from realised in many medical schools. Doctor-patient communication would benefit strongly from more continuity in training and imbedding in the daily working contexts of doctors. When an educational continuum is realised and attention for doctor-patient communication is embedded in the working context of doctors in training the benefits will be strong. Training is only a part of the solution. In view of the current dissatisfaction with doctor-patient communication a change in attitude of course directors is strongly called for. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  12. Use of relaxation skills in differentially skilled athletes.

    OpenAIRE

    Kudlackova, K.; Eccles, D. W.; Dieffenbach, K.

    2013-01-01

    Objectives: To examine the use of relaxation skills by differentially skilled athletes in relation to the deliberate practice framework. Design: Differentially skilled athletes completed a survey about their use of relaxation skills. Method: 150 athletes representing three skill levels (recreational, college, and professional) completed the deliberate relaxation for sport survey, which assessed relaxation on three deliberate practice dimensions (relevancy, concentration, and ...

  13. Taxonomy of Trauma Leadership Skills : A Framework for Leadership Training and Assessment

    NARCIS (Netherlands)

    Leenstra, Nico F; Jung, Oliver C; Johnson, Addie; Wendt, Klaus W; Tulleken, Jaap E

    PURPOSE: Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by

  14. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    Energy Technology Data Exchange (ETDEWEB)

    BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.; ZINSLI, L. C.; CUSACK, L. J.

    2012-09-19

    THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... Overview The skills kit contains: A booklet with information on the ... and home management. A DVD with demonstration of each skill Stoma ...

  16. Your skills are important

    CERN Document Server

    2004-01-01

    An ambitious project to compile a skills database, known as the Skills and Talents Inventory (STI), was launched at the beginning of this year. The STI is a vital tool for various aspects of human resources management. The Weekly Bulletin has interviewed Mr Andre John Naudi, CERN's Director of Finance and Human Resources, who was the initiator of the project.

  17. Elementary TIG Welding Skills.

    Science.gov (United States)

    Pierson, John E., III

    The text was prepared to help deaf students develop the skills needed by an employed welder. It uses simplified language and illustrations to present concepts which should be reinforced by practical experience with welding skills. Each of the 12 lessons contains: (1) an information section with many illustrations which presents a concept or…

  18. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ... facs.org Copyright © 1996-2018 by the American College of Surgeons, Chicago, IL 60611-3295 | Privacy Policy | Terms of Use

  20. Measuring internet skills

    NARCIS (Netherlands)

    van Deursen, Alexander Johannes Aloysius Maria; van Dijk, Johannes A.G.M.

    2010-01-01

    Research that considers Internet skills often lacks theoretical justifications and does not go beyond basic button knowledge. There is a strong need for a measurement framework that can guide future research. In this article, operational definitions for measuring Internet skills are proposed,

  1. learning and soft skills

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2000-01-01

    Learning of soft skills are becoming more and more necessary due to the complexe development of modern companies and their environments. However, there seems to be a 'gap' between intentions and reality regarding need of soft skills and the possiblities to be educated in this subject in particular...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Use Patient Opioid Use Position Statements and Task Force Patient Education Initiatives Advocacy and Health Policy Updates Selected Research ... at ACS ACS and Veterans Diversity at ACS Benefits ... Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  4. Ageing and skills

    DEFF Research Database (Denmark)

    Desjardins, Richard; Warnke, Arne Jonas

    The relationship between ageing and skills is becoming an important policy issue, not least in the context of population ageing. Data from the Programme for the International Assessment of Adult Competencies (PIAAC) will potentially add considerably to the understanding of the relationship between...... ageing and foundation skills. In particular, the fact that data from the 1994-1998 International Adult Literacy Survey (IALS) and the 2003-2007 Adult Literacy and Lifeskills Survey (ALL) will be linked with PIAAC offers a unique opportunity to examine trends over time at the cohort level for a wide range...... of countries. Specifically, repeated measures will enable an analysis of whether there is skill gain and skill loss over the lifespan of cohorts and overtime between cohorts. This is especially important because age-skill profiles observed on the basis of a single cross-section are difficult to interpret...

  5. Is There a Moral Skill?

    Science.gov (United States)

    Gotz, Ignacio L.

    1989-01-01

    The nature of skill, distinguished from habit, is sketched. Moral skill is defined as the skill, born of genetically rooted talent, which masterminds subsidiary skills into moral action (action conforming to certain moral principles). Training this skill is possible, but results will be uneven because talent varies. (IAH)

  6. Not-so-Soft Skills

    Science.gov (United States)

    Curran, Mary

    2010-01-01

    Much recent discussion about the skills needed to secure Britain's economic recovery has focused on skills for employability. However, too often, these fundamental skills are understood in narrow functional or vocational terms. So-called "soft skills", what Penelope Tobin, in her 2008 paper "Soft Skills: the hard facts", terms "traits and…

  7. Collagen Conduit Versus Microsurgical Neurorrhaphy

    DEFF Research Database (Denmark)

    Boeckstyns, Michel; Sørensen, Allan Ibsen; Viñeta, Joaquin Fores

    2013-01-01

    To compare repair of acute lacerations of mixed sensory-motor nerves in humans using a collagen tube versus conventional repair.......To compare repair of acute lacerations of mixed sensory-motor nerves in humans using a collagen tube versus conventional repair....

  8. Microsurgical therapy of pituitary adenomas.

    Science.gov (United States)

    Mortini, Pietro; Barzaghi, Lina Raffaella; Albano, Luigi; Panni, Pietro; Losa, Marco

    2018-01-01

    We report the efficacy and safety of transsphenoidal microsurgery in a large and homogeneous cohort of patients with pituitary adenomas (PAs) treated at a single Institute by a single neurosurgeon. A total of 2145 consecutive patients undergoing first surgery for a PA were included: 795 (37.1%) had a nonfunctioning pituitary adenoma (NFPA), 595 (27.7%) acromegaly, 496 (23.1%) Cushing's disease, 208 (9.7%) a PRL-secreting adenoma, and 51 patients (2.4%) a TSH-secreting adenoma. Remission was achieved when strict hormonal and radiological criteria were met. Early surgical remission was achieved in 66% of acromegalic patients, 79.6% of patients with Cushing's disease, 64.4% of prolactinomas, 74.5% of patients with a TSH-secreting adenoma, and 66.9% of NFPAs. The mean (±SE) follow-up was 60.1 ± 1.3 months. The recurrence-free survival at 10 years was 78.2% in acromegalic patients, 68.1% in prolactinomas, 74.3% in Cushing's disease, 70.3% in TSH-secreting adenomas, and 75.3% in NFPAs. Preoperative hypoadrenalism recovered in 35.3%, hypogonadism in 43.3% and hypothyroidism in 37.4% of patients with impaired function before surgery. The mortality rate was 0.2% and major morbidity 2.1%. New onset hypoadrenalism occurred after surgery in 2.5% of patients at risk, hypogonadism in 4.1%, and hypothyroidism in 1.8%. Permanent diabetes insipidus (DI) occurred in 0.9% of patients. In experienced hands, transsphenoidal microsurgery for PAs achieves remission in most patients with a low complication rate. Pituitary function is preserved in most cases and can recover in more than one-third of patients with preoperative hypopituitarism.

  9. Efficacy and safety of 0.75% ropivacaine instillation into subinguinal wound in patients after bilateral microsurgical varicocelectomy: a bi-center, randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Cui WS

    2017-07-01

    Full Text Available Wan Shou Cui,1,* Yu Seob Shin,2,3,* Jae Hyung You,3 A Ram Doo,4 Kiran Kumar Soni,3 Jong Kwan Park3 1Andrology Center, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Urology, Armed Forces Capital Hospital, Seongnam, 3Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju, 4Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea *These authors contributed equally to this work Objective: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy.Patients and methods: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins. Before repairing external oblique aponeurosis, 6 mL of 0.75% ropivacaine and 6 mL of normal saline were instilled under the fascia and around the funiculus (spermatic cord by a randomized and double-blind method. Visual analog scale (VAS pain score and Prince Henry Pain Score (PHPS were used for evaluating operative sites at 1, 2, 4, and 8 hours and 7 days after surgery. Safety and tolerability were evaluated throughout the course of this study by assessing adverse events.Results: A total of 55 men completed the study. Of these 55 men, 31 received instillation of ropivacaine on the left operative site, while 24 received instillation of ropivacaine on the right operative site. VAS pain scores and PHPS in

  10. Cognitive Skills in Medicine: An Introduction

    NARCIS (Netherlands)

    Cnossen, Fokie

    2015-01-01

    Cognition encompasses all processes from perception to action including attention and memory, reasoning, and decision making. Therefore, all skills (perceptual skills, motor skills, diagnosing skill, medical skills) are cognitiveskills. Cognitive skills are supported by two types of knowledge:

  11. Dispositional optimism and stock investments

    NARCIS (Netherlands)

    Angelini, Viola; Cavapozzi, D.

    This paper analyzes the relationship between dispositional optimism and stock investments, controlling for cognitive skills and personality traits such as trust, social interactions and risk aversion. We use data from the Survey of Health, Ageing and Retirement in Europe (SHARE) on investors aged

  12. Wages and Skills Utilization: Effect of Broad Skills and Generic Skills on Wages in Singapore

    Science.gov (United States)

    Ramos, Catherine R.; Ng, Michael Chi Man; Sung, Johnny; Loke, Fiona

    2013-01-01

    Many people go for training to upgrade their skills which is hoped to pave the way for better pay. But what are the kinds of skills that really affect wages? Employers have emphasized the value of generic skills such as interpersonal and communication skills, teamwork and problem solving. Does possession of these skills translate to at least the…

  13. YOUTH EMPLOYMENT AND ENTREPRENEURIAL SKILLS ...

    African Journals Online (AJOL)

    Apusigah

    enterprise development, community development ... estimates that by the year 2015 there will be three billion people in the world who .... skills such as technical skills and business management skills (Hisrich and .... Technical/Vocational 12.

  14. Presentation skills for nurses.

    Science.gov (United States)

    Foulkes, Mark

    2015-02-20

    This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters.

  15. Improve your communication skills

    CERN Document Server

    Barker, Alan

    2016-01-01

    Excellent communication skills are vital in today's workplace. Whether keeping the interest of a large audience, impressing a potential employer or simply winning the argument at an important meeting, sounding the part is key. This fourth edition of Improve Your Communication Skills is full of practical advice on all aspects of verbal and non-verbal communication. It gives vital tips on improving conversations and building rapport with colleagues, learning the skills of persuasion, and writing effective emails, letters and reports. This editionincludes new information focusing on communicating across borders and virtual teams and a new chapter on managing difficult conversations."

  16. Rethinking generic skills

    Directory of Open Access Journals (Sweden)

    Roy Canning

    2013-10-01

    Full Text Available The paper provides a critical analysis of the notion of generic or transversal skillscontained with European Union policy discourses. The author presents a conceptualframework that challenges the idea that generic skills are universal, transferable andautonomous. An alternative analysis is put forward that argues the case forcontextualising skills and knowledge within particular understandings and cultures thatare more collective than individualistic in nature. The arguments are framed withinwider cross-disciplinary debates in linguistics, geosemiotics and social-cultural theoryand build upon an earlier paper exploring core skills in the UK (Canning, 2007.

  17. Floorball game skills (evaluation criteria)

    OpenAIRE

    Chlumský, Marek

    2013-01-01

    Title: Playing skills in floorball (evaluation criteria). Target: To create a list of playing skills which an ideal player should demonstrate. Find and verify the evaluation criteria of these skills and inspire trainers to develop these skills in the best way. Methods: Informal interviews, individually structured interviews, analysis and verification of data, pilot testing. Results: Defined playing skills in floorball, developed scale of values of floorball playing skills, creation of exercis...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... to Choosing a Surgical Residency Education Modules Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety ... Involved Get Involved SurgeonsVoice American College of Surgeons Professional Association State Legislative Action Center Leadership & Advocacy Summit ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the American College of Surgeons ... and Associates Medical Students International Surgeons ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety Resources About the Patient Education ... Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of ...

  3. Entrepreneurial Integration Skills

    DEFF Research Database (Denmark)

    Bauer, Florian; Schriber, Svante; King, David R.

    2016-01-01

    on 116 acquisitions, we find that entrepreneurial integration skills can display both advantages and disadvantages. While it helps to realize expected and serendipitous synergies, it can also trigger employee uncertainty due to decreased transparency. In supplementary analysis, we show measures...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). The skills kit ... AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). Back to Top ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Resources Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient ...

  6. CIEEM Skills Gap Project

    OpenAIRE

    Bartlett, Deborah

    2017-01-01

    This paper describes the research conducted for the Chartered Institute for Ecology and Environmental Management to identify skills gaps within the profession. It involved surveys of professionals, conference workshops and an investigation into the views of employers regarding graduate recruitment.

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A booklet with information on the ...

  8. Robot skills for manufacturing

    DEFF Research Database (Denmark)

    Pedersen, Mikkel Rath; Nalpantidis, Lazaros; Andersen, Rasmus Skovgaard

    2016-01-01

    -asserting robot skills for manufacturing. We show how a relatively small set of skills are derived from current factory worker instructions, and how these can be transferred to industrial mobile manipulators. General robot skills can not only be implemented on these robots, but also be intuitively concatenated...... products are introduced by manufacturers. In order to compete on global markets, the factories of tomorrow need complete production lines, including automation technologies that can effortlessly be reconfigured or repurposed, when the need arises. In this paper we present the concept of general, self...... in running production facilities at an industrial partner. It follows from these experiments that the use of robot skills, and associated task-level programming framework, is a viable solution to introducing robots that can intuitively and on the fly be programmed to perform new tasks by factory workers....

  9. Skilled Nursing Facility PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services. Effective with cost...

  10. TEACHING INTERPERSONAL SKILLS

    DEFF Research Database (Denmark)

    Andersson, Niclas

    2009-01-01

    of the examination. This study aims at presenting and reviewing a practical approach to teaching of interpersonal skills, referred to as the Social Risk Analysis, which has been applied and integrated into the curriculum of two engineering courses. The Social Risk Analysis encourages and imposes a critical review......In addition to the traditional learning outcomes for technical disciplinary knowledge, the CDIO-syllabus also specifies personal and interpersonal learning outcomes. The argument for teaching interpersonal skills rest upon the team-based working environment that is typical for engineers, where...... knowledge and skills in teamwork, leadership, and communications are highly required. Thus, the practice of interpersonal skills need to be implemented in engineering teaching, not only in terms of learning objectives, but realised in practical teaching activities and as an integrated part...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ASE Resident Prep Curriculum ACS/ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... CME Accreditation PartnerCME Joint Providership Program Verification of Knowledge and Skills Academy of Master Surgeon Educators Academy ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury ... Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure ...

  15. Skills for Effective Consultation.

    Science.gov (United States)

    Dustin, Dick; Ehly, Stewart

    1984-01-01

    Discusses counselor skills that promote effective consultation. Reviews research on effective school consultation and presents a five-stage model which involves phasing in, problem identification, implementation, evaluation, and termination. Provides recommendations for the process and products of consultation. (JAC)

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available JACS Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate Become ... a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A ... Nurses (CETN), and the United Ostomy Associations of America (UOAA). Back to Top Find A Surgeon Find ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS/ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education ... Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills for Trauma Disaster Management and ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Join Member Login Login Enter Keyword Enter Keyword Search Member Services Member Services Overview Become a Member ... Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Overview Committee on Health Care Disparities Overview Why Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us Publications ACS Publications ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Asked Questions Resources Educational Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in ... Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues Stop Overregulating My OR ... Rectal Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). The skills kit contains: A booklet with information on the operation, home skills such as emptying ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues Stop Overregulating My OR ... American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). Program Overview The skills kit contains: A booklet with information on the operation, home skills such as emptying ...

  7. Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

    Directory of Open Access Journals (Sweden)

    Mert Çalış

    2017-12-01

    Full Text Available Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospital after maxillofacial trauma are reviewed in this study. Exploration of the facial nerve and Stensen’s duct was planned for all patients within the first 72 hours after their injuries. After intraoral catheterization of the Stensen’s duct through the papilla using an epidural catheter, microsurgical end-to-end anastomosis was performed. Concurrently, 100 units of botulinum toxin A was injected at standardized eight points to the parotid gland. Results: Postoperative magnetic resonance (MR sialography revealed patency in all patients at the end of postoperative first year. The mean postoperative parotid volume of the injured and non-injured sides were 19.82±10.55 cm3 and 17.79±10.98 cm3, respectively, and the results were found to be comparable. Fibrillation potentials in the postoperative electromyography recordings and clinical examination demonstrated nerve regeneration. Conclusion: Botulinum toxin A appears to be effective in treating duct injuries accompanied by glandular involvement in an acute setting, as well as in preventing long-term complications.

  8. Open knot-tying skills: residents skills assessed

    NARCIS (Netherlands)

    van Empel, P.J.; Verdam, M.G.E.; Huirne, J.A.; Bonjer, H.J.; Meijerink, W.J.; Scheele, F.

    2013-01-01

    Aim: Open knot-tying and suturing skills are fundamental surgical skills, founding many alternative knot-tying techniques. It is therefore mandatory for residents to possess adequate basic open knot-tying skills. The aim of this study was to compare an objective assessment of open knot-tying skills

  9. Contribution of Oral Language Skills, Linguistic Skills, and Transcription Skills to Chinese Written Composition among Fourth-Grade Students

    Science.gov (United States)

    Yeung, Pui-sze; Ho, Connie Suk-han; Chan, David Wai-ock; Chung, Kevin Kien-hoa

    2013-01-01

    The present study aimed to investigate the contribution of oral language skills, linguistic skills, and transcription skills to Chinese written composition among Grade 4 students in Hong Kong. Measures assessing verbal working memory, oral language skills, linguistic skills (i.e., syntactic skills and discourse skills), transcription skills (i.e.,…

  10. Let your communication skills equal your clinical skills.

    Science.gov (United States)

    Demarais, Ann; Baum, Neil

    2012-01-01

    Relating effectively with patients is among the most valued skills of clinical care. Honing your communication skills is an art that every physician needs to learn and understand. In this era of increased volume of patients there is a tendency to lose sight of the importance of having good communication skills. This article will review 11 suggestions for letting your communication skills equal your clinical skills.

  11. Mathematical Skills and Motor Life Skills in Toddlers: Do Differences in Mathematical Skills Reflect Differences in Motor Skills?

    Science.gov (United States)

    Reikerås, Elin; Moser, Thomas; Tønnessen, Finn Egil

    2017-01-01

    This study examines possible relations between early mathematical skills and motor life skills in 450 toddlers aged two years and nine months. The study employs baseline data from the longitudinal Stavanger Project--The Learning Child. The children's mathematical skills and motor life skills were assessed by structured observation in the natural…

  12. Employability Skills Assessment Tool Development

    Science.gov (United States)

    Rasul, Mohamad Sattar; Rauf, Rose Amnah Abd; Mansor, Azlin Norhaini; Puvanasvaran, A. P.

    2012-01-01

    Research nationally and internationally found that technical graduates are lacking in employability skills. As employability skills are crucial in outcome-based education, the main goal of this research is to develop an Employability Skill Assessment Tool to help students and lecturers produce competent graduates in employability skills needed by…

  13. Digital literacy and safety skills

    NARCIS (Netherlands)

    Sonck, N.; Livingstone, S.; Kuiper, E.; de Haan, J.

    2011-01-01

    Children’s digital skills were assessed by asking 25,000 European 9-16 year old internet users about their online activities, skills and self-efficacy. The range of digital skills and online activities are linked. But many younger (11-13 year old) children lack key critical and safety skills. Also,

  14. Teaching Soft Skills Employers Need

    Science.gov (United States)

    Ellis, Maureen; Kisling, Eric; Hackworth, Robbie G.

    2014-01-01

    This study identifies the soft skills community colleges teach in an office technology course and determines whether the skills taught are congruent with the soft skills employers require in today's entry-level office work. A qualitative content analysis of a community college office technology soft skills course was performed using 23 soft skills…

  15. Causes of Low-Skilled Workers’ Performance in Construction Projects

    Directory of Open Access Journals (Sweden)

    Alhaji Ali Zannah

    2017-06-01

    Full Text Available Skilled workers’ performance is one of the crucial aspects of labour productivity that requires proper attention for effective projects delivery in the construction industry. The level of skilled workers’ low performance has been seen to be a major factor which contributes toward inefficient construction projects productivity. Therefore, the objective of this research is to identify the causes of low-skilled workers’ performance in construction projects in the Nigeria. The objective was achieved through a structured quantitative method of questionnaire distributed to 150 respondents that comprise of active stakeholders in the Nigerian construction industry. 111 responses representing 74 % were retrieved. The data were analysed using descriptive statistics and analysis of variance (ANOVA. The finding shows that; low wages of skilled, lack of sufficient skill acquisition centres and lack of incentive schemes for skilled workers were the most significant causes of low-skilled workers’ performance in the Nigerian construction industry. The homogenous analysis indicates that there are significant differences in perception of respondents on few variables whereas majority of respondents have similarities in most of the variables. The research findings indicate the need for stakeholders in the Nigerian construction industry to provide incentives and motivate skilled workers, provide training and retraining, conducive working condition, supply of quality materials and equipment, and proper site management in order improve low-skilled workers’ performance in Nigerian construction industry towards optimal performance.

  16. Critical leadership and management skills for pathology practice.

    Science.gov (United States)

    Brimhall, Bradley B; Wright, Louis D; McGregor, Kelli L; Hernandez, James S

    2007-10-01

    Managed care has changed the nature of medical practice. The practice of pathology has also changed and is likely to undergo further modification. Additional skills in leadership and management are needed to perform optimally in the current medical marketplace. To determine whether pathologists view business and informatics skills as being important and valuable in their practices. A survey was sent electronically (via e-mail) to 2566 pathologists and pathology administrators. Two hundred sixteen survey recipients (8.4%) responded to the survey. The response rate to individual questions ranged from 86% to 99% (186 to 214 of 216 total respondents). Most who took the survey ranked communication (203/209; 97%), leadership skills (165/209; 79%), and systems thinking skills (155/209; 74%) as either "very important" or "essential." Fewer respondents were willing to offer salary premiums for marketing (108/196; 55%), business or finance (92/196; 47%), or staff leadership (95/196; 48%) skills unless the candidate had a track record of measurable achievement using these skills. Those practicing in academia as well as those making hiring decisions by themselves were more likely to value leadership and management skills. Fewer than 1% of respondents in any category considered current pathology residency training in leadership and management to be adequate. Prospective employers value leadership and management skills. Pathology residency programs must include meaningful training in pathology practice management and informatics to satisfy the demand for these skills in the modern pathology marketplace.

  17. Team skills training

    International Nuclear Information System (INIS)

    Coe, R.P.; Carl, D.R.

    1991-01-01

    Numerous reports and articles have been written recently on the importance of team skills training for nuclear reactor operators, but little has appeared on the practical application of this theoretical guidance. This paper describes the activities of the Training and Education Department at GPU Nuclear (GPUN). In 1987, GPUN undertook a significant initiative in its licensed operator training programs to design and develop initial and requalification team skills training. Prior to that time, human interaction skills training (communication, stress management, supervisory skills, etc.) focused more on the individual rather than a group. Today, GPU Nuclear conducts team training at both its Three Mile Island (YMI), PA and Oyster Creek (OC), NJ generating stations. Videotaped feedback is sued extensively to critique and reinforce targeted behaviors. In fact, the TMI simulator trainer has a built-in, four camera system specifically designed for team training. Evaluations conducted on this training indicated these newly acquired skills are being carried over to the work environment. Team training is now an important and on-going part of GPUN operator training

  18. Soft skills and dental education.

    Science.gov (United States)

    Gonzalez, M A G; Abu Kasim, N H; Naimie, Z

    2013-05-01

    Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses the different soft skills, how they are taught and assessed and the issues that need to be addressed in their teaching and assessment. The use of the module by the Faculty of Dentistry, University of Malaya for development of soft skills for institutions of higher learning introduced by the Ministry of Higher Education, Malaysia. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  19. Skill effort: A new theoretical perspective on the relation between skills, skill use, mismatches, and wages

    NARCIS (Netherlands)

    van der Velden, Rolf; Bijlsma, Ineke

    2017-01-01

    Mismatches between workers’ skills and job demands have large negative effects on productivity, job satisfaction, and other outcomes. Current approaches to measure the impact of skills and skill mismatches on wages fail to specify the mechanism through which skills and mismatches may affect

  20. Leadership Skills and Wages

    OpenAIRE

    Kuhn, Peter; Weinberger, Catherine

    2003-01-01

    American business is devoting a growing share of resources to identifying and developing a worker characteristic called ³leadership skill². Is there such a thing, and is it rewarded in labor markets? Using the Project Talent, NLS72 and High School and Beyond datasets, we show that men who occupied leadership positions in high school earn more as adults, even when cognitive skills are held constant. The pure leadership-wage effect varies, depending on definitions and time period, from four p...

  1. Nonlinear optimization

    CERN Document Server

    Ruszczynski, Andrzej

    2011-01-01

    Optimization is one of the most important areas of modern applied mathematics, with applications in fields from engineering and economics to finance, statistics, management science, and medicine. While many books have addressed its various aspects, Nonlinear Optimization is the first comprehensive treatment that will allow graduate students and researchers to understand its modern ideas, principles, and methods within a reasonable time, but without sacrificing mathematical precision. Andrzej Ruszczynski, a leading expert in the optimization of nonlinear stochastic systems, integrates the theory and the methods of nonlinear optimization in a unified, clear, and mathematically rigorous fashion, with detailed and easy-to-follow proofs illustrated by numerous examples and figures. The book covers convex analysis, the theory of optimality conditions, duality theory, and numerical methods for solving unconstrained and constrained optimization problems. It addresses not only classical material but also modern top...

  2. Website Optimization

    CERN Document Server

    King, Andrew

    2008-01-01

    Remember when an optimized website was one that merely didn't take all day to appear? Times have changed. Today, website optimization can spell the difference between enterprise success and failure, and it takes a lot more know-how to achieve success. This book is a comprehensive guide to the tips, techniques, secrets, standards, and methods of website optimization. From increasing site traffic to maximizing leads, from revving up responsiveness to increasing navigability, from prospect retention to closing more sales, the world of 21st century website optimization is explored, exemplified a

  3. Hard skills or soft skills? Findings about importance of various skills in work

    OpenAIRE

    Niva, Anu

    2016-01-01

    Getting a job requires many things: hard skills, soft skills, the right attitude and motivation. To develop the degree programme in Business Information Systems in Oulu university of Applied Sciences (Oulu UAS), three surveys were conducted, to study importance of skills and knowledge in professional life: a graduate career survey in 2013, an employer survey in 2014, and a student survey in 2015. According to the results, readiness for change, learning skills and basic ICT skills seem to be t...

  4. Organisational skills and tools.

    Science.gov (United States)

    Wicker, Paul

    2009-04-01

    While this article mainly applies to practitioners who have responsibilities for leading teams or supervising practitioners, many of the skills and tools described here may also apply to students or junior practitioners. The purpose of this article is to highlight some of the main points about organisation, some of the organisational skills and tools that are available, and some examples of how these skills and tools can be used to make practitioners more effective at organising their workload. It is important to realise that organising work and doing work are two completely different things and shouldn't be mixed up. For example, it would be very difficult to start organising work in the middle of a busy operating list: the organisation of the work must come before the work starts and therefore preparation is often an important first step in organising work. As such, some of the tools and skills described in this article may need to be used hours or even days prior to the actual work taking place.

  5. State Skill Standards: Welding

    Science.gov (United States)

    Pointer, Mike; Naylor, Randy; Warden, John; Senek, Gene; Shirley, Charles; Lefcourt, Lew; Munson, Justin; Johnson, Art

    2005-01-01

    The Department of Education has undertaken an ambitious effort to develop statewide occupational skill standards. The standards in this document are for welding programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school program. The writing team determined that any statewide…

  6. State Skill Standards: Photography

    Science.gov (United States)

    Howell, Frederick; Reed, Loretta; Jensen, Capra; Robison, Gary; Taylor, Susan; Pavesich, Christine

    2007-01-01

    The Department of Education has undertaken an ambitious effort to develop statewide skill standards for all content areas in career and technical education. The standards in this document are for photography programs and are designed to clearly state what the student should know and be able to do upon completion of an advanced high-school program.…

  7. Maine's Employability Skills Program

    Science.gov (United States)

    McMahon, John M.; Wolffe, Karen E.; Wolfe, Judy; Brooker, Carrie

    2013-01-01

    This Practice Report describes the development and implementation of the "Maine Employability Skills Program," a model employment program developed by the Maine Division for the Blind and Visually Impaired (DBVI). The program was designed to support the efforts of the chronically unemployed or underemployed. These consumers were either…

  8. Develop your presentation skills

    CERN Document Server

    Theobald, Theo

    2016-01-01

    Going beyond handling nerves and presenting PowerPoint slides, the third edition of "Develop Your Presentation Skills "offers practical advice on developing a captivating presentation, constructing compelling content, and boosting self-confidence. The book includes three new chapters on delivering a "stripped down"presentation, using new media to engage with the audience, and handling being asked to present on short notice."

  9. EMBODIMENT OF CAPOEIRA SKILLS

    Directory of Open Access Journals (Sweden)

    Urska Habjan

    2015-09-01

    Full Text Available This article is the result of twenty-one months of fieldwork among the capoeiristas in Brazil, primarily in the city of Salvador, between 2003 and 2013. The fieldwork methodology was based on participant observation. It also included conducting interviews and informal conversations, listening to life stories of locals, and writing a diary. My personal experiences within capoeira and the improvement of my own skills enabled me to better grasp what capoeira is about. By participating, I more fully understood the corporeal strain and pleasure involved in this particular embodied practice. The socio-economic situation of Brazilian society based on racial and gender discrimination enhances the cultivation of capoeiristic habitus and dictates the need for the acquisition of capoeiristic skills and attitudes in order to cope with, understand, and live within an unequal world. Capoeiristic habitus consists of knowledge, attitudes and skills enabling capoeiristas to stay in tune with the environment of lurking danger, to face with an ambiguous, unstable and uncertain environment. Capoeiristic habitus can be embodied early in life or learnt and acquired as a by-product of capoeira training. But it remains important whether the environment in which a capoeirista practises tolerates or inhibits the cultivation of capoeiristic skills.

  10. Developing Technical Skill Assessments

    Science.gov (United States)

    Hyslop, Alisha

    2009-01-01

    One of the biggest challenges facing the career and technical education (CTE) community as it works to implement the 2006 Perkins Act is responding to more rigorous requirements for reporting on CTE students' technical skill attainment. The U.S. Department of Education suggested in non-regulatory guidance that states and locals use the number of…

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... supports the entire surgical team with quality, comprehensive education. The ... A booklet with information on the operation, home skills such as emptying ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  13. The skilling fields

    International Nuclear Information System (INIS)

    Snieckus, D.

    1998-01-01

    A looming pan-industry skills crisis is among the most heated talking points in the oil and gas business today. But just what future damage will be suffered by an industry that has been unable to move professional training to the top of the agenda? (author)

  14. Counselling Communication Skills

    African Journals Online (AJOL)

    Emeka Egbochuku

    concern for the person we examine the most effective way to help them ... impact of the problem on her client's psychological well-being. The ... Empathic responding circumnavigates all the other skills. ... he is ashamed. ... 'I'm yawning again and I can see it's off-putting to you. .... to reach new perspectives in their own time.

  15. Negotiation Skill Development Exercise

    Science.gov (United States)

    Benson, Gregory E.; Chau, Ngan N.

    2017-01-01

    Conflict occurs naturally in all marketing related activities. When such conflict is handled well through proper negotiation, it helps solve problems and build stronger, deeper relationships between the negotiating parties. Nevertheless, many students feel uneasy about negotiating, yet they know it is a crucial skill that needs to be developed.…

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry Trauma Education Trauma Education Trauma Education Advanced Surgical Skills for Exposure in Trauma Advanced Trauma Life Support ... Quality Program Initiatives Communications to the Profession ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Learn. Interact. Transform. CoC Events Quality Education Quality Education Quality Education ...

  18. Highly Skilled Migrants

    DEFF Research Database (Denmark)

    Hvidt, Martin

    2016-01-01

    . It is pointed out that while the system facilitated speedy entry to the job market, the lack of inclusion in the Gulf economies of the migrants, the lack of long-term prospects of residing in the countries and the highly asymmetric power balance between sponsor and migrant, provides few incentives...... for the highly skilled migrants to fully contribute to the Gulf economies....

  19. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Christian Daniel

    The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static...

  20. Hearing poorly with skill

    DEFF Research Database (Denmark)

    Day, Dennis

    2012-01-01

    This paper offers an account of ongoing research into hearing. I offer a characterization of 'skil- led practitioners' from an Ethnomethodological perspective. The skilled practitioner in question is a generic 'hard of hearing' person. The ambition is that such a characterization, both in its...... making and its final state, may be an intrinsic part of design practices concerning the development of hearing aids....

  1. Otologic Skills Training

    DEFF Research Database (Denmark)

    Wiet, Gregory J; Sørensen, Mads Sølvsten; Andersen, Steven Arild Wuyts

    2017-01-01

    This article presents a summary of the current simulation training for otologic skills. There is a wide variety of educational approaches, assessment tools, and simulators in use, including simple low-cost task trainers to complex computer-based virtual reality systems. A systematic approach...

  2. Developing Scientists' "Soft" Skills

    Science.gov (United States)

    Gordon, Wendy

    2014-02-01

    A great deal of professional advice directed at undergraduates, graduate students, postdoctoral fellows, and even early-career scientists focuses on technical skills necessary to succeed in a complex work environment in which problems transcend disciplinary boundaries. Collaborative research approaches are emphasized, as are cross-training and gaining nonacademic experiences [Moslemi et al., 2009].

  3. Optimality Conditions in Vector Optimization

    CERN Document Server

    Jiménez, Manuel Arana; Lizana, Antonio Rufián

    2011-01-01

    Vector optimization is continuously needed in several science fields, particularly in economy, business, engineering, physics and mathematics. The evolution of these fields depends, in part, on the improvements in vector optimization in mathematical programming. The aim of this Ebook is to present the latest developments in vector optimization. The contributions have been written by some of the most eminent researchers in this field of mathematical programming. The Ebook is considered essential for researchers and students in this field.

  4. Medicinsk Optimering

    DEFF Research Database (Denmark)

    Birkholm, Klavs

    2010-01-01

    En undersøgelse af anvendelsen af medicin til optimering af koncentration, hukommelse og følelsestonus. Efterfulgt af etiske overvejelser og anbefalinger til det politiske system......En undersøgelse af anvendelsen af medicin til optimering af koncentration, hukommelse og følelsestonus. Efterfulgt af etiske overvejelser og anbefalinger til det politiske system...

  5. Structural optimization

    CERN Document Server

    MacBain, Keith M

    2009-01-01

    Intends to supplement the engineer's box of analysis and design tools making optimization as commonplace as the finite element method in the engineering workplace. This title introduces structural optimization and the methods of nonlinear programming such as Lagrange multipliers, Kuhn-Tucker conditions, and calculus of variations.

  6. Topology Optimization

    DEFF Research Database (Denmark)

    A. Kristensen, Anders Schmidt; Damkilde, Lars

    2007-01-01

    . A way to solve the initial design problem namely finding a form can be solved by so-called topology optimization. The idea is to define a design region and an amount of material. The loads and supports are also fidefined, and the algorithm finds the optimal material distribution. The objective function...... dictates the form, and the designer can choose e.g. maximum stiness, maximum allowable stresses or maximum lowest eigenfrequency. The result of the topology optimization is a relatively coarse map of material layout. This design can be transferred to a CAD system and given the necessary geometrically...... refinements, and then remeshed and reanalysed in other to secure that the design requirements are met correctly. The output of standard topology optimization has seldom well-defined, sharp contours leaving the designer with a tedious interpretation, which often results in less optimal structures. In the paper...

  7. Dispositional Optimism

    Science.gov (United States)

    Carver, Charles S.; Scheier, Michael F.

    2014-01-01

    Optimism is a cognitive construct (expectancies regarding future outcomes) that also relates to motivation: optimistic people exert effort, whereas pessimistic people disengage from effort. Study of optimism began largely in health contexts, finding positive associations between optimism and markers of better psychological and physical health. Physical health effects likely occur through differences in both health-promoting behaviors and physiological concomitants of coping. Recently, the scientific study of optimism has extended to the realm of social relations: new evidence indicates that optimists have better social connections, partly because they work harder at them. In this review, we examine the myriad ways this trait can benefit an individual, and our current understanding of the biological basis of optimism. PMID:24630971

  8. Parent-Implemented Behavioral Skills Training of Social Skills

    Science.gov (United States)

    Dogan, Rebecca K.; King, Melissa L.; Fischetti, Anthony T.; Lake, Candice M.; Mathews, Therese L.; Warzak, William J.

    2017-01-01

    Impairment in social skills is a primary feature of Autism Spectrum Disorders (ASDs). Research indicates that social skills are intimately tied to social development and negative social consequences can persist if specific social behaviors are not acquired. The present study evaluated the effects of behavioral skills training (BST) on teaching…

  9. Employment Social Skills: What Skills Are Really Valued?

    Science.gov (United States)

    Agran, Martin; Hughes, Carolyn; Thoma, Colleen A.; Scott, LaRon A.

    2016-01-01

    Although social skills have long been recognized as essential in promoting employees' employability (e.g., maintaining employment), there has been little research about work-related social skills for the last two decades. A systematic replication of Salzberg, Agran, and Lignugaris/Kraft's investigation of critical social skills was conducted.…

  10. Microsurgical anatomy and clinic significance of posterior inferior cerebellar artery%小脑后下动脉的显微解剖研究及其临床意义

    Institute of Scientific and Technical Information of China (English)

    吴江; 张世明; 徐峰

    2010-01-01

    目的 研究小脑后下动脉的显微解剖,为神经外科手术提供临床解剖资料.方法 手术显微镜下观察测量20具(共40侧)人脑标本的小脑后下动脉(PICA)的起始行径、直径、主要分支、穿动脉及分布,检查PICA与脑神经根的关系.结果 40侧标本共发出PICA 35支,平均管径(1.6±0.6)mm,距离椎基底动脉汇合点平均(16±5)mm.在35支PICA中28支PICA走行在第Ⅻ脑神经根之间,7支走行在第Ⅻ脑神经根下方,32支走行在第Ⅺ脑神经根之间.结论 PICA是椎基动脉系统重要的分支,变异多,走行与脑神经关系密切,熟悉解剖结构,在后颅窝手术中予以保护具有重要意义.%Objective To study the microsurgical anatomy of the posterior inferior cerebellar artery (PICA) for neurosurgery. Methods Twenty Chinese adult brain samples (40 sides) were measured with microscope for the diameters, lengths, origins, courses, and the branches of the PICA. The relationship between the PICA and cranial nerves was also checked. Results There were 35 PICAs in 20 brain samples.The mean diameter of the PICAs was (1.6±0.6) mm, the mean length from PICAs' origin of vertebral artery to the vertebrobasilar junction was (16±5) mm. In 35 PICAs,28 PICAs go through the rootlets of Ⅻ cranial nerves,7 PICAs go inferior Ⅻ cranial nerves, and 32 PICAs go through the rootlets of Ⅺ cranial nerves. Conclusions PICA is an important branch artery with more variation and complex relationship to the cranial nerves trend in the vertebral artery system. It is necessary to master the microsurgical anatomy of PICA and to be careful protection during the neurosurgical operations.

  11. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features on this page, ... to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may determine that you ...

  12. Training Adaptability in Digital Skills

    National Research Council Canada - National Science Library

    Hess-Kosa, Kathleen

    2001-01-01

    .... As outlined in this Phase I report, Aptima and the Group for Organizational Effectiveness (gOE) have lain the groundwork for an innovative, computer-based, digital-skills training package designed to increase the adaptability of digital skills...

  13. Engineering and design skills

    DEFF Research Database (Denmark)

    Schrøder, Anne Lise

    2006-01-01

    In various branches of society there is focus on the need for design skills and innovation potential as a means of communicating and handling constant change. In this context, the traditional idea of the engineer as a poly-technician inventing solutions by understanding the laws of nature...... concept of diagrammatic reasoning to some extent incarnates the very method of engineering and design. On this background, it is argued how the work field and techniques of the engineer and the engineering scientist could be characterized in a broader creative context of learning and communication....... This leads to considering the fundamental skills of the engineering practice as basic abilities to see the structures and dynamics of the world, to model it, and to create new solutions concerning practical as well as theoretical matters. Finally, it is assumed that the essence of engineering “bildung...

  14. Language as skill

    DEFF Research Database (Denmark)

    Chater, Nick; McCauley, Stewart M.; Christiansen, M. H.

    2016-01-01

    occurs on-line. These properties are difficult to reconcile with the 'abstract knowledge' viewpoint, and crucially suggest that language comprehension and production are facets of a unitary skill. This viewpoint is exemplified in the Chunk-Based Learner, a computational acquisition model that processes...... incrementally and learns on-line. The model both parses and produces language; and implements the idea that language acquisition is nothing more than learning to process. We suggest that the Now-or-Never bottleneck also provides a strong motivation for unified perception-production models in other domains......Are comprehension and production a single, integrated skill, or are they separate processes drawing on a shared abstract knowledge of language? We argue that a fundamental constraint on memory, the Now-or-Never bottleneck, implies that language processing is incremental and that language learning...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... About the ACS Catalog Find a Product Contribute ... NewsScope: May 25, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected Readings in General Surgery ...

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    Full Text Available ... the ACS Catalog Find a Product Contribute ... NewsScope: May 4, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected Readings in General Surgery Selected Readings ...

  17. Ostomy Home Skills Program

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    Full Text Available ... Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program for ISCR AHRQ Safety Program for ISCR ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... About the ACS Catalog Find a Product Contribute ... ACS NewsScope NewsScope: June 8, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... American College of Surgeons About JACS About JACS History Articles in Press ... NewsScope: May 25, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected ...

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    Full Text Available ... Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us Publications ... to Top Find A Surgeon Find A Surgeon Information For Patients and Family Surgeons Residents and Associates ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... NewsScope: May 25, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected Readings in General Surgery Selected Readings in ... Editorial Board Contact Resources in Surgical Education Newsletters ...

  2. Ostomy Home Skills Program

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    Full Text Available ... Quality ACS Leadership in Quality Setting the Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring ... Clinical Data Registry Quality and Safety Conference Resources Standards Manual Contact Us Breast Disease National Accreditation Program ...

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    Medline Plus

    Full Text Available ... About Quality Programs ACS Leadership in Quality ACS Leadership in Quality Setting the Quality Standard Optimal Resources for Surgical Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ...

  4. Ostomy Home Skills Program

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    Full Text Available ... on Health Care Disparities Overview Why Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications ... Foundation ACS Foundation ACS Foundation Why Your Support Matters Ways to Give Meet Our Donors Major Gift ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS Catalog About the ACS Catalog Find a Product Contribute ... NewsScope NewsScope: April 20, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected ...

  6. Develop your leadership skills

    CERN Document Server

    Adair, John

    2016-01-01

    "Develop Your Leadership Skills "is John Adair s most accessible title on leadership. Full of exercises and checklists, it can help boost confidence levels and guide and inspire anyone on their journey to becoming a leader of excellence. Acknowledged as a world expert, John Adair offers stimulating insights into recognizing and developing individual leadership qualities, acquiring personal authority, and mastering core leadership functions such as planning, communicating and motivating. The new edition includes summary points for each chapter.

  7. Graduate Information Skills

    Directory of Open Access Journals (Sweden)

    Niall McSweeney

    2010-09-01

    Full Text Available It is one of six modules within the SIF (Strategic Innovative Fund funded Generic Skills Project for PHDS. The Generic Skills Project itself was just one strand within others Supporting the development of 4th level education in Ireland. The Graduate Information Skills module is a collaborative project led by NUI Galway with partners Trinity College Dublin and University College Cork. It is aimed at PHDS but Masters Research and post-docs will find the module of benefit too. The module is developed to offer both an online and face-to-face environment and be customizable with eLearning environments. Project launched in 2007 and has a three year cycle. We agreed to outsource online development and after a tendering process a company called eMedia were awarded the contract. We have piloted full content to PHDS in the three institutions involved and have reviewed feed-back received from attendees. We have also met with module presenters and authors to review their feed-back. The initial content while generic to all PHDS has Science Technology Medicine specific examples. We have complete Online content and module is being offered locally for face-to-face credited teaching. The module has in all units Learning Outcomes and is intended to be fully credited and evaluated for module completion. Funds allowing we would hope to develop Humanities specific content, add units such as on Writing Skills etc. We feel the module has created very good blended learning opportunities and is offered to students in a very contemporary design format. In an Irish context we feel the module offers a national resource that could be used by other institutions.

  8. BUILD UP Skills Danmark

    DEFF Research Database (Denmark)

    Forsingdal, Charlotte Vartou; Lauridsen, Vagn Holk; Hougaard, Karsten Frøhlich

    opfyldelsen af 2020-målene, skal de rette kompetencer inden for energief-fektivitet og brug af vedvarende energi være til stede blandt de udførende i bygge- og an-lægsbranchen. Det er på denne baggrund, at Europa-Kommissionen har igangsat Build Up Skills projektet på tværs af Europa. Formålet med denne...

  9. Cultivating strategic thinking skills.

    Science.gov (United States)

    Shirey, Maria R

    2012-06-01

    This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author presents an overview of strategic leadership and offers approaches for cultivating strategic thinking skills.

  10. Employability Skills. At a Glance

    Science.gov (United States)

    Wibrow, Bridget

    2011-01-01

    In a competitive workforce it is not just having the right qualification or technical skills that will land an individual a job; it could very well be their interpersonal skills. How someone communicates is often the first impression an employer has of a possible worker. Yet, it is precisely communication skills that employers feel applicants are…

  11. Building nuclear skills in Australia

    International Nuclear Information System (INIS)

    Cameron, R.

    2007-01-01

    Demand for nuclear skills in Australia has traditionally been met by recruitment but as the nuclear industry grows worldwide, such skills are in demand. This paper discusses he likely numbers of skilled people needed for a nuclear industry in Australia and what initiatives have been, or could be in, taken to address the needs

  12. Physical Attractiveness and Counseling Skills.

    Science.gov (United States)

    Vargas, Alice M.; Borkowski, John G.

    1982-01-01

    Searched for interaction between quality of counseling skills (presence or absence of empathy, genuineness, and positive regard) and physical attractiveness as determinants of counseling effectiveness. Attractiveness influenced perceived effectiveness of counselor's skill. Analyses of expectancy data revealed that only with good skills did…

  13. Hard Thinking about Soft Skills

    Science.gov (United States)

    Claxton, Guy; Costa, Arthur L.; Kallick, Bena

    2016-01-01

    People use various terms to refer to traits and tendencies connected to social-emotional behavior and ways of thinking or approaching problems--from 21st century skills to mindsets to habits of mind. Such traits are also often called soft skills or non-cognitive skills. The authors contend that these latter terms imply that these traits and…

  14. Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years

    OpenAIRE

    Pitchford, Nicola J.; Papini, Chiara; Outhwaite, Laura A.; Gulliford, Anthea

    2016-01-01

    Fine motor skills have long been recognised as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths devel...

  15. Portfolio Optimization

    OpenAIRE

    Issagali, Aizhan; Alshimbayeva, Damira; Zhalgas, Aidana

    2015-01-01

    In this paper Portfolio Optimization techniques were used to determine the most favorable investment portfolio. In particular, stock indices of three companies, namely Microsoft Corporation, Christian Dior Fashion House and Shevron Corporation were evaluated. Using this data the amounts invested in each asset when a portfolio is chosen on the efficient frontier were calculated. In addition, the Portfolio with minimum variance, tangency portfolio and optimal Markowitz portfolio are presented.

  16. Leadership and Administrative Skills for Optimal Universal Basic ...

    African Journals Online (AJOL)

    DR Nneka

    dimensional and contingency theories respectively. ... understanding of the concept, Peretomode's (2003) views of leadership is .... People-Oriented – Administration, whether in small or large organizations is ..... Harvard Business Review.

  17. [Soft skills : Somewhat different doping].

    Science.gov (United States)

    Heppner, H J

    2018-02-01

    Doping actually means the taking of illegal substances or the use of forbidden methods to increase or maintain performance. Diseases associated with age and functional decline can lead to constraints in the activities of daily living and this leads to loss of autonomy; therefore, doping in its different variations is used to try to achieve performance, which would not otherwise be possible. A somewhat different method is soft skills, i.e. personal, social and methodological competences, which are adopted to remain fit with the help of selection and compensation. One of the main cornerstones for healthy aging apart from medical interventions is physical activity and to keep training up to old age. An early beginning with sports activities and to continue practicing sport in a variety of forms into old age, plays a decisive role in healthy aging. There are also many recommendations for nutrition, such as changing eating habits and the composition of nourishment to counteract the process of aging. With increasing age the interests and life style also change and therefore early planning is absolutely necessary. Preservation of cognitive capabilities is one of the most important requirements to overcome aging. Not only the cognitive resources must be promoted but also attention must be paid to the resilience to deal with losses. Resilience plays a key role. People with a positive attitude to living with old age show less functional physical impairment and recover from illness more quickly. Humor, optimism and physical activity are crucial for successful aging.

  18. Professional Skills in International Financial Surveillance

    DEFF Research Database (Denmark)

    Seabrooke, Leonard; Nilsson, Emelie Rebecca

    2015-01-01

    In 2006, the International Monetary Fund's (IMF) Financial Sector Assessment Program (FSAP) lauded Iceland's capacity to “withstand extreme, but plausible, shocks,” which was clearly an error in judgment. After the international financial crisis hit, IMF officials bemoaned the lack of professional...... use an Optimal Matching analysis of work roles in career histories to identify differences in policy teams and external experts' attributes. The article also draws on interviews with FSAP team members from 2008 to 2013. We demonstrate that changes in professional skills and team composition...

  19. Formal Mediation and Negotiation Training, Providing Greater Skills for Commanders in Bosnia

    National Research Council Canada - National Science Library

    McConnell, G

    1999-01-01

    .... However, the training is not optimized for the environment that they will encounter. The Bosnia environment requires battalion and brigade commanders to possess and utilize mediation and negotiation skills...

  20. Approach to team skills training

    International Nuclear Information System (INIS)

    Koontz, J.L.; Roe, M.L.; Gaddy, C.D.

    1987-01-01

    The US commercial nuclear power industry has recognized the importance of team skills in control room operation. The desire to combine training of team interaction skills, like communications, with technical knowledge of reactor operations requires a unique approach to training. An NRC-sponsored study identified a five-phase approach to team skills training designed to be consistent with the systems approach to training currently endorsed by the NRC Policy Statement on Training and Qualification. This paper describes an approach to team skills training with emphasis on the nuclear power plant control room crew. An approach to team skills training

  1. Hard evidence on soft skills.

    Science.gov (United States)

    Heckman, James J; Kautz, Tim

    2012-08-01

    This paper summarizes recent evidence on what achievement tests measure; how achievement tests relate to other measures of "cognitive ability" like IQ and grades; the important skills that achievement tests miss or mismeasure, and how much these skills matter in life. Achievement tests miss, or perhaps more accurately, do not adequately capture, soft skills -personality traits, goals, motivations, and preferences that are valued in the labor market, in school, and in many other domains. The larger message of this paper is that soft skills predict success in life, that they causally produce that success, and that programs that enhance soft skills have an important place in an effective portfolio of public policies.

  2. Personal Skills. Facilitator's Skill Packets 1-7. Social Skills Training.

    Science.gov (United States)

    Model Classrooms, Bellevue, WA.

    This document contains the following seven facilitators' skill packets on personal skills: (1) personal hygiene; (2) personal appearance; (3) locker hygiene; (4) dorm cleanliness; (5) punctuality and attendance; (6) responding to supervision; and (7) teamwork. Each packet contains the following sections: definition of personal skills; objective;…

  3. Procedural Skills Education – Colonoscopy as a Model

    Directory of Open Access Journals (Sweden)

    Maitreyi Raman

    2008-01-01

    Full Text Available Traditionally, surgical and procedural apprenticeship has been an assumed activity of students, without a formal educational context. With increasing barriers to patient and operating room access such as shorter work week hours for residents, and operating room and endoscopy time at a premium, alternate strategies to maximizing procedural skill development are being considered. Recently, the traditional surgical apprenticeship model has been challenged, with greater emphasis on the need for surgical and procedural skills training to be more transparent and for alternatives to patient-based training to be considered. Colonoscopy performance is a complex psychomotor skill requiring practioners to integrate multiple sensory inputs, and involves higher cortical centres for optimal performance. Colonoscopy skills involve mastery in the cognitive, technical and process domains. In the present review, we propose a model for teaching colonoscopy to the novice trainee based on educational theory.

  4. Motivational State, Reward Value, and Pavlovian Cues Differentially Affect Skilled Forelimb Grasping in Rats

    Science.gov (United States)

    Mosberger, Alice C.; de Clauser, Larissa; Kasper, Hansjörg; Schwab, Martin E.

    2016-01-01

    Motor skills represent high-precision movements performed at optimal speed and accuracy. Such motor skills are learned with practice over time. Besides practice, effects of motivation have also been shown to influence speed and accuracy of movements, suggesting that fast movements are performed to maximize gained reward over time as noted in…

  5. The Effects of Modified Games on the Development of Gross Motor Skill in Preschoolers

    Science.gov (United States)

    Lestari, Indah; Ratnaningsih, Tri

    2016-01-01

    Gross motor skills on children must be optimized much earlier since it plays important role not only on their interaction process but also in supporting other multiple developments. One of the means in developing child's motor skill is by providing innovative games i.e. modified games including game format, game timing, and game sequence. The…

  6. Teaching Skills through Literature

    Directory of Open Access Journals (Sweden)

    Saleh Ahmed Saif Abdulmughni

    2016-03-01

    Full Text Available This study tries to investigate the contributory factors in the success and failure in teaching of the four language skills through teaching of literature because literature is critically and crucially relevant to the evolution of a literary sensibility. The basic end of literature is to read which develops reading skills and to reinterpret the dynamics of a given society. In this process the language skills are actually manifested. Literature, if we deconstruct the term involves two stages of reading; one that is the text, and second; the subsequent evaluation which entails the ability to break the text and trace the possibilities of meanings. This cannot be done without a proper perspective of the literary and linguistic mind, and the very act of interpretation amply appropriates reading skills. Literature fundamentally helps to develop the spirit of inquiry and the variety of thoughts involved in the representation of the text and; therefore, the study of literature enhances the ability to think beyond what you have been provided with and also to be equipped with a quizzical bent of mind that seeks to establish the competence to question what is read as a matter of literary text. This makes the learner naturally acquire the language from the literary context and consequently develop the language skills. Teaching of language through literature has been a tested method as literary texts are so complete with vocabulary, the terrain of thoughts, the diversity of human encounters and the complexity of experiences. In the process of deconstructing a text, one comes across umpteen shades of thoughts conceived and delivered in a compressed form. Also the decoding of the language given its symbolic structure greatly enhances the prospects of independent thinking and writing. In this way the written skills are widely developed. A text is a bundle of thoughts clad in a complicated web of linguistic sophistication, and the sophistry alone suffices to

  7. Radiological optimization

    International Nuclear Information System (INIS)

    Zeevaert, T.

    1998-01-01

    Radiological optimization is one of the basic principles in each radiation-protection system and it is a basic requirement in the safety standards for radiation protection in the European Communities. The objectives of the research, performed in this field at the Belgian Nuclear Research Centre SCK-CEN, are: (1) to implement the ALARA principles in activities with radiological consequences; (2) to develop methodologies for optimization techniques in decision-aiding; (3) to optimize radiological assessment models by validation and intercomparison; (4) to improve methods to assess in real time the radiological hazards in the environment in case of an accident; (5) to develop methods and programmes to assist decision-makers during a nuclear emergency; (6) to support the policy of radioactive waste management authorities in the field of radiation protection; (7) to investigate existing software programmes in the domain of multi criteria analysis. The main achievements for 1997 are given

  8. Optimizing detectability

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    HPLC is useful for trace and ultratrace analyses of a variety of compounds. For most applications, HPLC is useful for determinations in the nanogram-to-microgram range; however, detection limits of a picogram or less have been demonstrated in certain cases. These determinations require state-of-the-art capability; several examples of such determinations are provided in this chapter. As mentioned before, to detect and/or analyze low quantities of a given analyte at submicrogram or ultratrace levels, it is necessary to optimize the whole separation system, including the quantity and type of sample, sample preparation, HPLC equipment, chromatographic conditions (including column), choice of detector, and quantitation techniques. A limited discussion is provided here for optimization based on theoretical considerations, chromatographic conditions, detector selection, and miscellaneous approaches to detectability optimization. 59 refs

  9. Capitalizing on Speaking Skill of EFL Learners for the Language Literacy

    Directory of Open Access Journals (Sweden)

    Fauzia Hasan Siddiqui

    2014-03-01

    Full Text Available This study aims at grabbing the attention of EFL /ESL teachers, trainers, and administrators towards the importance of teaching speaking skill to enhance overall language proficiency of EFL learners. Comprehensive research done in the field of applied linguistics and English Language Teaching (ELT establishes a positive correlation of speaking skill with the overall language proficiency. Despite this obvious significance of speaking skill in language learning process, it has not gained sufficient attention in the ELT or the assessments in Oman.  Relying on the available literature on the importance of the speaking skill and its effective role in enhancing other language macro skills (listening, reading, and writing, this exploratory research analyzes the currents status of speaking skill in ELT and assessments at the General Foundation Programme (GFP in Oman. As many GFP’s have IELTS (International English Language Testing System  exam as their programme exit examination, the study begins with measuring the correlation of speaking skill grades with other macro skill in order to accentuate the positive impact of speaking skill on other language skills. Secondly, it presents the statistics of time devoted to teaching and weights that speaking skill hold in the GFP in Oman. Finally, the study suggests the ways to optimize speaking skill opportunities to create successful literacy experience among adult EFL learners.

  10. Unconstrained Optimization

    DEFF Research Database (Denmark)

    Frandsen, P. E.; Jonasson, K.; Nielsen, Hans Bruun

    1999-01-01

    This lecture note is intended for use in the course 04212 Optimization and Data Fitting at the Technincal University of Denmark. It covers about 25% of the curriculum. Hopefully, the note may be useful also to interested persons not participating in that course. The aim of the note is to give...... an introduction to algorithms for unconstrained optimization. We present Conjugate Gradient, Damped Newton and Quasi Newton methods together with the relevant theoretical background. The reader is assumed to be familiar with algorithms for solving linear and nonlinear system of equations, at a level corresponding...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... NewsScope: June 22, 2018 Optimal Resources for Surgical Quality and Safety Selected Readings in General Surgery Selected Readings in General Surgery Selected Readings in General Surgery CME Test Login SRGS Online Login Subscribe to SRGS Issues Contact and FAQs ACS Case Reviews in Surgery ...

  12. Optimal transport

    CERN Document Server

    Eckmann, B

    2008-01-01

    At the close of the 1980s, the independent contributions of Yann Brenier, Mike Cullen and John Mather launched a revolution in the venerable field of optimal transport founded by G Monge in the 18th century, which has made breathtaking forays into various other domains of mathematics ever since. The author presents a broad overview of this area.

  13. Topology optimization

    DEFF Research Database (Denmark)

    Bendsøe, Martin P.; Sigmund, Ole

    2007-01-01

    Taking as a starting point a design case for a compliant mechanism (a force inverter), the fundamental elements of topology optimization are described. The basis for the developments is a FEM format for this design problem and emphasis is given to the parameterization of design as a raster image...

  14. Communication skills in psychiatry training.

    Science.gov (United States)

    Ditton-Phare, Philippa; Halpin, Sean; Sandhu, Harsimrat; Kelly, Brian; Vamos, Marina; Outram, Sue; Bylund, Carma L; Levin, Tomer; Kissane, David; Cohen, Martin; Loughland, Carmel

    2015-08-01

    Mental health clinicians can experience problems communicating distressing diagnostic information to patients and their families, especially about severe mental illnesses such as schizophrenia. Evidence suggests that interpersonal communication skills can be effectively taught, as has been demonstrated in the specialty of oncology. However, very little literature exists with respect to interpersonal communication skills training for psychiatry. This paper provides an overview of the communication skills training literature. The report reveals significant gaps exist and highlights the need for advanced communication skills training for mental health clinicians, particularly about communicating a diagnosis and/or prognosis of schizophrenia. A new communication skills training framework for psychiatry is described, based on that used in oncology as a model. This model promotes applied skills and processes that are easily adapted for use in psychiatry, providing an effective platform for the development of similar training programs for psychiatric clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  15. Decadal Prediction Skill in the GEOS-5 Forecast System

    Science.gov (United States)

    Ham, Yoo-Geun; Rienecker, Michele M.; Suarez, Max J.; Vikhliaev, Yury; Zhao, Bin; Marshak, Jelena; Vernieres, Guillaume; Schubert, Siegfried D.

    2013-01-01

    A suite of decadal predictions has been conducted with the NASA Global Modeling and Assimilation Office's (GMAO's) GEOS-5 Atmosphere-Ocean general circulation model. The hind casts are initialized every December 1st from 1959 to 2010, following the CMIP5 experimental protocol for decadal predictions. The initial conditions are from a multivariate ensemble optimal interpolation ocean and sea-ice reanalysis, and from GMAO's atmospheric reanalysis, the modern-era retrospective analysis for research and applications. The mean forecast skill of a three-member-ensemble is compared to that of an experiment without initialization but also forced with observed greenhouse gases. The results show that initialization increases the forecast skill of North Atlantic sea surface temperature compared to the uninitialized runs, with the increase in skill maintained for almost a decade over the subtropical and mid-latitude Atlantic. On the other hand, the initialization reduces the skill in predicting the warming trend over some regions outside the Atlantic. The annual-mean Atlantic meridional overturning circulation index, which is defined here as the maximum of the zonally-integrated overturning stream function at mid-latitude, is predictable up to a 4-year lead time, consistent with the predictable signal in upper ocean heat content over the North Atlantic. While the 6- to 9-year forecast skill measured by mean squared skill score shows 50 percent improvement in the upper ocean heat content over the subtropical and mid-latitude Atlantic, prediction skill is relatively low in the sub-polar gyre. This low skill is due in part to features in the spatial pattern of the dominant simulated decadal mode in upper ocean heat content over this region that differ from observations. An analysis of the large-scale temperature budget shows that this is the result of a model bias, implying that realistic simulation of the climatological fields is crucial for skillful decadal forecasts.

  16. Is Farm Management Skill Persistent?

    OpenAIRE

    Li, Xin; Paulson, Nicholas

    2014-01-01

    Farm management skills can affect farm managers' performance. In this article, farm management performance is analyzed based on yearly Illinois Farm Business Farm Management (FBFM) panel data across 6,760 farms from 1996 through 2011. Two out-of-sample measures of skill are used to analyze the ability of farm managers that consistently perform well over yearly and longer time horizons. Persistence tests show management skills are consistent and predictable. Results also suggest that the most ...

  17. STRESS COPING SKILLS IN ADDICTS

    OpenAIRE

    A EBRAHIMI; SG MOOSAVI; R SAMOOEIE; A ,HASAN ZADEH

    2002-01-01

    Introduction. Stress coping skills is one of the most important factors in prediction of addictive behavior. The purpose of this study was to determine this pattern and to compare them with those of non-addicts. Methods. One hundred subjects with substance dependency and 100 non-addict subjects were selected. Both groups were matched on the basis of their socioeconomic state. Stress coping skills of study participants were examined using CS-R scale. Results. Stress coping skills in ...

  18. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  19. Do laparoscopic skills transfer to robotic surgery?

    Science.gov (United States)

    Panait, Lucian; Shetty, Shohan; Shewokis, Patricia A; Sanchez, Juan A

    2014-03-01

    Identifying the set of skills that can transfer from laparoscopic to robotic surgery is an important consideration in designing optimal training curricula. We tested the degree to which laparoscopic skills transfer to a robotic platform. Fourteen medical students and 14 surgery residents with no previous robotic but varying degrees of laparoscopic experience were studied. Three fundamentals of laparoscopic surgery tasks were used on the laparoscopic box trainer and then the da Vinci robot: peg transfer (PT), circle cutting (CC), and intracorporeal suturing (IS). A questionnaire was administered for assessing subjects' comfort level with each task. Standard fundamentals of laparoscopic surgery scoring metric were used and higher scores indicate a superior performance. For the group, PT and CC scores were similar between robotic and laparoscopic modalities (90 versus 90 and 52 versus 47; P > 0.05). However, for the advanced IS task, robotic-IS scores were significantly higher than laparoscopic-IS (80 versus 53; P robotic-PT score when compared with laparoscopic-PT (92 versus 105; P  0.05). The robot was favored over laparoscopy for all drills (PT, 66.7%; CC, 88.9%; IS, 94.4%). For simple tasks, participants with preexisting skills perform worse with the robot. However, with increasing task difficulty, robotic performance is equal or better than laparoscopy. Laparoscopic skills appear to readily transfer to a robotic platform, and difficult tasks such as IS are actually enhanced, even in subjects naive to the technology. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. The assessment of practical skills

    OpenAIRE

    Reiss, M. J.; Abrahams, I.

    2015-01-01

    Major changes are currently afoot as to how practical work will be assessed in high status examinations (GCSEs for 16 year-olds and ‘A’ levels for 18 year-olds) in England. We explore here how practical skills might best be assessed in school science and introduce two terms: direct assessment of practical skills (DAPS) and indirect assessment of practical skills (IAPS). We conclude that both the direct and indirect assessment of practical skills have their place in effective assessment of sch...

  1. Improving Pathologists' Communication Skills.

    Science.gov (United States)

    Dintzis, Suzanne

    2016-08-01

    The 2015 Institute of Medicine report on diagnostic error has placed a national spotlight on the importance of improving communication among clinicians and between clinicians and patients [1]. The report emphasizes the critical role that communication plays in patient safety and outlines ways that pathologists can support this process. Despite recognition of communication as an essential element in patient care, pathologists currently undergo limited (if any) formal training in communication skills. To address this gap, we at the University of Washington Medical Center developed communication training with the goal of establishing best practice procedures for effective pathology communication. The course includes lectures, role playing, and simulated clinician-pathologist interactions for training and evaluation of pathology communication performance. Providing communication training can help create reliable communication pathways that anticipate and address potential barriers and errors before they happen. © 2016 American Medical Association. All Rights Reserved.

  2. Innovation and Academic Skills

    DEFF Research Database (Denmark)

    Nielsen, René Nesgaard

    2006-01-01

    that merely 14% of private Danish firms employ highly educated workers, and considering firm size it is especially small firms with less than 50 employees that do not employ highly educated workers (Rambøll-Management 2004). Evaluating these empirics in light of the ‘backbone status’ of SMEs in most economies......-level change a universal phenomenon? Is it mainly a US (or large country) phenomenon? Is it mainly a phenomenon flowing through large firms? Or do small, innovative, non-science-based Danish firms also start to hire highly educated labour? • And reversing the assumed causality: Can employment of a first highly...... different types of firm level developments and qualitative employment effects. Defining a small firm as a private business firm with 20-50 employees, and taking interest in small firms with no highly educated labour employed in 1993, the chapter on skill-bias aims to discover whether the innovative...

  3. Improving the training process of highly skilled bodybuilders in the preparatory period, general preparatory phase

    Directory of Open Access Journals (Sweden)

    Olexandr Tyhorskyy

    2015-08-01

    Full Text Available Purpose: to improve the method of training highly skilled bodybuilders during the general preparatory phase. Material and Methods: the study involved eight highly skilled athletes, members of the team of Ukraine on bodybuilding. Results: comparative characteristics of the most commonly used methods of training process in bodybuilding. Developed and substantiated the optimal method of training highly skilled bodybuilders during the general preparatory phase of the preparatory period, which can increase body weight through muscle athletes component. Conclusions: based on studies, recommended the optimum method of training highly skilled bodybuilders depending on mezotsykles and microcycles general preparatory phase

  4. Generic ICT Skills Profiles: Future Skills for Tomorrow's World.

    Science.gov (United States)

    International Co-operation Europe Ltd. (ICEL), Brussels, Belgium.

    This document describes generic skills profiles relevant to key jobs in information and communications technology (ICT). The profiles cover the main job areas for which the ICT industry is experiencing skills shortages. These types of information are provided for 18 generic job profiles: job description (vision, role, lifestyle); examples of job…

  5. Getting Skills Right: Assessing and Anticipating Changing Skill Needs

    Science.gov (United States)

    OECD Publishing, 2016

    2016-01-01

    Digitalisation, globalisation, demographic shifts and other changes in work organisation are constantly reshaping skill needs. This can lead to persistent skill shortages and mismatch which are costly for individuals, firms and society in terms of lost wages and lower productivity and growth. These costs can be reduced through better assessment…

  6. Peer Assessment of Soft Skills and Hard Skills

    Science.gov (United States)

    Zhang, Aimao

    2012-01-01

    Both the information technology (IT) industry and the Accreditation Board for Engineering and Technology (ABET) demand soft-skill training in higher education and require IT graduates to demonstrate competence in interpersonal communication, teamwork, and conflict management. Group projects provide teamwork environment for soft-skill training, but…

  7. Optimal control

    CERN Document Server

    Aschepkov, Leonid T; Kim, Taekyun; Agarwal, Ravi P

    2016-01-01

    This book is based on lectures from a one-year course at the Far Eastern Federal University (Vladivostok, Russia) as well as on workshops on optimal control offered to students at various mathematical departments at the university level. The main themes of the theory of linear and nonlinear systems are considered, including the basic problem of establishing the necessary and sufficient conditions of optimal processes. In the first part of the course, the theory of linear control systems is constructed on the basis of the separation theorem and the concept of a reachability set. The authors prove the closure of a reachability set in the class of piecewise continuous controls, and the problems of controllability, observability, identification, performance and terminal control are also considered. The second part of the course is devoted to nonlinear control systems. Using the method of variations and the Lagrange multipliers rule of nonlinear problems, the authors prove the Pontryagin maximum principle for prob...

  8. Resilience: a transversal occupational skill for current organizations

    Directory of Open Access Journals (Sweden)

    María del Rosario Piñeros-Botero

    2013-12-01

    some studies related to deal the resilience from the transverse occupational skills and the MCclelland approach TO KNOW TO BE AND TO KNOW TO DO, as a structural base for behavior and performance of people. Finally we propose an organizational resilience model that presents its functionality and categorization of profiles in occupational and individual skills that allow encouraging cultural and organizational behavior by means of optimization strategies to current organizations. The term organizations, is going to be used to talk about an industry or enterprise of any kind or financial sector.

  9. Life skills, wealth, health, and wellbeing in later life.

    Science.gov (United States)

    Steptoe, Andrew; Wardle, Jane

    2017-04-25

    Life skills play a key role in promoting educational and occupational success in early life, but their relevance at older ages is uncertain. Here we measured five life skills-conscientiousness, emotional stability, determination, control, and optimism-in 8,119 men and women aged 52 and older (mean 66.7 y). We show that the number of skills is associated with wealth, income, subjective wellbeing, less depression, low social isolation and loneliness, more close relationships, better self-rated health, fewer chronic diseases and impaired activities of daily living, faster walking speed, and favorable objective biomarkers (concentration of high-density lipoprotein cholesterol, vitamin D and C-reactive protein, and less central obesity). Life skills also predicted sustained psychological wellbeing, less loneliness, and a lower incidence of new chronic disease and physical impairment over a 4-y period. These analyses took account of age, sex, parental socioeconomic background, education, and cognitive function. No single life skill was responsible for the associations we observed, nor were they driven by factors such as socioeconomic status or health. Despite the vicissitudes of later life, life skills impact a range of outcomes, and the maintenance of these attributes may benefit the older population.

  10. The neural basis of task switching changes with skill acquisition

    Directory of Open Access Journals (Sweden)

    Koji eJimura

    2014-05-01

    Full Text Available Learning novel skills involves reorganization and optimization of cognitive processing involving a broad network of brain regions. Previous work has shown asymmetric costs of switching to a well-trained task versus a poorly-trained task, but the neural basis of these differential switch costs is unclear. The current study examined the neural signature of task switching in the context of acquisition of new skill. Human participants alternated randomly between a novel visual task (mirror-reversed word reading and a highly practiced one (plain word reading, allowing the isolation of task switching and skill set maintenance. Two scan sessions were separated by two weeks, with behavioral training on the mirror reading task in between the two sessions. Broad cortical regions, including bilateral prefrontal, parietal, and extrastriate cortices, showed decreased activity associated with learning of the mirror reading skill. In contrast, learning to switch to the novel skill was associated with decreased activity in a focal subcortical region in the dorsal striatum. Switching to the highly practiced task was associated with a non-overlapping set of regions, suggesting substantial differences in the neural substrates of switching as a function of task skill. Searchlight multivariate pattern analysis also revealed that learning was associated with decreased pattern information for mirror versus plain reading tasks in fronto-parietal regions. Inferior frontal junction and posterior parietal cortex showed a joint effect of univariate activation and pattern information. These results suggest distinct learning mechanisms task performance and executive control as a function of learning.

  11. An assessment of the impact of entrepreneurial skills of community pharmacists on pharmaceutical business performance in Jos metropolis, Nigeria

    Science.gov (United States)

    Nmadu, Teresa M.

    2018-01-01

    Background: Community pharmacy has been a lucrative area of practice for pharmacists in Jos, Nigeria, until about the turn of the millennium where a decline in viability of the business has been observed. Objective: This study assessed the entrepreneurial skills of community pharmacists, the business performance of community pharmacies and the impact of their entrepreneurial skills on business performance. Methods: A cross sectional survey was conducted by administering a pretested questionnaire to 30 community pharmacists in Jos. An adaptation of the Bernelli model and the expanded Katz (1974)/Herron (1990) Skill Typology Model was used to assess nine entrepreneurial skills - product, organizational, industry, networking, leadership, executive, entrepreneurial, marketing and money skills; while sales growth, net profit and stock growth were used to assess business performance. Frequency distribution of results was presented, with further analysis done with the Epi-Info software using the chi square test of association. Result: The results from this study showed that community pharmacies in Jos do possess requisite entrepreneurial skills, but to varying extents. Product skills ranked highest while money skills and entrepreneurial skills ranked least, portraying a need for skills enhancement in these areas. Business performance was suboptimal, being rated as average or poor by 56.6% of respondents. However, most respondents (90%) still assessed their businesses as profitable. Money skills had a significant impact on business performance (P=0.03) and stock growth (P=0.04); while stock growth was significantly affected by leadership skills (P=0.002) and entrepreneurial skills (0.02). Net profit was significantly affected by industry skills (P=0.008). Conclusions: Community pharmacy business is still a profitable business venture in Jos though business performance is sub optimal. The entrepreneurial skills set of a community pharmacist set has an impact on business

  12. An assessment of the impact of entrepreneurial skills of community pharmacists on pharmaceutical business performance in Jos metropolis, Nigeria.

    Science.gov (United States)

    Asieba, Iyeseun O; Nmadu, Teresa M

    2018-01-01

    Community pharmacy has been a lucrative area of practice for pharmacists in Jos, Nigeria, until about the turn of the millennium where a decline in viability of the business has been observed. This study assessed the entrepreneurial skills of community pharmacists, the business performance of community pharmacies and the impact of their entrepreneurial skills on business performance. A cross sectional survey was conducted by administering a pretested questionnaire to 30 community pharmacists in Jos. An adaptation of the Bernelli model and the expanded Katz (1974)/Herron (1990) Skill Typology Model was used to assess nine entrepreneurial skills - product, organizational, industry, networking, leadership, executive, entrepreneurial, marketing and money skills; while sales growth, net profit and stock growth were used to assess business performance. Frequency distribution of results was presented, with further analysis done with the Epi-Info software using the chi square test of association. The results from this study showed that community pharmacies in Jos do possess requisite entrepreneurial skills, but to varying extents. Product skills ranked highest while money skills and entrepreneurial skills ranked least, portraying a need for skills enhancement in these areas. Business performance was suboptimal, being rated as average or poor by 56.6% of respondents. However, most respondents (90%) still assessed their businesses as profitable. Money skills had a significant impact on business performance (P=0.03) and stock growth (P=0.04); while stock growth was significantly affected by leadership skills (P=0.002) and entrepreneurial skills (0.02). Net profit was significantly affected by industry skills (P=0.008). Community pharmacy business is still a profitable business venture in Jos though business performance is sub optimal. The entrepreneurial skills set of a community pharmacist set has an impact on business performance with money skills, leadership skills and

  13. An assessment of the impact of entrepreneurial skills of community pharmacists on pharmaceutical business performance in Jos metropolis, Nigeria

    Directory of Open Access Journals (Sweden)

    Asieba IO

    2018-03-01

    Full Text Available Background: Community pharmacy has been a lucrative area of practice for pharmacists in Jos, Nigeria, until about the turn of the millennium where a decline in viability of the business has been observed. Objective: This study assessed the entrepreneurial skills of community pharmacists, the business performance of community pharmacies and the impact of their entrepreneurial skills on business performance. Methods: A cross sectional survey was conducted by administering a pretested questionnaire to 30 community pharmacists in Jos. An adaptation of the Bernelli model and the expanded Katz (1974/Herron (1990 Skill Typology Model was used to assess nine entrepreneurial skills - product, organizational, industry, networking, leadership, executive, entrepreneurial, marketing and money skills; while sales growth, net profit and stock growth were used to assess business performance. Frequency distribution of results was presented, with further analysis done with the Epi-Info software using the chi square test of association. Result: The results from this study showed that community pharmacies in Jos do possess requisite entrepreneurial skills, but to varying extents. Product skills ranked highest while money skills and entrepreneurial skills ranked least, portraying a need for skills enhancement in these areas. Business performance was suboptimal, being rated as average or poor by 56.6% of respondents. However, most respondents (90% still assessed their businesses as profitable. Money skills had a significant impact on business performance (P=0.03 and stock growth (P=0.04; while stock growth was significantly affected by leadership skills (P=0.002 and entrepreneurial skills (0.02. Net profit was significantly affected by industry skills (P=0.008. Conclusions: Community pharmacy business is still a profitable business venture in Jos though business performance is sub optimal. The entrepreneurial skills set of a community pharmacist set has an impact on

  14. Proficiency deficiency: mastery of fundamental movement skills and skill components in overweight and obese children.

    Science.gov (United States)

    Cliff, Dylan P; Okely, Anthony D; Morgan, Philip J; Jones, Rachel A; Steele, Julie R; Baur, Louise A

    2012-05-01

    The purpose of this observational study was to compare the mastery of 12 fundamental movement skills (FMS) and skill components between a treatment-seeking sample of overweight/obese children and a reference sample from the United States. Mastery of six locomotor and six object-control skills (24 components in each subdomain) were video-assessed by one assessor using the test of gross motor development-2 (TGMD-2). The 153 overweight/obese children (mean ± s.d. age = 8.3 ± 1.1 years, BMI z-score = 2.78 ± 0.69, 58% girls, 77% obese) were categorized into age groups (for the underhand roll and strike: 7-8 years and 9-10 years; all other FMS: 6-7 years and 8-10 years) and mastery prevalence rates were compared with representative US data (N = 876) using χ(2) analysis. For all 12 skills in all age groups, the prevalence of mastery was lower among overweight/obese children compared with the reference sample (all P skill components (all P movement patterns that could be targeted for improvement include positioning of the body and feet, the control or release of an object at an optimal position, and better use of the arms to maintain effective force production during the performance of FMS. Physical activity programs designed for overweight and obese children may need to address deficiencies in FMS proficiency to foster the movement capabilities required for participation in health-enhancing physical activity.

  15. Especial Skills in Experienced Archers.

    Science.gov (United States)

    Nabavinik, Mahdi; Abaszadeh, Ali; Mehranmanesh, Mehrab; Rosenbaum, David A

    2017-09-05

    Especial skills are skills that are distinctive by virtue of massive practice within the narrow contexts in which they are expressed. In the first demonstration of especial skills, Keetch, Schmidt, Lee, and Young (2005) showed that experienced basketball players are better at shooting baskets from the foul line, where they had massive amounts of practice, than would expected from their success at other locations closer to or farther from the basket. Similar results were obtained for baseball throwing. The authors asked whether especial skills hold in archery, a sport requiring less movement. If the emergence of especial skills depends on large-scale movement, one would expect archery to escape so-called especialism. But if the emergence of especial skills reflects a more general tendency for highly specific learning, experienced archers should show especial skills. The authors obtained evidence consistent with the latter prediction. The expert archers did much better at their most highly practiced distance than would be expected by looking at the overall function relating shooting score to distance. We offer a mathematical model to account for this result. The findings attest to the generality of the especial skills phenomenon.

  16. PIAAC Skills and Economic Inequality

    Science.gov (United States)

    Pena, Anita Alves

    2016-01-01

    Mixed findings characterize the literature on skills and economic distributions within and across countries. The Programme for the International Assessment of Adult Competencies (PIAAC) offers new, internationally comparable data on literacy, numeracy, and digital problem-solving skills that can be combined with wage information. This paper…

  17. Life skills and children's characterstrengths

    DEFF Research Database (Denmark)

    Ledertoug, Mette Marie; Linder, Anne

    Psychologist Anne Linder and Psychologist and PhDstudent Mette Marie Ledertoug focus in ‘Life skills and Childrens’ Character Strengths’ on improving life skills for children and adolescents by adopting a strengths-based approach combining a theoretical foundation based on VIA strengths...

  18. Skills Methods to Prevent Smoking.

    Science.gov (United States)

    Schinke, Steven Paul; And Others

    1986-01-01

    Describes an evaluation of the added value of skills methods for preventing smoking with sixth-grade students from two schools. Skills conditions subjects learned problem-solving, self-instruction, and interpersonal communication methods. The article discusses the strengths, limits, and implications of the study for other smoking prevention…

  19. Evidence for Multiple Rhythmic Skills.

    Directory of Open Access Journals (Sweden)

    Adam Tierney

    Full Text Available Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions.

  20. Evidence for Multiple Rhythmic Skills

    Science.gov (United States)

    Tierney, Adam; Kraus, Nina

    2015-01-01

    Rhythms, or patterns in time, play a vital role in both speech and music. Proficiency in a number of rhythm skills has been linked to language ability, suggesting that certain rhythmic processes in music and language rely on overlapping resources. However, a lack of understanding about how rhythm skills relate to each other has impeded progress in understanding how language relies on rhythm processing. In particular, it is unknown whether all rhythm skills are linked together, forming a single broad rhythmic competence, or whether there are multiple dissociable rhythm skills. We hypothesized that beat tapping and rhythm memory/sequencing form two separate clusters of rhythm skills. This hypothesis was tested with a battery of two beat tapping and two rhythm memory tests. Here we show that tapping to a metronome and the ability to adjust to a changing tempo while tapping to a metronome are related skills. The ability to remember rhythms and to drum along to repeating rhythmic sequences are also related. However, we found no relationship between beat tapping skills and rhythm memory skills. Thus, beat tapping and rhythm memory are dissociable rhythmic aptitudes. This discovery may inform future research disambiguating how distinct rhythm competencies track with specific language functions. PMID:26376489

  1. Risk, Balanced Skills and Entrepreneurship

    NARCIS (Netherlands)

    Hsieh, C.; Parker, S.C.; van Praag, C.M.

    2016-01-01

    This paper proposes that risk aversion encourages individuals to invest in balanced skill profiles, making them more likely to become entrepreneurs. By not taking this possible linkage into account, previous research has underestimated the impacts of both risk aversion and balanced skills on the

  2. Improving Dictionary Skills in Ndebele

    African Journals Online (AJOL)

    rbr

    Abstract: This article proposes ways of improving dictionary skills amongst the Ndebele. One way of accomplishing this is incorporating the teaching of dictionary skills into teacher training syllabi. Teachers can impart their knowledge to students and a dictionary culture can develop for enhancing effective use of current ...

  3. Instruction of Competent Psychomotor Skill

    Science.gov (United States)

    Olson, Valerie Dong

    2008-01-01

    Instruction of competent psychomotor skill necessitates an eclectic approach. The principles of learning, complemented with learning styles and sensory modalities preferences, provide a background for teaching physical skills. The use of the psychomotor domain of Bloom's Taxonomy as a map and corresponding behavioral objectives foster the mastery…

  4. Collaborating To Teach Prosocial Skills.

    Science.gov (United States)

    Allsopp, David H.; Santos, Karen E.; Linn, Reid

    2000-01-01

    This article describes a collaborative prosocial skills program. Steps of the intervention include forming teams of educators, targeting necessary prosocial skills, developing an instructional plan, determining the setting and collaborative roles, delivery instruction, and providing opportunities for student practice, reinforcement, and…

  5. Business Financial Occupations: Skill Standards.

    Science.gov (United States)

    Vocational Technical Education Consortium of States, Decatur, GA.

    This report organizes the information provided by 71 individuals in finance-related occupations in 11 states into skills inventories for persons in these jobs. The skills inventories contain the following sections: (1) occupation-specific knowledge (communication, mathematics, science); (2) workplace behaviors (work ethics, interpersonal…

  6. Enhancing Literacy Skills through Technology.

    Science.gov (United States)

    Sistek-Chandler, Cynthia

    2003-01-01

    Discusses how to use technology to enhance literacy skills. Highlights include defining literacy, including information literacy; research to support reading and writing instruction; literacy software; thinking skills; organizational strategies for writing and reading; how technology can individualize literacy instruction; and a new genre of…

  7. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  8. Epilepsy, language, and social skills.

    Science.gov (United States)

    Caplan, Rochelle

    2017-10-04

    Language and social skills are essential for intrapersonal and interpersonal functioning and quality of life. Since epilepsy impacts these important domains of individuals' functioning, understanding the psychosocial and biological factors involved in the relationship among epilepsy, language, and social skills has important theoretical and clinical implications. This review first describes the psychosocial and biological factors involved in the association between language and social behavior in children and in adults and their relevance for epilepsy. It reviews the findings of studies of social skills and the few studies conducted on the inter-relationship of language and social skills in pediatric and adult epilepsy. The paper concludes with suggested future research and clinical directions that will enhance early identification and treatment of epilepsy patients at risk for impaired language and social skills. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Skill-Based and Planned Active Play Versus Free-Play Effects on Fundamental Movement Skills in Preschoolers.

    Science.gov (United States)

    Roach, Lindsay; Keats, Melanie

    2018-01-01

    Fundamental movement skill interventions are important for promoting physical activity, but the optimal intervention model for preschool children remains unclear. We compared two 8-week interventions, a structured skill-station and a planned active play approach, to a free-play control condition on pre- and postintervention fundamental movement skills. We also collected data regarding program attendance and perceived enjoyment. We found a significant interaction effect between intervention type and time. A Tukey honest significant difference analysis supported a positive intervention effect showing a significant difference between both interventions and the free-play control condition. There was a significant between-group difference in group attendance such that mean attendance was higher for both the free-play and planned active play groups relative to the structured skill-based approach. There were no differences in attendance between free-play and planned active play groups, and there were no differences in enjoyment ratings between the two intervention groups. In sum, while both interventions led to improved fundamental movement skills, the active play approach offered several logistical advantages. Although these findings should be replicated, they can guide feasible and sustainable fundamental movement skill programs within day care settings.

  10. Anatomia microcirúrgica do hipocampo na Amígdalo-hipocampectomia seletiva sob a perspectiva da técnica de Niemeyer e método pré-operatório para maximizar a corticotomia Hippocampal microsurgical anatomy regarding the selective amygdalohippocampectomy in the Niemeyer’s technique perspective and preoperative method to maximize the corticotomy

    Directory of Open Access Journals (Sweden)

    Gustavo Rassier Isolan

    2007-12-01

    Full Text Available O conhecimento da anatomia microcirúrgica do hipocampo tem importância fundamental na cirurgia da epilepsia do lobo temporal. Uma das técnicas mais utilizadas na cirurgia da epilepsia é a técnica de Niemeyer. OBJETIVO: Descrever em detalhes a anatomia do hipocampo e mostrar uma técnica na qual pontos de referências anatômicos pré-operatórios visualizados na RNM são usados para guiar a corticotomia. MÉTODO: Foram utilizados 20 hemisférios cerebrais e 8 cadáveres para dissecções anatômicas microcirúrgicas do lobo temporal e hipocampo para identificação e descrição das principais estruturas do hipocampo. Foram estudados prospectivamente 32 pacientes com epilepsia do lobo temporal refratários ao tratamento clínico submetidos a amígdalo-hipocampectomia seletiva pela técnica de Niemeyer três parâmetros anatômicos foram mensurados na RNM pré operatória e transferidos para o ato cirúrgico. RESULTADOS: O hipocampo foi dividido em cabeça, corpo e cauda e sua anatomia microcirúrgica descrita em detalhes. As medidas adquiridas são apresentadas e discutidas. CONCLUSÃO: A complexa anatomia do hipocampo pode ser entendida de uma forma tridimensional durante dissecções microcirúrgicas. As medidas pré-operatórias mostraram-se guias anatômicos úteis para corticotomia na técnica de Niemeyer.The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. PURPOSE: To describe the hippocampal anatomy in details and to present a technique which preoperative anatomical points in MRI are identified to guide the corticotomy. METHOD: Microsurgical dissections were performed in twenty brain hemispheres and eight cadaveric heads to identify temporal lobe and hippocampus structures. Thirty two patients with drug-resistent temporal lobe epilepsy underwent a selective amygdalohippocampectomy with Niemeyer’s technique being measured three

  11. Communication skills training in orthopaedics.

    Science.gov (United States)

    Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

    2008-06-01

    Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

  12. Discrete optimization

    CERN Document Server

    Parker, R Gary

    1988-01-01

    This book treats the fundamental issues and algorithmic strategies emerging as the core of the discipline of discrete optimization in a comprehensive and rigorous fashion. Following an introductory chapter on computational complexity, the basic algorithmic results for the two major models of polynomial algorithms are introduced--models using matroids and linear programming. Further chapters treat the major non-polynomial algorithms: branch-and-bound and cutting planes. The text concludes with a chapter on heuristic algorithms.Several appendixes are included which review the fundamental ideas o

  13. Content analysis of science material in junior school-based inquiry and science process skills

    Science.gov (United States)

    Patonah, S.; Nuvitalia, D.; Saptaningrum, E.

    2018-03-01

    The purpose of this research is to obtain the characteristic map of science material content in Junior School which can be optimized using inquiry learning model to tone the science process skill. The research method used in the form of qualitative research on SMP science curriculum document in Indonesia. Documents are reviewed on the basis of the basic competencies of each level as well as their potential to trace the skills of the science process using inquiry learning models. The review was conducted by the research team. The results obtained, science process skills in grade 7 have the potential to be trained using the model of inquiry learning by 74%, 8th grade by 83%, and grade 9 by 75%. For the dominant process skills in each chapter and each level is the observing skill. Follow-up research is used to develop instructional inquiry tools to trace the skills of the science process.

  14. EVA Skills Training

    Science.gov (United States)

    Parazynski, Scott

    2012-01-01

    Dr. Parazynski and a colleague from Extravehicular Activity (EVA), Robotics, & Crew Systems Operations (DX) worked closely to build the EVA Skills Training Program, and for the first time, defined the gold standards of EVA performance, allowing crewmembers to increase their performance significantly. As part of the program, individuals had the opportunity to learn at their own rate, taking additional water time as required, to achieve that level of performance. This focus on training to one's strengths and weaknesses to bolster them enabled the Crew Office and DX to field a much larger group of spacewalkers for the daunting "wall of EVA" required for the building and maintenance of the ISS. Parazynski also stressed the need for designers to understand the capabilities and the limitations of a human in a spacesuit, as well as opportunities to improve future generations of space. He shared lessons learned (how the Crew Office engaged in these endeavors) and illustrated the need to work as a team to develop these complex systems.

  15. Driving skills after whiplash.

    Science.gov (United States)

    Gimse, R; Bjørgen, I A; Straume, A

    1997-09-01

    Previous studies have shown that some persons with longlasting problems after whiplash have changed eye movements. These changes have been related to disturbance of the posture control system. The question raised in the present study is whether such disturbances can influence daily life functions connected with balance, position and external movements, such as car driving. A group of 23 persons with disturbed eye movements due to whiplash injury, was tested in a driving simulator, together with a closely matched control group. The results revealed significant differences between the two groups with respect to response times to the traffic signs presented, identification of type of sign, as well as steering precision while the subjects' attention was directed to the process of identifying the signs. Alternative explanations such as driving experience, pain, medication or malingering are at least partly controlled for, but cannot completely be ruled out. A distorted posture control system leading to disturbance of eye movements seems to be the most likely primary causative factor, but these disturbances are most certainly complexly determined. Reduced attention capacity is considered to be a mediating secondary factor. Registration of eye movements may be a useful diagnostic tool to evaluate driving skill after whiplash.

  16. Intercultural learning and skills

    Directory of Open Access Journals (Sweden)

    Alessio Surian

    2012-08-01

    Full Text Available The concept of intercultural competence is associated in the literature lists both abilities to be "successful" as an individual and an organization in cross-cultural relations, as most critical visions and interested in different contexts and social roles that play a role in the definition and perception of these relations.The concept of intercultural competence authors as Earley and Ang (2003, p. 59 prefer the concept of cultural intelligence in relation to how people can adapt to new cultural contexts, and in continuity with the work on intelligence of educational psychologists (H. Gardner, RJ Sternberg, and in relation to the interaction between cognitive styles and management of daily activities (Zhang, Sternberg, 2001, p. 198-200.From different approaches, has occurred in recent years a significant number of tools for assessing intercultural competence (Earley and Ang 2003, p. 193-199; Fowler and Blohm 2004, p. 37-84, Paige 2004, pp. 85-128.In this contribution we investigate the relevant aspects and implications of the discourses on intercultural skills for learning and for education policies that integrate an intercultural approach.

  17. Europe's Skill Challenge: Lagging Skill Demand Increases Risks of Skill Mismatch. Briefing Note

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2012

    2012-01-01

    The main findings of Cedefop's latest skill demand and supply forecast for the European Union (EU) for 2010-20, indicate that although further economic troubles will affect the projected number of job opportunities, the major trends, including a shift to more skill-intensive jobs and more jobs in services, will continue. Between 2008 and 2010…

  18. Skills Matter: Further Results from the Survey of Adult Skills. OECD Skills Studies

    Science.gov (United States)

    Kankaraš, Miloš; Montt, Guillermo; Paccagnella, Marco; Quintini, Glenda; Thorn, William

    2016-01-01

    In the wake of the technological revolution that began in the last decades of the 20th century, labour market demand for information-processing and other high-level cognitive and interpersonal skills is growing substantially. The "Survey of Adult Skills," a product of the OECD Programme for the International Assessment of Adult…

  19. Two Thinking Skills Assessment Approaches: "Assessment of Pupils' Thinking Skills" and "Individual Thinking Skills Assessments"

    Science.gov (United States)

    Burke, Lynsey A.; Williams, Joanne M.

    2012-01-01

    This paper is linked to a previous paper outlining an evaluation of a thinking skills intervention (Burke & Williams, 2008). Following extensive requests for the assessment tools used in the intervention, this short paper presents the development and potential uses of two thinking skills assessment tools. The aim of the paper is simply to make…

  20. Valuing skill differences : Perceived skill complementary and dyadic helping behavior in teams

    NARCIS (Netherlands)

    Oosterhof, A.; van der Vegt, G.S.; Van de Vliert, E.; Sanders, K.

    2009-01-01

    This article reports effects of perceived skill dissimilarity and perceived skill complementarity on dyadic helping behavior using a cross-lagged panel study. Specifically, the authors hypothesize that perceived skill dissimilarity is negatively related, whereas perceived skill complementarity is

  1. Valuing Skill Differences: Perceived Skill Complementarity and Dyadic Helping Behavior in Teams

    NARCIS (Netherlands)

    Oosterhof, Aad; van der Vegt, Gerben S.; van de Vliert, Evert; Sanders, Karin

    2009-01-01

    This article reports effects of perceived skill dissimilarity and perceived skill complementarity on dyadic helping behavior using a cross-lagged panel study. Specifically, the authors hypothesize that perceived skill dissimilarity is negatively related, whereas perceived skill complementarity is

  2. Optimal Admission to Higher Education

    DEFF Research Database (Denmark)

    Albæk, Karsten

    This paper constructs higher education admission rules that maximise graduation rates and thus increase the skill level of the work force. An application shows that students with a low level in mathematics in secondary school ought to find it easier to be admitted to an economics programme than...... to law or psychology programmes, even though economics is the most difficult programme from which to graduate without a strong background in mathematics. Indirect gains from optimal admission include the potential of making whole cohorts of students more able to graduate with a higher education degree....

  3. Nonsmooth Mechanics and Convex Optimization

    CERN Document Server

    Kanno, Yoshihiro

    2011-01-01

    "This book concerns matter that is intrinsically difficult: convex optimization, complementarity and duality, nonsmooth analysis, linear and nonlinear programming, etc. The author has skillfully introduced these and many more concepts, and woven them into a seamless whole by retaining an easy and consistent style throughout. The book is not all theory: There are many real-life applications in structural engineering, cable networks, frictional contact problems, and plasticity! I recommend it to any reader who desires a modern, authoritative account of nonsmooth mechanics and convex optimiz

  4. Skill versus luck: A motivational analysis of gambling involvement.

    Science.gov (United States)

    Chantal, Y; Vallerand, R J

    1996-12-01

    The purpose of the present investigation was to test the skill/luck distinction among gambling games by comparing the motivations underlying participation in a skill (horse racing) and a luck (lottery) betting activity. Predictions were made using Self-Determination Theory (Deci & Ryan, 1985, 1991). It was predicted that self-determined motivations (intrinsic motivation and identified regulation) would be more prominent for the skill game because it is conducive to optimal challenges, fun, and self-involvement. Conversely, the non self-determined forms of motivation (especially external regulation) should be more important for the game of luck because the luck dimension precludes true involvement of the self and orients the individual towards material gains. Results from a hierarchical discriminant function analysis, with 120 gamblers predominantly involved in one of the two betting activities, supported these hypotheses. These results highlight the relevance of a motivational analysis for a better understanding of the inherent properties of gambling games.

  5. Improving Creativity Training: A Study of Designer Skills

    DEFF Research Database (Denmark)

    Valgeirsdóttir, Dagný; Onarheim, Balder; Li-Ying, Jason

    2016-01-01

    and Cross2001]. Establishing that creativity is important for design and innovation implies that identifying ways of improving creativity is a relevant research area within design studies. Creativity is a basic human skill and multiple studies have been published showing that creativity is a skill that can...... be directed at the individual level by enhancing individual creativity skills, but also improvement at the team level, rendering it important to first improve the understanding of both these levels of creativity in the design process.There are multiple ways to train creativity, although currently most...... optimal way of training creativity is through a combination of (1) educating individuals about creativity, thereby building a solid theoretical understanding, and (2) providing them with a real world case where they are trained in the use of creative tools and processes[Scott et al. 2004]. The latter...

  6. Skills Development and Transfer Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Mutshena, M.T.; Nkuna, K.K. [Pebble Bed Modular Reactor Pty (Ltd), P O Box 9394, Centurion, 0046 (South Africa); South African Young Nuclear Professionals Society (South Africa); Thugwane, S.J. [South African Young Nuclear Professionals Society (South Africa); Rasweswe, M.A. [South African Young Nuclear Professionals Society (South Africa); Nuclear Energy Cooperation of South Africa, P O Box 582, PRETORIA 0001 (South Africa)

    2008-07-01

    South Africa as a developing country is faced with numerous challenges amongst them is the shortage of skills in the working environment. Skills shortage has been aggravated by the retirement of the ageing skilled workforce and emigration of most experienced professionals to first world countries. Some professionals once they acquire the experience they opt out for a consultative business. This leaves a gap or void in the industries which can results into poor performance and quality, lessening of business standards and loosing competition. This challenge need to be attended to, because it will lead to hiring of consultants in most jobs or having many young and less experienced professionals and new graduates filling these gaps. The South African Young Nuclear Professionals Society (SAYNPS) has developed a strategic plan to serve as a guideline on how these challenges mentioned above can be addressed [1]. The proposed strategy will be aligned with skills development in the line of work and should get support from the nuclear Industry. Young professionals and recent graduates are the most affected people who lack skills and shall benefit from these programmes. In order for skill development and transfer to be accomplished there should be a Skill Development and Transfer Strategy and procedures to be followed. (authors)

  7. Skills Development and Transfer Strategy

    International Nuclear Information System (INIS)

    Mutshena, M.T.; Nkuna, K.K.; Thugwane, S.J.; Rasweswe, M.A.

    2008-01-01

    South Africa as a developing country is faced with numerous challenges amongst them is the shortage of skills in the working environment. Skills shortage has been aggravated by the retirement of the ageing skilled workforce and emigration of most experienced professionals to first world countries. Some professionals once they acquire the experience they opt out for a consultative business. This leaves a gap or void in the industries which can results into poor performance and quality, lessening of business standards and loosing competition. This challenge need to be attended to, because it will lead to hiring of consultants in most jobs or having many young and less experienced professionals and new graduates filling these gaps. The South African Young Nuclear Professionals Society (SAYNPS) has developed a strategic plan to serve as a guideline on how these challenges mentioned above can be addressed [1]. The proposed strategy will be aligned with skills development in the line of work and should get support from the nuclear Industry. Young professionals and recent graduates are the most affected people who lack skills and shall benefit from these programmes. In order for skill development and transfer to be accomplished there should be a Skill Development and Transfer Strategy and procedures to be followed. (authors)

  8. Skill development in experimental courses

    Directory of Open Access Journals (Sweden)

    Héctor Bagán

    2015-09-01

    Full Text Available Experimental courses offer a good opportunity to work with competences, promoting the incorporation of strategies oriented towards motivating students to actively involve in the learning process, promoting reflexive learning and developing generic skills. This study presents different ways of developing and evaluating some important general skills, settle on four specific objectives: 1. To increase student motivation using samples of potential interest to students and explaining real-live application of their samples analyses; 2. To assist students’ self-regulation and learning autonomy by using the portfolio; 3. To promote group work through experiments in pairs and small-group discussions; 4. To develop communication skills through small-group discussions and oral presentations. Results show that the type of sample used and real-life application has important influence on motivation. The portfolio is a good tool to promote reflection and to evaluate both specific and generic skills in experimental courses, the dynamics of a laboratory course permit students to develop their group-work and communicative skills, and peer evaluations both improve students’ communication skills and promote metacognitive reflection. Finally, the project demonstrates that it is possible to train students in general skills using the specific course content and that the incorporation of participatory methodologies encourages students to become actively involved in the teaching-learning process.

  9. PENGEMBANGAN MODEL PEMBELAJARAN SOFT SKILLS DAN HARD SKILLS UNTUK SISWA SMK

    OpenAIRE

    Widarto Noto Widodo, Pardjono

    2013-01-01

    Abstrak: Pengembangan Model Pembelajaran Soft Skills dan Hard Skills untuk Siswa SMK. Era global menuntut sumber daya manusia yang memiliki daya saing, adaptif dan antisipatif, mampu belajar, terampil, mudah beradaptasi dengan teknologi baru. Profil tenaga kerja yang dibutuhkan pasar adalah yang kuat pada aspek soft skills dan hard skills. Ada tiga alternatif model pendidikan yang memadukan hard skills dan soft skills, yaitu (1) aspek soft skills dan hard skills dilaksanakan di sekolah; (2) a...

  10. Courage as a skill.

    Science.gov (United States)

    Reardon, Kathleen K

    2007-01-01

    A division vice president blows the whistle on corruption at the highest levels of his company. A young manager refuses to work on her boss's pet project because she fears it will discredit the organization. A CEO urges his board, despite push back from powerful, hostile members, to invest in environmentally sustainable technology. What is behind such high-risk, often courageous acts? Courage in business, the author has found, seldom resembles the heroic impulsiveness that sometimes surfaces in life-or-death situations. Rather, it is a special kind of calculated risk taking, learned and refined over time. Taking an intelligent gamble requires an understanding of what she calls the "courage calculation": six discrete decision-making processes that make success more likely while averting rash or unproductive behavior. These include setting attainable goals, tipping the power balance in your favor, weighing risks against benefits, and developing contingency plans. Goals may be organizational or personal. Tania Modic had both types in mind when, as a young bank manager, she overstepped her role by traveling to NewYork--on vacation time and on her own money--to revitalize some accounts that her senior colleagues had allowed to languish. Her high-risk maneuver benefited the bank and gained her a promotion. Lieutenant General Claudia J. Kennedy weighed the risks and benefits before deciding to report a fellow officer who had plagiarized a research paper at a professional army school. In her difficult courage calculation, loyalty to army standards proved stronger than the potential discomfort and embarrassment of "snitching" on a fellow officer. When the skills behind courageous decision making align with a personal, organizational, or societal philosophy, managers are empowered to make bold moves that lead to success for their companies and their careers.

  11. Taxonomy of Trauma Leadership Skills: A Framework for Leadership Training and Assessment.

    Science.gov (United States)

    Leenstra, Nico F; Jung, Oliver C; Johnson, Addie; Wendt, Klaus W; Tulleken, Jaap E

    2016-02-01

    Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by which they can be assessed across the five phases of trauma care, the authors developed the Taxonomy of Trauma Leadership Skills (TTLS). Critical incident interviews were conducted with trauma team leaders and members from different specialties-emergency physicians, trauma surgeons, anesthesiologists, and emergency ward nurses-at three teaching hospitals in the Netherlands during January-June 2013. Data were iteratively analyzed for examples of excellent leadership skills at each phase of trauma care. Using the grounded theory approach, elements of excellent leadership skills were identified and classified. Elements and behavioral markers were sorted and categorized using multiple raters. In a two-round verification process in late 2013, the taxonomy was reviewed and rated by trauma team leaders and members from the multiple specialties for its coverage of essential items. Data were gathered from 28 interviews and 14 raters. The TTLS details 5 skill categories (information coordination, decision making, action coordination, communication management, and coaching and team development) and 37 skill elements. The skill elements are captured by 67 behavioral markers. The three-level taxonomy is presented according to five phases of trauma care. The TTLS provides a framework for teaching, learning, and assessing team leadership skills in trauma care and other complex, acute care situations.

  12. Interpersonal skills for effective library management

    OpenAIRE

    Koganuramath, M. M.; Angadi, Mallikarjun

    2000-01-01

    This paper intends to reveal various facets of interpersonal skills and also the importance of public relations skills, including librarian's own skills, that helps the users to cultivate interpersonal skills as a positive reference service. Surveys of professional librarians show a high need for the skills for professional competencies, management, networking and teamwork. The perceived need for skills in these areas may reflect the increasing interdependence of library workers and relianc...

  13. How does Entrepreneurship Education Develop Soft Skills?

    Science.gov (United States)

    Humsona, R.; Yuliani, S.

    2018-02-01

    The objective of research was to identify the comprehensive information on the entrepreneurship education program in Olifant School, Yogyakarta, Indonesia. The research method employed was descriptive qualitative one. The sampling technique used was purposive; the data collection was carried out using observation, in-depth interview and document. The data validation was carried out using source triangulations, and data analysis using an interactive model. The result of research showed that the headmaster implemented entrepreneurship education program through holding some training for the teachers, admitting the students with special needs, modifying curriculum and providing school infrastructure in accordance with the needs of the students. The constraints with entrepreneurship education programs included the limited number of special assistant teachers and the response of parents. The result of learning process can be seen from the students’ creativity, independency, and optimism as mentioned in entrepreneurship skill.

  14. Developing nurses' transformational leadership skills.

    Science.gov (United States)

    Fischer, Shelly Ann

    2017-08-16

    Healthcare is a complex area with significant potential for service improvement despite the effects of increasing economic and social pressures on the quality and safety of patient care. As the largest group of healthcare professionals in direct contact with patients, nurses are well positioned to contribute to improvements in healthcare services and to the development of new policies. To influence healthcare improvements and policies effectively, nurses require leadership skills. Historically, it was thought that only nurses in management roles required leadership skills; however, the ability to influence change is a requirement at all levels of clinical practice. Transformational leadership competencies provide nurses with the skills to contribute to improvements in the quality and safety of patient care, while enhancing their career satisfaction. This article examines how nurses can apply transformational leadership to their practice. It also informs nurses how to conduct an initial self-assessment of their leadership skills and to formulate a transformational leadership development plan.

  15. Strategic leadership: the essential skills.

    Science.gov (United States)

    Schoemaker, Paul J H; Krupp, Steve; Howland, Samantha

    2013-01-01

    The more uncertain your environment, the greater the opportunity--if you have the leadership skills to capitalize on it. Research at the Wharton school and at the authors' consulting firm, involving more than 20,000 executives to date, has identified six skills that, when mastered and used in concert, allow leaders to think strategically and navigate the unknown effectively. They are the abilities to anticipate, challenge, interpret, decide, align, and learn. This article describes the six skills in detail and includes a self-assessment that will enable you to identify the ones that most need your attention. The authors have found that strength in one skill cannot easily compensate for a deficit in another. An adaptive strategic leader has learned to apply all six at once.

  16. Closing the Cybersecurity Skills Gap

    Directory of Open Access Journals (Sweden)

    Rebecca Vogel

    2016-05-01

    Full Text Available The current consensus is that there is a worldwide gap in skills needed for a competent cybersecurity workforce. This skills gap has implications for the national security sector, both public and private. Although the view is that this will take a concerted effort to rectify, it presents an opportunity for IT professionals, university students, and aspirants to take-up jobs in national security national intelligence as well military and law enforcement intelligence. This paper examines context of the issue, the nature of the cybersecurity skills gap, and some key responses by governments to address the problem. The paper also examines the emerging employment trends, some of the employment challenges, and what these might mean for practice. The paper argues that the imperative is to close the cyber skills gap by taking advantage of the window of opportunity, allowing individuals interested in moving into the cybersecurity field to do so via education and training.

  17. YOUTH EMPLOYMENT AND ENTREPRENEURIAL SKILLS ...

    African Journals Online (AJOL)

    Apusigah

    form of training and education in order to develop the relevant skills, knowledge and ..... entrepreneur aiming to provide a service or good that can capture a share of the market or even ..... improve performance, and maintain customers.

  18. Mindful movement and skilled attention

    Science.gov (United States)

    Clark, Dav; Schumann, Frank; Mostofsky, Stewart H.

    2015-01-01

    Bodily movement has long been employed as a foundation for cultivating mental skills such as attention, self-control or mindfulness, with recent studies documenting the positive impacts of mindful movement training, such as yoga and tai chi. A parallel “mind-body connection” has also been observed in many developmental disorders. We elaborate a spectrum of mindfulness by considering ADHD, in which deficient motor control correlates with impaired (disinhibited) behavioral control contributing to defining features of excessive distractibility and impulsivity. These data provide evidence for an important axis of variation for wellbeing, in which skillful cognitive control covaries with a capacity for skillful movement. We review empirical and theoretical literature on attention, cognitive control, mind wandering, mindfulness and skill learning, endorsing a model of skilled attention in which motor plans, attention, and executive goals are seen as mutually co-defining aspects of skilled behavior that are linked by reciprocal inhibitory and excitatory connections. Thus, any movement training should engage “higher-order” inhibition and selection and develop a repertoire of rehearsed procedures that coordinate goals, attention and motor plans. However, we propose that mindful movement practice may improve the functional quality of rehearsed procedures, cultivating a transferrable skill of attention. We adopt Langer’s spectrum of mindful learning that spans from “mindlessness” to engagement with the details of the present task and contrast this with the mental attitudes cultivated in standard mindfulness meditation. We particularly follow Feldenkrais’ suggestion that mindful learning of skills for organizing the body in movement might transfer to other forms of mental activity. The results of mindful movement training should be observed in multiple complementary measures, and may have tremendous potential benefit for individuals with ADHD and other

  19. Mindful Movement and Skilled Attention

    Directory of Open Access Journals (Sweden)

    Dav eClark

    2015-06-01

    Full Text Available Bodily movement has long been employed as a foundation for cultivating mental skills such as attention, self-control or mindfulness, with recent studies documenting the positive impacts of mindful movement training, such as yoga and tai chi. A parallel mind-body connection has also been observed in many developmental disorders. We elaborate a spectrum of mindfulness by considering ADHD, in which deficient motor control correlates with impaired (disinhibited behavioral control contributing to defining features of excessive distractibility and impulsivity. These data provide evidence for an important axis of variation for wellbeing, in which skillful cognitive control covaries with a capacity for skillful movement. We review empirical and theoretical literature on attention, cognitive control, mind wandering, mindfulness and skill learning, endorsing a model of skilled attention in which motor plans, attention, and executive goals are seen as mutually co-defining aspects of skilled behavior that are linked by reciprocal inhibitory and excitatory connections. Thus, any movement training should engage higher-order inhibition and selection and develop a repertoire of rehearsed procedures that coordinate goals, attention and motor plans. However, we propose that mindful movement practice may improve the functional quality of rehearsed procedures, cultivating a transferrable skill of attention. We adopt Langer’s spectrum of mindful learning that spans from mindlessness to engagement with the details of the present task and contrast this with the mental attitudes cultivated in standard mindfulness meditation. We particularly follow Feldenkrais’ suggestion that mindful learning of skills for organizing the body in movement might transfer to other forms of mental activity. The results of mindful movement training should be observed in multiple complementary measures, and may have tremendous potential benefit for individuals with ADHD and other

  20. Stick, Carrot and Skill Acquisition

    DEFF Research Database (Denmark)

    Filges, Trine; Larsen, Birthe

    This paper examines the macroeconomic effects of youth unemployment programmes in the form of vocational training (YUPs), developing a two sector general equilibrium model featuring matching frictions and worker-firm wage bargaining for skilled workers.......This paper examines the macroeconomic effects of youth unemployment programmes in the form of vocational training (YUPs), developing a two sector general equilibrium model featuring matching frictions and worker-firm wage bargaining for skilled workers....

  1. [SIAM conference on optimization

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-10

    Abstracts are presented of 63 papers on the following topics: large-scale optimization, interior-point methods, algorithms for optimization, problems in control, network optimization methods, and parallel algorithms for optimization problems.

  2. The Change of Planned Happenstance Skills and Its Association with Career-Related Variables during School-to-Work Transition

    Science.gov (United States)

    Yang, NaYeon; Yaung, Huk; Noh, Hyunkyung; Jang, Sun Hee; Lee, Bora

    2017-01-01

    The current study examined how planned happenstance skills (i.e., curiosity, flexibility, persistence, optimism, and risk-taking) changed during school-to-work transition and how career-related variables were associated with the initial levels and change rates of planned happenstance skills. In a sample of 307 South Korean college students, all…

  3. Retention of Vaginal Breech Delivery Skills Taught in Simulation.

    Science.gov (United States)

    Stone, Heather; Crane, Joan; Johnston, Kathy; Craig, Catherine

    2018-02-01

    The optimal frequency of conducting simulation training for high-acuity, low-frequency events in obstetrics and gynaecology residency programs is unknown. This study evaluated retention over time of vaginal breech delivery skills taught in simulation, by comparing junior and senior residents. In addition, the residents' subjective comfort level to perform this skill clinically was assessed. This prospective cohort study included 22 obstetrics and gynaecology residents in a Canadian residency training program. Digital recordings were completed for pre-training, immediate post-training, and delayed (10-26 weeks later) post-training intervals of a vaginal breech delivery simulation, with skill assessment by a blinded observer using a binary checklist. Residents also completed questionnaires to assess their subjective comfort level at each interval. Junior and senior residents had significant improvements in vaginal breech delivery skills from the pre-training assessment to both the immediate post-training assessment (junior, P simulation 10-26 weeks later, although a decline in skills occurred over this time period. Comfort level was positively affected and retained. These results will aid in determining the frequency of simulation teaching for high-acuity, low-frequency events in a residency simulation curriculum. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  4. Building Skills for All in Australia: Policy Insights from the Survey of Adult Skills. OECD Skills Studies

    Science.gov (United States)

    OECD Publishing, 2017

    2017-01-01

    Australia's overall performance in the Survey of Adult Skills (PIAAC) ranges from average to very good. However, three million adults, representing one-fifth of the working age population, have low literacy and/or numeracy skills. Building Skills for All in Australia describes the characteristics of the low-skilled and discusses the consequences…

  5. The Optimal Performance of Employees

    Directory of Open Access Journals (Sweden)

    Marta Pureber

    2000-12-01

    Full Text Available The Revoz company set itself the following task: we will enable also our blue colllar workers to improve their ski lls and be promoted. So we started implementing a project of step-by-step education, The Optimal Performance of Employees. Improving the workers' knowledges and skills guarantees higher independence, responsibility, faster development of organisation structure and more trust between the employees because of better communication in bas ic working units. The Optimal Performance program offers blue collar workers a possibility to  improve their professional skills, to adapt themselves to changes in managing, organisation, technology and new approaches to their tasks. The program is based on the following principles: • voluntariness-every worker can participate; • adapted pedagogical approach - based on routine workers' activities, the rhythm of education is adapted to their abilities of absorbing new knowledges; • including of managerial structure - before, du ring and after education; • connection with working environment - the contents of education are linked to a specific working environment.

  6. Assessing Writing Skills

    Science.gov (United States)

    Narayanan, M.

    2013-12-01

    This is an encore presentation of what was presented at the 2012 AGU International Conference. It was entitled: 'ASSESSING CORE COMPETENCIES.' The poster presentation, however, has been redesigned and reorganized with new, revised perspectives. The importance of ASSESSMENT principles has been emphasized. Catherine Palomba and Trudy Banta offer the following definition of assessment, adapted from one provided by Marchese in 1987. Assessment is the systematic collection, review, and use of information about educational programs undertaken for the purpose of improving student learning and development. (Palomba and Banta 1999). Educational institutions are committing substantial resources to the establishment of dedicated technology-based laboratories, so that they will be able to accommodate and fulfill students' desire to master certain of these specific skills. This type of technology-based instruction may raise some fundamental questions about the core competencies of the student learner. Some of the most important questions are : 1. Is the utilization of these fast high-powered computers and user-friendly software programs creating a totally non-challenging instructional environment for the student learner ? 2. Can technology itself all too easily overshadow the learning outcomes intended ? 3. Are the educational institutions simply training students how to use technology rather than educating them in the appropriate field ? 4. Are we still teaching content-driven courses and analysis oriented subject matter ? 5. Are these sophisticated modern era technologies contributing to a decline in the Critical Thinking Capabilities of the 21st century technology-savvy students ? The author tries to focus on technology as a tool and not on the technology itself. He further argues that students must demonstrate that they have the have the ability to think critically before they make an attempt to use technology in a chosen application-specific environment. The author further

  7. Social skills programmes for schizophrenia.

    Science.gov (United States)

    Almerie, Muhammad Qutayba; Okba Al Marhi, Muhammad; Jawoosh, Muhammad; Alsabbagh, Mohamad; Matar, Hosam E; Maayan, Nicola; Bergman, Hanna

    2015-06-09

    Social skills programmes (SSP) are treatment strategies aimed at enhancing the social performance and reducing the distress and difficulty experienced by people with a diagnosis of schizophrenia and can be incorporated as part of the rehabilitation package for people with schizophrenia. The primary objective is to investigate the effects of social skills training programmes, compared to standard care, for people with schizophrenia. We searched the Cochrane Schizophrenia Group's Trials Register (November 2006 and December 2011) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. We inspected references of all identified studies for further trials.A further search for studies has been conducted by the Cochrane Schizophrenia Group in 2015, 37 citations have been found and are currently being assessed by review authors. We included all relevant randomised controlled trials for social skills programmes versus standard care involving people with serious mental illnesses. We extracted data independently. For dichotomous data we calculated risk ratios (RRs) and their 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated mean differences (MD) and 95% CIs. We included 13 randomised trials (975 participants). These evaluated social skills programmes versus standard care, or discussion group. We found evidence in favour of social skills programmes compared to standard care on all measures of social functioning. We also found that rates of relapse and rehospitalisation were lower for social skills compared to standard care (relapse: 2 RCTs, n = 263, RR 0.52 CI 0.34 to 0.79, very low quality evidence), (rehospitalisation: 1 RCT, n = 143, RR 0.53 CI 0.30 to 0.93, very low quality evidence) and participants' mental state results (1 RCT, n = 91, MD -4.01 CI -7.52 to -0.50, very low quality evidence) were better in the group receiving social skill programmes

  8. Training Students’ Science Process Skills through Didactic Design on Work and Energy

    Science.gov (United States)

    Ramayanti, S.; Utari, S.; Saepuzaman, D.

    2017-09-01

    Science Process Skills (SPS) has not been optimally trained to the students in the learning activity. The aim of this research is finding the ways to train SPS on the subject of Work and Energy. One shot case study design is utilized in this research that conducted on 32 students in one of the High Schools in Bandung. The students’ SPS responses were analyzed by the development SPS based assessment portfolios. The results of this research showed the didactic design that had been designed to training the identifying variables skills, formulating hypotheses, and the experiment activity shows the development. But the didactic design to improve the students’ predicting skills shows that the development is still not optimal. Therefore, in the future studies need to be developed the didactic design on the subject Work and Energy that exercising these skills.

  9. The marginal cost of public funds is one at the optimal tax system

    NARCIS (Netherlands)

    B. Jacobs (Bas)

    2018-01-01

    textabstractThis paper develops a Mirrlees framework with skill and preference heterogeneity to analyze optimal linear and nonlinear redistributive taxes, optimal provision of public goods, and the marginal cost of public funds (MCF). It is shown that the MCF equals one at the optimal tax system,

  10. Specific skills and social competence in schizophrenia

    NARCIS (Netherlands)

    Appelo, M.T.; van Nieuwenhuizen, C.J.; Emmelkamp, P.M.G.; Slooff, C.J.; Louwerens, J.W.

    1992-01-01

    Generalization of skills is a major problem in social skills training for schizophrenic patients. Assessment of skills is mostly not based on objective indices of specific skill deficits. The results of this study show that global competence of schizophrenics can be differentiated from specific

  11. SPECIFIC SKILLS AND SOCIAL COMPETENCE IN SCHIZOPHRENIA

    NARCIS (Netherlands)

    APPELO, MT; WOONINGS, FMJ; VANNIEUWENHUIZEN, CJ; EMMELKAMP, PMG; SLOOFF, CJ; LOUWERENS, JW

    Generalization of skills is a major problem in social skills training for schizophrenic patients. Assessment of skills is mostly not based on objective indices of specific skill deficits. The results of this study show that global competence of schizophrenics can be differentiated from specific

  12. Empowering Engineering Students through Employability Skills

    Directory of Open Access Journals (Sweden)

    Urvashi Kaushal

    2016-12-01

    Full Text Available A professional course like engineering strives to get maximum number of its students placed through campus interviews. While communication skills have been added in all the engineering courses with the aim to improve their performance in placement, the syllabus mostly concentrates on the development of four language skills. The students are not made aware of the employability skills and their significance. the increasing competition makes it imperative that apart from a regular degree certain skills are required by engineers. Industries while advertising for various posts even mention essential skills required along with the essential qualification. However skills and the significance of skills while applying for jobs or while facing interviews is a topic which is rarely given consideration while preparing for job interviews or while entering the job market. This paper intends to enlist the importance of skills and why students need to be aware of the skills they possess and how they can work on packaging their candidature around a few skills.  Different profession requires different skills and if students identify their skills or acquire certain skills they can unquestionably have an added advantage in the interview and placement. Hence, this paper intends to enlist the skills, the importance of skills, ways to create awareness of individual skills specifically in engineering students who will step into the industry in near future.

  13. Government services: sector skills assessment 2012

    OpenAIRE

    Parry, Jon; Ojo, Adegbola

    2012-01-01

    The aim of this report is to provide authoritative labour market intelligence (LMI) for the Government Services sector to inform the strategic decision making of national governments in the development of employment and skills policy. It is one of 15 UK Sector Skills Assessment (SSA) reports produced by Sector Skills Councils and the UK Commission for Employment and Skills.

  14. Employability Skills: The Demands of the Workplace.

    Science.gov (United States)

    Leroux, Janice A.; Lafleur, Susan

    1995-01-01

    The Employability Skills Profile, critical work abilities identified by Canadian employers, was rated by 24 secondary teachers in Ontario. Personal management skills were rated most important, followed by academic and teamwork skills. Teaching of these skills was informal--absorbed through classroom policies and management practices. (SK)

  15. Wanted: Soft Skills for Today's Jobs

    Science.gov (United States)

    Hirsch, Barton J.

    2017-01-01

    Educating high school students for both college and career is difficult. Teaching trade skills seems alien to the academic culture. But new research indicates that soft skills are quite important to judgments of employability and that youth learn many soft skills in traditional academic subjects (e.g., literature). A focus on soft skills allows…

  16. Motivational state, reward value, and Pavlovian cues differentially affect skilled forelimb grasping in rats

    Science.gov (United States)

    de Clauser, Larissa; Kasper, Hansjörg; Schwab, Martin E.

    2016-01-01

    Motor skills represent high-precision movements performed at optimal speed and accuracy. Such motor skills are learned with practice over time. Besides practice, effects of motivation have also been shown to influence speed and accuracy of movements, suggesting that fast movements are performed to maximize gained reward over time as noted in previous studies. In rodents, skilled motor performance has been successfully modeled with the skilled grasping task, in which animals use their forepaw to grasp for sugar pellet rewards through a narrow window. Using sugar pellets, the skilled grasping task is inherently tied to motivation processes. In the present study, we performed three experiments modulating animals’ motivation during skilled grasping by changing the motivational state, presenting different reward value ratios, and displaying Pavlovian stimuli. We found in all three studies that motivation affected the speed of skilled grasping movements, with the strongest effects seen due to motivational state and reward value. Furthermore, accuracy of the movement, measured in success rate, showed a strong dependence on motivational state as well. Pavlovian cues had only minor effects on skilled grasping, but results indicate an inverse Pavlovian-instrumental transfer effect on movement speed. These findings have broad implications considering the increasing use of skilled grasping in studies of motor system structure, function, and recovery after injuries. PMID:27194796

  17. Skills methods to prevent smoking.

    Science.gov (United States)

    Schinke, S P; Gilchrist, L D; Schilling, R F; Snow, W H; Bobo, J K

    1986-01-01

    School health educators have devoted much attention to cigarette smoking. Recent years have seen the testing of interventions to prevent smoking. To date, controlled studies have not evaluated the added value of skills methods for preventing smoking. This article describes such an evaluation with sixth-grade students from two schools. Subjects were pretested and randomly assigned to receive conventional health education methods or to receive skills intervention. Both conditions included films, peer testimonials, discussions, and homework. Health education condition subjects additionally participated in oral quizzes, games, and debates. Skills condition subjects additionally learned problem-solving, self-instruction, and interpersonal communication methods. At postintervention, skills condition subjects, more than health education condition subjects, had better scores on measures of smoking-related knowledge, attitudes, and intentions. In addition, reported cigarette use, validated by biochemical data collection, was lower in the skills condition than in the health education condition at all postintervention measurements, including a 24-month follow-up. The article discusses the strengths, limits, and implications of the study for other smoking prevention efforts in schools.

  18. Social skills in dysphonic children.

    Science.gov (United States)

    Silva, Maíra da; Batista, Ana Priscila; Oliveira, Jáima Pinheiro de; Dassie-Leite, Ana Paula

    2012-01-01

    To obtain and analyze data from the social skills evaluation of dysphonic children. This is a cross-sectional and prospective study. Participants were 38 children enrolled in a public school, ranging in age from 7 to 11 years. They were separated into two groups: Study Group (SG)--19 dysphonic children; Control Group (CG)--19 non-dysphonic children. The groups were matched by gender and age range. Children with any history of organic vocal problems, according to the identification and investigation of general and vocal health questionnaire, which was answered by the legal guardian, were excluded. The Multimedia Social Skills Inventoire for Children (MUSSIC) was applied, which consists of 21 social interaction situations represented by photos, having a child as the leading figure. For each situation, the participant should select one out of three behaviors, putting themselves in the place of the main character. Each response corresponds to one out of three types of reaction: assertive, passive and aggressive. Data were statistically analyzed. There was no difference between the groups on the social skills evaluation results, that is, SG and CG children presented similar scores regarding assertiveness, aggressiveness and passiveness. Consequently, there was no difference on the subscales of the inventory regarding social skills. As for the SG, there was no relationship between the scores obtained on the MUSSIC and the severity of the voice disorder. It is not possible to determine specific behaviors of dysphonic children concerning social skills.

  19. Nuclear power - Sustainable development - Professional skill

    International Nuclear Information System (INIS)

    Comsa, Olivia; Paraschiva, M.V.; Banutoiu, Maria

    2002-01-01

    Sustainable development of society implies taking political decisions integrating harmoniously ingredients like these: - technological maturity; - socio-economic efficiency; - rational and equitable use of natural resources; - compliance with requirements concerning the environment and population; - professional ethics; - communications with the public and media; - professional skill; - public opinion acceptance. A rational analysis of these factors shows clearly that nuclear power appears to be an optimal ground for a sustainable power source besides the hydro and thermo-electric systems. Such a conclusion was confirmed by all types of analyses, methodologies or programs like for instance: MAED, WASP, FINPLAN, DECADES, ENPEP and more recently MESSAGE. The paper describes applications of these analytical methodologies for two scenarios of Cernavoda NPP future development. To find the optimal development strategy for the electric system, implying minimal costs the optimization analysis mode of the ELECSAM analysis module was used. The following conclusions were reached: - the majority of Romania's classical electrical stations are old; consequently, part of them should be decommissioned while others will be refurbished. Instead of installing new power groups these options will result in lowering the investment cost, as well as, in reduction of noxious gas emission; - the nuclear power system developed in Romania upon the CANDU technology appears to be one of the most performing and safe technology in the world. Cernavoda NPP Unit 1 commissioned on December 2, 1996 covers about 10% to 12% of the energy demand of the country. The CANDU systems offers simultaneously secure energy supply, safe operation, low energy costs and practically a zero impact upon the environment. The case study for Romania by means of DECADES project showed that the development program with minimal cost for electrical stations implies construction of new 706.5 MW nuclear units and new 660 MW

  20. Optimal income taxation with endogenous participation and search unemployment

    OpenAIRE

    Lehmann, Etienne; Parmentier, Alexis; van der Linden, Bruno

    2011-01-01

    This paper characterizes the optimal redistributive taxation when individuals are hetero- geneous in two exogenous dimensions: their skills and their values of non-market activities. Search-matching frictions on the labor markets create unemployment. Wages, labor demand and participation are endogenous. The government only observes wage levels. Under a Max- imin objective, if the elasticity of participation decreases along the distribution of skills, at the optimum, the average tax rate is in...

  1. Automated social skills training with audiovisual information.

    Science.gov (United States)

    Tanaka, Hiroki; Sakti, Sakriani; Neubig, Graham; Negoro, Hideki; Iwasaka, Hidemi; Nakamura, Satoshi

    2016-08-01

    People with social communication difficulties tend to have superior skills using computers, and as a result computer-based social skills training systems are flourishing. Social skills training, performed by human trainers, is a well-established method to obtain appropriate skills in social interaction. Previous works have attempted to automate one or several parts of social skills training through human-computer interaction. However, while previous work on simulating social skills training considered only acoustic and linguistic features, human social skills trainers take into account visual features (e.g. facial expression, posture). In this paper, we create and evaluate a social skills training system that closes this gap by considering audiovisual features regarding ratio of smiling, yaw, and pitch. An experimental evaluation measures the difference in effectiveness of social skill training when using audio features and audiovisual features. Results showed that the visual features were effective to improve users' social skills.

  2. Interactive Teaching in Interpersonal Skills

    DEFF Research Database (Denmark)

    Christensen, Jørgen Erik; Karhu, Markku; Christensen, Cecillia

    2013-01-01

    skills, leadership and awareness. Consequently, educational programs for teaching engineers should work with the fact that the capability of communicating with people with different background competences is important, nevertheless the engineering education has traditionally focused on technical skills...... to the CDIO (conceive, design, implement and operate) approach in the autumn of 2008. The CDIO pedagogy encouraged to develop an interactive course in interpersonal skills, where the students have to take an active part in the exercises as well as involve themselves in the interactive communication process....... The course consists of various exercises from which the participants will develop their awareness and knowledge of communication. It is the intention to give the students a personal understanding and idea of a different approach to communicating between people. The students evaluated the course, and the four...

  3. Vocational Education and Vocational Skills

    DEFF Research Database (Denmark)

    Madsen, Erik Skov

    , a framework of skills related to process tasks is developed. The paper and the presentation conclude that much more focus is needed on the development of vocational education and vocational skills in Denmark, the U.K, and in the U.S. and in China for employees to be able to handle future automated......Abstract: This paper and presentation is based on case studies in China, Mexico and Denmark. The paper identifies challenges posed to production companies by a lack of vocational skills and vocational education. The study is focusing on different types of production systems i.e. on manual, complex...... and automated production. The paper highlights how both China and Denmark have focused on theoretical rather than vocational education for more than a decade. Based on a combination of a literature review and field studies of cases, including studies of mass production and unmanned and automated production...

  4. Skill mismatch and skill use in developed countries: Evidence from the PIAAC study

    NARCIS (Netherlands)

    Allen, J.P.; Levels, M.; van der Velden, R.K.W.

    2013-01-01

    In this paper we develop and test a new set of measures of skill mismatches, based on data on skill levels and skill use in the domains of literacy and numeracy from the PIAAC project. The measures we develop represent the extent of skill use relative to one’s own skill level. We test the measures

  5. Two Reading Assessments for Youth in Alternative Basic Skills and Livelihood Skills Training Programs

    Science.gov (United States)

    Comings, John P.; Strucker, John; Bell, Brenda

    2017-01-01

    This article describes two assessment tools that have been used to assess the reading skills of youth participating in alternative basic skills and livelihood skills training programs. The Rapid Assessment of Reading Skills (RARS) was developed to identify potential participants who needed to improve their reading skills before beginning training…

  6. Improving the training process of highly skilled bodybuilders in the preparatory period, general preparatory phase

    Directory of Open Access Journals (Sweden)

    Olexandr Tyhorskyy

    2015-10-01

    Full Text Available Purpose: to improve the method of training highly skilled bodybuilders. Material and Methods: the study involved eight highly skilled athletes, members of the team of Ukraine on bodybuilding. Results: comparative characteristics of the most commonly used methods of training process in bodybuilding. Developed and substantiated the optimal method of training highly skilled bodybuilders during the general preparatory phase of the preparatory period, which can increase body weight through muscle athletes component. Conclusions: dynamic load factor to raise the intensity of training loads allows orientation help to increase volumes shoulder muscles

  7. Internet skills, sources of support, and benefiting from internet use

    NARCIS (Netherlands)

    van Deursen, Alexander Johannes Aloysius Maria; Courtois, Cédric; van Dijk, Johannes A.G.M.

    2014-01-01

    This study added communication Internet skills to an existing skill framework of operational, formal, information, and strategic skills. The study investigated how people deal with inadequate skill levels by identifying support sources. Furthermore, we investigated which of the Internet skills

  8. Communication training: Skills and beyond.

    Science.gov (United States)

    Deveugele, Myriam

    2015-10-01

    As communication is a central part of every interpersonal meeting within healthcare and research reveals several benefits of effective communication, we need to teach students and practitioners how to communicate with patients and with colleagues. This paper reflects on what and how to teach. In the previous century two major changes occurred: clinical relationship between doctor and patient became important and patients became partners in care. Clinicians experienced that outcome and especially compliance was influenced by the relational aspect and in particular by the communicative skills of the physician. This paper reflects on teaching and defines problems. It gives some implications for the future. Although communication skills training is reinforced in most curricula all over the word, huge implementation problems arise; most of the time a coherent framework is lacking, training is limited in time, not integrated in the curriculum and scarcely contextualized, often no formal training nor teaching strategies are defined. Moreover evidence on communication skills training is scarce or contradictory. Knowing when, what, how can be seen as an essential part of skills training. But students need to be taught to reflect on every behavior during every medical consultation. Three major implications can be helpful to overcome the problems in communication training. First research and education on healthcare issues need to go hand in hand. Second, students as well as healthcare professionals need a toolkit of basic skills to give them the opportunity not only to tackle basic and serious problems, but to incorporate these skills and to be able to use them in a personal and creative way. Third, personal reflection on own communicative actions and dealing with interdisciplinary topics is a core business of medical communication and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. KINERJA DOSEN DALAM MENINGKATKAN KEMAMPUAN AKADEMIK (HARD SKILL DAN PENGUASAAN KETERAMPILAN (SOFT SKILL PADA MAHASISWA PKK FKIP UNSYIAH

    Directory of Open Access Journals (Sweden)

    Zahraini Zahraini

    2014-02-01

    Full Text Available The performance of the lecturers is important factor in order to ensure the quality management of a college. The lecturers performance at PKK study program FKIP Unsyiahis truly play role in producing students not only work in government with satisfying academic grade (hard skill but also students must be able to create their own work field by possessing skill (soft skills to take over the world work. This study aims at knowing the ability, motivation, disciplines, responsibility, and supporting factors on the lecturers performance in improving academic competence and skill acquisition of the students at PKK, FKIP Unsyiah. This study used a qualitative approach through data collecting techniques i.e. documentation, observations , and interviews. The subjects of the research were the dean, deputy dean of academic affairs, the chairman of the PKK department, lecturers, laboratory chairman, and students. This study shows that 1 The ability of the lecturers in carrying out teaching can be seen through arrangement of the lecturing material, lecturing implementation, and evaluation. 2 Motivation in conducting lectures , that the PKK lecturers of FKIP Unsyiah have conducted real efforts to reach the decided aim, but few lecturers less motivated the students optimally, lack of guiding of the lecturers or their seniors as well as program chairman, action less than optimal motivation lecturer , received guidance from lecturers more senior or chief Prodi . 3 The lecturers discipline is reflected through factual time in implementing the lecture, obeying the obtain rules and conducting continuously. Lecturer’s discipline reflected by timeliness in implementing the course, follow the rules, and do it continuously. 4 The lecturer’s responsibility and commitment in implementing the lecturer can be seen through guiding the students in accordance with the main duty and its function. 5 Improving performance in academic competence and skill acquisition are

  10. Establishing Fire Safety Skills Using Behavioral Skills Training

    Science.gov (United States)

    Houvouras, Andrew J., IV; Harvey, Mark T.

    2014-01-01

    The use of behavioral skills training (BST) to educate 3 adolescent boys on the risks of lighters and fire setting was evaluated using in situ assessment in a school setting. Two participants had a history of fire setting. After training, all participants adhered to established rules: (a) avoid a deactivated lighter, (b) leave the training area,…

  11. Undergraduate Perceptions of Value: Degree Skills and Career Skills

    Science.gov (United States)

    Galloway, Kyle W.

    2017-01-01

    Recent data suggests that of the UK students graduating with a degree in chemistry in 2015, only 18.9% continued to employment as "Science Professionals". While this shows the wide range of employment that is available for chemistry graduates, it also highlights the need for them to have relevant transferable skills, rather than just the…

  12. Assessing Trainee Surgeons’ Nontechnical Skills

    DEFF Research Database (Denmark)

    Spanager, Lene; Konge, Lars; Dieckmann, Peter

    2015-01-01

    BACKGROUND: Trainee surgeons would benefit from regular, formative assessments to ensure they learn the nontechnical aspects of surgical performance. Non-Technical Skills for Surgeons in Denmark (NOTSSdk) is a tool to assess surgeons' nontechnical skills (NTS) during an operation. The aims...... of this study were to explore which parts of NOTSSdk supervisors use to assess trainee surgeons' NTS, to determine the internal consistency reliability of NOTSSdk, and to estimate how many operations were needed to obtain reliable ratings of a trainee surgeon's NTS. METHODS: A total of 12 supervisors from 2...

  13. SOME THOUGHTS ON WRITING SKILLS

    Directory of Open Access Journals (Sweden)

    Sim Monica Ariana

    2010-07-01

    Full Text Available Writing is one of the central pillars of language learning and should be of major interest and concern to teachers, students and researchers. This paper is intended to be a plea for writing and explores issues regarding instruction and evaluation of writing skills of nonnative speaker students. It examines expectations of nonnative speakers writing quality and performance on writing proficiency exams, as well. Finally, it is trying to ring a bell about this skill that has been neglected in spite of its importance when it comes to foreign language acquisition

  14. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  15. Knowledge and Skills for PISA

    DEFF Research Database (Denmark)

    Dohn, Nina Bonderup

    2007-01-01

    to the claims of PISA, PISA is not an assessment of the ‘knowledge and skills for life' of students, but only of ‘knowledge and skills in assessment situations'. Even this latter form of assessment is not fully reliable, however, because of problems at the level of concrete test items and because of an inherent......This article gives a critique of the methodology of OECD's Programme for International Student Assessment (PISA). It is argued that PISA is invalidated by the fact that the methodology chosen does not constitute an adequate operationalisation of the question of inquiry. Therefore, contrary...

  16. Do resident's leadership skills relate to ratings of technical skill?

    Science.gov (United States)

    Gannon, Samantha J; Law, Katherine E; Ray, Rebecca D; Nathwani, Jay N; DiMarco, Shannon M; D'Angelo, Anne-Lise D; Pugh, Carla M

    2016-12-01

    This study sought to compare general surgery research residents' survey information regarding self-efficacy ratings to their observed performance during a simulated small bowel repair. Their observed performance ratings were based on their leadership skills in directing their assistant. Participants were given 15 min to perform a bowel repair using bovine intestines with standardized injuries. Operative assistants were assigned to help assist with the repair. Before the procedure, participants were asked to rate their expected skills decay, task difficulty, and confidence in addressing the small bowel injury. Interactions were coded to identify the number of instructions given by the participants to the assistant during the repair. Statistical analyses assessed the relationship between the number of directional instructions and participants' perceptions self-efficacy measures. Directional instructions were defined as any dialog by the participant who guided the assistant to perform an action. Thirty-six residents (58.3% female) participated in the study. Participants who rated lower levels of decay in their intraoperative decision-making and small bowel repair skills were noted to use their assistant more by giving more instructions. Similarly, a higher number of instructions correlated with lower perceived difficulty in selecting the correct suture, suture pattern, and completing the entire surgical task. General surgery research residents' intraoperative leadership skills showed significant correlations to their perceptions of skill decay and task difficulty during a bowel repair. Evaluating resident's directional instructions may provide an additional individualized intraoperative assessment metric. Further evaluation relating to operative performance outcomes is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Optimal Taxation and Social Insurance in a Lifetime Perspective

    DEFF Research Database (Denmark)

    Bovenberg, A. Lans; Sørensen, Peter Birch

    Advances in information technology have improved the administrative feasibility of redistribution based on lifetime earnings recorded at the time of retirement. We study optimal lifetime income taxation and social insurance in an economy in which redistributive taxation and social insurance serve...... to insure (ex ante) against skill heterogeneity as well as disability risk. Optimal disability benefits rise with previous earnings so that public transfers depend not only on current earnings but also on earnings in the past. Hence, lifetime taxation rather than annual taxation is optimal. The optimal tax...

  18. Life Skills – Key to Success

    Directory of Open Access Journals (Sweden)

    Beena Johnson

    2017-10-01

    Full Text Available Life skills are the abilities for adaptive and positive behavior which enable the individuals to deal effectively with the challenges and stress of everyday life. Cognitive skills are used for analyzing information, personal skills help in self-management and inter-personal skills are needed for good communication and effective social interaction. These skills can be developed through scientific professional training. Life skills empower the adolescents to choose the best values and behaviors which are essential for positive health. Students who acquire life skills become better adjusted to the school environment and their academic performance will definitely improve. Their self esteem increases and they become capable of coping with the demands and challenges of daily life. Through repeated practicing, individuals can develop mastery over these skills. They learn to apply life skills in all problematic situations in real life and gain control over stressful situations easily.

  19. Correlations between technical skills and behavioral skills in simulated neonatal resuscitations.

    Science.gov (United States)

    Sawyer, T; Leonard, D; Sierocka-Castaneda, A; Chan, D; Thompson, M

    2014-10-01

    Neonatal resuscitation requires both technical and behavioral skills. Key behavioral skills in neonatal resuscitation have been identified by the Neonatal Resuscitation Program. Correlations and interactions between technical skills and behavioral skills in neonatal resuscitation were investigated. Behavioral skills were evaluated via blinded video review of 45 simulated neonatal resuscitations using a validated assessment tool. These were statistically correlated with previously obtained technical skill performance data. Technical skills and behavioral skills were strongly correlated (ρ=0.48; P=0.001). The strongest correlations were seen in distribution of workload (ρ=0.60; P=0.01), utilization of information (ρ=0.55; P=0.03) and utilization of resources (ρ=0.61; P=0.01). Teams with superior behavioral skills also demonstrated superior technical skills, and vice versa. Technical and behavioral skills were highly correlated during simulated neonatal resuscitations. Individual behavioral skill correlations are likely dependent on both intrinsic and extrinsic factors.

  20. A Shared Responsibility for Skills

    Science.gov (United States)

    Clough, Bert

    2011-01-01

    Co-investment between the state, employer, and employee is an intrinsic feature of most vocational and education training systems. The government's strategy is to "profoundly" shift responsibility for funding learning and skills from the state to individuals and businesses. At a time of stringent cuts in publicly-funded further education…

  1. Assessing Students' Technical Skill Attainment

    Science.gov (United States)

    Jorgensen, Haley

    2010-01-01

    The Wisconsin Technical College System (WTCS) is working to comply with the Carl D. Perkins Career and Technical Education Improvement Act of 2006 (Perkins) to ensure that its graduates have mastered the technical skills needed by business and industry. The legislation requires that each state identify and approve program assessment strategies…

  2. Engineering Science, Skills, and Bildung

    DEFF Research Database (Denmark)

    Christensen, Jens

    The background for the book is a quest for a thorough analysis of engineering, engineering science, and engineering education. Focusing on the concepts of engineering science, skills, and Bildung, the book investigates the real challenges that are confronting engineering today, and discusses how...

  3. Games for Mathematics Skill Practice.

    Science.gov (United States)

    Ludeman, Clinton; Sevier, Bonnie

    1982-01-01

    Multivision is designed to practice simple multiplication and division with one-digit numbers, and is played similarly to Sorry. Fraction Monopoly was designed to assist in practicing addition and subtraction skills with fractions, along with recognizing basic parts and matching numerals with pictorial representations, and is similar to Monopoly.…

  4. Hard Facts and Soft Skills

    Science.gov (United States)

    Terego, Alex

    2009-01-01

    The argument now raging in academic circles pits those who espouse teaching 21st century skills against those who believe that schools should be teaching explicit and well-sequenced content. This debate has largely been framed as an either-or proposition. In this author's view, portraying this debate as one between two mutually exclusive sides…

  5. Systematic Interviewing Skills. Typescript Manual.

    Science.gov (United States)

    Farley, Roy C.; Rubin, Stanford E.

    Part of a five-part package (see note) of training materials to teach interviewing skills to human services personnel, this typescript manual is intended for use as a visual reference to aid in understanding the taped dialogues of the packages tape/slide demonstrations of interview interaction, and for referral in class discussions. The typescript…

  6. Communications skills for CRM training

    Science.gov (United States)

    Shearer, M.

    1984-01-01

    A pilot training program in communication skills, listening, conflict solving, and task orientation, for a small but growing commuter airline is discussed. The interactions between pilots and management, and communication among crew members are examined. Methods for improvement of cockpit behavior management personnel relations are investigated.

  7. Building citizenship and life skills

    Directory of Open Access Journals (Sweden)

    Margaret Sinclair

    2005-01-01

    Full Text Available As displaced people are sheltered (some would say ‘warehoused’ in huge camps, is enough being done to help them acquire the life and survival skills to enable a future based on reconciliation, human rights and democratic governance?

  8. Does your Robot have Skills?

    DEFF Research Database (Denmark)

    Bøgh, Simon; Nielsen, Oluf Skov; Pedersen, Mikkel Rath

    2012-01-01

    This article presents a unifying terminology for task-level programming of highly flexible mobile ma- nipulators in industrial environments. With a terminology of tasks and object-centered skills, industrial applications are analyzed in the logistic and assistive domains. The analysis shows that ...

  9. Motor Skill Learning in Children.

    Science.gov (United States)

    Gabbard, Carl P.

    The purpose of this article is to briefly describe schema theory and indicate its relevance to early childhood development, with specific reference to children's acquisition of motor skills. Schema theory proposes an explanation of how individuals learn and perform a seemingly endless variety of movements. According to Schmidt (1975), goal…

  10. Community Living Skills Guide: Art.

    Science.gov (United States)

    Sobol, Sheila; Kreps, Alice Roelofs

    One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Art. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized persons to eventual…

  11. Development of managerial leadership skills

    OpenAIRE

    VEJVODOVÁ, Klára

    2013-01-01

    This work summarizes the most important theoretical approaches of leadership, describes the main styles leadership styles and task of managers in the organization, influences on the effectiveness of leadership, and how to develop leadership skills. The practical part applies this knowledge in practice and provides the particular company guidance of management development on the basis of data collected by questionnaire survey.

  12. Mathematical Games: Skill + Luck = Learning

    Science.gov (United States)

    Parsons, John

    2008-01-01

    Left to their own devices, many students are happy to work within their comfort zone of skill and understanding, a level where they are confident that they will achieve regular success. The job of the classroom teacher is to help students reach beyond this and to help them make this level their new comfort zone. Clearly, teachers need to employ a…

  13. New skills for entrepreneurial researchers

    NARCIS (Netherlands)

    Leloux, Mirjam; Popescu, Florentin; Koops, Andries

    2016-01-01

    Knowledge exchange between universities and business in collaborative/ contractual research and public-private partnerships has become far more significant. These developments instigate new mind-sets and skills for academic researchers, that should be able to translate their new technological

  14. Integrating Communication and Skills Training.

    Science.gov (United States)

    Bean, Robert

    1994-01-01

    Discusses the need for effective basic language, literacy, numeracy and other communication skills to support all workforce development programs. The general cultural bias towards these programs has marginalized them and is reflected in policy, curriculum and practice. Adjustments are needed in the approaches to the new climate of workplace…

  15. Assessing Business Student Thinking Skills

    Science.gov (United States)

    Smith, Gerald F.

    2014-01-01

    The development of student thinking skills is a major goal of business education. As with other such goals, student outcomes assessment must be undertaken to measure goal achievement. Thinking is difficult to teach; it is also difficult to assess. The purpose of this article is to improve management educators' understanding of student thinking…

  16. Walking the bridge: Nursing students' learning in clinical skill laboratories.

    Science.gov (United States)

    Ewertsson, Mona; Allvin, Renée; Holmström, Inger K; Blomberg, Karin

    2015-07-01

    Despite an increasing focus on simulation as a learning strategy in nursing education, there is limited evidence on the transfer of simulated skills into clinical practice. Therefore it's important to increase knowledge of how clinical skills laboratories (CSL) can optimize students' learning for development of professional knowledge and skills, necessary for quality nursing practice and for patient safety. Thus, the aim was to describe nursing students' experiences of learning in the CSL as a preparation for their clinical practice. Interviews with 16 students were analysed with content analysis. An overall theme was identified - walking the bridge - in which the CSL formed a bridge between the university and clinical settings, allowing students to integrate theory and practice and develop a reflective stance. The theme was based on categories: conditions for learning, strategies for learning, tension between learning in the skills laboratory and clinical settings, and development of professional and personal competence. The CSL prepared the students for clinical practice, but a negative tension between learning in CSL and clinical settings was experienced. However, this tension may create reflection. This provides a new perspective that can be used as a pedagogical approach to create opportunities for students to develop their critical thinking. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Labor and skills gap analysis of the biomedical research workforce

    Science.gov (United States)

    Mason, Julie L.; Johnston, Elizabeth; Berndt, Sam; Segal, Katie; Lei, Ming; Wiest, Jonathan S.

    2016-01-01

    The United States has experienced an unsustainable increase of the biomedical research workforce over the past 3 decades. This expansion has led to a myriad of consequences, including an imbalance in the number of researchers and available tenure-track faculty positions, extended postdoctoral training periods, increasing age of investigators at first U.S. National Institutes of Health R01 grant, and exodus of talented individuals seeking careers beyond traditional academe. Without accurate data on the biomedical research labor market, challenges will remain in resolving these problems and in advising trainees of viable career options and the skills necessary to be productive in their careers. We analyzed workforce trends, integrating both traditional labor market information and real-time job data. We generated a profile of the current biomedical research workforce, performed labor gap analyses of occupations in the workforce at regional and national levels, and assessed skill transferability between core and complementary occupations. We conclude that although supply into the workforce and the number of job postings for occupations within that workforce have grown over the past decade, supply continues to outstrip demand. Moreover, we identify practical skill sets from real-time job postings to optimally equip trainees for an array of careers to effectively meet future workforce demand.—Mason, J. L., Johnston, E., Berndt, S., Segal, K., Lei, M., Wiest, J. S. Labor and skills gap analysis of the biomedical research workforce. PMID:27075242

  18. Labor and skills gap analysis of the biomedical research workforce.

    Science.gov (United States)

    Mason, Julie L; Johnston, Elizabeth; Berndt, Sam; Segal, Katie; Lei, Ming; Wiest, Jonathan S

    2016-08-01

    The United States has experienced an unsustainable increase of the biomedical research workforce over the past 3 decades. This expansion has led to a myriad of consequences, including an imbalance in the number of researchers and available tenure-track faculty positions, extended postdoctoral training periods, increasing age of investigators at first U.S. National Institutes of Health R01 grant, and exodus of talented individuals seeking careers beyond traditional academe. Without accurate data on the biomedical research labor market, challenges will remain in resolving these problems and in advising trainees of viable career options and the skills necessary to be productive in their careers. We analyzed workforce trends, integrating both traditional labor market information and real-time job data. We generated a profile of the current biomedical research workforce, performed labor gap analyses of occupations in the workforce at regional and national levels, and assessed skill transferability between core and complementary occupations. We conclude that although supply into the workforce and the number of job postings for occupations within that workforce have grown over the past decade, supply continues to outstrip demand. Moreover, we identify practical skill sets from real-time job postings to optimally equip trainees for an array of careers to effectively meet future workforce demand.-Mason, J. L., Johnston, E., Berndt, S., Segal, K., Lei, M., Wiest, J. S. Labor and skills gap analysis of the biomedical research workforce. © FASEB.

  19. Gender: Its relation to Mathematical Creative Thinking Skill

    Science.gov (United States)

    Permatasari, H. R.; Wahyudin, W.

    2017-09-01

    Mathematical creative thinking skill is one of the most important capabilities in the present century, both for men and women. One of the current issues is about gender and how gender mainstreaming can be realized optimally. The purpose of this study is to determine the comparison of the mathematical creative thinking skill increasing between male and female students after the application of Team Games Tournament (TGT) learning. This research was conducted at 28 students in the 4th grade of an elementary school in Bandung City. The research method used is quasi experiment because it is aimed to test wether there are differences in mathematical creative thinking skill improving between male and female students after being treatment in the form of learnig with TGT. The result of this research is that there is no difference in mathematical creative thinking skill improving between male and female students after the application of TGT learning. It is influenced by some factors such as how the teacher treats male and female with the same treatment in learning process. Recommendation of this research that can be done further research about this topic more deeply. Beside that, the teacher especially in elementary school can use the TGT learning application to reduce the gap between male and female students during the learning process.

  20. 海绵窦内颅神经血液供应显微外科解剖研究%The blood supply of the intracavernous cranial nerves: a microsurgical anatomy study.

    Institute of Scientific and Technical Information of China (English)

    吴建东; 惠国桢; 夏春林

    2001-01-01

    Objective To minimize injurying of the blood supply of intracavernous cranial nerves during microsurgical operation on cavernous sinus. Methods 50 adult cadaver brains include cavernous sinus were dissected in detail under anatomical microscope. Results (1) The oculomotor nerve received branches from the inferolateral trunk in 90% of the specimens. (2) The proximal trochlear nerver received branches from the inferolateral trunk in 74% of the specimens and from the tentorial artery of the meningohypophyseal trunk in 26%. The distal half was supplied mainly by the branches from the inferolateral trunk. (3) In the region of Dorellos canal, the proximal part of the abducens nerve received branches from the dorsal meningeal artery. The middle and distal parts received branches from the inferolateral trunk. (4) The ophthalmic and proximal maxillary segments of the trigeminal nerve received branches from the inferolateral trunk. The medial part of ganglion received branches from inferolateral trunk and the tentorial artery. The middle part of it received branches from the inferolateral trunk. The lateral part of it received branches from either the inferolateral trunk or the middle meningeal artery. Conclusions The inferolateral trunk play an important role in the blood supply of the intracavernous cranial nerves. We should preserve the blood supply to the cranial nerves during cavernous sinus surgery, thus minimizing postoperative cranial nerve deficits.%目的 为减少海绵窦显微外科手术时损伤海绵窦内颅神经血供而研究这些颅神经的血液供应解剖。方法 50具成人尸体海绵窦标本,在解剖显微镜下解剖和分析。结果 (1)90侧(占90%)的标本示动眼神经由颈内动脉的下外侧动脉分支供血;(2)滑车神经近段有74侧(占74%)的标本示其接受下外侧动脉的分支供血,有26侧(占26%)的标本示其接受脑膜垂体动脉分支天幕动脉的供血,滑车神经远段主要由

  1. CityVille: collaborative game play, communication and skill development in social networks

    Directory of Open Access Journals (Sweden)

    María-Esther Del-Moral Pérez

    2014-01-01

    Full Text Available This paper has as its aim to analyze how CityVille, a videogame hosted on Facebook and oriented to the construction of a virtual city, can favor collaboration between gamers along with the exchange of strategies, equally contributing to learning transfer and skill acquisition. The first step consists in identifying the opportunities which the said game can offer in order to develop skills and promote learning formats linked with planning and resource management, after which a presentation is made of the opinions expressed by a sample of gamers (N=105 –belonging to the Fans-CityVille community– about the priorities established by them to communicate with their neighbors and the skills that they believe to have acquired playing this game. 85.7% of them state that they communicate with others to share strategies and expand their city. Unlike women, who value collaboration, men prioritize competition. Designing their city has enhanced a number of gamer skills in different proportions: creative skills (71.4%; organizational ones (68.0%; skills associated with decision-making and problem-solving (67.0%; and interpersonal skills through interaction with others (61.9%. The CityVille game mode favors skill development and helps to create a ludic atmosphere of collaboration and optimal strategy exchange through communication between neighbors by strengthening their mutual relationships. Its formula moves away from the often-criticized competitive practices of other games.  

  2. Attitudes towards transferable skills in medical undergraduates.

    Science.gov (United States)

    Whittle, S R; Eaton, D G

    2001-02-01

    Changes to the style of medical teaching will place a greater responsibility on individual medical students to manage their own learning, highlighting the need for students to develop good so-called 'transferable' skills at an early stage in their undergraduate career. To assess the attitudes of first year undergraduates towards transferable skills, and investigate the gender difference in these attitudes. To assess the contribution of their first year course to skills development. First year students, enrolled on a traditional-style course. A questionnaire asking the students to consider: (a) the importance of named transferable skills for medicine; (b) their own ability in these areas; and (c) the influence of their first year course. All students, irrespective of gender, regarded transferable skills as very important to medicine, rating organizational skills and self-learning skills as most important. Overall, students have a high level of confidence in their own skills. Male students rated their overall level of skills more highly than women. In particular they rated their information handling, managing self-learning and technical skills more highly. Students feel that their first year course has enhanced their skills in most areas. Our results suggest that students will feel equipped to succeed in a learning system which places the onus on them to take responsibility for their own learning. They clearly believe that they have the necessary skills for independent learning. The study highlights the need to enhance students' self-evaluation skills.

  3. Low skilled work, Work Life experiences and Learner identity

    DEFF Research Database (Denmark)

    Kondrup, Sissel

    on an educational optimism not necessarily shared by the target groups . I therefore wanted to examine how an unskilled work life conditions the experience of a need for and possibility to participate in different kind of formal, informal and non-formal learning activities related to the job, and how...... this constitutes a certain learner identity. By conducting narrative interviews with 23 employees in 6 different small and medium sized private manufacturing companies in Denmark, I have focused on peoples work life stories, how they entered the labour marked, what kind of jobs and tasks they have undertaken, how...... their jobs have developed and how they have obtained the skills required in their jobs. I have thus examined the specific work life experiences of people working in unskilled jobs, most likely to be marginalised in a labour marked characterised by skill bias, and how these experiences constitutes a certain...

  4. Skill Learning and Skill Transfer Mediated by Cooperative Haptic Interaction.

    Science.gov (United States)

    Avila Mireles, Edwin Johnatan; Zenzeri, Jacopo; Squeri, Valentina; Morasso, Pietro; De Santis, Dalia

    2017-07-01

    It is known that physical coupling between two subjects may be advantageous in joint tasks. However, little is known about how two people mutually exchange information to exploit the coupling. Therefore, we adopted a reversed, novel perspective to the standard one that focuses on the ability of physically coupled subjects to adapt to cooperative contexts that require negotiating a common plan: we investigated how training in pairs on a novel task affects the development of motor skills of each of the interacting partners. The task involved reaching movements in an unstable dynamic environment using a bilateral non-linear elastic tool that could be used bimanually or dyadically. The main result is that training with an expert leads to the greatest performance in the joint task. However, the performance in the individual test is strongly affected by the initial skill level of the partner. Moreover, practicing with a peer rather than an expert appears to be more advantageous for a naive; and motor skills can be transferred to a bimanual context, after training with an expert, only if the non-expert subject had prior experience of the dynamics of the novel task.

  5. Urban College Graduates: Their Investments in and Returns for Strong Quantitative Skills, Social Capital Skills, and Soft Skills

    Science.gov (United States)

    Haynes, Marie Ellen

    2010-01-01

    This case study examined strong quantitative skills, social capital skills, and soft skills of urban college graduates using data from the Multi-City Study of Urban Inequality Household Survey. The urban college graduates lived in Atlanta, Boston, or Los Angeles and had bachelor's, master's, PhD, and professional degrees. Among the three skills…

  6. Hands-On Skills for Caregivers

    Science.gov (United States)

    ... A + A You are here Home Hands-On Skills for Caregivers Printer-friendly version When you’re ... therapist who can help you develop your transferring skills. Allow for their reality Remember to accept your ...

  7. Parenting Skills: Tips for Raising Teens

    Science.gov (United States)

    ... adult is no small task. Understand the parenting skills you need to help guide your teen. By ... teen and encourage responsible behavior. Use these parenting skills to deal with the challenges of raising a ...

  8. Visual perception skills testing: preliminary results

    CSIR Research Space (South Africa)

    Smith, Andrew C

    2009-02-01

    Full Text Available Good visual perception skills are important in the effective manipulation of Tangible User Interfaces. This paper reports on the application of a test set researchers have developed specifically to quantify the visual perception skills of children...

  9. Medicare Provider Payment Data - Skilled Nursing Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

  10. THE RELEVANCE OF COMMUNICATION SKILLS TO LIBRARY ...

    African Journals Online (AJOL)

    therefore discusses the importance, and the need for librarians to possess ... Keywords: Communication skills, Library Service, Services Delivery, Information .... The use of communication skills to enhance quality service delivery is not.

  11. Marketing your skills outside the hospital walls.

    Science.gov (United States)

    Waxman, K T

    1998-08-01

    As patient care shifts from acute care to outpatient and community home health care, nurses need to repackage their skills. A personal skill assessment on an ongoing basis helps nurses plan for the future.

  12. Skills and Content: Coordinating the Classroom.

    Science.gov (United States)

    Erlich, Howard; Kennedy, Mary Lynch

    1983-01-01

    Describes Ithaca College's project incorporating basic skills development in traditional liberal arts courses. Explains the techniques used to develop skills in reading and studying, writing, speaking and listening, and language and reasoning in courses from nine disciplines. (DMM)

  13. Fine and gross motor skills: The effects on skill-focused dual-tasks.

    Science.gov (United States)

    Raisbeck, Louisa D; Diekfuss, Jed A

    2015-10-01

    Dual-task methodology often directs participants' attention towards a gross motor skill involved in the execution of a skill, but researchers have not investigated the comparative effects of attention on fine motor skill tasks. Furthermore, there is limited information about participants' subjective perception of workload with respect to task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. The task required participants to stand 15 feet from a projector screen which depicted virtual targets and fire a modified Glock 17 handgun equipped with an infrared laser. Participants performed the primary shooting task alone (control), or were also instructed to focus their attention on a gross motor skill relevant to task execution (gross skill-focused) and a fine motor skill relevant to task execution (fine skill-focused). Results revealed that workload was significantly greater during the fine skill-focused task for both skill levels, but performance was only affected for the lesser-skilled participants. Shooting performance for the lesser-skilled participants was greater during the gross skill-focused condition compared to the fine skill-focused condition. Correlational analyses also demonstrated a significant negative relationship between shooting performance and workload during the gross skill-focused task for the higher-skilled participants. A discussion of the relationship between skill type, workload, skill level, and performance in dual-task paradigms is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. COGNITIVE SKILLS: A Modest Way of Learning through Technology

    OpenAIRE

    Satya Sundar SETHY

    2012-01-01

    Learning is an ever-present phenomenon. It takes place irrespective of time and place. It engages learners in their interested topic/content. Learning absorbs many skills, such as; reading skills, writing skills, technological skills, emotional skills, behavioral skills, cognitive skills, and language skills. Out of all these, cognitive skills play significant role for apprehending a concept and comprehending a discussion. In the context of distance education (DE), learning never restrains to...

  15. Portability of Technical Skills Across Occupations

    OpenAIRE

    Mukuni, Joseph Siloka

    2012-01-01

    In the literature, much has been reported about skill shortages in the labor market and many solutions have been suggested but most of them do not appear to work well for developing countries. This study investigated the place of portable technical skills as an option for addressing skill shortages, particularly in developing countries. The objective of the study was to determine whether different occupations have portable technical skills, which graduates of workforce development programs ca...

  16. Soft And Hard Skills of Social Worker

    OpenAIRE

    HANTOVÁ, Libuše

    2011-01-01

    The work deals with soft and hard skills relevant to the profession of social worker. The theoretical part at first evaluates and analyzes important soft and hard skills necessary for people working in the field of social work. Then these skills are compared. The practical part illustrates the use of soft and hard skills in practice by means of model scenes and deals with the preferences in three groups of people ? students of social work, social workers and people outside the sphere, namely ...

  17. Securing the skills for a nuclear future

    International Nuclear Information System (INIS)

    Bonser, D.R.

    2004-01-01

    There is a growing concern regarding the loss of skills in some countries. There is also a negative trend in university entrants studying science and engineering. The labour market can respond to skills shortage. But we should not invent jobs just to retain skills. Capture and retention of knowledge is the key. We need to be able to explain clean-up as exciting and demanding of nuclear skills

  18. Obesity and Skill Attainment in Early Childhood

    OpenAIRE

    John Cawley; C. Katharina Spiess

    2008-01-01

    This paper investigates the association between obesity and skill attainment in early childhood (aged 2-4 years). Data from the German Socio-Economic Panel Study are used to estimate models of developmental functioning in four critical areas (verbal skills, activities of daily living, motor skills, and social skills) as a function of various measures of weight (including body mass index and obesity) controlling for a rich set of child, parent, and family characteristics. The findings indicate...

  19. Enhancing undergraduate students’ communications skills

    DEFF Research Database (Denmark)

    Jørgensen, Merete; Witt, Klaus; Fridorff-Jens, Peter Kindt

    2014-01-01

    ,Monika Bullinger,Matthias Rose, Sylke Andreas.Enhancing medical students' communication skills: development and evaluation of an undergraduate training program.Published online 2012 March 24. doi: 10.1186/1472-6920-12-16 2.William T. Branch, Jr, MD; David Kern, MD; Paul Haidet, MD, MPH; Peter Weissmann, MD......19729 Abstract Title: Enhancing undergraduate students communications skills Abstract Authors: •Merete Jorgensen, Copenhagen University , Family Medicine , Copenhagen •Klaus Witt, Research Unit , Family Medicine , Copenhagen •Peter Kindt Fridorff-Jens, Copenhagen University , IT-unit , Copenhagen...... Abstract Presenter(s): •Merete Jorgensen, Copenhagen University , Family Medicine , Øster Farigmagsgade 5 , 1014 , K , Denmark , mejor@sund.ku.dk Abstract: Background Being teachers in Clinical Course of Family Medicine since 1995, we have developed two schemes for communication analysing purposes called...

  20. Skill learning from kinesthetic feedback.

    Science.gov (United States)

    Pinzon, David; Vega, Roberto; Sanchez, Yerly Paola; Zheng, Bin

    2017-10-01

    It is important for a surgeon to perform surgical tasks under appropriate guidance from visual and kinesthetic feedback. However, our knowledge on kinesthetic (muscle) memory and its role in learning motor skills remains elementary. To discover the effect of exclusive kinesthetic training on kinesthetic memory in both performance and learning. In Phase 1, a total of twenty participants duplicated five 2 dimensional movements of increasing complexity via passive kinesthetic guidance, without visual or auditory stimuli. Five participants were asked to repeat the task in the Phase 2 over a period of three weeks, for a total of nine sessions. Subjects accurately recalled movement direction using kinesthetic memory, but recalling movement length was less precise. Over the nine training sessions, error occurrence dropped after the sixth session. Muscle memory constructs the foundation for kinesthetic training. Knowledge gained helps surgeons learn skills from kinesthetic information in the condition where visual feedback is limited. Copyright © 2016 Elsevier Inc. All rights reserved.