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Sample records for surgeon general david

  1. Generalized Stillinger--David Potential

    CERN Document Server

    Zhyganiuk, Igor

    2012-01-01

    We present an improved version of the Stillinger--David polarization potential of the intermolecular interaction in water. A clear algorithm of construction of a function describing the oxygen-hydrogen interaction in water molecules is formulated. A new approach to the modeling of a function screening the charge-dipole interaction on small distances is developed. To describe the long-range asymptotics of the intermolecular potential, the bare Stillinger--David potential is supplemented by a term related to the interaction of dipole moments of oxygen ions. In addition, we introduce a term involving a deformation of the electron shells of oxygen ions to the polarization component. These corrections allow us to successfully reproduce all essential results of quantum mechanical calculations of the interaction energy for water molecules obtained by Clementi. Analyzing the behavior of the dipole moment of a water molecule as a function of the intermolecular distance, we obtain the estimate of irreducible two-partic...

  2. [International Relationship of Japanese General Thoracic Surgeons].

    Science.gov (United States)

    Okumura, Meinoshin

    2017-01-01

    Japanese thoracic surgeons have created personal relationship with European and North American surgeons. During the last 10 years, official relation between Japanese Association for Chest Surgery(JACS) and European Society of Thoracic Surgeons (ESTS) has been established besides personal interaction, and communication among the thoracic surgeons in Asia was prompted through Asia Thoracoscopic Surgery Education Program( ATEP). International relationship through academic associations is expected to contribute to encouraging general thoracic surgeons.

  3. [General surgeons and varicose vein surgery].

    Science.gov (United States)

    Morales-Cuenca, Germán; Moreno-Egea, Alfredo; Aguayo-Albasini, Jose Luis

    2009-04-01

    Chronic venous insufficiency is a highly prevalent condition, with significant health and economic repercussions. Although important therapeutic developments have been introduced in recent years, the majority are dealt with by general surgeons in national health hospitals. These surgeons do not have the required and continuous training, and continue to perform classic surgery techniques. Also, their presence at scientific, organisational meetings and training is almost nil. We present an update on developments in phlebology, and tapping into the preliminary results of a national survey, we reflect on the current status of phlebology and beyond for those general surgeons who should have a role in this field.

  4. The Core Competencies for General Orthopaedic Surgeons.

    Science.gov (United States)

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

    2017-01-18

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

  5. Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education

    Science.gov (United States)

    2010-01-01

    Background Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. Methods The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. Results A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p < 0.03) from the converging learning style found in the residents and faculty. The predominant learning styles of the residents and faculty were convergent and accommodative, with no statistically significant differences between the residents and the faculty. Conclusions We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents. PMID:20591159

  6. Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education.

    Science.gov (United States)

    Engels, Paul T; de Gara, Chris

    2010-06-30

    Surgical education is evolving under the dual pressures of an enlarging body of knowledge required during residency and mounting work-hour restrictions. Changes in surgical residency training need to be based on available educational models and research to ensure successful training of surgeons. Experiential learning theory, developed by David Kolb, demonstrates the importance of individual learning styles in improving learning. This study helps elucidate the way in which medical students, surgical residents, and surgical faculty learn. The Kolb Learning Style Inventory, which divides individual learning styles into Accommodating, Diverging, Converging, and Assimilating categories, was administered to the second year undergraduate medical students, general surgery resident body, and general surgery faculty at the University of Alberta. A total of 241 faculty, residents, and students were surveyed with an overall response rate of 73%. The predominant learning style of the medical students was assimilating and this was statistically significant (p learning style found in the residents and faculty. The predominant learning styles of the residents and faculty were convergent and accommodative, with no statistically significant differences between the residents and the faculty. We conclude that medical students have a significantly different learning style from general surgical trainees and general surgeons. This has important implications in the education of general surgery residents.

  7. Perfil profesional del cirujano general: Professional profile General surgeon

    Directory of Open Access Journals (Sweden)

    José Antonio Hernández Varea

    2009-09-01

    Full Text Available El perfil del egresado es un elemento clave para confección del currículo, y constituye el modelo de las características, conocimientos y habilidades que se aspira formar en el futuro cirujano. Dicho perfil debe responder a las necesidades sociales, permitir la planificación del proceso docente-educativo y concretar la relación universidad-sociedad. En el presente artículo se analizan, a partir de la situación actual, los antecedentes históricos del modelo de formación del especialista en cirugía general, la definición de cirugía general, los principales cambios internacionales en el modelo de formación de cirujanos y las funciones generales que se deben considerar en el perfil profesional del cirujano y su cumplimiento en el programa de cirugía.Graduate profile is a key element to make the curriculum, and it is a representation of the possible features, knowledges, and abilities in the future surgeon. Such profile must to account for social needs, to allow the planning of teaching-educational process, and to stay exactly the university-society relation. In present paper, from a current situation, are analyzed the historical backgrounds of training model of general surgery specialist, general surgery definition, the main international changes in the training model of surgeon, and its fulfillment in surgery program.

  8. Advocacy--answering old mail. Canadian Association of General Surgeons.

    Science.gov (United States)

    Keith, R G

    1999-06-01

    Since its inception in 1977, the Canadian Association of General Surgeons (CAGS) has struggled with its responsibility to represent general surgeons in practices across this country. The CAGS has tended to be mute in the presentation of many of its accomplishments, which have improved the role of specialists in community practice, training programs and the subspecialties of general surgery. With the forthcoming changes in direction for the Royal College of Physicians and Surgeons of Canada, based on a recent external survey, the CAGS has a golden opportunity to advocate for a clear identity, autonomous from the Royal College for the purposes of scientific meetings, continuing professional development, scientific and practice affiliation with other surgical specialty societies, and new developments with corporate sector support for advancements in science technology and education. Advocacy for general surgery must be stressed as the priority for the CAGS into the future.

  9. H1N1 Message from the Acting Surgeon General

    Centers for Disease Control (CDC) Podcasts

    2009-05-13

    In this podcast, Acting Surgeon General Dr. Steven Galson discusses what you can do to protect yourself from H1N1 flu.  Created: 5/13/2009 by U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC).   Date Released: 5/13/2009.

  10. Surgeon General's Workshop on Health Promotion and Aging.

    Science.gov (United States)

    1988-01-01

    The following report contains all of the recommendations of the working group on oral health that met during the Surgeon General's Workshop on Health Promotion and Aging, March 20-23, 1988, in Washington, DC, under the direction of Surgeon General C. Everett Koop and a number of leaders in geriatrics and gerontology. The working group was composed of 17 specialists, including Frank Martin, technical manager; Scott Presson, reporter; James Beck, chairman; and group members Ronald Ettinger, Jean Frazier, Mary Alice Gaston, Helen Gift, Neville Gilmore, Marc Heft, H. Asuman Kiyak, James Marshall, Roseann Mulligan, Linda Niessen, Vincent Rogers, Michele Saunders, Ruth Seigler, and Hongying Wang. The report also includes dental-related recommendations made by the working groups on medication, preventive health services, alcohol, physical fitness and exercise, injury prevention, mental health, smoking cessation, and nutrition. Eight workshops have been sponsored by the surgeon general since his appointment to office in 1981; this workshop was the first to focus on dentistry and aging.

  11. U.S. Surgeon General Calls for Crackdown on E-Cig Use in Teens

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162443.html U.S. Surgeon General Calls for Crackdown on E-Cig ... product among American teens, according to a new U.S. Surgeon General's report that calls for a crackdown ...

  12. Colorectal surgeons teaching general surgery residents: current challenges and opportunities.

    Science.gov (United States)

    Schmitz, Connie C; Chow, Christopher J; Rothenberger, David A

    2012-09-01

    Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training. In this article, we review important national developments with respect to graduate medical education that impact resident supervision, curriculum implementation, resident assessment, and program evaluation. We argue that establishing a culture of respect and professionalism in today's teaching environment is one of the most important legacies that surgical educators can leave for the coming generation. Faculty role modeling and the process of socializing residents is highlighted. We review the American College of Surgeons' Code of Professional Conduct, summarize some of the current strategies for teaching and assessing professionalism, and reflect on principles of motivation that apply to resident training both for the trainee and the trainer.

  13. Ureteral inguinal hernia: an uncommon trap for general surgeons

    Science.gov (United States)

    Yahya, Zarif; Al-habbal, Yahya; Hassen, Sayed

    2017-01-01

    Inguinal hernias involving the ureter, a retroperitoneal structure, is an uncommon phenomenon. It can occur with or without obstructive uropathy, the latter posing a trap for the unassuming general surgeon performing a routine inguinal hernia repair. Ureteral inguinal hernia should be included as a differential when a clinical inguinal hernia is diagnosed concurrently with unexplained hydronephrosis, renal failure or urinary tract infection particularly in a male. The present case describes a patient with a known ureteroinguinal hernia who proceeded to having a planned hernia repair and ureteric protection. The case is a reminder that when faced with an unexpected finding such an indirect sliding inguinal hernia, extreme care should be taken to ensure that no structures are inadvertently damaged and that a rare possibility is the entrapment of the ureter in the inguinal canal. PMID:28275027

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

    African Journals Online (AJOL)

    2014-08-03

    Aug 3, 2014 ... the data had been presented reflecting different institutions (without necessarily ... is no formal training in clinical governance to equip graduating surgeons for a ... shifting healthcare landscape, in SA and globally. Martin D ...

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

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-08-01

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

  16. A First Hard Look at the Surgeon General's Report on Television and Violence.

    Science.gov (United States)

    Cater, Douglass; Strickland, Stephen

    In March of 1972 the Aspen Program on Communications and Society convened a meeting which brought together the Surgeon General, staff members connected with the Surgeon General's Report on Television and Violence, and social scientists. The purpose of the meeting was to evaluate the Report, which had just been issued. This conference report…

  17. Emergent management of postpartum hemorrhage for the general and acute care surgeon

    Directory of Open Access Journals (Sweden)

    Blankenship Charles L

    2009-11-01

    Full Text Available Abstract Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.

  18. My Family Health Portrait, A tool from the Surgeon General | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. My Family Health Portrait, A tool from the Surgeon General ... use Why is it important to know my family medical history? Your family medical history is a ...

  19. Colorectal Surgeons Teaching General Surgery Residents: Current Challenges and Opportunities

    National Research Council Canada - National Science Library

    Schmitz, Connie; Chow, Christopher; Rothenberger, David

    2012-01-01

    Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training...

  20. Information retrieval patterns and needs among practicing general surgeons: a statewide experience.

    OpenAIRE

    Shelstad, K R; Clevenger, F W

    1996-01-01

    Information retrieval has progressed from a reliance on traditional print sources to the modern era of computer databases and online networks. Surgeons, many from remote areas not served by professional medical libraries, must develop and maintain skills in information retrieval and management in both electronic and standard formats. One hundred thirty-three New Mexico general surgeons were surveyed to identify their information-seeking patterns in five areas: retrieval purposes, retrieval so...

  1. Breast conserving surgery versus mastectomy: cancer practice by general surgeons in Iran

    Directory of Open Access Journals (Sweden)

    Hashemi Esmat

    2005-04-01

    Full Text Available Abstract Background There appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran. Methods A structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences. Results In all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS and this was significantly associated with their breast cancer case load (P Conclusion The findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance.

  2. Colorectal Surgeons Teaching General Surgery Residents: Current Challenges and Opportunities

    OpenAIRE

    Schmitz, Connie C.; Chow, Christopher J.; Rothenberger, David A

    2012-01-01

    Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training. In this article, we review important national developments with respect to graduate medical education that impact resident supervision, curriculum implementation, resident assessment, and program evaluation. We argue that establishing a culture of respect and professionalism in today's...

  3. [Abdominal compartment syndrome: survey on the awareness of Portuguese general surgeons].

    Science.gov (United States)

    Costa, Sílvia; Gomes, Aline; Graça, Susana; Ferreira, António; Fernandes, Gonçalo; Esteves, Joana; Costa, Alexandre; Fernandes, Paula; Castelões, Paula; Maciel, Jorge

    2011-12-01

    The Abdominal Compartment Syndrome (ACS) is a clinical entity recognized for over a century, but only recently its risk criteria, monitorization and treatment have been defined by the World Society of the Abdominal Compartment Syndrome (WSACS). The general surgeon's involvement is vital since this syndrome is common in surgical patients and because its treatment may culminate in a laparostomy. 250 questionnaires of 17 questions were distributed among general surgeons attending the XXVIII Portuguese Congress of Surgery. The data were analyzed using SPSS® v16. We received 36,4% (91) of the delivered questionnaires, most of which from male surgeons (63,7%), from central hospitals (75,8%), working 42 h per week (70.3%), whose average of age was 38 years. About half of the respondents received training in Intensive Care Units. All surgeons had already heard about measuring the Intra- abdominal Pressure (IAP), which was being performed at 89% of their hospitals. About 40% of surgeons only admitted intra-abdominal hypertension above 20 mmHg (only 22% indicated the correct value of 12 mmHg). 36,3% of surgeons suggested that a decompressive laparostomy must be carried out for primary ACS if IAP greater then 20 mmHg with new organ failure; 36.3% favoured the "Vacuum-pack"-like system, and 56% only re-operate the patients "as needed". 48,4% of surgeons had already performed decompressive laparostomy, 66% of which had residence training in a ICU (p = 0,005). Respondents also pointed an average mortality related to ACS of 81% without laparostomy, and a reduction to 38,5% after performing that procedure. Only 26% of the surgeons were aware of the WSACS consensus definitions and recommendations, of those, 83% had already performed a laparostomy (Pdivulgation.

  4. Information retrieval patterns and needs among practicing general surgeons: a statewide experience.

    Science.gov (United States)

    Shelstad, K R; Clevenger, F W

    1996-10-01

    Information retrieval has progressed from a reliance on traditional print sources to the modern era of computer databases and online networks. Surgeons, many from remote areas not served by professional medical libraries, must develop and maintain skills in information retrieval and management in both electronic and standard formats. One hundred thirty-three New Mexico general surgeons were surveyed to identify their information-seeking patterns in five areas: retrieval purposes, retrieval sources, barriers to access, techniques used, and continuing education needs. Ninety-nine (74.4%) surgeons responded to the survey. Ninety-five percent utilize professional meetings, the medical literature, and physician colleagues as information sources. Only 17% utilize the outreach services of the state's only medical school library. Common retrieval barriers were practice demands (71%), isolation from medical schools (30%), computer illiteracy (28%), and rural environment (25%). Continuing education topics related to information management would be valuable to 61% of the surgeons. Sixty-nine percent believe their current ability to access biomedical information is adequate, despite most frequently accessing their personal libraries for information related to decision-making or patient management. These data suggest that, despite significant information needs, surgeons have not embraced newer forms of information retrieval. It is imperative that surgeons acquire and maintain modern information retrieval skills as a means of remaining up-to-date in their profession. Professional surgical organizations and medical librarians should collaborate on these continuing education ventures.

  5. Drunk Driving. Surgeon General's Workshop. Proceedings (Washington, D.C., December 14-16, 1988).

    Science.gov (United States)

    Janus Associates.

    This volume presents solutions, recommendations, and strategies in eleven interrelated areas considered at the Surgeon General's Workshop on Drunk Driving held in Washington, D.C. in December of 1988. Lists of the members of the Workshop Planning Committee and members of the federal advisory group on follow-up activities for the workshop are…

  6. Caution: Alcohol Advertising and the Surgeon General's Alcohol Warnings May Have Adverse Effects on Young Adults.

    Science.gov (United States)

    Blood, Deborah J.; Snyder, Leslie B.

    A study investigated the effects of the newly introduced Surgeon General's alcohol warnings and advertisements on college students. One hundred fifty-nine undergraduates in communication sciences at the University of Connecticut viewed slides of alcohol products, with or without advertisements and warnings. Following the viewings, subjects filled…

  7. Canadian Hepatitis C Look-Back Investigation to Detect Transmission from an Infected General Surgeon

    Directory of Open Access Journals (Sweden)

    Meenakshi Dawar

    2010-01-01

    Full Text Available BACKGROUND: In February 2007, a general surgeon in Charlottetown, Prince Edward Island, tested positive for hepatitis C virus (HCV. The surgeon’s infection onset date could not be determined; however, episodic hepatic enzyme elevations were first detected in November 2004 and again in February 2007. HCV transmission during surgery, alhough rare, has been documented. A phased look-back HCV screening program was conducted to detect HCV transmission from this surgeon to patients who underwent the highest-risk procedures in the three years before his positive test.

  8. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  9. Comparison of surgical outcomes among infants in neonatal intensive care units treated by pediatric surgeons versus general surgeons: The need for pediatric surgery specialists.

    Science.gov (United States)

    Boo, Yoon Jung; Lee, Eun Hee; Lee, Ji Sung

    2017-01-31

    This study compared the outcomes of infants who underwent surgery in neonatal intensive care units by pediatric surgeons and by general surgeons. This was a retrospective study of infants who underwent surgery in neonatal intensive care units between 2010 and 2014. A total of 227 patients were included. Of these patients, 116 were operated on by pediatric surgeons (PS) and 111 were operated on by general surgeons (GS). The outcome measures were the overall rate of operative complications, unplanned reoperation, mortality rate, length of stay, operative time, and number of total number of operative procedures. The overall operative complication rate was higher in the GS group compared with the PS group (18.7% vs. 7.0%, p=0.0091). The rate of unplanned reoperations was also higher in the GS group (10.8% vs. 3.5%, p=0.0331). The median operation time (90min vs. 75min, p=0.0474) and median length of stay (24days vs. 18days, p=0.0075) were significantly longer in the GS group. The adjusted odd ratios of postoperative complications for GS were 2.9 times higher than that of PS (OR 2.90, p=0.0352). The operative quality and patient outcomes of the PS group were superior to those of the GS group. III. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Hwang, Hamish

    2009-06-01

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

  11. Role of the General Surgeon in the Early Diagnosis and Treatment of Charcot Foot.

    Science.gov (United States)

    Sellés Dechent, Rafael; Rueda Alcárcel, Camilo; Primo Romaguera, Vicent; Martínez Caamaño, Asunción; Asencio Arana, Francisco

    2015-05-01

    The Charcot foot (CF) consists of a progressive deterioration of the bones and joints, most common in diabetic patients with advanced neuropathy. The great problem is that can be confused with other processes, delaying the diagnosis and specific treatment. The aim is to analyze the cases of CF diagnosed in our hospital and especially to highlight the role of the general surgeon. Retrospective study of all registered cases diagnosed of CF between the diabetic population of our Department of Health. A review of the literature was performed. From 2008 to 2012, there 7 cases of CF were diagnosed (prevalence 1:710). Two of the patients were diagnosed erroneously of cellulitis. The average time of delay in the diagnosis was 10 weeks (minimum 1, maximum 24). The initial treatment was immobilization of the extremity. Once the edema was eliminated, an offload orthesis was placed according to Sanders's anatomical classification. Evolution was favorable in 5 patients, 1 patient needed amputation, and other one died of acute cardiac pathology. The CF is a more frequent pathology than we believe. The general surgeon is the fundamental prop in the diagnosis and initial treatment. Before the presence of inflammation and edema of the foot in a patient with diabetes and severe neuropathy, once cellulitis, osteomyelitis, and TVP are ruled out, Charcot neuroarthropathy should be considered. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Joseph Lovell, MD (1788-1836): First US army surgeon general.

    Science.gov (United States)

    Craig, Stephen C

    2016-08-01

    Joseph Lovell, trained in medicine at Harvard and in military medicine/surgery by the War of 1812, became the first Surgeon General to sit on the reorganised army staff at the tender age of 29 in 1818. With a keen intellect, medical acumen, and wartime experiences for his tools and a close supporting relationship with Commanding General Jacob Jennings Brown and Secretary of War John C Calhoun (1728-1850), Lovell constructed an efficient and effective organisational and administrative framework for the new Medical Department of the US Army. Moreover, he not only redefined the role of the American military physician but also established the professional dignity, respectability and value of the medical officer among line officers and staff. Lovell's 18-year tenure came to an abrupt end, but the operational framework he created became both foundation and legacy for his successors.

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

    Science.gov (United States)

    Hwang, Hamish

    2009-01-01

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

  14. Career satisfaction among general surgeons in Canada: a qualitative study of enablers and barriers to improve recruitment and retention in general surgery.

    Science.gov (United States)

    Ahmed, Najma; Conn, Lesley Gotlib; Chiu, Mary; Korabi, Bochra; Qureshi, Adnan; Nathens, Avery B; Kitto, Simon

    2012-11-01

    To understand what influences career satisfaction among general surgeons in urban and rural areas in Canada in order to improve recruitment and retention in general surgery. Semistructured interviews were conducted with 32 general surgeons in 2010 who were members of the Canadian Association of General Surgeons and who currently practice in either an urban or rural area. Interviews explored factors contributing to career satisfaction, as well as suggestions for preventive, screening, or management strategies to support general surgery practice. Findings revealed that both urban and rural general surgeons experienced the most satisfaction from their ability to resolve patient problems quickly and effectively, enhancing their sense of the meaningfulness of their clinical practice. The supportive relationships with colleagues, trainees, and patients was also cited as a key source of career satisfaction. Conversely, insufficient access to resources and a perceived disconnect between hospital administration and clinical practice priorities were raised as key "systems-level" problems. As a result, many participants felt alienated from their work by these systems-level barriers that were perceived to hinder the provision of high-quality patient care. Career satisfaction among both urban and rural general surgeons was influenced positively by the social aspects of their work, such as patient and colleague relationships, as well as a perception of an increasing amount of control and autonomy over their professional commitments. The modern general surgeon values a balance between professional obligations and personal time that may be difficult to achieve given the current system constraints.

  15. Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents.

    Science.gov (United States)

    Mizrahi, Ido; Mazeh, Haggi; Levy, Yair; Karavani, Gilad; Ghanem, Muhammad; Armon, Yaron; Vromen, Amos; Eid, Ahmed; Udassin, Raphael

    2013-04-01

    Appendectomy is the most common urgent procedure in children, and surgical outcomes may be affected by the surgeon's experience. This study's aim is to compare appendectomy outcomes performed by pediatric surgeons (PSs) and general surgery residents (GSRs). A retrospective review of all patients younger than 16y treated for appendicitis at two different campuses of the same institution during the years 2008-2009 was performed. Appendectomies were performed by PS in one campus and GSR in the other. Primary end points included postoperative morbidity and hospital length of stay. During the study period, 246 (61%) patients were operated by senior GSR (postgraduate year 5-7) versus 157 (39%) patients by PS. There was no significant difference in patients' characteristics at presentation to the emergency room and the rate of appendeceal perforation (11% versus 15%, P=0.32), and noninfectious appendicitis (5% versus 5% P=0.78) also was similar. Laparoscopic surgery was performed more commonly by GSR (16% versus 9%, P=0.02) with shorter operating time (54±1.5 versus 60±2.1, P=0.01). Interestingly, the emergency room to operating room time was shorter for GSR group (419±14 versus 529±24min, P<0.001). The hospital length of stay was shorter for the GSR group (4.0±0.2 versus 4.5±0.2, P=0.03), and broad-spectrum antibiotics were used less commonly (20% versus 53%, P<0.0001) and so was home antibiotics continuation (13% versus 30%, P<0.0001). Nevertheless, postoperative complication rate was similar (5% versus 7%, P=0.29) and so was the rate of readmissions (2% versus 5%, P=0.52). The results of this study suggest that the presence of a PS does not affect the outcomes of appendectomies. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. David Garcia

    Institute of Scientific and Technical Information of China (English)

    郭华艳(翻译)

    2009-01-01

    丹麦哥本哈根Henning Larsen建筑事务所合伙人,David Garcia Studio拥有者。他是建筑师,也是教育家,在刚刚举办的以“ID-ENTITY多重身份实体”为主题的北欧艺术节上,

  17. Pattern of traumatic brain injury treated by general surgeons in a tertiary referral hospital.

    Science.gov (United States)

    Chattopadhyay, Shankar Das; Karmakar, Nisith Chandra; Sengupta, Ritankar; SenGupta, Tamal Kanti; Ray, Debasis; Basus, Shibaji

    2013-09-01

    The number of polytrauma patient with associated brain injury or commonly referred as 'head injury' has increased tremendously in recent times courtesy to road traffic accident or other causes. This prospective observational study was conducted in patients of head injury admitted through emergency in the department of general surgery in NRS Medical College, Kolkata during the year 2011 to determine the pattern of head injury patients admitted and nature of intervention. A total number of 3861 patients were admitted in a single year. Obviously this represents the tip of the iceburg. Traumatic brain injury was the highest in the age group of 31-40 years (33.5%) followed by 21-30 years (29.1%) in the most fruitful phase of life. The traumatic brain injury death was more common in males. The maximum number of cases was from rural areas ie, farmers and labours. To minimise the morbidity and mortality resulting from head injury there is need for better maintenance of roads, improvement of road visibility and lighting, rigid enforcement of traffic rules and imparting road safety education to school children. Despite valiant efforts and advancement in medical sciences and infrastructure in the form of neurosurgery departments and trauma care units to cope with the changing world of trauma, there still remains a huge responsibility and a definite part to be played by the general surgeons to manage head injury patient even in tertiary hospitals.

  18. David Hull's generalized natural selection as an explanation for scientific change

    Science.gov (United States)

    Little, Michelle Yvette

    2001-10-01

    Philosophers of science such as Karl Popper and Thomas Kuhn have employed evolutionary idiom in describing scientific change. In Science as a Process (1988) Hull makes evolutionary theory explanatorily applicable. He modifies key evolutionary terms in order that both biological evolution and scientific change are instances of a general selection process. According to Hull, because of naturally-existing competition for credit among researchers and the professional lineages they constitute, scientists are constrained to cooperate and collaborate. This process entails two important philosophical consequences. First, it allows for a natural justification of why the sciences can provide objective empirical knowledge. Second, appreciating its strength means that a philosophical analysis of scientific change is solidly difficult features to combine. I work on strengthening two weaknesses in Hull's arguments. First, operating in his analysis is an unexplicated notion of ``information'' running parallel to the equally opaque notion of genetic information. My third chapter provides a clear account of ``genetic information'' whose usefulness extends beyond the assistance it can render Hull as a clear concept is needed in biological contexts as well. The fourth and fifth chapters submit evidence of scientific change from radio astronomy. Hull insists on empirical backing for philosophical theses but his own book stands to suffer from selection effects as it offers cases drawn from a single subspecialty in the biological sciences. I found that in the main scientists and the change they propel accords well with Hull's explanation. However, instances of major change reveal credit- and resource-sharing to a degree contrary with what Hull would expect. My conclusion is that the naturalness of competition, instantiated during the course of standardized and relatively ``normal'' scientific research, is not the norm during periods of new research and its uncertain standards of

  19. The 2014 Surgeon General's report: commemorating the 50th Anniversary of the 1964 Report of the Advisory Committee to the US Surgeon General and updating the evidence on the health consequences of cigarette smoking.

    Science.gov (United States)

    Alberg, Anthony J; Shopland, Donald R; Cummings, K Michael

    2014-02-15

    The question of whether cigarette smoking was associated with lung cancer was central to the expansion of epidemiology into the study of chronic diseases in the 1950s. The culmination of this era was the 1964 report of the Advisory Committee to the Surgeon General, a landmark document that included an objective synthesis of the evidence of the health consequences of smoking according to causal criteria. The report concluded that cigarette smoking was a cause of lung cancer in men and sufficient in scope that "remedial action" was warranted at the societal level. The 2014 Surgeon General's report commemorates the 50th anniversary of the 1964 report. The evidence on the health consequences of smoking has been updated many times in Surgeon General's reports since 1964. These have summarized our increasingly greater understanding of the broad spectrum of the deleterious health effects of exposure to tobacco smoke across most major organ systems. In turn, this evidence has been translated into tobacco control strategies implemented to protect the public's health. The Surgeon General report process is an enduring example of evidence-based public health in practice. Substantial progress has been made, but cigarette smoking remains one of the most pressing global health issues of our time.

  20. General surgeon's antibiotic stewardship: Climbing the Rogers Diffusion of Innovation Curve-Prospective Cohort Study.

    Science.gov (United States)

    Rizan, Chantelle; Phee, Jaewon; Boardman, Charlotte; Khera, Goldie

    2017-04-01

    The primary aim of this study was to establish concordance of general surgeon's prescribing practice with local IV-oral antibiotic guidelines. The secondary aim was to evaluate the effect of introducing educational antibiotic measures. The Rogers Diffusion of Innovation Model was used to explore the adoption of antibiotic stewardship practices. In this prospective, cohort study, data was collected on 100 pre and 100 post awareness intervention programme patients. The educational intervention comprised raising awareness of a) the guidelines b) pre-intervention results c) introducing an IV-oral antibiotic prompt sheet. The concordance with local guidelines was compared between pre- and post-intervention groups using Fisher's Exact Test or Pearson's Chi Test (SPSS Statistics V22). The concordance of general surgical doctors with local IV-oral antibiotic guidelines was poor and did not improve significantly following the awareness intervention programme. There was no uptake of the antibiotic prompt sheet. There was a trend towards increase in the number of patients switched from IV to oral antibiotics at 48-72 h and significant increase (p review IV antibiotics. Antibiotic governance measures failed to inspire even an initial group of innovators to use the antibiotic prompt sheets. It appears educational measures are effective in improving prescribing behavior and intent amongst a group of early adopters, but this fails to reach a critical mass. In order to improve antibiotic governance and embark upon the Rogers Diffusion of Innovation Curve, more must be done to engage general surgical doctors in timely, judicious antibiotic prescribing. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Prevention of orofacial clefts caused by smoking: implications of the Surgeon General's report.

    Science.gov (United States)

    Honein, Margaret A; Devine, Owen; Grosse, Scott D; Reefhuis, Jennita

    2014-11-01

    According to the 2014 Surgeon General's Report, smoking in early pregnancy can cause orofacial clefts. We sought to examine the implications of this causal link for the potential prevention of orofacial clefts in the United States. Using published data on the strength of the association between orofacial clefts and smoking in early pregnancy and the prevalence of smoking at the start of pregnancy, we estimated the attributable fraction for smoking as a cause of orofacial clefts. We then used the prevalence of orofacial clefts in the United States to estimate the number of orofacial clefts that could be prevented in the United States each year by eliminating exposure to smoking during early pregnancy. We also estimated the financial impact of preventing orofacial clefts caused by maternal smoking based on a published estimate of attributable healthcare costs through age 10 for orofacial clefts. The estimated attributable fraction of orofacial clefts caused by smoking in early pregnancy was 6.1% (95% uncertainty interval 4.4%, 7.7%). Complete elimination of smoking in early pregnancy could prevent orofacial clefts in approximately 430 infants per year in the United States, and could save an estimated $40.4 million in discounted healthcare costs through age 10 for each birth cohort. Understanding the magnitude of the preventable burden of orofacial clefts related to maternal smoking could help focus smoking cessation efforts on women who might become pregnant. © 2014 Wiley Periodicals, Inc.

  2. General versus vascular surgeon: impact of a vascular fellowship on clinical practice, surgical case load, and lifestyle.

    Science.gov (United States)

    Franz, Randall W

    2010-02-01

    An applicant shortage for vascular surgery (VS) residencies exists despite an increase in available training positions created to meet the growing demands for vascular surgeons. After 3 years of practice as an American Board of Surgery (ABS)-certified/board-eligible general surgeon, the author of this study attended an accredited 1-year VS training fellowship and received an ABS certificate of Added Qualifications in VS. The purpose of this review was to investigate the implications completing a vascular fellowship has had on VS procedure patterns, vascular procedure competency, clinical practice, career, and lifestyle with the aim of attracting trainees to the field of VS. The author's operative logs were reviewed retrospectively to summarize vascular procedures performed before and after the vascular fellowship. Statistical analysis was performed comparing the types and volume of vascular procedures before and after the vascular fellowship. Changes in professional career and personal life also were examined. The author performed 401 vascular procedures during 2.8 years as a general surgeon. In the first 3.4 years after the vascular fellowship, vascular procedure volume increased to 1563. The mean number of vascular procedures performed per year increased from 143.2 as a general surgeon to 459.7 as a vascular surgeon. The three major differences in vascular procedures occurring after the vascular fellowship were (1) a threefold increase in the number of vascular procedures performed, (2) a shift from major open to venous and endovascular procedures, and (3) an increase in case complexity. Specializing in VS also has resulted in increased career opportunities, more career satisfaction, a direct financial benefit, and more flexibility for lifestyle and family. Because of these positive changes, the author encourages medical students and residents interested in VS to explore the specialty early, seek vascular surgeons to serve as mentors, and enter one of the new VS

  3. Changing guidelines of cardiopulmonary resuscitation and basic life support for general dental practitioners and oral and maxillofacial surgeons.

    Science.gov (United States)

    Gadipelly, Srinivas; Neshangi, Srisha

    2015-06-01

    Every general dental practitioner and oral and maxillofacial surgeon needs a thorough knowledge of the diagnosis and management of medical emergencies. Cardiopulmonary arrest is the most urgent of emergencies and diagnosis must be done as soon as possible. This paper discusses the importance of the International Liaison Committee on Resuscitation which forms the guidelines for cardiopulmonary resuscitation (CPR), highlighting the important changes in the guidelines of CPR from the year 2000 to 2010, the basic sequence of performing CPR and also the role of defibrillation and the use of automated external defibrillators. Finally the five part chain of survival which is of utmost importance to dental health care professionals and oral and maxillofacial surgeons. All dental health care personnel and oral & maxillofacial surgeons should recognize the importance of the changes in the guidelines of CPR, be trained and allowed to use a properly maintained defibrillator, to respond to cardiac arrest victims.

  4. Comparison of Pediatric and General Orthopedic Surgeons? Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus

    OpenAIRE

    Ramin Haj Zargarbashi; Hirbod Nasiri Bonaki; Shayan Zadegan; Taghi Baghdadi; Mohammad Hossein Nabian; Mehdi Ramezan Shirazi

    2017-01-01

    Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked t...

  5. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking: What It Means to You. A Guide to Action for Educators

    Science.gov (United States)

    Wing, Stephen; Beazley, Hamilton; Fine, Theodora

    2007-01-01

    The Surgeon General, the Nation's top public health officer, is appointed by the President of the United States to help protect and promote the health of the Nation. The recently published "Surgeon General's Call to Action To Prevent and Reduce Underage Drinking" [ED496083] highlights underage alcohol use as a major public health and…

  6. David Huebner

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Less than one year after becoming the chaiman of Coudert Brothers LLP,David Huebner made his second visit to Beijing in March to celebrate the firm's 25 years presence in China,Coudert began operations from an office in the Beijing Hotel in 1979,at the request of the Beijing Municipal Government to teach its officials foreign trade law.The one-man show has since evolved into a multicultural legal staff of 80 lawyers,with the landmark being the obtaining of the No.001 license from the Ministry of Justice of the People's Republic of China in 1992 to become the first foreign law firm to open an hourly billing rate of US$500 when practicing law,explains to CIB the significance of the 25 years' mark,and the future direction of his firm in China.

  7. Practice patterns and perceptions of margin status for breast conserving surgery for breast carcinoma: National Survey of Canadian General Surgeons.

    Science.gov (United States)

    Lovrics, Peter J; Gordon, Maggie; Cornacchi, Sylvie D; Farrokhyar, Forough; Ramsaroop, Amanda; Hodgson, Nicole; Quan, May Lynn; Wright, Francis; Porter, Geoffrey

    2012-12-01

    We surveyed Canadian General Surgeons to examine decision-making in early stage breast cancer. A modified Dillman Method was used for this mail survey of 1443 surgeons. Practice patterns and factors that influence management choices for: preoperative assessment, definition of margin status, surgical techniques and recommendations for re-excision were assessed. The response rate was 51% with 41% treating breast cancer. Most (80%) were community surgeons, with equal distribution of low/medium/high volume and years of practice categories. Approximately 25% of surgeons "sometimes or frequently" performed diagnostic excisional biopsies while 90% report "frequently" or "always" performing preoperative core biopsies. There was marked variation in defining negative and close margins, in the use of intra-operative margin assessment techniques and recommendations for re-excision. Responses revealed significant variation in attitudes and practices. These findings likely reflect an absence of consensus in the literature and potential gaps between best evidence and practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. If the data contradict the theory, throw out the data: Nicotine addiction in the 2010 report of the Surgeon General

    Directory of Open Access Journals (Sweden)

    Frenk Hanan

    2011-05-01

    Full Text Available Abstract The reports of US Surgeon General on smoking are considered the authoritative statement on the scientific state of the art in this field. The previous report on nicotine addiction published in 1988 is one of the most cited references in scientific articles on smoking and often the only citation provided for specific statements of facts regarding nicotine addiction. In this commentary we review the chapter on nicotine addiction presented in the recent report of the Surgeon General. We show that the nicotine addiction model presented in this chapter, which closely resembles its 22 years old predecessor, could only be sustained by systematically ignoring all contradictory evidence. As a result, the present SG's chapter on nicotine addiction, which purportedly "documents how nicotine compares with heroin and cocaine in its hold on users and its effects on the brain," is remarkably biased and misleading.

  9. If the data contradict the theory, throw out the data: Nicotine addiction in the 2010 report of the Surgeon General.

    Science.gov (United States)

    Frenk, Hanan; Dar, Reuven

    2011-05-19

    The reports of US Surgeon General on smoking are considered the authoritative statement on the scientific state of the art in this field. The previous report on nicotine addiction published in 1988 is one of the most cited references in scientific articles on smoking and often the only citation provided for specific statements of facts regarding nicotine addiction. In this commentary we review the chapter on nicotine addiction presented in the recent report of the Surgeon General. We show that the nicotine addiction model presented in this chapter, which closely resembles its 22 years old predecessor, could only be sustained by systematically ignoring all contradictory evidence. As a result, the present SG's chapter on nicotine addiction, which purportedly "documents how nicotine compares with heroin and cocaine in its hold on users and its effects on the brain," is remarkably biased and misleading.

  10. Reducing Tobacco Use. A report of the Surgeon General. Executive Summary.

    Science.gov (United States)

    2000-12-22

    This report of the Surgeon General on smoking and health, Reducing Tobacco Use, appears at a time of considerable upheaval in the arena of tobacco use control and prevention. Legal and legislative efforts to protect children from tobacco initiation and to diminish the prevalence of smoking among adults are in a state of flux, with some important gains and some sobering setbacks. Major changes in the public stance of the tobacco industry have evoked a reevaluation of strategies for controlling and preventing tobacco uptake. Enormous monetary settlements have provided the resources to fuel major new comprehensive antitobacco efforts, but the ultimate cost and benefit of these resources are still to be determined. Into this changing landscape, the report introduces an assessment of information about the value and efficacy of the major approaches that have been used--educational, clinical, regulatory, economic, and comprehensive--to reduce tobacco use. The report evaluates the scientific evidence for each approach, attempts to place the approaches in the larger context of tobacco control, and provides a vision of the trajectory for tobacco use prevention and control based on these available tools. Thus, although our knowledge about tobacco control remains imperfect, we know more than enough to act now. Widespread dissemination of the approaches and methods shown to be effective in each modality and especially in combination would substantially reduce the number of young people who will become addicted to tobacco, increase the success rate of young people and adults trying to quit using tobacco, decrease the level of exposure of nonsmokers to environmental tobacco smoke, reduce the disparities related to tobacco use and its health effects among different population groups, and decrease the future health burden of tobacco-related disease and death in this country. These achievable improvements parallel the health objectives set forth in Healthy People 2010, the national

  11. Umbilical endometriosis mimicking as papilloma to general surgeons: A case report

    Directory of Open Access Journals (Sweden)

    A Singh

    2012-05-01

    Full Text Available IntroductionCutaneous or umbilical endometriosis is a rare entity that isoften overlooked because of chronic abdominal pain. Wepresent a case of umbilical hernia that presented to thegeneral surgeons due to chronic abdominal pain and nodulein the umbilicus, which was clinically diagnosed as umbilicalpapilloma.Case presentationA 48-year old multiparous Caucasian woman presented withpainful nodule in the umbilicus for two and half years. Thenodule was excised and the histopathological diagnosis wasumbilicus endometriosis.ConclusionUmbilical endometriosis is a very rare disease but should beconsidered as a differential diagnosis in women presentingwith umbilical swelling.

  12. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  13. Sir Donald Ross, pioneer aortic valve surgeon.

    Science.gov (United States)

    Wheatley, David

    2015-06-01

    Tribute to Sir Donald Ross by David Wheatley, as read by Robert Kleinloog, President, Society of Cardiothoracic Surgeons of South Africa at the Annual Congress of the South African Heart Association 19 October 2014.

  14. Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

    Science.gov (United States)

    Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

    2011-05-01

    Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

  15. Evaluation of Effective Factors on the Clinical Performance of General Surgeons in Tehran University of Medical Science, 2015

    Science.gov (United States)

    Farzianpour, Fereshteh; Mohamadi, Efat; najafpour, Zhila; Yousefinezhadi, Taraneh; Forootan, Sara; Foroushani, Abbas Rahimi

    2016-01-01

    Background and Objective: Existence of doctors with high performance is one of the necessary conditions to provide high quality services. There are different motivations, which could affect their performance. Recognizing Factors which effect the performance of doctors as an effective force in health care centers is necessary. The aim of this article was evaluate the effective factors which influence on clinical performance of general surgery of Tehran University of Medical Sciences in 2015. Methods: This is a cross-sectional qualitative-quantitative study. This research conducted in 3 phases-phases I: (use of library studies and databases to collect data), phase II: localization of detected factors in first phase by using the Delphi technique and phase III: prioritizing the affecting factors on performance of doctors by using qualitative interviews. Results: 12 articles were analyzed from 300 abstracts during the evaluation process. The output of assessment identified 23 factors was sent to surgeons and their assistants for obtaining their opinions. Quantitative analysis of the findings showed that “work qualification” (86.1%) and “managers and supervisors style” (50%) have respectively the most and the least impact on the performance of doctors. Finally 18 effective factors were identified and prioritized in the performance of general surgeons. Conclusion: The results showed that motivation and performance is not a single operating parameter and it depends on several factors according to cultural background. Therefore it is necessary to design, implementation and monitoring based on key determinants of effective interventions due to cultural background. PMID:27157161

  16. The Surgeon General's Report and special-needs patients: a framework for action for children and their caregivers.

    Science.gov (United States)

    Slavkin, H C

    2001-01-01

    The Surgeon General's Report, Oral Health in America, is the first comprehensive assessment of oral, dental, and craniofacial health in the history of our nation. The intent of this first-ever Report is to alert Americans to the full meaning of oral health and its importance to general health and well-being across the lifespan. Moreover, the Report has been released at a time in human history of enormous changes as well as opportunities. The convergence of public health policies, "quality of life" expectations, global informatics, a new century of biotechnology, the completion of the Human Genome Project, changes in the management of health care, and the acknowledgment of enormous health disparities herald a call to action. These profound dynamics particularly affect children and their caregivers and the multitude of social, economic, and health issues associated with special patients and developmental disabilities. This paper will highlight the issues, provide recommendations, and suggest a call to action.

  17. Reliable assessment of general surgeons' non-technical skills based on video-recordings of patient simulated scenarios

    DEFF Research Database (Denmark)

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

    2013-01-01

    Nontechnical skills are essential for safe and efficient surgery. The aim of this study was to evaluate the reliability of an assessment tool for surgeons' nontechnical skills, Non-Technical Skills for Surgeons dk (NOTSSdk), and the effect of rater training.......Nontechnical skills are essential for safe and efficient surgery. The aim of this study was to evaluate the reliability of an assessment tool for surgeons' nontechnical skills, Non-Technical Skills for Surgeons dk (NOTSSdk), and the effect of rater training....

  18. Appearance of urology at the beginining of xxth century -from the general surgeon up to the highly trained specialist

    Directory of Open Access Journals (Sweden)

    Ignjatović Ivan M.

    2003-01-01

    Full Text Available Evolvement of urology as a separate scientific discipline depends on several factors. Endoscopic diagnostics, radiological diagnostics, and operative techniques in general surgery, had provided an ability to perform more complex and longer operations. Urology had evolved from the great schools of surgery in Germany and France, and their the most important surgeons, who were intersted in urological surgery. The first endoscope was introduced in 1806, and received today’s form in 1879. Application of "X" rays in medicine started in 1895, and it was later applied as a cystography, retrograde pyelography as well as intravenous urography. The most important thing for the operative technique evolution were application of anhestesia, asepsis and new hemostatic devices. During the one century long development, urology had passed the way from completely unknown field, up to the discipline with the best diagnostic preciseness.

  19. Dealing with sickness certification – a survey of problems and strategies among general practitioners and orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Nilsson Gunnar

    2007-10-01

    Full Text Available Abstract Background In order to get sickness benefit a sick-listed person need a medical certificate issued by a physician; in Sweden after one week of self-certification. Physicians experience sick-listing tasks as problematic and conflicts may arise when patients regard themselves unable to work due to complaints that are hard to objectively verify for the physician. Most GPs and orthopaedic surgeons (OS deal regularly with sick-listing issues in their daily practice. The aim of this study was to explore perceived problems and coping strategies related to tasks of sickness certification among general practitioners (GP and orthopaedic surgeons (OS. Methods A cross-sectional study about sickness certification in two Swedish counties, with 673 participating GPs and 149 OSs, who answered a comprehensive questionnaire. Frequencies together with crude and adjusted (gender and working years Odds ratios were calculated. Results A majority of the GPs and OSs experienced problems in sickness certification every week. To assess the patient's work ability, to handle situations when they and the patient had different opinions about the need for sickness absence, and to issue prolongation certificates when the previous was issued by another physician were reported as problematic by a majority in both groups. Both GPs and OSs prolonged sickness certifications due to waiting times in health care or at Social Insurance Office (SIO. To handle experienced problems they used different strategies; OSs issued sickness certificates without personal appointment more often than the GPs, who on the other hand reported having contact with SIO more often than the OSs. A higher rate of GPs experienced support from management and had a common strategy for handling sickness certification at the clinic than the OSs. Conclusion Most GPs and OSs handled sickness certification weekly and reported a variety of problems in relation to this task, generally GPs to a higher extent

  20. Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeongeneral practitioner Delphi approach

    Directory of Open Access Journals (Sweden)

    Augestad KM

    2014-09-01

    Full Text Available Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 4Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs' EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £ to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670 and 37 (range 29–49 referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to

  1. European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery.

    Science.gov (United States)

    Szold, Amir; Bergamaschi, Roberto; Broeders, Ivo; Dankelman, Jenny; Forgione, Antonello; Langø, Thomas; Melzer, Andreas; Mintz, Yoav; Morales-Conde, Salvador; Rhodes, Michael; Satava, Richard; Tang, Chung-Ngai; Vilallonga, Ramon

    2015-02-01

    Following an extensive literature search and a consensus conference with subject matter experts the following conclusions can be drawn: 1. Robotic surgery is still at its infancy, and there is a great potential in sophisticated electromechanical systems to perform complex surgical tasks when these systems evolve. 2. To date, in the vast majority of clinical settings, there is little or no advantage in using robotic systems in general surgery in terms of clinical outcome. Dedicated parameters should be addressed, and high quality research should focus on quality of care instead of routine parameters, where a clear advantage is not to be expected. 3. Preliminary data demonstrates that robotic system have a clinical benefit in performing complex procedures in confined spaces, especially in those that are located in unfavorable anatomical locations. 4. There is a severe lack of high quality data on robotic surgery, and there is a great need for rigorously controlled, unbiased clinical trials. These trials should be urged to address the cost-effectiveness issues as well. 5. Specific areas of research should include complex hepatobiliary surgery, surgery for gastric and esophageal cancer, revisional surgery in bariatric and upper GI surgery, surgery for large adrenal masses, and rectal surgery. All these fields show some potential for a true benefit of using current robotic systems. 6. Robotic surgery requires a specific set of skills, and needs to be trained using a dedicated, structured training program that addresses the specific knowledge, safety issues and skills essential to perform this type of surgery safely and with good outcomes. It is the responsibility of the corresponding professional organizations, not the industry, to define the training and credentialing of robotic basic skills and specific procedures. 7. Due to the special economic environment in which robotic surgery is currently employed special care should be taken in the decision making process when

  2. Hello, David! / Vladlen Livshits

    Index Scriptorium Estoniae

    Livshits, Vladlen

    2005-01-01

    Autori kohtumisest silmapaistva ameerika ajakirjaniku ja kirjaniku David Shipleriga Kohtla-Järvel 1978. aastal, ameerika matemaatiku Benoit Mandelbroti fraktaalse geomeetria teooriast, Lea Livshitsi maalidest

  3. Hello, David! / Vladlen Livshits

    Index Scriptorium Estoniae

    Livshits, Vladlen

    2005-01-01

    Autori kohtumisest silmapaistva ameerika ajakirjaniku ja kirjaniku David Shipleriga Kohtla-Järvel 1978. aastal, ameerika matemaatiku Benoit Mandelbroti fraktaalse geomeetria teooriast, Lea Livshitsi maalidest

  4. The doctor and the market: about the influence of market reforms on the professional medical ethics of surgeons and general practitioners in the Netherlands

    NARCIS (Netherlands)

    Dwarswaard, J.; Hilhorst, M.; Trappenburg, M.

    2011-01-01

    To explore whether market reforms in a health care system affect medical professional ethics of hospital-based specialists on the one hand and physicians in independent practices on the other. Qualitative interviews with 27 surgeons and 28 general practitioners in The Netherlands, held 2-3 years aft

  5. David Lynch (Sammelrezension)

    OpenAIRE

    2002-01-01

    Ralfdieter Füller: Fiktion und Antifiktion. Die Filme David Lynchs und der Kulturprozeß im Amerika der 1980er und 90er Jahre.Stefan Höltgen: Spiegelbilder. Strategien der ästhetischen Verdoppelung in den Filmen von David Lynch

  6. Characterization of David Copperfield

    Institute of Scientific and Technical Information of China (English)

    WANG Yi-jun

    2015-01-01

    Abstracts:David Copperfield is one of the masterpieces of the famous British novelist Charles Dickens in the 19th century. Dick⁃ens portrays a series of characters with distinctive disposition such as David Copperfield, the Peggottys, Mr. and Mrs. Micawber, Murdstone, Uriah Heep etc. Through the actions and conflicts of these figures, the author reveals the panorama of the social life at the time.

  7. Wilfred Trotter: surgeon, philosopher.

    Science.gov (United States)

    Rosen, Irving B

    2006-08-01

    There is no significant biography that records the accomplishments of Sir Wilfred Trotter, who was a general surgeon in its pure sense at a time when surgical specialization was in its infancy. Trotter was born in the 1870s in England. Despite being bedridden during his childhood with a musculoskeletal condition he was able to study medicine at London University, and eventually became Professor and Chair of Surgery at the University College Hospital, a position he held until his death in November 1939. He made many contributions to surgical care, particularly in the field of oncology. He attended to many famous people, including King George V and Sigmund Freud and was greatly honoured in his own milieu. He was named honorary surgeon and Sargent Surgeon to the king. In addition, he was a thoughtful individual who addressed problems in human behaviour, contradicting the stereotype of the contemporary surgeon.

  8. [What Must the (Abdominal) Surgeon Know about Experimental Medicine (?) - Translational Research in General (Abdominal) Surgery(Viszeral-)Chirurg & experimentelle Medizin].

    Science.gov (United States)

    Wex, T; Kuester, D; Meyer, F

    2015-08-01

    Experimental medicine has evolved tremendously in the last few years. In particular, the introduction of novel techniques, in-vitro models, knock-out/transgenic animals and high-through put analytical methodologies have resulted in a deeper understanding of cellular pathophysiology and diseases. The daily clinical management has benefited by the introduction of biomarkers and targeted therapies. This development has been accompanied by increasing specialisation across all fields of research and medicine. Therefore, clinical-translational research requires a team of competent partners nowadays. The visceral surgeon can contribute significantly to these projects. The present review highlights several aspects of translational research and put chances and potential pitfalls into perspective in context with the work of the visceral surgeon.

  9. Comparison of Pediatric and General Orthopedic Surgeons' Approaches in Management of Developmental Dysplasia of the Hip and Flexible Flatfoot: the Road to Clinical Consensus.

    Science.gov (United States)

    Zargarbashi, Ramin Haj; Bonaki, Hirbod Nasiri; Zadegan, Shayan Abdollah; Baghdadi, Taghi; Nabian, Mohammad Hossein; Shirazi, Mehdi Ramezan

    2017-01-01

    Developmental dysplasia of the hip (DDH) and flatfoot are common pediatric orthopedic disorders, being referred to and managed by both general and pediatric orthopedic surgeons, through various modalities. Our study aimed to evaluate their consensus and perspective disagreements in terms of diagnostic and therapeutic approaches of the mentioned deformities. Forty participants in two groups of general orthopedic surgeons (GOS) (n=20) and pediatric orthopedic surgeons (POS) (n=20), were asked to answer an 8-item questionnaire on DDH and flexible flatfoot. The questions were provided with two- or multiple choices and a single choice was accepted for each one. Chi-square and Fisher's exact tests was performed to compare the responses. For a neonate with limited hip abduction, hip ultrasonography was the agreed-upon approach in both groups (100% POS vs 71% GOS), and for its interpretation 79% of POS relied on their own whereas 73% of GOS relied on radiologist's report (P=0.002). In failure of a 3-week application of the Pavlik harness, ending it and closed reduction (57% POS vs. 41% GOS) followed by surgery quality assessment with CT scan (64% POS vs. 47% GOS) and without the necessity for avascular necrosis evaluation (79% POS vs. 73% GOS) were the choice measures. In case of closed reduction failure, open reduction via medial approach was the favorite next step in both groups (62% POS and 80% GOS). For the patient with flexible flat foot, reassurance was the choice plan of 79% of pediatric orthopedists. Our findings demonstrated significant disagreements among the orthopedic surgeons. This proposes insufficiency of high-level evidence.

  10. The essential David Bohm

    CERN Document Server

    Nichol, Lee

    2002-01-01

    There are few scientists of the twentieth century whose life's work has created more excitement and controversy than that of physicist David Bohm (1917-1992). For the first time in a single volume, The Essential David Bohm offers a comprehensive overview of Bohm's original works from a non-technical perspective. Including three chapters of previously unpublished material, and a forward by the Dalai Lama, each reading has been selected to highlight some aspect of the implicate order process, and to provide an introduction to one of the most provocative thinkers of our time.

  11. David Hockney Portraits

    NARCIS (Netherlands)

    Howgate, S.; Stern Shapiro, B.

    2007-01-01

    David Hockney is one of the most significant artists exploring and pushing the boundaries of figurative art today. He has been engaged with portraiture since his teenage years, when he painted Portrait of My Father (1955), and portraits of family, lovers, friends and well-known subjects represent an

  12. David Hockney Portraits

    NARCIS (Netherlands)

    Howgate, S.; Stern Shapiro, B.

    2007-01-01

    David Hockney is one of the most significant artists exploring and pushing the boundaries of figurative art today. He has been engaged with portraiture since his teenage years, when he painted Portrait of My Father (1955), and portraits of family, lovers, friends and well-known subjects represent an

  13. Recollections of David Marr.

    Science.gov (United States)

    Nishihara, H K

    2012-01-01

    David Marr came to MIT's Artificial Intelligence (AI) Lab in the early 1970s and energized the study of vision at the intersection of computer science, psychology, and neuroscience. As one of his first graduate students, I had the privilege of getting to know him and working with him during that heady period of AI research.

  14. Interview with David Moore

    Science.gov (United States)

    Rossman, Allan; Dietz, E. Jacquelin; Moor, David

    2013-01-01

    David Moore is Professor Emeritus of Statistics at Purdue University. He served as the first President of the International Association for Statistical Education (IASE) from 1993-1995 and as President of the American Statistical Association (ASA) in 1998. He is a Fellow of the ASA and of the IMS and was awarded the ASA's Founders Award in…

  15. Mentoring surgeons.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    From time immemorial mentoring has been the angular stone sustaining the building of medical and surgical education. Good teachers are not necessarily good mentors, and good mentors are not always good teachers. A combination of both is very plausible and should be encouraged. Today, the qualities of a good mentor, in our case the surgeon-mentor, should include respect, time, commitment, trust, determination, encouragement, patience, and opportunity for independence. The mentee would need to respond to similar virtues of trust, encouragement, and respect. The reciprocal consideration of equally divided roles would be clearly desirable. Recognizing the importance of a good mentor and making this role the priority of medical schools would enhance our ability to form better professionals. It would certainly promote professionalism, better patient care, and research.

  16. Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country

    Directory of Open Access Journals (Sweden)

    Ahmed Abdel-Aziz

    2013-01-01

    Full Text Available Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3% was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5% and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group (P=0.03. Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines.

  17. David Keynes Hill.

    Science.gov (United States)

    Huxley, Andrew

    2003-01-01

    David Hill followed his father, A.V. Hill FRS, into the study of muscular contraction. Using a wide range of experimental techniques, he made several important advances of which the most important was the discovery of the 'short-range elastic component', a phenomenon which implied that even in the resting state there was an interaction between the thick (myosin) and thin (actin) filaments. He also studied physical changes in nerve when stimulated.

  18. David B. Steinman

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1961-01-01

    Full Text Available El doctor ingeniero David B. Steinman, diseñador de más de cuatrocientos puentes en todo el mundo, ha fallecido en Nueva York, a los setenta y tres años de edad. Como homenaje a su memoria, y en agradecimiento a sus frecuentes colaboraciones en nuestra revista, “Informes de la Construcción” le dedica este cálido recuerdo.

  19. David Warner (1934 - 2003)

    CERN Multimedia

    2004-01-01

    It is with great sadness that we learned that our friend and former colleague, David Warner, passed away on Christmas Eve. The funeral was held the following Monday. David was a "linac man". His career centred around linacs, but with a multitude of different subjects. He began at CERN by building the 3 MeV linac in the extension of the South Hall. He did pioneering work on this machine, which paved the way towards the design of the Alvarez cavities for the CERN Linac 2, for which he was responsible. After this challenge was successfully finished, David was the first member of the small but growing team, that was in charge of building the LEP Injector Linacs (LIL). After having been recognised as a proton linac expert, he quickly converted to electron linacs where he soon became the respected key expert for the design, parameters and ultimate performance of LIL. His predilection for precise and detailed documentation, and his vision that the know-how acquired with LIL should be preserved a...

  20. The New Governor General of Canada's Love Fate of China%加拿大新总督DAVID JOHNSTON的中国情缘

    Institute of Scientific and Technical Information of China (English)

    彭小年

    2010-01-01

    @@ 经加拿大总理哈珀提名,专家委员会在全国各界广泛征求意见,并经英国女王伊丽莎白二世批准,加拿大滑铁卢大学校长DAVID JOHNSTON(戴·约翰斯顿)教授将于10月1日接替现任总督米夏埃尔·让出任加拿大新总督,任期五年.加拿大是英联邦国家,英国女王也是加拿大女王.总督是女王在加拿大的代表,是加拿大的国家元首,也是加拿大武装部队总司令.

  1. Sir Charles Ballance: pioneer British neurological surgeon.

    Science.gov (United States)

    Stone, J L

    1999-03-01

    Sir Charles A. Ballance (1856-1936) began his medical career at St. Thomas's Hospital the University College, London, England, in 1875, receiving honors in every subject and a gold medal in surgery. Victor Horsley (1857-1916) and Ballance were classmates at the University and in the later 1880s began work together at the Brown Institute and the National Hospital, Queen Square. In addition to important studies on vascular surgery, Ballance was involved in primate work on cerebral localization with lifelong friends Charles Beevor, Charles Sherrington, David Ferrier, and others. In June of 1887, Ballance assisted Horsley at Queen Square in the successful removal of an extramedullary spinal cord tumor. Horsley was about to abandon the operation, but his friend urged the removal of one lamina higher and the tumor was discovered. Ballance, a demonstrator in anatomy, realized the spinal cord segments lay higher in relation to the vertebral bodies than was generally appreciated. Ballance popularized the operation of radical mastoidectomy for advanced middle ear infection (1890), standardized an approach to drain or excise temporal brain abscesses, and was the first to clearly understand the neurological signs of cerebellar abscess (1894). Ballance also devised cranial base approaches to attack infectious thrombophlebitis of the lateral, petrosal, and cavernous sinuses. He was the first to completely remove an acoustic tumor (1894); 18 years later, the patient remained well. Ballance also drained a posterior fossa subdural hematoma (1906) and successfully sectioned the auditory nerve for Meniere's syndrome (1908). Ballance's operative experience with both supra- and infratentorial brain lesions included approximately 400 cases, which are detailed in his 1907 book, Some Points in the Surgery of the Brain and Its Membranes. His two-volume set, Essays on the Surgery of the Temporal Bone (1919), remains a brilliantly written and illustrated classic. Ballance was an expert on

  2. 21 CFR 878.4460 - Surgeon's glove.

    Science.gov (United States)

    2010-04-01

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

  3. 76 FR 24901 - Request for Input To Inform a Possible Surgeon General Action on Prescription Drug Abuse in Youth

    Science.gov (United States)

    2011-05-03

    ... Action on Prescription Drug Abuse in Youth AGENCY: National Institute on Drug Abuse, National Institutes...: The National Institute on Drug Abuse, a Research Institute of the National Institutes of Health, is... General response to the public health problem of prescription drug abuse among youth....

  4. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  5. Knowledge, Attitude and Practices of General Surgeons Regarding Pediatric Inguinal Hernia at Liaquat University Hospital Jamshoro Sindh

    OpenAIRE

    Pushpa Goswami; Samreen Memon; Nand Lal Kella

    2014-01-01

    Inguinal hernia is a most common surgical condition worldwide during infancy. In spite of significant improvements in pediatric surgery it still carries mortality and morbidity due to delay between diagnosis and surgical intervention. A delay in the treatment of inguinal hernia may lead to incarceration and strangulation. In developing countries like us the risk of incarceration and complications is much higher due to delay in seeking treatment due to lack of awareness among parents, general ...

  6. [The robotic surgeon training].

    Science.gov (United States)

    Crestani, Alessandro; Rossanese, Marta; Abbinante, Maria; Calandriello, Mattia; Kungulli, Afrovita; Giannarini, Gianluca; Ficarra, Vincenzo

    2015-10-01

    The widespread robotic surgery in the world highlighted the relevance of the training programs for young urologists and residents. In the last years, urologic societies and some independent robotic surgeons strongly worked to standardize some general and specific training modules. Theoretical and practical sections of robotic training programs have been recently specified. The role of simulators, dry and wet laboratories, bedside assistance, and modular (step-by-step) training at console represent the most relevant elements of robotic surgeon training. Ideally, these didactic tools should be available in modern training centers. The development of structured robotic training programs should be considered as one of the priorities that the urologic community must take into account in the near future.

  7. Entretien avec David Toscana

    OpenAIRE

    Vanden Berghe, Kristine; Toscana, David

    2015-01-01

    David Toscana (Monterrey, 1961) es autor de siete novelas y de un libro de relatos. Se le conoce también como el escritor que tuvo la iniciativa de hacer una antología de cuentos publicada bajo el título de Mc Ondo (Barcelona: Mondadori, 1996). En ella se incluyó un cuento suyo, «La noche de una vida difícil», colindante con la cultura pop y la literatura urbana, rasgos que hacen de este cuento un texto poco representativo de su obra que se caracteriza por una confección más bien clásica y re...

  8. Response to David Harvey.

    Directory of Open Access Journals (Sweden)

    Antonio Negri

    2011-01-01

    Full Text Available The text is a response of authors of Commonwealth to criticism presented by David Harvey. Hard and Negri turn down the primacy of class division over other various identity formations (e.g. race, gender and they perceive it as field of revolutionary struggle. Then, starting with Spinoza they highlight variety of definitions of singularity and do not agree withthe significant role ascribed to the notion of fictitious capital; they point out immaterial aspect of financialization and its role as a “central form of the accumulation of capital.” Finally, they emphasize the importance of recognition of present indignation and revolutionary actions, which could be made only from below.

  9. Pora prodavat znanija / David Tisch

    Index Scriptorium Estoniae

    Tisch, David

    2006-01-01

    California Ülikooli (Berkeley) professor David Tisch teadmistepõhistest väärtustest ja nende mõjust konkurentsivõimele, konkurentsist innovatsiooniturul, Silicon Valley edu põhjustest, väikeste ja keskmiste ettevõtete osast innovatsioonis. Lisa: David Tisch

  10. Pora prodavat znanija / David Tisch

    Index Scriptorium Estoniae

    Tisch, David

    2006-01-01

    California Ülikooli (Berkeley) professor David Tisch teadmistepõhistest väärtustest ja nende mõjust konkurentsivõimele, konkurentsist innovatsiooniturul, Silicon Valley edu põhjustest, väikeste ja keskmiste ettevõtete osast innovatsioonis. Lisa: David Tisch

  11. Laurance David Hall.

    Science.gov (United States)

    Coxon, Bruce

    2011-01-01

    An account is given of the life, scientific contributions, and passing of Laurance David Hall (1938-2009), including his early history and education at the University of Bristol, UK, and the synthesis and NMR spectroscopy of carbohydrates and other natural products during ∼20 years of research and teaching at the University of British Columbia in Vancouver, Canada. Lists of graduate students, post-doctoral fellows, and sabbatical visitors are provided for this period. Following a generous endowment by Dr. Herchel Smith, Professor Hall built a new Department of Medicinal Chemistry at Cambridge University, UK, and greatly expanded his researches into the technology and applications of magnetic resonance imaging (MRI) and zero quantum NMR. MRI technology was applied both to medical problems such as the characterization of cartilage degeneration in knee joints, the measurement of ventricular function, lipid localization in animal models of atherosclerosis, paramagnetic metal complexes of polysaccharides as contrast agents, and studies of many other anatomical features, but also to several aspects of materials analysis, including food analyses, process control, and the elucidation of such physical phenomena as the flow of liquids through porous media, defects in concrete, and the visualization of fungal damage to wood. Professor Hall's many publications, patents, lectures, and honors and awards are described, and also his successful effort to keep the Asilomar facility in Pacific Grove, California as the alternating venue for the annual Experimental NMR Conference. Two memorial services for Professor Hall are remembered.

  12. Preliminary validation of a consumer-oriented colorectal cancer risk assessment tool compatible with the US Surgeon General's My Family Health Portrait.

    Science.gov (United States)

    Feero, W Gregory; Facio, Flavia M; Glogowski, Emily A; Hampel, Heather L; Stopfer, Jill E; Eidem, Haley; Pizzino, Amy M; Barton, David K; Biesecker, Leslie G

    2015-09-01

    This study examines the analytic validity of a software tool designed to provide individuals with risk assessments for colorectal cancer based on personal health and family history information. The software is compatible with the US Surgeon General's My Family Health Portrait (MFHP). An algorithm for risk assessment was created using accepted colorectal risk assessment guidelines and programmed into a software tool (MFHP). Risk assessments derived from 150 pedigrees using the MFHP tool were compared with "gold standard" risk assessments developed by three expert cancer genetic counselors. Genetic counselor risk assessments showed substantial, but not perfect, agreement. MFHP risk assessments for colorectal cancer yielded a sensitivity for colorectal cancer risk of 81% (95% confidence interval: 54-96%) and specificity of 90% (95% confidence interval: 83-94%), as compared with genetic counselor pedigree review. The positive predictive value for risk for MFHP was 48% (95% confidence interval: 29-68%), whereas the negative predictive value was 98% (95% confidence interval: 93-99%). Agreement between MFHP and genetic counselor pedigree review was moderate (κ = 0.54). The analytic validity of the MFHP colorectal cancer risk assessment software is similar to those of other types of screening tools used in primary care. Future investigations should explore the clinical validity and utility of the software in diverse population groups.Genet Med 17 9, 753-756.

  13. Memories of David Kirzhnits

    Science.gov (United States)

    Bolotovsky, B. M.

    2013-06-01

    In the mid-1950s, a new staff member appeared at the Theory Division of the Physical Institute of the Academy of Sciences (FIAN): David Abramovich Kirzhnits. A Moscow State University alumnus, after graduation he had been assigned to a large defense plant in the city of Gorky, where he had worked for several years as an engineer. He was "liberated" from there by Igor Evgenyevich Tamm, our department head, who managed to transfer him to FIAN. Igor Evgenyevich knew D. A. Kirzhnits - they had met in Moscow before Kirzhnits finished university. At that time Kirzhnits was performing thesis work with professor A. S. Kompaneyets as academic adviser. At his adviser's suggestion, D. Kirzhnits consulted with I. E. Tamm on questions pertaining to the thesis topic. I. E. Tamm took a great liking for the diploma student, and he even wanted to recruit D. A. Kirzhnits for the Theory Division immediately after graduation. But at that time (1949) this proved impossible for several reasons. First, D. Kirzhnits was, as they say, an "invalid of the fifth group"REFID="9789814436571_0026FN001"> - a Jew - which during those years of violent struggle against cosmopolitanismb often proved an obstacle in looking for work. Second, during the years of mass repressions D. Kirzhnits' father had been arrested on treason charges (according to the charges, he had wanted to sell the Far East to Japan). After intensive investigation his father was released, but he lived only a little longer. Reports of this also could have impeded his acceptance. Third, Igor Evgenyevich didn't have enough weight in officials' eyes at that time and so was unable to overcome "first" and "second."...

  14. David Asbury (1950-2015)

    CERN Multimedia

    2015-01-01

    It was with great sadness that we learned that David Asbury passed away in his sleep last week.   David joined CERN in 1984 after having worked for some years at RAL in the UK. He was a skilled programmer and systems engineer, and much appreciated by both users and colleagues at CERN. His contributions to IT services include the IBM mainframe workhorse CERN VM, the backup tape service and in recent years the version control services, until his well-deserved retirement at the end of March this year. We will all remember David for his friendly and helpful manners, and as a warm person who was always caring for others, particularly newcomers. David was also a passionate musician and active tennis player. He will be greatly missed by his colleagues. A memorial service took place at 11 a.m. on Monday, 14 December 2015 at the Auditoire Calvin next to the Cathedral in Geneva. His colleagues and friends

  15. Rõnotshnaja jeres kapitalizma / David Korten

    Index Scriptorium Estoniae

    Korten, David

    2002-01-01

    Järg 4,18 september lk. 12. Hinnatud antiglobalismi ideoloog David Korten: totalitaarse tuleviku oht ei kao kuni transnatsionaalsed korporatsioonid juhivad maailma majandust rahvusvaheliste organisatsioonide ja valitsuste kontrolli all

  16. Rõnotshnaja jeres kapitalizma / David Korten

    Index Scriptorium Estoniae

    Korten, David

    2002-01-01

    Järg 4,18 september lk. 12. Hinnatud antiglobalismi ideoloog David Korten: totalitaarse tuleviku oht ei kao kuni transnatsionaalsed korporatsioonid juhivad maailma majandust rahvusvaheliste organisatsioonide ja valitsuste kontrolli all

  17. The surgeon and the child.

    Science.gov (United States)

    Klein, Michael D

    2016-01-01

    For many reasons pediatric surgeons have been asked to do all general and thoracic procedures in children. The profession has responded by training more, but the core of special cases requiring pediatric surgical expertise has not changed, and there is concern that the many surgeons now in training will not each do enough cases to attain and maintain operative expertise. This presentation examines the psychological, educational, and surgical literature on the development of expertise, especially operative expertise. From this I conclude that individual surgeon volume when gained in deliberate practice with a coach and with effort is essential, and that several technologies hold promise for allowing deliberate practice in simulation environments. I propose that in order to avoid a decline in pediatric surgical operative expertise we must reorganize pediatric surgical training and practice to align with Optimal Resources for Children's Surgery and the evolution of training in general surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Surgeon length of service and risk-adjusted outcomes: linked observational analysis of the UK National Adult Cardiac Surgery Audit Registry and General Medical Council Register.

    Science.gov (United States)

    Hickey, Graeme L; Grant, Stuart W; Freemantle, Nick; Cunningham, David; Munsch, Christopher M; Livesey, Steven A; Roxburgh, James; Buchan, Iain; Bridgewater, Ben

    2014-09-01

    To explore the relationship between in-hospital mortality following adult cardiac surgery and the time since primary clinical qualification for the responsible consultant cardiac surgeon (a proxy for experience). Retrospective analysis of prospectively collected national registry data over a 10-year period using mixed-effects multiple logistic regression modelling. Surgeon experience was defined as the time between the date of surgery and award of primary clinical qualification. UK National Health Service hospitals performing cardiac surgery between January 2003 and December 2012. All patients undergoing coronary artery bypass grafts and/or valve surgery under the care of a consultant cardiac surgeon. All-cause in-hospital mortality. A total of 292,973 operations performed by 273 consultant surgeons (with lengths of service from 11.2 to 42.0 years) were included. Crude mortality increased approximately linearly until 33 years service, before decreasing. After adjusting for case-mix and year of surgery, there remained a statistically significant (p=0.002) association between length of service and in-hospital mortality (odds ratio 1.013; 95% CI 1.005-1.021 for each year of 'experience'). Consultant cardiac surgeons take on increasingly complex surgery as they gain experience. With this progression, the incidence of adverse outcomes is expected to increase, as is demonstrated in this study. After adjusting for case-mix using the EuroSCORE, we observed an increased risk of mortality in patients operated on by longer serving surgeons. This finding may reflect under-adjustment for risk, unmeasured confounding or a real association. Further research into outcomes over the time course of surgeon's careers is required. © The Royal Society of Medicine.

  19. An examination of the advances in science and technology of prevention of tooth decay in young children since the Surgeon General's Report on Oral Health.

    Science.gov (United States)

    Milgrom, Peter; Zero, Domenick T; Tanzer, Jason M

    2009-01-01

    This paper addresses a number of areas related to how effectively science and technology have met Healthy People 2010 goals for tooth decay prevention. In every area mentioned, it appears that science and technology are falling short of these goals. Earlier assessments identified water fluoridation as one of the greatest public health accomplishments of the last century. Yet, failure to complete needed clinical and translational research has shortchanged the caries prevention agenda at a critical juncture. Science has firmly established the transmissible nature of tooth decay. However, there is evidence that tooth decay in young children is increasing, although progress has been made in other age groups. Studies of risk assessment have not been translated into improved practice. Antiseptics, chlorhexidine varnish, and polyvinylpyrrolidone iodine (PVI-I) may have value, but definitive trials are needed. Fluorides remain the most effective agents, but are not widely disseminated to the most needy. Fluoride varnish provides a relatively effective topical preventive for very young children, yet definitive trials have not been conducted. Silver diamine fluoride also has potential but requires study in the United States. Data support effectiveness and safety of xylitol, but adoption is not widespread. Dental sealants remain a mainstay of public policy, yet after decades of research, widespread use has not occurred. We conclude that research has established the public health burden of tooth decay, but insufficient research addresses the problems identified in the report Oral Health in America: A Report of the Surgeon General. Transfer of technology from studies to implementation is needed to prevent tooth decay among children. This should involve translational research and implementation of scientific and technological advances into practice.

  20. David's Understanding of Functions and Periodicity

    Science.gov (United States)

    Gerson, Hope

    2008-01-01

    This is a study of David, a senior enrolled in a high school precalculus course. David's understandings of functions and periodicity was explored, through clinical interviews and contextualized through classroom observations. Although David's precalculus class was traditional his understanding of periodic functions was unconventional David engaged…

  1. David's Understanding of Functions and Periodicity

    Science.gov (United States)

    Gerson, Hope

    2008-01-01

    This is a study of David, a senior enrolled in a high school precalculus course. David's understandings of functions and periodicity was explored, through clinical interviews and contextualized through classroom observations. Although David's precalculus class was traditional his understanding of periodic functions was unconventional David engaged…

  2. Henry David Thoreau's Spiritual World

    Institute of Scientific and Technical Information of China (English)

    马云

    2013-01-01

    Henry David Thoreau was wholeheartedly in love with nature and he devoted almost all his life time to observation, appreciation and study of nature. Thus he formed a deep understanding of nature. In 1845, Thoreau began a two-year and two-month residence at Walden Pond. His life was lonely but full of fragrance. He wanted to live meaningfully, confront the essential facts of life and live a simple life. Based on the review of the literature related to this topic, this paper aims to study Henry David Thoreau’s spiritual world, especially reflected in his famous book-Walden.

  3. O RACIONALISMO EM DAVID HUME

    OpenAIRE

    da Silva, Lorena Fiungo

    2016-01-01

    Resumo: Para David Hume, o conhecimento humano tem sua origem na experiência. Entretanto, há uma parte deste conhecimento que não tem a mesma origem. Neste caso, para o filósofo, quando um conhecimento não tem sua origem na experiência, ele deriva da imaginação. Este é, precisamente, o caso da matemática, que embora originalmente derivado da experiência, carrega consigo um conhecimento seguro e certo. Nesse sentido, o presente estudo tem por objetivo expor a teoria do conhecimento em David Hu...

  4. Surgeons' perceptions on industry relations: A survey of 822 surgeons.

    Science.gov (United States)

    Altieri, Maria S; Yang, Jie; Wang, Lily; Yin, Donglei; Talamini, Mark; Pryor, Aurora D

    2017-07-01

    The relationships between industry and medical professionals are controversial. The purpose of our study was to evaluate surgeons' current opinions regarding the industry-surgery partnership, in addition to self-reported industry ties. After institutional review board approval, a survey was sent via RedCap to 3,782 surgeons across the United States. Univariate and multivariable regression analyses were performed to evaluate the responses. The response rate was 23%. From the 822 responders, 226 (27%) reported at least one current relationship with industry, while 297 (36.1%) had at least one such relationship within the past 3 years. There was no difference between general surgery versus other surgical specialties (P = .5). Among the general surgery subspecialties, respondents in minimally invasive surgery/foregut had greater ties to industry compared to other subspecialties (P = .001). In addition, midcareer surgeons, male sex, and being on a reviewer/editorial board were associated with having industry ties (P industry are important for innovation. Our study showed that relationships between surgeons and industry are common, because more than a quarter of our responders reported at least one current relationship. Industry relations are perceived as necessary for operative innovation. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU Lu; WANG Yiran

    2015-01-01

    Military surgeons are a special group of doctors. They are both medical workers and soldiers.Their mission is to serve the wounded on the battlefield.And there is no doubt that military surgeons will save our comrades in the army. However,should a military surgeon save the wounded enemy? It is indeed a dilemma.Some may save the wounded enemy because military surgeons are doctors after all and they can't possibly abandon anybody to his fate,but some refuse to do so because military surgeons are soldiers.Therefore,some situations on the battlefield are discussed and advice is suggested for military surgeons,with heartfelt anticipation for there being less casualties on the battlefield as well as alleviating human suffering caused by war.

  6. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU; Lu; WANG; Yiran

    2015-01-01

    Military surgeons are a special group of doctors.They are both medical workers and soldiers.Their mission is to serve the wounded on the battlefield.And there is no doubt that military surgeons will save our comrades in the army.However,should a military surgeon save the wounded enemy?It is indeed a dilemma.Some may save the wounded enemy because military surgeons are doctors after all and they can’t possibly abandon anybody to his fate,but some refuse to do so because military surgeons are soldiers.Therefore,some situations on the battlefield are discussed and advice is suggested for military surgeons,with heartfelt anticipation for there being less casualties on the battlefield as well as alleviating human suffering caused by war.

  7. David Hume on Competent Judges

    Science.gov (United States)

    Eaton, Marcia Muelder

    2004-01-01

    This essay is the eighth in an occasional series on past treatments of major issues in arts education policy from antiquity through the twentieth century. The essay on which it is based, David Hume's "Of the Standard of Taste," originally published in 1757, is too extensive to be reprinted here, but it is easily accessible in the public domain.…

  8. David Hume on Competent Judges

    Science.gov (United States)

    Eaton, Marcia Muelder

    2004-01-01

    This essay is the eighth in an occasional series on past treatments of major issues in arts education policy from antiquity through the twentieth century. The essay on which it is based, David Hume's "Of the Standard of Taste," originally published in 1757, is too extensive to be reprinted here, but it is easily accessible in the public…

  9. Society of Gynecologic Surgeons

    Science.gov (United States)

    Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ... Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ...

  10. Find a Surgeon

    Science.gov (United States)

    ... skin, muscle, bone and cartilage finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ... skin, muscle, bone and cartilage finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ...

  11. Surgeon compensation and motivation.

    Science.gov (United States)

    Leitch, K K; Walker, P M

    2000-06-01

    Financial incentives are the only form of compensation that will motivate surgeons at an academic health sciences center to perform the tasks outlined in the hospital's mission statement. A questionnaire divided into 5 sections: demographics, compensation, time allocation, benefits and incentives, and motivational factors. The Department of Surgery, The Toronto Hospital, Toronto, Ontario. All academic surgeons (N=64) practicing at The Toronto Hospital in July 1997. Of the 64 eligible mailed surveys, there were responses for 59. Of these 59 surgeons, 48 (81%) receive compensation through a fee-for-service method. However, only 32 (54%) of the surgeons prefer the fee-for-service method, while 18 (31%) prefer salary and 9 (15%) prefer an alternative system. On average, these academic surgeons spend 44% of their time teaching or performing research, for which they receive 14% of their total income. Of the motivational factors assessed, financial bonuses are a positive motivational factor for all "surgeon tasks." In addition, task-specific motivational factors were established for research, teaching, and operating, including research facilities, mentorship and prestige, and interesting case types, respectively. Surgeons are not appropriately renumerated for time spent on academic activities, and many would prefer an alternative form of compensation to the fee-for-service method. Knowledge that surgeons are receptive to tasks supporting the hospital's mission statement leads us to conclude that appropriate motivation can shape the activity of academic surgeons. Financial rewards ranked the highest as a motivational factor for all surgeon tasks; however, task-specific motivational factors were identified. Overall, multiple factors, specifically targeted to the individual, will serve to motivate. Thus, compensation packages based on individual preferences and personal motivational factors will be the most successful.

  12. The general practitioner and the surgeon: stereotypes and medical specialties O clínico e o cirurgião: esteriótipos e especialidades médicas

    Directory of Open Access Journals (Sweden)

    Patrícia Lacerda Bellodi

    2004-02-01

    Full Text Available OBJECTIVE: To investigate and characterize the professional stereotypes associated with general medicine and surgery among Brazilian medical residents. METHODS: A randomized sample of residents of the General Medicine and Surgery Residence Programs were interviewed and their perceptions and views of general and surgical doctors were compared. RESULTS: The general practitioner was characterized by the residents in general to be principally a sensitive and concerned doctor with a close relationship with the patient; (45%; calm, tranquil, and balanced (27%; with intellectual skills (25%; meticulous and attentive to details (23%; slow to resolve problems and make decisions (22%; and working more with probabilities and hypotheses (20%. The surgeon was considered to be practical and objective (40%; quickly resolving problems (35%; technical with manual skills (23%; omnipotent, arrogant, and domineering (23%; anxious, stressed, nervous, and temperamental (23%; and more decided, secure, and courageous (20%. Only the residents of general medicine attributed the surgeon with less knowledge of medicine and only the surgeons attributed gender characteristics to their own specialty. CONCLUSION: There was considerable similarity in the description of a typical general practitioner and surgeon among the residents in general, regardless of the specialty they had chosen. It was interesting to observe that these stereotypes persist despite the transformations in the history of medicine, i.e. the first physicians (especially regarding the valorization of knowledge and the first surgeons, so-called "barber surgeons" in Brazil (associated with less knowledge and the performance of high-risk procedures.OBJETIVOS: Investigar e caracterizar entre residentes brasileiros os estereótipos profissionais associados ao médico clínico e ao cirurgião. METODOLOGIA: uma amostra randomizada de residentes dos programas de Clínica Médica e Cirurgia foi entrevistada e suas

  13. 21 CFR 878.4470 - Surgeon's gloving cream.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgeon's gloving cream. 878.4470 Section 878.4470...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4470 Surgeon's gloving cream. (a) Identification. Surgeon's gloving cream is an ointment intended to be used to lubricate the...

  14. Civil Surgeon Info

    Data.gov (United States)

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

  15. Searching for Surgeons

    Science.gov (United States)

    ... Clinical Scholars in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry NSQIP Annual ... Southern Territories Gabon Gambia Gaza Strip Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey ...

  16. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Care for You How to Use Apps and Social Media for Your Practice Why Participation in the STS ... STS_CTsurgery Surgeons Residents & Students Allied ... Hotel Discount for STS Members Copyright © 2016 The Society ...

  17. Honoring Jean-David Rochaix.

    Science.gov (United States)

    Govindjee; Redding, Kevin

    2017-02-01

    We honor Jean-David Rochaix, an outstanding scholar of chloroplast biogenesis and photosynthesis, who received the prestigious Lifetime Achievement Award of the International Society of Photosynthesis Research at its 17th International Photosynthesis Congress held in Maastricht, The Netherlands (August 5-12, 2016). With this award he joins other major discoverers in the field of photosynthesis: Pierre Joliot (of France, 2013); Ulrich W. Heber* (of Germany, 2010) and Kenneth Sauer (of USA, 2010); Jan M. Anderson* (of Australia, 2007); and Horst T. Witt* (of Germany, 2004). See "Appendix 1" for the list of those who have received the ISPR Communication, Innovation, Calvin-Benson, and Hill awards.

  18. Transplant surgeon formation: vocation, incentives, between old and new surgeon generations.

    Science.gov (United States)

    Iaria, G; Cardillo, A

    2006-05-01

    The training of the transplant surgeon is one of the most difficult paths in medicine. The transplant surgeon must be trained as a general and a vascular surgeon; he has to be skilled and upgraded in transplant surgical technique; he has to decide the suitability of the donor and of the organs as well as the immunosuppressive therapy for each recipient; he must know the intensive care unit, hepatology, and nephrology. The transplant surgeon has to deal with surgical, infectious, and metabolic complications after organ transplantation. Thus, clinical formation of the transplant surgeon is multifactorial and always upgraded. However, transplants never happen in the morning; retrivals are more likely to be in the night (especially the holidays ones). "Weekend" is a word not frequently used by transplant surgeons. Moreover, when the transplant procedure happens, the normal activity of the ward and of the outpatient clinic were have to be done. The transplant surgeon must have a sort of "vocation" for such a job. Organ harvesting setting is a good proof of adaptability, always during nighttime, often in small hospitals with operating room nurses unfamiliar with the procedure, sometimes waiting for some colleagues or delaying the surgery. This vocation is enhanced by enthusiasm, but incentives are necessary to feed this love. Incentives should be professional and economic; transplant surgeons should be allowed to make clinical decisions, to choose the surgical technique of transplantation, to control the decision process. Lastly, due to the "total on call," the surgeon should profit from a right salary avoiding extramural activities.

  19. David Owen Williams (1944 - 2006)

    CERN Multimedia

    2006-01-01

    Many people, not only at CERN but also throughout the world, were saddened to learn that their friend and colleague David Williams had passed away in the early hours of Tuesday 24 October. His death came after a year of fighting cancer with all of his usual determination and optimism. Even days before the end he was still welcoming to visitors, and was alert and interested in all their news. Born in 1944, David came to CERN from the University of Cambridge in 1966, with a degree in Physics and Computer Science. Joining what at the time was called the Documents and Data (DD) Division, in the earlier part his career he worked first on software for analysis of bubble chamber photographs, subsequently leading the group that supported experiments with 'hybrids' of bubble chambers and electronic detectors and then the group supporting online computing in experiments. He thus witnessed all of the enormous changes that took place in particle physics as the era of bubble chambers came to an end and the availability ...

  20. Distributed Access View Integrated Database (DAVID) system

    Science.gov (United States)

    Jacobs, Barry E.

    1991-01-01

    The Distributed Access View Integrated Database (DAVID) System, which was adopted by the Astrophysics Division for their Astrophysics Data System, is a solution to the system heterogeneity problem. The heterogeneous components of the Astrophysics problem is outlined. The Library and Library Consortium levels of the DAVID approach are described. The 'books' and 'kits' level is discussed. The Universal Object Typer Management System level is described. The relation of the DAVID project with the Small Business Innovative Research (SBIR) program is explained.

  1. Leo Doyle, master surgeon.

    Science.gov (United States)

    Vellar, I

    2000-10-01

    On 3 March 1953 Leo Doyle died at the Mercy Hospital, Melbourne. The day before he died Leo Doyle had been operating at the Mercy Hospital when he took ill. Doyle's final illness was almost certainly the result of the severe aortic stenosis that had been developing over some years. His death at the relatively young age of 61 ended the career of a man described by Sir Gordon Gordon Taylor as the greatest technical surgeon that he had ever seen. In all likelihood Australian surgery will never see the likes of Doyle, a virtuoso surgeon, again. And yet to many of the surgeons who were Doyle's contemporaries and to those who followed him he remained somewhat of an enigma. Perhaps in some way the description of the great French surgeon Baron Dupuytren may also be applicable to Leo Doyle: known to all, loved by many, understood by few. By all accounts Leo Doyle's surgical repertoire knew no bounds. He operated with equal facility on the central nervous system, the head and neck, in the thorax, abdomen and pelvis and he was more than competent in gynaecology, urology and orthopaedics. In the latter part of his career he became, par excellence, a cancer surgeon. He was, arguably, Australia's first surgical oncologist. No procedure was deemed too complicated or demanding. Like some other superb technicians his judgement at times did not match his technical ability. Doyle was one of the first surgeons in Australia to perform hindquarter amputation and he helped to pioneer the operations of total gastrectomy and oesophagogastrectomy. An avid reader of the surgical literature, he possessed an enormous library which was matched by an equally large collection of surgical instruments. Unlike Devine he published relatively little. He was not a good clinical teacher, preferring to teach by example in the operating theatre. Although interested in music and the visual arts, surgery was his life.

  2. [Hospitals and surgeons: Madrid 1940].

    Science.gov (United States)

    de Quevedo, Francisco Vázquez

    2007-01-01

    The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.

  3. [Book review] Green engineering: environmentally conscious design, by David T. Allen and David R. Shonnard

    Science.gov (United States)

    Boustany, R.G.

    2002-01-01

    Review of: Green engineering: Environmentally conscious design / David T. Allen and David R. Shonnard / Prentice-Hall, Inc., One Lake Street, Upper Saddle River, NJ 07458. 2002. 552 pages. ISBN 0-13-061908-6.

  4. David Mechanic: Professional Zombie Hunter.

    Science.gov (United States)

    Hafferty, Frederic W; Tilburt, Jon

    2016-08-01

    Within the fields of medicine and sociology, the descriptor "profession" (along with its brethren: profession, professionalization, and professionalism) has had a rich etymological history, with terms taking on different meanings at different times-sometimes trespassing into shibboleth and jargon. This etymological journey has co-evolved with the career of David Mechanic to whom this issue of the Journal of Health Politics, Policy and Law is devoted. We exploit a provocative metaphor applied to Mechanic's work on the challenges facing medicine as a profession as a playful exegesis on what we call "profession" to excavate an ensconced and encrusted domain of health jargon operating at the tensive interface of society and modern medical work.

  5. Sir David Brewster: polarization pioneer

    Science.gov (United States)

    Coulson, Kinsell L.

    1992-12-01

    Sir David Brewster, Scottish physicist of the Nineteenth Century, was one of the pioneers in the investigation of the polarization of light. Every physics student is familiar with the Brewster angle of reflection, and the Brewster neutral point of skylight polarization is a well- known feature in atmospheric optics. He was at one time the most honored natural philosopher in Britain, having received numerous medals plus a knighthood for his work in the polarization of light. This paper, having arisen from my new biography of Brewster, traces his polarization work throughout his most productive period in the first half of the last century. It is of interest to science historians, as well as to those working in the field of polarization phenomena.

  6. A Star of David catenane

    Science.gov (United States)

    Leigh, David A.; Pritchard, Robin G.; Stephens, Alexander J.

    2014-11-01

    We describe the synthesis of a [2]catenane that consists of two triply entwined 114-membered rings, a molecular link. The woven scaffold is a hexameric circular helicate generated by the assembly of six tris(bipyridine) ligands with six iron(II) cations, with the size of the helicate promoted by the use of sulfate counterions. The structure of the ligand extension directs subsequent covalent capture of the catenane by ring-closing olefin metathesis. Confirmation of the Star of David topology (two rings, six crossings) is provided by NMR spectroscopy, mass spectrometry and X-ray crystallography. Extraction of the iron(II) ions with tetrasodium ethylenediaminetetraacetate affords the wholly organic molecular link. The self-assembly of interwoven circular frameworks of controlled size, and their subsequent closure by multiple directed covalent bond-forming reactions, provides a powerful strategy for the synthesis of molecular topologies of ever-increasing complexity.

  7. David Hubel and Torsten Wiesel.

    Science.gov (United States)

    Hubel, David; Wiesel, Torsten

    2012-07-26

    While attending medical school at McGill, David Hubel developed an interest in the nervous system during the summers he spent at the Montreal Neurological Institute. After heading to the United States in 1954 for a Neurology year at Johns Hopkins, he was drafted by the army and was assigned to the Neuropsychiatry Division at the Walter Reed Hospital, where he began his career in research and did his first recordings from the visual cortex of sleeping and awake cats. In 1958, he moved to the lab of Stephen Kuffler at Johns Hopkins, where he began a long and fruitful collaboration with Torsten Wiesel. Born in Sweden, Torsten Wiesel began his scientific career at the Karolinska Institute, where he received his medical degree in 1954. After spending a year in Carl Gustaf Bernhard's laboratory doing basic neurophysiological research, he moved to the United States to be a postdoctoral fellow with Stephen Kuffler. It was at Johns Hopkins where he met David Hubel in 1958, and they began working together on exploring the receptive field properties of neurons in the visual cortex. Their collaboration continued until the late seventies. Hubel and Wiesel's work provided fundamental insight into information processing in the visual system and laid the foundation for the field of visual neuroscience. They have had many achievements, including--but not limited to--the discovery of orientation selectivity in visual cortex neurons and the characterization of the columnar organization of visual cortex through their discovery of orientation columns and ocular-dominance columns. Their work earned them the Nobel Prize for Physiology or Medicine in 1981, which they shared with Roger Sperry. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. David L. Harrison: A Work Of Art

    Science.gov (United States)

    Raymond, Allen

    2005-01-01

    This article describes poet and writer David L. Harrison. A former School Board Chairman from Springfield, MO, David was responsible for beginning an annual "Teacher Appreciation Banquet" and for launching the "Sky High for Reading" program. The "Sky High for Reading" program encourages children in Springfield to read enough books so that, if…

  9. [Exhibition review of] David Bowie is

    DEFF Research Database (Denmark)

    Langkjær, Michael Alexander

    2014-01-01

    Anmeldelse af en udstilling d. 23. marts - 28. juli 2013 om rockmusikeren David Bowie på Victoria and Albert Museet, London.......Anmeldelse af en udstilling d. 23. marts - 28. juli 2013 om rockmusikeren David Bowie på Victoria and Albert Museet, London....

  10. David L. Harrison: A Work Of Art

    Science.gov (United States)

    Raymond, Allen

    2005-01-01

    This article describes poet and writer David L. Harrison. A former School Board Chairman from Springfield, MO, David was responsible for beginning an annual "Teacher Appreciation Banquet" and for launching the "Sky High for Reading" program. The "Sky High for Reading" program encourages children in Springfield to read enough books so that, if…

  11. Akinetic mutism and the story of David.

    Science.gov (United States)

    Sinden, Rebecca; Wilson, Barbara A; Rose, Anita; Mistry, Nimisha

    2017-02-02

    Following a description about the characteristics of akinetic mutism (AM) and how it differs from locked-in syndrome (LIS) and a disorder of consciousness (DOC), we present the case of David, a 71-year-old man with AM. David sustained a stroke following a middle cerebral artery (MCA) thrombus. A CT scan at the time detected old ischaemic infarcts affecting the right frontal lobe, the left occipital lobe and the left parietal lobe so David had bilateral brain damage. Initially thought to have a DOC, further neuropsychological assessments administered when David had improved a little, resulted in the diagnosis of AM. Although David spoke little, when he did speak, his words and phrases were well articulated, grammatical and with appropriate intonation. He was alert and visually aware and he was not paralysed. We discuss whether the diagnosis was correct and address the difficulties in assessing such patients.

  12. Canadian cardiac surgeons' perspectives on biomedical innovation.

    Science.gov (United States)

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

    2012-01-01

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

  13. Do Surrealismo em David Lynch

    Directory of Open Access Journals (Sweden)

    Mirian Tavares

    2009-01-01

    Full Text Available O surrealismo, como a arte do seu tempo, propõe uma nova estética, capaz de extrair o belo do absurdo e de instaurar o desvio para que daí surja, de fato, o real. Através da análise de algumas obras de David Lynch e dos livros Les champs magnétiques de Breton e Philippe Soupault e Poisson soluble, de Breton, irei mostrar a pertinência da designação surrealista para a obra do cineasta norte-americano. Lynch, como os surrealistas, constrói uma operação dialética entre o racional/irracional. Ao mesmo tempo em que opera no campo artístico em direção à irracionalidade absoluta, Lynch não nega a sua inserção na sociedade. Acredito que o realizador, como os surrealistas, tenha conseguido encontrar um equilíbrio entre as duas formas de se estar no mundo, racional/irracional, jogando com suas antíteses. O prazer do jogo surrealista consiste em ir até as profundezas do inconsciente e retornar com matéria suficiente para fazer uma obra de arte.Surrealism, as the art of its time, proposes a new aesthetics, one that is able to extract the beautiful from the absurd and to establish the swerve from the standard, from which, in fact, the real comes through. Through the analysis of some works by David Lynch, of Breton and Soupault's Les champs magnétiques, and of Breton's Poisson soluble, I will attempt to show the relevance of the surrealist designation for the work of the American filmmaker. Lynch, like the surrealists, builds a dialectic operation between the rational and the irrational. While operating in the artistic field towards absolute irrationality, Lynch does not deny its role in society. It is my belief that the director, as the surrealists, has managed to find a balance between the two ways of being in the world: rational and irrational; by playing with their antitheses. The pleasure of the surrealist game is to go to the depths of the unconscious and return with sufficient material to make a work of art out of it.

  14. Magnification for the dermatologic surgeon.

    Science.gov (United States)

    Chodkiewicz, Hubert M; Joseph, Aaron K

    2017-06-01

    Ergonomic practice increases the productivity, quality, and longevity of the dermatologic surgeon. When used properly, magnification devices can be ergonomic and beneficial additions to the dermatologic surgeon's practice. Herein, we review the available magnification options for the dermatologic surgeon and evaluate the options based on cost, design, and functional advantages and disadvantages. Magnification for the dermatologic surgeon may be a useful tool for a healthier, more efficient, and higher-quality practice.

  15. Herniation of the cervical disk in plastic surgeons.

    Science.gov (United States)

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Chen, Tim-Mo

    2012-12-01

    Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease.

  16. Chinese medicine and the surgeon.

    Science.gov (United States)

    Leung, Ping-Chung; Biji, Sreedhar; Yeung, Chung-Kwong

    2011-07-01

    The surgeon aims at a direct, complete removal of the pathology. In spite of the modern advancements of imaging facilities and precision instrumentations, unsatisfactory results and recurrences are not uncommon. This paper provides a general review of the four specific areas in surgery that would benefit from Chinese medicine. Extensive searches were made on four surgical areas based on available English language journals, viz. low-back pain, chronic ulcers, renal calculus, and enuresis in children, in the past 10 years. The quoted communications are mainly related to clinical evidences, while a smaller number of crucial laboratory reports are also included. Low-back pain, a most frequent orthopaedic problem, would benefit from acupuncture treatment. Chronic leg ulcers could achieve better results of healing using herbal supplements. Problems of renal stones, besides the conventional methods of removal, could be further supplemented with herbal drinks that aim at prevention of recurrences. Enuresis in children, an untreatable common condition, may respond well to acupuncture. Surgeons should keep an open mind. In case of difficulties, they could seriously consider options of traditional treatment.

  17. American Society of Plastic Surgeons

    Science.gov (United States)

    ... PRS PRS GO PSN PSEN GRAFT Contact Us Cosmetic Surgery New procedures and advanced technologies offer plastic surgery ... David Berman MD 14 Pidgeon Hill Drive Berman Cosmetic Surgery & S... Sterling, VA 20165 Website Franklin Richards MD Suite ...

  18. [The surgeon at retirement].

    Science.gov (United States)

    Fernández del Castillo-Sánchez, Carlos

    2012-01-01

    Our vocation has called us to become physicians and we have learned and practiced surgery as part of our medical training and knowledge. Surgery is an art expressed during each intervention carried out with effectiveness and devotion; enjoying the pleasure to perform it without hurry, with harmony, fluency and cleanness. Therefore, medicine and surgery belong to the same vocation being at service of people with the clear mission to heal patients and if we favor it, this activity will get our attention firmly and forever. A physician is a sensitive person that understands the sadness and happiness consequence of his actions at the office, operating room, research and relationships with colleagues. This provides him a pleasant experience of practicing medicine and especially surgery. Medical and surgical professions produce an irresistible attraction and they are very rewarding experiences; however, as time goes by there are effects over physician's health. Surgeons will switch from an active professional role into a passive agent and will need to assess himself and answer if he is still in optimal conditions to practice medicine. Therefore, every surgeon must be prepared to grow old from the start and preserve his Faith once retirement has been accepted as the next step in his career.

  19. Decreased heart rate variability in surgeons during night shifts

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  20. Dr. David Syz, State Secretary for Economic Affairs, Switzerland

    CERN Multimedia

    Patrice Loïez

    2003-01-01

    Photo 01: Dr. David Syz (left) with Professor Roger Cashmore, Research Director for Collider Programmes.Photo 02: Dr. David Syz signing the VIP visitors' book, with Prof. Roger Cashmore.Photo 03: Dr. David Syz signing the VIP visitors' book.Photo 04: Handshake between Dr. David Syz (left) and Prof. Roger Cashmore.

  1. Cost and logistics of implementing a tissue-based American College of Surgeons/Association of Program Directors in Surgery surgical skills curriculum for general surgery residents of all clinical years.

    Science.gov (United States)

    Henry, Brandon; Clark, Philip; Sudan, Ranjan

    2014-02-01

    The cost and logistics of deploying the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) National Technical Skills Curriculum across all training years are not known. This information is essential for residency programs choosing to adopt similar curricula. A task force evaluated the authors' institution's existing simulation curriculum and enhanced it by implementing the ACS/APDS modules. A 35-module curriculum was administered to 35 general surgery residents across all 5 clinical years. The costs and logistics were noted, and resident satisfaction was assessed. The annual operational cost was $110,300 ($3,150 per resident). Cost per module, per resident was $940 for the cadaveric module compared with $220 and $240 for dry simulation and animal tissue-based modules, respectively. Resident satisfaction improved from 2.45 to 4.78 on a 5-point, Likert-type scale after implementing the ACS/APDS modules. The ACS/APDS skills curriculum was implemented successfully across all clinical years. Cadaveric modules were the most expensive. Animal and dry simulation modules were equivalent in cost. The addition of tissue-based modules was associated with high satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-08-01

    Burnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions. We asked: (1) For surgeons treating musculoskeletal conditions, what risk factors are associated with worse job dissatisfaction? (2) What risk factors are associated with burnout symptoms? Two hundred ten (52% of all active members of the Science of Variation Group [SOVG]) surgeons who treat musculoskeletal conditions (94% orthopaedic surgeons and 6% trauma surgeons; in Europe, general trauma surgeons do most of the fracture surgery) completed the Global Job Satisfaction instrument, Shirom-Malamed Burnout Measure, and provided practice and surgeon characteristics. Most surgeons were male (193 surgeons, 92%) and most were academically employed (186 surgeons, 89%). Factors independently associated with job satisfaction and burnout were identified with multivariable analysis. Greater symptoms of burnout (β, -7.13; standard error [SE], 0.75; 95% CI, -8.60 to -5.66; p < 0.001; adjusted R(2), 0.33) was the only factor independently associated with lower job satisfaction. Having children (β, -0.45; SE, 0.0.21; 95% CI, -0.85 to -0.043; p = 0.030; adjusted R(2), 0.046) was the only factor independently associated with fewer symptoms of burnout. Among an active research group of largely academic surgeons treating musculoskeletal conditions, most are satisfied with their job. Efforts to limit burnout and job satisfaction by optimizing engagement in and deriving meaning from the work are effective in other settings and merit attention among surgeons. Level II, prognostic study.

  3. Obituary: David Stanley Evans, 1916-2004

    Science.gov (United States)

    Bash, Frank N.

    2005-12-01

    David Stanley Evans died on 14 November 2004 in Austin, Texas. He was a noted observational astronomer whose career was divided between South Africa and Texas. He also used the extensive historical collections at the University of Texas to write several books on the history of astronomy. He was born in Cardiff, Wales on 28 January 1916. David received his BA degree in mathematics in 1937 from Kings College, Cambridge. He became a PhD student at Cambridge Observatory in 1937, and was one of Sir Arthur Eddington's last surviving students. He received his PhD degree in 1941 with a dissertation entitled, "The Formation of the Balmer Series of Hydrogen in Stellar Atmospheres." He was a conscientious objector to war and, thus, spent the war years at Oxford working with physicist Kurt Mendelssohn on medical problems, involving cadavers, relating to the war. During these years, David was scientific editor of "Discovery", and he was editor of "The Observatory". David left England in 1946 in order to take up the position of Second Assistant at the Radcliffe Observatory, Pretoria, South Africa. He and H. Knox Shaw were the entire staff after R. O. Redman left, and they aluminized and installed the mirrors in the 74-inch telescope. His notable scientific contribution was to use lunar occultations to measure stellar angular diameters during the 1950s. He succeeded in determining the angular diameter of Antares and determined that Arcturus was not circular but had an elliptical shape. The elliptical shape was later shown to be an instrumental artifact, but the utility of using lunar occultations to measure stellar diameters and stellar multiplicity was conclusively demonstrated. T. Gold presented David's paper on lunar occultation angular diameters at the January 1953 meeting of the Royal Astronomical Society. For the rest of his life, David resented Gold's remarks, because he felt that he had been ridiculed. By 1953, David Evans was Chief Assistant at the Royal Observatory

  4. Surgeon-industry conflict of interest: survey of North Americans' opinions regarding surgeons consulting with industry.

    Science.gov (United States)

    DiPaola, Christian P; Dea, Nicolas; Noonan, Vanessa K; Bailey, Christopher S; Dvorak, Marcel F S; Fisher, Charles G

    2014-04-01

    Surgeon-industry conflict of interest (COI) has become a source of considerable interest. Professional medical societies, industry, and policy makers have attempted to regulate potential COI without consideration for public opinion. The objective of this study was to report on the opinions of individuals representing the general public regarding surgeon-industry consulting relationships. Web-based survey. Survey was administered using a "spine Web site," and opinions are collected on surgeon-industry consulting and regulation. Associations among responses to similar questions were assessed to ensure validity and subgroup analysis performed for respondent age, sex, education, insurance, employment, and patient status. Six hundred ten of 642 surveys had complete data. The sample population comprised more females and was older and more educated than the American population. About 80% of respondents felt it was ethical and either beneficial or of no influence to the quality of health care if surgeons were consultants for surgical device companies. Most felt disclosure of an industry relationship was important and paying surgeons royalties for devices, other than those they directly implant, would not affect quality of care. Respondents support multidisciplinary surgeon-industry COI regulation and trust doctors and their professional societies to head this effort. Despite the known potential negative impact of surgeon-industry COI on patient care, this study revealed that this does not seem to be reflected in the opinion of the general public. The respondents felt that disclosure is deemed one of the most important means of self-regulation and COI management, which is in agreement with current trends of most spine societies and journals that are increasing the stringency of disclosure policies. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. David Barker, Buruli ulcer and the epidemiology of a neglected tropical disease.

    Science.gov (United States)

    Phillips, D I W

    2015-10-01

    In 1969, David Barker, his wife and four children moved to Uganda to work at Makerere Medical School in the capital Kampala. During the 1960s, Makerere had become a research and teaching centre with an international reputation based on the work of Trowell, Burkitt, Hutt and many others who had pioneered studies explaining the disease patterns in the West Nile area on the basis of the local climate, nutrition and lifestyle. David Barker was funded by the Medical Research Council to carry out research on a poorly understood disease, Buruli ulcer, joining Scottish surgeon Wilson Carswell, who was later to achieve fame as the role model for Dr Garrigan in Giles Foden's novel The Last King of Scotland.

  6. American Society of Plastic Surgeons

    Science.gov (United States)

    ... know the risks and trust a board-certified plastic surgeon to perform your cosmetic or reconstructive surgery. ASPS member surgeons have the training and experience that ... 1300 Chain Bridge Road McLean, VA 22101 (703) 790-5454 Timothy Germain ...

  7. Surgeon-industry conflict of interest: survey of opinions regarding industry-sponsored educational events and surgeon teaching: clinical article.

    Science.gov (United States)

    DiPaola, Christian P; Dea, Nicolas; Dvorak, Marcel F; Lee, Robert S; Hartig, Dennis; Fisher, Charles G

    2014-03-01

    Conflict of interest (COI) as it applies to medical education and training has become a source of considerable interest, debate, and regulation in the last decade. Companies often pay surgeons as faculty for educational events and often sponsor and give financial support to major professional society meetings. Professional medical societies, industry, and legislators have attempted to regulate potential COI without consideration for public opinion. The practice of evidence-based medicine requires the inclusion of patient opinion along with best available evidence and expert opinion. The primary goal of this study was to assess the opinion of the general population regarding surgeon-industry COI for education-related events. A Web-based survey was administered, with special emphasis on the surgeon's role in industry-sponsored education and support of professional societies. A survey was constructed to sample opinions on reimbursement, disclosure, and funding sources for educational events. There were 501 completed surveys available for analysis. More than 90% of respondents believed that industry funding for surgeons' tuition and travel for either industry-sponsored or professional society educational meetings would either not affect the quality of care delivered or would cause it to improve. Similar results were generated for opinions on surgeons being paid by industry to teach other surgeons. Moreover, the majority of respondents believed it was ethical or had no opinion if surgeons had such a relationship with industry. Respondents were also generally in favor of educational conferences for surgeons regardless of funding source. Disclosures of a surgeon-industry relationship, especially if it involves specific devices that may be used in their surgery, appears to be important to respondents. The vast majority of respondents in this study do not believe that the quality of their care will be diminished due to industry funding of educational events, for surgeon

  8. Effect of surgeon experience on femoral component size selection during total knee arthroplasty.

    Science.gov (United States)

    Nandi, Sumon; Bono, James V; Froimson, Mark; Jones, Morgan; Bershadsky, Boris

    2013-01-01

    Femoral component size selection during total knee arthroplasty should not vary from surgeon to surgeon for patients with the same bone size. This study explored if systematic variations in femoral component size selection exist. Thirteen surgeons' choices of femoral component size (Duracon, n = 1388; Triathlon, n = 740) were analyzed using a generalized linear model with femoral component size as the dependent variable and surgeon identification, years in practice, and adult reconstruction fellowship training as the independent variables. The model adjusted for differences in bone size. It was found that more experienced surgeons implant larger femoral components. New instruments and training protocols may be necessary to adjust for surgeon experience.

  9. Think small: nanotechnology for plastic surgeons.

    Science.gov (United States)

    Nasir, Amir R; Brenner, Sara A

    2012-11-01

    The purpose of this article is to introduce the topic of nanotechnology to plastic surgeons and to discuss its relevance to medicine in general and plastic surgery in particular. Nanotechnology will be defined, and some important historical milestones discussed. Common applications of nanotechnology in various medical and surgical subspecialties will be reviewed. Future applications of nanotechnology to plastic surgery will be examined. Finally, the critical field of nanotoxicology and the safe use of nanotechnology in medicine and plastic surgery will be addressed.

  10. A Conversation with...David Satcher.

    Science.gov (United States)

    Campbell, Neil A.

    1996-01-01

    David Satcher began his career as a medical geneticist and was appointed director of the Centers for Disease Control and Prevention (CDC) in 1993. In this interview, Dr. Satcher talks about the responsibilities of the CDC and explains how a childhood experience inspired his interest in medicine and his continuing commitment to community service.…

  11. Binary Structure in David Lodge's Novels

    Institute of Scientific and Technical Information of China (English)

    高萍

    2008-01-01

    David Lodge is one of the most renowned modern English writers.He is known for the binary structure in his novels.In this paper,the writer will try to the binary structure in some of his novels to show his reflections on Catholicism and culture conflicts.

  12. David Ben-Gurion: A Creative Leader

    Science.gov (United States)

    Rosemarin, Shoshana

    2014-01-01

    David Ben-Gurion (1886-1973), the first Prime Minister of Israel, is included in Pasternak's (2001) list of the nine most memorable leaders of the twentieth century. All of them are remembered for the reforms they initiated. Roosevelt (USA), Stalin (Russia), Castro (Cuba), and Thatcher (England) focused on social-economical changes, whereas Gandhi…

  13. David L. Gutmann (1925-2013).

    Science.gov (United States)

    Rose, Jon; Huyck, Margaret; Grunes, Jerome

    2014-01-01

    David L. Gutmann, a pioneer in geropsychology and professor emeritus at Northwestern University, died on November 3, 2013, at the age of 88. A student of Bernice Neugarten, Bruno Bettelheim, and Erik Erikson, Gutmann discovered changes in adult psychological development related to parenting styles that held across diverse cultures.

  14. Emil Theodor Kocher (1841-1917)--orthopaedic surgeon and the first surgeon Nobel Prize winner.

    Science.gov (United States)

    Bumbasirević, Marko Z; Zagorac, Slavisa G; Lesić, Aleksandar R

    2013-01-01

    Theodor Emil Kocher (1841-1917), born in Bern, educated in many universities in Europe. Kocher as many surgeons of that time performed orthopedic surgery, general surgery, neurosurgery and endocrine surgery, but he become famous in orthopaedic surgery and endocrine surgery. He is remember as a surgeon who described the approach to the hip joint, elbow joint, maneuver for the reduction of dislocated shoulder joint. He introduced many instruments and many of them, such as Kocher clamp is still in use. Most important Kocher work was the thyroid gland surgery, and he received the Nobel Prize for Medicine in 1909, for-in this matter. His nature of meticulous surgeon, scientific and hard working person, dedicated to his patients and students made- found him the place in a history of medicine.

  15. [Surgeons in Krakow between WWI and WWII].

    Science.gov (United States)

    Wysocki, A; Dolecki, M

    2001-01-01

    During the war time when Polish borders had not been established yet, apart from having two surgical departments Jagiellonian University, Krakow had surgical departments in the Bonifratow, Izraelicki and Military Hospitals. More surgical departments were opened up in later years in pubic Health System Hospitals, among them were Narutowicz at near Pradnicka street and Sisters of Mercy at Lea street. Other well-known Krakow surgeons operated in smaller, private surgeries, such as: Dom Zdrowia (House of Health) or Zwiazkowy (Union) Clinic. At that time only 30 Surgeons worked in Kraków. They were outstanding specialists with a broad practice. Among them were Maksymilian Rutkowski, Jan Glatzel, Stanislaw Nowicki, Michal Hladij. Gradually, younger surgeons started to join them. they were: Jan Kowalczyk, Jerzy Jasienski, Stanislaw Kania, Wladyslaw Laszczak, Jozef Bugusz, Jozef Gasinski. Many of them who worked in the surgical hospitals in Krakow, left the city after obtaining a professorship (like Kornel Michejda, professor at the University of Wilno) or became heads of wards, like Zygmunt Drobniewicz, Alfons Mackowski and Tadeusz Guschlbauer. All of these surgeons were highly respected by the medical community as well as by the general public in their respective town and surrounding areas. A large income allowed that best of them to fund and supply their own wards. Occasionally, however, among the less successful surgeons, an uncompromising competition for patients developed. These events were disapproved and condemned by the medical establishment. Many surgeons led an active life outside of their profession. A surgeon with an exceptionally colorful personality was Jan Glatzel: witty, highly intelligent, a connoisseur of fine art, book lover with an active social life. Maksymilian Rutkowski was active in charitable organizations, helping to support Bratnia Pomoc Medykow. Michal Hladij, president of KS Cracovia, vice president of Krakowski Klub Automobilowy rendered his

  16. Unravelling the Franklin Mystery, Second Edition with David C. Woodman

    DEFF Research Database (Denmark)

    Burke, Danita Catherine

    2017-01-01

    This is a forthcoming book review of David C. Woodman's second edition of his book "Unravelling the Franklin Mystery."......This is a forthcoming book review of David C. Woodman's second edition of his book "Unravelling the Franklin Mystery."...

  17. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  18. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

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

  19. Smartphones and the plastic surgeon.

    Science.gov (United States)

    Al-Hadithy, Nada; Ghosh, Sudip

    2013-06-01

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

  20. [The first woman surgeons in the Netherlands].

    Science.gov (United States)

    Mulder, M; De Jong, E

    1997-01-01

    This article describes the position of woman surgeons in the Netherlands. In 1913 the first woman, Heleen Robert, was accepted as member of the Dutch Society of Surgery. Three others, Jeanne Knoop, Frieda van Hasselt and Rosalie Wijnberg, followed during the next ten years. The nomination of Rosalie Wijnberg caused a turbulent discussion as she was working as a gynaecologist and not as a surgeon. One can wonder about this argument as other members were gynaecologists too. It seems that the male attitudes towards women were changing as more women entered the male dominated field. Nevertheless, from 1931 on, the year in which the registration of specialists was created, a number of women succeeded in obtaining a registration in surgery. Four of them were interviewed: dr. D.A.E. Norel, A.G. Wiersum-de Kwaadsteniet, J. Leeksma-Lievense and A.A. Fierstra. The general opinion still is that surgery is not a female profession. At the moment there are some twenty women working as general surgeon compared to a seven hundred men.

  1. Surgical complications and their implications for surgeons' well-being.

    Science.gov (United States)

    Pinto, A; Faiz, O; Bicknell, C; Vincent, C

    2013-12-01

    Healthcare professionals can be seriously affected when they are involved in major clinical incidents. The impact of such incidents on staff is of particular relevance to surgery, as the operating room is one of the highest-risk areas for serious complications. This qualitative study aimed to assess the personal and professional impact of surgical complications on surgeons. This single time point study involved semistructured, individual interviews with general and vascular surgeons, consultants and senior registrars from two National Health Service organizations in London, UK. Twenty-seven surgeons participated. Many were seriously affected by major surgical complications. Surgeons' practice was also often affected, not always in the best interest of their patients. The surgeons' reactions depended on the preventability of the complications, their personality and experience, patient outcomes and patients' reactions, as well as colleagues' reactions and the culture of the institution. Discussing complications, deconstructing the incidents and rationalizing were the most commonly quoted coping mechanisms. Institutional support was generally described as inadequate, and the participants often reported the existence of strong institutional blame cultures. Suggestions for supporting surgeons in managing the personal impact of complications included better mentoring, teamwork approaches, blame-free opportunities for the discussion of complications, and structures aimed at the human aspects of complications. Those involved in the management of surgical services need to consider how to improve support for surgeons in the aftermath of major surgical incidents. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

  2. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

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

    2015-01-01

    BACKGROUND: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts. METHODS: Surgeons were monitored...... prospectively for 4 days: pre call, on call, post call day 1 (PC1), and post call day 2 (PC2). The urinary metabolite of melatonin and cortisol in saliva were measured to assess the circadian rhythm. Sleep and activity were measured by actigraphy. Subjective measures were assessed by the Karolinska Sleepiness...... Scale and Visual Analog Scale of fatigue, general well-being, and sleep quality. RESULTS: For both metabolite of melatonin and cortisol, a significant difference (P sleep time during the day on call...

  3. Occupational Stress and Burnout among Surgeons in Fiji.

    Science.gov (United States)

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

    2017-01-01

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

  4. David's Dying Directives according to Josephus

    Directory of Open Access Journals (Sweden)

    Begg, Christopher

    2005-12-01

    Full Text Available 1 Kgs 2,1-9, «the testament of David», records the king's final instructions to his son Solomon. This article offers a detailed study of Josephus' version (Ant. 7.383- 388 of the testament in relation to its biblical source. The study focusses particularly on the textual affinities of Josephus' presentation, given the differences among the various ancient versions (MT, LXX, Targum of the testament. The article likewise examines the range of re-writing techniques utilized by Josephus in Ant. 7.383-388 and their contribution in generating a distinctive rendition of David's testament.

    1 Re 2,1-9, «el testamento de David», recoge las últimas instrucciones del rey para su hijo Salomón. Este artículo ofrece un detallado estudio de la versión de Josefo (Ant. 7.383-388 del testamento en relación con su fuente bíblica. El estudio se centra especialmente en las afinidades textuales de la presentación de Josefo, a la vista de las diferencias entre las distintas versiones antiguas del testamento (TM, LXX, Targum. Así mismo, el artículo examina las diferentes técnicas de reescritura empleadas por Josefo en Ant. 7.383-388 y su contribución a la producción de una versión diferenciada del testamento de David.

  5. Integral Evolution: An Interview with David Loye

    Directory of Open Access Journals (Sweden)

    Russ Volckmann

    2008-12-01

    Full Text Available David Loye is one of those people that the longer you get to know them the more you begin todiscover a bit of their depth and breadth of perspective and creativity in the world. Hispublications speak for themselves. His network with leading scientists and thinkers around theworld is equally impressive.Actually, my first contact was with David’s wife, Riane Eisler, author of the Chalice and theBlade (among other books written with and without David. Despite the fact that they live overthe hill from me, I did not meet her face to face right away. Rather, I interviewed her over thetelephone for the Integral Leadership Review, which I publish and edit. When I first approachedher about doing the interview she suggested that I should interview David, but I did not knowDavid Loye’s work at all. In that interview I discovered more about Riane’s work and the extentof their partnership. In fact, they are prime movers of a partnership approach to leadership thatthey promote through a nonprofit center and in a Master’s program at the California Institute ofIntegral Studies in San Francisco.My conversation with Riane piqued my curiosity about David’s work and I bought one of hisbooks, Darwin’s Lost Theory of Love. Here I found evidence of the extraordinary scope anddepth of David’s work that made him a natural candidate for an interview. The only questionwas would I use it in Integral Leadership Review or in Integral Review: such is the quality of hisinterests and intellect.Before doing the interview, I borrowed a copy of one of David’s earlier books. When I went totheir house to pick it up I met them both. They are quite a team and I recommend their work toall.

  6. 15th Chapter of Surgeons Lecture: Surgeon of the new millennium--surgeon, scientist and scholar.

    Science.gov (United States)

    Tan, S K

    2004-11-01

    The surgeon of the new millennium has come a long way from his humble beginnings in the Middle Ages as the lowly barber-surgeon. The skills and techniques developed by outstanding surgeons like Astley Cooper of the 19th century have withstood the test of time and have been refined by subsequent generations of surgical masters. The scientific basis of modern surgery was put on a firm footing in the early 19th century through the discovery of anaesthesia and microorganisms as a cause of many diseases and surgical complications. The 20th century brought about rapid progress in medicine, information technology (IT) and the life sciences, and closed with a big bang with the completion of the sequencing of the human genome. For the surgeon of the 21st century to remain relevant, he must embrace the concept of the Total Surgeon. Not doing so will render him irrelevant in the course of time, for having good surgical technique alone is insufficient. He must also lead in scientific endeavours to push the frontiers of the life sciences in attempts to solve the insoluble, and be scholarly in thought, attitude and behaviour. In other words, he must be a Surgeon-Scientist-Scholar.

  7. David Gopperfield is an Autobiography of Dickens

    Institute of Scientific and Technical Information of China (English)

    李倩

    2011-01-01

    Dickens is considered to be one of the greatest English novelists of the Victorian period. David Copperfield published in 1849-1850,was written when Dickens creative power reached his height. The story is narrated in the first person through the mouth of its hero: David Copperfield. In David Copperfield. Dickens made good use of his own life experiences to expose the social evils of its own. For example, they were also born on Friday, they had wretched childhood. David's love for Dora modeled after Dickens" youthful fascination for Maria Beadnell, Dickens" father was the original form of Mr. Micawber in DC and Dickens" mother was the original form of David's pretty young mother. And in the book, we also can see that the immorality and the treachery were prevalent in the England realism. So the novel is not only a personal record, but also a broad picture of the society of the author's day. In my opinion , we could say DC is an autobiography of Dickens.

  8. David Gill - Magnificent and Desirable Astronomer

    CERN Document Server

    Reid, John S

    2016-01-01

    This paper was given to mark the centenary of the death of David Gill, the foremost British astronomer in the last quarter of the 19th century and into the 20th century. Gill abandoned a successful career as a clock and watchmaker. His speciality was in astrometry, an area of astronomy of both practical and scientific importance that tended to be eclipsed in the 20th century by the rise of astrophysics. As Her Majesty's Astronomer at the Cape of Good Hope for 27 years, David Gill was admired for his prolific contribution to highly accurate and trustworthy results. David Gill's collaboration was desired by leading astronomers of the day and he was the only southern hemisphere representative on the hugely important Conference Internationale des Etoiles Fondamentales of 1896. He created with Jacobus Kapetyn the first extensive star catalogue derived from photographic plates (the CPD), including over 450,000 stars. He was an initiator of the biggest multi-national and multi-observatory project of the century, tak...

  9. [The educational program for modern military surgeons].

    Science.gov (United States)

    Willy, C; Gutcke, A; Klein, B; Rauhut, F; Friemert, B; Kollig, E W; Weller, N; Lieber, A

    2010-02-01

    Casualties in military conflict produce patterns of injuries that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialization the deployed surgeon needs to acquire and maintain a wide range of skills from a variety of surgical specialties. Improvised explosive devices (IEDs) have become the modus operandi for terrorists and in the current global security situation these tactics can be equally employed against civilian targets. Therefore, knowledge and training in the management of these injuries are relevant to both military and civilian surgeons. To create this kind of military surgeon the so-called "DUO-plus" model for the training of surgical officers (specialization general surgery plus a second specialization either in visceral surgery or orthopedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery and emergency gynecology, are integrated into this concept and will be taught in courses. Log books will be kept in accordance with the training curricula. On successful completion of the program medical officers will be officially appointed as Medical Officer "Einsatzchirurg" by their commanding officers for a maximum of 5 years and it will be necessary to renew it after this period. These refresher programs will require participation in visiting physicians programs in the complementary surgical disciplines in order to retain the essential specific skills.

  10. Surgeon-related factors and outcome in rectal cancer.

    Science.gov (United States)

    Porter, G A; Soskolne, C L; Yakimets, W W; Newman, S C

    1998-01-01

    OBJECTIVE: To determine whether surgical subspecialty training in colorectal surgery or frequency of rectal cancer resection by the surgeon are independent prognostic factors for local recurrence (LR) and survival. SUMMARY BACKGROUND DATA: Variation in patient outcome in rectal cancer has been shown among centers and among individual surgeons. However, the prognostic importance of surgeon-related factors is largely unknown. METHODS: All patients undergoing potentially curative low anterior resection or abdominoperineal resection for primary adenocarcinoma of the rectum between 1983 and 1990 at the five Edmonton general hospitals were reviewed in a historic-prospective study design. Preoperative, intraoperative, pathologic, adjuvant therapy, and outcome variables were obtained. Outcomes of interest included LR and disease-specific survival (DSS). To determine survival rates and to control both confounding and interaction, multivariate analysis was performed using Cox proportional hazards regression. RESULTS: The study included 683 patients involving 52 surgeons, with > 5-year follow-up obtained on 663 (97%) patients. There were five colorectal-trained surgeons who performed 109 (16%) of the operations. Independent of surgeon training, 323 operations (47%) were done by surgeons performing < 21 rectal cancer resections over the study period. Multivariate analysis showed that the risk of LR was increased in patients of both noncolorectal trained surgeons (hazard ratio (HR) = 2.5, p = 0.001) and those of surgeons performing < 21 resections (HR = 1.8, p < 0.001). Stage (p < 0.001), use of adjuvant therapy (p = 0.002), rectal perforation or tumor spill (p < 0.001), and vascular/neural invasion (p = 0.002) also were significant prognostic factors for LR. Similarly, decreased disease-specific survival was found to be independently associated with noncolorectal-trained surgeons (HR = 1.5, p = 0.03) and surgeons performing < 21 resections (HR = 1.4, p = 0.005). Stage (p < 0

  11. The Will to Touch: David Copperfield’s Hand

    Directory of Open Access Journals (Sweden)

    Pamela K. Gilbert

    2014-10-01

    Full Text Available In the nineteenth century, touch was considered to be a more privileged sense than has been generally noted, and the hand was pre-eminently the site of active touching. The hand comes newly to rival the face in descriptive significance in mid-nineteenth-century fiction, and reflects contemporary notions of the role of touch in the exercise of the will and the development of the sensorium. This article explores medical and philosophical understandings of embodied touch within the period, and examines why the hand emerged as a focal point for scientific, poetic, and popular discussion. Such scientists as Charles Bell, Herbert Spencer, and Alexander Bain tend to work within two paradigms: the hand as a site of sensory input that forms a conduit between inner and outer worlds, and the hand as an instrument of the will. The article explores Dickens's use of these ideas about touch and development in his 1850 'Bildungsroman', 'David Copperfield'. David struggles to establish his proper status as a middle-class male, in part by learning to use his hands to impose his own will and to resist the dominance of inappropriate others through touch.

  12. [The surgeons civil responsibility insurance].

    Science.gov (United States)

    Santovito, D

    2004-10-01

    After a short research in the field national insurances, the author analyses the professional physician insurance policy; the ambiguity and difficulty of contracts concerning the professional health activity of surgeon, whether as state employee or as independent professional are pointed put. With the introduction of the ministerial decree dated January 29,1992, the new labour agreement, the privacy law, the evolution of ''informed consent'', the esthetic injury concept, the safety regulations law and the administrative liability, surgeons must pay attention to draw up an insurance policy suitable to their profession.

  13. 我国普通外科医师培养模式及教学面临的问题及对策%Problems and strategies faced by training model and education of general surgeon

    Institute of Scientific and Technical Information of China (English)

    杨镇

    2015-01-01

    At present, chinese general surgery should improve residency and subspecialty residencies training utilized global standards which is consisted of 3 overlapping phases.Fundamentals of surgery curriculum and surgical skills curriculum are an effective way to enhance the students' basic surgical skills and would obtain the global standards for postgraduate medical education. Working-hour restrictions and a heightened awareness of patient safety has changed resident education and training. Specialization and the current practices of general surgeons are a important problem. Postgraduate medical students program should be combined with resident training.Interprofessional education and service learning is a model for the future of health professions education. Simulation-based surgical education and simulator center has completely revolutionized the training process, especially in the laparoscopic and robotic surgery curriculum for resident training. Virtual realicy is the application of the computer aid technique in recent years, which shows its dominant position in medical education. E-learning will play an important role in the near future.%当前,我国普通外科要以国际标准完善住院医师和专科培训,涵盖医学教育连续统一体的3个阶段。外科基础课程和外科技能课程能有效地提升学生的基本手术技术和能达到全球医学教育最基本要求。医师工作时间的限制和病人安全意识的加强改变了住院医师教育和培训的模式。普通外科医师的专业化与当前的临床实践是重要问题。研究生的教育应与专科医师培训相结合。跨专业教育和学习服务是对未来医疗卫生教育的一种模式。基于虚拟技术的外科培训和模拟中心完全改变了教育的程序,特别是住院医师培训的腹腔镜和机器人外科课程。虚拟现实技术是近年出现的计算机辅助应用技术,在医学教育领域展显优势。电子学习系统将发挥重要作用。

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

    Science.gov (United States)

    Lewis, Priya; Kobayashi, Emily; Gupta, Subhas

    2015-05-01

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

  15. Kant and the cosmetic surgeon.

    Science.gov (United States)

    Carey, J S

    1989-07-01

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

  16. Miracle and Causality in David Hume

    Directory of Open Access Journals (Sweden)

    Mustafa Çevik

    2012-12-01

    Full Text Available In this paper it has been discussed the problems arise from the definition of miracle which take place in some religious and philosophical texts. The definitions particularly quoted from David Hume’s texts and Islamic resources. The problems discussed in two titles. First problem is the possibility of miracle as a historical event. The other is the possibility of miracle as “the law of nature”. Here we discussed particularly the “law” and the “violation of law”.

  17. David Bowie的音乐遗产

    Institute of Scientific and Technical Information of China (English)

    肖沣

    2016-01-01

    2013年4月,我在《通俗歌曲》写了一篇关于专辑《The Next Day》的介绍.当时第一句话是:“我们不得不感谢上帝,让David Bowie还活在这个世界上,当我们翻阅他这么多年来的各种造型时.依然很难相信,他居然还没有死。”

  18. David Hume: Dios y el hecho religioso

    Directory of Open Access Journals (Sweden)

    Iñaki Oneca Agurruza

    2003-12-01

    Full Text Available El objeto del presente estudio es ahondar en la concepción religiosa de David Hume y en su idea de Dios, así como profundizar en este interesante pilar de su estructura filosófico-empírica. El contexto histórico-filosófico en el cual este autor investigó sobre dicho tema, así como las diferentes visiones del mencionado objeto de estudio, serán, por tanto, tenidas en suficiente consideración.

  19. Smartphone apps for orthopaedic surgeons.

    Science.gov (United States)

    Franko, Orrin I

    2011-07-01

    The use of smartphones and their associated applications (apps) provides new opportunities for physicians, and specifically orthopaedic surgeons, to integrate technology into clinical practice. The purpose of this study was twofold: to review all apps specifically created for orthopaedic surgeons and to survey orthopaedic residents and surgeons in the United States to characterize the need for novel apps. The five most popular smartphone app stores were searched for orthopaedic-related apps: Blackberry, iPhone, Android, Palm, and Windows. An Internet survey was sent to ACGME-accredited orthopaedic surgery departments to assess the level of smartphone use, app use, and desire for orthopaedic-related apps. The database search revealed that iPhone and Android platforms had apps specifically created for orthopaedic surgery with a total of 61 and 13 apps, respectively. Among the apps reviewed, only one had greater than 100 reviews (mean, 27), and the majority of apps had very few reviews, including AAOS Now and AO Surgery Reference, apps published by the American Academy of Orthopaedic Surgeons and AO Foundation, respectively. The national survey revealed that 84% of respondents (n = 476) have a smartphone, the majority (55%) have an iPhone, and that 53% of people with smartphones already use apps in clinical practice. Ninety-six percent of respondents who use apps reported they would like more orthopaedic apps and would pay an average of nearly $30 for useful apps. The four most requested categories of apps were textbook/reference, techniques/guides, OITE/board review, and billing/coding. The use of smartphones and apps is prevalent among orthopaedic care providers in academic centers. However, few highly ranked apps specifically related to orthopaedic surgery are available, and the types of apps available do not appear to be the categories most desired by residents and surgeons.

  20. David Hume filósofo e historiador

    Directory of Open Access Journals (Sweden)

    Sara Albieri

    2004-12-01

    Full Text Available Among all the great philosophers, David Hume has the rare merit of joining to a properly philosophical work an equally important output as historian. According to him, the interpretation of history by means of the general principles of political theory must not be guided by ethical or normative considerations, as when judging historic events according to what things ought to be, for instance, in view of the best government, but it should be restricted to explain the exercise of power in the different times, just as it can be established by the testimony of the sources. Only this methodological attitude allows us to avoid the partisan interpretations that try to justify the present by the past, instead of investigating it to corroborate the most appropriate explanation.

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Temporal geomapping of pediatric surgeons in the United States.

    Science.gov (United States)

    Snyder, Charles L

    2008-03-01

    Several studies have addressed the issue of manpower needs in pediatric surgery. The number of training programs has multiplied dramatically over the past decade. The distribution of surgeons is more significant than the absolute change in numbers--are major metropolitan areas seeing a more dramatic increase than less populated areas? To evaluate the geographic and demographic changes associated with this increase, we used choropleth and geomapping techniques to evaluate the change in number and distribution of American Pediatric Surgical Association (APSA) members (and by proxy, pediatric surgeons) in the United States over the past decade. Data regarding membership were obtained from APSA. In 1996, management companies changed, and accurate data for initial year of membership were only available after 1996. Online sources (www.services.alphaworks.ibm.com/manyeyes/home and www.mapresso.com) were used for data analysis. There was a 175% increase in the number of APSA members over the past decade. The geographic distribution parallels the state population to some extent but is uneven. The number of APSA members by state over time is displayed in color density maps. Predictions of prior manpower studies were generally accurate. The number of pediatric surgeons in the United States has rapidly increased in the past decade, with no sign of diminution in this trend. Increases in the number of surgeons correlates with state population, indicating a tendency for surgeons to reside in more densely populated areas, as expected. Areas with a disproportionately high or low number of surgeons can be identified via choropleth mapping.

  3. A New Culture of Transparency: Industry Payments to Orthopedic Surgeons.

    Science.gov (United States)

    Lopez, Joseph; Ahmed, Rizwan; Bae, Sunjae; Hicks, Caitlin W; El Dafrawy, Mostafa; Osgood, Greg M; Segev, Dorry L

    2016-11-01

    Under the Physician Payments Sunshine Act, "payments or transfers of value" by biomedical companies to physicians must be disclosed through the Open Payments Program. Designed to provide transparency of financial transactions between medication and device manufacturers and health care providers, the Open Payments Program shows financial relationships between industry and health care providers. Awareness of this program is crucial because its interpretation or misinterpretation by patients, physicians, and the general public can affect patient care, clinical practice, and research. This study evaluated nonresearch payments by industry to orthopedic surgeons. A retrospective cross-sectional review of the first wave of Physician Payments Sunshine Act data (August through December 2013) was performed to characterize industry payments to orthopedic surgeons by subspecialty, amount, type, origin, and geographic distribution. During this 5-month period, orthopedic surgeons (n=14,828) received $107,666,826, which included 3% of those listed in the Open Payments Program and 23% of the total amount paid. Of orthopedic surgeons who received payment, 45% received less than $100 and 1% received $100,000 or more. Median payment (interquartile range) was $119 ($34-$636), and mean payment was $7261±95,887. The largest payment to an individual orthopedic surgeon was $7,849,711. The 2 largest payment categories were royalty or license fees (68%) and consulting fees (13%). During the study period, orthopedic surgeons had substantial financial ties to industry. Of orthopedic surgeons who received payments, the largest proportion (45%) received less than $100 and only 1% received large payments (≥$100,000). The Open Payments Program offers insight into industry payments to orthopedic surgeons. [Orthopedics. 2016; 39(6):e1058-e1062.]. Copyright 2016, SLACK Incorporated.

  4. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

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

  5. Association Between Surgeon Scorecard Use and Operating Room Costs.

    Science.gov (United States)

    Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph

    2017-03-01

    Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting. Intervention participants were attending surgeons in orthopedic surgery, otolaryngology-head and neck surgery, and neurological surgery (n = 63). Control participants were attending surgeons in cardiothoracic surgery, general surgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 186). From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type performed in the prior month compared with the surgeon's baseline (July 1, 2012, to November 30, 2014) and compared with all surgeons at the institution performing the same procedure at baseline. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal. The primary outcome was each group's median surgical supply cost per case. Secondary outcome measures included total departmental surgical supply costs, case mix index-adjusted median surgical supply costs, patient outcomes (30-day readmission, 30-day mortality, and discharge status), and surgeon responses to a postintervention study-specific health care value survey. The median surgical supply direct costs per case decreased 6.54% in the intervention group, from $1398 (interquartile range [IQR], $316-$5181) (10 637 cases) in 2014 to $1307 (IQR, $319-$5037) (11 820 cases) in 2015. In contrast, the median surgical supply direct cost increased 7.42% in the control group, from $712 (IQR, $202-$1602) (16 441 cases

  6. Surgeons' motivation for choice of workplace.

    Science.gov (United States)

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

    2012-09-01

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

  7. Rainforest pioneer. Millennium trailblazers 3: David Cassell.

    Science.gov (United States)

    Gilmour, D

    1999-01-01

    The Iwokrama International Centre for Rain Forest Conservation in Guyana is headed by Australian forester David Cassells who is also chairman of the Advisory Group for the World Conservation Union Forest Conservation Program. He states that this program is different from other projects to conserve tropical forests since it focuses on financial sustainability and self-sufficiency. He also plans that the revenue for the center will come from a mixture of eco-forestry with certified logging, ecotourism, sustainable production of non-timber products such as vines and latexes, bioprospecting, and the sale of forest management expertise. He further added that the program's success could change the way people value and use tropical forests.

  8. Guerra e Paz, por David Grossman

    Directory of Open Access Journals (Sweden)

    Luis Sérgio Krausz

    2010-03-01

    Full Text Available Na Bíblia Hebraica, a guerra é um assunto diretamente vinculado à esfera do sagrado. A proteção de Deus ao povo de Israel em suas batalhas é, assim, um dos fundamentos da teologia bíblica. No romance, A mulher foge, de David Grossman, como em Homero, a realidade da guerra contrapõe-­se à realidade das pessoas comuns e, assim, separa, em um vasto abismo, as experiências deste e daquele lado. Ao contrário do que acontece na Bíblia, e também na Ilíada, não há, nas guerras do romance, qualquer tipo de crença divina, seja ela de molde pagão, seja ela de caráter retributivo, conforme a teologia bíblica.

  9. David Lukens Reasoner (1941-1992)

    Science.gov (United States)

    Chappell, Rick

    David Lukens Reasoner, former head of NASA's Ionospheric Physics branch, died on April 21, 1992. Reasoner was born July 1, 1941. He worked tirelessly to expand NASA's Space Physics Division, bringing his deep experience and personal expertise to bear on the challenges of growth.During the magical period of the late 1950s and early 1960s when America turned its eyes toward space and the Moon, David Lukens Reasoner journeyed north from the nearby Texas town of Dickinson to Rice University with an idea of getting involved in exploring the frontiers of space. He pursued a course of study in electrical engineering and received a bachelor's degree in 1963 and a master's degree in 1964. In the early 1960s, the Space Science Department at Rice was formed, and President John Kennedy visited to say that America chose to go to space not because it is easy but because it is hard and because it would require the very best talents of our nation to succeed. Dave Reasoner was one of those talented people. His excellence in electrical engineering and physics, combined with his natural abilities in the laboratory, suited him ideally for building the machines of space. As a student, he built sounding rocket payloads and multiple instruments for satellites and experiment packages that were placed on the Moon by the Apollo astronauts. He completed his doctoral degree in space science in 1968. It was in these early thrilling days of space exploration that I first met Dave, beginning a friendship and collegial relationship that was to last 27 years.

  10. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  11. Venemaa - lähedane ja kauge / David Vseviov

    Index Scriptorium Estoniae

    Vseviov, David, 1949-

    2007-01-01

    Rmt.: Sergejev, Vladimir ; Vseviov, David. Venemaa - lähedane ja kauge : aegade algusest kuni Vassili III-ni. Tallinn : Valgus, 2002 ; Sergejev, Vladimir ; Vseviov, David. Venemaa - lähedane ja kauge : vürstiriigist tsaaririigiks. Ivan IV. Tallinn : Valgus, 2007.

  12. Histological Study on Reproductive Organ of Rana Temporaria Chensinesis David

    Institute of Scientific and Technical Information of China (English)

    HUANG He; TIAN Yaguang; NING Fangyong; BAI Xiujuan; ZHANG Guixue

    2006-01-01

    The experiment was designed to study the histology of reproductive organ of Rana temporaria chensinesis David in reproductive season and dereproductive season, The results displayed that the sexual gland weight and oviduct weight of the Rana temporaria chensinesis David were significantly different between reproductive season and dereproductive season.

  13. Binary Opposition of the Characterization of David in Bible

    Institute of Scientific and Technical Information of China (English)

    游伟

    2013-01-01

    Characters in Bible are like the coin possessing two sides. David, the most complicated figure in Bible, is just a case in point. From this perspective, this paper tries to use the principle of binary opposition to analyze the characterization of David in Bible, that is, David’s tolerance vs. vengeance, piety vs. impiety, and iron heart vs. sentiment.

  14. 77 FR 26765 - David H.M. Phelps: Debarment Order

    Science.gov (United States)

    2012-05-07

    ... HUMAN SERVICES Food and Drug Administration David H.M. Phelps: Debarment Order AGENCY: Food and Drug... under the Federal Food, Drug, and Cosmetic Act (FD&C Act) debarring David H.M. Phelps for a period of 20.... FDA bases this order on a finding that Mr. Phelps was convicted, as defined in section 306(l)(1)(B)...

  15. Social outcomes of learning - Response to paper by David Campwell

    DEFF Research Database (Denmark)

    Andersen, John

    Expert kommentar til rapportudkast fra David Cambell (tidligere forskningsassistent for Robert Putman) i OECD projektet SOL (Social Outcomes of Learning). Publiceres senere som Discussionpaper af OECD......Expert kommentar til rapportudkast fra David Cambell (tidligere forskningsassistent for Robert Putman) i OECD projektet SOL (Social Outcomes of Learning). Publiceres senere som Discussionpaper af OECD...

  16. Third Annual David Derse Memorial Lecture and Award | Poster

    Science.gov (United States)

    By Anne Arthur, Guest Writer The Third Annual David Derse Memorial Lecture and Award presentation was held on Nov. 18 at NCI at Frederick to honor the outstanding research accomplishments of David Derse, Ph.D., and to stimulate the exchange of innovative ideas that Derse was well known for promoting throughout his scientific career.

  17. Correspondentie David van Dantzig-Gerrit Mannoury : historische notitie SEN

    NARCIS (Netherlands)

    Siegenbeek van Heukelom, J.; Alberts, G.

    2000-01-01

    Correspondence David van Dantzig--Gerrit Mannoury October 23rd 1917, after the second lecture in a course on analytical geometry David van Dantzig, student of chemistry, wrote a long letter to the professor of mathematics Gerrit Mannoury. It proved the starting point of a life-long symbiosis of pupi

  18. Venemaa - lähedane ja kauge / David Vseviov

    Index Scriptorium Estoniae

    Vseviov, David, 1949-

    2007-01-01

    Rmt.: Sergejev, Vladimir ; Vseviov, David. Venemaa - lähedane ja kauge : aegade algusest kuni Vassili III-ni. Tallinn : Valgus, 2002 ; Sergejev, Vladimir ; Vseviov, David. Venemaa - lähedane ja kauge : vürstiriigist tsaaririigiks. Ivan IV. Tallinn : Valgus, 2007.

  19. Third Annual David Derse Memorial Lecture and Award | Poster

    Science.gov (United States)

    By Anne Arthur, Guest Writer The Third Annual David Derse Memorial Lecture and Award presentation was held on Nov. 18 at NCI at Frederick to honor the outstanding research accomplishments of David Derse, Ph.D., and to stimulate the exchange of innovative ideas that Derse was well known for promoting throughout his scientific career.

  20. Does Surgeon Sex Matter?: Practice Patterns and Outcomes of Female and Male Surgeons.

    Science.gov (United States)

    Sharoky, Catherine E; Sellers, Morgan M; Keele, Luke J; Wirtalla, Christopher J; Karakousis, Giorgos C; Morris, Jon B; Kelz, Rachel R

    2017-07-24

    We sought to compare postoperative outcomes of female surgeons (FS) and male surgeons (MS) within general surgery. FS in the workforce are increasing in number. Female physicians provide exceptional care in other specialties. Differences in surgical outcomes of FS and MS have not been examined. We linked the AMA Physician Masterfile to discharge claims from New York, Florida, and Pennsylvania (2012 to 2013) to examine practice patterns and to compare surgical outcomes of FS and MS. We paired FS and MS operating at the same hospital using cardinality matching with refined balance and compared inpatient mortality, any postoperative complication, and prolonged length of stay (pLOS) in FS and MS. Overall practice patterns differed between the 663 FS and 3219 MS. We identified 2462 surgeons (19% FS, 81% MS) at 429 hospitals who met inclusion criteria for outcomes analysis. FS were younger (mean age ± SD FS: 48.5 ± 8.4 years, MS: 54.3 ± 9.4y; P best fit for them regardless of sex.

  1. Emergency surgeon-performed hepatobiliary ultrasonography.

    Science.gov (United States)

    Kell, M R; Aherne, N J; Coffey, C; Power, C P; Kirwan, W O; Redmond, H P

    2002-11-01

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

  2. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

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

  3. Surgeons' non-technical skills.

    Science.gov (United States)

    Yule, Steven; Paterson-Brown, Simon

    2012-02-01

    The importance of non-technical skills to surgical performance is gaining wide acceptance. This article discusses the core cognitive and social skills categories thought to underpin medical knowledge and surgical expertise, and describes the rise of non-technical skill models of assessment in surgery. Behavior rating systems such as NOTSS (Non-Technical Skills for Surgeons) have been developed to support education and assessment in this regard. We now understand more about these critical skills and how they impact surgery. The challenge in the future is to incorporate them into undergraduate teaching, postgraduate training, workplace assessment, and perhaps even selection.

  4. Obituary: David L. Band (1957-2009)

    Science.gov (United States)

    Cominsky, Lynn

    2011-12-01

    David L. Band, of Potomac Maryland, died on March 16, 2009 succumbing to a long battle with spinal cord cancer. His death at the age of 52 came as a shock to his many friends and colleagues in the physics and astronomy community. Band showed an early interest and exceptional aptitude for physics, leading to his acceptance at the Massachusetts Institute of Technology as an undergraduate student in 1975. After graduating from MIT with an undergraduate degree in Physics, Band continued as a graduate student in Physics at Harvard University. His emerging interest in Astrophysics led him to the Astronomy Department at the Harvard Smithsonian Center for Astrophysics (CfA), where he did his dissertation work with Jonathan Grindlay. His dissertation (1985) entitled "Non-thermal Radiation Mechanisms and Processes in SS433 and Active Galactic Nuclei" was "pioneering work on the physics of jets arising from black holes and models for their emission, including self-absorption, which previewed much to come, and even David's own later work on Gamma-ray Bursts," according to Grindlay who remained a personal friend and colleague of Band's. Following graduate school, Band held postdoctoral positions at the Lawrence Livermore Laboratory, the University of California at Berkeley and the Center for Astronomy and Space Sciences at the University of California San Diego where he worked on the BATSE experiment that was part of the Compton Gamma Ray Observatory (CGRO), launched in 1991. BATSE had as its main objective the study of cosmic gamma-ray bursts (GRBs) and made significant advances in this area of research. Band became a world-renowned figure in the emerging field of GRB studies. He is best known for his widely-used analytic form of gamma-ray burst spectra known as the "Band Function." After the CGRO mission ended, Band moved to the Los Alamos National Laboratory where he worked mainly on classified research but continued to work on GRB energetics and spectra. When NASA planned

  5. Genitourinary Prosthetics: A Primer for the Non-urologic Surgeon.

    Science.gov (United States)

    Lavien, Garjae; Zaid, Uwais; Peterson, Andrew C

    2016-06-01

    Genitourinary prosthetics are used for correction of functional deficits and to improve the quality of lives of affected patients. General surgeons must evaluate patients scheduled for nonurologic surgery with urologic devices that can impact their perioperative management. Lack of recognition of these prosthetics preoperatively can lead to unnecessary morbidity for the patient and have legal implications for the surgeon. Close consultation with a urologist may avoid common complications associated with these devices and allows for surgical assistance when operative misadventures do occur. This article reviews 3 common urologic prosthetics: testicular prosthesis, artificial urinary sphincter, and penile prosthesis.

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

    Science.gov (United States)

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

    2014-07-01

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

  7. David Cronenberg y el cuerpo abierto

    Directory of Open Access Journals (Sweden)

    Johanna Rodríguez Ahumada

    2014-12-01

    Full Text Available En la sociedad actual, la relación entre el cuerpo y la tecnología ha planteado una de las fisuras más importantes en la concepción de la subjetividad. La enigmática y fascinante relación entre el humano y la máquina, explorada tanto por el cine como por otros (viejos y nuevos medios en el ámbito de la ciencia ficción, ha planteado la figura del cyborg u organismo cibernético como una criatura híbrida, ambigua, que rompe con la dicotomía naturaleza-artificialidad. ¿Cómo leer los nuevos productos culturales que surgen a raíz de la revolución tecnológica? El objeto de este estudio es Crash (David Cronenberg ,1995, que parte de una interpretación audiovisual de la novela de J.G. Ballard y aborda las fantasías de hibridación del yo con el otro, de lo orgánico con lo inorgánico; en últimas, de cuerpos en tránsito.

  8. Assessment and remedial clinical education of surgeons in California.

    Science.gov (United States)

    Cosman, Bard C; Alverson, Aaron D; Boal, Peter A; Owens, Erik L; Norcross, William A

    2011-12-01

    Assessment and remedial clinical education of practicing surgeons is feasible and possibly beneficial. Retrospective series. Urban academic medical center. Licensed surgeons. Structured assessment and remedial clinical education based on resident-education models. Assessment and clinical education results. Forty-seven general, general/vascular, and colorectal surgeons were assessed by the University of California, San Diego, Physician Assessment and Clinical Education program in 2000 to 2010. Forty-six (98%) were male (mean [SD] age, 54 [11] years; range, 34-80 years). Thirty-three (70%) came from state medical board actions: 25 from California's disciplinary division, 2 from California's licensing division, 3 from other state boards, and 3 self-referred during other state board actions. Fourteen (30%) came from health care organizations: 8 from California hospitals, 3 from hospitals in other states, 2 self-referred during hospital proceedings, and 1 self-referred during a medical group investigation. Twenty-three (49%) underwent a 2-day assessment only, including a 1-hour mock oral board examination: 8 "passed" with no recommendations; 6, with minor recommendations; 6 had major recommendations; and 3 "failed." Twenty-four surgeons (51%) also completed 26 five-day clinical education programs, with 20 "passes," 1 minor recommendation, 3 major recommendations, and 2 "fails." A program of assessment and remedial clinical education of surgeons designed to meet the needs of one medical board is being used by nongovernmental organizations as well, and it seems to meet the needs of some individual surgeons. This type of program may play a role in the profession's self-regulation.

  9. Transatlantic Miscommunication in David Hare’s Drama Stuff Happens

    Directory of Open Access Journals (Sweden)

    Golimowska, Karolina

    2012-01-01

    Full Text Available This article addresses the transatlantic relations between the United States and Europe and specifically Great Britain in the context of post-9/11 international politics as reflected in the drama Stuff Happens (2004 written by British playwright David Hare. It focuses on the way re­cent history is performed and contextualized in dramatic form and analyzes the function and power of the theatricalization of historic events and particularly of finding ways to address 9/11 on a stage. Furthermore, it discusses the method of mixing parts of public speeches quoted ver­batim with fiction and its effects on readers and audiences. The play addresses the struggles and fragility of international diplomacy in the aftermath of 9/11. It reflects a general skepticism to­wards politicians and their decisions as well as the helpless position of millions of observers who are affected by these decisions and yet feel like they have no influence. This article sees post-9/11 verbatim theater as a chance for playwright and spectators to get access to the world of politics and to take part in the process of writing transatlantic history. More generally, through the ex­ample of this play, the article aims at discussing new challenges and functions of post-9/11 theater.

  10. Society of U.S. Air Force Surgeons’ 2010 State of the Flight Surgeon Survey: The Medical Treatment Facility Commander’s Perspective

    Science.gov (United States)

    2010-08-01

    filling an active billet as a flight surgeon may be very short (i.e., immediate), as in the case of a general medical officer ( GMO ), or very long...Inexperience (9/19) • The two assigned flight surgeons are general medical officers ( GMOs ). It is difficult to complete the necessary training at a...other two are newly assigned GMOs , who are motivated but are still in the learning phase. I have no doubt they will eventually grow into outstanding

  11. 21 CFR 878.4480 - Absorbable powder for lubricating a surgeon's glove.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Absorbable powder for lubricating a surgeon's... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4480 Absorbable powder for lubricating a surgeon's glove. (a) Identification. Absorbable powder...

  12. Second Annual David Derse Memorial Lecture and Award | Poster

    Science.gov (United States)

    By Anne Arthur, Guest Writer The Second Annual David Derse Memorial Lecture and Award presentation was held on November 12, 2013, at the NCI at Frederick Conference Center to honor David Derse’s outstanding research accomplishments and to stimulate the exchange of innovative ideas that Derse was well known for promoting throughout his scientific career. The Annual David Derse Memorial Lecture and Award is sponsored by the HIV Drug Resistance Program, with support from Hye Kyung Chung-Derse, Ph.D., the National Cancer Institute (NCI), the Foundation for the National Institutes of Health (NIH), and colleagues and friends of Derse who contributed to the memorial fund in his honor.

  13. Dr. David Syz, State Secretary for Economic Affairs, Switzerland

    CERN Multimedia

    Maximilien Brice

    2003-01-01

    Dr. David Syz, State Secretary for Economic Affairs, Switzerland, toured the assembly hall of the ATLAS experiment on a recent visit to CERN.Photos 01, 02: Dr. Peter Jenni, spokesperson for the ATLAS experiment (second from left), explains to Dr. David Syz (fourth from left) and accompanying visitors the process of integration of a 26-metre-long coil of the barrel toroid magnet system into its coil casing.Photo 03: Dr. Peter Jenni (extreme right) with Dr. David Syz (front row, fourth from right) behind a stack of 26-metre-long 'racetrack' coils awaiting integration into their coil casings.

  14. Second Annual David Derse Memorial Lecture and Award | Poster

    Science.gov (United States)

    By Anne Arthur, Guest Writer The Second Annual David Derse Memorial Lecture and Award presentation was held on November 12, 2013, at the NCI at Frederick Conference Center to honor David Derse’s outstanding research accomplishments and to stimulate the exchange of innovative ideas that Derse was well known for promoting throughout his scientific career. The Annual David Derse Memorial Lecture and Award is sponsored by the HIV Drug Resistance Program, with support from Hye Kyung Chung-Derse, Ph.D., the National Cancer Institute (NCI), the Foundation for the National Institutes of Health (NIH), and colleagues and friends of Derse who contributed to the memorial fund in his honor.

  15. Impact of Surgeon Experience During Carotid Endarterectomy Operation and Effects on Perioperative Outcomes

    Directory of Open Access Journals (Sweden)

    Volkan Yüksel

    Full Text Available Abstract Objective: We evaluated the effect of surgeon experience on complication and mortality rates of carotid endarterectomy operation. Methods: Fifty-nine consecutive patients who underwent carotid endarterectomy between January 2013 and February 2016 were divided into two groups. Patients who had been operated by surgeons performing carotid endarterectomy for more than 10 years were allocated to group 1 (experienced surgeons; n=34. Group 2 (younger surgeons; n=25 consisted of patients operated by surgeons independently performing carotid endarterectomy for less than 2 years. Both groups were compared in respect of operative results and postoperative complications. Results: No intergroup difference was found for laterality of the lesion or concomitant coronary artery disease. In group 1, signs of local nerve damage (n=2; 5.9% were detected, whereas in group 2 no evidence of local nerve damage was observed. Surgeons in group 1 used local and general anesthesia in 3 (8.8% and 31 (91.2% patients, respectively, while surgeons in group 2 preferred to use local and general anesthesia in 1 (4% and 24 (96% patients, respectively. Postoperative stroke was observed in group 1 (n=2; 5.9% and group 2 (n=2; 5.8%. Conclusion: Younger surgeons perform carotid endarterectomy with similar techniques and have similar results compared to experienced surgeons. Younger surgeons rarely prefer using shunt during carotid endarterectomy. The experience and the skills gained by these surgeons during their training, under the supervision of experienced surgeons, will enable them to perform successful carotid endarterectomy operations independently after completion of their training period.

  16. Robotics and the pediatric surgeon.

    Science.gov (United States)

    Lorincz, Attila; Langenburg, Scott; Klein, Michael D

    2003-06-01

    Surgical robots are enabling devices for minimally invasive (laparoscopic) surgery (MIS). They use a computer to enhance a surgeon's skills as hand movements are transmitted to robotic arms. The computer filters tremor, which becomes important at high magnifications of 10 to 15 times available in MIS. It also provides motion scaling so that large hand movements are converted to very small movements of the robotic arm. The robotic arms also have wrists that make suturing and knot tying far more accurate and efficient. Surgical robots are currently used clinically for procedures such as MIS Nissen fundoplication, cholecystectomy, and splenectomy. Laboratory experience indicates that they may provide advantages for newborn procedures such as portoenterostomy for biliary atresia and repair of esophageal atresia and tracheoesophageal fistula. They have a potential for making possible MIS procedures, which can only be done open now, and for introducing entirely new procedures as well as for the performance of procedures by operators distant from the patient.

  17. Preoperative Breast MRI: Surgeons' Patient Selection Patterns and Potential Bias in Outcomes Analyses.

    Science.gov (United States)

    Lee, Jiyon; Tanaka, Elaine; Eby, Peter R; Zhou, Shouhao; Wei, Wei; Eppelheimer, Christine; Loving, Vilert A

    2017-04-01

    The purpose of this study is to determine which patient- and tumor-related and clinical variables influence dedicated breast surgeons' and general surgeons' referrals for preoperative breast MRI for patients with newly diagnosed breast cancer. Surgeons who perform breast surgery responded to a survey from June 16, 2014, through August 11, 2014. Participants self-identified as breast or general surgeons and provided professional practice details. They used Likert scores (range, 1-7 with increasing likelihood to order MRI) to weigh numerous patient- and tumor-related and clinical variables. Mean likelihood scores were calculated and compared using a linear mixed model. A p ≤ 0.05 was considered statistically significant. Two hundred eighty-nine surveys from 154 (53%) breast surgeons and 135 (47%) general surgeons showed an overall likelihood to refer for patients with a BRCA mutation (mean Likert score, 6.17), familial (mean Likert score, 5.33) or personal (mean Likert score, 5.10) breast cancer history, extremely dense breasts (mean Likert score, 5.30), age younger than 40 years (mean Likert score, 5.24), axillary nodal involvement (mean Likert score, 6.22), tumor that is mammographically occult (mean Likert score, 5.62) or fixed to the pectoralis (mean Likert score, 5.49), tumor that is a candidate for neoadjuvant treatment (mean Likert score, 5.38), multifocal or multicentric disease (mean Likert score, 5.22), invasive lobular carcinoma (mean Likert score, 5.20), T3 (mean Likert score, 4.48) or T2 (mean Likert score, 4.41) tumor, triple-negative breast cancer (mean Likert score, 4.66), a patient who is a candidate for mastectomy requesting breast conservation therapy (mean Likert score, 5.27), and radiologists' recommendations (mean Likert score, 5.19). Across all patient ages, breast surgeons referred more often than did general surgeons (mean Likert score, 4.32 vs 3.92; p = 0.03), especially for patients with BRCA mutation (mean Likert score, 6.39 vs 5.93; p

  18. The advent of the restorative plastic surgeon.

    Science.gov (United States)

    Carty, Matthew J; Pribaz, Julian J; Talbot, Simon G; Caterson, Edward J; Pomahac, Bohdan

    2014-01-01

    Plastic surgery is presently typified by the existence of discrete clinical identities, namely that of the cosmetic plastic surgeon and the reconstructive plastic surgeon. The emergence of vascularized composite allotransplantation has been accompanied by the development of a third distinct clinical identity, that of the restorative plastic surgeon. The authors describe the core competencies that characterize this new identity, and discuss the implications of the advent of this new professional paradigm.

  19. David Barker: the revolution that anticipates existence

    Directory of Open Access Journals (Sweden)

    Italo Farnetani

    2014-01-01

    Full Text Available David Barker is the man who “anticipated" the existence of babies by focusing attention on the importance of the fetus and what takes place during intrauterine life. Barker was one of the physicians who in the last decades brought about the greatest changes in medicine, changes so important as to represent a veritable revolution in medical thought. According to Barker's studies, the embryo obviously has a genetic complement coming from the mother and father, but from the very first stages of development it begins to undergo the influence of the outside environment, just as occurs for adults whose biological, psychological and pathological aspects are influenced by the environment to a not well-established percentage between genetic complement and epigenetics. Much of our future lives as adults is decided in our mothers' wombs. If Barker's discovery was revolutionary from the cultural standpoint, it was even more so from the strictly medical one. Barker's research method was rigid from the methodological standpoint, but innovative and speculative in its working hypotheses, with a humanistic slant. Barker's idea has another practical corollary: it is evident that the role of obstetricians, perinatologists and neonatologists is more and more relevant in medicine and future prevention. Unquestionably, besides the enormous merits of his clinical research, among the benefits that Barker has contributed there is that of having helped us to see things from new points of view. Not only is the neonate (and even more so the fetus not an adult of reduced proportions, but perhaps the neonate is the "father" of the adult person.

  20. American Society of Colon and Rectal Surgeons

    Science.gov (United States)

    ... Assessment and Safety Committee Initiatives Past Presidents Healthcare Economics Committee 2017 Tripartite Meeting Search form Search Login Join Now Find a Surgeon ASCRS Patients Members Physicians Latest ...

  1. DAVID HUME AND THE CRITICAL EXAMINATION OF EMPIRICISM

    National Research Council Canada - National Science Library

    IONUŢ ŞTEFAN

    2012-01-01

    The research is related to David Hume. This philosopher is described as being an empiricist, but it should be noted that the empiricism promoted by Hume represents the development up to the final consequences of this philosophical...

  2. NOAA Ship David Starr Jordan Underway Meteorological Data, Quality Controlled

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA Ship David Starr Jordan Underway Meteorological Data (delayed ~10 days for quality control) are from the Shipboard Automated Meteorological and Oceanographic...

  3. Eesti keel barbarite suus / David J. Peterson ; intervjueerinud Peeter Helme

    Index Scriptorium Estoniae

    Peterson, David J.

    2011-01-01

    USA telekanali HBO telesarjas "Troonide mäng" (mis on George R. R. Martini "Jää ja tule laulu" sarja esimese raamatu "Troonide mäng" teleekraniseering) tegeles dothraki keele loomisega keeleteadlane David J. Peterson

  4. Eesti keel barbarite suus / David J. Peterson ; intervjueerinud Peeter Helme

    Index Scriptorium Estoniae

    Peterson, David J.

    2011-01-01

    USA telekanali HBO telesarjas "Troonide mäng" (mis on George R. R. Martini "Jää ja tule laulu" sarja esimese raamatu "Troonide mäng" teleekraniseering) tegeles dothraki keele loomisega keeleteadlane David J. Peterson

  5. David Simpson Receives 2012 Waldo E. Smith Medal: Citation

    Science.gov (United States)

    Lerner-Lam, Arthur

    2013-01-01

    David Simpson was awarded the 2012 Waldo E. Smith Medal at the AGU Fall Meeting Honors Ceremony, held on 5 December 2012 in San Francisco, Calif. The medal is for "extraordinary service to geophysics".

  6. David Nolfi Receives NAHRS Award for Professional Excellence

    Directory of Open Access Journals (Sweden)

    Maureen Diana Sasso

    2013-09-01

    Full Text Available News AnnouncementDavid A. Nolfi, MLS, AHIP, Health Sciences Librarian & Library Assessment Coordinator at Duquesne University’s Gumberg Library, received the 2013 NAHRS Award for Professional Excellence at the One Health Conference in Boston, MA.

  7. David Rosenmann-Taub: Lectura de sus Silencios David Rosenmann-Taub: Reading his Silence

    Directory of Open Access Journals (Sweden)

    Cristián Gómez O

    2010-12-01

    Full Text Available Este artículo intentará poner la obra poética de David Rosenmann-Taub en la perspectiva de aquellas condiciones de posibilidad que hacen factible una obra como la suya. Hemos querido, así, razonar los procedimientos internos de su poesía, interrogándola en su propia retórica, pero también en lo que esa retórica silencia o se niega a decir. En el complemento de estas dos preguntas, es donde se puede desplegar el rol que cumple la historia como principio de realidad de la obra incluso si no es explícitamente mencionada.The following paper will try to see in which perspectives a poetic work, such as the one by David Rosenmann-Taub, is feasible. The paper will try to understand the inner procedures of his poetry by questioning its own rhetoric, and by analyzing what this rhetoric denies to say or silences. As a complement to these two questions, the role of history will unravel so as to reveal its participation as a principle of reality in the work, even though it is not explicitly mentioned.

  8. David Bowie:摇滚变色龙

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    1月8日是David Bowie的69岁生日,才过去两天,讣告传来,David Bowie突然离世,他来不及接受自己的第25张专辑带来的声誉,也看不到自己儿子执导的《魔兽世界》了。

  9. Kommunist mittekommunisti ei usalda / David Satter ; interv. Viktor Niitsoo

    Index Scriptorium Estoniae

    Satter, David

    2005-01-01

    Tallinnas esitles oma raamatut "Meeletuste ajastu. Nõukogude Liidu allakäik ja langus" Finacial Times'i endine Moskva korrespondent David Satter, tegemist on NL-i viimase viieteistkümne aasta koondkroonikaga. Intervjuus meenutab David Satter oma tööaastaid Moskvas 1976-1982. a., kus ta keskendus põhiliselt ühiskondlik-poliitilistele teemadele, kaasa arvatud dissidentlik liikumine. Suhted võimudega, KGB provokatsioonid

  10. Burnout and career satisfaction among American surgeons.

    Science.gov (United States)

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

    2009-09-01

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

  11. New Zealand plastic surgeons' life-time contribution to peer-reviewed literature.

    Science.gov (United States)

    Brian, Tess; Adams, Brandon

    2017-05-12

    The New Zealand Medical Association commits the New Zealand doctor to evidence-based medicine, scholarship, teaching, collaboration and communication. To assess this commitment, one measure, contribution to the peer-reviewed literature, was examined for one group of New Zealand doctors: plastic surgeons. Plastic surgeons with a current practising certificate were identified on the New Zealand medical register (April 2016). Scopus database was searched for publications by each. Sixty-five surgeons authored 541 unique items in 134 journals, generating 8,047 citations. Between medical graduation and specialty qualification, a mean 1.8 items were published per practitioner (range 0-11). Twenty-three practitioners (35.4%) did not publish during this time. Between specialty qualification and the end of 2015, mean number of items published per surgeon was 7.3 (range 0-97). Thirteen (20.0%) surgeons had not published since specialist qualification. The general trend was for surgeons to become less productive with increasing time in practice. Mean surgeon h-index was 4.4 (range 0-26). Four surgeons (6.2%) had not published at any time. As a group, but with exceptions and less so in later practice, New Zealand plastic surgeons would seem to demonstrate commitment to evidence-based medicine, scholarship, teaching, collaboration and communication expected of a New Zealand doctor, as evidenced by peer-review publication.

  12. A leadership development program for surgeons: First-year participant evaluation.

    Science.gov (United States)

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

    2016-08-01

    In a dynamic health care system, strong leadership has never been more important for surgeons. Little is known about how to design and conduct effectively a leadership program specifically for surgeons. We sought to evaluate critically a Leadership Development Program for practicing surgeons by exploring how the program's strengths and weaknesses affected the surgeons' development as physician-leaders. At a large academic institution, we conducted semistructured interviews with 21 surgical faculty members who applied voluntarily, were selected, and completed a newly created Leadership Development Program in December 2012. Interview transcripts underwent qualitative descriptive analysis with thematic coding based on grounded theory. Themes were extracted regarding surgeons' evaluations of the program on their development as physician-leaders. After completing the program, surgeons reported personal improvements in the following 4 areas: self-empowerment to lead, self-awareness, team-building skills, and knowledge in business and leadership. Surgeons felt "more confident about stepping up as a leader" and more aware of "how others view me and my interactions." They described a stronger grasp on "giving feedback" as well as a better understanding of "business/organizational issues." Overall, surgeon-participants reported positive impacts of the program on their day-to-day work activities and general career perspective as well as on their long-term career development plans. Surgeons also recommended areas where the program could potentially be improved. These interviews detailed self-reported improvements in leadership knowledge and capabilities for practicing surgeons who completed a Leadership Development Program. A curriculum designed specifically for surgeons may enable future programs to equip surgeons better for important leadership roles in a complex health care environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    Science.gov (United States)

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

    2016-06-01

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

  14. William Cheselden: anatomist, surgeon, and medical illustrator.

    Science.gov (United States)

    Sanders, M A

    1999-11-01

    William Cheselden was Great Britain's foremost surgeon/scientist in the first half of the 18th century. Cheselden directly challenged the Company of Barber-Surgeons' exclusive right to control dissection in London by being the first to conduct a regular series of anatomy lectures and demonstrations outside of the Company's Hall. He incorporated his lecture syllabus into a handbook of anatomy, The Anatomy of the Humane Body, which was used by students for nearly 100 years. Cheselden also wrote the text and drew the illustrations for a majestic atlas of comparative osteology, the Osteographia, or the Anatomy of the Bones. Cheselden used his superior knowledge of anatomy to reduce the morbidity and mortality associated with perineal lithotomy, one of the few operations possible in his era. Sagacious and pragmatic, Cheselden recognized that the enlightened practice of surgery beginning to take root in 18th-century London could flourish only under an autonomous body of surgeons. Cheselden used his personal funds and political skills to urge Parliament to pass legislation for the dissolution of the combined Company of Barber-Surgeons and the establishment of separate and distinct Surgeons' and Barbers' Companies. After disjoinder of the two groups on May 2, 1745, Cheselden served as one of the Wardens of the new Company of Surgeons--a predecessor of the Royal College of Surgeons of England. In 1746, Cheselden, who helped design the first Surgeons' Hall, served as the Company's Master.

  15. [Michel Latarjet (1913-1999), surgeon explorer!].

    Science.gov (United States)

    Awada, T; Liverneaux, P

    2010-05-01

    In 1954, Michel Latarjet, anatomist and surgeon of Lyon, developed an original surgical technique to treat the unstable shoulder . This technique since kept his name: "Latarjet". He was a character in 1000 facets: highly skilled anatomist, skillful surgeon, talented sportsman, accomplished musician, big traveler, and many others... An eclectic life, symbol of an abundant XXth century.

  16. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad

    2014-01-01

    that the risk was equal to traditional laparoscopy (3%). The fraction of surgeons willing to learn SILS and NOTES was 44.6% and 32.7%, respectively. The desire to learn was higher among less experienced and surgically active surgeons. Of the responders, 68.8% considered SILS and 43.2% considered NOTES would...

  17. Cation Exchange Resins and colonic perforation. What surgeons need to know

    Directory of Open Access Journals (Sweden)

    María Rita Rodríguez-Luna

    2015-01-01

    Conclusion: Despite the low incidence of colonic complication and lethal colonic necrosis associated with the CER clinical use, the general surgeon needs a high index of suspicion when dealing with patients treated with CER and abdominal pain.

  18. Surgeon and nonsurgeon personalities at different career points.

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

    Willcocks, S

    2011-02-12

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

  20. Obituary: David Q. Wark, 1918-2002

    Science.gov (United States)

    McMillin, Larry Max

    2003-12-01

    David Q. Wark, a research meteorologist at the National Environmental Satellite, Data, and Information Service of the National Oceanic and Atmospheric Administration (NOAA/NESDIS) and its predecessor organizations for 55 years, died of cancer 30 July 2002. He will be long remembered for his seminal contributions to the weather satellite program. A pioneer in the use of satellite sensors to provide observations of the Earth's environment for application to weather forecasting and atmospheric science, Dr. Wark was noted for his brilliant insights, dedication, and exceptional scientific achievements. He developed many of the theoretical and experimental techniques on which NOAA's current multi- billion-dollar meteorological satellite program is based. In the 1960's and early 1970's, he and his NOAA colleague Donald Hilleary were the motivating force and principal investigators for the first satellite instruments dedicated to sounding the atmosphere for temperature and water-vapor. These instruments included the Satellite Infra-Red Spectrometer (SIRS)-A and -B and the Vertical Temperature Profile Radiometer (VTPR), which were flown on NASA's Nimbus satellites and NOAA's ITOS-D satellites, respectively. With colleague Henry Fleming, he formulated the radiative transfer equation that quantifies the spectral radiances of the Earth and its atmosphere (measured at satellite altitude) and inverted that equation mathematically to infer the atmospheric temperature profile from satellite-based measurements of those radiances. A difficulty they had to overcome was that the mathematical problem is ill-posed, i.e., it admits of an infinite number of solutions. They arrived at a unique solution via an innovative application of a-priori information on the atmospheric state. This work was described in the landmark 1965 Wark and Fleming paper in the American Meteorological Society's Monthly Weather Review. From that early period until just weeks before his death, Dr. Wark continued

  1. Obituary: David Fulmer Bender, 1913-2004

    Science.gov (United States)

    Miller, Sylvia L.

    2004-12-01

    David Fulmer Bender died in San Diego, California, on 13 September 2004, at the age of 91. His heart stopped suddenly while he was dancing. His pioneering work in establishing comprehensive, computer-accessible ephemerides of asteroids and comets found many applications, including the first-ever visit to an asteroid, Gaspra, by an interplanetary spacecraft. Dave was born in Reno, Nevada, on 10 February 1913, to Homer Charles Bender and Susan Bowers Bender. The family moved to Spokane, Washington, while Dave was very young. His father was a civil engineer and a graduate of MIT, who helped design bridges and dams throughout the Northwest, including the Grand Coolie Dam. Dave had a brother, Phillip (now deceased), who was one year younger. Advancing rapidly in the Spokane school system, Dave finished high school when he was 15 years old. At 16 he moved to Pasadena, California, and began his studies at the California Institute of Technology (Caltech). In addition to pursuing his course work, he was active in track and football, a tendency toward physical exercise that stayed with him for the rest of his life. It was probably during these years that Dave heard a lecture by Albert Einstein, as mentioned to colleagues many years later. Dave received a BS degree in physics in 1933, an MS in 1934, and a PhD in 1937, all from Caltech. His dissertation was entitled, "The Index of Refraction of Air in the Photographic Infrared." During his sophomore year he found his way to Pomona College in Claremont, California, where he met his future wife, Elizabeth Boyden at a social gathering. They were married in 1935. Dave's academic career spanned the years from 1937 to 1970, initially at Louisiana State University, Vanderbilt University, and then Fisk. As a life-long pacifist and conscientious objector, Dave served alternate duty during World War II. In 1946 he joined the faculty of the physics department at Whittier College in California, where he became the department chair and

  2. Determinants of vigilance in a reintroduced population of Père David's deer

    Institute of Scientific and Technical Information of China (English)

    Wei ZHENG; Guy BEAUCHAMP; Xuelei JIANG; Zhongqiu LI; Qinglong YANG

    2013-01-01

    After being kept in captivity and isolated from natural predators for more than 1,200 years,Père David's deer has been reintroduced in China and now occurs in a reserve where human activity is the only potential threat.Antipredator vigilance is an important component of survival for many prey animals in their natural habitat.Do deer still adjust vigilance as a function of risk after such a long period of relaxed predation pressure? Here,we examined vigilance levels in Père David's deer groups as a function of group size,sex and level of human disturbance.The results showed that individual vigilance significantly decreased with group size in all-female groups but not in all-males or mixed-sex groups.In rutting season,males compete with one another and harass females,and we argue that vigilance is partly aimed at threatening males and that such vigilance increases with group size.This explains why overall vigilance did not vary with group size for males in general and for females in mixed-sex groups.Vigilance increased in more disturbed areas but in in male deer only.The results indicate that despite relaxed predation pressure over centuries,Père David's deer can still adjust antipredator responses as a function of perceived risk.Such information may become useful in the rewilding programme now under way for this species in China.

  3. The surgeon and human immunodeficiency virus.

    Science.gov (United States)

    Mielke, Jens; Kalangu, Kazadi K N

    2003-08-01

    The moral dilemmas faced by surgeons worldwide who treat patients infected with the human immunodeficiency virus (HIV) can be viewed against the background of experience in sub-Saharan countries, where the community prevalence is in excess of 25% (90% of hospital inpatients). When seeking consent for an HIV test before surgery, frank communication regarding the surgeons' perspective of risks to themselves and the patient is helpful. When consent for a test must be obtained from a substitute decision-maker, the surgeon should consider if the patient would want the decision-maker to know the result. Understanding the natural history of HIV in the surgical setting can help deal with the uncertainties encountered and should be a research priority for developing countries. International professional organizations are useful platforms for the exchange of ideas when surgeons encounter uncertainty by increasing access to journals and creating opportunities for discussion. Although supervisory bodies in some parts of the world prevent HIV-infected surgeons from putting patients at risk by offering surgery, the withdrawal of their services in developing countries can cause more harm than good. Surgeons in that position may be entitled to offer surgery but only with full disclosure of the risk of HIV infection to the patient. The decision-making process known as "accountability for reasonableness" allows surgeons to determine fairness, legitimacy, and acceptability when making resource allocation decisions involving patients with HIV.

  4. The Future of Plastic Surgery: Surgeon's Perspective.

    Science.gov (United States)

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih

    2015-11-01

    Since the days of Sushruta, innovation has shaped the history of plastic surgery. Plastic surgeons have always been known as innovators or close followers of innovations. With this descriptive international survey study, the authors aimed to evaluate the future of plastic surgeons by analyzing how plastic surgery and plastic surgeons will be affected by new trends in medicine. Aesthetic surgery is the main subclass of plastic surgery thought to be the one that will change the most in the future. Stem cell therapy is considered by plastic surgeons to be the most likely "game changer." Along with changes in surgery, plastic surgeons also expect changes in plastic surgery education. The most approved assumption for the future of plastic surgery is, "The number of cosmetic nonsurgical procedures will increase in the future." If surgeons want to have better outcomes in their practice, they must at least be open minded for innovations if they do not become innovators themselves. Besides the individual effort of each surgeon, international and local plastic surgery associations should develop new strategies to adopt these innovations in surgical practice and education.

  5. INTRODUCTION: David Sherrington as a mentor of young scientists

    Science.gov (United States)

    Goldbart, Paul M.

    2008-08-01

    How deeply honoured I am to have the opportunity to express my thoughts at this delightful celebration of David's achievements, so far, in his remarkable career. I have been asked to center my remarks on David's contributions to the mentoring and professional development of scientists early in their careers. This is a topic that I am more than happy to reflect on, because it gives me the opportunity to recall the exciting period I spent as one of David's postgraduate students at Imperial College in the early 1980s. It also gives me the chance to publicly express my gratitude to David for the opportunities he created for me at that time, as well as for the interest and care he has shown in my career and well-being ever since, as we have met up and exchanged news and ideas around the world: in New Mexico and Colorado, in Cancun, Paris and Trieste, at numerous March Meetings of the American Physical Society and, of course in London, Oxford, and my home town, Champaign-Urbana, location of the University of Illinois. I have been a member of David's circle for 25 years now, and I would like to tell you a little about how this came to be. Not because of what this says about me, but, rather, because of what it tells you about David and the rich generosity of his spirit and effort when it comes to supporting the underdog. I was indeed one such underdog—and that's putting it charitably—when I first met David in September of 1982, not long before the academic year was to begin. I had heard about the exciting circle of physical and mathematical ideas swirling around the spin glass question during the previous year, which I had spent at the University of California's Los Angeles campus, through an opportunity kindly arranged, as it happens, by Sam Edwards. But I was eager to return to the UK for postgraduate studies and to work on spin glasses, so I simply showed up at David's Imperial College office, unannounced (if I remember correctly). And with his characteristic

  6. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

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

    Background: A large proportion of surgeons performing minimally invasive surgery (MIS) experience musculoskeletal pain in the upper body possibly due to awkward and long-term static positions. This can be detrimental for workability and health. The objective of the present review is to sum up...... in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...

  7. Richard von Volkmann: surgeon and Renaissance man.

    Science.gov (United States)

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

    2008-02-01

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

  8. Organism Encumbrance of Cardiac Surgeon During Surgery

    Science.gov (United States)

    Karabdic, Ilirijana Haxhibeqiri; Veljovic, Fikret; Straus, Slavenka

    2016-01-01

    Introduction: Most everyday activities, performed over a long period leads to performance degradation of skeletal muscles as well as spinal column which is reflected in the reduction of maximum force, reduction of the speed of response, reducing control of the movement etc. Although until now many mathematical models of muscles are developed, very small number takes into account the fatigue, and those models that take into account changes in the characteristics of muscles for extended activities, generally considered tiring under certain conditions. Given that the current models of muscle fatigue under arbitrary conditions of activation and load are very limited, this article presents a new model that includes scale of muscles overload. Material and Methods: There are three female cardiac surgeons working performing these surgeries in operating rooms, and their average anthropometric measures for this population is: a) Weight: 62 kg; b) Height: 166 cm. Age: 45 taken in the calculation within the CATIA software, that entity is entitled to 50% of healthy female population that is able to execute these and similar jobs. During the surgery is investigated the two most common positions: position “1” and “2”. We wish to emphasize that the experiment or surgical procedure lasted for two positions for five hours, with the position “1” lasted 0.5 hours, and position “2” lasted about 4.5 hours. The additional load arm during surgery is about 1.0 kg. Results: The analysis was done in three positions: “Operating position 1”, “Operating position 2 ‘, and each of these positions will be considered in its characteristic segments. These segments are: when the body takes the correct position, but is not yet burdened with external load, then when the surgeon receives the load and the third position when the load is lifted at the end of the position. Calculation of internal energy used on the joints is carried out in the context of software analysis of this

  9. Organism Encumbrance of Cardiac Surgeon During Surgery.

    Science.gov (United States)

    Karabdic, Ilirijana Haxhibeqiri; Veljovic, Fikret; Straus, Slavenka

    2016-07-16

    Most everyday activities, performed over a long period leads to performance degradation of skeletal muscles as well as spinal column which is reflected in the reduction of maximum force, reduction of the speed of response, reducing control of the movement etc. Although until now many mathematical models of muscles are developed, very small number takes into account the fatigue, and those models that take into account changes in the characteristics of muscles for extended activities, generally considered tiring under certain conditions. Given that the current models of muscle fatigue under arbitrary conditions of activation and load are very limited, this article presents a new model that includes scale of muscles overload. There are three female cardiac surgeons working performing these surgeries in operating rooms, and their average anthropometric measures for this population is: a) Weight: 62 kg; b) Height: 166 cm. Age: 45 taken in the calculation within the CATIA software, that entity is entitled to 50% of healthy female population that is able to execute these and similar jobs. During the surgery is investigated the two most common positions: position "1" and "2". We wish to emphasize that the experiment or surgical procedure lasted for two positions for five hours, with the position "1" lasted 0.5 hours, and position "2" lasted about 4.5 hours. The additional load arm during surgery is about 1.0 kg. The analysis was done in three positions: "Operating position 1", "Operating position 2 ', and each of these positions will be considered in its characteristic segments. These segments are: when the body takes the correct position, but is not yet burdened with external load, then when the surgeon receives the load and the third position when the load is lifted at the end of the position. Calculation of internal energy used on the joints is carried out in the context of software analysis of this model using CATIA R5v19. The proposed model is based on CATIA software

  10. Surgeon-patient communication during awake procedures.

    Science.gov (United States)

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

    2017-06-01

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

  11. Society of American Gastrointestinal and Endoscopic Surgeons

    Science.gov (United States)

    ... The Research Foundation of the American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American ... W. OIympic Blvd Suite 600 Los Angeles, CA 90064 USA webmaster@sages.org Tel: (310) 437- ...

  12. David i fortællingen i verden

    DEFF Research Database (Denmark)

    Hasselbalch, Trine Bjørnung

    2013-01-01

    Interpretations of the narratives about David in the Books of Samuel can be divided roughly into works that understand them one way or the other as products of history, and works that tend to disregard questions about their historical conditions. But neither strategy – studying the meaning of the...... in unresolved social situations of which the authors are not in control. From this perspective, some nuances are suggested about how the writing of the David narratives could be meaningful to their author(s)....

  13. Should the surgeon or the general practitioner (GP follow up patients after surgery for colon cancer? A randomized controlled trial protocol focusing on quality of life, cost-effectiveness and serious clinical events

    Directory of Open Access Journals (Sweden)

    Ringberg Unni

    2008-06-01

    Full Text Available Abstract Background All patients who undergo surgery for colon cancer are followed up according to the guidelines of the Norwegian Gastrointestinal Cancer Group (NGICG. These guidelines state that the aims of follow-up after surgery are to perform quality assessment, provide support and improve survival. In Norway, most of these patients are followed up in a hospital setting. We describe a multi-centre randomized controlled trial to test whether these patients can be followed up by their general practitioner (GP without altering quality of life, cost effectiveness and/or the incidence of serious clinical events. Methods and Design Patients undergoing surgery for colon cancer with histological grade Dukes's Stage A, B or C and below 75 years of age are eligible for inclusion. They will be randomized after surgery to follow-up at the surgical outpatient clinic (control group or follow-up by the district GP (intervention group. Both study arms comply with the national NGICG guidelines. The primary endpoints will be quality of life (QoL (measured by the EORTC QLQ C-30 and the EQ-5D instruments, serious clinical events (SCEs, and costs. The follow-up period will be two years after surgery, and quality of life will be measured every three months. SCEs and costs will be estimated prospectively. The sample size was 170 patients. Discussion There is an ongoing debate on the best method of follow-up for patients with CRC. Due to a wide range of follow-up programmes and paucity of randomized trials, it is impossible to draw conclusions about the best combination and frequency of clinic (or family practice visits, blood tests, endoscopic procedures and radiological examinations that maximize the clinical outcome, quality of life and costs. Most studies on follow-up of CRC patients have been performed in a hospital outpatient setting. We hypothesize that postoperative follow-up of colon cancer patients (according to national guidelines by GPs will not have

  14. Therapists, Trainers, and Acupuncturists: Focused Review for the Orthopedic Surgeon.

    Science.gov (United States)

    Domes, Christopher M; Kruger, Cori L

    2015-12-01

    Effective treatment of orthopedic injuries requires a multidisciplinary team, including physical and occupational therapists, athletic trainers, massage therapists, and acupuncturists. Orthopedic surgeons commonly encounter these practitioners but may not be familiar with the training, credentialing, and most importantly, the appropriate use of members of this team. There are general similarities in practice locations as well as types of symptoms addressed by the providers discussed, which include the treatment of physical pain, evaluation and treatment of physical impairment, and some facilitation of adaptation to the limitations caused by injuries. Across the 5 types of providers discussed there are widely varying training and licensing requirements, specializations, and continuing education requirements to maintain licensure. This article provides a focused review of these members of the multidisciplinary team and highlights the current American Academy of Orthopaedic Surgeons recommendations for the use of occupational and physical therapists for orthopedic conditions, including hip fractures, total hip arthroplasty, and anterior cruciate ligament reconstruction.

  15. Assessment of patient factors, surgeons, and surgeon teams in immediate implant-based breast reconstruction outcomes.

    Science.gov (United States)

    Gfrerer, Lisa; Mattos, David; Mastroianni, Melissa; Weng, Qing Y; Ricci, Joseph A; Heath, Martha P; Lin, Alex; Specht, Michelle C; Haynes, Alex B; Austen, William G; Liao, Eric C

    2015-02-01

    Outcome studies of immediate implant-based breast reconstruction have focused largely on patient factors, whereas the relative impact of the surgeon as a contributing variable is not known. As the procedure requires collaboration of both a surgical oncologist and a plastic surgeon, the effect of the surgeon team interaction can have a significant impact on outcome. This study examines outcomes in implant-based breast reconstruction and the association with patient characteristics, surgeon, and surgeon team familiarity. A retrospective review of 3142 consecutive implant-based breast reconstruction mastectomy procedures at one institution was performed. Infection and skin necrosis rates were measured. Predictors of outcomes were identified by unadjusted logistic regression followed by multivariate logistic regression. Surgeon teams were grouped according to number of cases performed together. Patient characteristics remain the most important predictors for outcomes in implant-based breast reconstruction, with odds ratios above those of surgeon variables. The authors observed significant differences in the rate of skin necrosis between surgical oncologists with an approximately two-fold difference between surgeons with the highest and lowest rates. Surgeon teams that worked together on fewer than 150 procedures had higher rates of infection. Patient characteristics are the most important predictors for surgical outcomes in implant-based breast reconstruction, but surgeons and surgeon teams are also important variables. High-volume surgeon teams achieve lower rates of infection. This study highlights the need to examine modifiable risk factors associated with optimum implant-based breast reconstruction outcomes, which include patient and provider characteristics and the surgical team treating the patient. Risk, III.

  16. Common contractual concerns for the oral and maxillofacial surgeon.

    Science.gov (United States)

    Luciani, Eugene W

    2008-02-01

    Whether new to private practice or a seasoned practitioner, an oral and maxillofacial surgeon (OMS) needs to understand how to handle complicated and often stressful negotiations of contracts for which he or she usually is untrained. This article is designed to give a general understanding of certain common contractual language. It is not comprehensive in scope, but it attempts to cover contracts that are most often seen by an OMS in practice. It is a general discussion of common legal concepts that could face an OMS, but it is not, nor is it intended to be, legal advice.

  17. Knowledge, Attitude, and Practices of Dental Surgeons in managing Child Patients

    Science.gov (United States)

    Siddiqui, Talha Mufeed; Khan, Rabia; Batool, Kanza

    2016-01-01

    The aim of the study was to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cross-sectional study was conducted to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cluster-sampling technique was used and 200 dental surgeons from six different dental institutions were selected. A self-constructed questionnaire was distributed to the dental surgeons that comprised 20 closed-ended questions. The data was entered and analyzed for frequency and percentages by using Statistical Package for the Social Sciences (SPSS) version 19. The results showed that 76 (38%) dental surgeons took the responsibility of managing pediatric patient when given; 68 (34%) dental surgeons allowed the parents in the clinic; 111 (55.5%) dental surgeons are of the view that colorful and fun environment in dental clinic make the child at ease; 59 (29.5%) always demonstrate the dental procedure to the child to eradicate imaginary fears; 94 (47.0%) dental surgeons preferred the child to be treated in general anesthesia (GA) to avoid difficult behavior of the child; 135 (67.5%) dental surgeons did not show syringe needle or any instrument to the child. All the members of dental profession must be aware of patient perceptions, preferences, and fear to meet patient’s needs. Dental studies should include guidelines and techniques to train the upcoming dentists for excellent practice in pediatric dentistry. How to cite this article Wali A, Siddiqui TM, Khan R, Batool K. Knowledge, Attitude, and Practices of Dental Surgeons in managing Child Patients. Int J Clin Pediatr Dent 2016;9(4):372-378. PMID:28127171

  18. Current Practice Patterns Regarding the Conduct of Thyroidectomy and Parathyroidectomy amongst Surgeons - A Survey Study

    Directory of Open Access Journals (Sweden)

    LR Henry, LB Helou, NP Solomon, A Chang, SK Libutti, A Stojadinovic

    2012-01-01

    Full Text Available Background: Heterogeneity of surgical care exists among surgeons regarding the conduct of thyroidectomy and parathyroidectomy.Aim: To identify the current patterns of technical conduct of operation amongst surgeons performing thyroidectomy or parathyroidectomy.Methods: A survey was designed and beta-tested on five surgical oncologists for face validity and usability. The final version of this survey was constructed and disseminated using the professional version of the internet-based survey mechanism Survey Monkey and consisted of two eligibility questions and 22 questions regarding thyroidectomy/parathyroidectomy treatment patterns. The survey was disseminated electronically to American Association of Endocrine Surgeons (AAES and American College of Surgeons (ACS members. Survey results were collected, tabulated and analyzed. Responses among groups were compared using two sample T- tests. Significant responses were subsequently analyzed in generalized linear models to ascertain if significance remained with control of covariates.Results: Of 420 initial web survey visits, 236 (56.2% surveys were completed. The majority of respondents reported being 'fellowship trained', experienced and 'high-volume' surgeons. The most common fellowship trainings were endocrine (46%, oncology (22%, head & neck (13%, or combinations of the three fellowships (14%. Most surgeons reported that they dissect the course of the recurrent laryngeal nerve (RLN without using neuromonitoring. Nearly a third of respondents reported routinely using the Harmonic scalpel during the conduct of the operations. Significant differences emerged regarding operative technique according to residency training type, fellowship training, surgeon volume, and practice setting, but only those associated with residency training type and annual surgeon surgical volume remained significant within generalized linear models.Conclusion: Most surgeons who responded to this survey do not routinely

  19. Nähtamatu revolutsioon / David R. Smith ; interv. Philip Ball

    Index Scriptorium Estoniae

    Smith, David R.

    2007-01-01

    Tehisstruktuuriga metamaterjalid võivad põhjapanevalt muuta telekommunikatsiooni, andmekandjaid ja isegi päikeseenergeetikat, kinnitab Dukeѫi ülikooli töörühma juht David R. Smith. Artikkel üldpealkirja all: 10 tulevikutehnoloogiat 2007

  20. Challenging Texts: Teaching Deliberately--Reading Henry David Thoreau's "Walden"

    Science.gov (United States)

    Davis, Andrea

    2011-01-01

    One of the more difficult 19th-century American texts for high school students to read is undoubtedly Henry David Thoreau's "Walden." His erudite allusions, often page-long sentences, and sophisticated sense of the ironic initially leave many students cold. Still, the author encourages them to read amid the din of a cultural cacophony that shouts…

  1. Battling Creaticide: An Interview with David C. Berliner

    Science.gov (United States)

    Ambrose, Don

    2012-01-01

    This article presents an interview with David C. Berliner, a Regents' Professor in the College of Education at Arizona State University. His books include "Educational Psychology," "The Manufactured Crisis," and "The Handbook of Educational Psychology." He has served as president of the American Educational Research Association and of the…

  2. Battling Creaticide: An Interview with David C. Berliner

    Science.gov (United States)

    Ambrose, Don

    2012-01-01

    This article presents an interview with David C. Berliner, a Regents' Professor in the College of Education at Arizona State University. His books include "Educational Psychology," "The Manufactured Crisis," and "The Handbook of Educational Psychology." He has served as president of the American Educational Research Association and of the…

  3. Inside the Classroom of Harvard Law School Professor David Wilkins.

    Science.gov (United States)

    Lawrence-Lightfoot, Sara

    1999-01-01

    Examines the teaching methods of David Wilkins, an African American Harvard Law School professor considered an exciting teacher by his students and colleagues. Describes his skill in getting students to attend class, engage in legal thinking, feel comfortable in the classroom, and learn the formal rituals and procedures for the court. (SM)

  4. "David Byrne really does love PowerPoint"

    DEFF Research Database (Denmark)

    van Leeuwen, Theo; Djonov, Emilia

    2014-01-01

    This article presents a reading if David Byrne's Envisioning Emotional Epistemological Information, an art work created with Microsoft's presentation software PowerPoint, as an instance of creative research on semiotics and semiotic technology. It reveals commonalities and differences between Byrne...

  5. In Memoriam: David Judson Sencer, A Public Health Giant

    Centers for Disease Control (CDC) Podcasts

    2011-12-15

    Dr. Jeffery Koplan, Director of the Emory Global Health Institute at Emory University, reflects on the career of Dr. David Sencer.  Created: 12/15/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/19/2011.

  6. David Almond's "Skellig": "A New Vista of Contemplation"?

    Science.gov (United States)

    Stewart, Susan Louise

    2009-01-01

    The debates that have arisen regarding Darwin's theories of evolution and Christian views of creation and their place in education in the United States have frequently been extremely heated, resulting in trials, hearings, and laws. This article provides an overview of some of the disagreements and illustrates how David Almond's British novel,…

  7. Life after Death in Poverty: David Treuer's "Little"

    Science.gov (United States)

    Stirrup, David

    2005-01-01

    David Treuer's debut novel, "Little" (1995), is set on a Minnesota reservation, centering around a dilapidated housing tract that its small community of residents call "Poverty." Aptly named both for the condition and background of the housing, this name is the first pointer to the type of multifaceted reading that the novel…

  8. Empowering Adolescent Readers: Intertextuality in Three Novels by David Almond

    Science.gov (United States)

    Latham, Don

    2008-01-01

    In "Skellig," "Kit's Wilderness," and "Clay", David Almond employs various types of intertextuality to enrich his narratives. Through the use of allusion, adaptation, collage, and mise-en-abyme, he encourages his adolescent readers to seek out precursor texts and to consider the interrelationships between these texts and his own. By so doing, he…

  9. Fatboy Slim ja David Byrne teevad Imelda Marcosest muusikali

    Index Scriptorium Estoniae

    2005-01-01

    Inglise DJ Fatboy Slim'i ja USA art-rockmuusiku David Byrne'i diskokeskne muusikal "Here Love Lives" kajastab Filipiinide diktaatori Ferdinand Macrose abikaasa elu. Muusikal esietendub tuleva aasta märtsis Austraalias Adelaide'i kultuurifestivalil, Euroopa esietendus toimub seejärel Liverpoolis

  10. Child Welfare Research and Training: A Response to David Stoesz

    Science.gov (United States)

    Smith, Brenda D.; Vandiver, Vikki L.

    2016-01-01

    In this response to David Stoesz' critique, "The Child Welfare Cartel," the authors agree that child welfare research and training must be improved. The authors disagree, however, with Stoesz' critique of social work education, his assessment of the most-needed forms of child welfare research, and his depiction of the goals and…

  11. David Sackett en 25 jaar evidencebased geneeskunde : Individu en context

    NARCIS (Netherlands)

    Bolt, Timo C; Huisman, Frank G

    2015-01-01

    David Sackett, the father of evidence-based medicine (EBM), died recently - exactly 25 years after the term EBM was coined. This coincidence calls for reflection on the historical significance of EBM and on Sackett's role. The rise of EBM appears to be part of a much broader development: a shift fro

  12. Instructional Implications of David C. Geary's Evolutionary Educational Psychology

    Science.gov (United States)

    Sweller, John

    2008-01-01

    David C. Geary's thesis has the potential to alter our understanding of those aspects of human cognition relevant to instruction. His distinction between biologically primary knowledge that we have evolved to acquire and biologically secondary knowledge that is culturally important, taught in educational institutions and which we have not evolved…

  13. Comments on forty chairs in four feet by David Rowland

    DEFF Research Database (Denmark)

    2005-01-01

    I forbindelse med 40-års jubilæet for David Rowlands stol ”40/4” har 22 internationale designere skabt deres egne fortolkninger af stolen Danske designere på udstillingen: Finn Sködt, Louise Campbell, Nanna Ditzel, Erik Simonsen, Boris Berlin & Poul Christiansen, Hans Sandgren Jakobsen Redaktøren...

  14. Video from Panel Discussion with Joseph Fraumeni and David Schottenfeld

    Science.gov (United States)

    Video footage from Panel Discussion with Joseph Fraumeni and David Schottenfeld on Cancer Epidemiology over the Last Half-Century and Thoughts on the Future. The discussion took place on May 11, 2012, when DCEG hosted Dr. Schottenfeld as a Visiting Scholar.

  15. My Journey Into the Physics of David Finkelstein

    Science.gov (United States)

    Alexander, Stephon

    2016-12-01

    David Finkelstein was a co-pioneer of the use of topology and solitons in theoretical physics. The author reflects on the great impact Finkelstein had on his research throughout his career. The author provides an application of one of Finkelsteins idea pertaining to the fusion of quantum theory with relativity by utilizing techniques from Loop Quantum Gravity.

  16. Grade 1 Students Meet David Wiesner's "Three Pigs."

    Science.gov (United States)

    Pantaleo, Sylvia

    2002-01-01

    Describes the oral, written, and visual arts responses of a group of Grade 1 children. Discusses first grade children's understandings of and responses to several Radical Change characteristics and metafictive techniques found in David Wiesner's "The Three Pigs" (2001), the 2002 Randolph Caldecott Medal winner. Explores the nature of the literary…

  17. 76 FR 12971 - David E. Berman: Debarment Order

    Science.gov (United States)

    2011-03-09

    ... the Federal Food, Drug, and Cosmetic Act (the FD&C Act) debarring David E. Berman, MD, for 3 years..., specializing in plastic surgery with an office in Sterling, VA. On or about January 16, 2004, and on or about... offered it for sale to, and used it on, thirty of his patients as BOTOX Cosmetic. Dr. Berman did...

  18. Drawing borders of mental disorders : An interview with David Kupfer

    NARCIS (Netherlands)

    Verhoeff, Berend

    2010-01-01

    The new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is on its way and will most likely be published in 2013. The chair of the task force of this significant project, Dr David Kupfer, was in the Netherlands at a national psychiatry conference to give an update on its progress. Short

  19. David E. Smith Receives 2012 Charles A. Whitten Medal: Citation

    Science.gov (United States)

    Phillips, Roger J.

    2013-01-01

    David E. Smith was awarded the 2012 Charles A. Whitten Medal at the AGU Fall Meeting Honors Ceremony, held on 5 December 2012 in San Francisco, Calif. The medal is for "outstanding achievement in research on the form and dynamics of the Earth and planets."

  20. Henry David Thoreau and Martin Luther King, Jr. Lesson Plan.

    Science.gov (United States)

    Powell, Brent

    1995-01-01

    Presents a five-lesson, high school instructional unit on the ideas and activities of Henry David Thoreau and Martin Luther King, Jr. Includes student objectives, step-by-step instructional procedures, and discussion questions. Provides quotations by Thoreau and King. (CFR)

  1. Fatboy Slim ja David Byrne teevad Imelda Marcosest muusikali

    Index Scriptorium Estoniae

    2005-01-01

    Inglise DJ Fatboy Slim'i ja USA art-rockmuusiku David Byrne'i diskokeskne muusikal "Here Love Lives" kajastab Filipiinide diktaatori Ferdinand Macrose abikaasa elu. Muusikal esietendub tuleva aasta märtsis Austraalias Adelaide'i kultuurifestivalil, Euroopa esietendus toimub seejärel Liverpoolis

  2. SuchThatCast Episode 7: David Koepsell

    NARCIS (Netherlands)

    Soraker, Johnny

    2013-01-01

    David Koepsell earned his PhD in philosophy as well as his law degree from the University at Buffalo, where he studied with Barry Smith. He has authored numerous articles as well as authored and edited several books, including Searle on the Institutions of Social Reality, The Ontology of Cyberspace:

  3. Nähtamatu revolutsioon / David R. Smith ; interv. Philip Ball

    Index Scriptorium Estoniae

    Smith, David R.

    2007-01-01

    Tehisstruktuuriga metamaterjalid võivad põhjapanevalt muuta telekommunikatsiooni, andmekandjaid ja isegi päikeseenergeetikat, kinnitab Dukeѫi ülikooli töörühma juht David R. Smith. Artikkel üldpealkirja all: 10 tulevikutehnoloogiat 2007

  4. Surgeons and non-surgeons prefer haptic feedback of instrument vibrations during robotic surgery.

    Science.gov (United States)

    Koehn, Jacqueline K; Kuchenbecker, Katherine J

    2015-10-01

    Clinical robotic surgery systems do not currently provide haptic feedback because surgical instrument interactions are difficult to measure and display. Our laboratory recently developed a technology that allows surgeons to feel and/or hear the high-frequency vibrations of robotic instruments as they interact with patient tissue and other tools. Until now, this type of feedback had not been carefully evaluated by users. We conducted two human-subject studies to discover whether surgeons and non-surgeons value the addition of vibration feedback from surgical instruments during robotic surgery. In the first experiment, 10 surgeons and 10 non-surgeons (n = 20) used an augmented Intuitive da Vinci Standard robot to repeatedly perform up to four dry-lab tasks both with and without haptic and audio feedback. In the second experiment, 68 surgeons and 26 non-surgeons (n = 94) tested the same robot at a surgical conference: each participant spent approximately 5 min performing one or two tasks. Almost all subjects in both experiments (95 and 98 %, respectively) preferred receiving feedback of tool vibrations, and all subjects in the second experiment thought it would be useful for surgeons to have the option of such feedback. About half of the subjects (50, 60 %) preferred haptic and audio feedback together, and almost all the rest (45, 35 %) preferred haptic feedback alone. Subjects stated that the feedback made them more aware of tool contacts and did not interfere with use of the robot. There were no significant differences between the responses of different subject populations for any questions in either experiment. This study illustrates that both surgeons and non-surgeons prefer instrument vibration feedback during robotic surgery. Some participants found audio feedback useful but most preferred haptic feedback overall. This strong preference for tool vibration feedback indicates that this technology provides valuable tactile information to the surgeon.

  5. Designing a leadership development program for surgeons.

    Science.gov (United States)

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

    2016-01-01

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

  6. History of the Congenital Heart Surgeons' Society.

    Science.gov (United States)

    Mavroudis, Constantine; Williams, William G

    2015-10-01

    The Congenital Heart Surgeons' Society is a group of over 100 pediatric heart surgeons representing 72 institutions that specialize in the treatment of patients with congenital heart defects. The Society began in 1972 and incorporated as a not-for-profit charitable organization in 2004. It has become the face and voice of congenital heart surgery in North America. In 1985, the Society established a data center for multicenter clinical research studies to encourage congenital heart professionals to participate in improving outcomes for our patients. The goals of the Congenital Heart Surgeons' Society are to stimulate the study of congenital cardiac physiology, pathology, and management options which are instantiated in data collection, multi-institutional studies, and scientific meetings. Honest and open discussion of problems with possible solutions to the challenges facing congenital heart professionals have been the strength of the Congenital Heart Surgeons' Society. It is imperative for the growth of an organization to know from where it came in order to know to where it is going. The purpose of this article is to review the history of the Congenital Heart Surgeons' Society. © The Author(s) 2015.

  7. David·Shirreff:Basel Faulty

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ The intense scrutiny undergone by the financial sector will reach a hiatus in 2004. Regulators will have learnt that they cannot, by prescribing ever more complex or draconian rules, prevent financial companies from taking disastrous risks, or form exploiting privileged information and diddling their customers.Those two dangers, which have preoccupied bank supervisors since the collapses of Long-Term Capital Management in 1998dan Enron in 2001, are inherent in the financial business and cannot be magicked away. With luck, 2004 will see regulators take a different tack and begin to simplify the complex rules on bank capital, known as Basel 2. It should also see the witch-hunters, such as Eliot Spitzeer, the New York State attorney-general, accept that digging ever deeper into the way financial firms do business will not reach clear blue water-there is none. Financial dealings are nearly always at root unfair for someone.

  8. David Bruce Payton : väikeriigid mõistavad üksteist / David Bruce Payton ; interv. Marianne Mikko

    Index Scriptorium Estoniae

    Payton, David Bruce

    2003-01-01

    Uus-Meremaa suursaadik Eestis David Bruce Payton talupidaja toetamise loobumisest Uus-Meremaal, Uus-Meremaa põllumajandussektorist, veinidest, ekspordist, Eesti saamisest EL-i ja NATO liikmeks, Uus-Meremaa rahvastikust, elatustasemest, Iraagi võimalikust ründamisest, Põhja-Koreast

  9. David Bruce Payton : väikeriigid mõistavad üksteist / David Bruce Payton ; interv. Marianne Mikko

    Index Scriptorium Estoniae

    Payton, David Bruce

    2003-01-01

    Uus-Meremaa suursaadik Eestis David Bruce Payton talupidaja toetamise loobumisest Uus-Meremaal, Uus-Meremaa põllumajandussektorist, veinidest, ekspordist, Eesti saamisest EL-i ja NATO liikmeks, Uus-Meremaa rahvastikust, elatustasemest, Iraagi võimalikust ründamisest, Põhja-Koreast

  10. Surgeon General's Call to Action to Prevent Skin Cancer

    Science.gov (United States)

    ... Tanning is not a safe way to get vitamin D. The best way to protect your skin from UV rays is by using effective sun ... skin. Although it is important to get enough vitamin D, the safest way is through what you eat. Tanning ... IN What can policymakers do? • ...

  11. Smoking and Health: A Report of the Surgeon General.

    Science.gov (United States)

    Public Health Service (DHEW), Rockville, MD.

    This book is divided into three sections. In the first section the health consequences of smoking are delineated. Part two contains discussions of the behavioral and biological aspects of smoking. The final section is devoted to educational opportunities for preventing addiction to tobacco. (JD)

  12. ["Stress" ulcer--a problem of the general surgeon].

    Science.gov (United States)

    Danelisen, D; Zigić, B; Rac, S

    1982-01-01

    Contemporary way of living accompanied by everday frustrations, a frequent use of medicaments, an easy application of corticosteroids, complexity of an opeation, so as an increased incidence of polytraumas --those are the factors responsible for an increasing rate of stress ulcus. The rate of 54 verified stress ulcus in the period from 1969-1979 in Regional Medical Centre of Banja Luka, at Surgical Department, are very often indicative of this disease. Thirty eight operatively treated patients are indicative of severity of this disease. The authors are reporting their experiences in resolving this disease by method of vagotomy with partial gastrectomy in comparison to simple sutures of acutely developed ulcus in addition to PS vagotomy. Perforation, which has, usually, been bigger than the chronic ulcus, we had in 31 cases. If the reports of the world authors are reliable, perforation occurs in 5% of cases only, therefore it is clear how many such conditions has remained undetected or treated under various other "working" diagnoses: (DIC, consumer coagulopathy, fibrinolysis, etc.". The stress ulcus is the disease which is a danger to any patient at Surgical Department.

  13. Shouldice Herniorrhaphy Technique: Surgeons Need to Remember It

    Directory of Open Access Journals (Sweden)

    Adem Dervişoğlu

    2012-01-01

    Full Text Available Aim: Hernia surgery is the second most common surgical intervention performed by general surgeons following emergent surgeries. Shouldice herniorraphy is a classical surgery which is in the high tension repair group. This technique should be known by every surgeon. Also being an alternative method, it can be a necessity in cases in which tension free methods can not be performed. In the present study we investigated the advantages, disadvantages and complications of the Shouldice herniorraphy and Lichtenstein technique with the review of the technical literature. Material and Method: We compared 75 patients who were diagnosed with inguinal hernia and treated with Lichtenstein herniorraphy with 33 patients who were treated with Shouldice herniorraphy in Samsun Bafra Public Hospital between April 2007 and May 2008. Age, sex, hernia type, anesthesia method, mean hospitalisation length, early and late post operative complications were recorded. Result: Early post operative complications were urinary retention, wound infection and hematoma. The patients under spinal anesthesia with urinary retention were treated with urinary catheterization. Superficial wound infection was treated with drainage and antibiotic threapy. Among late postoperative complications; we observed paresthesia in the thigh in one patient in the Shouldice group and relapse hernia in one patient in the Lichtenstein group. Discussion: We suggest that this surgical technique which should be known by every surgeon should be taught to new surgery attenders as an alternative technique. This technique can be an alternative method and also may be the first choice in patients in whom tension free methods can not be applicated.

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

    NARCIS (Netherlands)

    Janssen, S.J.; Teunis, T.; Guitton, T.G.; Ring, D.; Biert, J.

    2015-01-01

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

  15. Maximizing efficiency on trauma surgeon rounds.

    Science.gov (United States)

    Ramaniuk, Aliaksandr; Dickson, Barbara J; Mahoney, Sean; O'Mara, Michael S

    2017-01-01

    Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55. Five full-time attending trauma surgeons were evaluated. Value-added (VA) and NVA components of rounding were identified. The components of each patient interaction during daily rounds were documented. Summary data were presented to the surgeons. An action plan of improvement was provided at group and individual interventions. Change plans were presented to the multidisciplinary team. Data were recollected 6 mo after intervention. The percent of interactions with NVA components decreased (16.0% to 10.7%, P = 0.0001). There was no change between the two periods in time of evaluation of individual patients (4.0 and 3.5 min, P = 0.43). Overall time to complete rounds did not change. There was a reduction in the number of interactions containing NVA components (odds ratio = 2.5). The trauma surgeons were able to reduce the NVA components of rounds. We did not see a decrease in rounding time or individual patient time. This implies that surgeons were able to reinvest freed time into patient care, or that the NVA components were somehow not increasing process time. Direct intervention for isolated improvements can be effective in the rounding process, and efforts should be focused upon improving the value of time spent rather than reducing time invested. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The business acumen of Canadian plastic surgeons.

    Science.gov (United States)

    Bliss, J A; Caputy, G G

    1995-08-01

    We as plastic surgeons are engrossed and consumed by our quest to optimize patient care. In so doing, we are often distracted by that aspect of our practice which has direct bearing on patient care yet for which we are the least prepared--the business aspect. The entire population of Canadian plastic surgeons was surveyed in an effort to establish real and perceived needs of this group with respect to the business management of their practices. The survey elicited demographic information, information on business educational background, interest, and current commitment in acquiring business knowledge, and a final category of questions dealing with how well these surgeons function as business managers. Of the 315 plastic surgeons surveyed, 122 (39 percent) responded, which, in and of itself, indicates an interest in this aspect of their practices. Twelve respondents were excluded from the study for various reasons. Eighty of the 110 remaining respondents (72 percent) used a hospital-integrated facility for both emergency and elective outpatient procedures. Eighty-four of the 110 respondents (76 percent) indicated that 10 percent of their hours per week of inpatient booked operating time was canceled. Ninety-three percent of respondents felt that a business course to familiarize surgeons with common business situations and areas of personal finance would be beneficial. Few were previously educated in business, and similarly, few had great ongoing interest in business, although the majority of respondents used publications specifically dealing with financial matters (provided by the Canadian Medical Association). Twenty-three percent of respondents saw themselves in a growing role as businesspeople; 24 percent felt this dual role was enjoyable, while 29 percent felt this role was forced on them. A total of 21 percent of respondents did not see themselves as businesspeople at all. The six basic functions of a manager (planning, acquiring, organizing, actuating

  17. Social media and your practice: navigating the surgeon-patient relationship.

    Science.gov (United States)

    McLawhorn, Alexander S; De Martino, Ivan; Fehring, Keith A; Sculco, Peter K

    2016-12-01

    Utilization of social media both in the private and professional arenas has grown rapidly in the last decade. The rise of social media use within health care can be viewed as the Internet-based corollary of the patient-centered care movement, in which patient perspectives and values are central to the delivery of quality care. For orthopedic surgeons and their practices, general-purpose online social networks, such as Facebook and Twitter, are convenient platforms for marketing, providing patient education and generating referrals. Virtual health communities are used less frequently by orthopedic surgeons but provide forums for patient engagement and active surgeon-to-patient communication via blogs and ask-the-doctor platforms. This commentary reviews the current state of social media use in orthopedic practice, with particular emphasis on managing the extension of the surgeon-patient relationship online, including the unique practice risks social media poses, such as privacy concerns, potential liability, and time consumption.

  18. Radar detection of pedestrian-induced vibrations on Michelangelo's David.

    Science.gov (United States)

    Pieraccini, Massimiliano; Betti, Michele; Forcellini, Davide; Dei, Devis; Papi, Federico; Bartoli, Gianni; Facchini, Luca; Corazzi, Riccardo; Kovacevic, Vladimir Cerisano

    2017-01-01

    This paper summarizes the results of a two-day dynamic monitoring of Michelangelo's David subject to environmental loads (city traffic and pedestrian loading induced by tourists visiting the Accademia Gallery). The monitoring was carried out by a no-contact technique using an interferometric radar, whose effectiveness in measuring the resonant frequencies of structures and historic monuments has proved over the last years through numerous monitoring activities. Owing to the dynamic behavior of the measurement system (radar and tripod), an accelerometer has been installed on the radar head to filter out the movement component of the measuring instrument from the measurement of the David's displacement. Measurements were carried out in the presence and absence of visitors, to assess their influence on the dynamic behavior of the statue. A numerical model of the statue was employed to evaluate the experimental results.

  19. David Bohm la physique de l'infini

    CERN Document Server

    Teodorani, Massimo

    2014-01-01

    Les idées de David Bohm, indépendamment du scepticisme de ses collègues les plus traditionalistes, ont profondément influencé la physique du siècle dernier et ouvert une porte à la physique du nouveau millénaire. Grâce aussi aux contacts qu'il sut nouer avec des chercheurs d'autres branches du savoir, ses idées ont été accueillies avec beaucoup d'enthousiasme par les neuroscientifiques, les philosophes, les théologiens, les psychologues, les sociologues, les poètes, les artistes et les éducateurs. David Bohm avait peut-être pressenti qu'il existe une "physique de l'âme" et avec elle il voulait tracer un nouveau chemin pour une humanité à la dérive.

  20. Pupazzi di neve. David Lynch fotografo e l’"Unheimliche"

    Directory of Open Access Journals (Sweden)

    Paolo Sebastiano Lanzi

    2013-02-01

    Full Text Available L’opera di David Lynch non si limita al cinema, come ha dimostrato l’esposizione del 2007 alla Fondation Cartier di Parigi, The Air is on Fire. Tuttavia gli studi teorici hanno trascurato ciò che gallerie e musei hanno evidenziato da tempo: il Lynch pittore, fotografo, musicista, artista poliedrico. L’articolo si focalizza su una serie fotografica, Snowmen, ed è tratto da una ricerca di Paolo Sebastiano Lanzi sulla figura di David Lynch fotografo. Alla luce del saggio di Freud sul Perturbante (Das Unheimliche, 1919 si interpretano gli Snowmen come immagini di morte. Si chiariscono alcuni aspetti della poetica dell’artista-regista, come l’inquietudine dell’Inland Empire o di certe idee care al Surrealismo. Lo studio della produzione fotografica di Lynch riempie un vuoto nell’analisi critica sul suo lavoro, che va necessariamente riconsiderato in una prospettiva più ampia.

  1. Designing Wearable Personal Assistants for Surgeons: An Egocentric Approach

    DEFF Research Database (Denmark)

    Jalaliniya, Shahram; Pederson, Thomas

    2015-01-01

    The design of general-purpose wearable computers demands particular care for how human perception, cognition, and action work and work together. The authors propose a human body-and-mind centric (egocentric as opposed to device-centric) design framework and present initial findings from deploying...... it in the design of a wearable personal assistant (WPA) for orthopedic surgeons. The result is a Google Glass-based prototype system aimed at facilitating touchless interaction with x-ray images, browsing of electronic patient records (EPR) when on the move, and synchronized ad hoc remote collaboration...

  2. DAVID HUME AND THE CRITICAL EXAMINATION OF EMPIRICISM

    OpenAIRE

    IONUŢ ŞTEFAN

    2012-01-01

    The research is related to David Hume. This philosopher is described as being an empiricist, but it should be noted that the empiricism promoted by Hume represents the development up to the final consequences of this philosophical doctrine that should be subjected to the observability requirement. The core problem for Hume’s philosophy is the difficulty of causality thinking. The Scottish philosopher promotes a moderate and inconsistent skepticism because he does not doubt the permanency of f...

  3. Dr. David Syz, State Secretary for Economic Affairs, Switzerland

    CERN Document Server

    Maximilien Brice

    2003-01-01

    Dr. David Syz, State Secretary for Economic Affairs, Switzerland is seen here (seventh from right) visiting the assembly hall for the ATLAS experiment during his recent visit to CERN. To his right is Dr. Peter Jenni (blue shirt), spokesperson for the ATLAS Collaboration. The horizontal metal cylinder behind the group is one of the eight vacuum vessels for the superconducting coils of the ATLAS barrel toroid magnet system.

  4. PC-give and David Hendry's econometric methodology

    OpenAIRE

    Neil R. Ericsson; Julia Campos; Hong-Anh Tran

    1991-01-01

    This paper summarizes David Hendry's empirical econometric methodology, unifying discussions in many of his and his co-authors' papers. Then, we describe how Hendry's suite of computer programs PC-GIVE helps users implement that methodology. Finally, we illustrate that methodology and the programs with three empirical examples: post­war narrow money demand in the United Kingdom, nominal income determination in the United Kingdom from Friedman and Schwartz (1982), and consumers' expenditure in...

  5. Professors David and Isabel Crook and Their Family

    Institute of Scientific and Technical Information of China (English)

    Shu; Zhang

    2015-01-01

    Professors David and Isabel Crook and their family are loved by the Chinese people.Four generations of the family live and work in China and regard China as their homeland.Born in Britain in 1910,Davidgraduated from Columbia University in the United States.He joined the Communist Party of Great Britain in 1935.Being an anti-fascist internationalist fighter,he joined the International Brigades and plunged himself into the anti-fascist struggle in Spain.

  6. About David Ruelle, After His 80th Birthday

    Science.gov (United States)

    Gallavotti, Giovanni

    2017-02-01

    This is, with minor modifications, a text read at the 114th Statistical Mechanics meeting, in honor of D. Ruelle and Y. Sinai, at Rutgers, Dec. 13-15, 2015. It does not attempt to analyze, or not even just quote, all works of David Ruelle; I discuss, as usual in such occasions, a few among his works with which I have most familiarity and which were a source of inspiration for me.

  7. David Cronenberg, author of naked lunch: Intersemiotic translation as transcreation

    Directory of Open Access Journals (Sweden)

    Rosângela Fachel de Medeiros

    2016-05-01

    Full Text Available This paper presents and analyzes the intersemiotic translation process performed by filmmaker David Cronenberg of William Burroughs' novel Naked Lunch, and the intertextual bifurcations involved in this process. Investigating the similarities and differences between the creative worlds of both artists and how they reframe each other. For this, are used as the theoretical the idea of transcreation proposed by Haroldo de Campos, and the notion of the translator as a reader proposed by Jorge Luis Borges.

  8. David Nelson, MD, MPH | Division of Cancer Prevention

    Science.gov (United States)

    Dr. David E Nelson is the Director of the Cancer Prevention Fellowship Program (CPFP) Branch in the National Cancer Institute's Division of Cancer Prevention. The CPFP is an internationally renowned postdoctoral program designed to train early career scientific researchers and leaders in the field of cancer prevention. Dr. Nelson came to the CPFP in 2008 after working at the Centers for Disease Control and Prevention in Atlanta for many years. |

  9. MAKING SENSE OF THE WORLD: AN INTERVIEW WITH DAVID KRANTZ

    Directory of Open Access Journals (Sweden)

    Jhon Shooter

    2016-09-01

    Full Text Available David L. Krantz is Professor of Psychology at Lake Forest College. A Fromer Fellow at the Center for Advanced Studies in Behavioral Science, be has published articles and books in the social psychology of science and topic related to power, knowing, and life's meaning. He recently completed a book tentatively titled journays and Destinations: Searching for life's Meanings while a Visiting Professor at the University of Ghent, Belgium.

  10. Princípiosnorteadores da filosofia moral de David Hume

    Directory of Open Access Journals (Sweden)

    André Luiz Holanda de Oliveira

    2017-02-01

    Full Text Available O presente artigo objetiva apresentar os princípios norteadores da filosofia moral de David Hume. Para tanto se buscará demonstrar que a razão é escrava das paixões, que os juízos morais não são demonstráveis, nem refletem a realidade objetiva, para por fim, demonstrar a importância da utilidade.

  11. About David Ruelle, after his 80th birthday

    CERN Document Server

    Gallavotti, Giovanni

    2016-01-01

    This is, with minor modifications, a text read at the 114th Statistical Mechanics meeting, in honor of D.Ruelle and Y.Sinai, at Rutgers, Dec.13-15, 2015. It does not attempt to analyze, or not even just quote, all works of David Ruelle; I discuss, as usual in such occasions, a few among his works with which I have most familiarity and which were a source of inspiration for me.

  12. How helpful is capsule endoscopy to surgeons?

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Bulent Sivri; Yusuf Bayraktar

    2007-01-01

    Capsule endoscopy is a new technology that, for the first time, allows complete, non-invasive endoscopic imaging of the small bowel. The efficacy of capsule endoscopy in the diagnosis of suspected small bowel diseases has been established. Important applications for surgeons include observations of obscure gastrointestinal bleeding and small bowel neoplasms.

  13. Contemporary social media engagement by breast surgeons.

    Science.gov (United States)

    Ekatah, Gregory E; Walker, Stephanie G; McDonald, James J; Dixon, J Michael; Brady, Richard R W

    2016-12-01

    There continues to be a steady rise in the use of social media among healthcare professionals. We present an overview of social media use among breast surgeons within the United Kingdom including demographic variations and some of the factors that underpin these trends. The benefits and drawbacks of open social media platforms are also considered.

  14. The nature of surgeon human capital depreciation.

    Science.gov (United States)

    Hockenberry, Jason M; Helmchen, Lorens A

    2014-09-01

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

  15. Has medical history importance for surgeons?

    Science.gov (United States)

    Wangensteen, O W

    1975-03-01

    Surgeons will do well to remember that the two most important contributions to the growth and extension of surgery came from two disciplines, not then regarded as the most innovative. Anesthesia came from dentistry, the work primarily of W.T.G. Morton of Boston; prophylactic surgical antisepsis originated with the obstetrician Semmelweis, who developed a scheme of prophylactic chemical antisepsis that still remains the core of surgical antisepsis. In the mid 1880's, largely as a result of the work of Chamberland and others of the Pasteur school, surgeons in France and Germany substituted thermal for chemical antisepsis, whenever applicable. Whereas Lister's influence was tremendous in fostering acceptance of antisepsis by surgeons, by the end of his professorial career he had begun his capitulation to prophylactic antisepsis, which was complete by 1896 to the very practices that Semmelweis had proved the value of almost five decades previously. These were 19th century innovations. The greatest boon to surgery's advance in this century has been control of cellulitic infections through chemotherapeutic agencies, the sulfonamides and antibiotics. The tremendous upsurge of interest in research at the end of World War II brought surgeons to a fuller realization of the significant part they could play in the advance of their discipline. Intimate alignment of surgeons with physiologists of the circulation begot intracardiac surgery, a significant innovation with consequences of tremendous import for greater medicine's advance. Today, surgeons attacking the problem of tissue transplantation are aligning themselves with biochemists, geneticists, immunologists, experimental pathologists, and pharmacologists in their broad approach to the phenomenon of allograft rejection. The great extension of vascular surgery since World War II has made jewelers of surgeons of small tubular structures. The technical phases of these demanding operative procedures have largely been overcome

  16. Malpractice awareness among surgeons at a teaching hospital in Pakistan.

    Science.gov (United States)

    Sheikh, Asfandyar; Ali, Sajid; Ejaz, Sadaf; Farooqi, Marium; Ahmed, Syed Salman; Jawaid, Imran

    2012-11-06

    The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6%) was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9%) was most frequently disagreed. In the event of a medical error, majority (67.7%) were ready to disclose their error to the patient. The most

  17. Malpractice awareness among surgeons at a teaching hospital in Pakistan

    Directory of Open Access Journals (Sweden)

    Sheikh Asfandyar

    2012-11-01

    Full Text Available Abstract Background The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. Methods This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Results Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6% was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9% was most frequently disagreed. In the event of a medical error, majority (67.7% were ready

  18. Comparison of pediatric surgical outcomes by the surgeon's degree of specialization in children.

    Science.gov (United States)

    Rhee, Daniel; Papandria, Dominic; Yang, Jessica; Zhang, Yiyi; Ortega, Gezzer; Colombani, Paul M; Chang, David C; Abdullah, Fizan

    2013-08-01

    Improved surgical outcomes in children have been associated with pediatric surgical specialization, previously defined by surgeon operative volume or fellowship training. The present study evaluates pediatric surgical outcomes through classifying surgeons by degrees of pediatric versus adult operative experience. A cross-sectional study was performed using nationally representative hospital discharge data from 1998 to 2007. Patients under 18 years of age undergoing inpatient operations in neurosurgery, otolaryngology, cardiothoracic, general surgery, orthopedic surgery, and urology were included. An index was created, calculating the proportion of children treated by each surgeon. In-hospital mortality and length of stay were compared by index quartiles. Multivariate analysis was adjusted for patient and hospital characteristics. A total of 119,164 patients were operated on by 13,141 surgeons. Within cardiothoracic surgery, there were 1.78 (p=0.02) and 2.61 (ppediatric specialization respectively with the highest quartile. For general surgery, a 2.15 (p=0.04) increase in odds for mortality was found when comparing surgeons between the lowest and the highest quartiles. Comparing the least to the most specialized surgeons, length of stay increased 1.14 days (p=0.02) for cardiothoracic surgery, 0.58 days (p=0.04) for neurosurgery, 0.23 days (p=0.02) for otolaryngology, and decreased by 1.06 days (psurgery. The present study demonstrates that surgeons caring preferentially for children-as a proportion of their overall practice-generally have improved mortality outcomes in general and cardiothoracic surgery. These data suggest a benefit associated with increased referral of children to pediatric practitioners, but further study is required. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. HIV/AIDS: occupational risk, attitude and behaviour of surgeons in southeast Nigeria.

    Science.gov (United States)

    Obi, S N; Waboso, P; Ozumba, B C

    2005-05-01

    Our objective was to evaluate the level of occupational risk, attitude and behaviour of surgeons towards HIV-infected patients. A questionnaire survey of 264 randomly selected surgeons in training or in practice in five different health institutions in southeast Nigeria within a five-month period was carried out. A 94% response rate was obtained with completed questionnaires from 264 surgeons. The respondents included obstetricians and gynaecologists (n = 78), general surgeons (n = 121), orthopaedic surgeons (n = 40), dental surgeons (n = 10), ophthalmologists (n = 6), urologists (n = 5), and ear, nose and throat surgeons (n = 4). Of them, 31% (n = 82) were qualified surgeons in practice, while the remaining 69% (n = 182) were resident surgeons in training. In the past five years, 40.2% (n = 106) and 26% (n = 70) of the respondents reported needle-stick injuries and blood splash, respectively, during surgery. The majority of the victims were resident surgeons, obstetricians and gynaecologists, and orthopaedic surgeons. Level of clinical experience and high patient blood loss are likely to contribute to this observation. In all, 89% (n = 236) were engaged in the risky practice of operating on patients with open wounds in their hand and the wounds were contaminated with blood in 5% of cases. During surgical procedures, all (100%) respondents wore protective apron, 65.2% (n = 172) wore double gloves and 30.3% (n = 80) used protective goggles. The use of double gloves and protective eye wear increased remarkably over the past decade, probably because the fear of occupational transmission of HIV was substantial. In total, 83% (n = 220) of the respondents had some reservations about treating patients infected with HIV, while 13.3% (n = 35) viewed them with fear. The remaining 3.4% (n = 9) had a more positive attitude towards HIV-infected patients. Further, 92% advocated preoperative screening, with special precaution during surgery, if the results are positive. In

  20. Comparison of patient and surgeon expectations of total hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Claire Jourdan

    Full Text Available OBJECTIVES: Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement. METHODS: 132 adults (mean age 62.8+/-13.7 years, 52% men on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100. Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences. RESULTS: Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100. Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons. CONCLUSION: Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.

  1. Career and lifestyle satisfaction among surgeons: what really matters? The National Lifestyles in Surgery Today Survey.

    Science.gov (United States)

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

    2009-08-01

    Optimizing recruitment of the next surgical generation is paramount. Unfortunately, many nonsurgeons perceive surgeons' lifestyle as undesirable. It is unknown, however, whether the surgeons-important opinion makers about their profession-are indeed dissatisfied. We analyzed responses to a survey mailed to all surgeons who were certified by the American Board of Surgery in 1988, 1992, 1996, 2000, and 2004. We performed multivariate analyses to study career dissatisfaction and inability to achieve work-life balance, while adjusting for practice characteristics, demographics, and satisfaction with reimbursement. A total of 895 (25.5%) surgeons responded: mean age was 46 years; 80% were men; 88% were married; 86% had children; 45% were general surgeons; 72% were in urban practice; and 83% were in nonuniversity practice. Surgeons worked 64 hours per week; ideally, they would prefer to work 50 hours per week (median). Fifteen percent were dissatisfied with their careers. On multivariate analysis, significant (p career to their own children. On multivariate analysis, significant risk factors were nonuniversity practice (OR 2.5) and dissatisfaction with reimbursement (OR 3.4). In all, 33.5% did not achieve work-life balance. On multivariate analysis, dissatisfaction with reimbursement (OR 3.0) was a significant risk factor. Respondents' lives could be improved by "limiting emergency call" (77%), "diminishing litigation" (92%), and "improving reimbursement" (94%). Most surgeons are satisfied with their careers. Areas in need of improvement, particularly for nonuniversity surgeons, include reimbursement, work hours, and litigation. Strong local and national advocacy may not only improve career satisfaction, but could also render the profession more attractive for those contemplating a surgical career.

  2. Smart apps for the smart plastic surgeon

    Directory of Open Access Journals (Sweden)

    Aniketh Venkataram

    2015-01-01

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

  3. Professionalism and Commercialism on Cosmetic Surgeons' Websites.

    Science.gov (United States)

    Park, Sung-Yeon; Park, SangHee

    2016-07-15

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

  4. Ethics and the facial plastic surgeon.

    Science.gov (United States)

    Sethi, Neeraj

    2016-09-01

    The facial plastic surgeon potentially has a conflict of interest when confronted with the patients requesting surgery, due to the personal gain attainable by agreeing to perform surgery. The aim of this review is to discuss the potential harm the surgeon can inflict by carrying out facial plastic surgery, beyond the standard surgical complications of infection or bleeding. It will discuss the desire for self-improvement and perfection and increase in the prevalence facial plastic surgery. We address the principles of informed consent, beneficence and non-maleficence, as well as justice and equality and how the clinician who undertakes facial plastic surgery is at risk of breaching these principles without due care and diligence.

  5. Paying surgeons less has cost more.

    Science.gov (United States)

    Bernstein, Joseph; Derman, Peter

    2012-12-01

    The Balanced Budget Act of 1997 mandated reductions in physician reimbursement. This reduction in payments could be envisioned to limit expenditures on 2 counts: first, individual fees would be lower, producing inherent savings. Furthermore, reducing fees should depress the incentive to work, thereby generating additional savings from reduced output. A rival point of view holds that lower fees might paradoxically lead to greater spending because surgeons compensate for per-case reductions by performing more cases. If this income-targeting hypothesis is correct, lower per-case fees leads to increased volume. Increased work output has particularly sizable economic effects in fields like orthopedic surgery because the total cost of orthopedic interventions is usually many times larger than the physician's fee (largely owing to the cost of implants). As such, increases in work volume more than negate the potential savings from lower surgeon's fees.This phenomenon was studied in the context of total knee arthroplasty. In the decade spanning 1996 to 2005, inflation-adjusted physician reimbursement decreased by approximately 5% per year, leading to a cumulative drop in reimbursement from $2847 to $1685. Nonetheless, because the number of procedures performed increased from 253,841 to 498,169 and because payments to hospitals far exceeded payments to surgeons, total expenditures for total knee arthroplasty increased dramatically: more than $7.1 billion additional was spent on hospital payments. Continuing to pay surgeons less is apt to continue to cost more. Counter to intuition, the best strategy for controlling overall spending might be higher, not lower, surgical fees.

  6. Eulogy John Ludbrook: surgeon, physiologist and biostatistician.

    Science.gov (United States)

    Evans, Roger G; Johnston, Colin I

    2017-08-12

    On the morning of Friday June 9, Professor John Ludbrook died peacefully in his sleep at the age of 87. John will be deeply missed by his family, friends and colleagues. John Ludbrook had a long and distinguished career as a teacher, educator, surgeon, physiologist and lastly as a statistician. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Plaster of Paris: the orthopaedic surgeon heritage.

    Science.gov (United States)

    Hernigou, Philippe

    2016-08-01

    Plastering is one of the most ancient of the building handicrafts. Plaster is the common name for calcium sulphate hemi hydrate made by heating the mineral gypsum, the common name for sulphate of lime. In the tenth century the Arabs used liquid plaster in orthopaedic treatment. At the beginning of the nineteenth century, patients with fractures of the lower extremities-and often of the upper extremities as well-were treated in bed with restriction of all activity for many weeks until the fractures united. It was the practice of surgeons to dress wounds and fractures at frequent intervals. The bandages, pads, and splints were removed, the fractures manipulated, and the dressings reapplied. The search for simpler, less cumbersome methods of treatment led to the development of occlusive dressings, stiffened at first with starch and later with plaster of Paris. The ambulatory treatment of fractures was the direct result of these innovations. Two military surgeons, Antonius Mathijsen of the Netherlands, and Nikolai Ivanovitch Pirogov of Russia, were responsible for the introduction of the new plaster bandage technique. At the beginning of the twentieth century the technique was improved by Jean-François Calot, a French surgeon, who invented the hand manufacture of plaster bandage as a roll. During the twentieth century, walking cast and ambulation for fresh fractures were developed with plaster and pin incorporated in plaster; the open fracture care concept was introduced with plaster of Paris by Trueta before the external fixation.

  8. Choosing a Breast Reconstruction Surgeon and Questions to Ask

    Science.gov (United States)

    ... Reconstruction Surgery Questions to Ask Your Surgeon About Breast Reconstruction If you’ve had surgery to treat your ... reconstruction. Finding the right plastic surgeon for your breast reconstruction If you decide to have breast reconstruction, you’ ...

  9. Emergency neurosurgery in Darwin: still the generalist surgeons' responsibility.

    Science.gov (United States)

    Luck, Tara; Treacy, Peter John; Mathieson, Matthew; Sandilands, Jessica; Weidlich, Stephanie; Read, David

    2015-09-01

    Royal Darwin Hospital (RDH) is the only major hospital for the 'Top End' of Northern Territory and Western Australia. As retrieval distances exceed 2600 km, resident generalist surgeons undertake all emergency neurosurgery. Retrospective clinical study from RDH records and review of prospectively collected datasets from RDH Intensive Care Unit and National Critical Care Trauma Response Centre for all emergency neurosurgery patients between 2008 and 2013. Data were obtained from 161 patients with 167 admissions (73% male, 39% indigenous) who underwent 195 procedures (33 per year), including burr hole, craniotomy, cerebral and posterior fossa craniectomy, elevation fracture and ventricular drain. Trauma accounted for 68%, with alcohol as a known factor in 57%. Subdural haematoma (SDH) accounted for 53%. Severity of head injury at presentation correlated with outcome (R(2) = 0.12, P 24 h (P = 0.023) and specific diagnoses of acute SDH (P = 0.006), acute-on-chronic SDH (P = 0.053) and infection (P = 0.052). Indigenous patients were younger (40 versus 55 years, P < 0.001) and more likely to have alcohol as a factor in trauma cases (71% versus 49%, P = 0.027). Time from injury to hospital was high for accidents at a remote location (12.9 versus 1.3 h, P < 0.001); however, Glasgow Outcome Scales (P = 0.13) were no different to accident at metropolitan Darwin. General surgeons at RDH perform a wide range of emergency neurosurgical procedures primarily for trauma. Factors contributing to poor outcomes included remote location of trauma and delay in reaching the hospital. Outcomes at 3 months appear acceptable. © 2015 Royal Australasian College of Surgeons.

  10. LAS GRIETAS DE LA CIUDAD CAPITALISTA Entrevista con David Harvey

    OpenAIRE

    Rendueles, César; del Olmo, Carolina

    2011-01-01

    David Harvey es uno de los investigadores de la ciudad capitalista más renombrados de la actualidad. Geógrafo de formación, Harvey ha desarrollado el grueso de su carrera profesional en Estados Unidos, donde actualmente enseña Geografía y Estudios Urbanos en City University of New York tras haber sido durante más de treinta años profesor en la Johns Hopkins University de Baltimore. El principal e indiscutido mérito de la obra de Harvey reside en su fructífera fusión de geografía y marxismo co...

  11. Eric A. Posner and David Weisbach, Climate Change Justice

    OpenAIRE

    Kelleher, J. Paul

    2016-01-01

    Even when this book was first published in 2010, there was a large literature on the nature of climate change justice. (The 2015 paperback release that occasioned this review makes no changes to the 2010 text.) Of course not all of the climate justice literature to that date was penned by philosophers, but a great of it was and naturally philosophers claim to have much to say about climate justice. So it is somewhat surprising how infrequently Eric Poser and David Weisbach engage with the phi...

  12. David Bohm : causality and chance, letters to three women

    CERN Document Server

    2017-01-01

    The letters transcribed in this book were written by physicist David Bohm to three close female acquaintances in the period 1950 to 1956. They provide a background to his causal interpretation of quantum mechanics and the Marxist philosophy that inspired his scientific work in quantum theory, probability and statistical mechanics. In his letters, Bohm reveals the ideas that led to his ground breaking book Causality and Chance in Modern Physics. The political arguments as well as the acute personal problems contained in these letters help to give a rounded, human picture of this leading scientist and twentieth century thinker.

  13. Uma leitura do romance Ver: Amor de David Grossman

    Directory of Open Access Journals (Sweden)

    Maria Lúcia Barbosa

    2015-05-01

    Full Text Available David Grossman, a partir das listas e enumerações, em especial a dos nomes para simbolizar o contato com o “outro”, deixa vislumbrar em Ver: Amor uma tentativa de contato com a alteridade. Embora não desconstrua o conceito de identidade, o escritor coloca em xeque os processos de concepção de uma identidade plena, atribuindo-lhe um princípio que, antes de ser social e histórico é, primordialmente, discursivo e fragmentário.

  14. Can a Plastic Surgeon be a Department Chairman?….Really?

    Science.gov (United States)

    Neumeister, M W

    2016-04-01

    There is significant responsibility in being a Department of Surgery Chairman within a medical school. The Chairman is appointed by the Dean of Medicine to lead surgery in a path that serves the mission of the school. The Department of Surgery Chairman is charged with facilitating the academic, operational, and programmatic surgical initiatives of the School of Medicine. Traditionally the Chairman of Surgery has been a general surgeon but now our educational and clinical experiences have changed making traditional leadership less intuitive. Plastic surgeons appointed as current Chairman of the Department of Surgery are rare in the United States. Whereas, general surgeons may have less interaction with other surgical sub-specialties today, Plastic surgeons have more interaction crossing all disciplines of surgery. Innovation and creativity that defines our discipline, seems to fit well with Department leadership where strategic planning, vision and curriculum development, and the pursuit of academic and clinical quality remain core essentials to plastic surgery. This article is an editorial of my philosophy as a plastic surgeon leading a Department of Surgery.

  15. A tribute to Charles David Kelman MD: ophthalmologist, inventor and pioneer of phacoemulsification surgery.

    Science.gov (United States)

    Pandey, Suresh K; Milverton, E John; Maloof, Anthony J

    2004-10-01

    Charles David Kelman was born in Brooklyn, New York, USA, on 23 May 1930 and passed away in Boca Raton, Florida, USA, on 1 June 2004 at the age of 74 years after a long battle with cancer. He received a Bachelor of Science degree from Tufts University in 1950 and completed medical studies at the University of Geneva, Switzerland, in 1956. He was Clinical Professor of Ophthalmology at New York Medical College and an Attending Surgeon at New York Eye and Ear Infirmary and Manhattan Eye, Ear and Throat Hospital. Although a prolific inventor, he will be best remembered for developing phacoemulsification, following his realization while sitting in a dentist's chair, that ultrasonic vibrations could be used to emulsify the aged crystalline lens through a very small incision. His pioneering work revolutionized cataract surgery. He also pioneered cryo-extraction of cataracts, the use of freezing for the repair of retinal detachments and designed numerous ophthalmic instruments and intraocular lenses. Dr Kelman received numerous awards, including the American Academy of Ophthalmology Achievement Award (1970), the Ridley Medal from the International Congress of Ophthalmology (1990), and the Inventor of the Year Award from The New York Patent, Trademark and Copyright Law Association (1992). Most recently (2003), Dr Kelman was honoured by the American Academy of Ophthalmology with the Laureate Recognition award. Dr Kelman was also an accomplished Broadway producer, composer and jazz saxophonist. With his demise, the ophthalmic and medical community lost a famed inventor with multifaceted talents and one of the great ophthalmologists of the twentieth century.

  16. "Einsatzchirurgie"--experiences of German military surgeons in Afghanistan.

    Science.gov (United States)

    Willy, Christian; Hauer, Thorsten; Huschitt, Niels; Palm, Hans-Georg

    2011-04-01

    the training of military surgeons (specialisation general surgery plus a second sub-specialisation either in visceral surgery or orthopaedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery, and emergency gynaecology are also integrated into this concept and will be addressed in special courses. On successful completion of this training programme, military surgeons will be officially appointed as "Einsatzchirurg" for a duration of 5 years. After this time, it will be obligatory to renew this "combat ready" status. The buildings and materials in German military medical treatment facilities provide for excellent working conditions. The training programme for military surgeons in its end-2010 version has been designed specifically with data about injury pattern and non-battle diseases as well as the political situation and professional requirements in the civilian sphere in mind.

  17. David Falk: Algunas cuestiones abiertas para el marketing deportivo. [David Falk: Some open questions for the sports marketing arena].

    OpenAIRE

    Martínez, José A.

    2015-01-01

    David Falk, el que fuera el representante del jugador de baloncesto Michael Jordan, es una figura de referencia para el marketing deportivo. Falk contribuyó decisivamente a revitalizar el marketing deportivo, ayudó a construir lo que probablemente sea la relación comercial más importante del deporte (Jordan-Nike), y llevó hasta el extremo la filosofía de que en la negociación lo importante es que tu cliente llegue a conseguir el máximo dinero posible, más allá de que ese sea su valor de mer...

  18. Attitudes of Mississippi college students toward David Duke before and after seeing the film Who is David Duke?

    Science.gov (United States)

    Eisenman, R; Girdner, E J; Burroughs, R G; Routman, M

    1993-01-01

    The attitudes of 211 students at a university in Mississippi were investigated both before and after seeing the Public Broadcasting Film Who Is David Duke? The film provided evidence of Duke's current racism, anti-Semitism, and pro-Nazi leanings. In a previous study with university students in Louisiana, the majority did not change their attitudes after watching the film (Eisenman, 1993). However, in the present study, students' attitudes showed change in an anti-Duke direction. The findings are discussed and reasons given for the differences between the two samples, and for the popularity of Duke, a former leader of the Ku Klux Klan.

  19. Lola Cercas en Soldados de Salamina (David Trueba, 2003

    Directory of Open Access Journals (Sweden)

    Sally Faulkner

    2009-12-01

    Full Text Available Este artículo defiende la importancia de Lola Cercas, interpretada por Ariadna Gil, en la obra de David Trueba Soldados de Salamina. Si su trabajo anterior se había enfocado en la historia, la memoria y el uso de fuentes archivísticas, se sostiene que estos temas son filtrados por la psique de Lola, cuyo papel es crucial. A través de medios tradicionales, como un trabajo de cámara subjetiva, y recursos más innovadores, como el “mindscreen” (Kawin, Trueba impulsa nuestra identificación con la protagonista. La preocupación de Lola sobre su falta de descendencia añade una dimensión ulterior, permitiendo a Trueba insinuar un futuro incierto al examinar un complejo pasado._______________________ABSTRACT:This article argues for the importance of Lola Cercas, played by Ariadna Gil, in David Trueba’s Soldados de Salamina. If previous work has focussed on history and memory and the use of archival sources in the work, I argue that these areas are filtered through Lola’s psyche, thus her role is crucial. Through traditional means, such as subjective camera-work, and more innovative approaches, like the ‘mindscreen’ (Kawin, Trueba fosters our identification with an otherwise off-putting protagonist. Lola’s concern about her childlessness adds a further dimension, allowing Trueba to point to an uncertain future as he examines a complex past.

  20. David Rosenthal’s Tirant lo Blanc turns 30

    Directory of Open Access Journals (Sweden)

    Jan Reinhart

    2014-12-01

    Full Text Available The groundbreaking English language translation of Tirant lo Blanc by New York poet and academic David Rosenthal remains dominant three decades after its initial, and celebrated, release. Rosenthal’s controversially fluid and concise rendering of the Valencian classic survived a serious challenge 20 years ago by a more literal version from a well-meaning amateur translator and journeyman academic backed by a leading U.S.-based Catalan scholar. The article reviews the controversy and compares the two versions, adding comments from some of the key critics. La traducció capdavantera a l’anglés del Tirant lo Blanc, feta pel poeta i erudit de Nova York, David Rosenthal, continua mantenint la seua importància, tres dècades després de publicar-se. La polèmica versió dúctil i concisa de Rosenthal del clàssic valencià, ha sobreviscut el desafiament seriós, de fa vint anys, de la versió més literal d’un benintencionat traductor amateur i acadèmci oficial, recolzat per un destacat erudit català establert als Estats Units. L’article revisa la polèmica i compara les dues versions, tot afegint els comentaris d’alguns dels crítics més importants.

  1. First Scholarship at AGU Established by David E. Lumley

    Science.gov (United States)

    Tahar, Joanna G.

    2009-09-01

    Shortly after AGU launched its annual voluntary contribution campaign last year—the theme was “Building Tomorrow's Talent Today”—the Union's development office received an e-mail message from David E. Lumley about establishing a scholarship for a high-school student or undergraduate. Many scientific societies and associations have quite a few named scholarships, but for AGU this was a new concept. Lumley was sure of what he wanted to do and even more excited when he learned that his scholarship would be a first for AGU. “I want to help inspire today's young minds to work on problems of global importance in both the energy and environment sectors of industry and academia,” Lumley said. Recipients of the David E. Lumley Young Scientist Scholarship for Energy and Environmental Science will be expected to present a paper and to participate in various student activities at Fall Meeting. “Meeting some of the ‘giants’ of geoscience and getting their feedback on research is a big deal for these young students. We sometimes lose sight of this,” he said.

  2. David Kelley et la politique de la complicité

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Esquenazi

    2011-04-01

    Full Text Available La télévision est liée à sa diffusion familiale, comme le prouve l’histoire américaine de la télévision. Les séries télévisées sont elles-mêmes attachées à ce contexte. Elles multiplient les marques rituelles de reconnaissance. David Kelley, auteur de Ally Mc Beal ou de Boston Legal, aime jouer avec cette nécessité. Il crée une relation de complicité entre ses personnages et le téléspectateur. Le texte en étudie les principales figures.Television is linked to its family broadcasting; American history reminds us of it. And television series are tied to this context. They multiply signs of recognition. David Kelley, Ally Mc Beal or Boston Legal's producer, likes to play with this necessity. He creates a relation of complicity between his figures and the viewer. This text studies his main methods.

  3. Mentoring during residency education: a unique challenge for the surgeon?

    Science.gov (United States)

    Pellegrini, Vincent D

    2006-08-01

    A mentor serves as role model, counselor, and advocate for an understudy or protégé. The art and science of mentoring have been investigated most thoroughly in the educational literature, yet there are unique situational and individual considerations in the surgical arena that may warrant special consideration. The general attributes of successful mentors are not foreign to academic surgeons but may require deliberate cultivation to optimize mentorship in the context of academic medicine. Moreover, the stages of productive mentoring may be counter to the learned adaptive behaviors and instinctive personality traits of some accomplished surgeon educators. Indeed, examples of failed mentorship are common in our medical centers and, specifically, in surgical training programs. The behavioral adaptation that supports surgical decision-making under conditions of incomplete data and unusual stress often devalues succession planning and derivation of satisfaction from the success of other members of the team. Accordingly, fostering effective mentoring relationships in academic surgery will require a concerted effort to develop appropriate behaviors conducive to the mentoring process. The personal and professional growth of our students as well as the succession planning for our specialty are dependent upon the successful creation of an environment conducive to mentoring in academic orthopaedics.

  4. John M. T. Finney: distinguished surgeon and Oslerphile

    Science.gov (United States)

    2016-01-01

    John Finney (1863–1942) was born near Natchez, Mississippi. After receiving his medical degree from Harvard, he interned at Massachusetts General Hospital and then went to Baltimore to become one of the first interns at the new Johns Hopkins Hospital. He met William Osler the day the hospital opened and became a lifelong admirer of “the Chief.” Finney specialized in gastrointestinal surgery and was recognized for his expertise in the field. Osler recommended Finney to a physician colleague, writing, “You could not be in better hands…. Finney has been most successful and his judgment is so good.” Finney served for 33 years under William Halsted at Hopkins. After Halsted's death, Finney was offered the chair of surgery at Johns Hopkins but declined. He was a founder and first president of the American College of Surgeons. He also served as president of the American Surgical Association and the Society of Clinical Surgery. Finney became chief surgical consultant for the Allied Expeditionary Forces in World War I. He was decorated by the United States, France, and Belgium. Finney was a master surgeon and a role model for generations of students and physicians. PMID:26722185

  5. [Recurrent depressive disorder in Caspar David Friedrich. A pathographical approach with operationalized diagnosis].

    Science.gov (United States)

    Spitzer, C; Dahlenburg, B; Freyberger, H J

    2006-07-01

    Caspar David Friedrich (1774 - 1840) is one of the most important German Romantic painters. In his paintings, he prototypically represents the melancholy, which has been mentioned by his contemporaries and later biographers. Art scientists have also referred to his melancholy for the interpretation of his work. From a medical point of view, there are only two pathographies which remain inconclusive. Having applied diagnostic criteria for psychiatric disorders to his letters and publications, to statements of his contemporaries and to his art, we propose that he had suffered from a recurrent major depression which occurred in 1799 for the first time. At least three depressive episodes followed before he was struck by a stroke in 1835. There are epidemiological, psychodynamic and personality-typological reasons supporting our diagnostic assumption. The course of his depression corresponds to phases of reduced creativity, to the chosen techniques and motives. Finally we discuss the implications of our approach for the pathographical method in general.

  6. The reconstitution of political theory: David Easton, behavioralism, and the long road to system.

    Science.gov (United States)

    Gunnell, John G

    2013-01-01

    During the last half of the twentieth century, the concept of system was arguably the most important concept in the theoretical repertoire of the discipline of American political science. Although systems analysis was broadly employed in the behavioral sciences, David Easton's work was particularly influential in the study of politics. This is in part because he attempted to develop a distinct account of the political system that was not theoretically subservient either to general systems theory or to conceptions of the social system such as that advanced by Talcott Parsons. Although a great deal of attention has been devoted to Easton's theory, the origins and evolution of the system concept in his work have not been carefully reconstructed and analyzed. © 2013 Wiley Periodicals, Inc.

  7. Idealism and romantic patriotism for science - an interview with José Francisco David-Ferreira.

    Science.gov (United States)

    David-Ferreira, José Francisco

    2009-01-01

    Jose Francisco David-Ferreira is one of the most influential Professors of Cell and Developmental Biology in Portugal. David-Ferreira pioneered the use of electron microscopy in cell biology and experimental embryology. He also paved the way for successive generations of biologists who cross-fertilized the national scientific community. As we discuss briefly below, David-Ferreira is above all a Pedagogue and an Institution builder.

  8. Australia's female military surgeons of World War I.

    Science.gov (United States)

    Neuhaus, Susan J

    2013-10-01

    The war service of Lilian Violet Cooper, the first female surgeon of the Royal Australasian College of Surgeons, is well recognized. Not so well known however, are the other pioneering female doctors who also undertook work as military surgeons during World War I. At least four of the 14 Australian female doctors that undertook overseas war service during World War I were engaged as surgeons and treated Australian, British and Allied casualties. These women operated in London, in Egypt and on the frontlines of the Macedonian campaign. While none of these other women became Fellows of the Royal Australasian College of Surgeons, their war efforts deserve recognition.

  9. Thoracic surgery in the real world: does surgical specialty affect outcomes in patients having general thoracic operations?

    Science.gov (United States)

    Ferraris, Victor A; Saha, Sibu P; Davenport, Daniel L; Zwischenberger, Joseph B

    2012-04-01

    Most general thoracic operations in the United States are performed by general surgeons. Results obtained by those identified as general surgeons are often compared with those identified as thoracic surgeons. We interrogated the American College of Surgeons National Surgical Quality Improvement Project database over a 5-year period to compare outcomes in patients who underwent similar operations by surgeons identified as either thoracic surgeons or general surgeons. We employed propensity-score matching to minimize confounding when estimating the effect of surgeon identity on postoperative outcomes. During the study period, thoracic surgeons performed 3,263 major pulmonary or esophageal operations, and general surgeons performed 15,057 similar operations. Compared with patients operated on by general surgeons, patients operated on by thoracic surgeons had significant excess multivariate comorbidities, including insulin-dependent diabetes mellitus, chronic obstructive pulmonary disease, concurrent pneumonia, congestive heart failure, previous cardiac surgery, dialysis-dependent renal failure, disseminated cancer, prior sepsis, and previous operation within 30 days. Likewise, patients in highest risk categories had operations performed by thoracic surgeons more commonly than by general surgeons. Unadjusted comparisons for mortality and serious morbidity showed significantly worse mortality and pulmonary complications in patients operated on by thoracic surgeons. However, with propensity matching according to surgeon type, thoracic surgeons had significantly fewer serious adverse outcomes compared with general surgeons, and this decreased morbidity occurred in a higher risk cohort. Our results show that patients operated on by thoracic surgeons have higher acuity compared with patients operated on by general surgeons. When patients are matched for comorbidities and serious preoperative risk factors, thoracic surgeons have improved outcomes, especially with regard to

  10. American Orthopaedic Surgeons in World War I.

    Science.gov (United States)

    Green, David P; DeLee, Jesse C

    2017-04-05

    On April 6, 1917, the United States declared war on Germany and entered what was then called the Great War. Among the first officers sent to Europe were 21 orthopaedic surgeons in the so-called First Goldthwait Unit. Prior to the war, orthopaedics had been a nonoperative "strap-and-buckle" specialty that dealt primarily with infections, congenital abnormalities, and posttraumatic deformity. The Great War changed all of that forever, creating a new surgical specialty with emphasis on acute treatment, prevention of deformity, restoration of function, and rehabilitation.

  11. [The cardiovascular surgeon and the Syntax score].

    Science.gov (United States)

    Gómez-Sánchez, Mario; Soulé-Egea, Mauricio; Herrera-Alarcón, Valentín; Barragán-García, Rodolfo

    2015-01-01

    The Syntax score has been established as a tool to determine the complexity of coronary artery disease and as a guide for decision-making among coronary artery bypass surgery and percutaneous coronary intervention. The purpose of this review is to systematically examine what the Syntax score is, and how the surgeon should integrate the information in the selection and treatment of patients. We reviewed the results of the SYNTAX Trial, the clinical practice guidelines, as well as the benefits and limitations of the score. Finally we discuss the future directions of the Syntax score.

  12. Embedding of Poly Honeycomb Networks and the Metric dimension of Star of David Network

    Directory of Open Access Journals (Sweden)

    F.Simonraj

    2013-01-01

    Full Text Available In this paper, we have introduced few Interconnection Networks, called David Derived Network DD(n ,Dominating David Derived Network DDD(n, Honeycomb cup Network HCC(n and Kite RegularTrianguline Mesh KRrTM(n. We have given drawing algorithm for DDD(n from Honeycomb networkHC(n and embedded poly–Honeycomb Networks, KRrTM(n in to Dominating David Derived Networks.Also we have investigated the metric dimension of Star of David network SD(n and lower bound of themetric dimension for DD(n.

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

    Science.gov (United States)

    2009-12-11

    Care with Physicians .................................. 47  Benefits of Specialty Care at Battalion Level...Battalion Aid Station BN Battalion BS Battalion Surgeon CBMM Core Battalion Medical Mission DOW Died of Wounds FSO Full Spectrum Operations GMO ...General Medical Officers or GMOs . Young, motivated, and greedy for knowledge, GMOs propelled the field of military medicine forward during

  14. Discordance between patient and surgeon satisfaction after total joint arthroplasty.

    Science.gov (United States)

    Harris, Ian A; Harris, Anita M; Naylor, Justine M; Adie, Sam; Mittal, Rajat; Dao, Alan T

    2013-05-01

    We surveyed 331 patients undergoing total hip or knee arthroplasty pre-operatively, and patients and surgeons were both surveyed 6 and 12 months post-operatively. We identified variables (demographic factors, operative factors and patient expectations) as possible predictors for discordance in patient-surgeon satisfaction. At 12 months, 94.5% of surgeons and 90.3% of patients recorded satisfaction with the outcome. The discordance between patient and surgeon satisfaction was mainly due to patient dissatisfaction-surgeon satisfaction. In an adjusted analysis, the strongest predictors of discordance in patient-surgeon satisfaction were unmet patient expectations and the presence of complications. Advice to potential joint arthroplasty candidates regarding the decision to proceed with surgery should be informed by patient reported outcomes, rather than the surgeon's opinion of the likelihood of success.

  15. Impact of objectively assessing surgeons' teaching on effective perioperative instructional behaviors.

    Science.gov (United States)

    Anderson, Cheryl I; Gupta, Rama N; Larson, Joseph R; Abubars, Omar I; Kwiecien, Andrew J; Lake, Alexander D; Hozain, Ahmed E; Tanious, Adam; O'Brien, Trevor; Basson, Marc D

    2013-10-01

    Advancing surgical technology and decreasing resident learning hours have limited exposure to perioperative training, necessitating more effective and efficient perioperative teaching by faculty surgeons. Participation in collaborative efforts and process improvement can change behaviors and enhance teaching. To promote deliberate teaching of residents, change resident perception of their teachers, and produce sustainable improvements by objectively measuring surgeons' perioperative teaching performance. This 3-phase observational study of surgeons' perioperative teaching behaviors included university-based surgeons, general surgery residents, and preclinical student observers and involved elective cases at a 600+ bed tertiary hospital. Initially, we measured teaching behaviors by surgeons unaware of study objectives, provided aggregate and confidential individual feedback, and developed standardized preoperative briefings and postoperative debriefings. Phase 2 applied a deliberate teaching model and reinforced behaviors with continuous process improvement efforts (Plan, Do, Check, Act) and repeat observations. Phase 3 used resident prompts to enhance teaching behaviors and demonstrate sustainability. Resident surveys conducted 3 times assessed perceptions of deliberate guidance by faculty when compared with national benchmarks. Introduction of deliberate faculty preprocedural focusing and postprocedural reinforcement to facilitate resident learning. More frequent and complete perioperative teaching by faculty and the perception of enhanced teaching by residents. Faculty more commonly and more completely performed the 10-step preoperative briefings and postoperative debriefings (P teaching styles significantly improved and residents' survey-reported assessments of faculty teaching improved over national data for describing procedural steps (P = .02) and requests for resident self-evaluation (P = .006). Objective recording of teaching behavior frequency

  16. Surgeons' Knowledge and Practices Regarding the Role of Radiation Therapy in Breast Cancer Management

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jessica [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Hawley, Sarah T.; Zikmund-Fisher, Brian J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Janz, Nancy K. [Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan (United States); Sabel, Michael S. [Department of Surgery, University of Michigan, Ann Arbor, Michigan (United States); Katz, Steven J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-12-01

    Purpose: Population-based studies suggest underuse of radiation therapy, especially after mastectomy. Because radiation oncology is a referral-based specialty, knowledge and attitudes of upstream providers, specifically surgeons, may influence patients' decisions regarding radiation, including whether it is even considered. Therefore, we sought to evaluate surgeons' knowledge of pertinent risk information, their patterns of referral, and the correlates of surgeon knowledge and referral in specific breast cancer scenarios. Methods and Materials: We surveyed a national sample of 750 surgeons, with a 67% response rate. We analyzed responses from those who had seen at least 1 breast cancer patient in the past year (n=403), using logistic regression models to identify correlates of knowledge and appropriate referral. Results: Overall, 87% of respondents were general surgeons, and 64% saw >10 breast cancer patients in the previous year. In a scenario involving a 45-year-old undergoing lumpectomy, only 45% correctly estimated the risk of locoregional recurrence without radiation therapy, but 97% would refer to radiation oncology. In a patient with 2 of 20 nodes involved after mastectomy, 30% would neither refer to radiation oncology nor provide accurate information to make radiation decisions. In a patient with 4 of 20 nodes involved after mastectomy, 9% would not refer to radiation oncology. Fewer than half knew that the Oxford meta-analysis revealed a survival benefit from radiation therapy after lumpectomy (45%) or mastectomy (32%). Only 16% passed a 7-item knowledge test; female and more-experienced surgeons were more likely to pass. Factors significantly associated with appropriate referral to radiation oncology included breast cancer volume, tumor board participation, and knowledge. Conclusions: Many surgeons have inadequate knowledge regarding the role of radiation in breast cancer management, especially after mastectomy. Targeted educational

  17. Development of a charting method to monitor the individual performance of surgeons at the beginning of their career.

    Directory of Open Access Journals (Sweden)

    Antoine Duclos

    Full Text Available BACKGROUND: Efforts to provide a valid picture of surgeons' individual performance evolution should frame their outcomes in relation to what is expected depending on their experience. We derived the learning curve of young thyroidectomy surgeons as a baseline to enable the accurate assessment of their individual outcomes and avoid erroneous conclusions that may derive from more traditional approaches. METHODS: Operative time and postoperative recurrent laryngeal nerve palsy of 2006 patients who underwent a thyroidectomy performed by 19 young surgeons in five academic hospitals were monitored from April 2008 to December 2009. The database was randomly divided into training and testing datasets. The training data served to determine the expected performance curve of surgeons during their career and factors influencing outcome variation using generalized estimating equations (GEEs. To simulate prospective monitoring of individual surgeon outcomes, the testing data were plotted on funnel plots and cumulative sum charts (CUSUM. Performance charting methods were utilized to present outcomes adjusted both for patient case-mix and surgeon experience. RESULTS: Generation of performance curves demonstrated a gradual reduction in operative time from 139 (95% CI, 137 to 141 to 75 (71 to 80 minutes, and from 15.7% (15.1% to 16.3% to 3.3% (3.0% to 3.6% regarding the nerve palsy rate. Charts interpretation revealed that a very young surgeon had better outcomes than expected, whereas a more experienced surgeon appeared to be a poor performer given the number of years that he had already spent in practice. CONCLUSIONS: Not considering the initial learning curve of surgeons exposes them to biased measurement and to misinterpretation in assessing their individual performance for thyroidectomy. The performance chart represents a valuable tool to monitor the outcome of surgeons with the expectation to provide safe and efficient care to patients.

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

    Science.gov (United States)

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

    2017-07-25

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

  19. Congenital Ulnar Drift in a Surgeon

    Directory of Open Access Journals (Sweden)

    Desirae McKee

    2015-01-01

    Full Text Available Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations. In 1994 Wood reviewed all of the descriptions of cases of windblown hand and pointed out how many variants of congenital ulnar drift there are, suggesting that the many variations seen may all belong to a larger type of arthrogryposis. While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud’s arthropathy. While most hand surgeons are familiar with presentations of congenital ulnar drift, few of them are knowledgeable about Jaccoud’s arthropathy as this is usually discussed within medical communities such as Rheumatology. We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s. We propose that the current case is a demonstration of a type of windblown hand that has some hereditary component but is not immediately obvious at birth and presents physically more like Jaccoud’s arthropathy than traditional windblown hand.

  20. Training cardiac surgeons: the Indiana University experience.

    Science.gov (United States)

    Brown, John W

    2016-12-01

    In this article, I will outline the origin of cardiothoracic surgical (CTS) training at Indiana University (IU) and its evolution to the present. I will describe my educational background, surgical training in this specialty, and my role as an educator of CT surgeons. I will describe our faculty and the structure of the CTS residency. Finally, I will describe a newly adopted smart phone "App" called SIMPL, which allows the resident and faculty to quickly (50% of the most critical aspects of each surgical procedure, the resident's performance during the critical portion of the operation from poor to excellent, and the degree of difficulty of the operation from simple to complex. The attending surgeon and the resident data are then forwarded to the SIMPL database where the SIMPL software aggregates data for each resident and procedure producing a report at the end of the rotation of the resident's performance relative to his peers. This additional evaluation process will better ensure that our CTS residents are "practice ready" when they complete their training.

  1. Denis Browne: maverick or master surgeon?

    Science.gov (United States)

    Smith, D E

    2000-11-01

    The current generation of surgeons may remember Denis Browne only as an inventor of surgical instruments which few people use, an innovator of procedures condemned as inadequate, and a personality bristling with controversy: a maverick indeed. And yet this assessment belies his influence as the founder of modern paediatric surgery in the development of British surgery. Further, his innovative operations in a range of paediatric lesions were revolutionary in the context of the time. Browne was born in 1892 and educated in Australia, although his whole surgical career was in England. He had a remarkable family background; unique Australian experiences in childhood, when he commenced to display independence and individuality of spirit, through University, where he gained 'Blues' in tennis and shooting, to war, where he served in Gallipoli and France; and to controversies that surrounded him in his battle to establish paediatric surgery as a legitimate surgical discipline. He certainly had a prickly personality and a particular venom reserved for orthopaedic surgeons and anatomists, but his achievements may have been possible only by one possessed of such a strong and towering character.

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

    Science.gov (United States)

    Murtha, Yvonne

    2013-10-01

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

  3. Postcardiotomy centrifugal assist: a single surgeon's experience.

    Science.gov (United States)

    Curtis, Jack J; McKenney-Knox, Charlotte A; Wagner-Mann, Colette C

    2002-11-01

    Because of the infrequent application of cardiac assist devices for postcardiotomy heart failure, most published reports include the results of learning curves from multiple surgeons. Between October 1986 and June 2001, a single surgeon used 35 Sarns Centrifugal Pumps as ventricular assist devices in 21 patients with severe hemodynamic compromise after open heart surgery (0.88% incidence). Patients' ages ranged from 39 to 77 (mean, 59.6 years). Three patients required right ventricular assist devices, 4 left ventricular assist devices, and 14 had biventricular assist devices. For all, the indication for application was inability to wean from cardiopulmonary bypass despite multiple inotropes and intraaortic balloon pumping. All were expected to be intraoperative deaths without further mechanical assistance. Patients were assisted from 2 to 434 h (median, 48 h). Fifteen patients (71.4%) were weaned from device(s), and 11 patients (52.4%) were hospital survivors. Actuarial survival in those dismissed from the hospital was 78% at 5 years and 39% at 10 years. Patients facing certain demise after cardiac surgery can be salvaged with temporary centrifugal mechanical assist. Results are competitive with that achieved with more sophisticated devices. Hospital survivors enjoy reasonable longevity.

  4. The surgeon, the Countess, her husband and his lover: John Hunter (1728-93) and the Countess of Strathmore (1749-1800).

    Science.gov (United States)

    Moore, Wendy

    2007-08-01

    John Hunter (1728-93) was one of the most popular and controversial surgeons of the 18th century. He treated the celebrities of his day including William Pitt the younger, Adam Smith and David Hume. Today he is acclaimed for his pioneering approach as the founder of scientific surgery. Yet a hitherto unknown aspect of his work--looking after the illegitimate offspring of one of his patients--has only recently come to light in some letters transcribed in archives at Glamis Castle in Scotland.

  5. Astronaut David Brown talks to FIRST team members

    Science.gov (United States)

    2000-01-01

    Astronaut David Brown talks with FIRST team members, Baxter Bomb Squad, from Mountain Home High School, Mountain Home, Ariz., during the FIRST competition. Students from all over the country are at the KSC Visitor Complex for the FIRST (For Inspiration and Recognition of Science and Technology) Southeast Regional competition March 9-11 in the Rocket Garden. Teams of high school students are testing the limits of their imagination using robots they have designed, with the support of business and engineering professionals and corporate sponsors, to compete in a technological battle against other schools' robots. Of the 30 high school teams competing, 16 are Florida teams co-sponsored by NASA and KSC contractors. Local high schools participating are Astronaut, Bayside, Cocoa Beach, Eau Gallie, Melbourne, Melbourne Central Catholic, Palm Bay, Rockledge, Satellite, and Titusville.

  6. Filosofia e retórica em David Hume

    OpenAIRE

    Dircilene da Mota Falcão

    2014-01-01

    Uma comparação atenta entre o Tratado da natureza humana, obra de estreia de David Hume, e as Investigação sobre o entendimento humano e Investigação sobre os princípios da moral nas quais a primeira obra foi reeditada, revela uma diferença considerável na escrita do filósofo. Provavelmente levado por uma profunda decepção com sua obra inicial, Hume as reescreve adotando mudanças estilísticas e no foco de suas discussões para torná-las mais próximas de suas convicções filosóficas. Como instru...

  7. A Teoria da Consciência de David Chalmers

    Directory of Open Access Journals (Sweden)

    João de Fernandes Teixeira

    1997-01-01

    Full Text Available O artigo tem por objetivo apresentar e discutir a teoria da consciência elaborada pelo filósofo David Chalmers no seu livro The Conscious Mind, publicado em 1996. O artigo é dividido em duas partes. A primeira expõe os principais delineamentos da teoria de Chalmers; a segunda discute seus principais conceitos, abordando a plausibilidade metafísica da existência dos "zumbis" e a idéia de superveniência.The paper focuses on Chalmer´s theory of consciousness as it is presented in his most recent book, The Conscious Mind, published in 1996. The first part is devoted to a presentation of the main outlines of Chalmer´s theory. The second part discusses such a theory by focusing on the metaphysical plausibility of the existence of zombies as well as on the notion of supervenience.

  8. Quantenmechanik im Kalten Krieg David Bohm und Richard Feynman

    CERN Document Server

    Forstner, Christian

    2007-01-01

    Mitte des 20. Jahrhunderts entwickelten David Bohm und Richard Feynman zwei grundlegend verschiedene Ansätze der moderne Quantenmechanik: Bohm eine realistische Deutung mit Hilfe verborgener Parameter und Feynman den Pfadintegralformalismus. Dies ist umso bemerkenswerter, weil beide Physiker von ähnlichen Voraussetzungen ausgingen und aus ähnlichen Zusammenhängen stammten. Durch ihren vergleichenden Ansatz bietet diese Studie mehr als einen Beitrag zur Geschichte der Quantentheorie. Mit der Frage nach den sozialen und kulturellen Bedingungen der Theoriebildung ist sie darüberhinaus von wissenschaftssoziologischem und wissenschaftstheoretischem Interesse. Die anfangs ähnliche und später unterschiedliche Einbindung der beiden Wissenschaftler in die Scientific Community erlaubt es überdies zu untersuchen, welchen Anpassungsdruck die jeweilige Gruppe auf den individuellen Wissenschaftler und die Kernbestandteile seiner Forschungen ausübt und welche neuen Freiheitsgrade für die Theoriebildung entstehen, ...

  9. Respuestas a "Needs, Values and Truth", de David Wiggins

    Directory of Open Access Journals (Sweden)

    Hilary Putnam

    2006-01-01

    Full Text Available En este artículo, se trata de presentar algunas opiniones criticas sobre el significado de "verdad" lingüístico y pragmático, en la obra Needs, Values, Truth de Wiggins. Se explora el sentido de la "verdad" en su contexto gramatical y en su significación contextual. Es difícil suponer un concepto "absoluto" de verdad, sobre todo si lo relacionamos con el con texto ético de la acción. Referidas la ideas de Wiggins a Williams, David son, Peirce, Wittgenstein, Habermas, se considera que la suposición de que la verdad está asociada a la analogía, la identidad, la equivalencia, no es suficiente para obtener el grado de certeza de las cosas. Es ne cesaria una indagación más profunda sobre la intencionalidad y el relativismo donde la "verdad" se funda.

  10. David Harvey’s contribution to urban sociology

    Directory of Open Access Journals (Sweden)

    Cvjetković Marija

    2015-01-01

    Full Text Available David Harvey is a neo-Marxist theorist influential in many disciplines. This paper analyses his specific use of Marx’s theory as a contribution to urban sociology. Observing cities in the context of a constant need of capitalism to overcome the problem of over-accumulation of capital, urbanization is seen as an important factor of capitalist development. Methods of temporary relocation and resolutions of capitalist contradictions, with the help of so-called accumulation by dispossession, are intensified in neo-liberalism, which is seen as a project for the restoration of class power. Therefore, Harvey demands more equitable cities in which the interest of private capital will not be the main factor of their shaping. Harvey’s Marxism is alluring, but it is also the subject of numerous criticisms.

  11. David Duke, running for governor, proposes tattooing people with HIV.

    Science.gov (United States)

    1995-05-19

    Former Ku Klux Klan leader, David Duke, planning a second run for governor of Louisiana, said he would curb the AIDS epidemic by tattooing people who are infected with HIV. His suggestion is to put indelible, glow-in-the-dark tattoos on the genitals of people infected with HIV. According to Duke, it may sound very draconian but it would not demean people. He also believes that tattooing would be legal because courts have a history of supporting the quarantining and institutionalizing of people with infectious diseases, such as tuberculosis. Duke said Cuba has had some success in using quarantines to reduce HIV infection, but he does not think it would work in the United States because it would cost too much. According to Duke, many people who get HIV from irresponsible behavior do not tell their partners that they have AIDS--these people are mad at the world and engage in dangerous behaviors even more.

  12. Astronaut David Brown talks with team members from South Carolina

    Science.gov (United States)

    2000-01-01

    Astronaut David Brown looks over the robot named 'L'il Max' with members of the team The Bot Kickers! from Northwestern High School, Rock Hill, S.C. Students from all over the country are at the KSC Visitor Complex for the FIRST (For Inspiration and Recognition of Science and Technology) Southeast Regional competition being held March 9-11 in the Rocket Garden. Teams of high school students are testing the limits of their imagination using robots they have designed, with the support of business and engineering professionals and corporate sponsors, to compete in a technological battle against other schools' robots. Of the 30 high school teams competing, 16 are Florida teams co- sponsored by NASA and KSC contractors. Local high schools participating are Astronaut, Bayside, Cocoa Beach, Eau Gallie, Melbourne, Melbourne Central Catholic, Palm Bay, Rockledge, Satellite, and Titusville.

  13. Infinite potential the life and times of David Bohm

    CERN Document Server

    Peat, David

    1997-01-01

    Throughout his life, David Bohm felt himself to be different, and this was reflected in his lifestyle and in his physics. His life was one of unfulfilled searching. If one compares mainstream physics to the church, with a solid hierarchy of cardinals, archbishops and bishops, Bohm was an ascetic hermit who would occasionally come in from the wilderness with a compelling message, only to disappear again. Bohmian quantum mechanics is not part of mainstream physics, but for those who do cross over, like John Bell, the commitment can be rewarding. In the post-war 'Un-American Activities' purge, Bohm lost a prestigious job at Princeton and t emporarily his US citizenship, and his nomadic career took him to Brazil, Israel and Bristol before he finally settled in London's Birkbeck College. A sensitive-written book about a gifted, unusual and sometimes provocative figure. The interaction between Bohm and Oppenheimer is especially interesting, while Bohm's later life was bizarre.

  14. The Dangers of Gathering Data: Surgeon-Specific Outcomes Revisited

    Science.gov (United States)

    Ferraris, Victor A.; Ferraris, Suellen P.; Wehner, Paulette S.; Setser, Edward R.

    2011-01-01

    The accuracy of risk adjustment is important in developing surgeon profiles. As surgeon profiles are obtained from observational, nonrandomized data, we hypothesized that selection bias exists in how patients are matched with surgeons and that this bias might influence surgeon profiles. We used the Society of Thoracic Surgeons risk model to calculate observed to expected (O/E) mortality ratios for each of six cardiac surgeons at a single institution. Propensity scores evaluated selection bias that might influence development of risk-adjusted mortality profiles. Six surgeons (four high and two low O/E ratios) performed 2298 coronary artery bypass grafting (CABG) operations over 4 years. Multivariate predictors of operative mortality included preoperative shock, advanced age, and renal dysfunction, but not the surgeon performing CABG. When patients were stratified into quartiles based on the propensity score for operative death, 83% of operative deaths (50 of 60) were in the highest risk quartile. There were significant differences in the number of high-risk patients operated upon by each surgeon. One surgeon had significantly more patients in the highest risk quartile and two surgeons had significantly less patients in the highest risk quartile (p < 0.05 by chi-square). Our results show that high-risk patients are preferentially shunted to certain surgeons, and away from others, for unexplained (and unmeasured) reasons. Subtle unmeasured factors undoubtedly influence how cardiac surgery patients are matched with surgeons. Problems may arise when applying national database benchmarks to local situations because of this unmeasured selection bias. PMID:23204823

  15. Bram Stoker's brother, the brain surgeon.

    Science.gov (United States)

    Stiles, Anne

    2013-01-01

    This essay examines the life and work of Sir William Thornley Stoker, 1st Baronet (1845-1912), the eldest brother of Bram Stoker (1847-1912), the author of Dracula (1897). Sir William or "Thornley," as he was commonly known, was one of Ireland's leading physicians. He performed some of the first brain surgeries in Ireland using Sir David Ferrier's maps of the cerebral cortex. From 1879 into the twentieth century, Thornley served as inspector for Ireland under the 1876 Cruelty to Animals Act. In this role, Thornley was responsible for granting licenses to researchers who performed experiments on live animals. Due to his reservations about animal experimentation, Thornley eventually became an advocate for the antivivisection cause, testifying at the second Royal Commission on Vivisection (1906-1912). Thornley also influenced Irish literature, albeit indirectly. Bram Stoker's composition notes for Dracula show that he consulted his older brother about the medical scenes in his novel. Thornley's knowledge of cerebral localization and his animal rights advocacy both surface in Dracula. © 2013 Elsevier Inc. All rights reserved.

  16. Role of the treating surgeon in the consent process for elective refractive surgery

    Directory of Open Access Journals (Sweden)

    Schallhorn SC

    2016-11-01

    Full Text Available Steven C Schallhorn,1–3 Stephen J Hannan,3 David Teenan,3 Julie M Schallhorn1 1Department of Ophthalmology, University of California, San Francisco, San Francisco, 2Roski Eye Institute, University of Southern California, Los Angeles, CA, USA; 3Optical Express, Glasgow, UK Purpose: To compare patient’s perception of consent quality, clinical and quality-of-life outcomes after laser vision correction (LVC and refractive lens exchange (RLE between patients who met their treating surgeon prior to the day of surgery (PDOS or on the day of surgery (DOS. Design: Retrospective, comparative case series. Setting: Optical Express, Glasgow, UK. Methods: Patients treated between October 2015 and June 2016 (3972 LVC and 979 RLE patients who attended 1-day and 1-month postoperative aftercare and answered a questionnaire were included in this study. All patients had a thorough preoperative discussion with an optometrist, watched a video consent, and were provided with written information. Patients then had a verbal discussion with their treating surgeon either PDOS or on the DOS, according to patient preference. Preoperative and 1-month postoperative visual acuity, refraction, preoperative, 1-day and 1-month postoperative questionnaire were compared between DOS and PDOS patients. Multivariate regression model was developed to find factors associated with patient’s perception of consent quality. Results: Preoperatively, 8.0% of LVC and 17.1% of RLE patients elected to meet their surgeon ahead of the surgery day. In the LVC group, 97.5% of DOS and 97.2% of PDOS patients indicated they were properly consented for surgery (P=0.77. In the RLE group, 97.0% of DOS and 97.0% of PDOS patients stated their consent process for surgery was adequate (P=0.98. There was no statistically significant difference between DOS and PDOS patients in most of the postoperative clinical or questionnaire outcomes. Factors predictive of patient’s satisfaction with consent quality

  17. Iconografía, música y narración en Wild at Heart, de David Lynch

    OpenAIRE

    García Escrivá, Vicente

    2011-01-01

    El análisis del texto fílmico Corazón Salvaje (Wild at Heart, David Lynch, EEUU, 1990) permite localizar toda una serie de rasgos característicos de la narrativa y la estética cinematográfica posmoderna. Por un lado, el film presenta una notable descomposición narrativa, lo que se traduce en una sucesión de escenas un tanto inconexas, a modo de cuadros intensos pero poco trabados. Asimismo, en la película se produce una suerte de hibridación de géneros, aglutinados por un tono general de paro...

  18. Je zult eerst moeten ontdekken hoe leerlingen denken: Interview David Orme Tall

    NARCIS (Netherlands)

    Verhoef, N.C.

    2012-01-01

    In de zomer van 2011 logeert Nellie Verhoef bij David Tall, emeritus hoogleraar in het wiskundig denken aan de Universiteit vanWarwick. Het idee is dat ze oog in oog de resultaten betreffende de Nederlandse experimenten met ‘Lesson Study’ zullen kunnen bespreken. Nellie interviewt David bij gelegenh

  19. A Cabinet of Mathematical Curiosities at Teachers College: David Eugene Smith's Collection

    Science.gov (United States)

    Murray, Diane R.

    2012-01-01

    This dissertation is a history of David Eugene Smith's collection of historical books, manuscripts, portraits, and instruments related to mathematics. The study analyzes surviving documents, images, objects, college announcements and catalogs, and secondary sources related to Smith's collection. David Eugene Smith (1860-1944) travelled…

  20. David Hume. Una bibliografía de ediciones españolas e iberoamericanas

    OpenAIRE

    Tasset, José Luis

    2011-01-01

    La bibliografía actual sobre David Hume es literalmente inabarcable. Hume Studies a través de la página web de la Hume Society publica anualmente un listado bastante completo de todo lo publicado sobre cualquier aspecto del pensamiento y la vida de David Hume. http://www.humesociety.org/

  1. 78 FR 36591 - David M. Lewis, D.M.D., Dismissal of Proceeding

    Science.gov (United States)

    2013-06-18

    ... Enforcement Administration David M. Lewis, D.M.D., Dismissal of Proceeding On December 5, 2012, the Deputy... to Show Cause to David M. Lewis, D.M.D. (Registrant), of Sacramento, California. The Show Cause Order..., according to the DI, is the Registrant's attorney. However, `` umerous Federal Courts have held that `...

  2. Should Advertising by Aesthetic Surgeons be Permitted?

    Science.gov (United States)

    Nagpal, Neeraj

    2017-01-01

    Cosmetic, aesthetic and cutaneous surgical procedures require qualified specialists trained in the various procedures and competent to handle complications. However, it also requires huge investments in terms of infrastructure, trained staff and equipment. To be viable advertising is essential to any establishment which provides cosmetic and aesthetic procedures. Business men with deep pockets establish beauty chains which also provide these services and advertise heavily to sway public opinion in their favour. However, these saloons and spas lack basic medical facilities in terms of staff or equipment to handle any complication or medical emergency. To have a level playing field ethical advertising should be permitted to qualified aesthetic surgeons as is permitted in the US and UK by their respective organisations. PMID:28529421

  3. Mapping a surgeon's becoming with Deleuze.

    Science.gov (United States)

    Cristancho, Sayra; Fenwick, Tara

    2015-12-01

    The process of 'becoming' shapes professionals' capability, confidence and identity. In contrast to notions of rugged individuals who achieve definitive status as experts, 'becoming' is a continuous emergent condition. It is often a process of struggle, and is always interminably linked to its environs and relationships. 'Becoming' is a way of understanding the tensions of everyday practice and knowledge of professionals. In this paper, we explore the notion of 'becoming' from the perspective of surgeons. We suggest that 'becoming', as theorised by Deleuze, offers a more nuanced understanding than is often represented using conventional vocabularies of competence, error, quality and improvement. We develop this conception by drawing from our Deleuze-inspired study of mapping experience in surgery. We argue for Deleuzian mapping as a method to research health professionals' practice and experience, and suggest the utility of this approach as a pedagogical tool for medical education.

  4. Partial denture-- an ENT surgeon's nightmare.

    Science.gov (United States)

    Venugopal, M; Sagesh, M

    2012-11-01

    Foreign body oesophagus is one among the common otorhinolaryngology emergencies that we come across. Artificial partial denture impaction in the oesophagus is often an ENT surgeon's nightmare. This study was done in the department of otorhinolaryngology, Government Medical College Kozhikode for a period of 2 years. All patients presented with history of accidental swallowing of partial denture followed by dysphagia. Radiological evaluation was done and subsequently oesophagoscopy and removal of the denture was done. In failed cases exploration and removal of foreign body was required. Complications were found in partial denture with metal wire clasps. It is better to avoid using malfitting dentures with small base, those with metal wire clasps and be cautious of using dentures in alcoholics and unconscious patients.

  5. John Banister: an Elizabethan surgeon in Brazil.

    Science.gov (United States)

    Mello, Amílcar D'Avila de

    2011-03-01

    In Brazil's sixteenth-century history, very few references are made to health professionals. On the expedition of Edward Fenton, dispatched by the English Crown in 1582 to set up a trading post in Asia, was the famous barber-surgeon and physician John Banister. The naval squadron, diverted from its original route to repeat the feats of Sir Francis Drake, stopped over in Africa, crossed the Atlantic and anchored off the Santa Catarina coast in Brazil. In these waters, the expedition degenerated into piracy and returned unsuccessful to Europe. John Banister is considered the person who liberated English anatomy from mediaeval slavery, shedding upon it the light of the Renaissance. It was the first time that anyone of this importance in the area of health had visited these latitudes.

  6. David Falk: Algunas cuestiones abiertas para el marketing deportivo. [David Falk: Some open questions for the sports marketing arena].

    Directory of Open Access Journals (Sweden)

    José A. Martínez

    2015-04-01

    Full Text Available David Falk, el que fuera el representante del jugador de baloncesto Michael Jordan, es una figura de referencia para el marketing deportivo. Falk contribuyó decisivamente a revitalizar el marketing deportivo, ayudó a construir lo que probablemente sea la relación comercial más importante del deporte (Jordan-Nike, y llevó hasta el extremo la filosofía de que en la negociación lo importante es que tu cliente llegue a conseguir el máximo dinero posible, más allá de que ese sea su valor de mercado o que el propio mercado pueda admitir esa inflación. En este artículo se repasan algunos de los hechos más destacados de su vida profesional y, desde una perspectiva crítica, se relacionan con varias cuestiones abiertas que el mundo académico y profesional del deporte continúa discutiendo. Abstract David Falk, former agent of the basketball player Michael Jordan, is a figure of reference for sports marketing. Falk was instrumental in revitalizing the sports marketing. He helped to build what is probably the most important relationship in sport business (Jordan-Nike, and strongly defended a radical philosophy of negotiation, where the most important is the maximization of client gains, regardless their true market value or if the market can admit such inflation. This article reviews some of the highlights of his career facts and, from a critical perspective, discusses several open issues related to the academic and professional world of sports. To achieve this aim, several recent contributions to the marketing and sports literature are commented.

  7. Surgeon unemployment: would practice sharing be a viable solution?

    Science.gov (United States)

    Wakeam, Elliot; Feinberg, Stan

    2016-04-01

    Surgeon unemployment has become a crisis within Canadian surgery in recent years. Without dedicated governmental workforce planning, ensuring that new residency graduates can find employment will require new models of employment. Practice sharing, whereby a new graduate and a senior surgeon partner to divide their practices, allows the senior surgeon to wind down and the newer surgeon to ramp up. Importantly, this arrangement builds in formal mentoring, which is so important in the early years of starting a surgical practice. Practice sharing may be a solution for the workforce issues currently afflicting new surgical graduates across Canada.

  8. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons.

    Science.gov (United States)

    Reddy, Vikram; Coffey, M Justin

    2016-08-01

    Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients.

  9. Two surgeons and the ECG-a double blind study

    Institute of Scientific and Technical Information of China (English)

    Ulf Martin Schilling

    2012-01-01

    Objective: To assess the capability of operating abdominal and orthopaedic surgeons to analyze a set of standardized ECG. Methods: Twenty operating abdominal and orthopaedic surgeons at a university hospital were included. Each participant analyzed a set of five standardized ECG with an answering scheme for eight different items, giving a maximum score of 40. The answers were matched according to specialty and experience of the doctors of less than 5 years, between 5 and 10 years or more than 10 years. The reference standard was set by two independent consultants in cardiology. Results: The mean overall score was 25.25 (63.13%±4.78%) varying between 38 (95%) and 20(50%). Abdominal surgeons performed a mean score of 27.625 (69.06%±9.53%), and orthopaedic surgeons 23.67 points (59.17%±3.69%). The difference between the performance of abdominal and orthopaedic surgeons was not significant (P=0.09). 20/20 surgeons identified ST-elevation and no surgeon accepted the ECG showing acute ST-elevation myocardial infarction as normal. Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

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

    Science.gov (United States)

    Jähne, J

    2012-04-01

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

  11. Choosing surgery as a specialty: opinions of medical students about surgery and surgeons.

    Science.gov (United States)

    Borracci, Raúl A; Ferraina, Pedro; Arribalzaga, Eduardo B; Poveda Camargo, Ricardo L

    2014-11-01

    Since the number of applicants to residencies in general surgery in Argentina seems to be decreasing, we designed this work with the objective of studying the factors considered undesirable by students when choosing surgery as a specialty. Between March and April 2012, one-hundred students were surveyed with a structured questionnaire with true/false binary answers in an observational case-control design. The survey contained 26 statements that made reference to characteristics of surgery as a specialty, or about the personality and lifestyle of surgeons, as they could be perceived by students. As a control group the same survey was applied to 20 surgeons who were in contact with the students and that could represent a role model for them during their rotation in surgery. Comparison between students and surgeons showed no difference in most answers, except in «surgery has poor reimbursement» (OR: 8,9; P=.0001), «there is not enough job demand» (OR: 8,1; P=.015), «surgery restrains intellectual development» (OR: 17,5; P=.014), «surgeons have too many non-scheduled activities» (OR: 9,36; P=.024), «they have a limited patient-physician relationship» (OR: 3,61; P=.009), «they have little time for family» (OR: 4,27; P=.036) and «they are exposed to infectious diseases» (OR: 5,90; P=.007). Women would be as interested as men in working as surgeons; a remarkable fact when considering that the surgical specialties have been predominantly filled by men. The fact that surgeons mostly coincide with the views of students means that role models should be reviewed to promote vocations. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  12. The Impact of Individual Surgeon Volume on Hysterectomy Costs

    Science.gov (United States)

    Shepherd, Jonathan P.; Kantartzis, Kelly L.; Lee, Ted; Bonidie, Michael J.

    2017-01-01

    Background and Objective: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost. The objective is to determine the impact of individual surgeon volume on total hospital costs for hysterectomy. Methods: This is a retrospective cohort of women undergoing hysterectomy for benign indications from 2011 to 2013 at 10 hospitals within the University of Pittsburgh Medical Center System. Cases that included concomitant procedures were excluded. Costs by surgeon volume were analyzed by tertile group and with linear regression. Results: We studied 5,961 hysterectomies performed by 257 surgeons: 41.5% laparoscopic, 27.9% abdominal, 18.3% vaginal, and 12.3% robotic. Surgeons performed 1–542 cases (median = 4, IQR = 1–24). Surgeons were separated into equal tertiles by case volume: low (1–2 cases; median total cost, $4,349.02; 95% confidence interval [CI] [$3,903.54–$4,845.34]), medium (3–15 cases; median total cost, $2,807.90; 95% CI [$2,693.71–$2,926.93]) and high (>15 cases, median total cost $2,935.12, 95% CI [$2,916.31–$2,981.91]). ANOVA analysis showed a significant decrease (P < .001) in cost from low-to-medium– and low-to-high–volume surgeons. Linear regression showed a significant linear relationship (P < .001), with a $1.15 cost reduction per case with each additional hysterectomy. Thus, if a surgeon performed 100 cases, costs were $115 less per case (100 × $1.15), for a total savings of $11,500.00 (100 × $115). Conclusion: Overall, in our models, costs decreased as surgeon volume increased. Low-volume surgeons had significantly higher costs than both medium- and high-volume surgeons.

  13. A profile of female academic surgeons: training, credentials, and academic success.

    Science.gov (United States)

    Wyrzykowski, Amy D; Han, E; Pettitt, B J; Styblo, T M; Rozycki, G S

    2006-12-01

    The objective of this study was to determine the profile (credentials, training, and type of practice) of female academic general surgeons and factors that influenced their career choice. A survey was sent to female academic surgeons identified through general surgery residency programs and American medical schools. The women had to be Board eligible/certified by the American Board of Surgery or equivalent Board and have an academic appointment in a Department of Surgery. Data were analyzed using the SPSS program. Two hundred seventy women (age range, 32-70 years) completed the survey (98.9% response rate). Fellowships were completed by 82.3 per cent (223/270), most commonly in surgical critical care. There were 134 (50.2%, 134/367) who had two or more Board certificates, most frequently (46%, 61/134) in surgical critical care. Full-time academic appointments were held by 86.7 per cent of women, most as assistant professors, clinical track; only 12.4 per cent were tenured professors. The majority of women described their practice as "general surgery" or "general surgery with emphasis on breast." The most frequent administrative title was "Director." Only three women stated that they were "chair" of the department. The top reason for choosing surgery was "gut feeling," whereas "intellectual challenge" was the reason they pursued academic surgery. When asked "Would you do it again?", 77 per cent responded in the affirmative. We conclude that female academic surgeons are well trained, with slightly more than half having two or more Board certificates; that most female academic surgeons are clinically active assistant or associate professors whose practice is "general surgery," often with an emphasis on breast disease; that true leadership positions remain elusive for women in academic general surgery; and that 77 per cent would choose the same career again.

  14. The attitude and perceptions of work-life balance: a comparison among women surgeons in Japan, USA, and Hong Kong China.

    Science.gov (United States)

    Kawase, Kazumi; Kwong, Ava; Yorozuya, Kyoko; Tomizawa, Yasuko; Numann, Patricia J; Sanfey, Hilary

    2013-01-01

    The objective of the present study was to explore how women surgeons manage their work-life balance in three environmental and cultural settings. Members of the Japan Association of Women Surgeons (JAWS), the United States of America (US) based Association of Women Surgeons (AWS), and the Women's Chapter of the College of Surgeons of Hong Kong (WCHK) were surveyed. Among 822 women surgeons contacted, 252 responded (response rate 31.8 %; 55.5 % JAWS, 28.2 % AWS, and 25.3 % WCHK). Japanese women surgeons think that work is the number one priority, whereas US and Hong Kong China (HK) respondents think the number one priority is home life. Work satisfaction level was generally high among women surgeons in all countries; however, 19 % of US surgeons are somewhat dissatisfied with their work and 76.1 % think that men are treated more favorably than women at work. Whereas 51.6 % of Japanese women surgeons think that men are treated more favorably than women at home, at the same time they placed more importance on the role of women in the family. More than half of Japanese women surgeons are "uncertain" about their career path in the future, whereas 55.2/87.1 % of US/HK respondents are optimistic. All surgeons recommended expanding support for child rearing or nursing care during work hours, promoting a flexible work schedule and changing some of the older conventional ideas about gender role. It is essential to address women surgeons' concerns to enable them to have a clearer vision and a challenging career, and to be more certain about their personal and professional goals.

  15. Reconstructing apology: David Cameron's Bloody Sunday apology in the press.

    Science.gov (United States)

    McNeill, Andrew; Lyons, Evanthia; Pehrson, Samuel

    2014-12-01

    While there is an acknowledgement in apology research that political apologies are highly mediated, the process of mediation itself has lacked scrutiny. This article suggests that the idea of reconstruction helps to understand how apologies are mediated and evaluated. David Cameron's apology for Bloody Sunday is examined to see how he constructs four aspects of apology: social actors, consequences, categorization, and reasons. The reconstruction of those aspects by British, Unionist, and Nationalist press along with reconstructions made by soldiers in an online forum are considered. Data analysis was informed by thematic analysis and discourse analysis which helped to explore key aspects of reconstruction and how elements of Cameron's apology are altered in subsequent mediated forms of the apology. These mediated reconstructions of the apology allowed their authors to evaluate the apology in different ways. Thus, in this article, it is suggested that the evaluation of the apology by different groups is preceded by a reconstruction of it in accordance with rhetorical goals. This illuminates the process of mediation and helps to understand divergent responses to political apologies.

  16. "David Copperfield": Perfect Reflection of Dickens' Creative Ideas

    Institute of Scientific and Technical Information of China (English)

    肖双喜

    2001-01-01

    @@ Charles Dickens ( 1812- 1870 ) was the most popular and internationally known as an Engilsh novelist. Being the greatest representative of the English critical realism, he gives us a most vivid picture of the everyday life of the ordinary people of his time. He created a large number of characters ,well drawn, full of life and unforgettable. He has suffered so bitterly himself as a child and had seen so much evil that he burned with the desire to fight it to the end .While presenting a truthful account of the hardships borne by the poor people, he believed that a hard-working and honest man could achieve his little personal happiness under capitalism. He criticized the vices of the capitalist society, but failed to see the necessity of a bitter struggle of the oppressed against their oppressors, He wished that the oppressors would become kind through proper education and persuasion, and that the social contradictions would be resolved by the kindness and beneficence of the oppessors. So, "kindness ","beneficence" and "love" are the main ideas guiding his literary creations. "David Copperfield", one of Dickens' best novels, perfectly reflects these ideas.

  17. “Silencio”: hearing loss in David Lynch's Mulholland Drive

    Directory of Open Access Journals (Sweden)

    Allister Mactaggart

    2014-11-01

    Full Text Available In a filmmaking career replete with extraordinary images and sounds, David Lynch's Mulholland Drive (2001 stands out for attention as a striking and seemingly inexhaustible resource for analysis. In this article, this film is used to examine the specific ways in which Lynch uses pre-existing pop songs to wrap the spectator within the filmic soundscape. Nowhere is the complexity and uncanniness of pop music made more explicit than in Rebekah Del Rio's stunning performance of “Llorando (Crying” in the Club Silencio scene. The split between the singer's powerful performance and her subsequent collapse with the sound of the voice left hanging in the air marks a pivotal point in the film. This scene, coupled with other examples of feminine jouissance, is contrasted with the deadening roar of the master's voice, which solely demands obedience but is deaf to any reply. At the core of this article is an analysis of the status of the voice (and the gaze as examples of the Lacanian object a and its relationship to Marx's concept of surplus value. Mulholland Drive provides a powerful demonstration of how these concepts can be seen, heard, and felt in relation to film, and how sound can reverberate into the spaces and silences beyond the screen.

  18. DAVID HUME AND THE CRITICAL EXAMINATION OF EMPIRICISM

    Directory of Open Access Journals (Sweden)

    IONUŢ ŞTEFAN

    2012-11-01

    Full Text Available The research is related to David Hume. This philosopher is described as being an empiricist, but it should be noted that the empiricism promoted by Hume represents the development up to the final consequences of this philosophical doctrine that should be subjected to the observability requirement. The core problem for Hume’s philosophy is the difficulty of causality thinking. The Scottish philosopher promotes a moderate and inconsistent skepticism because he does not doubt the permanency of facts. The Humean epistemology is mixed with elements belonging to some naïve ontology of a materialistic nature and with elements of a sensualistic psychology of an associationist type. The causality or the causal connection between events is based on a psychological belief, which has a pragmatic end for people, in that it offers us the psychological comfort of habitual events and the familiar existential. Causality refers to certain events that have already happened in a certain way, but it cannot constitute a necessary and sufficient basis for similar future events.

  19. Risk Factors for Late Aortic Valve Dysfunction After the David V Valve-Sparing Root Replacement.

    Science.gov (United States)

    Esaki, Jiro; Leshnower, Bradley G; Binongo, Jose N; Lasanajak, Yi; McPherson, LaRonica; Guyton, Robert A; Chen, Edward P

    2017-06-29

    Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR. The mean age was 46.4 years. Sixty-four patients (22.7%) had bicuspid valves, and 41 patients (14.5%) had Marfan syndrome. The incidence of reoperations was 27 (9.6%), and 42 cases (14.9%) presented with acute type A dissection. Operative mortality was 8 (2.8%). Seven-year survival was 90.9%. Seven-year cumulative incidence of reoperation, greater than 2+ AI and greater than moderate AS were 3.1%, 2.2%, and 0.8%, respectively. Multivariable analysis showed aortic root size 55 mm or larger (hazard ratio 3.44, 95% confidence interval: 1.27 to 9.29, p = 0.01) to be a risk factor for late AI whereas bicuspid valve (hazard ratio 16.07, 95% confidence interval: 3.12 to 82.68, p = 0.001) and cusp repair were found to be risk factors (hazard ratio 5.91, 95% confidence interval: 1.17 to 29.86, p = 0.03) for late AS. Valve-sparing root replacement can be performed with low operative risk and good overall long-term survival even in complex clinical settings. Durable valve function can be expected; however, aortic root size 55 cm or more, bicuspid valve anatomy, and cusp repair represent independent risk factors for late aortic valve dysfunction after these procedures. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Regional variability in use of a novel assessment of thoracolumbar spine fractures: United States versus international surgeons

    Directory of Open Access Journals (Sweden)

    Harrop James S

    2007-09-01

    -US surgeons. Intra-rater reliability for management was substantial in both US and non-US surgeons. The TLISS incorporates generally accepted features of spinal injury assessment into a simple patient evaluation tool. The management recommendation of the treatment algorithm component of the TLISS shows good inter-rater and substantial intra-rater reliability in both non-US and US based spine surgeons. The TLISS may improve communication between health providers and may contribute to more efficient management of thoracolumbar injuries.

  1. How Can We Improve Education of Breast Surgeons Across Europe?

    Science.gov (United States)

    Kolacinska, Agnieszka

    2017-01-01

    Club) research fellowship; SSO/ ESSO fellowshipthrough its partnership with ESSO, SSO provides a grant to attend the SSO Annual Symposium; Reciprocal International Exchange Programmes with Japan, Latin America and North America (2). ESSO courses and masterclasses: expanded portfolio of courses, in- and outside Europe, basic and advanced, international faculty, multidisciplinary approach, learning methods: hands-on with human cadavers, workshops in small groups, live and case demonstrations, interactive sessions, 3D videos (for instance in 2017 ESSO course on ultrasound of breast in Barcelona, advanced course on oncoplastic surgery in Barcelona, advanced course on breast cancer surgery in Naples) (2). Trials: Interantional Nipple- Sparing Mastectomy Registry (INSPIRE), EURECCA (European Cancer Audit) project. The aim of INSPIRE is to provide pooled evidence derived from a prospective collaborative high-quality registry between international centers, oncological safety, patient- reported outcome measures, launched in March, 2016, European Breast Cancer Conference EBCC 10, Amsterdam (2). European Board of Surgery Qualification in Breast Surgery (EBSQ in BS): phase 1-eligibility assessment (CV, logbook, references); phase 2- test; phase 3- oral examination with 2 clinical cases and 1 critical review of academic paper. The applicant must hold a current license to practice as a surgeon (general or plastic or gynaecologist), demonstrate work for one year in a breast surgery unit with at least 150 new primary breast cancer cases per year, attended at least one national/ international training course in breast surgery and has attended at least one well recognized international congress. The applicant should present a signed log book for breast surgery with application; published either one paper or book chapter on breast disease Conclusions 1. The need for certified breast units: Standardised techniques by specialist breast surgeons across Europe should be the aim. 2. No man

  2. Changing perceptions of beauty: a surgeon's perspective.

    Science.gov (United States)

    Adamson, Peter A; Zavod, Matthew B

    2006-08-01

    Beauty is a mystery that has been with us for ages. Scholars and scientists have investigated its roots and effects, and its presence is ubiquitous. Has the construct of beauty changed over time? Is our sense of beauty learned or innate? What IS beauty, and can we quantify it? A substantial amount of work supports a Darwinian theory of selection, which predicts a survival advantage based on physical attractiveness. However, there is evidence that certain perceptions of beauty change with time. Indeed, the recent globalization of modern society has wrought changes in our perceptions of beauty. Are patients electing cosmetic surgery procuring a survival advantage, or are they bypassing genetics and setting a new standard for beauty? As facial plastic surgeons, we must be poised to respond to this metamorphosis and understand its roots. Although there is some equivocation and debate about this elusive subject, it is our duty to stay abreast of the current dynamic to make sound judgments that are in the best interests of our patients.

  3. Occupational Hazards Among Dental Surgeons In Karachi.

    Science.gov (United States)

    Baig, Nabeel Naeem; Aleem, Sajid Atif

    2016-04-01

    To determine the frequency of different occupational hazards among dental surgeons in Karachi. Cross-sectional survey. Amulticenter study conducted at Ameen Diabetic and Dental Hospital, Dental OPD, Karachi Medical and Dental College, and Abbasi Shaheed Hospital, Karachi, from February to March 2014. Dentists, practicing in different areas of Karachi, were given a self-administered questionnaire. It comprised of a form containing information about the socio-demographic profile of dentists and questionnaires regarding occupational hazards experienced in practice. Atotal of 130 dentists, involved in clinical practice, were randomly selected. There were 45 (35%) males and 85 (65%) females. The average age was 39 ±5.76 years. Out of 130 dentists, 93.8% (122/130) had occupational hazard during practice. Cervical back pain was observed in 81.96% dentists followed by knee / elbow joint pain in 53.27%, eye infection in 44.615%, impaired hearing in 40.98%, psychological stress in 41.80% and material allergy was 12.29%. Various spinal and joint pains, eye infections, impaired hearing, stress and material allergy represented occupational hazard to 93.8% of the surveyed dentists.

  4. Diathermy awareness among surgeons-An analysis in Ireland

    Directory of Open Access Journals (Sweden)

    P.M. McQuail

    2016-12-01

    Conclusion: Our results show a dearth of awareness among surgeons regarding diathermy. Given our findings, we urge a shift in attitude towards diathermy, with surgeons adopting a more cautious and safe approach to diathermy use. We recommend that formal training be introduced as a hospital based initiative.

  5. Two surgeons and the ECG-a double blind study

    Directory of Open Access Journals (Sweden)

    Ulf Martin Schilling

    2012-01-01

    Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

  6. Patients' Opinions about Polish Surgeons and Surgical Treatment.

    Science.gov (United States)

    Olakowski, Marek; Hładoń, Aleksandra; Seweryn, Mariusz; Ciosek, Jakub; Świątkiewicz, Wojciech

    2016-10-01

    In Polish society Stereotypes about the surgeons are deeply rooted, which could really affect their relationship with the patient and the entire treatment process. The aim of the study was to evaluate the results of an opinion survey on the image of the surgeon and operative treatment.

  7. Spine Surgeon Selection Criteria: Factors Influencing Patient Choice.

    Science.gov (United States)

    Manning, Blaine T; Ahn, Junyoung; Bohl, Daniel D; Mayo, Benjamin C; Louie, Philip K; Singh, Kern

    2016-07-01

    A prospective questionnaire. The aim of this study was to evaluate factors that patients consider when selecting a spine surgeon. The rise in consumer-driven health insurance plans has increased the role of patients in provider selection. The purpose of this study is to identify factors that may influence a patient's criteria for selecting a spine surgeon. Two hundred thirty-one patients who sought treatment by one spine surgeon completed an anonymous questionnaire consisting of 26 questions. Four questions regarded demographic information; 16 questions asked respondents to rate the importance of specific criteria regarding spine surgeon selection (scale 1-10, with 10 being the most important); and six questions were multiple-choice regarding patient preferences toward aspects of their surgeon (age, training background, etc.). Patients rated board certification (9.26 ± 1.67), in-network provider status (8.10 ± 3.04), and friendliness/bedside manner (8.01 ± 2.35) highest among factors considered when selecting a spine surgeon. Most patients (92%) reported that 30 minutes or less should pass between check-in and seeing their surgeon during a clinic appointment. Regarding whether their spine surgeon underwent training as a neurosurgeon versus an orthopedic surgeon, 25% reported no preference, 52% preferred neurosurgical training, and 23% preferred orthopedic training. Our findings suggest that board certification and in-network health insurance plans may be most important in patients' criteria for choosing a spine surgeon. Advertisements were rated least important by patients. Patients expressed varying preferences regarding ideal surgeon age, training background, proximity, medical student/resident involvement, and clinic appointment availability. The surgeon from whom patients sought treatment completed an orthopedic surgery residency; hence, it is notable that 52% of patients preferred a spine surgeon with a neurosurgical background. In the context

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

    Science.gov (United States)

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

    2017-08-01

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

  9. [Patient's pain feeling and surgeon's comfort--ECCE versus phacoemulsification].

    Science.gov (United States)

    Kałuzny, Jakub J; Eliks, Iwona; Mierzejewski, Andrzej; Kałuzny, Bartłomiej

    2004-01-01

    To compare patient's pain and surgeon's comfort during ECCE performed under retrobulbar anesthesia and phacoemulsification under topical anesthesia. 120 patients scheduled for planned routine cataract extraction were divided in 2 groups: group 1-60 eyes, ECCE under retrobulbar anesthesia and group II-60 eyes, phacoemulsification under topical anesthesia. Immediately after operation patients were asked, to answer questions about their feeling during surgery. Simultaneously, the surgeon filled up the questionnaire, concerning patients behavior during the entire procedure. Statistically significant higher level of pain was reported in group I (ECCE). The most painful moment of the procedure was retrobulbar injection. During surgery pain feeling in both groups was similar. Both types of anesthesia provided very good level of surgeon's comfort. The longer operation, the higher level of pain and lower surgeon's comfort were reported in both groups. Patients having ECCE performed under retrobulbar anesthesia reported more pain comparing to phacoemulsification under topical anesthesia. Both anesthesia methods provided high level of surgeon's comfort.

  10. Combat surgeons before, during, and after war: the legacy of Loyal Davis.

    Science.gov (United States)

    Cannon, Jeremy W; Teff, Richard J

    2010-05-01

    By 1942, Loyal Davis had firmly established himself as a preeminent civilian neurosurgeon. With military operations rapidly escalating, he was recruited to serve in the European Theater of Operations as a consultant to the Surgeon General. Davis brought tremendous experience, insight, and leadership to this position; however, he found the military system in which he was suddenly immersed inefficient and impassive. His requests for even basic equipment became mired in endless bureaucracy even as his communiqués to the Chief Surgeon in the European Theater and to the Surgeon General's staff in Washington seemed to fall short of their intended recipients. Then, when he attempted to vent his frustrations to his academic colleagues, he was nearly court-martialed. Notwithstanding, Davis became the first to formally recognize high-altitude frostbite and also developed protective headgear for airmen, and later in his service, he joined a contingent of senior medical leaders who visited the Soviet Union to study their system of combat casualty care. Subsequent to his service on active duty, Davis returned to his academic practice at Northwestern where he used his position as editor of Surgery, Gynecology, and Obstetrics to advocate for change within the military medical corps. Others like Davis have contributed greatly to the advancement of combat casualty care both during active service and long after their time in uniform. This paper examines the lessons from Davis's experiences as a military neurosurgeon and his continued advocacy for change in the medical corps along with additional recent examples of change effected by former military surgeons. For those currently serving, these lessons illustrate the value of contributing wherever a need is recognized, and for those who have served in the past, they demonstrate the importance of having a continued voice with junior combat surgeons and the military leadership.

  11. Patient and surgeon factors are associated with the use of laparoscopy in appendicitis.

    LENUS (Irish Health Repository)

    McCartan, D P

    2012-02-01

    Aim The use of a minimally invasive approach to treat appendicitis has yet to be universally accepted. The objective of this study was to examine recent trends in Ireland in the surgical management of acute appendicitis. Method Data were obtained from the Irish Hospital In-Patient Enquiry system for patients discharged with a diagnosis of appendicitis between 1999 and 2007. An anonymous postal survey was sent to all general surgeons of consultant and registrar level in Ireland to assess current attitudes to the use of laparoscopic appendectomy. Results The use of laparoscopic appendectomy increased throughout the study and was the most common approach for appendectomy in 2007. Multivariate analysis revealed age under 50 years (OR = 1.51), female sex (OR = 2.84) and residence in high-density population areas (OR = 4.15) as predictive factors for undergoing laparoscopic appendectomy in the most recent year of the study. While 97% of surgeons reported current use of laparoscopy in patients with acute right iliac fossa pain, in most cases it was selective. Surgeons in university teaching hospitals (42 of 77; 55%) were more likely to report using laparoscopic appendectomy for all cases of appendicitis than those in regional (six of 23; 26%) or general (13 of 53; 25%) hospitals (P = 0.048). Conclusion This study has demonstrated a significant increase in laparoscopic appendectomy, yet a variety of patient and surgeon factors contribute to the choice of procedure. Differences in the perception of benefit of the laparoscopic approach amongst surgeons appears to be an important factor in determining the operative approach for appendectomy.

  12. Reduction Mammoplasty: A Comparison Between Operations Performed by Plastic Surgery and General Surgery

    OpenAIRE

    Kordahi, Anthony M.; Hoppe, Ian C.; Lee, Edward S.

    2015-01-01

    Background: Reduction mammoplasty is an often-performed procedure by plastic surgeons and increasingly by general surgeons. The question has been posed in both general surgical literature and plastic surgical literature as to whether this procedure should remain the domain of surgical specialists. Some general surgeons are trained in breast reductions, whereas all plastic surgeons receive training in this procedure. The National Surgical Quality Improvement Project provides a unique opportuni...

  13. Quality of life of indian pediatric surgeons: Results of a survey (of indian association of pediatric surgeons members

    Directory of Open Access Journals (Sweden)

    M M Zameer

    2017-01-01

    Conclusion: This is the first study which objectively highlights that most surgeons are happy professionally and financially in due course of time and demolishes the common belief that pediatric surgeons are unsatisfied. It also acts as a point of reference and encouragement to newer aspirants in pediatric surgery.

  14. Jalutu David tantsib auhinna vääriliselt / Andres Laasik

    Index Scriptorium Estoniae

    Laasik, Andres, 1960-2016

    2006-01-01

    Tantsufilm "Elu hind" ("The Cost of Living") : lavastaja ja koreograaf Lloyd Newson : peaosades David Toole, Eddie Kay : Suurbritannia 2004. Filmi aluseks on Londoni tantsuteatri DV 8 Physical Theatre' 2000.a. valminud lavastus

  15. Siim Nestor soovitab : David Morales. Reede ja laupäeva parimad palad / Siim Nestor

    Index Scriptorium Estoniae

    Nestor, Siim, 1974-

    2004-01-01

    Popmuusikaüritustest: David Morales 15. apr. klubis Moskva, "Eklekter" 16. apr Von Krahlis (esinejaks rootsi diskor DJ Mad Mats), prantsuse diskor DJ Yellow 16. apr. klubis Hollywood, üritusest "Dependent" 17. apr. Tartus

  16. Milline on olnud teie vapustavaim muuseumielamus? / Lauri Leesi, David Vseviov, Andres Herkel...[jt.

    Index Scriptorium Estoniae

    2010-01-01

    Küsimusele vastasid Tallinna prantsuse lütseumi direktor Lauri Leesi, kirjanik Doris Kareva, ajaloolane David Vseviov, riigikogu Isamaa ja Res Publica liidu fraktsiooni aseesimees Andres Herkel ja kirjanik Olev Remsu

  17. Jalutu David tantsib auhinna vääriliselt / Andres Laasik

    Index Scriptorium Estoniae

    Laasik, Andres, 1960-2016

    2006-01-01

    Tantsufilm "Elu hind" ("The Cost of Living") : lavastaja ja koreograaf Lloyd Newson : peaosades David Toole, Eddie Kay : Suurbritannia 2004. Filmi aluseks on Londoni tantsuteatri DV 8 Physical Theatre' 2000.a. valminud lavastus

  18. Prozaci asemel GTD ehk getting things done / David Allen ; interv. Endrik Randoja

    Index Scriptorium Estoniae

    Allen, David

    2007-01-01

    Konsultant ja koolitaja David Allen oma aja- ja enesejuhtimise meetodist GTD - getting things done. Vt. samas: Väikesed nipid, et tõhusam olla; Milles seisneb Alleni meetod; Kuidas ma oma ülesannet täitsin - logiraamat

  19. Prozaci asemel GTD ehk getting things done / David Allen ; interv. Endrik Randoja

    Index Scriptorium Estoniae

    Allen, David

    2007-01-01

    Konsultant ja koolitaja David Allen oma aja- ja enesejuhtimise meetodist GTD - getting things done. Vt. samas: Väikesed nipid, et tõhusam olla; Milles seisneb Alleni meetod; Kuidas ma oma ülesannet täitsin - logiraamat

  20. [David Feest. Zwangskollektivierung im Baltikum : die Sowjetisierung des estnischen Dorfes 1944-1953] / Anu Mai Kõll

    Index Scriptorium Estoniae

    Kõll, Anu Mai, 1946-

    2008-01-01

    Arvustus: Feest, David. Zwangskollektivierung im Baltikum : die Sowjetisierung des estnischen Dorfes 1944-1953. Köln [etc.] : Böhlau, 2007. Esimesest rahvusvaheliselt kättesaadavast laiahaardelisest Eesti kollektiviseerimist käsitlevast teosest

  1. "Handbook of biomedical optics", edited by David A. Boas, Constantinos Pitris, and Nimmi Ramanujam

    Directory of Open Access Journals (Sweden)

    Gramatikov Boris

    2012-02-01

    Full Text Available Abstract David A. Boas, Constantinos Pitris, and Nimmi Ramanujam, Eds.: Handbook of Biomedical Optics CRC Press, Taylor and Francis Group, Boca Raton, London, New York, 2011 ISBN: 978-1-4200-9036-9 (Hardback, 787 pages

  2. "Handbook of biomedical optics", edited by David A. Boas, Constantinos Pitris, and Nimmi Ramanujam

    OpenAIRE

    Gramatikov Boris

    2012-01-01

    Abstract David A. Boas, Constantinos Pitris, and Nimmi Ramanujam, Eds.: Handbook of Biomedical Optics CRC Press, Taylor and Francis Group, Boca Raton, London, New York, 2011 ISBN: 978-1-4200-9036-9 (Hardback), 787 pages

  3. Osborne's trilogy : a critique of the management philosophy of David Osborne / Jan-Erik Lane

    Index Scriptorium Estoniae

    Lane, Jan-Erik

    2006-01-01

    Kriitiline lühiülevaade David Osborne'i raamatutes Reinventing government (kaasautor T. Gaebler, 1992), Banishing bureaucracy (kaasautor P. Plastrik, 1997) ja The price of government (kaasautor P. Hutchinson, 2004) avaldatud teooriatest

  4. Clinton või Trump - USA jaoks ühtviisi katastroof / David Satter ; intervjueerinud Taavi Minnik

    Index Scriptorium Estoniae

    Satter, David

    2016-01-01

    Intervjuu maineka Ühendriikide Venemaa eksperdi David Satteriga, kes hoiatab, et Ameerika presidendivalimistel on inimestel valida kahe äärmiselt halva kandidaadi - Donald Trumpi ning Hillary Clintoni vahel

  5. [David Feest. Zwangskollektivierung im Baltikum : die Sowjetisierung des estnischen Dorfes 1944-1953] / Anu Mai Kõll

    Index Scriptorium Estoniae

    Kõll, Anu Mai, 1946-

    2008-01-01

    Arvustus: Feest, David. Zwangskollektivierung im Baltikum : die Sowjetisierung des estnischen Dorfes 1944-1953. Köln [etc.] : Böhlau, 2007. Esimesest rahvusvaheliselt kättesaadavast laiahaardelisest Eesti kollektiviseerimist käsitlevast teosest

  6. Osborne's trilogy : a critique of the management philosophy of David Osborne / Jan-Erik Lane

    Index Scriptorium Estoniae

    Lane, Jan-Erik

    2006-01-01

    Kriitiline lühiülevaade David Osborne'i raamatutes Reinventing government (kaasautor T. Gaebler, 1992), Banishing bureaucracy (kaasautor P. Plastrik, 1997) ja The price of government (kaasautor P. Hutchinson, 2004) avaldatud teooriatest

  7. Robert Bresson, Mariano Barroso, Paskaljevich, Mary Harron, David Trueba, Lars von Trier, Liv Ullmann, Zhang Yimou

    OpenAIRE

    La madriguera

    2000-01-01

    La madriguera (2000). Robert Bresson, Mariano Barroso, Paskaljevich, Mary Harron, David Trueba, Lars von Trier, Liv Ullmann, Zhang Yimou. Ediciones de intervención cultural S.L. http://hdl.handle.net/10251/41911. 80 80 33

  8. Siim Nestor soovitab : David Morales. Reede ja laupäeva parimad palad / Siim Nestor

    Index Scriptorium Estoniae

    Nestor, Siim, 1974-

    2004-01-01

    Popmuusikaüritustest: David Morales 15. apr. klubis Moskva, "Eklekter" 16. apr Von Krahlis (esinejaks rootsi diskor DJ Mad Mats), prantsuse diskor DJ Yellow 16. apr. klubis Hollywood, üritusest "Dependent" 17. apr. Tartus

  9. David Oistrahhi festival läheneb lõpule / Toivo Traks

    Index Scriptorium Estoniae

    Traks, Toivo

    2006-01-01

    Kontsertidest David Oistrahhi festivali raames: saksa viola da gamba mängija Holger Faust-Peters ja klavessinist Iren Lill 19. juulil Pärnu Eliisabeti kirikus, briti laulja Patricia Rozario ja RTE Vanbrugh Quartet 20. juulil Eliisabeti kirikus

  10. Clinton või Trump - USA jaoks ühtviisi katastroof / David Satter ; intervjueerinud Taavi Minnik

    Index Scriptorium Estoniae

    Satter, David

    2016-01-01

    Intervjuu maineka Ühendriikide Venemaa eksperdi David Satteriga, kes hoiatab, et Ameerika presidendivalimistel on inimestel valida kahe äärmiselt halva kandidaadi - Donald Trumpi ning Hillary Clintoni vahel

  11. Ethical challenges in surgery as narrated by practicing surgeons

    Directory of Open Access Journals (Sweden)

    Nordam Ann

    2005-02-01

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

  12. [Jaan Kross ja David Samoilov. Mu sõbra avatud akna all] / M. J.

    Index Scriptorium Estoniae

    Jõgi, Mall, 1947-

    2016-01-01

    Tutvustus: Kross, Jaan. Mu sõbra avatud akna all : [luuletused ja tõlked] = В окно моего друга : [стихи и переводы] / Jaan Kross ja David Samoilov ; Tallinna Ülikool. Tallinn : Avenarius, 2015 ; David Samoilovi Pärnu : teejuht. Luuletusi. Tallinn : Avenarius, 2015

  13. David Benjamin Sherry摄影展在纽约举办

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009年9月10日至10月17日.摄影家David Benjamin Sherry摄影作品展在纽约Bellwether画廊举办。“我发誓.这里还有天赐的极品.美到极致,根本无法用言语形容。”这是摄影师David Benjamin Sherry最大的感慨。

  14. [Jaan Kross ja David Samoilov. Mu sõbra avatud akna all] / M. J.

    Index Scriptorium Estoniae

    Jõgi, Mall, 1947-

    2016-01-01

    Tutvustus: Kross, Jaan. Mu sõbra avatud akna all : [luuletused ja tõlked] = В окно моего друга : [стихи и переводы] / Jaan Kross ja David Samoilov ; Tallinna Ülikool. Tallinn : Avenarius, 2015 ; David Samoilovi Pärnu : teejuht. Luuletusi. Tallinn : Avenarius, 2015

  15. Antropología y colonialismo interno : David J. Guzman, entre poder supremo y capital

    OpenAIRE

    Lara Martinez, Rafael

    2010-01-01

    Introducción. David J. Guzmán y los Anales del Museo Nacional. Dinámica entre lo propio y lo ajeno. Etnicidad. Migración neocolonial. Conclusión. Bibliografía mínima de David J. Guzmán. En Kóot, enero 2010, año N°1, N°1, p. 11-22 Universidad Tecnológica de El Salvador

  16. [Jaan Kross ja David Samoilov. Mu sõbra avatud akna all] / M. J.

    Index Scriptorium Estoniae

    Jõgi, Mall, 1947-

    2016-01-01

    Tutvustus: Kross, Jaan. Mu sõbra avatud akna all : [luuletused ja tõlked] = В окно моего друга : [стихи и переводы] / Jaan Kross ja David Samoilov. Tallinn : Avenarius, 2015 ; David Samoilovi Pärnu : teejuht. Luuletusi. Tallinn : Avenarius, 2015

  17. Theory of Money of David Ricardo: Quantity Theory and Theory of Value

    Directory of Open Access Journals (Sweden)

    Susumu Takenaga

    2003-01-01

    Full Text Available En lo que es necesario enfatizar, al caracterizar la teoría cuantitativa de David Ricardo, es en que ésta es una teoría de determinación del valor del dinero en una situación particular en la cual se impide que el dinero, sin importar cual sea su forma, entre y salga libremente de la circulación. Para Ricardo, la regulación del valor del dinero por su cantidad es un caso particular en el cual el ajuste del precio de mercado al precio natural requiere un largo periodo de tiempo. La determinación cuantitativa es completamente inadmisible, pero solo cuando el período de observación es más corto que el de ajuste. En todo caso, la determinación del valor del dinero rara vez es vinculada a su teoría del valor de las mercancías. Contrario a la interpretación aceptada comúnmente, Ricardo no aplicó a la determinación del valor del dinero una teoría del valor distinta de aquélla aplicada a las mercancías en general.

  18. Human genomics and microarrays: implications for the plastic surgeon.

    Science.gov (United States)

    Cole, Jana; Isik, Frank

    2002-09-01

    The Human Genome Project was launched in 1989 in an effort to sequence the entire span of human DNA. Although coding sequences are important in identifying mutations, the static order of DNA does not explain how a cell or organism may respond to normal and abnormal biological processes. By examining the mRNA content of a cell, researchers can determine which genes are being activated in response to a stimulus. Traditional methods in molecular biology generally work on a "one gene: one experiment" basis, which means that the throughput is very limited and the "whole picture" of gene function is hard to obtain. To study each of the 60,000 to 80,000 genes in the human genome under each biological circumstance is not practical. Recently, microarrays (also known as gene or DNA chips) have emerged; these allow for the simultaneous determination of expression for thousands of genes and analysis of genome-wide mRNA expression. The purpose of this article is twofold: first, to provide the clinical plastic surgeon with a working knowledge and understanding of the fields of genomics, microarrays, and bioinformatics and second, to present a case to illustrate how these technologies can be applied in the study of wound healing.

  19. Resident surgeon efficiency in femtosecond laser-assisted cataract surgery

    Science.gov (United States)

    Pittner, Andrew C; Sullivan, Brian R

    2017-01-01

    Purpose Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. Patients and methods A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications. Review of digital video records provided quantitative interval measurements of core steps of the procedures, including completion of incisions, anterior capsulotomy, nucleus removal, cortical removal, and intraocular lens implantation. Results Total room time, operation time, and corneal incision completion time were found to be significantly longer in the femtosecond laser group versus the traditional phacoemulsification group (each Pcataract surgery is generally less efficient when trainees have more experience with traditional phacoemulsification. FLACS was found to have a significant advantage in completion of capsulotomy, but subsequent surgical steps were not shorter or longer. Resident learning curve for the FLACS technology may partially explain the disparities of performance. Educators should be cognizant of a potential for lower procedural efficiency when introducing FLACS into resident training. PMID:28203055

  20. Orthopedic surgeons' attitudes to osteoporosis investigation and management after minimal trauma fracture (MTF).

    Science.gov (United States)

    Anderson-Wurf, Jane; McGirr, Joe; Seal, Alexa; Harding, Catherine

    2017-12-01

    A study of orthopedic surgeons in rural and regional Southeast Australia to determine attitudes to investigation and management of osteoporosis found they believe follow-up in regard to osteoporosis after MTF is important; responsibility for follow-up diagnosis and management lies with primary health care and current communication systems are poor. The investigation and treatment of osteoporosis after minimal trauma fracture (MTF) is regarded as sub-optimal. There is strong evidence of the benefit of identifying and treating osteoporosis after MTF, and there has been discussion of the possible role that orthopedic surgeons might play in the management of osteoporosis after MTF. The study surveyed orthopedic surgeons in rural and regional Southeast Australia to determine their attitudes to investigation and management of osteoporosis, the role health professionals should play, and the communication and co-ordination of follow-up care. A survey was developed and piloted prior to being posted to 69 orthopedic surgeons asking for their opinions about the general management of osteoporosis, and the roles and responsibilities of health professionals in dealing with osteoporosis following an MTF. Responses were received from 42 participants (60.8%) with the majority of respondents agreeing that it is important to treat osteoporosis following MTF. Less than 15% of respondents felt that it was their responsibility to initiate discussion or treatment or investigation after MTF. No respondent felt that the coordination of osteoporosis care was good and 45% stated it was poor. Communication after discharge is mostly left to the hospital (30%), while 20% stated they did not follow up at all. This study shows that many rural orthopedic surgeons believe that follow-up in regard to osteoporosis after MTF is important, that responsibility for follow-up diagnosis and management of osteoporosis lies with primary health care and the current communication systems are poor.

  1. Review of Planning for uncertainty: living wills and other advance directives for you and your family, 2nd edition by David John Doukas, M.D., and William Reichel, M.D

    Directory of Open Access Journals (Sweden)

    Bernal Ellen W

    2008-05-01

    Full Text Available Abstract Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

  2. Skeletal metastases - the role of the orthopaedic and spinal surgeon.

    Science.gov (United States)

    Eastley, Nicholas; Newey, Martyn; Ashford, Robert U

    2012-09-01

    Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots. Several key principals should be adhered to whenever operating on skeletal metastases. Discussions should be held early with an appropriate multi-disciplinary team prior to intervention. Detailed pre-assessment is essential to gauge a patient's suitability for surgery - recovery from elective surgery must be shorter than the anticipated survival. Staging and biopsies provide prognostic information. Primary bone tumours must be ruled out in the case of a solitary bone lesion to avoid inappropriate intervention. Prophylactic surgical fixation of a lesion prior to a pathological fracture reduces morbidity and length of hospital stay. Regardless of a lesion or pathological fracture's location, all regions of the affected bone must be addressed, to reduce the risk of subsequent fracture. Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be utilised in all cases to minimise disease progression. Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological compromise. The opinion of a spinal surgeon should be sought early, as delays in referral directly correlate to worse functional recovery following intervention

  3. EDITORIAL: Van der Waals interactions in advanced materials, in memory of David C Langreth Van der Waals interactions in advanced materials, in memory of David C Langreth

    Science.gov (United States)

    Hyldgaard, Per; Rahman, Talat S.

    2012-10-01

    sufficiently close to any corrugated—and/or any smooth—surface and thus enforce a strong vdW-type adhesion; it exploits what is then essentially a contact force (dominated by the attraction exerted in the near-surface regions) to defy the pull of gravity on its own bulk. This Journal of Physics: Condensed Matter special issue is dedicated to the memory of David C Langreth. David is a dearly missed friend and mentor who inspired many of us. He was an outstanding condensed matter theorist and a scholar who greatly influenced us through his many-particle-physics based insights into density functional theory (DFT), surface science and related areas. His seminal works range from conserving formulations of interacting nonequilibrium transport [1] and formal-scattering theory [2] to an explicit formulation [3] of the exact DFT exchange-correlation energy in the adiabatic connection formula (ACF), the latter also being derived independently by Gunnarsson and Lundqvist [4]. David's portfolio also includes an analysis [5] that helped catalyze and guide the development of DFT from the local-density approximation (LDA) to the formulations of generalized gradient approximations (GGAs). Another salient contribution of David's is in the area of vdW interactions in materials. He was a key architect of the vdW density functional (vdW-DF) method [6, 7]. This method was developed in a long-standing Rutgers-Chalmers collaboration between David's group and that of Bengt I Lundqvist, later extending to a wider group of researchers on both sides of the Atlantic. Plasmons are collective excitations that depend on electron-density variation. The plasmon response can be seen as defining the nature of the LDA [4] and their description can thus also be seen as contributing to the success of GGA. The vdW-DF method is a regular constraint-based density functional (for ground-state DFT) which is derived within the ACF framework and which emphasizes the electrodynamical nature of the coupling between

  4. The effects of surgeons and anesthesiologists on operating room efficiency

    Directory of Open Access Journals (Sweden)

    Nessa Timoney

    2016-09-01

    Conclusion: In some procedures types a significant part of the variability in operative time is due to the interaction between the surgeon and anesthesiologist. Reviewing operative records should allow identification of efficient/inefficient combinations.

  5. Concussion in Sports: What Do Orthopaedic Surgeons Need to Know?

    Science.gov (United States)

    Cahill, Patrick J; Refakis, Christian; Storey, Eileen; Warner, William C

    2016-12-01

    A concussion is a relatively common sports-related injury that affects athletes of all ages. Although orthopaedic surgeons are not expected to replace sports medicine physicians and neurologists with regard to the management of concussions, orthopaedic surgeons, particularly those who are fellowship-trained in sports medicine, must have a current knowledge base of what a concussion is, how a concussion is diagnosed, and how a concussion should be managed. Orthopaedic surgeons should understand the pathophysiology, assessment, and management of concussion so that they have a basic comprehension of this injury, which is at the forefront of the academic literature and North American media. This understanding will prepare orthopaedic surgeons to work in concert with and assist sports medicine physicians, athletic trainers, and physical therapists in providing comprehensive care for athletes with a concussion.

  6. A Methodological Critique of the ProPublica Surgeon Scorecard.

    Science.gov (United States)

    Friedberg, Mark W; Pronovost, Peter J; Shahian, David M; Safran, Dana Gelb; Bilimoria, Karl Y; Elliott, Marc N; Damberg, Cheryl L; Dimick, Justin B; Zaslavsky, Alan M

    2016-05-09

    On July 14, 2015, ProPublica published its Surgeon Scorecard, which displays "Adjusted Complication Rates" for individual, named surgeons for eight surgical procedures performed in hospitals. Public reports of provider performance have the potential to improve the quality of health care that patients receive. A valid performance report can drive quality improvement and usefully inform patients' choices of providers. However, performance reports with poor validity and reliability are potentially damaging to all involved. This article critiques the methods underlying the Scorecard and identifies opportunities for improvement. Until these opportunities are addressed, the authors advise users of the Scorecard-most notably, patients who might be choosing their surgeons-not to consider the Scorecard a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide. The authors hope that this methodological critique will contribute to the development of more-valid and more-reliable performance reports in the future.

  7. [Andreas Vesalius, distinguished surgeon of the 16th century].

    Science.gov (United States)

    Van Hee, R

    1996-01-01

    The author gives here some considerations about A. Vesalius through his life and his works as a surgeon. He was the father of the anatomical revolution against Galen but was also an eminent clinician and surgeon. He was immediately able to adapt his surgical practice whenever the promising methodology was identified (see Consilia). The author concludes with a critical analysis of the Chirurgia magna in septem libros digesta attributed to A. Vesalius.

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

    Science.gov (United States)

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

    2017-06-29

    Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs. Descriptive and univariate analyses were performed. A total of 126 surgeons responded from all 5 regions of the United States. Although 76.9% believed new products advance technology in orthopedics, most (66.7%) supported informing patients that new implants lack long-term clinical data and restricting new implants to a small number of investigators prior to widespread market launch. The survey revealed that 66.7% would forgo gain-sharing incentives in exchange for more freedom to choose implants. Further, 76.9% believed that patients should be allowed to pay incremental costs for "premium" implants. Surgeons who believed that premium products advance orthopedic technology were more willing to forgo gain-sharing (P=.040). Surgeons with higher surgical volume (P=.007), those who believed implant companies should be allowed to charge more for new technology (Pinnovation advances the field but support discussing the "unproven" nature of new implants with patients. Many surgeons support alternative payment models permitting surgeons and patients to retain implant selection autonomy. Most respondents prioritized patient beneficence and surgeon autonomy above personal financial gain. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2017, SLACK Incorporated.

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

    Directory of Open Access Journals (Sweden)

    Massimiliano Orri

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

  10. How do Orthopedic Surgeons Address Psychological Aspects of Illness?

    Directory of Open Access Journals (Sweden)

    Ana-Maria Vranceanu

    2017-01-01

    Full Text Available Background: Orthopaedic surgeons have a pivotal role in transitioning the care of orthopedic patients from a biomedical to a biopsychosocial model. In an effort to foster this transition, we designed a study aimed to determine surgeons’ attitudes and practice of noticing, screening, discussing psychological illness with patients, as well as making referrals to address psychosocial issues in patients in need. Additionally, we asked surgeons to rank order potential barriers to and reasons for referrals to psychosocial treatment.   Methods: Orthopaedic surgeons members of the Science and Variation Group and Ankle Platform (N =350 completed demographics, and a 4-part survey assessing the degree to which surgeons notice, assess, screen and refer for psychological treatments, as well ranked ordered barriers to engaging in these processes. Results: As a group surgeons were neutral to referral for psychological treatment and formal screening of psychological factors, and somewhat likely to notice and discuss psychological factors. Surgeons were more likely to refer for psychological treatment if they engaged in research, or if they reside in South America as opposed to North America. The highest ranked barriers to screening, noticing, discussing and referring for psychological treatment were lack of time, stigma and feeling uncomfortable. Conclusion: Overall surgeons are likely to notice and discuss psychological factors, but less likely to formally screen or refer for psychological treatment. Transition to biopsychosocial models should focus on problem solving these barriers by teaching surgeons communication skills to increase comfort with discussing psychoemotional factors associated with orthopedic problems. The use of empathic communication can be very helpful in normalizing the difficulty of coping with an orthopedic condition, and may facilitate referral.

  11. The surgeon and self-harm: at the cutting edge.

    Science.gov (United States)

    Kinahan, James C; MacHale, Siobhan

    2014-12-01

    Surgeons frequently treat the consequences of self-harm. Self-harm is a common problem and presentations to Irish hospitals are increasing. It increases the risk of suicide and is associated with long term morbidity. Appropriate management can improve the prognosis. Surgeons require a number of skills to appropriately manage patients who self-harm. In this review we outline those skills including diagnosis, communication, capacity and risk assessment.

  12. Surgeon commitment to trauma care decreases missed injuries.

    Science.gov (United States)

    Lin, Yen-Ko; Lin, Chia-Ju; Chan, Hon-Man; Lee, Wei-Che; Chen, Chao-Wen; Lin, Hsing-Lin; Kuo, Liang-Chi; Cheng, Yuan-Chia

    2014-01-01

    Missed injuries sustain an important issue concerning patient safety and quality of care. The purpose of this study is to examine the effect of surgeon commitment to trauma care on missed injuries. We hypothesised that surgeons committed to the trauma service has less missed injuries than surgeons not committed to the trauma service would have. By retrospective analysis of 976 adult patients admitted to the trauma intensive care unit (ICU) at an urban, university-based trauma centre. Missed injuries were compared between two groups; in group 1 the patients were evaluated and treated by the surgeons who were committed to the trauma service and in group 2 the patients were evaluated and treated by surgeons practicing mainly in other specialties. Patients had significantly lower rates of missed major or life-threatening injuries when treated by group 1 surgeons. Logistic regression model revealed significant factors associated with missed major or life-threatening injuries including ISS and groups in which patients were treated by different group surgeons. Physicians will perform better when they are trained and interested in a specific area than those not trained, or even not having any particular interest in that specific area. Surgeons committed to the trauma service had less missed injuries in severely injured patients, and it is vital to improve patient safety and quality of care for trauma patients. Staff training and education for assessing severely injured patients and creating an open culture with detection and reduction of the potential for error are important and effective strategies in decreasing missed injuries and improving patient safety. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Motivado por cirujanos Motivated by Surgeons

    Directory of Open Access Journals (Sweden)

    Carlos Salazar-Vargas

    2010-12-01

    interrogate and to examine those individuals, and every gesture, every question, every maneuver they did, was jealously kept in our minds. However even at an early stage, we clearly perceived, the differences between medical branches and practitioners, and involuntarily, every one was leaning towards this or that specialty. It was during those years when 7 wonderful persons and excellent surgeons, crossed the path of my life, inspiring me to follow their steps and to embrace a surgical career. Two were classic academicians, Dr. Manuel Aguilar Bonilla and Dr. Andres Vesalio Guzman Calleja, 3 were determined, tireless and highly skilled, Dr. Longino Soto Pacheco, Dr. Claudio Orlich Carranza, y el Dr. Carlos Prada Diaz, and 2 were, although well prepared, unassuming, practical and openly friendly, Dr. Fernando Valverde Soley y el Dr. Randall Ferris Iglesias....

  14. A model of disruptive surgeon behavior in the perioperative environment.

    Science.gov (United States)

    Cochran, Amalia; Elder, William B

    2014-09-01

    Surgeons are the physicians with the highest rates of documented disruptive behavior. We hypothesized that a unified conceptual model of disruptive surgeon behavior could be developed based on specific individual and system factors in the perioperative environment. Semi-structured interviews were conducted with 19 operating room staff of diverse occupations at a single institution. Interviews were analyzed using grounded theory methods. Participants described episodes of disruptive surgeon behavior, personality traits of perpetrators, environmental conditions of power, and situations when disruptive behavior was demonstrated. Verbal hostility and throwing or hitting objects were the most commonly described disruptive behaviors. Participants indicated that surgical training attracts and creates individuals with particular personality traits, including a sense of shame. Interviewees stated this behavior is tolerated because surgeons have unchecked power, have strong money-making capabilities for the institution, and tend to direct disruptive behavior toward the least powerful employees. The most frequent situational stressors were when something went wrong during an operation and working with unfamiliar team members. Each factor group (ie, situational stressors, cultural conditions, and personality factors) was viewed as being necessary, but none of them alone were sufficient to catalyze disruptive behavior events. Disruptive physician behavior has strong implications for the work environment and patient safety. This model can be used by hospitals to better conceptualize conditions that facilitate disruptive surgeon behavior and to establish programs to mitigate conduct that threatens patient safety and employee satisfaction. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. A national study of burnout among American transplant surgeons.

    Science.gov (United States)

    Bertges Yost, W; Eshelman, A; Raoufi, M; Abouljoud, M S

    2005-03-01

    This study examines burnout in a national sample of transplant surgeons. Data analyses were conducted on a sample of 209 actively practicing transplant surgeons. Measures included the Maslach Burnout Inventory, a demographic survey, and the Surgeon Coping Inventory. Burnout was reflected in 38% of surgeons scoring high on the Emotional Exhaustion dimension, whereas 27% showed high levels of Depersonalization, and 16% had low levels of Personal Accomplishment. Several significant predictors of emotional exhaustion were identified and included questioning one's career choice, giving up activities, and perceiving oneself as having limited control over the delivery of medical services (R2= 0.43). Those who perceived themselves as having a higher ability to control delivery of medical services and who felt more appreciated by patients had lower levels of depersonalization and were less likely to question their career choice (R2= 0.16). Surgeons with high personal accomplishment experienced greater professional growth opportunities, perceived their institution as supportive, felt more appreciated by patients, and were less likely to question their career (R2= 0.24). The prioritization of goals to reflect both professional and personal values accounted for a significant amount of the variance in predicting both emotional exhaustion and personal accomplishment in separate regression equations. Recommendations to decrease burnout would include greater institutional support, increased opportunities for professional growth, and greater surgeon control over important services to facilitate efficient work. Coping strategies to moderate stress and burnout are also beneficial and should include prioritizing goals to reflect both professional and personal values.

  16. Depth Perception of Surgeons in Minimally Invasive Surgery.

    Science.gov (United States)

    Bogdanova, Rositsa; Boulanger, Pierre; Zheng, Bin

    2016-10-01

    Minimally invasive surgery (MIS) poses visual challenges to the surgeons. In MIS, binocular disparity is not freely available for surgeons, who are required to mentally rebuild the 3-dimensional (3D) patient anatomy from a limited number of monoscopic visual cues. The insufficient depth cues from the MIS environment could cause surgeons to misjudge spatial depth, which could lead to performance errors thus jeopardizing patient safety. In this article, we will first discuss the natural human depth perception by exploring the main depth cues available for surgeons in open procedures. Subsequently, we will reveal what depth cues are lost in MIS and how surgeons compensate for the incomplete depth presentation. Next, we will further expand our knowledge by exploring some of the available solutions for improving depth presentation to surgeons. Here we will review the innovative approaches (multiple 2D camera assembly, shadow introduction) and devices (3D monitors, head-mounted devices, and auto-stereoscopic monitors) for 3D image presentation from the past few years.

  17. A change in opinion on surgeon's performance indicators.

    Science.gov (United States)

    Maytham, Gary; Kessaris, Nicos

    2011-04-01

    Individual performance indicators for cardiac surgeons in the UK were published in 2004. A comprehensive update published in 2009 reported statistically significant decreases in mortality rates suggesting that the publication of this data may have contributed to this improvement in outcomes. In view of this, the authors present an assessment of the attitudes of cardiac surgeons to individual performance tables, having performed this by sending questionnaires exploring the surgeon's views on performance tables to UK cardiac surgeons in 2005 and 2009. The responses demonstrated that whilst the majority of cardiac surgeons (68.8%) were initially opposed to performance tables, the number welcoming their introduction increased significantly (22.9-48.5%) over the four-year period. The attitude of the consultants towards the possible effect of this data on the management of high-risk patients also changed, with fewer consultants believing they would (P=0.0001) or may (P=0.023) avoid these patients. The observed change in attitude of cardiac surgeons may be due to acclimatization to an established system of audit, improved mortality rates, a desire for more transparency following the Bristol Enquiry, or improved risk stratification. These findings may be of benefit to those tasked with initiating these indicators elsewhere.

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

    Science.gov (United States)

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

    2015-02-01

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

  19. Isn't it time to start speaking about "European surgeons"?

    Directory of Open Access Journals (Sweden)

    Lazzareschi Daniel

    2009-07-01

    Full Text Available Abstract Background Emergency surgery has become a neglected specialization in Europe and in many other parts of the world. In certain medical fields, emergency surgery isn't even considered an autonomous specialization. However every emergency surgeon must have a good formation in General Surgery but exist huge disparities between different European surgical formative systems. Methods An analysis of the main problems of the European surgical formative system was conducted. Results This discrepancy between formative systems is absolutely unacceptable and presents a notable hazard for the European Union, considering that surgical certifications are reciprocally recognized between programs within all European Union states. Conclusion Considering the increasing possibilities to move inside the European Union, is necessary to improve the European surgical formative system to warrant an uniform formation for all surgeons.

  20. Quality of Life of Indian Pediatric Surgeons: Results of a Survey (of Indian Association of Pediatric Surgeons Members)

    Science.gov (United States)

    Zameer, M. M.; Rao, Sanjay; Vinay, C.; D’Cruz, Ashley

    2017-01-01

    Introduction: Much is debated on the quality of life of pediatric surgeons practicing in India, all based on anecdotal and personal experiences. There is no systematic study on this. This study addresses this and attempts to glean a clearer picture of the life as a pediatric surgeon in India. Methodology: This questionnaire-based study was administered via an online survey to all Indian Association of Pediatric Surgeons members. The responses were anonymous and investigators blinded. Data were collated and analyzed using STAT11.1. Results: A total of 173 pediatric surgeons responded. Eighty-six percent were men. About 73.7% of the surgeons were between 31 and 50 years of age. Almost 63.4% practiced in urban areas, whereas 36% in other smaller towns. About 0.6% reported that their practice was rural. Almost 26.4% were in private/solo practices, whereas 53.4% were in institution-based practice. Almost 80% felt that they were adequately trained while starting their practice. About 78% are professionally satisfied with their work. Only 44.5% of surgeons felt that they were compensated adequately financially. Reading was the favorite pass time. Almost 40% of the surgeons felt that they were either overweight or obese. About 41% of the surgeons exercise more than 3 times a week. Only 11.4% smoke, whereas 36% drink. Fifty-three percent of surgeons felt that their personal savings were adequate. Seventy-six percent use Facebook. Sixty-eight percent were satisfied with their quality of life. Age was significantly associated with professional satisfaction, financial satisfaction, and quality of life and all improve as one's age progresses. None were affected with one's gender, type of practice, and the place of practice. Age, weight, exercise, and one's savings significantly affected ones quality of life. Conclusion: This is the first study which objectively highlights that most surgeons are happy professionally and financially in due course of time and demolishes the common

  1. Heparin and Lovenox: What the Oral and Maxillofacial Surgeon Needs to Know.

    Science.gov (United States)

    Pasquale, LisaMarie Di; Ferneini, Elie M

    2016-11-01

    For the oral and maxillofacial surgeon, many patients will be on heparin products during surgery. So far, there is no standardized approach to treating anticoagulated patients during oral and maxillofacial surgical procedures. When a patient is on heparin therapy, heparin may be stopped 4 to 6 hours before surgery and resumed once hemostasis is achieved, usually within 24 hours. If low-molecular-weight heparin is administered, the treatment is generally stopped at least 12 hours before surgery and then resumed in a similar fashion. Local measures are generally enough to provide adequate hemostasis. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Are shoulder surgeons any good at diagnosing rotator cuff tears using ultrasound?: A comparative analysis of surgeon vs radiologist

    Directory of Open Access Journals (Sweden)

    Jeyam Muthu

    2008-01-01

    Full Text Available High-resolution ultrasound has gained increasing popularity as an aid in the diagnosis of rotator cuff pathology. With the advent of portable machines, ultrasound has become accessible to clinicians. Aim: This study was conducted to evaluate the accuracy and reliability of ultrasound in diagnosing rotator cuff tears by a shoulder surgeon and comparing their ability to that of a musculoskeletal radiologist. Materials and Methods: Seventy patients undergoing shoulder arthroscopy for rotator cuff pathology underwent preoperative ultrasonography (US. All patients were of similar demographics and pathology. The surgeon used a Sonosite Micromax portable ultrasound machine with a 10-MHz high frequency linear array transducer and the radiologist used a 9-12 MHz linear array probe on a Siemens Antares machine. Arthroscopic diagnosis was the reference standard to which ultrasound findings were compared. Results: The sensitivity in detecting full thickness tears was similar for both the surgeon (92% and the radiologist (94%. The radiologist had 100% sensitivity in diagnosing partial thickness tears, compared to 85.7% for the surgeon. The specificity for the surgeon was 94% and 85% for the radiologist. Discussion: Our study shows that the surgeons are capable of diagnosing rotator cuff tears with the use of high-resolution portable ultrasound in the outpatient setting. Conclusion: Office ultrasound, by a trained clinician, is a powerful diagnostic tool in diagnosing rotator cuff tears and can be used effectively in running one-stop shoulder clinics.

  3. Musculoskeletal disorders among robotic surgeons: A questionnaire analysis

    Directory of Open Access Journals (Sweden)

    Claudio Giberti

    2014-06-01

    Full Text Available Objective: Robotic surgical systems offer better workplace in order to relieve surgeons from prolonged physical efforts and improve their surgical outcomes. However, robotic surgery could produce musculoskeletal disorders due to the prolonged sitting position of the operator, the fixed position of the console viewer and the movements of the limbs. Until today, no one study has been reported concerning the association between robotics and musculoskeletal pain. The aim of this work was verify the prevalence of musculoskeletal disorders among Italian robotic surgeons. Material and methods: Between July 2011 and April 2012 a modified Standardized Nordic Questionnaire was delivered to thirty-nine Italian robotic centres. Twentytwo surgeons (56% returned the questionnaires but only seventeen questionnaires (43.5% were evaluable. Results: Seven surgeons (41.2% reported musculoskeletal disorders, by since their first use of the robot which significantly persisted during the daily surgical activity (P < 0.001. Regarding the body parts affected, musculoskeletal disorders were mainly reported in the cervical spine (29.4% and in the upper limbs (23.5%. Six surgeons (35.3% defined the robotic console as less comfortable or neither comfortable/uncomfortable with a negative influence on their surgical procedures. Conclusions: In spite of some important limitations, our data showed musculoskeletal disorders due to posture discomfort with negative impact on daily surgical activity among robotic surgeons. These aspects could be due to the lack of ergonomic seat and to the fixed position of the console viewer which could have produced an inadequate spinal posture. The evaluation of these postural factors, in particular the development of an integrated and more ergonomic chair, could further improve the comfort feeling of the surgeon at the console and probably his surgical outcomes.

  4. Remedial investigation/feasibility study for the David Witherspoon, Inc., 901 Site, Knoxville, Tennessee: Volume 2, Appendixes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This document contains the appendixes for the remedial investigation and feasibility study for the David Witherspoon, Inc., 901 site in Knoxville, Tennessee. The following topics are covered in the appendixes: (A) David Witherspoon, Inc., 901 Site Historical Data, (B) Fieldwork Plans for the David Witherspoon, Inc., 901 Site, (C) Risk Assessment, (D) Remediation Technology Discussion, (E) Engineering Support Documentation, (F) Applicable or Relevant and Appropriate Requirements, and (G) Cost Estimate Documentation.

  5. The Danish Fracture Database can monitor quality of fracture-related surgery, surgeons' experience level and extent of supervision

    DEFF Research Database (Denmark)

    Andersen, Morten Jon; Gromov, Kirill; Brix, Michael

    2014-01-01

    INTRODUCTION: The importance of supervision and of surgeons' level of experience in relation to patient outcome have been demonstrated in both hip fracture and arthroplasty surgery. The aim of this study was to describe the surgeons' experience level and the extent of supervision for: 1) fracture......-related surgery in general; 2) the three most frequent primary operations and reoperations; and 3) primary operations during and outside regular working hours. MATERIAL AND METHODS: A total of 9,767 surgical procedures were identified from the Danish Fracture Database (DFDB). Procedures were grouped based...... on the surgeons' level of experience, extent of supervision, type (primary, planned secondary or reoperation), classification (AO Müller), and whether they were performed during or outside regular hours. RESULTS: Interns and junior residents combined performed 46% of all procedures. A total of 90% of surgeries...

  6. The Danish Fracture Database can monitor quality of fracture-related surgery, surgeons' experience level and extent of supervision

    DEFF Research Database (Denmark)

    Andersen, M. J.; Gromov, K.; Brix, M.

    2014-01-01

    INTRODUCTION: The importance of supervision and of surgeons' level of experience in relation to patient outcome have been demonstrated in both hip fracture and arthroplasty surgery. The aim of this study was to describe the surgeons' experience level and the extent of supervision for: 1) fracture......-related surgery in general; 2) the three most frequent primary operations and reoperations; and 3) primary operations during and outside regular working hours. MATERIAL AND METHODS: A total of 9,767 surgical procedures were identified from the Danish Fracture Database (DFDB). Procedures were grouped based...... on the surgeons' level of experience, extent of supervision, type (primary, planned secondary or reoperation), classification (AO Muller), and whether they were performed during or outside regular hours. RESULTS: Interns and junior residents combined performed 46% of all procedures. A total of 90% of surgeries...

  7. Up Close and Personal: A Statewide Collaborative's Effort to Get Individual Surgeon Quality Improvement Data to the Practitioner.

    Science.gov (United States)

    Daley, Brian J; Cecil, William; Cofer, Joseph B; Clarke, P Chris; Guillamondegui, Oscar

    2016-03-01

    Ranking of surgeons and hospitals focuses on procedure volume and hospitality. The National Surgical Quality Improvement Program provides vetted outcomes of surgical quality and therefore can direct improvement. Our statewide collaborative's analysis creates personalized surgeon data to drive quality improvement. Statewide National Surgical Quality Improvement Program data generated specific measures from 103,656 general/vascular cases and identified individual surgeon's outcome of occurrences and length of procedure. We assumed a normal distribution and called the top 2.5 per cent as exemplars and the bottom 2.5 per cent as outliers. For length of operation, a standard duration was calculated, and identified outliers as longer than the 95th percentile of the upper confidence interval/procedure. Since 2009, sharing best practice reduced statewide mortality rate by 31.5 per cent and postoperative morbidity by 33.3 per cent. For length of surgery, long outliers have more complications (urinary tract infection, organ space/surgical site infection, sepsis, septic shock, prolonged intubation, pneumonia, deep venous thrombosis, deep incisional infection, and wound disruption). No significant trends in surgeon performance were seen over 24 months. A statewide collaborative has resulted in substantial risk-adjusted reductions in surgical morbidity and mortality. These results of the individual surgeon demonstrate best practices are shared, a proven tool for improvement in our collaborative.

  8. The Multi-wire Ionization Chamber (DAVID)'s Influence on the Beams of Accelerator%多丝电离室(DAVID)系统对加速器射束的影响

    Institute of Scientific and Technical Information of China (English)

    徐慧军; 李玉; 张素静; 韩萍; 张军华

    2013-01-01

    Abjective: Through measuring the parameters of the accelerator beams under two conditions of uninstalled and installed DAVID system,to analyze DAVID system's influence on the beams. Methods: We chosed the Siemens ARTISTE Linear Accelerator which was allocated with a 160 MLC multi-leaf collimator, and the 6 MV X-ray was used. The model number of the multi-wire ionization chamber was T34084. Utilizing the equipments like 3D water tank and semiconductor detector to measure PDD, profile, TPR2010 and the absorbed dose underwater 5 cm under the conditions of uninstalled and installed DAVID system, we analyzed DAVID system's influence on the PDD, flatness, symmetry and actinogen of accelerator beams, and calculated the attenuation coefficient of DAVID system. Results: Under the two conditions of uninstalled and installed DAVID system, the R100 deviation of the three fields (5 cm×5 cm 、10 cm×10 cm and 20 cm×20 cm) lay between 0.6 mm ~1.3 mm, R80 deviation of them lay between 0.13 mm~0.66 mm, and R50 deviation lay between 0.38 mm~1.12 mm. The R100, R80, and R50 deviation of the fields of 40 cmx40 cm were 3.12 mm, 3.31 mm and 2.04 mm; The QI deviations were 0.0020, 0.0045, 0.0101, and 0.0061; The flatness deviation in the x and y direction was between 0.10%~0.58%; The symmetry deviation lay between 0.04%~0.26%; And the TPR2010 deviation was 0.002. The beams went across DAVID system and attenuated 7.67% of the dose. Conclusions: The comprehensive structure and making materials of DAVID system have little effect on the PDD, symmetry, flatness, and TPR2010 of the 6 MV X-ray beams, but the beams attenuate the dose when going across DAVID system.%目的:通过测量未安装和已安装DAVID系统两种情况下加速器射束的参数,分析DAVID系统对射束的影响.方法:西门子ARTISTE直线加速器,配备160叶多叶光栅,选择6 MV的X线.多丝电离室(DAVID),型号为T34084.利用三维水箱、半导体探测器等仪器测量未安装和已安

  9. Does the surgeon still have a role to play in the diagnosis and management of lymphomas?

    Directory of Open Access Journals (Sweden)

    Verghese Anju

    2008-02-01

    Full Text Available Abstract Background Over the course of the past 40 years, there have been a significant number of changes in the way in which lymphomatous disease is diagnosed and managed. With the advent of computed tomography, there is little role for staging laparotomy and the surgeon's role may now more diagnostic than therapeutic. Aims To review all cases of lymphoma diagnosed at a single institution in order determine the current role of the surgeon in the diagnosis and management of lymphoma. Patients and methods Computerized pathology records were reviewed for a five-year period 1996 to 2000 to determine all cases of lymph node biopsy (incisional or excisional in which tissue was obtained as part of a planned procedure. Cases of incidental lymphadenopathy were thus excluded. Results A total of 297 biopsies were performed of which 62 (21% yielded lymphomas. There were 22 females and 40 males with a median age of 58 years (range: 19–84 years. The lymphomas were classified as 80% non-Hodgkin's lymphoma, 18% Hodgkin's lymphoma and 2% post-transplant lymphoproliferative disorder. Diagnosis was established by general surgeons (n = 48, ENT surgeons (n = 9, radiologists (n = 4 and ophthalmic surgeons (n = 1. The distribution of excised lymph nodes was: cervical (n = 23, inguinal (n = 15, axillary (n = 11, intra-abdominal (n = 6, submandibular (n = 2, supraclavicular (n = 2, periorbital (n = 1, parotid (n = 1 and mediastinal (n = 1. Fine needle aspiration cytology had been performed prior to biopsy in only 32 (52% cases and had suggested: lymphoma (n = 10, reactive changes (n = 13, normal (n = 5, inadequate (n = 4. The majority (78% of cervical lymph nodes were subjected to FNAC prior to biopsy whilst this was performed in only 36% of non-cervical lymphadenopathy. Conclusion The study has shown that lymphoma is a relatively common cause of surgical lymphadenopathy. Given the limitations of FNAC, all suspicious lymph nodes should be biopsied following FNAC even

  10. Pectus excavatum repair from a plastic surgeon's perspective.

    Science.gov (United States)

    Schwabegger, Anton H

    2016-09-01

    Minimally invasive repair of pectus excavatum (MIRPE) or similar procedures for pectus excavatum (PE) repair, nowadays no longer performed by one single speciality, may not always achieve sufficient aesthetic results, particularly in the infrapectoral or infraxiphoidal region. Reasons for this include the diaphragm inhibiting correct positioning of the bars, as well as asymmetric deformities which may still be present after remodelling attempts. Furthermore, some cases develop a mild recurrence or partial concavity once the correction bar is removed. However, any secondary re-do MIRPE procedure remains risky because of adhesions between the pleura, lung, pericardium, thoracic wall as residuals from the primary intervention. Treatment options as secondary correction for these deformities may include open access surgery, resection or reshaping of deformed costal cartilage. Moreover, augmentation of a residual concave area can be achieved by autologous transplantation of resected over-abundant cartilage, as well as by liposhifting or implantation of customized alloplastics. A physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques in order to provide the best options for a variety of expressions of anterior wall deformities. Among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. An appropriate technique, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be selected carefully based on the heterogeneity of symptoms, severity, expectations and surgical skill in addition to the available equipment. Out of a variety of such ancillary procedures available and based on experience within general plastic reconstructive surgery, some techniques for PE repair are explained and illustrated here with their advantages and disadvantages.

  11. Resident surgeon efficiency in femtosecond laser-assisted cataract surgery

    Directory of Open Access Journals (Sweden)

    Pittner AC

    2017-01-01

    Full Text Available Andrew C Pittner,1 Brian R Sullivan2 1Department of Ophthalmology, Stritch School of Medicine, Loyola University Chicago, Maywood, 2Edward Hines Jr VA Hospital, Ophthalmology Section, Hines, IL, USA Purpose: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS versus conventional phacoemulsification.Patients and methods: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications. Review of digital video records provided quantitative interval measurements of core steps of the procedures, including completion of incisions, anterior capsulotomy, nucleus removal, cortical removal, and intraocular lens implantation.Results: Total room time, operation time, and corneal incision completion time were found to be significantly longer in the femtosecond laser group versus the traditional phacoemulsification group (each P<0.05. Mean duration for manual completion of anterior capsulotomy was shorter in the laser group (P<0.001. There were no statistically significant differences in the individual steps of nucleus removal, cortical removal, or intraocular lens placement. Surgical complication rates were not significantly different between the groups.Conclusion: In early cases, resident completion of femtosecond cataract surgery is generally less efficient when trainees have more experience with traditional phacoemulsification. FLACS was found to have a significant advantage in completion of capsulotomy, but subsequent surgical steps were not shorter or longer. Resident learning curve for the

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

    Science.gov (United States)

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

    2016-12-01

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

  13. [Physicians and surgeons during the inquisition in new Spain].

    Science.gov (United States)

    de Micheli-Serra, Alfredo

    2003-01-01

    The origins of New Spain Inquisition whose jurisdiction extended also to Philippine Islands, are related herein. Physicians and surgeons who worked as Inquisition officers are discussed, from the first Dr. Juan de la Fuente who was appointed on May 9, 1572, to Dr. Pedro del Castillo, appointed on September 24, 1644. Likewise, physicians and surgeons judged by the Holy Office are mentioned. During the XVI century, those judged were few and insignificant personages, the first was the Irish Protestant William Corniels a barber surgeon, who arrived with the John Hawkins' pirate fleet in 1568 and settled in Guatemala. Some physicians and surgeons were judged as "Judaizers" during the first half of the XVII century. Many physicians and surgeons were prosecuted in Mexico, as well as in the Philippine Islands, in the second half of the XVIII century because they were Freemasons or supporters of French Revolution ideology. Among those was the unfortunate Dr. Enrique Esteban Morel, who introduced into Mexico the method of antivariolar inoculation at the time of the great epidemic out-break of 1779. It should be a gesture of justice to build a memorial in the ancient Inquisition Palace to honor this Public Health's worthy physician.

  14. Effects of disruptive surgeon behavior in the operating room.

    Science.gov (United States)

    Cochran, Amalia; Elder, William B

    2015-01-01

    Surgeons are the physician group most commonly identified as "disruptive physicians." The aim of this study was to develop a conceptual model of the results of disruptive surgeon behavior and to identify the coping strategies used by perioperative staff. Perspectives of 19 individuals of diverse occupations in the perioperative setting were drawn together using a grounded theory methodology. Effects of disruptive behavior described by participants included shift in attention from the patient to the surgeon, increased mistakes during procedures, deterrence from careers in surgery, and diminished respect for surgeons. Individual coping strategies employed in the face of intimidation include talking to colleagues, externalizing the behavior, avoidance of perpetrators, and warning others. Using grounded theory analysis, we were able to elucidate the impact of disruptive surgeon behavior in the perioperative environment. This conceptual model may be used to understand and counter the negative effects of manipulation and intimidation of hospital staff and trainees and to build on current programmatic strengths to improve surgical environments and training. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Treating Wisely: The Surgeon's Role in Antibiotic Stewardship.

    Science.gov (United States)

    Leeds, Ira L; Fabrizio, Anne; Cosgrove, Sara E; Wick, Elizabeth C

    2016-10-04

    Antibiotic resistance continues to receive national attention as a leading public health threat. In 2015, President Barack Obama proposed a National Action Plan to Combat Antibiotic-Resistant Bacteria to curb the rise of "superbugs," bacteria resistant to antibiotics of last resort. Whereas many antibiotics are prescribed appropriately to treat infections, there continue to be a large number of inappropriately prescribed antibiotics. Although much of the national attention with regards to stewardship has focused on primary care providers, there is a significant opportunity for surgeons to embrace this national imperative and improve our practices. Local quality improvement efforts suggest that antibiotic misuse for surgical disease is common. Opportunities exist as part of day-to-day surgical care as well as through surgeons' interactions with nonsurgeon colleagues and policy experts. This article discusses the scope of the antibiotic misuse in surgery for surgical patients, and provides immediate practice improvements and also advocacy efforts surgeons can take to address the threat. We believe that surgical antibiotic prescribing patterns frequently do not adhere to evidence-based practices; surgeons are in a position to mitigate their ill effects; and antibiotic stewardship should be a part of every surgeons' practice.

  16. Musculoskeletal pain among surgeons performing minimally invasive surgery

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  17. Oncofertility Knowledge, Attitudes, and Practices of Canadian Breast Surgeons.

    Science.gov (United States)

    Warner, Ellen; Yee, Samantha; Kennedy, Erin; Glass, Karen; Foong, Shu; Seminsky, Maureen; Quan, May Lynn

    2016-11-01

    Guidelines recommend that oncologists discuss treatment-related fertility issues with young cancer patients as early as possible after diagnosis and, if appropriate, expedite referral for fertility preservation (FP). This study sought to determine the attitudes and practices of Canadian breast surgeons regarding fertility issues, as well as barriers to and facilitators of fertility discussion and referrals. Semistructured telephone interviews were conducted with 28 site lead surgeons (SLSs) at 28 (97 %) of 29 centers (25 % cancer centers, 64 % teaching hospitals) across Canada participating in RUBY, a pan-Canadian research program for young women with breast cancer. In addition, 56 (65 %) of 86 of their surgical colleagues (non-site lead surgeons [NSLSs]) completed an online survey of their oncofertility knowledge, attitudes, and practices. Of the 28 SLSs (43 % male, 36 % in practice knowledge, 25 % discussed fertility only if mentioned by the patient, 21 % believed fertility discussion and referral were the mandate of the medical oncologist, and 45 % did not know of an FP center in their area. More than 80 % of the NSLSs (54 % male, 30 % in practice knowledge was low among the SLSs, especially the NSLSs, and barriers to referral were identified. An oncofertility knowledge translation intervention specifically for breast surgeons is being developed to increase surgeon knowledge and awareness of oncofertility issues and referral.

  18. 为了生活而生活——完美人生David Bowie

    Institute of Scientific and Technical Information of China (English)

    So

    2006-01-01

    David Bowie,原名 DavidRobert Jones,1947年1月8日出生于英国伦敦的布里克顿。他最终身高是5英尺10.5英寸,也就是大约1.79米——不过 David 看上去怎么也不像有这么高。David 有两个姐姐和一个哥哥,用比较委婉的说法是:他们和他都没有完全的血缘关系。他的大姐 Myra Ann 后来嫁到了埃及,改信伊斯兰教,并把名字改为:Iman,和David 第二个妻子一样。David很爱的哥哥 Terence,和他是同母异父兄弟。同母亲改嫁过来后,随了继父的姓氏:Jones,不过在去世之前的最后几年里,Terence 坚持把姓氏改回了母亲娘家的 Burns。Terence 在1970年就因为抑郁症住进精神病医院,1985年1月6日自杀。当时已经十几年如一日般红得发紫的 David 没有参加葬礼,因为他知道自己参加的话媒体将会带来什么样的关注,而这些关注

  19. Exploring Surgeons' Perceptions of the Role of Simulation in Surgical Education: A Needs Assessment

    Directory of Open Access Journals (Sweden)

    Marcia Clark

    2011-11-01

    Full Text Available Introduction: The last two decades have seen the adoption of simulation-based surgical education in various disciplines. The current study’s goal was to perform a needs assessment using the results to inform future curricular planning and needs of surgeons and learners. Methods: A survey was distributed to 26 surgeon educators and interviews were conducted with 8 of these surgeons.  Analysis of survey results included reliability and descriptive statistics. Interviews were analyzed for thematic content with a constant comparison technique, developing coding and categorization of themes. Results: The survey response rate was 81%. The inter-item reliability, according to Cronbach’s alpha was 0.81 with strongest agreement for statements related to learning new skills, training new residents and the positive impact on patient safety and learning.   There was less strong agreement for maintenance of skills, improving team functioning and reducing teaching in the operating room. Interview results confirmed those themes from the survey and highlighted inconsistencies for identified perceived barriers and a focus on acquisition of skills only.  Interview responses specified concerns with integrating simulation into existing curricula and the need for more evaluation as a robust educational strategy. Conclusion: The findings were summarized in four themes: 1 use of simulation, 2 integration into curriculum, 3 leadership, and 4 understanding gaps in simulation use. This study exemplifies a mixed-methods approach to planning a surgical simulation program through a general needs assessment.

  20. Simulation-based education and performance assessments for pediatric surgeons.

    Science.gov (United States)

    Barsness, Katherine

    2014-08-01

    Education in the knowledge, skills, and attitudes necessary for a surgeon to perform at an expert level in the operating room, and beyond, must address all potential cognitive and technical performance gaps, professionalism and personal behaviors, and effective team communication. Educational strategies should also seek to replicate the stressors and distractions that might occur during a high-risk operation or critical care event. Finally, education cannot remain fixed in an apprenticeship model of "See one, do one, teach one," whereby patients are exposed to the risk of harm inherent to any learning curve. The majority of these educational goals can be achieved with the addition of simulation-based education (SBE) as a valuable adjunct to traditional training methods. This article will review relevant principles of SBE, explore currently available simulation-based educational tools for pediatric surgeons, and finally make projections for the future of SBE and performance assessments for pediatric surgeons.

  1. Communication between the obese patient and bariatric surgeon.

    Science.gov (United States)

    Ruiz de Angulo, David; Munitiz, Vicente; Ortiz, M Ángeles; Martínez de Haro, Luisa F; Frutos, M Dolores; Hernández, Antonio; Parrilla, Pascual

    2015-10-01

    Communication between the bariatric surgeon and the obese patient is very important as it influences the expectations of patients with regard to surgery, aim of the surgery and the understanding of the mechanisms of failure of surgery. Furthermore, the incidence of certain psychopathology in these patients makes it necessary for the surgeon to have the ability to communicate to the patient the need for motivation and the maintenance of healthy life habits. Although the topic is subjective, in this article we review several useful recommendations to optimize communication before and after surgery. Finally, we emphasize the need to create workshops to train the bariatric surgeon in these issues that we consider so important. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Was the real Sherlock Holmes a pediatric surgeon?

    Science.gov (United States)

    Raffensperger, John

    2010-07-01

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

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

    Science.gov (United States)

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

    2010-08-01

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

  4. Sponsoring surgeons; an investigation on the influence of the da Vinci robot.

    Science.gov (United States)

    Criss, Cory N; Gadepalli, Samir K

    2017-08-26

    The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons. Publicly available financial data from the CMS website regarding the top-20 earners from ISI for 2015 was gathered. Studies conducted by these surgeons were identified using PubMed. Inclusion criteria consisted of publications about the da Vinci(®) robot on patient outcomes. The primary outcome of our study was if the study conclusion was positive/equivocal/negative towards the robot. Secondary outcomes included authorship, sponsorship, study controls, and disclosure. The top earners received $3,296,844 in 2015, with a median of $141,959. Sub-specialties included general surgery (55%), colorectal (20%), thoracic (15%), and obstetrics/gynecology (10%). Of the 37 studies, there was 1 RCT, with observational studies comprising the rest. The majority of the studies (n = 16, 43%) had no control population, with 11 (30%) comparing to same institution/surgeon, Though ISI sponsored only 6 (16%) studies, all with positive conclusions, 27 (73%) studies had positive conclusions for robot use, 9 (24%) equivocal, and only 1 (3%) negative. Overall, 13 earners had lead authorship and 11 senior. This initial pilot study highlights a potential bias as current literature published by benefactors demonstrates low quality and highly positive conclusions towards approval of the robot. This substantiates the need for a large, systematic review of the potential influence of sponsoring surgeons on medical literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Reduction in Surgical Wound Infection Rates Associated with Reporting Data to Surgeons

    Directory of Open Access Journals (Sweden)

    GD Taylor

    1994-01-01

    Full Text Available Several studies have shown that wound infection (surgical site infection [ ssi ] rates fall when surgeons are provided with data on their performance. Since 1987, the authors have been performing concurrent surveillance of surgical patients and confidentially reporting surgeon-specific ssi rates to individual surgeons and their clinical directors, and providing surgeons with the mean rates of their peers. The program has been gradually refined and expanded. Data are now collected on wound infection risk and report risk adjusted rates compared with the mean for hospitals in the United States National Nosocomial Infections Surveillance (nnis data bank. Since inception through to December 1993, ssi rates have fallen 68% in clean contaminated general surgery cases (relative risk [rr] 0.36, 95% ci 0.2 to 0.6, P=0.0001, 64% in clean plastic surgery cases (rr 0.35, 95% ci 0.06 to 1.8, 72% in caesarean section cases (rr 0.23, 95% ci 0.03 to 1.96 and 42% in clean cardiovascular surgery cases (rr 0.59, 95% ci 0.34 to 1.0. In clean orthopedic surgery the ssi rate remained stable from 1987 through 1992. In 1993 a marked increase was experienced. Reasons for this are being explored. Overall there was a 32% decrease in ssi rate between the index year and 1993 or, in percentage terms, 2.8% to 1.9% (rr 0.65, 95% ci 0.51 to 0.86, P=0.002. ssi surveillance should become standard in Canadian hospitals interested in improving the quality of surgical care and reducing the clinical impact and cost associated with nosocomial infection.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

  8. Reporting sharp injuries among Surgeons in Zagazig University Hospitals, Egypt

    Directory of Open Access Journals (Sweden)

    Eman Mohamed Mortada

    2015-12-01

    Full Text Available Background and rationale of the study: Although Sharps injuries are a preventable hazard faced by medical personnel in the operating room yet it continues to be one of the hidden problems among HCP. The potential consequence of such injuries includes transmission of blood-borne pathogens with detrimental effects. Despite the advances in technology and increased awareness of medical staff, annually around 600 thousand to one million workers are affected thus considered as one of the most serious threats facing health care workers specially surgeon.Methodology: a cross sectional study of Zagazig University Hospitals surgical departments. Using a sample composed of 287 surgeons randomly chosen from different surgical departments. A questionnaire assessed in addition to personal and professional characteristics, the history of sharp injuries, types of instrument causing the injury, their post exposure prophylaxis including reporting. The results: There were total 287 surgeons participated in this study. (47% of the respondent surgeons had been exposed to at least one episode of sharp injury in the preceding 3 months and most of the exposures (68% occurred in the operation room. The injury was mainly caused during suturing (83%. The commonest devices, accused in most of the injuries were suturing needle and scalpel (74 and 59%. The majority of the surgeons (62% didn’t report the SI and it was largely explained by the majority of the sampled respondents (89% were not aware of the reporting system existing in their hospital.Conclusions: The most common reason of underreporting  in our study was the lack of awareness that all injuries must be reported.Recommendations: The observed high level of under reporting reflects the need for education on prevention. Our results can guide in planning an education program for the surgeons to increase awareness about dangers of sharp injuries and help improve the reporting strategy  and other potential

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

    Science.gov (United States)

    Krieger, Lloyd M

    2002-10-01

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

  10. Patient-specific hip prostheses designed by surgeons

    Directory of Open Access Journals (Sweden)

    Coigny Florian

    2016-09-01

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

  11. Update in achalasia: what the surgeon needs to know.

    Science.gov (United States)

    Hamer, Peter W; Holloway, Richard H; Crosthwaite, Gary; Devitt, Peter G; Thompson, Sarah K

    2016-07-01

    Achalasia is a motility disorder encountered by surgeons during the investigation and treatment of dysphagia. Recent advances in manometry technology, a widely accepted new classification system and a new treatment rapidly gaining international acceptance, have changed the working knowledge required to successfully manage patients with achalasia. We review the Chicago classification subtypes of achalasia with type II achalasia being a predictor of success and type III achalasia a predictor of treatment failure. We review per-oral endoscopic myotomy as an emerging treatment option and its potential for improving the treatment of type III achalasia. © 2016 Royal Australasian College of Surgeons.

  12. The Role of the Orthopaedic Surgeon in Workers' Compensation Cases.

    Science.gov (United States)

    Daniels, Alan H; Kuris, Eren O; Palumbo, Mark A

    2017-03-01

    Workers' compensation is an employer-funded insurance program that provides financial and medical benefits for employees injured at work. Because many occupational injuries are musculoskeletal in nature, the orthopaedic surgeon plays an important role in the workers' compensation system. Along with establishing the correct diagnosis and implementing an appropriate treatment plan, the clinician must understand the fundamental components of the workers' compensation system to manage an injured employee. Ultimately, effective claim management requires collaboration among the employer, the employee, the legal representatives, the insurance company, and the orthopaedic surgeon.

  13. Surgeon-Directed Cost Variation in Isolated Rotator Cuff Repair.

    Science.gov (United States)

    Terhune, E Bailey; Cannamela, Peter C; Johnson, Jared S; Saad, Charles D; Barnes, John; Silbernagel, Janette; Faciszewski, Thomas; Shea, Kevin G

    2016-12-01

    As value becomes a larger component of heath care decision making, cost data can be evaluated for regional and physician variation. Value is determined by outcome divided by cost, and reducing cost increases value for patients. "Third-party spend" items are individual selections by surgeons used to perform procedures. Cost data for third-party spend items provide surgeons and hospitals with important information regarding care value, potential cost-saving opportunities, and the total cost of ownership of specific clinical decisions. To perform a cost review of isolated rotator cuff repair within a regional 7-hospital system and to document procedure cost variation among operating surgeons. Economic and decision analysis; Level of evidence, 4. Current Procedural Terminology (CPT) codes were used to retrospectively identify subjects who received an isolated rotator cuff repair within a 7-hospital system. Cost data were collected for clinically sensitive third-party spend items and divided into 4 cost groups: (1) suture anchors, (2) suture-passing devices and needles, (3) sutures used for cuff repair, and (4) disposable tools or instruments. A total of 62 isolated rotator cuff repairs were performed by 17 surgeons over a 13-month period. The total cost per case for clinically sensitive third-party spend items (in 2015 US dollars) ranged from $293 to $3752 (mean, $1826). Four surgeons had a mean procedure cost that was higher than the data set mean procedure cost. The cost of an individual suture anchor ranged from $75 to $1775 (mean, $403). One disposable suture passer was used, which cost $140. The cost of passing needles ranged from $140 to $995 (mean, $468). The cost per repair suture (used to repair cuff tears) varied from $18 to $298 (mean, $61). The mean suture (used to close wounds) cost per case was $81 (range, $0-$454). A total of 316 tools or disposable instruments were used, costing $1 to $1573 per case (mean, $624). This study demonstrates significant cost

  14. Surgeon`s adherence to guidelines for surgical antimicrobial prophylaxis-a review

    Directory of Open Access Journals (Sweden)

    Ru Shing Ng

    2012-05-01

    Full Text Available AbstractSurgical site infections are the most common nosocomial infection among surgical patients. Patients who experience surgical site infections are associated with prolonged hospital stay, rehospitalisation, increased morbidity and mortality, and costs. Consequently, surgical antimicrobial prophylaxis (SAP, which is a very brief course of antibiotic given just before the surgery, has been introduced to prevent the occurrence of surgical site infections. The efficacy of SAP depends on several factors, including selection of appropriate antibiotic, timing of administration, dosage, duration of prophylaxis and route of administration. In many institutions around the globe, evidence-based guidelines have been developed to advance the proper use of SAP. This paper aims to review the studies on surgeons’ adherence to SAP guidelines and factors influencing their adherence. A wide variation of overall compliance towards SAP guidelines was noted, ranging from 0% to 71.9%. The misuses of prophylactic antibiotics are commonly seen, particularly inappropriate choice and prolonged duration of administration. Lack of awareness of the available SAP guidelines, influence of initial training, personal preference and influence from colleagues were among the factors which hindered the surgeons’ adherence to SAP guidelines. Immediate actions are needed to improve the adherence rate as inappropriate use of SAP can lead to the emergence of a strain of resistant bacteria resulting in a number of costs to the healthcare system. Corrective measures to improve SAP adherence include development of guidelines, education and effective dissemination of guidelines to targeted surgeons and routine audit of antibiotic utilisation by a dedicated infection control team.

  15. [Chronic surplus of Japanese cardiac surgeon--ideal nurse practitioner for cardiac surgery, cardiac surgeon's attitude toward the future].

    Science.gov (United States)

    Ikegami, Hirohisa

    2014-03-01

    It is chronically surplus of doctors in the world of cardiac surgery. There are too many cardiac surgeons because cardiac surgery requires a large amount of manpower resources to provide adequate medical services. Many Japanese cardiac surgeons do not have enough opportunity to perform cardiac surgery operations, and many Japanese cardiac surgery residents do not have enough opportunity to learn cardiac surgery operations. There are physician assistants and nurse practitioners in the US. Because they provide a part of medical care to cardiac surgery patients, American cardiac surgeons can focus more energy on operative procedures. Introduction of cardiac surgery specialized nurse practitioner is essential to deliver a high quality medical service as well as to solve chronic problems that Japanese cardiac surgery has had for a long time.

  16. David Hume against the contractualists of his time

    Directory of Open Access Journals (Sweden)

    Gabriel Bertin de Almeida

    2007-01-01

    Full Text Available This paper puts forward an interpretation of Hume's work which suggests a new means of refuting contractualism. This interpretation differs from the 'official' refutation, in that it is based on a concept of artifice which is significantly different from the concept of artifice propounded by the contractualists. This difference is not generally noticed in traditional commentary on Humean political philosophy when it deals with the refutation of contractualism.

  17. Isolated specialist or system integrated physician – different views on sickness certification among orthopaedic surgeons: an interview study

    Directory of Open Access Journals (Sweden)

    Swartling Malin

    2008-12-01

    Full Text Available Abstract Background Sickness certification is a frequent and sometimes problematic task for orthopaedic surgeons. Our aim was to explore how orthopaedic surgeons view their sick-listing commission and sick-listing practice. Methods Semi-structured interviews with seventeen orthopaedic surgeons from five orthopaedic clinics in four Swedish counties. The focus was on the experiences of these physicians in relation to handling of sickness certification. Phenomenographic analysis was performed to reveal differences in existing views. Results The orthopaedic surgeons' views on sick-listing seemed mainly to be a consequence of how they perceived their role in the healthcare system. Three categories were found: The "isolated specialists", whose work and responsibilities were confined to the orthopaedic clinic, and did not really include sickness certification; the "orthopaedic advisers", who saw themselves mainly as advice-givers in the general health care system and perceived sickness certification as part of their job; the "system-integrated physicians", who perceived the orthopaedic clinic as one part of the healthcare system and whose ultimate goal was to get the patient well functioning in her life again with regained work ability, seeing sick-listing as one of the instruments to achieve this. Some informants described difficulties in handling conflicting opinions with patients in relation to the need for sick-leave. Conclusion Orthopaedic surgeons certify a large proportion of total sickness benefits. Some orthopaedic surgeons may certify sickness benefits sub-optimally for patients and society due to a narrow view of their role in the health care system or due to poor skills in handling discordant opinions with the patient. This problem can be addressed at the level of the individual physician and at the system level.

  18. Käsitsi tegemise võlu / David Jones ; intervjueerinud Kai Lobjakas

    Index Scriptorium Estoniae

    Jones, David, 1953-

    2010-01-01

    10. Kohila keraamikasümpoosionil osalenud briti keraamik ja teoreetik David Jones endast, rakutehnikast, huvist põletamisega seonduvate teemade vastu, Kohila sümpoosioni raames tehtust, keraamika õpetamisest Inglismaal, käsitöö ja keraamika positsioonist praegu ja tulevikus jm.

  19. The Archives of the History of American Psychology: An Interview with David B. Baker.

    Science.gov (United States)

    Prieto, Loreto R.

    2001-01-01

    Presents an interview with David B. Baker, Director of the Archives of the History of American Psychology. Covers topics such as: Baker's interest in the history of psychology, his work at the Archives of the History of American Psychology, and recommendations for teachers when addressing history in non-history courses. (CMK)

  20. Investing in the Child Welfare Workforce: A Response to David Stoesz

    Science.gov (United States)

    Briar-Lawson, Katharine; Leake, Robin; Dickinson, Nancy; McCarthy, Mary; Anderson, Gary; Groza, Victor; Gilmore, Grover C.

    2016-01-01

    Responding to David Stoesz's invited article criticizing the Children's Bureau and the National Child Welfare Workforce Institute (NCWWI), the author's inaccurate assertions are challenged, and new information is provided about the significant work underway to support the child welfare workforce. The Children's Bureau has made historic investments…