WorldWideScience

Sample records for surgeons aaos published

  1. Observational analysis of BOA free-papers (2001): from presentation to publication and comparison with the American Academy of Orthopaedic Surgeons (AAOS).

    Science.gov (United States)

    ul Haq, Muhammad Imran; Gill, Inder

    2011-04-01

    The objectives of this study were to: determine the presentation to publication conversion rate (PPCR) in peer-reviewed indexed journals of free papers and posters presented at 12-14th September 2001 British Orthopaedic Association (BOA) annual meeting and to compare the publication rate with the American Academy of Orthopaedic Surgeons (AAOS) meeting in 2001. We looked at all presentations including both podium and poster presentations at British Orthopaedic Association meeting held in 2001 and assessed for subsequent publication as full-text article with a fixed PubMed search protocol. Once the abstract was identified as being published, we noted the name of the journal, citation, and time to presentation. The level of evidence was assigned for each abstract along the guidelines published by the centre for evidence-based medicine, Oxford, UK. This conversion rate was compared with the presentation to publication rate for the AAOS meeting in 2001. A total of 179 abstracts were presented at the 2001 BOA meeting. 65 of these were published as full-text articles in 30 different journals. The overall publication rate was 36.3%. The publication rate of the papers presented at AAOS annual meeting 2001 was 49% (367/756). The mean time from presentation to publication was 18.6 months (±9.4 months). Three fourths of them were published after 2 years of presentations (63% for AAOS). Majority of studies were either level III or IV. 14 full-text articles were published in Journal of Bone and Joint Surgery British (JBJS Br) and 8 in the Injury Journal. This is the first study reporting the publication rate of presentations for BOA meeting and comparing it with the publication rate of AAOS meeting in 2001. The publication rate of BOA presentations is much lower than the AAOS meeting. We believe the publication rate is an important tool in judging the quality of research work and the reputation of a scientific meeting with higher conversion rates suggesting better quality. Thus

  2. A Clinical Practice Update on the Latest AAOS/ADA Guideline (December 2012) on Prevention of Orthopaedic Implant Infection in Dental Patients

    OpenAIRE

    Hamedani Sh. DDS, MSc

    2013-01-01

    The American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA), along with 10 other academic associations and societies recently (December 2012) published their mutual clinical practice guideline “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.” This evidence-based guideline ,detailed in 325 pages, has three recommendations and substitutes the previous AAOS guideline. The new published clinical guideline is a protocol to pre...

  3. Research articles published by Korean spine surgeons: Scientific progress and the increase in spine surgery.

    Science.gov (United States)

    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun Jib; Kawaguchi, Yoshiharu

    2017-02-01

    There has been a marked increase in spine surgery in the 21st century, but there are no reports providing quantitative and qualitative analyses of research by Korean spine surgeons. The study goal was to assess the status of Korean spinal surgery and research. The number of spine surgeries was obtained from the Korean National Health Insurance Service. Research articles published by Korean spine surgeons were reviewed by using the Medline/PubMed online database. The number of spine surgeries in Korea increased markedly from 92,390 in 2004 to 164,291 in 2013. During the 2000-2014 period, 1982 articles were published by Korean spine surgeons. The annual number of articles increased from 20 articles in 2000 to 293 articles in 2014. There was a positive correlation between the annual spine surgery and article numbers (particles with Oxford levels of evidence 1, 2, and 3. The mean five-year impact factor (IF) for article quality was 1.79. There was no positive correlation between the annual IF and article numbers. Most articles (65.9%) were authored by neurosurgical spine surgeons. But spinal deformity-related topics were dominant among articles authored by orthopedics. The results show a clear quantitative increase in Korean spinal surgery and research over the last 15years. The lack of a correlation between annual IF and published article numbers indicate that Korean spine surgeons should endeavor to increase research value.

  4. Inconsistencies Between Physician-Reported Disclosures at the AAOS Annual Meeting and Industry-Reported Financial Disclosures in the Open Payments Database.

    Science.gov (United States)

    Hannon, Charles P; Chalmers, Peter N; Carpiniello, Matthew F; Cvetanovich, Gregory L; Cole, Brian J; Bach, Bernard R

    2016-10-19

    The purpose of this study was to determine the rate and type of inconsistencies between disclosures self-reported by physicians at a major academic meeting in the United States and industry-reported disclosures in the Open Payments database for a concordant time period. Disclosures for every first and last author from the United States with a medical degree of a podium or poster presentation at the 2014 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting were collected and were compared with the disclosures reported in the Open Payments database to determine if any inconsistencies were present and, if so, within which category. In total, 1,925 total AAOS presenters were identified, and 1,113 met the inclusion criteria. Based on AAOS disclosures, 432 (39%) should have been listed within the Open Payments database. There were 125 presenters (11%) who reported an AAOS disclosure and thus should have been included in the Open Payments database, but were not included. An additional 259 presenters (23%) had ≥1 AAOS disclosures that were not reported or were improperly categorized in the Open Payments database. Inconsistencies were more common for authors who had significantly more poster presentations (p database (p financial relationships for presenters at the AAOS Annual Meeting and industry-reported relationships published in the Open Payments database. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  5. Quantificational Etching of AAO Template

    Institute of Scientific and Technical Information of China (English)

    Guojun SONG; Dong CHEN; Zhi PENG; Xilin SHE; Jianjiang LI; Ping HAN

    2007-01-01

    Ni nanowires were prepared by electrodeposition in porous anodized aluminum oxide (AAO) template from a composite electrolyte solution. Well-ordered Ni nanowire arrays with controllable length were then made by the partial removal of AAO using a mixture of phosphoric acid and chromic acid (6 wt pct H3PO4:1.8 wt pct H3CrO4). The images of Ni nanowire arrays were studied by scanning electron microscopy (SEM) to determine the relationship between etching time and the length of Ni nanowire arrays. The results indicate that the length of nanowires exposed from the template can be accurately controlled by controlling etching time.

  6. 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.

  7. American Academy of Orthopaedic Surgeons Disclosure Policy Fails to Accurately Inform Its Members of Potential Conflicts of Interest.

    Science.gov (United States)

    Tanzer, Dylan; Smith, Karen; Tanzer, Michael

    2015-07-01

    The American Academy of Orthopaedic Surgeons (AAOS) disclosure policy is designed to ensure that members involved in education or policy development remain free of outside influence. Although mandatory for these members, it is voluntary for the rest of the AAOS membership. To determine surgeon compliance with disclosure policy, we conducted a study in which we compared surgeon-consultants' disclosures as posted on 6 major orthopedic companies' websites in 2011 with those surgeons' disclosures as listed in AAOS disclosure program records. We found that 549 AAOS members were identified by at least 1 company as having received consulting payments. Overall, 44% of AAOS members did not comply with disclosure policy, or their information was not available on the AAOS website (range, 37%-61%). This study demonstrated that AAOS's policy of mandatory disclosure for select members and voluntary disclosure for all other members is ineffective. The AAOS disclosure program and the potential consequences of noncompliance need to be reevaluated by the organization if it wants its program to succeed.

  8. Fabrication of nanopore and nanoparticle arrays with high aspect ratio AAO masks

    Science.gov (United States)

    Li, Z. P.; Xu, Z. M.; Qu, X. P.; Wang, S. B.; Peng, J.; Mei, L. H.

    2017-03-01

    How to use high aspect ratio anodic aluminum oxide (AAO) membranes as an etching and evaporation mask is one of the unsolved problems in the application of nanostructured arrays. Here we describe the versatile utilizations of the highly ordered AAO membranes with a high aspect ratio of more than 20 used as universal masks for the formation of various nanostructure arrays on various substrates. The result shows that the fabricated nanopore and nanoparticle arrays of substrates inherit the regularity of the AAO membranes completely. The flat AAO substrates and uneven AAO frontages were attached to the Si substrates respectively as an etching mask, which demonstrates that the two kinds of replication, positive and negative, represent the replication of the mirroring of Si substrates relative to the flat AAO substrates and uneven AAO frontages. Our work is a breakthrough for the broad research field of surface nano-masking.

  9. Fabrication of YBCO nanowires with anodic aluminum oxide (AAO) template

    Energy Technology Data Exchange (ETDEWEB)

    Dadras, Sedigheh, E-mail: dadras@alzahra.ac.ir; Aawani, Elaheh

    2015-10-15

    We have fabricated YBCO nanowires by using anodic aluminum oxide (AAO) template and sol–gel method, to investigate the fundamental properties of the one-dimensional nanostructure YBCO high-temperature superconductor and enhance its applications. The field-emission scanning electron microscopy and X-ray diffraction pattern results have shown forming of Y-123 nanowires in the template. As an outcome, the YBCO nanowires, prepared by dipping AAO template into YBCO sol method, have average diameter of about 38 nm and length of 1 μm; this is an optimum nanowire sample with larger diameter and length. The resistance–temperature measurement indicates that the onset critical temperature of these samples occurs at 91 K, and the resistance of the optimum sample at onset transition is 10 times lower than the other sample.

  10. 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.

  11. 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.

  12. Effect of electrolyte temperature on the thickness of anodic aluminium oxide (AAO layer

    Directory of Open Access Journals (Sweden)

    P. Michal

    2016-07-01

    Full Text Available Effect of electrolyte temperature on the thickness of resulting oxide layer has been studied. Unlike previous published studies this article was aimed to monitor the relationship between electrolyte temperature and resulting AAO layer thickness in interaction with other input factors affecting during anodizing process under special process condition, i.e. lower concentration of sulphuric acid, oxalic acid, boric acid and sodium chloride. According to Design of Experiments (DOE 80 individual test runs of experiment were carried out. Using statistical analysis and artificial intelligence for evaluation, the computational model predicting the thickness of oxide layer in the range from 5 / μm to 15 / μm with tolerance ± 0,5 / μm was developed.

  13. Induction and purification by three-phase partitioning of aryl alcohol oxidase (AAO) from Pleurotus ostreatus.

    Science.gov (United States)

    Kumar, Vaidyanathan Vinoth; Rapheal, Vinohar Stephen

    2011-02-01

    Aryl alcohol oxidase (AAO) is an extracellular flavoenzyme involved in lignin degradation by white rot fungi. Screening of lignolytic and AAO activity from twenty different fungal species were carried out. Among them, seven species showed lignolytic activity and three of them (Pleurotus ostreatus, Pleurotus eous, and Pleurotus platypus) were found to be AAO positive. Maximal AAO activity was observed in batch cultures of P. ostreatus and was found to be induced by aromatic amino acids and aryl alcohols up to a level of 289 U/l. Purification of AAO was carried out by three-phase partitioning (TPP). The 67 kDa enzyme was purified up to 10.19-fold by TPP with an overall recovery of 10.95%. Optimum pH and temperature for P. ostreatus AAO activity was found to be around 6 and 40 °C, respectively. From the LB plot, K (m) value of AAO for oxidizing veratryl alcohol was determined to be 0.6 mM. Results of the study indicate that P. ostreatus is the best producers of AAO, and they could be employed as promising fungal species for biotechnological applications.

  14. Most American Academy of Orthopaedic Surgeons' online patient education material exceeds average patient reading level.

    Science.gov (United States)

    Eltorai, Adam E M; Sharma, Pranav; Wang, Jing; Daniels, Alan H

    2015-04-01

    Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level. Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

  15. Nanoporous AAO: A platform for regular heterogeneous nanostructures and energy storage devices

    Science.gov (United States)

    Perez, Israel

    Nanoporous anodic aluminum oxide (AAO) has vast implications as a tool for nanoscience research and as a nanostructure in which nanoscale devices can be fabricated because of its regular and ordered nanopores. Self-assembly plays a critical role in pore ordering, causing nanopores to grow parallel with one another in high density. The mild electrochemical conditions in which porous AAO grows along with its relatively cheap starting materials makes this nanomaterial a cost effective alternative to advanced photolithography techniques for forming high surface area nanostructures over large areas. In this research, atomic layer deposition (ALD) was used to deposit conformal films within in nanoporous AAO with hopes to (1) develop methodologies to characterize ALD depositions within its high aspect ratio nanopores and (2) to better understand how to use nanoporous AAO templates as a scaffold for energy devices, specifically Metal-Insulator-Metal (MIM) capacitors. Using the nanotube template synthesis method, ALD films were deposited onto nanoporous AAO, later removing the films deposited within the templates nanopores for characterization in TEM. This nanotube metrology characterization involves first obtaining images of full length ALD-AAO nanotubes, and then measuring wall thickness as a function of depth within the nanopore. MIM nanocapacitors were also constructed in vertical AAO nanopores by deposition of multilayer ALD films. MIM stacks were patterned into micro-scale capacitors for electrical characterization.

  16. 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.

  17. FRICTION PROPERTIES OF OIL-INFILTRATED POROUS AAO FILM ON AN ALUMINUM SUBSTRATE

    Institute of Scientific and Technical Information of China (English)

    C.X. Jiang; J.P. Tu; S.Y. Guo; M.F. Fu; X.B. Zhao

    2005-01-01

    The porous anodic aluminum oxide (AAO) film on a pure aluminum substrate was prepared by a two-step anodization in a 0.3M oxalic acid solution and pore-enlargement treatment in the phosphoric acid aqueous solution at 50℃. The diameter of highly ordered pore on the AAO film was about 90nm, and the thickness of the AAO film was 3μm. The mineral oil was infiltrated in the ordered nanometer sized pores of AAO film on an aluminum substrate due to the capillarity effect. The friction coefficient was measured using a ball-on-disk tribotester.The tests were conducted at loads range from 490 to 2450mN and at sliding velocities beably improved the wear resistance. As compared to the porous AAO film, the oil-infiltrated specimen had low friction coefficient. With increasing the applied load and sliding velocity,the friction coefficient of the oil-infiltrated film decreased. It indicates that the oil-infiltrated AAO film produced a new way to modify the friction and wear of aluminum alloy.

  18. The American Academy of Orthopaedic Surgeons/Society of Military Orthopaedic Surgeons/Orthopaedic Trauma Associations/Pediatric Orthopaedic Association Disaster Response and Preparedness Course.

    Science.gov (United States)

    Johnson, Anthony E; Gerlinger, Tad L; Born, Christopher T

    2015-10-01

    A disaster is a catastrophic event that disrupts normal infrastructure to such a degree that normal response mechanisms and capabilities cannot manage what is required to respond appropriately to the event. Launched after the largest urban disaster in modern history--the 2010 Haiti Earthquake--the American Academy of Orthopaedic Surgeons/Society of Military Orthopaedic Surgeons/Orthopaedic Trauma Association/Pediatric Orthopaedic Association of North America (AAOS/SOMOS/OTA/POSNA) Disaster Response Course (DRC) is designed to prepare orthopaedic surgeons for service in disaster response and humanitarian assistance efforts in both the acute phases as well as in the recovery and reconstructions phases. To date, 395 orthopaedic surgeons have completed the DRC and 286 (72.4%) have opted to become registered disaster responders.

  19. A colorimetric sensor based on anodized aluminum oxide (AAO) substrate for the detection of nitroaromatics.

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Y.; Wang, H. H.; Indacochea, J. E.; Wang, M. L. (Materials Science Division); (Northeastern Univ.); (Univ. of Illinois at Chicago)

    2011-12-15

    Simple and low cost colorimetric sensors for explosives detection were explored and developed. Anodized aluminum oxide (AAO) with large surface area through its porous structure and light background color was utilized as the substrate for colorimetric sensors. Fabricated thin AAO films with thickness less than {approx} 500 nm allowed us to observe interference colors which were used as the background color for colorimetric detection. AAO thin films with various thickness and pore-to-pore distance were prepared through anodizing aluminum foils at different voltages and times in dilute sulfuric acid. Various interference colors were observed on these samples due to their difference in structures. Accordingly, suitable anodization conditions that produce AAO samples with desired light background colors for optical applications were obtained. Thin film interference model was applied to analyze the UV-vis reflectance spectra and to estimate the thickness of the AAO membranes. We found that the thickness of produced AAO films increased linearly with anodization time in sulfuric acid. In addition, the growth rate was higher for AAO anodized using higher voltages. The thin film interference formulism was further validated with a well established layer by layer deposition technique. Coating poly(styrene sulfonate) sodium salt (PSS) and poly(allylamine hydrochloride) (PAH) layer by layer on AAO thin film consistently shifted its surface color toward red due to the increase in thickness. The red shift of UV-vis reflectance was correlated quantitatively to the number of layers been assembled. This sensitive red shift due to molecular attachment (increase in thickness) on AAO substrate was applied toward nitroaromatics detection. Aminopropyltrimethoxysilane (APTS) which can be attached onto AAO nanowells covalently through silanization and attract TNT molecules was coated and applied for TNT detection. UV-vis spectra of AAO with APTS shifted to the longer wavelength side due to

  20. Fluorescence detection of trace PCB101 based on PITC immobilized on porous AAO membrane.

    Science.gov (United States)

    Wang, Meiling; Meng, Guowen; Huang, Qing; Li, Mingtao; Li, Zhongbo; Tang, Chaolong

    2011-01-21

    A sensitive and selective fluorescent membrane for rapid detection of trace 2,2',4,5,5'-pentachlorinated biphenyl (PCB101) has been achieved by immobilizing the fluorophore phenyl isothiocyanate (PITC) onto porous anodic aluminium oxide (AAO) membrane (denoted as PITC@AAO). The fluorescence of the PITC@AAO membrane is obviously enhanced after titrating the analyte PCB101 into the membrane, being ascribed to the halogen-bonding interaction between the fluorophore PITC and the analyte PCB101. The fluorescence intensity increases with the PCB101 concentration in the low range below 1 ppm, and there exists an approximate linear relationship between the relative fluorescence intensity and the PCB101 concentration in the low range of 1-6 ppb. Moreover, the PITC@AAO membrane shows good selectivity; for example, it is insensitive to common structural analogs (polychlorinated aromatics). The mechanisms of the fluorescence enhancement and the better sensitivity and selectivity of the PITC@AAO membrane to PCB101 than that of PITC/n-hexane solution are also discussed. This work demonstrates that trace (in ppb range) PCBs can be detected by simple fluorescence measurement.

  1. 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.

  2. 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.

  3. Fabrication of multi-level branched metal nanowires by AAO template electrodeposition

    Institute of Scientific and Technical Information of China (English)

    XU Liping; YUAN Zhihao; ZHANG Xiaoguang

    2006-01-01

    Anodic aluminum oxide (AAO) templates with various branched pores were prepared through one- to multi-step varying the anodic voltage by a factor of 1√2 during an anodization of aluminum. The corresponding branched Fe nanowires (i.e. Y-branched, two-level branched and more complex tree-like nanostructures) were achieved by electrodepositing Fe into the branched pores of the AAO template. Selecting area electron diffraction and high-resolution TEM images show that the stem and branches of the branched Fe nanowires are single- crystalline with a face-centered cubic lattice. These branched Fe nanowires will be of great fundamental and practical significance.

  4. 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 ...

  5. 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 ...

  6. 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.

  7. Self-ordering behavior of nanoporous anodic aluminum oxide (AAO) in malonic acid anodization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, W; Nielsch, K; Goesele, U [Max Planck Institute of Microstructure Physics, Weinberg 2, D-06120 Halle (Germany)

    2007-11-28

    The self-ordering behavior of anodic aluminum oxide (AAO) has been investigated for anodization of aluminum in malonic acid (H{sub 4}C{sub 3}O{sub 4}) solution. In the present study it is found that a porous oxide layer formed on the surface of aluminum can effectively suppress catastrophic local events (such as breakdown of the oxide film and plastic deformation of the aluminum substrate), and enables stable fast anodic oxidation under a high electric field of 110-140 V and {approx}100 mA cm{sup -2}. Studies on the self-ordering behavior of AAO indicated that the cell homogeneity of AAO increases dramatically as the anodization voltage gets higher than 120 V. Highly ordered AAO with a hexagonal arrangement of the nanopores could be obtained in a voltage range 125-140 V. The current density (i.e., the electric field strength (E) at the bottom of a pore) is an important parameter governing the self-ordering of the nanopores as well as the interpore distance (D{sub int}) for a given anodization potential (U) during malonic acid anodization.

  8. Electrically conducting polymer nanostructures confined in anodized aluminum oxide templates (AAO)

    National Research Council Canada - National Science Library

    Blaszczyk-Lezak, I; Desmaret, V; Mijangos, C

    2016-01-01

    ...) as representative of intrinsically and extrinsically conducting polymers, respectively. In this work, porous anodic aluminum oxide (AAO) templates have been used both as a nanoreactor to synthesize 1D PANI nanostructures by polymerization of the ANI monomer and as a nanomold to prepare 1D PVDF-MWCNT nanorods by melt infiltration of the precursor...

  9. 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...

  10. 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 ...

  11. 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.

  12. 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 ...

  13. Readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine.

    Science.gov (United States)

    Ganta, Abhishek; Yi, Paul H; Hussein, Khalil; Frank, Rachel M

    2014-04-01

    Although studies have revealed high readability levels of orthopedic patient education materials, no study has evaluated sports medicine-related patient education materials. We conducted a study to assess the readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM). All sports medicine patient education articles available online in 2012 from the AAOS and the AOSSM, including the Stop Sports Injuries Campaign (STOP), were identified, and their readability was assessed with the Flesch-Kinkaid (FK) readability test. Mean overall FK grade level of the 170 articles reviewed (104 from AAOS, 36 from AOSSM, 30 from STOP) was 10.2. Mean FK levels for the 3 sources were 9.5 (AAOS), 11.0 (AOSSM), and 11.5 (STOP) (P = .16). Fifteen (8.8%) of the 170 articles had a readability level at or below eighth grade (average reading level of US adults); only 2 (1.2%) of the 170 articles were at or below the recommended sixth-grade level. The majority of sports medicine-related patient education materials from AAOS and AOSSM had reading levels higher than recommended, indicating that the majority of the patient population may find it difficult to comprehend these articles.

  14. Fabrication and characterization of nanostructured Mg-doped CdS/AAO nanoporous membrane for sensing applications

    Science.gov (United States)

    Shaban, Mohamed; Mustafa, Mona; Hamdy, Hany

    2016-04-01

    In this study, Mg-doped CdS nanostructure was deposited onto anodic aluminum oxide (AAO) membrane substrate using sol-gel spin coating method. The AAO membrane was prepared by a two-step anodization process combined with pore widening process. The morphology, chemical composition, and structure of the spin- coated CdS nanostructure have been studied. The morphology of the fabricated AAO membrane and the deposited Mg-doped CdS nanostructure was investigated using scanning electron microscopy (SEM). The SEM of AAO illustrates a typical hexagonal and smooth nanoporous alumina membrane with interpore distance of ~ 100 nm, the pore diameter of ~ 60 nm. SEM of Mgdoped CdS shows porous nanostructured film of CdS nanoparticles. This film well adherents and covers the AAO substrate. The energy dispersive X-ray (EDX) pattern exhibits the signals of Al, O from AAO membrane and Mg, Cd, and S from the deposited CdS. This indicates the high purity of the fabricated membrane and the deposited Mg-doped CdS nanostructure. Using X-ray diffraction (XRD) pattern, Scherrer equation was used to calculate the average crystallite size. Additionally, the texture coefficients and density of dislocations were calculated. The fabricated CdS/AAO was applied to detect glucose of different concentrations. The proposed method has some advantages such as simple technology, low cost of processing, and high throughput. All of these factors facilitate the use of the prepared films in sensing applications.

  15. The biocompatibility and anti-biofouling properties of magnetic core-multishell Fe@C NWs-AAO nanocomposites.

    Science.gov (United States)

    Lindo, André M; Pellicer, Eva; Zeeshan, Muhammad A; Grisch, Roman; Qiu, Famin; Sort, Jordi; Sakar, Mahmut S; Nelson, Bradley J; Pané, Salvador

    2015-05-28

    Soft-magnetic core-multishell Fe@C NWs-AAO nanocomposites were synthesized using anodization, electrodeposition and low-pressure chemical vapour deposition (CVD) at 900 °C. High chemical and mechanical stability is achieved by the conversion from amorphous to θ- and δ-Al2O3 phases above 600 °C. Moreover, the surface properties of the material evolve from bioactive, for porous AAO, to bioinert, for Fe@C NW filled AAO nanocomposite. Although the latter is not cytotoxic, cells do not adhere onto the surface of the magnetic nanocomposite, thus proving its anti-biofouling character.

  16. 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.

  17. Critical review of patient education materials from the American Academy of Orthopaedic Surgeons.

    Science.gov (United States)

    Feghhi, Daniel P; Agarwal, Nitin; Hansberry, David R; Berberian, Wayne S; Sabharwal, Sanjeev

    2014-08-01

    We performed an expanded readability analysis to determine if the American Academy of Orthopaedic Surgeons, AAOS, had sufficiently improved its patient education materials since they were originally studied in 2007. In March 2013, we downloaded patient education materials from the AAOS patient information website, Your Orthopaedic Connection. Using 10 different readability formulas, we found that the mean grade level of patient education materials on the website is 8.84. Flesch-Kincaid analysis showed a mean grade level of 9.98, range, 6.6-12.6. Nine other readability analyses showed a mean reading level of 7.7, range, 6.5-13.7. Although this is an improvement over the 2007 level, it is above the average national reading comprehension level. The readability of patient education materials on the AAOS website still exceeds the average reading ability of a US adult. Revisions made over the 5 years leading up to this latest study resulted in better readability. The Prevention and Safety entries, written near seventh-grade level, should serve as a model for the remaining articles.

  18. Electrochemical synthesis of highly ordered Ni nanowire arrays through AAO templates

    Institute of Scientific and Technical Information of China (English)

    LI Mei-jing; LI Xiao-ru; SONG Guo-jun; ZHAO Qing-pei

    2015-01-01

    One-dimensional Ni nanowires arrays were fabricated successfully by the electrochemical deposit in porous anodic alumina oxide (AAO) templates. The microstructure of nanoarrays was respectively observed by scanning electron microscope s (SEM) and transmission electron microscopes (TEM). The results show that the obtained Ni nanowires are arranged orderly and the diameter is about 200nm. Crystallization way was observed by X-ray diffraction (XRD). The results show that Ni nanowire is face-centered cubic structure.

  19. Fabrication of vertically aligned Pd nanowire array in AAO template by electrodeposition using neutral electrolyte

    Directory of Open Access Journals (Sweden)

    Yüzer Hayrettin

    2010-01-01

    Full Text Available Abstract A vertically aligned Pd nanowire array was successfully fabricated on an Au/Ti substrate using an anodic aluminum oxide (AAO template by a direct voltage electrodeposition method at room temperature using diluted neutral electrolyte. The fabrication of Pd nanowires was controlled by analyzing the current–time transient during electrodeposition using potentiostat. The AAO template and the Pd nanowires were characterized by scanning electron microscopy (SEM, energy-dispersive X-ray (EDX methods and X-Ray diffraction (XRD. It was observed that the Pd nanowire array was standing freely on an Au-coated Ti substrate after removing the AAO template in a relatively large area of about 5 cm2, approximately 50 nm in diameter and 2.5 μm in length with a high aspect ratio. The nucleation rate and the number of atoms in the critical nucleus were determined from the analysis of current transients. Pd nuclei density was calculated as 3.55 × 108 cm−2. Usage of diluted neutral electrolyte enables slower growing of Pd nanowires owing to increase in the electrodeposition potential and thus obtained Pd nanowires have higher crystallinity with lower dislocations. In fact, this high crystallinity of Pd nanowires provides them positive effect for sensor performances especially.

  20. [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.

  1. 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.

  2. Fabrication of nanostructure via self-assembly of nanowires within the AAO template

    Directory of Open Access Journals (Sweden)

    Brust Mathias

    2006-01-01

    Full Text Available AbstractThe novel nanostructures are fabricated by the spatial chemical modification of nanowires within the anodic aluminum oxide (AAO template. To make the nanowires better dispersion in the aqueous solution, the copper is first deposited to fill the dendrite structure at the bottom of template. During the process of self-assembly, the dithiol compound was used as the connector between the nanowires and nanoparticles by a self-assembly method. The nanostructures of the nano cigars and structure which is containing particles junction are characterized by transmission electron microscopy (TEM. These kinds of novel nanostructure will be the building blocks for nanoelectronic and nanophotonic devices.

  3. Linking of the American Academy of Orthopaedic Surgeons Distal Radius Fracture Clinical Practice Guidelines to the International Classification of Functioning, Disability, and Health; International Classification of Diseases; and ICF Core Sets for Hand Conditions.

    Science.gov (United States)

    Esakki, Saravanan; MacDermid, Joy; Vajravelu, Saipriya

    2016-09-01

    Background: American Academy of Orthopaedic Surgeons (AAOS) distal radius fracture (DRF) clinical practice guidelines (CPG) are readily available to clinicians, patients, and policymakers. International Classification of Functioning, Disability, and Health (ICF) provides a framework for describing the impact of health conditions. The International Classification of Diseases-10th Revision (ICD-10) is a classification system to classify health conditions as specific disease or disorders. The aim of this study is to analyze and describe the scope and focus of the AAOS DRF CPG using the ICF and ICD-10 as a basis for content analysis, and to compare the content of the CPG with the ICF hand core sets as the reference standard. Methods: Established linking rules were used by 2 independent raters to analyze the 29 recommendations of the AAOS DRF CPG. ICD-10 codes were assigned in the same process. Summary linkage statistics were used to describe the results for ICF and the hand core sets. Results: Among the 29 recommendations of the AAOS DRF CPG, 5 meaningful concepts were linked to the ICF codes. Of these, 5 codes appeared on the comprehensive ICF core set and only 3 codes appeared in the brief ICF core set, and 7 conditions were covered in ICD-10 codes. Conclusions: The AAOS DRF CPG focuses on surgical interventions and has minimal linkage to the constructs of the ICD-10 and ICF. It does not address activity or participation (disability), and is not well linked to key concepts relevant to hand conditions.

  4. Impedance spectroscopy of highly ordered nano-porous electrodes based on Au-AAO (anodic aluminum oxide) structure.

    Science.gov (United States)

    Ahn, Jaehwan; Cho, Sungbo; Min, Junhong

    2013-11-01

    Electrochemical measurements using the microelectrodes are increasingly utilized for the label-free detection of the small amount of biological materials such as DNA, protein, and cells. However, the interfacial electrode impedance increases and may hinder the detection of weak signals as the size of electrode decreases. To enhance the measurement sensitivity while reducing the electrode size, in this study, microelectrodes employing a nanoporous structure were fabricated and characterized by using electrical impedance spectroscopy. We made the highly ordered honeycomb nanoporous structure of Anodic Aluminum Oxide (AAO) by electrochemical anodizing and formed Au layer on the surface of AAO (Au/AAO) by electroless Au plating method. The electrical characteristics of the fabricated Au/AAO electrodes were evaluated by using de Levie's model derived for the pore electrodes. As a result, the interfacial electrode impedance of the fabricated Au/AAO electrodes was 2-3 order lower than the value of the planar electrodes at frequencies below 1 kHz. It implies this nanoporous electrode could be directly applied to label free detection of biomaterials.

  5. [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.

  6. DC electrodeposition of NiGa alloy nanowires in AAO template

    Energy Technology Data Exchange (ETDEWEB)

    Maleki, K. [Nanomaterials Group, Department of Materials Engineering, Tarbiat Modares University, Iran, P.O. Box: 14115-143, Tehran (Iran, Islamic Republic of); Sanjabi, S., E-mail: sanjabi@modares.ac.ir [Nanomaterials Group, Department of Materials Engineering, Tarbiat Modares University, Iran, P.O. Box: 14115-143, Tehran (Iran, Islamic Republic of); Alemipour, Z. [Department of Physics, University of Kurdistan, Sanandaj (Iran, Islamic Republic of)

    2015-12-01

    NiGa alloy nanowires were electrodeposited from an acidic sulfate bath into nanoporous anodized alumina oxide (AAO). This template was fabricated by two-step anodizing. The effects of bath composition and current density were explored on the Ga content of electrodeposited nanowires. The Ga content in the deposits was increased by increasing both Ga in the bath composition and electrodepositing current density. The NiGa alloy nanowires were synthesized for Ga content up to 2–4% without significant improving the magnetic properties. Above this threshold Ga clusters were formed and decreased the magnetic properties of the nanowires. For Ga content of the alloy above 30%, the wires were too short and incomplete. X-ray diffraction patterns reveal that the significant increase of Ga content in the nanowires, changes the FCC crystal structure of Ni to an amorphous phase. It also causes a sizeable increase in the Ga cluster size; these both lead to a significant reduction in the coercivity and the magnetization respectively. - Highlights: • NiGa alloy nanowires were electrodeposited from acidic sulphate baths into nanoporous anodized alumina oxide (AAO) template. • The Ga content was increased by increasing the Ga in the bath composition and electrodeposition current density. • The magnetic parameters such as coercivity and magnetization were not changed for the alloy nanowire with Ga content less than 4%.

  7. MASH-II: More Planetary Nebulae from the AAO/UKST H\\alpha Survey

    CERN Document Server

    Miszalski, B; Acker, A; Birkby, J L; Frew, D J; Kovacevic, A

    2007-01-01

    We present a supplement to the Macquarie/AAO/Strasbourg H$\\alpha$ planetary nebulae (PNe) catalogue (MASH), which we denote MASH-II. The supplement consists of over 300 true, likely and possible new Galactic PNe found after re-examination of the entire AAO/UKST H$\\alpha$ survey of the southern Galactic Plane in digital form. We have spectroscopically confirmed over 240 of these new candidates as bona-fide PNe and we include other high quality candidates awaiting spectroscopic confirmation as possible PNe. These latest discoveries largely comprise two distinct groups: small, star-like or moderately resolved PNe at one end and mostly large, extremely low surface brightness PNe at the other. Neither group were easy to discover from simple visual scrutiny of the original survey exposures as for MASH but were relatively straightforward to uncover from the digital images via application of semi-automated discovery techniques. We suspect the few PNe still hidden in the H$\\alpha$ survey will lie outside our search cr...

  8. Steam reforming of methanol over copper loaded anodized aluminum oxide (AAO) prepared through electrodeposition

    Science.gov (United States)

    Linga Reddy, E.; Karuppiah, J.; Lee, Hyun Chan; Kim, Dong Hyun

    2014-12-01

    In order to study the steam reforming of methanol (SRM) to produce hydrogen for fuel cells, porous γ-alumina support is developed on Al substrate using anodic oxidation process and copper catalyst particles are deposited homogeneously over anodic aluminum oxide (AAO) surface by electrodeposition method. We investigated the effect of electrodeposition time and hot water treatment (HWT) on the activity of catalysts for SRM reaction in the temperature range between 160 and 360 °C. The experimental results indicate that the SRM activity, CO2 and dimethyl ether (DME) selectivity's over Cu catalysts increased as the electrodeposition time increased from 30 to 120 s, further increment in deposition time of Cu have no significant effect on it. The rates of SRM conversion are found to be higher for the catalysts made from the supports obtained after HWT, which may be due to the enhancement in the surface area of AAO support. It is found that the SRM activity and CO2 selectivity strongly depended upon the free exposed copper sites available for methanol adsorption and reaction, and DME in products is mainly observed in the reaction temperature range between 300 and 350 °C and it is higher for the catalysts with low Cu content.

  9. Electrically conducting polymer nanostructures confined in anodized aluminum oxide templates (AAO

    Directory of Open Access Journals (Sweden)

    I. Blaszczyk-Lezak

    2016-03-01

    Full Text Available Intrinsically or extrinsically conducting polymers are considered good candidates for replacement of metals in specific applications. In order to further expand their applications, it seems necessary to examine the influence of confinement effects on the electric properties of nanostructured conducting polymers in comparison to the bulk. The present study reports a novel way to fabricate and characterize high quality and controllable one-dimensional (1D polymer nanostructures with promising electrical properties, with the aid of two examples polyaniline (PANI and poly(vinylidene fluoride with multiwall carbon nanotubes (PVDF-MWCNT as representative of intrinsically and extrinsically conducting polymers, respectively. In this work, porous anodic aluminum oxide (AAO templates have been used both as a nanoreactor to synthesize 1D PANI nanostructures by polymerization of the ANI monomer and as a nanomold to prepare 1D PVDFMWCNT nanorods by melt infiltration of the precursor PVDF-MWCNT film. The obtained polymer nanostructures were morphologically and chemically characterized by SEM and Confocal Raman Spectroscopy, respectively, and the electrical properties determined by Broadband Dielectric Spectroscopy (BDS in a non-destructive way. SEM study allowed to establish the final nanostructure of PANI and PVDF-MWCNT and confirmed, in both cases, the well-aligned and uniform rodlike polymer nanostructures. Confocal Raman Microscopy has been performed to study the formation of the conducting emeraldine salt of PANI through all the length of AAO nanocavities. Finally, the electrical conductivity of both types of polymer nanostructures was easily evaluated by means of Dielectric Spectroscopy.

  10. Music Publishing

    OpenAIRE

    A.Manuel B. Simoes; J.Joao Dias De Almeida

    2003-01-01

    Current music publishing in the Internet is mainly concerned with sound publishing. We claim that music publishing is not only to make sound available but also to define relations between a set of music objects like music scores, guitar chords, lyrics and their meta-data. We want an easy way to publish music in the Internet, to make high quality paper booklets and even to create Audio CD's. In this document we present a workbench for music publishing based on open formats, using open-source t...

  11. Performance enhancement of pc-Si solar cells through combination of anti-reflection and light-trapping: Functions of AAO nano-grating

    Science.gov (United States)

    Wu, Lei; Zhang, Haiming; Qin, Feifei; Bai, Xiaogang; Ji, Ziye; Huang, Dan

    2017-02-01

    Anodic aluminium oxide (AAO) nanogratings are experimentally applied to polycrystalline silicon (pc-Si) solar cells at front surface to improve the light coupling. On the basis of the Fresnel Reflection Principle, the primary reflection loss can be reduced by multi-layer dielectric film with varing refactive index. And this multi-layer film is regarded as anti-reflection coating. An efficient light-trapping structure is significant in absorption enhancement of long wavelength band (around 900-1100 nm) for silicon solar cells. In this paper, we put AAO nanogratings on the front side of pc-Si solar cells to serve as anti-reflecting coating and light-trapping structure. The operation leads to light absorption enhancement eventually. Thanks to AAO nano-grating's structure parameters, the anti-reflecting and light-trapping effects are changeable. This is discussed in three aspects: AAO lattice period, AAO thickness and its pore diameter. Optical interaction between AAO nanograting and Ag electrodes is also discussed. We find an increase of short-circuit current density (1.32 mA/cm2) with SiNx:H/AAO complex coating. The relative power conversion efficiency obtains a growth about 2.2% points. Additionally, AAO nanogratings may facilitate carrier separation. This improves the performance of pc-Si solar cells in electrical aspect.

  12. 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 ...

  13. Stacked pulse-electroplated CoNiMnP-AAO nanocomposite permanent magnets for MEMS

    Science.gov (United States)

    Wu, P. R.; Chao, T. Y.; Cheng, Y. T.

    2015-12-01

    The paper presents a CMOS compatible pulse-electroplating technique combined with a low temperature bonding process for the synthesis of CoNiMnP-AAO (anodic alumina oxide) nanocomposite films and the fabrication of stacked composite permanent magnets (PMs). The magnetic nanocomposite film exhibits the best characteristics of the coercivity of 2472 Oe, remanence of 4000 G, and {{≤ft(\\text{BH}\\right)}\\max} of 16.13 kJ m-3, in the existing CoNiMnP systems. Meanwhile, a surface magnetic flux density of 9.2 mT generated by a 15-layer-stacked composite PM with a volume of 9 mm3 has shown the potential for various magnetic microelectromechanical systems (MEMS) fabrication using the nanocomposite material.

  14. Preparation of thin hexagonal highly-ordered anodic aluminum oxide (AAO) template onto silicon substrate and growth ZnO nanorod arrays by electrodeposition

    Science.gov (United States)

    Chahrour, Khaled M.; Ahmed, Naser M.; Hashim, M. R.; Elfadill, Nezar G.; Qaeed, M. A.; Bououdina, M.

    2014-12-01

    In this study, anodic aluminum oxide (AAO) templates of Aluminum thin films onto Ti-coated silicon substrates were prepared for growth of nanostructure materials. Hexagonally highly ordered thin AAO templates were fabricated under controllable conditions by using a two-step anodization. The obtained thin AAO templates were approximately 70 nm in pore diameter and 250 nm in length with 110 nm interpore distances within an area of 3 cm2. The difference between first and second anodization was investigated in details by in situ monitoring of current-time curve. A bottom barrier layer of the AAO templates was removed during dropping the voltage in the last period of the anodization process followed by a wet etching using phosphoric acid (5 wt%) for several minutes at ambient temperature. As an application, Zn nanorod arrays embedded in anodic alumina (AAO) template were fabricated by electrodeposition. Oxygen was used to oxidize the electrodeposited Zn nanorods in the AAO template at 700 °C. The morphology, structure and photoluminescence properties of ZnO/AAO assembly were analyzed using Field-emission scanning electron microscope (FESEM), Energy dispersive X-ray spectroscopy (EDX), Atomic force microscope (AFM), X-ray diffraction (XRD) and photoluminescence (PL).

  15. 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.

  16. 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? ...

  17. 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 ...

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. Preparation of AAO-CeO2 nanotubes and their application in electrochemical oxidation desulfurization of diesel

    Science.gov (United States)

    Du, Xiaoqing; Yang, Yumeng; Yi, Chenxi; Chen, Yu; Cai, Chao; Zhang, Zhao

    2017-02-01

    The coaxial arrays of AAO-CeO2 NTs have been successfully galvanostatically deposited on an anode, characterized and adopted as a catalyst for removing organic sulfurs from diesel. The influence of the main electrochemical oxidation factors on the efficiency of desulfurization have also been investigated. The results show that the fabrication process of AAO-CeO2 NTs is accompanied by the formation of a new phase, namely Al3Ce, and the main oxidation products of the diesel are soluble inorganic sulphides, especially Ce2(SO4)3. When compared with dibenzothiophene and 4, 6-dimethyldibenzothiophene, benzothiophene is much more easily removed, with a removal efficiency that reaches 87.2%. Finally, a possible electrochemical oxidation desulfurization pathway for diesel is proposed.

  4. Laser-MBE of nickel nanowires using AAO template: a new active substrate of surface enhanced Raman scattering.

    Science.gov (United States)

    Zhang, Lisheng; Fang, Yan; Zhang, Pengxiang

    2008-01-01

    The highly ordered anodic aluminum oxide (AAO) template was fabricated using aluminum anodizing in electrolytes with two-step method, which apertures were about 50-80nm. The nickel nanowires with about 40-70nm in diameter was prepared on the AAO template by laser-MBE (molecular beam epitaxy). And high quality Raman spectra of SudanII were obtained on the glass covered with the nickel nanowires. On the nickel nanowires there are both surface enhanced Raman scattering (SERS) and tip enhanced Raman scattering (TERS). The new observations not only enlarge the range of SERS applications, but also imply a possible new enhancement mechanism. Otherwise the Raman and SERS frequencies of SudanII molecule were calculated using, respectively, DFT and B3PW91.

  5. The Sydney-AAO Multi-object Integral field spectrograph (SAMI)

    CERN Document Server

    Croom, Scott M; Bland-Hawthorn, Joss; Bryant, Julia J; Fogarty, Lisa; Richards, Samuel; Goodwin, Michael; Farrell, Tony; Miziarski, Stan; Heald, Ron; Jones, D Heath; Lee, Steve; Colless, Matthew; Brough, Sarah; Hopkins, Andrew M; Bauer, Amanda E; Birchall, Michael N; Ellis, Simon; Horton, Anthony; Leon-Saval, Sergio; Lewis, Geraint; Lopez-Sanchez, A R; Min, Seong-Sik; Trinh, Christopher; Trowland, Holly

    2011-01-01

    We demonstrate a novel technology that combines the power of the multi-object spectrograph with the spatial multiplex advantage of an integral field spectrograph (IFS). The Sydney-AAO Multi-object IFS (SAMI) is a prototype wide-field system at the Anglo-Australian Telescope (AAT) that allows 13 imaging fibre bundles ("hexabundles") to be deployed over a 1-degree diameter field of view. Each hexabundle comprises 61 lightly-fused multimode fibres with reduced cladding and yields a 75 percent filling factor. Each fibre core diameter subtends 1.6 arcseconds on the sky and each hexabundle has a field of view of 15 arcseconds diameter. The fibres are fed to the flexible AAOmega double-beam spectrograph, which can be used at a range of spectral resolutions (R=lambda/delta(lambda) ~ 1700-13000) over the optical spectrum (3700-9500A). We present the first spectroscopic results obtained with SAMI for a sample of galaxies at z~0.05. We discuss the prospects of implementing hexabundles at a much higher multiplex over wid...

  6. Telementoring: use of augmented reality in orthopaedic education: AAOS exhibit selection.

    Science.gov (United States)

    Ponce, Brent A; Jennings, Jonathan K; Clay, Terry B; May, Mathew B; Huisingh, Carrie; Sheppard, Evan D

    2014-05-21

    Virtual interactive presence (VIP) is a new technology that allows an individual to deliver real-time virtual assistance to another geographically remote individual via a standard Internet connection. The objectives of this pilot study were to evaluate the efficiency and performance of a VIP system implemented in an operating room setting, determine the potential utility of the system for guidance of surgical procedures, and assess the safety of the system. Following institutional review board approval, fifteen patients underwent arthroscopic shoulder procedures. Two VIP stations were used, one in the operating room and the other in an adjoining dictation room. The attending surgeon proctored operating resident surgeons from the dictation room until his physical presence was required in the operating room. Following each procedure, the attending surgeon, resident surgeons, and three surgical staff members completed a Likert-scale questionnaire regarding the educational utility, efficiency of use, and safety of the system. The operative time was also compared with historical data. Both attending and resident surgeons assigned a favorable rating to the utility of the VIP to highlight anatomy and provide feedback to the resident (p > 0.05 for the difference). Both groups agreed that the system was easy to use and that safety was not compromised (p > 0.05). The majority of resident and attending surgeon responses indicated no perceptible lag between motions (95% and 100%, respectively; p > 0.99) and no interference of the VIP system with the surgical procedure (85% and 100%, respectively; p = 0.24). The mean operative times with and without VIP use did not differ significantly for rotator cuff repair (p = 0.90) or for treatment of instability (p = 0.57). This pilot study revealed that the VIP technology was efficient, safe, and effective as a teaching tool. The attending and resident surgeons agreed that training was enhanced, and this occurred without increasing

  7. 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.

  8. The preparation of La2O3@AAO with simple hydrothermal method under ambient pressure and the enhanced electrowetting-on-dielectric performance

    Science.gov (United States)

    Jin, Hongxia; Wang, Jian; Yin, Yangyang; An, Yuying; Wang, Xiangzhuo; Li, Yan; Wang, Chengwei; Lv, Yudong

    2017-10-01

    Anodic aluminum oxide (AAO) has unique nanostructure and is a conventional EWOD material. The lanthanum oxide, a kind of rare-earth oxide, has unique electronic structure and high dielectric constant, but its synthesis is still complicated. A simple method is proposed to prepare the La2O3@AAO nanocomposites through immersing highly ordered AAO films into La(NO3)3 solution under ambient temperature and pressure and subsequent annealing. It can be known that when the immersion temperature gets to 60 °C, the La2O3 starts to grow in AAO by the characterization of morphology, crystal phase structure and surface chemical composition. The measurement of EWOD performance indicates that the incorporation of La2O3 into AAO greatly enhances the capacitance about 2-3 orders of magnitude, and the large contact angle modulation is acquired. Furthermore, the EW properties of La2O3@AAO nanocomposites, such as relaxation time, critical voltage, can be easily modulated by the immersion temperature and time.

  9. Easy-to-Fabricate and High-Sensitivity LSPR Type Specific Protein Detection Sensor Using AAO Nano-Pore Size Control.

    Science.gov (United States)

    Kim, Sae-Wan; Lee, Jae-Sung; Lee, Sang-Won; Kang, Byoung-Ho; Kwon, Jin-Beom; Kim, Ok-Sik; Kim, Ju-Seong; Kim, Eung-Soo; Kwon, Dae-Hyuk; Kang, Shin-Won

    2017-04-13

    In this study, we developed a pore size/pore area-controlled optical biosensor-based anodic aluminum oxide (AAO) nanostructure. As the pore size of AAO increases, the unit cell of AAO increases, which also increases the non-pore area to which the antibody binds. The increase in the number of antibodies immobilized on the surface of the AAO enables effective detection of trace amounts of antigen, because increased antigen-antibody bonding results in a larger surface refractive index change. High sensitivity was thus achieved through amplification of the interference wave of two vertically-incident reflected waves through the localized surface plasmon resonance phenomenon. The sensitivity of the fabricated sensor was evaluated by measuring the change in wavelength with the change in the refractive index of the device surface, and sensitivity was increased with increasing pore-size and non-pore area. The sensitivity of the fabricated sensor was improved and up to 11.8 ag/mL serum amyloid A1 antigen was detected. In addition, the selectivity of the fabricated sensor was confirmed through a reaction with a heterogeneous substance, C-reactive protein antigen. By using hard anodization during fabrication of the AAO, the fabrication time of the device was reduced and the AAO chip was fabricated quickly and easily.

  10. Publisher's Announcement

    Science.gov (United States)

    McGlashan, Yasmin

    2008-01-01

    Important changes for 2008 As a result of reviewing several aspects of our content, both in print and online, we have made some changes for 2008. These changes are described below: Article numbering Plasma Physics and Controlled Fusion has moved from sequential page numbering to an article numbering system, offering important advantages and flexibility by speeding up the publication process. Papers in different issues or sections can be published online as soon as they are ready, without having to wait for a whole issue or section to be allocated page numbers. The bibliographic citation will change slightly. Articles should be referenced using the six-digit article number in place of a page number, and this number must include any leading zeros. For instance, from this issue: Z Y Chen et al 2008 Plasma Phys. Control. Fusion 50 015001 Articles will continue to be published on the web in advance of the print edition. A new look and feel We have also taken the opportunity to refresh the design of the journal cover, in order to modernise the typography and create a consistent look and feel across our range of publications. We hope you like the new cover. If you have any questions or comments about any of these changes, please contact us at ppcf@iop.org.

  11. 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.

  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. 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.

  14. [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.

  15. Nano integrated lithium polymer electrolytes based on anodic aluminum oxide (AAO) templates

    Science.gov (United States)

    Bokalawela, Roshan S. P.

    Since their discovery in the 1970s, polymer electrolytes have been actively studied because they have properties important for many device applications. However, even after 40 years, the detailed mechanisms of conductivity in these electrolytes are still not completely understood. Moreover, the conductivity in polymer electrolytes is one of the limiting factors of these devices so that different methods to enhance conductivity are actively being explored. One proposed method of enhancing the conductivity is to confine the polymer electrolyte in the nanoscale, but the study of material properties at the nanoscale is challenging in this area. In this work, we confine poly(ethylene oxide) lithium triflate (PEO:LiTf)(X:1)X=10,30 polymer electrolytes in carefully fabricated nanometer-diameter anodized aluminum oxide (AAO) pore structures. We demonstrate two orders of magnitude higher conductivity in the confined structures versus that of bulk films. Using x-ray characterization we show that this increased conductivity is associated with ordered PEO polymer chains aligned in the template pore direction. The activation energy of the AAO-confined polymer electrolyte is found to be smaller than that of the unconfined melt and about half that of the unconfined solid. This result indicates that not only is the room-temperature confined polymer ordered, but that this order persists at temperatures where the nano-confined polymer electrolyte is expected to be a liquid. The geometric bulk resistances of the electrolytes were obtained by AC-impedance spectra, from which the ionic conductivities were calculated. The Arrhenius plots of temperature dependent ionic conductivities showed that the usual melting temperature of the PEO phase in confined PEO:LiTf(X:1) X=10,30 is suppressed and a single activation energy was evident throughout the temperature range 25--90 °C. Wide-angle x-ray scattering (WAXS) patterns show that the polymer chains in both the pure PEO and PEO:LiTf(10

  16. 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.

  17. 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.

  18. 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.

  19. AAO-assisted synthesis of highly ordered, large-scale TiO2 nanowire arrays via sputtering and atomic layer deposition.

    Science.gov (United States)

    Yao, Zhao; Wang, Cong; Li, Yang; Kim, Nam-Young

    2015-01-01

    Highly ordered nanoporous anodic aluminum oxide (AAO) thin films were fabricated in oxalic acid under a constant voltage via a two-step anodization process. To investigate the high-aspect-ratio (7.5:1) filling process, both sputtering and atomic layer deposition (ALD) were used to form TiO2 nanowires. Field emission scanning electron microscopy and high-resolution transmission electron microscopy images indicated that mushroom-like TiO2 structures were sputtered onto the AAO template surface, and the ALD-coated TiO2 exhibited fine filling results and clear crystal grain boundaries. Large-scale and free-standing TiO2 nanowire arrays were liberated by selectively removing the aluminum substrate and AAO template via a wet etching process with no collapsing or agglomeration after the drying process. ALD-deposited TiO2 nanowire arrays that were 67 nm in diameter and 400 nm high were transferred from the AAO template. The ALD process enabled the rapid, simple synthesis of highly ordered TiO2 nanowire arrays with desired parameters such as diameter, density, and thickness determined using diverse AAO templates.

  20. 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.

  1. Design and Operation of Multi-mode AAO/ABF Process at Fuyong Sewage Treatment Plant in Shenzhen%深圳福永污水厂多模式AAO/ABF工艺设计与运行

    Institute of Scientific and Technical Information of China (English)

    鄢卫东

    2013-01-01

    The recent treatment capacity of Fuyong Sewage Treatment Plant is 12. 5 × 10 m /d, the secondary treatment uses multi-mode AAO process, and the advanced treatment uses the automatic backwash fdter ( ABF). The effluent quality meets the first class A criteria specified in the Discharge Standard of Pollutants for Municipal Wastewater Treatment Plant ( GB 18918 - 2002). The process flow, design parameters, technical characteristics and running effect of the project were introduced. sewage treatment plant; AAO; nitrogen and phosphorus removal; automatic%深圳福永污水处理厂近期处理规模为12.5×104 m3/d,二级处理采用了多模式AAO工艺,深度处理采用自动反冲洗滤池(ABF),出水水质满足《城镇污水处理厂污染物排放标准》(GB 18918-2002)的一级A标准.详细介绍了该工程工艺流程及设计参数、技术特点和运行效果.

  2. 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.

  3. 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...

  4. 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

    those in practice for less than 5 years. Education on the dangers of social media should not be limited to residents but should instead be extended to attending surgeons as well. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Characterizing and simulation the scintillation properties of zinc oxide nanowires in AAO membrane for medical imaging applications

    Science.gov (United States)

    Esfandi, F.; Saramad, S.; Rezaei Shahmirzadi, M.

    2017-07-01

    In this work, a new method is proposed for extracting some X-ray detection properties of ZnO nanowires electrodeposited on Anodized Aluminum Oxide (AAO) nanoporous template. The results show that the detection efficiency for 12μm thickness of zinc oxide nano scintillator at an energy of 9.8 keV, near the K-edge of ZnO (9.65 keV), is 24%. The X-rays that interact with AAO can also generate electrons that reach the nano scintillator. The scintillation events of these electrons are seen as a low energy tail in the spectrum. In addition, it is found that all the X-rays that are absorbed in 300 nm thickness of the gold layer on the top of the zinc oxide nanowires can participate in the scintillation process with an efficiency of 6%. Hence, the scintillation detection efficiency of the whole detector for 9.8 keV X-ray energy is 30%. The simulation results from Geant4 and the experimental detected photons per MeV energy deposition are also used to extract the light yield of the zinc oxide nano scintillator. The results show that the light yield of the zinc oxide nanowires deposited by the electrochemical method is approximately the same as for single crystal zinc oxide scintillator (9000). Much better spatial resolution of this nano scintillator in comparison to the bulk ones is an advantage which candidates this nano scintillator for medical imaging applications.

  6. 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.

  7. [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.

  8. 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.

  9. 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.

  10. Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009.

    Science.gov (United States)

    Hennedige, Anusha A; Kong, Tze Yean; Gandhi, Ashu

    2011-07-01

    Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown. Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons. A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods. 64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening: 92% Breast 41% Plastic (p Plastic. Routine histology for BBR specimens: 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old: Breast 38% Plastic 10%. Selective screening of patients aged 40-50: Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer: Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer: Breast 77%, Plastic 93%. There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice. Copyright © 2010. Published by Elsevier Ltd.

  11. 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.

  12. 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.

  13. 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 ...

  14. 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.

  15. 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.

  16. Dual antiplatelet therapy use by Canadian cardiac surgeons.

    Science.gov (United States)

    Yanagawa, Bobby; Ruel, Marc; Bonneau, Christopher; Lee, Myunghyun M; Chung, Jennifer; Al Shouli, Sadek; Fagan, Andrew; Al Khalifa, Abdulwahab; White, Christopher W; Yamashita, Michael H; Currie, Maria E; Teoh, Hwee; Mewhort, Holly E M; Verma, Subodh

    2015-12-01

    Dual antiplatelet therapy is the cornerstone treatment for patients with acute coronary syndrome. Recent Canadian Guidelines recommend the use of dual antiplatelet therapy for 1 year after coronary artery bypass grafting in patients with acute coronary syndrome, but considerable variability remains. We performed a survey of 75 Canadian cardiac surgeons to assess the use of dual antiplatelet therapy. Whereas 58.6% of respondents indicated that the benefits of dual antiplatelet therapy were seen irrespective of how patients were managed after acute coronary syndrome, 36.2% believed that the benefits of dual antiplatelet therapy were limited to those treated medically or percutaneously. In regard to the timing of dual antiplatelet therapy administration, 57% of respondents indicated that dual antiplatelet therapy should be given upstream in the emergency department, whereas 36.2% responded that dual antiplatelet therapy should be given only once the coronary anatomy has been defined. The majority surveyed (81%) weighed bleeding risk as being more important than ischemic risk reduction. In stable patients after acute coronary syndrome, the majority of surgeons would wait approximately 4 days after the last dose of P2Y12 antagonist before coronary artery bypass grafting. Only 44.6% indicated that they routinely use dual antiplatelet therapy postrevascularization in the setting of acute coronary syndrome. Rather, most surgeons use dual antiplatelet therapy for select patients, such as those with a stented vessel without a bypass graft, endarterectomy, or off-pump coronary artery bypass grafting. Cardiac surgeons exhibit variation in their attitudes and practice patterns toward dual antiplatelet therapy after coronary artery bypass grafting, and in approximately half of cases, their practice does not adhere to current guideline recommendations. New trials focusing on coronary artery bypass grafting cases in their primary analysis and educational initiatives for surgeons

  17. 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.

  18. [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.

  19. 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...

  20. Donald Nixon Ross, BS, MB, ChB, FRCS: pioneering surgeon and true gentleman.

    Science.gov (United States)

    Chitwood, W Randolph

    2015-03-01

    Donald Nixon Ross, FRCS, was a master surgeon, a consummate scholar, and fine gentleman. Herein, are descriptions of his education, practice of cardiac surgery, and legacy contributions. He always will be known for developing and applying the aortic autograft "switch" procedure for aortic stenosis known in perpetuity as the Ross procedure. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. The Society of Thoracic Surgeons National Database 2016 Annual Report.

    Science.gov (United States)

    Jacobs, Jeffrey P; Shahian, David M; Prager, Richard L; Edwards, Fred H; McDonald, Donna; Han, Jane M; D'Agostino, Richard S; Jacobs, Marshall L; Kozower, Benjamin D; Badhwar, Vinay; Thourani, Vinod H; Gaissert, Henning A; Fernandez, Felix G; Wright, Cameron D; Paone, Gaetano; Cleveland, Joseph C; Brennan, J Matthew; Dokholyan, Rachel S; Brothers, Leo; Vemulapalli, Sreekanth; Habib, Robert H; O'Brien, Sean M; Peterson, Eric D; Grover, Frederick L; Patterson, G Alexander; Bavaria, Joseph E

    2016-12-01

    The art and science of outcomes analysis, quality improvement, and patient safety continue to evolve, and cardiothoracic surgery leads many of these advances. The Society of Thoracic Surgeons (STS) National Database is one of the principal reasons for this leadership role, as it provides a platform for the generation of knowledge in all of these domains. Understanding these topics is a professional responsibility of all cardiothoracic surgeons. Therefore, beginning in January 2016, The Annals of Thoracic Surgery began publishing a monthly series of scholarly articles on outcomes analysis, quality improvement, and patient safety. This article provides a summary of the status of the STS National Database as of October 2016 and summarizes the articles about the STS National Database that appeared in The Annals of Thoracic Surgery 2016 series, "Outcomes Analysis, Quality Improvement, and Patient Safety."

  2. Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites.

    Science.gov (United States)

    Badarudeen, Sameer; Sabharwal, Sanjeev

    2008-01-01

    While experts recommend that the readability of patient education materials should be less than the sixth grade level, the available information pertaining to orthopaedic diseases may be excessively complex for some to read and comprehend. The Flesch-Kincaid grade level is the most widely used tool to evaluate the readability score of a given text, with a lower grade level suggesting easier readability. The goal of our study was to assess the readability of pediatric orthopaedic patient education materials that were developed by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) and were accessible to the general public through the Internet. All articles from the "Children" section of the patient education library, "Your Orthopaedic Connection," on the AAOS web site and the "Parent/Patient" section on the POSNA web site were identified. The Flesch-Kincaid grade level of each article was determined with use of Microsoft Office Word software. The mean grade levels of articles that were available in 2001 were compared with those accessible in 2007. Fifty-seven unique articles were available in 2007 on both web sites compared with twenty-five articles available in 2001. The readability score of only one (2%) of the currently available articles was less than sixth grade level. The mean Flesch-Kincaid grade level of the currently available articles was 8.9 compared with 8.7 for the articles available in 2001 (p = 0.71). Our findings suggest that most of the pediatric orthopaedic patient education materials available on the AAOS and POSNA web sites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States population.

  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. Publishing corruption discussion: predatory journalism.

    Science.gov (United States)

    Jones, James W; McCullough, Laurence B

    2014-02-01

    Dr Spock is a brilliant young vascular surgeon who is up for tenure next year. He has been warned by the chair of surgery that he needs to increase his list of publications to assure passage. He has recently had a paper reviewed by one of the top journals in his specialty, Journal X-special, with several suggestions for revision. He received an e-mail request for manuscript submission from a newly minted, open access, Journal of Vascular Disease Therapy, which promises a quick and likely favorable response for a fee. What should be done? A. Send the paper to another peer reviewed journal with the suggested revisions. B. Resubmit the paper to Journal X-special. C. Submit to the online journal as is to save time. D. Submit to the online journal and another regular journal. E. Look for another job. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  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. [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.

  8. Results of radial and astigmatic keratotomy by beginning refractive surgeons.

    Science.gov (United States)

    Friedberg, M L; Imperia, P S; Elander, R; Alcala, P L; Maloney, R K; Holland, G N

    1993-05-01

    There is little information available on the results of radial and astigmatic keratotomy surgery that is performed by beginning refractive surgeons. A retrospective review of all refractive keratotomies performed by Corneal Fellows in the University of California, Los Angeles, Department of Ophthalmology between October 1985 and October 1991 was performed. Data from all eyes with at least 3 months of follow-up were analyzed. Visual acuity, refractive error, and complication rates were compared with published case series. The mean preoperative spherical equivalent for the 79 eyes analyzed was -3.97 diopters (D) (range, -0.75 to -8.50 D). The mean postoperative spherical equivalent was -0.44 D (range, +1.50 to -3.88 D). The postoperative spherical equivalent was within 1.00 D of emmetropia in 85% of eyes, and uncorrected visual acuity was 20/40 or better in 94% of eyes. There were no vision-threatening complications. No patient lost more than one line of best-corrected visual acuity. Radial and astigmatic keratotomies that are performed by beginning refractive surgeons in a supervised setting can be safe and effective procedures with results comparable with those obtained by experienced refractive surgeons.

  9. Postural Preference and Musculoskeletal Complaints in Oral and Maxillofacial Surgeons.

    Science.gov (United States)

    Taylor, Corey A; Strauss, Robert A; Best, Alvin M

    2017-04-26

    Oral and maxillofacial surgeons traditionally have musculoskeletal pain. The aim of this study was to determine the postural preferences of oral and maxillofacial surgeons and their effect on musculoskeletal pain. The authors designed and implemented a cross-sectional study. The association of demographic characteristics with postural preferences and use of loupes was explored. Then, the relation of demographic characteristics, postural preferences, and use of loupes to painful musculoskeletal complaints was analyzed. Contingency analysis was used to compare participants' responses and multiple logistic regression analysis was used to identify relevant predictor variables. The sample was composed of 153 oral and maxillofacial surgeons, of which 32% indicated that they had ever had pain attributable to their practice that lasted longer than 2 weeks. Practitioners reported neck and back pain as being most common. Eighty-four percent of practitioners stood for extractions and placement of implants. Those who stood did so for visibility. Practitioners who sat indicated they did so for orthopedic reasons (P < .001). Thirty-one percent of practitioners indicated loupes use. Those who used loupes were more likely to report pain (P = .022). Most respondents stood and did not use loupes. Those who did use loupes were more likely to report pain. Those who stood did so for visibility; those who sat did so for orthopedic reasons. Almost one third of respondents reported pain lasting at least 2 weeks during practice. Copyright © 2017. Published by Elsevier Inc.

  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. 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.

  12. 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- ...

  13. Publishing with XML structure, enter, publish

    CERN Document Server

    Prost, Bernard

    2015-01-01

    XML is now at the heart of book publishing techniques: it provides the industry with a robust, flexible format which is relatively easy to manipulate. Above all, it preserves the future: the XML text becomes a genuine tactical asset enabling publishers to respond quickly to market demands. When new publishing media appear, it will be possible to very quickly make your editorial content available at a lower cost. On the downside, XML can become a bottomless pit for publishers attracted by its possibilities. There is a strong temptation to switch to audiovisual production and to add video and a

  14. Is there consistency in cephalometric landmark identification amongst oral and maxillofacial surgeons?

    Science.gov (United States)

    Miloro, M; Borba, A M; Ribeiro-Junior, O; Naclério-Homem, M G; Jungner, M

    2014-04-01

    There may be significant variation amongst oral and maxillofacial surgeons (OMFS) in the identification and placement of cephalometric landmarks for orthognathic surgery, and this could impact upon the surgical plan and final treatment outcome. In an effort to assess this variability, 10 lateral cephalometric radiographs were selected for evaluation by 16 OMFS with different levels of surgical knowledge and experience, and the position of 21 commonly used cephalometric landmarks were identified on radiographs displayed on a computer screen using a computer mouse on a pen tablet. The database consisted of real position measurements (x, y) to determine the consistency of landmark identification between surgeons and within individual surgeons. Inter-examiner analysis demonstrated that most landmark points had excellent reliability (intra-class correlation coefficient >0.90). Regardless of the level of surgeon experience, certain landmarks presented consistently poor reliability, and intra-examiner reliability analysis demonstrated that some locations had a higher average difference for both x and y axes. In particular, porion, condylion, and gonion showed poor agreement and reliability between examiners. The identification of most landmarks showed some inconsistencies within different parameters of evaluation. Such variability among surgeons may be addressed by the consistent use of high-quality images, and also by periodic surgeon education of the definition of the specific landmarks. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. G315.1+2.7: a new Galactic SNR from the AAO/UKST HAlpha survey

    CERN Document Server

    Stupar, M; Filipovic, M D

    2006-01-01

    New narrow-band HAlpha imaging and subsequent optical spectra confirm G315.1+2.7, a previously identified candidate supernova remnant (SNR), as a bona-fide Galactic SNR. Present observations are based on independent discovery of filamentary optical emission nebulosity on images of the AAO/UKST HAlpha survey of the southern Galactic plane which were found to co-incide with existing multi-frequency radio detections. Separate medium and high dispersion spectra were taken across two locations of this 11 arcmin N-S aligned optical filament. The resulting spectral signatures were found to strongly confirm the SNR identification based on standard emission line ratio discriminators which characterise emission from shock heated gas. The average observed ratios of [SII]/HAlpha=1.13, [NII]/HAlpha=1.43 and [SII] 6717/6731=1.46, together with the simultaneous detection of [OII] at 3727A, [OIII] 5007A and [OI] 6300A, all point to an SNR origin of the observed optical emission. Careful scrutiny of the low-resolution but hig...

  16. Ag-nanoparticles-decorated NiO-nanoflakes grafted Ni-nanorod arrays stuck out of porous AAO as effective SERS substrates.

    Science.gov (United States)

    Zhou, Qitao; Meng, Guowen; Huang, Qing; Zhu, Chuhong; Tang, Haibin; Qian, Yiwu; Chen, Bin; Chen, Bensong

    2014-02-28

    NiO-nanoflakes (NiO-NFs) grafted Ni-nanorod (Ni-NR) arrays stuck out of the porous anodic aluminum oxide (AAO) template are achieved by a combinatorial process of AAO-confined electrodeposition of Ni-NRs, selectively etching part of the AAO template to expose the Ni-NRs, wet-etching the exposed Ni-NRs in ammonia to obtain Ni(OH)2-NFs grafted onto the cone-shaped Ni-NRs, and annealing to transform Ni(OH)2-NFs in situ into NiO-NFs. By top-view sputtering, Ag-nanoparticles (Ag-NPs) are decorated on each NiO-NFs grafted Ni-NR (denoted as NiO-NFs@Ni-NR). The resultant Ag-NPs-decorated NiO-NFs@Ni-NR (denoted as Ag-NPs@NiO-NFs@Ni-NR) arrays exhibit not only strong surface-enhanced Raman scattering (SERS) activity but also reproducible SERS-signals over the whole array. It is demonstrated that the strong SERS-activity is mainly ascribed to the high density of sub-10 nm gaps (hot spots) between the neighboring Ag-NPs, the semiconducting NiO-NFs induced chemical enhancement effect, and the lightning rod effect of the cone-shaped Ni-NRs. The three-level hierarchical nanostructure arrays stuck out of the AAO template can be utilized to probe polychlorinated biphenyls (PCBs, a kind of global environmental hazard) with a concentration as low as 5 × 10(-6) M, showing promising potential in SERS-based rapid detection of organic environmental pollutants.

  17. Self-assembled synthesis of 3D Cu(In(1-x)Ga(x))Se2 nanoarrays by one-step electroless deposition into ordered AAO template.

    Science.gov (United States)

    Zhang, Bin; Zhou, Tao; Zheng, Maojun; Xiong, Zuzhou; Zhu, Changqing; Li, Hong; Wang, Faze; Ma, Li; Shen, Wenzhong

    2014-07-25

    Quaternary nanostructured Cu(In1 - xGax)Se2 (CIGS) arrays were successfully fabricated via a novel and simple solution-based protocol on the electroless deposition method, using a flexible, highly ordered anodic aluminium oxide (AAO) substrate. This method does not require electric power, complicated sensitization processes, or complexing agents, but provides nearly 100% pore fill factor to AAO templates. The field emission scanning electron microscopy (FE-SEM) images show that we obtained uniformly three-dimensional nanostructured CIGS arrays, and we can tailor the diameter and wall thicknesses of the nanostructure by adjusting the pore diameter of the AAO and metal Mo layer. Their chemical composition was determined by energy-dispersive spectroscopy analysis, which is very close to the stoichiometric value. The Raman spectroscopy, x-ray diffraction (XRD) pattern, and transmission electron microscopy (TEM) further confirm the formation of nanostructured CIGS with prominent chalcopyrite structure. The nanostructured CIGS arrays can support the design of low-cost, highlight-trapping, and enhanced carrier collection nanostructured solar cells.

  18. Self-assembled synthesis of 3D Cu(In1 - xGax)Se2 nanoarrays by one-step electroless deposition into ordered AAO template

    Science.gov (United States)

    Zhang, Bin; Zhou, Tao; Zheng, Maojun; Xiong, Zuzhou; Zhu, Changqing; Li, Hong; Wang, Faze; Ma, Li; Shen, Wenzhong

    2014-07-01

    Quaternary nanostructured Cu(In1 - xGax)Se2 (CIGS) arrays were successfully fabricated via a novel and simple solution-based protocol on the electroless deposition method, using a flexible, highly ordered anodic aluminium oxide (AAO) substrate. This method does not require electric power, complicated sensitization processes, or complexing agents, but provides nearly 100% pore fill factor to AAO templates. The field emission scanning electron microscopy (FE-SEM) images show that we obtained uniformly three-dimensional nanostructured CIGS arrays, and we can tailor the diameter and wall thicknesses of the nanostructure by adjusting the pore diameter of the AAO and metal Mo layer. Their chemical composition was determined by energy-dispersive spectroscopy analysis, which is very close to the stoichiometric value. The Raman spectroscopy, x-ray diffraction (XRD) pattern, and transmission electron microscopy (TEM) further confirm the formation of nanostructured CIGS with prominent chalcopyrite structure. The nanostructured CIGS arrays can support the design of low-cost, highlight-trapping, and enhanced carrier collection nanostructured solar cells.

  19. Surgeon-Based 3D Printing for Microvascular Bone Flaps.

    Science.gov (United States)

    Taylor, Erin M; Iorio, Matthew L

    2017-07-01

    Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models. These were printed in the surgeon's office as 3D models for the planned reconstruction. Vascularized bone flaps were designed intraoperatively based on the 3D printed models. Results Three-dimensional models were created for intraoperative use in vascularized bone flaps, including (1) medial femoral trochlea (MFT) flap for scaphoid avascular necrosis and nonunion, (2) MFT flap for lunate avascular necrosis and nonunion, (3) medial femoral condyle (MFC) flap for wrist arthrodesis, and (4) free fibula osteocutaneous flap for distal radius septic nonunion. Templates based on the 3D models allowed for the precise and rapid contouring of well-vascularized bone flaps in situ, prior to ligating the donor pedicle. Conclusions Surgeon-based 3D printing is a feasible, innovative technology that allows for the precise and rapid contouring of models that can be created in various configurations for pre- and intraoperative planning. The technology is easy to use, convenient, and highly economical as compared with traditional send-out manufacturing. Surgeon-based 3D printing is a useful adjunct in vascularized bone transfer. Level of Evidence Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. A snapshot survey of perceptions of healthcare professionals on ageing surgeons.

    Science.gov (United States)

    Rajaratnam, Vaikunthan; Kumar, Chandra M; Roy Chowdhury, Anupama; Su, Chang

    2017-03-01

    should be 65 while 22% believed it should be over 65. Forty-four per cent agreed that a regular multidisciplinary, objective and comprehensive evaluation of an older surgeon's physical and cognitive function would help to identify and treat reversible problems which when corrected would aid in restoring the surgeon's function. Seventy-four per cent felt that it was the responsibility of all stakeholders to decide or report on when an ageing surgeon is unsafe to continue practicing. Fifty-five per cent disagreed with a mandatory retirement age for surgeons. This study showed that, in Singapore, stakeholders agreed there are changes in physical and cognitive abilities of ageing surgeons but they thought that these can be overcome with selective strategies to optimise their role in the workforce. They also disagreed on a mandatory retirement age. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. 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.

  2. 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.

  3. 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.

  4. PROGRESS REPORT OF FY 2004 ACTIVITIES: IMPROVED WATER VAPOR AND CLOUD RETRIEVALS AT THE NSA/AAO

    Energy Technology Data Exchange (ETDEWEB)

    E. R. Westwater; V. V. Leuskiy; M. Klein; A. J. Gasiewski; and J. A. Shaw

    2004-11-01

    The basic goals of the research are to develop and test algorithms and deploy instruments that improve measurements of water vapor, cloud liquid, and cloud coverage, with a focus on the Arctic conditions of cold temperatures and low concentrations of water vapor. The importance of accurate measurements of column amounts of water vapor and cloud liquid has been well documented by scientists within the Atmospheric Radiation Measurement Program. Although several technologies have been investigated to measure these column amounts, microwave radiometers (MWR) have been used operationally by the ARM program for passive retrievals of these quantities: precipitable water vapor (PWV) and integrated water liquid (IWL). The technology of PWV and IWL retrievals has advanced steadily since the basic 2-channel MWR was first deployed at ARM CART sites Important advances are the development and refinement of the tipcal calibration method [1,2], and improvement of forward model radiative transfer algorithms [3,4]. However, the concern still remains that current instruments deployed by ARM may be inadequate to measure low amounts of PWV and IWL. In the case of water vapor, this is especially important because of the possibility of scaling and/or quality control of radiosondes by the water amount. Extremely dry conditions, with PWV less than 3 mm, commonly occur in Polar Regions during the winter months. Accurate measurements of the PWV during such dry conditions are needed to improve our understanding of the regional radiation energy budgets. The results of a 1999 experiment conducted at the ARM North Slope of Alaska/Adjacent Arctic Ocean (NSA/AAO) site during March of 1999 [5] have shown that the strength associated with the 183 GHz water vapor absorption line makes radiometry in this frequency regime suitable for measuring low amounts of PWV. As a portion of our research, we conducted another millimeter wave radiometric experiment at the NSA/AAO in March-April 2004. This

  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. ONLINE PUBLISHING CURRENT SCENARIO

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2012-12-01

    Full Text Available This article attempts to unravel the current scenario in online publishing. Advent of internet has brought with it tremendous changes in the publishing industry. What was hither to an industry dominated by publisher has been thrown open to one and sundry. Online publishing has brought with it a reach which was hitherto never been imagined. In the normal course it would take at least a year to publish a manuscript. Online publishing has managed to bring this time down to a few weeks / at most a month. This article attempts to discusses the positives and perils of online publishing scenario.

  8. Changes of bacterial diversity and tetracycline resistance in sludge from AAO systems upon exposure to tetracycline pressure

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Manhong, E-mail: egghmh@163.com; Qi, Fangfang; Wang, Jue; Xu, Qi; Lin, Li

    2015-11-15

    Highlights: • High-throughput sequencing was used to compare sludge bacteria with and without TC. • Bacterial diversity increased with TC addition despite of various oxygen conditions. • Total TRGs proliferated with TC addition in three kinds of sludge. • The concentration of efflux pump genes was the highest in the three groups of TRGs. - Abstract: Two lab-scale anaerobic-anoxic-oxic (AAO) systems were used to investigate the changes in tetracycline (TC) resistance and bacterial diversity upon exposure to TC pressure. High-throughput sequencing was used to detect diversity changes in microorganisms at the level of class in sludge from different bioreactors with and without TC. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) was used to detect the abundances of eight tetracycline resistance genes (TRGs), tetA, tetB, tetC, tetE, tetM, tetO, tetS and tetX. The results showed that the diversities of the microbial communities of anoxic, anaerobic and aerobic sludge all increased with the addition of TC. TC substantially changed the structure of the microbial community regardless of oxygen conditions. Bacteroidetes and Proteobacteria were the dominant species in the three kinds of sludge and were substantially enriched with TC pressure. In sludge with TC added, almost all target TRGs proliferated more than those in sludge without TC except tetX, which decreased in anaerobic sludge with TC addition. The concentration of efflux pump genes, tet(A–C, E), was the highest among the three groups of TRGs in the different kinds of sludge.

  9. 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

  10. 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.

  11. Twelve years of scientific production on Medline by Latin American spine surgeons.

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    Full Text Available BACKGROUND: Despite the small contribution of LA in the Science Citation Index (SCI, a growing contribution by LA research to international literature has been observed in recent years. STUDY DESIGN: Systematic review. PURPOSE: To evaluate the scientific contribution of Latin American (LA Spine Surgeons in the last decade. METHODS: A literature search of publications by LA spinal surgeons on topics concerning the spine or spinal cord was performed using an online database; Pubmed.gov. The results were limited to articles published from January 2000 to December 2011. The quality of the publication was evaluated with the journal impact factor (IF, Oxford classification and number of citations. RESULTS: This study comprised 320 articles published in the Medline database by LA spine surgeons from 2000 to 2011. In recent years, there has been an increase in the number of publications by LA spine surgeons. It was observed that 38.4% of LA papers were published in LA journals. 46.6% of the articles were published in journals with an IF lower than 1, and there was no statistically significant difference in the number of articles published in journals with a higher IF during the period. Linear-by-linear association analysis demonstrated an improvement in the level of evidence provided by LA articles published in recent years. CONCLUSIONS: This study showed a growth in the number of publications in last 12 years by LA spinal surgeons. It is necessary to discuss a way to increase quantity and quality of scientific publications, mainly through a better education in research.

  12. 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

  13. Indications for incisional hernia repair: An international questionnaire among hernia surgeons

    NARCIS (Netherlands)

    J. Nieuwenhuizen (Jeroen); G.J. Kleinrensink (Gert Jan); W.C.J. Hop (Wim); J. Jeekel (Hans); J.F. Lange (Johan)

    2008-01-01

    textabstractBackground: Incisional hernia repair can be a significant challenge for both surgeon and patient. Despite the growing amount of literature describing various methods of surgical techniques, little has been published regarding the natural course of incisional hernia and the opinions about

  14. Participation in sports after hip and knee arthroplasty: review of literature and survey of surgeon preferences.

    Science.gov (United States)

    McGrory, B J; Stuart, M J; Sim, F H

    1995-04-01

    To summarize previously published findings and to present the opinions of a group of reconstructive orthopedic surgeons from a single institution on participation in sports after hip or knee arthroplasty. We reviewed the literature pertaining to participation in sports after hip or knee arthroplasty and surveyed a group of orthopedic surgeons about their recommendations for resumption of various sports activities by patients who had undergone total hip or knee arthroplasty. A computerized literature search was performed, and salient issues about participation in sports after joint replacement procedures were synthesized. At the Mayo Clinic, 28 orthopedic surgeons (13 consultants and 15 fellows or residents) completed a single-page questionnaire that requested a recommendation ("yes," "no," or "depends") about patients resuming participation in 28 common sports after recovery from total hip or knee arthroplasty. Staff surgeon responses were compared with responses from fellows and residents by using the Mann-Whitney U test. Sports in which 75% of surgeons would not allow participation were identified as "not recommended," whereas sports in which 75% of surgeons would allow participation were labeled as "recommended." Fellows and residents were less likely than staff surgeons to allow return to cross-country skiing after total knee arthroplasty. Otherwise, responses from consultant surgeons and from fellows and residents did not differ significantly. Recommended sports included sailing, swimming laps, scuba diving, cycling, golfing, and bowling after hip and knee replacement procedures and also cross-country skiing after knee arthroplasty. Sports not recommended after hip or knee arthroplasty were running, waterskiing, football, baseball, basketball, hockey, handball, karate, soccer, and racquetball. After hip or knee arthroplasty, participation in no-impact or low-impact sports can be encouraged, but participation in high-impact sports should be prohibited.

  15. Surgeons' work engagement: influencing factors and relations to job and life satisfaction.

    Science.gov (United States)

    Mache, Stefanie; Vitzthum, Karin; Klapp, Burghard F; Danzer, Gerhard

    2014-08-01

    Work engagement has become a topic of great interest in recent years. However, clinicians' work engagement has rarely been studied and relatively little is known about its predictors and consequences. Therefore the objective of this cross-sectional questionnaire study was to test a model of possible institutional and personal predictors and significant relations to job and life satisfaction. 123 clinicians specializing in Surgery Medicine participated in the study. Self-administered questionnaires, including the Copenhagen Psychosocial Questionnaire, the Utrecht Work Engagement Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism, were administered. Bivariate analyses and a stepwise regression analysis were performed. The whole sample of surgeons rated work engagement with a high mean of M = 4.38; SD = .91. Job satisfaction and perceived quality of life have been rated with moderate scores. The results show that job resources have a greater impact on surgeons' work engagement than their job demands. Significant correlations between surgeons' work engagement, their job satisfaction and quality of life were found. Moreover, work engagement mediated the relation between institutional factors and surgeons' job satisfaction. Our research suggests that strengthening surgeons' work engagement will contribute to a more sustainable workplace, in terms of both individual and hospital performance. Therefore, increasing work engagement among surgeons should be of concern for supervisors and hospital managers. Future research should focus on further predictors that may have an influence on health professionals' work engagement. Another field for future research is to study potential effects of interventions on work engagement. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. Plagiarism in Scientific Publishing

    National Research Council Canada - National Science Library

    Izet Masic

    2012-01-01

    .... If the author has published an article in a scientific journal it cannot publish the article in any other journal h with a few minor adjustments or without quoting parts of the first article, which...

  17. Darwin and his publisher.

    Science.gov (United States)

    McClay, David

    2009-01-01

    Charles Darwin's publisher John Murray played an important, if often underrated, role in bringing his theories to the public. As their letters and publishing archives show they had a friendly, business like and successful relationship. This was despite fundamental scientific and religious differences between the men. In addition to publishing Darwin, Murray also published many of the critical and supportive works and reviews which Darwin's own works excited.

  18. CHINA INTERNATIONAL PUBLISHING GROUP

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The China International Publishing Group (CIPG) specializes in international communications. Its operationsencompass reporting, editing, translation, publishing, printing, distribution, and the Internet. It incorporates sevenpublishing companies, five magazines and 19 periodicals, published in over 20 languages. The ChinaInternational Book Trading Corporation, another group facet, distributes all of these to over 180 countries and

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. [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

  4. Acute toxicity reduction and toxicity identification in pigment-contaminated wastewater during anaerobic-anoxic-oxic (A/A/O) treatment process.

    Science.gov (United States)

    Deng, Minjie; Zhang, Ying; Quan, Xie; Na, Chunhong; Chen, Shuo; Liu, Wei; Han, Shuping; Masunaga, Shigeki

    2017-02-01

    In China, a considerable part of industrial wastewater effluents are discharged into the municipal wastewater treatment plants (WWTPs) after pretreatment in their own wastewater treatment plants. Even though the industrial effluents meet the professional emission standards, many micro-pollutants still remained, and they could be resistant in the municipal WWTPs with conventional activated sludge process. Pigment wastewater was chosen in this study, and the acute toxicity reduction and identification of the pigment-contaminated wastewater treated by the conventional anaerobic-anoxic-oxic (A/A/O) process were evaluated. Results indicated that the raw pigment-contaminated wastewater was acutely toxic to Photobacterium phosphoreum (P. phosphoreum), Daphnia magna (D. magna) and Danio rerio (D. rerio). The acute toxicity was decreased in some degree after A/A/O treatment, but the final effluent still exhibited acute toxicity to D. magna and D. rerio with the toxic units (TU) of 1.1 and 2.0, respectively. Chemical analyses showed the presence of various refractory and toxic nitrogen-containing polycyclic and heterocyclic compounds in the pigment-contaminated wastewater. Toxicity identification by combining chemical analyses and correlation analysis showed that N-containing refractory organic toxicants were the main toxicity source for the pigment-contaminated wastewater, and several toxicants showed significant correlation with P. phosphoreum and D. magna. This study indicated that the A/A/O process was not efficient for pigment-contaminated wastewater treatment, and it was irradiative for technology improvement in the WWTPs receiving pretreated industrial wastewater effluents.

  5. Etiquette in scientific publishing.

    Science.gov (United States)

    Krishnan, Vinod

    2013-10-01

    Publishing a scientific article in a journal with a high impact factor and a good reputation is considered prestigious among one's peer group and an essential achievement for career progression. In the drive to get their work published, researchers can forget, either intentionally or unintentionally, the ethics that should be followed in scientific publishing. In an environment where "publish or perish" rules the day, some authors might be tempted to bend or break rules. This special article is intended to raise awareness among orthodontic journal editors, authors, and readers about the types of scientific misconduct in the current publishing scenario and to provide insight into the ways these misconducts are managed by the Committee of Publishing Ethics. Case studies are presented, and various plagiarism detection software programs used by publishing companies are briefly described.

  6. Incidence of Complications During the Surgeon Learning Curve Period for Primary Total Ankle Replacement: A Systematic Review.

    Science.gov (United States)

    Simonson, Devin C; Roukis, Thomas S

    2015-10-01

    Surgeons performing primary total ankle replacement have achieved outcomes comparable to ankle arthrodesis. However, while many reports exist suggesting the presence of a surgeon learning curve period during initial performance of primary total ankle replacement, no published analysis of the actual incidence of complications encountered during this period exists. Therefore, we sought to provide such an analysis through systematic review. A total of 2453 primary total ankle replacements with 1085 complications (44.2%) were identified. Our results revealed conflicting data whether an acceptably low incidence of high-grade complications leading to total ankle replacement failure exists during the surgeon learning curve period.

  7. 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…

  8. 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.

  9. On "The Natural History of the Human Teeth" by Joseph Fox (published in 1803)

    OpenAIRE

    1987-01-01

    "The Natural History of the Human Teeth," written by English surgeon, John Hunter, was first published in 1771, and is one of the most famous works in the history of dentistry. In 1803, another English surgeon, Joseph Fox, also published a book with the same title as Hunter's, but it is not as famous as the former. However, Fox's work is remembered for its description of appliances for correcting dental irregularity and his account of diseases which affect children during their first dentitio...

  10. Publishing studies: what else?

    Directory of Open Access Journals (Sweden)

    Bertrand Legendre

    2015-07-01

    Full Text Available This paper intends to reposition “publishing studies” in the long process that goes from the beginning of book history to the current research on cultural industries. It raises questions about interdisciplinarity and the possibility of considering publishing independently of other sectors of the media and cultural offerings. Publishing is now included in a large range of industries and, at the same time, analyses tend to become more and more segmented according to production sectors and scientific fields. In addition to the problems created, from the professional point of view, by this double movement, this one requires a questioning of the concept of “publishing studies”.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. [Surgeon 2.0: the challenge is on the Web].

    Science.gov (United States)

    Belda Lozano, Ricardo; Ferrer Márquez, Manuel; García Torrecillas, Juan Manuel; Alvarez García, Antonio; Reina Duarte, Angel

    2013-01-01

    Numerous articles and opinions have been published in the last few years on how the Internet is changing clinical practice. In this article we focus on describing 2 aspects that we believe are fundamental in the web 2.0 and Medicine-Surgery inter-relationship: a) web 2.0 conceptualisation and its differences with other pre-existing tools, and b) a description of some of the tools that from a medical-surgical view could be of major interest to the professionals, the patients, and interaction between both. The time has arrived to board train 2.0, where the channels of communication between the professionals, and between them and the patients, are improving disease situations daily, to improve learning through contact with other physicians and surgeons, at the same time providing an excellent resource for maintaining health and to know the disease and its treatment.

  16. 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.

  17. 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.

  18. 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.

  19. Data Sharing & Publishing at Nature Publishing Group

    Science.gov (United States)

    VanDecar, J. C.; Hrynaszkiewicz, I.; Hufton, A. L.

    2015-12-01

    In recent years, the research community has come to recognize that upon-request data sharing has important limitations1,2. The Nature-titled journals feel that researchers have a duty to share data without undue qualifications, in a manner that allows others to replicate and build upon their published findings. Historically, the Nature journals have been strong supporters of data deposition in communities with existing data mandates, and have required data sharing upon request in all other cases. To help address some of the limitations of upon-request data sharing, the Nature titles have strengthened their existing data policies and forged a new partnership with Scientific Data, to promote wider data sharing in discoverable, citeable and reusable forms, and to ensure that scientists get appropriate credit for sharing3. Scientific Data is a new peer-reviewed journal for descriptions of research datasets, which works with a wide of range of public data repositories4. Articles at Scientific Data may either expand on research publications at other journals or may be used to publish new datasets. The Nature Publishing Group has also signed the Joint Declaration of Data Citation Principles5, and Scientific Data is our first journal to include formal data citations. We are currently in the process of adding data citation support to our various journals. 1 Wicherts, J. M., Borsboom, D., Kats, J. & Molenaar, D. The poor availability of psychological research data for reanalysis. Am. Psychol. 61, 726-728, doi:10.1037/0003-066x.61.7.726 (2006). 2 Vines, T. H. et al. Mandated data archiving greatly improves access to research data. FASEB J. 27, 1304-1308, doi:10.1096/fj.12-218164 (2013). 3 Data-access practices strengthened. Nature 515, 312, doi:10.1038/515312a (2014). 4 More bang for your byte. Sci. Data 1, 140010, doi:10.1038/sdata.2014.10 (2014). 5 Data Citation Synthesis Group: Joint Declaration of Data Citation Principles. (FORCE11, San Diego, CA, 2014).

  20. 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.

  1. [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.

  2. [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.

  3. PublisherPartners webshop

    OpenAIRE

    Piferrer Torres, Enric

    2013-01-01

    Projecte realitzat en col·laboració amb Fontys University of Applied Sciences i l'empresa PublisherPartners. The main goal in the project was to build a website where the company PublisherPartners could sell and offer its products online to the customer

  4. Publishing for Impact

    NARCIS (Netherlands)

    Gerritsma, W.

    2015-01-01

    The starting point of my presentation is that you have carried out the most valuable, relevant and exciting research. This presentation is to point out to you some publishing tips that should be part of your publishing strategy. My goal is to make you think about a publication strategy. Your publica

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

    Science.gov (United States)

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

    2016-11-01

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

  6. Reproducibility of manifest refraction between surgeons and optometrists in a clinical refractive surgery practice.

    Science.gov (United States)

    Reinstein, Dan Z; Yap, Timothy E; Carp, Glenn I; Archer, Timothy J; Gobbe, Marine

    2014-03-01

    To measure and compare the interobserver reproducibility of manifest refraction according to a standardized protocol for normal preoperative patients in a refractive surgery practice. Private clinic, London, United Kingdom. Retrospective case series. This retrospective study comprised patients attending 2 preoperative refractions before laser vision correction. The first manifest refraction was performed by 1 of 7 optometrists and the second manifest refraction by 1 of 2 surgeons, all trained using a standard manifest refraction protocol. Spherocylindrical data were converted into power vectors for analysis. The dioptric power differences between observers were calculated and analyzed. One thousand nine hundred twenty-two consecutive eyes were stratified into a myopia group and a hyperopia group and then further stratified by each surgeon-optometrist combination. The mean surgeon-optometrist dioptric power difference was 0.21 diopter (D) (range 0.15 to 0.32 D). The mean difference in spherical equivalent refraction was 0.03 D, with 95% of all refractions within ±0.44 D for all optometrist-surgeon combinations. The severity of myopic or hyperopic ametropia did not affect the interobserver reproducibility of the manifest refraction. There was close agreement in refraction between surgeons and optometrists using a standard manifest refraction protocol of less than 0.25 D. This degree of interobserver repeatability is similar to that in intraobserver repeatability studies published to date and may represent the value of training and the use of a standard manifest refraction protocol between refraction observers in a refractive surgery practice involving co-management between surgeons and optometrists. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. 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’ ...

  8. 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.

  9. Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises.

    Science.gov (United States)

    Doumouras, A G; Hamidi, M; Lung, K; Tarola, C L; Tsao, M W; Scott, J W; Smink, D S; Yule, S

    2017-07-01

    Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses. Behaviour was assessed by four trained raters using the Non-Technical Skills for Surgeons (NOTSS) and Anaesthetists' Non-Technical Skills (ANTS) rating scales before and during the crisis phase of each scenario. The primary endpoint was time to crisis resolution; secondary endpoints included NTS scores before and during the crisis. A cross-classified linear mixed-effects model was used for the final analysis. Thirteen different surgical teams were assessed. Higher NTS ratings resulted in significantly faster crisis resolution. For anaesthetists, every 1-point increase in ANTS score was associated with a decrease of 53·50 (95 per cent c.i. 31·13 to 75·87) s in time to crisis resolution (P technical skills scores were lower during the crisis phase of the scenarios than those measured before the crisis for both surgeons and anaesthetists. A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. Outcomes of manual extracapsular versus phacoemulsification cataract extraction by beginner resident surgeons.

    Science.gov (United States)

    Meeks, Landen A; Blomquist, Preston H; Sullivan, Brian R

    2013-11-01

    To evaluate the safety and efficacy of phacoemulsification cataract extraction and manual extracapsular cataract extraction (ECCE) performed by beginning resident surgeons. Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. Retrospective cohort study. A review was performed of each resident's series of initial cataract surgery procedures as a late first-year or second-year resident. Data were collected for cases performed over almost a 6-year period during which initially the first primary surgeon cases were ECCE and later, the first primary surgeon cases were phacoemulsification. For each case, the following data were gathered: technique of cataract extraction, laterality, resident, vitreous loss or dropped nucleus, placement of posterior chamber intraocular lens (IOL), and need for reoperation within 90 days of surgery. Complications occurred in 6 (2.5%) of 244 cases in which phacoemulsification was performed by a beginner resident primary surgeon and in 7 (4.1%) of 172 cases in which ECCE was used (P=.40). Posterior chamber IOLs were placed in all but 2 phacoemulsification cases and 4 ECCE cases (P=.24). Moreover, 3 cases in the phacoemulsification group and 1 case in the ECCE group required a reoperation within 90 days (P=.65). Phacoemulsification cataract extraction can be taught safely and effectively to residents with no cataract surgery experience as a primary surgeon. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. 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...

  12. Elearning and digital publishing

    CERN Document Server

    Ching, Hsianghoo Steve; Mc Naught, Carmel

    2006-01-01

    ""ELearning and Digital Publishing"" will occupy a unique niche in the literature accessed by library and publishing specialists, and by university teachers and planners. It examines the interfaces between the work done by four groups of university staff who have been in the past quite separate from, or only marginally related to, each other - library staff, university teachers, university policy makers, and staff who work in university publishing presses. All four groups are directly and intimately connected with the main functions of universities - the creation, management and dissemination

  13. Academic nightmares: Predatory publishing.

    Science.gov (United States)

    Van Nuland, Sonya E; Rogers, Kem A

    2017-07-01

    Academic researchers who seek to publish their work are confronted daily with a barrage of e-mails from aggressive marketing campaigns that solicit them to publish their research with a specialized, often newly launched, journal. Known as predatory journals, they often promise high editorial and publishing standards, yet their exploitive business models, poor quality control, and minimal overall transparency victimize those researchers with limited academic experience and pave the way for low-quality articles that threaten the foundation of evidence-based research. Understanding how to identify these predatory journals requires thorough due diligence on the part of the submitting authors, and a commitment by reputable publishers, institutions, and researchers to publicly identify these predators and eliminate them as a threat to the careers of young scientists seeking to disseminate their work in scholarly journals. Anat Sci Educ 10: 392-394. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  14. A Publisher's Perspective.

    Science.gov (United States)

    McElderry, Margaret K.

    1988-01-01

    Compares the publishing industry of forty years ago to that of today, noting that the earlier market was less demanding and allowed the pursuit of excellence as well as the backlisting of high quality books. (ARH)

  15. About EBSCO Publishing

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>EBSCO Publishing,headquartered in Ipswich,Massachusetts[1],is an aggregator of premium full-text content. EBSCO Publishing’s core business is providing online databases via EBSCOhost to libraries worldwide.

  16. Publishing for Impact

    OpenAIRE

    Gerritsma, W.

    2015-01-01

    The starting point of my presentation is that you have carried out the most valuable, relevant and exciting research. This presentation is to point out to you some publishing tips that should be part of your publishing strategy. My goal is to make you think about a publication strategy. Your publication strategy. And assure that your research finds the best possible publication venue and is presented in the most optimal way.

  17. Open-Access Publishing

    Directory of Open Access Journals (Sweden)

    Nedjeljko Frančula

    2013-06-01

    Full Text Available Nature, one of the most prominent scientific journals dedicated one of its issues to recent changes in scientific publishing (Vol. 495, Issue 7442, 27 March 2013. Its editors stressed that words technology and revolution are closely related when it comes to scientific publishing. In addition, the transformation of research publishing is not as much a revolution than an attrition war in which all sides are buried. The most important change they refer to is the open-access model in which an author or an institution pays in advance for publishing a paper in a journal, and the paper is then available to users on the Internet free of charge.According to preliminary results of a survey conducted among 23 000 scientists by the publisher of Nature, 45% of them believes all papers should be published in open access, but at the same time 22% of them would not allow the use of papers for commercial purposes. Attitudes toward open access vary according to scientific disciplines, leading the editors to conclude the revolution still does not suit everyone.

  18. 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.

  19. 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.

  20. 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.

  1. Sir Charles Ballance: pioneer British neurological surgeon.

    Science.gov (United States)

    Stone, J L

    1999-03-01

    nerve regeneration and nerve grafting, and after many years of devoted research, he devised successful operations for facial nerve paralysis. For this and early vascular work, he is often credited as the first English surgeon to reintroduce classical Hunterian methods of experiment into surgery. He was honored as the founder and President of The Society of British Neurological Surgeons in 1926. Perhaps best known as a general and aural surgeon, Ballance was second only to Horsley in reputation as a pioneer British neurological surgeon. Described as a painstakingly slow but delicate and meticulous operator, Ballance made a contribution to neurosurgery and temporal bone surgery that was immense.

  2. 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.

  3. [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.

  4. Practice patterns in the perioperative treatment of patients undergoing septorhinoplasty: a survey of facial plastic surgeons.

    Science.gov (United States)

    Shadfar, Scott; Deal, Allison M; Jarchow, Andrea M; Yang, Hojin; Shockley, William W

    2014-01-01

    RELEVANCE Perioperative care and practices after nasal surgery vary among the most highly trained and leading rhinoplasty surgeons. No published communication or consensus on perioperative practices has been disseminated in this setting. Given the results from those surgeons performing the most rhinoplasties in our field, some surgeons may choose to vary their practices to coincide with those of experienced surgeons. These guidelines could facilitate future studies of patient outcomes.

  5. 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.

  6. Fairness in scientific publishing

    Science.gov (United States)

    Matthews, Philippa C.

    2017-01-01

    Major changes are afoot in the world of academic publishing, exemplified by innovations in publishing platforms, new approaches to metrics, improvements in our approach to peer review, and a focus on developing and encouraging open access to scientific literature and data. The FAIR acronym recommends that authors and publishers should aim to make their output Findable, Accessible, Interoperable and Reusable. In this opinion article, I explore the parallel view that we should take a collective stance on making the dissemination of scientific data fair in the conventional sense, by being mindful of equity and justice for patients, clinicians, academics, publishers, funders and academic institutions. The views I represent are founded on oral and written dialogue with clinicians, academics and the publishing industry. Further progress is needed to improve collaboration and dialogue between these groups, to reduce misinterpretation of metrics, to minimise inequity that arises as a consequence of geographic setting, to improve economic sustainability, and to broaden the spectrum, scope, and diversity of scientific publication.

  7. 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.

  8. Publishers and repositories

    CERN Document Server

    CERN. Geneva

    2007-01-01

    The impact of self-archiving on journals and publishers is an important topic for all those involved in scholarly communication. There is some evidence that the physics arXiv has had no impact on physics journals, while 'economic common sense' suggests that some impact is inevitable. I shall review recent studies of librarian attitudes towards repositories and journals, and place this in the context of IOP Publishing's experiences with arXiv. I shall offer some possible reasons for the mis-match between these perspectives and then discuss how IOP has linked with arXiv and experimented with OA publishing. As well as launching OA journals we have co-operated with Cornell and the arXiv on Eprintweb.org, a platform that offers new features to repository users. View Andrew Wray's biography

  9. Ethics in Scientific Publishing

    Science.gov (United States)

    Sage, Leslie J.

    2012-08-01

    We all learn in elementary school not turn in other people's writing as if it were our own (plagiarism), and in high school science labs not to fake our data. But there are many other practices in scientific publishing that are depressingly common and almost as unethical. At about the 20 percent level authors are deliberately hiding recent work -- by themselves as well as by others -- so as to enhance the apparent novelty of their most recent paper. Some people lie about the dates the data were obtained, to cover up conflicts of interest, or inappropriate use of privileged information. Others will publish the same conference proceeding in multiple volumes, or publish the same result in multiple journals with only trivial additions of data or analysis (self-plagiarism). These shady practices should be roundly condemned and stopped. I will discuss these and other unethical actions I have seen over the years, and steps editors are taking to stop them.

  10. Improving Quality Metric Adherence to Minimally Invasive Breast Biopsy among Surgeons Within a Multihospital Health Care System.

    Science.gov (United States)

    Tjoe, Judy A; Greer, Danielle M; Ihde, Sue E; Bares, Diane A; Mikkelson, Wendy M; Weese, James L

    2015-09-01

    Minimally invasive breast biopsy (MIBB) is the procedure of choice for diagnosing breast lesions indeterminate for malignancy. Multihospital health care systems face challenges achieving systemwide adherence to standardized guidelines among surgeons with varying practice patterns. This study tested whether providing individual feedback about surgeons' use of MIBB to diagnose breast malignancies improved quality metric adherence across a large health care organization. We conducted a prospective matched-pairs study to test differences (or lack of agreement) between periods before and after intervention. All analytical cases of primary breast cancer diagnosed during 2011 (period 1) and from July 2012 to June 2013 (period 2) across a multihospital health care system were reviewed for initial diagnosis by MIBB or open surgical biopsy. Open surgical biopsy was considered appropriate care only if MIBB could not be performed for reasons listed in the American Society of Breast Surgeons' quality measure for preoperative diagnosis of breast cancer. Individual and systemwide results of adherence to the MIBB metric during period 1 were sent to each surgeon in June 2012 and were later compared with period 2 results using McNemar's test of marginal homogeneity for matched binary responses. Forty-six surgeons were evaluated on use of MIBB to diagnose breast cancer. In period 1, metric adherence for 100% of cases was achieved by 37 surgeons, for a systemwide 100% compliance rate of 80.4%. After notification of individual performance, 44 of 46 surgeons used MIBB solely or otherwise appropriate care to diagnose breast cancer, which improved systemwide compliance to 95.7%. Providing individual and systemwide performance results to surgeons can increase self-awareness of practice patterns when diagnosing breast cancer, leading to standardized best-practice care across a large health care organization. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Characteristics of cardiothoracic surgeons practicing at the top-ranked US institutions.

    Science.gov (United States)

    Rosati, Carlo Maria; Koniaris, Leonidas G; Molena, Daniela; Blitzer, David; Su, Katherine W; Tahboub, Mohammad; Vardas, Panos N; Girardi, Leonard N; Gaudino, Mario

    2016-11-01

    We aimed to determine which factors distinguish cardiothoracic (CT) surgeons practicing at the top-ranked US institutions from their peers. Using online resources, we collected demographics, training information and academic metrics of 694 cardiac (n=489; 70%) and thoracic (n=205; 30%) surgeons practicing at 57 preeminent US institutions, including those with the highest US News & World Report ranking ("top CT centers"). Two hundred and ninety-nine (43.1%) CT surgeons were practicing at the 18 "top CT centers" and had higher academic productivity (publications, citations) than their peers. While there was no difference in the proportion of international medical graduates (IMGs) (21.4% overall) or of surgeons with a PhD degree (9.4% overall) across institutions, the "top CT centers" had a higher proportion of faculty who received their entire CT training abroad (10.4% vs. 5.8%; P=0.038) or at highly-ranked US institutions. Those who published more during their early career years (residency, fellowship and first 5 years as faculty) were more likely to attain academic (professorship) and institutional leadership (division/department chair) positions and to practice at the "top CT centers". Women represented a minority (7.3% overall; 5.1% of cardiac vs. 12.7% of thoracic surgeons, P<0.001), but with growing prevalence among younger faculty and without differences across institutions. CT surgeons of the best US centers have a more international background and received their training at highly-ranked institutions. Early academic productivity is associated with life-long career achievements, with special importance of the first 5 years as faculty. Women represent a growing proportion of the CT surgical workforce.

  18. Educating surgeons for the new golden hours: honing the skills of palliative care.

    Science.gov (United States)

    Huffman, Joan L

    2005-04-01

    All surgeons should maintain a lifetime commitment to education and learning. Those who already are in practice need to make the effort to obtain or refresh their education in basic competencies in palliative care and to provide a measured balance between philosophy and practical skills. Many resources and teaching tools are available to assist in this continuing process: surgical peers (and peers from other medical specialties),journals, textbooks, CME conferences, surgical governance and educational organizations, and palliative care websites. A tremendous summary article on palliative care education for surgeons was published recently in JACS[24]. Surgeons must be competent in the following palliative care skills:communication, holistic patient evaluation, control of pain and symptoms,understanding legal/ethical issues, withdrawing care, and the continuum of acute to chronic to terminal care. If they cannot attend to all of these areas individually, they need to be aware of the local, regional, and national resources that are available to assist the patient (or their surrogate decision maker) and themselves in the end-of-life arena. Consultations and referrals should be accomplished in such a manner that the patient does not feel abandoned by his/her surgeon at such a critical point in his/her life. Practicing surgeons also must be involved actively in the education of resident and medical students in didactic and clinical situations. Most importantly, they must model the appropriate behaviors for their charges personally, whether it be in the consultation room breaking bad news compassionately or at the bedside easing the path to the next world. In these golden hours, the educated surgeon who wields new and mighty resources can be the greatest champion of the patient who is at the end of life.

  19. In surgeons performing cardiothoracic surgery is sleep deprivation significant in its impact on morbidity or mortality?

    Science.gov (United States)

    Asfour, Leila; Asfour, Victoria; McCormack, David; Attia, Rizwan

    2014-09-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is there a difference in cardiothoracic surgery outcomes in terms of morbidity or mortality of patients operated on by a sleep-deprived surgeon compared with those operated by a non-sleep-deprived surgeon? Reported search criteria yielded 77 papers, of which 15 were deemed to represent the best evidence on the topic. Three studies directly related to cardiothoracic surgery and 12 studies related to non-cardiothoracic surgery. Recommendations are based on 18 121 cardiothoracic patients and 214 666 non-cardiothoracic surgical patients. Different definitions of sleep deprivation were used in the studies, either reviewing surgeon's sleeping hours or out-of-hours operating. Surgical outcomes reviewed included: mortality rate, neurological, renal, pulmonary, infectious complications, length of stay, length of intensive care stay, cardiopulmonary bypass times and aortic-cross-clamp times. There were no significant differences in mortality or intraoperative complications in the groups of patients operated on by sleep-deprived versus non-sleep-deprived surgeons in cardiothoracic studies. One study showed a significant increase in the rate of septicaemia in patients operated on by severely sleep-deprived surgeons (3.6%) compared with the moderately sleep-deprived (0.9%) and non-sleep-deprived groups (0.8%) (P = 0.03). In the non-cardiothoracic studies, 7 of the 12 studies demonstrated statistically significant higher reoperation rate in trauma cases (P sleep deprivation in cardiothoracic surgeons on morbidity or mortality. However, overall the non-cardiothoracic studies have demonstrated that operative time and sleep deprivation can have a significant impact on overall morbidity and mortality. It is likely that other confounding factors concomitantly affect outcomes in out-of-hours surgery. © The Author 2014. Published by Oxford University Press on behalf of

  20. 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.

  1. Effective Leadership of Surgical Teams: A Mixed Methods Study of Surgeon Behaviors and Functions.

    Science.gov (United States)

    Stone, Juliana L; Aveling, Emma-Louise; Frean, Molly; Shields, Morgan C; Wright, Cameron; Gino, Francesca; Sundt, Thoralf M; Singer, Sara J

    2017-08-01

    The importance of effective team leadership for achieving surgical excellence is widely accepted, but we understand less about the behaviors that achieve this goal. We studied cardiac surgical teams to identify leadership behaviors that best support surgical teamwork. We observed, surveyed, and interviewed cardiac surgical teams, including 7 surgeons and 116 team members, from September 2013 to April 2015. We documented 1,926 surgeon/team member interactions during 22 cases, coded them by behavior type and valence (ie, positive/negative/neutral), and characterized them by leadership function (conductor, elucidator, delegator, engagement facilitator, tone setter, being human, and safe space maker) to create a novel framework of surgical leadership derived from direct observation. We surveyed nonsurgeon team members about their perceptions of individual surgeon's leadership effectiveness on a 7-point Likert scale and correlated survey measures with individual surgeon profiles created by calculating percentage of behavior types, leader functions, and valence. Surgeon leadership was rated by nonsurgeons from 4.2 to 6.2 (mean, 5.4). Among the 33 types of behaviors observed, most interactions constituted elucidating (24%) and tone setting (20%). Overall, 66% of interactions (range, 43%-84%) were positive and 11% (range, 1%-45%) were negative. The percentage of positive and negative behaviors correlated strongly (r = 0.85 for positive and r = 0.75 for negative, p leadership. Facilitating engagement related most positively (r = 0.80; p = 0.03), and negative forms of elucidating, ie, criticism, related most negatively (r = -0.81; p = 0.03). We identified 7 surgeon leadership functions and related behaviors that impact perceptions of leadership. These observations suggest actionable opportunities to improve team leadership behavior. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Surgeon and Hospital Level Variation in the Costs of Robot-Assisted Radical Prostatectomy.

    Science.gov (United States)

    Cole, Alexander P; Leow, Jeffrey J; Chang, Steven L; Chung, Benjamin I; Meyer, Christian P; Kibel, Adam S; Menon, Mani; Nguyen, Paul L; Choueiri, Toni K; Reznor, Gally; Lipsitz, Stuart R; Sammon, Jesse D; Sun, Maxine; Trinh, Quoc-Dien

    2016-10-01

    We assessed surgeon and hospital level variation in robot-assisted radical prostatectomy costs and predictors of high and low cost surgery. The study population consisted of a weighted sample of 291,015 men who underwent robot-assisted radical prostatectomy for prostate cancer by 667 surgeons at 197 U.S. hospitals from 2003 to 2013. We evaluated 90-day direct hospital costs (2014 USD) in the Premier Hospital Database. High costs per robot-assisted radical prostatectomy were those above the 90th percentile and low costs were those below the 10th percentile. Mean hospital cost per robot-assisted radical prostatectomy was $11,878 (95% CI $11,804-$11,952). Mean cost was $2,837 (95% CI $2,805-$2,869) in the low cost group vs $25,906 (95% CI $24,702-$25,490) in the high cost group. Nearly a third of the variation in robot-assisted radical prostatectomy cost was attributable to hospital characteristics and more than a fifth was attributable to surgeon characteristics (R-squared 30.43% and 21.25%, respectively). High volume surgeons and hospitals (90th percentile or greater) had decreased odds of high cost surgery (surgeons: OR 0.24, 95% CI 0.11-0.54; hospitals: OR 0.105, 95% CI 0.02-0.46). The performance of robot-assisted radical prostatectomy at a high volume hospital was associated with increased odds of low cost robot-assisted radical prostatectomy (OR 839, 95% CI 122-greater than 999). This study provides insight into the role of surgeons and hospitals in robot-assisted radical prostatectomy costs. Given the substantial variability, identifying and remedying the root cause of outlier costs may yield substantial benefits. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Scholars | Digital Representation | Publishing

    Science.gov (United States)

    Hodgson, Justin

    2014-01-01

    Understanding the current state of digital publishing means that writers can now do more and say more in more ways than ever before in human history. As modes, methods, media and mechanisms of expression mutate into newer and newer digital forms, writers find themselves at a moment when they can create, critique collaborate, and comment according…

  4. Book on CPC Published

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    A book that answers 13 questions about how the Communist Party of China(CPC) works in China and why the Party has made great achievements in the past decades has been recently published by the Beijing-based New World Press.

  5. Publishing top tips

    NARCIS (Netherlands)

    Benneworth, Paul Stephen; Haselsberger, Beatrix

    2012-01-01

    As part of our wider mission Regional Insights organised a “Publishing Workshop” in the frame of the RSA European Conference, held at the Delft University of Technology, May 13th-16th, 2012. Our six very engaged panellists (experienced authors, reviewers, editors and mentors) provided the audience

  6. Publishers, Participants All

    Science.gov (United States)

    Richardson, Will

    2011-01-01

    Students need opportunities throughout the curriculum to follow their passions and publish quality work for global audiences to interact with. Social media afford the opportunity for students to contribute to the world in meaningful ways, do real work for real audiences for real purposes, find great teachers and collaborators from around the…

  7. 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.

  8. 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

  9. Support open access publishing

    DEFF Research Database (Denmark)

    Ekstrøm, Jeannette

    2013-01-01

    Projektet Support Open Access Publishing har til mål at få opdateret Sherpa/Romeo databasen (www.sherpa.ac.uk/romeo) med fagligt relevante, danske tidsskrifter. Projektet skal endvidere undersøge mulighederne for at få udviklet en database, hvor forskere på tværs af relevante tidsskriftsinformati......Projektet Support Open Access Publishing har til mål at få opdateret Sherpa/Romeo databasen (www.sherpa.ac.uk/romeo) med fagligt relevante, danske tidsskrifter. Projektet skal endvidere undersøge mulighederne for at få udviklet en database, hvor forskere på tværs af relevante...... tidsskriftsinformationer (faglig disciplin, BFI niveau, Impact Factor, Open Access) vil kunne danne sig et hurtigt overblik, for derved at kunne træffe et kvalificeret valg om, hvor og hvordan man skal publicere sine forskningsresultater....

  10. Prepare to publish.

    Science.gov (United States)

    Price, P M

    2000-01-01

    "I couldn't possibly write an article." "I don't have anything worthwhile to write about." "I am not qualified to write for publication." Do any of these statements sound familiar? This article is intended to dispel these beliefs. You can write an article. You care for the most complex patients in the health care system so you do have something worthwhile to write about. Beside correct spelling and grammar there are no special skills, certificates or diplomas required for publishing. You are qualified to write for publication. The purpose of this article is to take the mystique out of the publication process. Each step of publishing an article will be explained, from idea formation to framing your first article. Practical examples and recommendations will be presented. The essential components of the APA format necessary for Dynamics: The Official Journal of the Canadian Association of Critical Care Nurses will be outlined and resources to assist you will be provided.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. Towards Hypermedia Electronic Publishing

    OpenAIRE

    Konstantas, Dimitri; Morin, Jean-Henry

    1995-01-01

    The most important problem that decision makers face in today's ever increasing information flux is how to find efficiently and fast the useful information. Hypermedia Electronic Publishing systems, supporting active information distribution and offering hypertext browsing facilities, provide a promising solution to this problem. Nevertheless several issues, like value added services, retrieval and access mechanism, information marketing as well as financial and security aspects should be res...

  16. Open Access Publishing

    Directory of Open Access Journals (Sweden)

    Amelia Hadfield

    2013-07-01

    Full Text Available The rise of open source online journals, free online courses, and other changes in the research and education environment, coined the "academic spring" by some commentators, represents an increasing trend in opening up the rules of access for research. Universities, libraries, publishers and even govern­ments are paying attention to this new movement often referred to with the acronym A2K (access to knowledge.

  17. Reclaiming Society Publishing

    Directory of Open Access Journals (Sweden)

    Philip E. Steinberg

    2015-07-01

    Full Text Available Learned societies have become aligned with commercial publishers, who have increasingly taken over the latter’s function as independent providers of scholarly information. Using the example of geographical societies, the advantages and disadvantages of this trend are examined. It is argued that in an era of digital publication, learned societies can offer leadership with a new model of open access that can guarantee high quality scholarly material whose publication costs are supported by society membership dues.

  18. What surgeons can learn from athletes: mental practice in sports and surgery.

    Science.gov (United States)

    Cocks, Margaret; Moulton, Carol-Anne; Luu, Shelly; Cil, Tulin

    2014-01-01

    Mental practice has been successfully applied in professional sports for skills acquisition and performance enhancement. The goals of this review are to describe the literature on mental practice within sport psychology and surgery and to explore how the specific principles of mental practice can be applied to the improvement of surgical performance-both in novice and expert surgeons. The authors reviewed the sports psychology, education, and surgery literatures through Medline, PubMed, PsycINFO, and Embase. In sports, mental practice is a valuable tool for optimizing existing motor skill sets once core competencies have been mastered. These techniques have been shown to be more advantageous when used by elite athletes. Within surgery, mental practice studies have focused on skill acquisition among novices with little study of how expert surgeons use it to optimize surgical preparation. We propose that performance optimization and skills acquisition should be viewed as 2 separate domains of mental practice. Further understanding of this phenomenon has implications for changing how we teach and train not only novice surgeons but also how experienced surgeons continue to maintain their skills, acquire new ones, and excel in surgery. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. [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.

  4. PLAGIARISM IN SCIENTIFIC PUBLISHING

    Science.gov (United States)

    Masic, Izet

    2012-01-01

    Scientific publishing is the ultimate product of scientist work. Number of publications and their quoting are measures of scientist success while unpublished researches are invisible to the scientific community, and as such nonexistent. Researchers in their work rely on their predecessors, while the extent of use of one scientist work, as a source for the work of other authors is the verification of its contributions to the growth of human knowledge. If the author has published an article in a scientific journal it cannot publish the article in any other journal h with a few minor adjustments or without quoting parts of the first article, which are used in another article. Copyright infringement occurs when the author of a new article with or without the mentioning the author used substantial portions of previously published articles, including tables and figures. Scientific institutions and universities should,in accordance with the principles of Good Scientific Practice (GSP) and Good Laboratory Practices (GLP) have a center for monitoring,security, promotion and development of quality research. Establish rules and compliance to rules of good scientific practice are the obligations of each research institutions,universities and every individual-researchers,regardless of which area of science is investigated. In this way, internal quality control ensures that a research institution such as a university, assume responsibility for creating an environment that promotes standards of excellence, intellectual honesty and legality. Although the truth should be the aim of scientific research, it is not guiding fact for all scientists. The best way to reach the truth in its study and to avoid the methodological and ethical mistakes is to consistently apply scientific methods and ethical standards in research. Although variously defined plagiarism is basically intended to deceive the reader’s own scientific contribution. There is no general regulation of control of

  5. Plagiarism in scientific publishing.

    Science.gov (United States)

    Masic, Izet

    2012-12-01

    Scientific publishing is the ultimate product of scientist work. Number of publications and their quoting are measures of scientist success while unpublished researches are invisible to the scientific community, and as such nonexistent. Researchers in their work rely on their predecessors, while the extent of use of one scientist work, as a source for the work of other authors is the verification of its contributions to the growth of human knowledge. If the author has published an article in a scientific journal it cannot publish the article in any other journal h with a few minor adjustments or without quoting parts of the first article, which are used in another article. Copyright infringement occurs when the author of a new article with or without the mentioning the author used substantial portions of previously published articles, including tables and figures. Scientific institutions and universities should,in accordance with the principles of Good Scientific Practice (GSP) and Good Laboratory Practices (GLP) have a center for monitoring,security, promotion and development of quality research. Establish rules and compliance to rules of good scientific practice are the obligations of each research institutions,universities and every individual-researchers,regardless of which area of science is investigated. In this way, internal quality control ensures that a research institution such as a university, assume responsibility for creating an environment that promotes standards of excellence, intellectual honesty and legality. Although the truth should be the aim of scientific research, it is not guiding fact for all scientists. The best way to reach the truth in its study and to avoid the methodological and ethical mistakes is to consistently apply scientific methods and ethical standards in research. Although variously defined plagiarism is basically intended to deceive the reader's own scientific contribution. There is no general regulation of control of

  6. Hprints - Licence to publish

    DEFF Research Database (Denmark)

    Rabow, Ingegerd; Sikström, Marjatta; Drachen, Thea Marie

    2010-01-01

    This is the final report from Phase 2, the last phase of the second Nordbib-project on hprints and related issues. The first project set out to establish an e-print archive for the humanities and social sciences. Our case studies have shown that when informed more thoroughly about OA, researchers...... realised the potential advantages for them. The universities have a role here as well as the libraries that manage the archives and support scholars in various aspects of the publishing processes. Libraries are traditionally service providers with a mission to facilitate the knowledge production...

  7. PUBLISHER'S ANNOUNCEMENT: Refereeing standards

    Science.gov (United States)

    Bender, C.; Scriven, N.

    2004-08-01

    On 1 January 2004 I will be assuming the position of Editor-in-Chief of Journal of Physics A: Mathematical and General (J. Phys. A). I am flattered at the confidence expressed in my ability to carry out this challenging job and I will try hard to justify this confidence. The previous Editor-in-Chief, Ed Corrigan, has worked tirelessly for the last five years and has done an excellent job for the journal. Everyone at the journal is profoundly grateful for his leadership and for his achievements. Before accepting the position of Editor-in-Chief, I visited the office of J. Phys. A to examine the organization and to assess its strengths and weaknesses. This office is located at the Institute of Physics Publishing (IOPP) headquarters in Bristol. J. Phys. A has been expanding rapidly and now publishes at the rate of nearly 1000 articles (or about 14,000 pages) per year. The entire operation of the journal is conducted in a very small space---about 15 square metres! Working in this space are six highly intelligent, talented, hard working, and dedicated people: Neil Scriven, Publisher; Mike Williams, Publishing Editor; Rose Gray and Sarah Nadin, Publishing Administrators; Laura Smith and Steve Richards, Production Editors. In this small space every day about eight submitted manuscripts are downloaded from the computer or received in the post. These papers are then processed and catalogued, referees are selected, and the papers are sent out for evaluation. In this small space the referees' reports are received, publication decisions are made, and accepted articles are then published quickly by IOPP. The whole operation is amazingly efficient. Indeed, one of the great strengths of J. Phys. A is the speed at which papers are processed. The average time between the receipt of a manuscript and an editorial decision is under sixty days. (Many distinguished journals take three to five times this amount of time.) This speed of publication is an extremely strong enticement for

  8. RETRACTION: Publishers' Note

    Science.gov (United States)

    post="(Executive Editor">Graeme Watt,

    2010-06-01

    Withdrawal of the paper "Was the fine-structure constant variable over cosmological time?" by L. D. Thong, N. M. Giao, N. T. Hung and T. V. Hung (EPL, 87 (2009) 69002) This paper has been formally withdrawn on ethical grounds because the article contains extensive and repeated instances of plagiarism. EPL treats all identified evidence of plagiarism in the published articles most seriously. Such unethical behaviour will not be tolerated under any circumstance. It is unfortunate that this misconduct was not detected before going to press. My thanks to Editor colleagues from other journals for bringing this fact to my attention.

  9. "Best Case/Worst Case": Training Surgeons to Use a Novel Communication Tool for High-Risk Acute Surgical Problems.

    Science.gov (United States)

    Kruser, Jacqueline M; Taylor, Lauren J; Campbell, Toby C; Zelenski, Amy; Johnson, Sara K; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Kwekkeboom, Kris L; Schwarze, Margaret L

    2017-04-01

    Older adults often have surgery in the months preceding death, which can initiate postoperative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. The objective of this study was to evaluate a structured training program designed to teach surgeons how to use BC/WC. Twenty-five surgeons from one tertiary care hospital completed a two-hour training session followed by individual coaching. We audio-recorded surgeons using BC/WC with standardized patients and 20 hospitalized patients. Hospitalized patients and their families participated in an open-ended interview 30 to 120 days after enrollment. We used a checklist of 11 BC/WC elements to measure tool fidelity and surgeons completed the Practitioner Opinion Survey to measure acceptability of the tool. We used qualitative analysis to evaluate variability in tool content and to characterize patient and family perceptions of the tool. Surgeons completed a median of 10 of 11 BC/WC elements with both standardized and hospitalized patients (range 5-11). We found moderate variability in presentation of treatment options and description of outcomes. Three months after training, 79% of surgeons reported BC/WC is better than their usual approach and 71% endorsed active use of BC/WC in clinical practice. Patients and families found that BC/WC established expectations, provided clarity, and facilitated deliberation. Surgeons can learn to use BC/WC with older patients considering acute high-risk surgical interventions. Surgeons, patients, and family members endorse BC/WC as a strategy to support complex decision making. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. PADB : Published Association Database

    Directory of Open Access Journals (Sweden)

    Lee Jin-Sung

    2007-09-01

    Full Text Available Abstract Background Although molecular pathway information and the International HapMap Project data can help biomedical researchers to investigate the aetiology of complex diseases more effectively, such information is missing or insufficient in current genetic association databases. In addition, only a few of the environmental risk factors are included as gene-environment interactions, and the risk measures of associations are not indexed in any association databases. Description We have developed a published association database (PADB; http://www.medclue.com/padb that includes both the genetic associations and the environmental risk factors available in PubMed database. Each genetic risk factor is linked to a molecular pathway database and the HapMap database through human gene symbols identified in the abstracts. And the risk measures such as odds ratios or hazard ratios are extracted automatically from the abstracts when available. Thus, users can review the association data sorted by the risk measures, and genetic associations can be grouped by human genes or molecular pathways. The search results can also be saved to tab-delimited text files for further sorting or analysis. Currently, PADB indexes more than 1,500,000 PubMed abstracts that include 3442 human genes, 461 molecular pathways and about 190,000 risk measures ranging from 0.00001 to 4878.9. Conclusion PADB is a unique online database of published associations that will serve as a novel and powerful resource for reviewing and interpreting huge association data of complex human diseases.

  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. 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

  14. 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

  15. 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

  16. PUBLISHER'S ANNOUNCEMENT: Editorial developments

    Science.gov (United States)

    2009-01-01

    We are delighted to announce that from January 2009, Professor Murray T Batchelor of the Australian National University, Canberra will be the new Editor-in-Chief of Journal of Physics A: Mathematical and Theoretical. Murray Batchelor has been Editor of the Mathematical Physics section of the journal since 2007. Prior to this, he served as a Board Member and an Advisory Panel member for the journal. His primary area of research is the statistical mechanics of exactly solved models. He holds a joint appointment in mathematics and physics and has held visiting positions at the Universities of Leiden, Amsterdam, Oxford and Tokyo. We very much look forward to working with Murray to continue to improve the journal's quality and interest to the readership. We would like to thank our outgoing Editor-in-Chief, Professor Carl M Bender. Carl has done a magnificent job as Editor-in-Chief and has worked tirelessly to improve the journal over the last five years. Carl has been instrumental in designing and implementing strategies that have enhanced the quality of papers published and service provided by Journal of Physics A: Mathematical and Theoretical. Notably, under his tenure, we have introduced the Fast Track Communications (FTC) section to the journal. This section provides a venue for outstanding short papers that report new and timely developments in mathematical and theoretical physics and offers accelerated publication and high visibility for our authors. During the last five years, we have raised the quality threshold for acceptance in the journal and now reject over 60% of submissions. As a result, papers published in Journal of Physics A: Mathematical and Theoretical are amongst the best in the field. We have also maintained and improved on our excellent receipt-to-first-decision times, which now average less than 50 days for papers. We have recently announced another innovation; the Journal of Physics A Best Paper Prize. These prizes will honour excellent papers

  17. Conflicts of interest with the hand surgeon's relationship with industry.

    Science.gov (United States)

    DelSignore, Jeanne L; Goodman, Murray J

    2012-01-01

    Many advances in hand surgery have been supported and enabled by the integral relationship that exists between the profession of hand surgery and industry. This relationship takes many forms, including medical education, development of new technology and methodology, research, and opportunities for patient education. As with all of these endeavors, the primary focus of both the physician and industry must be the care of the patient. When a collaborative relationship exists between physicians and industry, a conflict of interest is present and must be recognized as such and managed to avoid any detriment to patient care. Although the hand surgeon, the patient, and industry share the common interest of advancement of patient care, there does exist real and potential conflicts of interest, which are unavoidable, but not necessarily undesirable. Multiple guidelines exist to govern relationships between industry and physicians. The cooperative relationship between the physician and industry is not only helpful, but it can be critical to the advancement of and innovations in patient care. When properly managed, collaboration between the physician and industry can effectively achieve the common goal of serving the best interest of the patient. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  18. Usefulness of Cochrane intervention reviews for the practicing dermatologic surgeon.

    Science.gov (United States)

    Alam, Murad

    2013-09-01

    The Cochrane Collaboration produces systematic, evidence-based reviews of clinically relevant topics in medicine, including those relevant to dermatologic surgery. To assess the utility of Cochrane reviews for practicing dermatologic surgeons. Search of the Cochrane Database of Systematic Reviews on February 20, 2012 for topics relevant to dermatologic surgery. Assessment of clinical recommendations with regard to their likelihood to affect medical decision-making in clinical dermatologic surgery. Fifteen Cochrane reviews met the search criteria; three offered positive conclusions regarding the comparative effectiveness of different therapies for the same indications. Cochrane reviews offer outstandingly complete evidence-based summaries of their topics. As such, the methodology of Cochrane reviews is a model for reviews in dermatologic surgery. Because of the dearth of high-level evidence in dermatologic surgery, the ability of Cochrane reviews to provide specific recommendations remains limited. Furthermore, dermatologic surgery may be inherently difficult to study because of the rapid evolution of procedures, intraprocedure complexity and variation, difficulties inherent in randomizing patients to interventions, and intersurgeon skill variation. That being said, the dermatologic surgery literature continues to improve and grow, and investigators are now broaching the special challenges associated with research in this area. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  19. Knowledge, attitudes, and practice patterns in surgical management of bicuspid aortopathy: a survey of 100 cardiac surgeons.

    Science.gov (United States)

    Verma, Subodh; Yanagawa, Bobby; Kalra, Sameer; Ruel, Marc; Peterson, Mark D; Yamashita, Michael H; Fagan, Andrew; Currie, Maria E; White, Christopher W; Wai Sang, Stephane Leung; Rosu, Cristian; Singh, Steve; Mewhort, Holly; Gupta, Nandini; Fedak, Paul W M

    2013-11-01

    would perform valve-sparing surgery. Of note, 40% of respondents used an index measure of aortic size to body surface area in addition to absolute aortic diameter in assessing the threshold for intervention. This large survey uncovered significant gaps in the knowledge and attitudes of surgeons toward the diagnosis and management of bicuspid aortopathy, many of which were at odds with current guideline recommendations. Efforts to promote knowledge translation in this area are strongly encouraged. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  20. Response to ProPublica's Rebuttal of Our Critique of the Surgeon Scorecard.

    Science.gov (United States)

    Friedberg, Mark W; Bilimoria, Karl Y; Pronovost, Peter J; Shahian, David M; Damberg, Cheryl L; Zaslavsky, Alan M

    2016-06-20

    In the summer of 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. In September 2015, RAND released a critique of the Scorecard authored by a group of health policy researchers from RAND and other institutions, and on October 7, 2015 ProPublica published a rebuttal of our critique. In this follow-on Perspective, we revisit the main points in our initial critique, summarize ProPublica's rebuttal, explain why this rebuttal fails to address our methodological concerns, provide suggestions on how to validate and improve the Scorecard, and explain why we continue to advise potential users of the Scorecard, as it is currently constructed, not to consider it a valid or reliable predictor of the health outcomes any individual surgeon is likely to provide.

  1. Why publish with AGU?

    Science.gov (United States)

    Graedel, T. E.

    The most visible activity of the American Geophysical Union is its publication of scientific journals. There are eight of these: Journal of Geophysical Research—Space Physics (JGR I), Journal of Geophysical Research—Solid Earth (JGR II), Journal of Geophysical Research—Oceans and Atmospheres (JGR III), Radio Science (RS), Water Resources Research (WRR), Geophysical Research Letters (GRL), Reviews of Geophysics and Space Physics (RGSP), and the newest, Tectonics.AGU's journals have established solid reputations for scientific excellence over the years. Reputation is not sufficient to sustain a high quality journal, however, since other factors enter into an author's decision on where to publish his or her work. In this article the characteristics of AGU's journals are compared with those of its competitors, with the aim of furnishing guidance to prospective authors and a better understanding of the value of the products to purchasers.

  2. Potential media influence on the high incidence of medical disputes from the perspective of plastic surgeons.

    Science.gov (United States)

    Chen, Chiehfeng; Lin, Ching-Feng; Chen, Cha-Chun; Chiu, Shih-Feng; Shih, Fuh-Yuan; Lyu, Shu-Yu; Lee, Ming-Been

    2017-08-01

    The main purpose of this study is to investigate the prevalence of medical disputes among plastic surgeons in Taiwan and to elucidate their perspectives regarding the influence of medical litigation media coverage on the physician-patient relationship. A self-administered questionnaire was distributed among plastic surgeons attending a series of continuing education training lectures organized by the Taiwan Society of Plastic Surgery in 2015. Of the 109 respondents, over a third (36.4%) had previously experienced a medical dispute. The vast majority of both physicians who had medical disputes (77.1%) and those who did not (72.1%) felt that the media tends to be supportive of patients in their reporting, and 37.1% of all plastic surgeons felt that the media always portrays the patient as a victim. Respondents who experienced medical disputes in this study felt that the top five leading causes of the high incidence of medical disputes were patient disappointment with procedure results (81.1%), insufficient patient psychological preparation or emotional instability (61.7%), inadequate risk communication on the part of the physician (64.9%), patient uneasiness with the procedure or perception of carelessness (60.6%), and insufficient physician training or incorrect medical evaluation (57.4%). Over a third of the respondents had previously experienced a medical dispute. This study highlights the perception among plastic surgeons that the media reporting of medical disputes and medical litigation is biased in favor of the patients, with 37.1% of the plastic surgeons surveyed opining that patients are always cast as victims. Copyright © 2017. Published by Elsevier B.V.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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'...

  9. 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

  10. 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

  11. Surgery for a tree surgeon? Acute presentation of contact dermatitis due to Ailanthus altissima.

    Science.gov (United States)

    Bennett, Warren O; Paget, James T; Mackenzie, Duncan

    2013-03-01

    A tree surgeon presented to hospital with multiple blackening, non-blanching regions of skin on both forearms, following exposure to sap from the 'tree of heaven' (Ailanthus altissima). A referral to plastic surgery was made to consider debridement. Following input from the national poisons centre and dermatology, conservative management with emollient was undertaken. The lesions blistered and exfoliated and were treated with topical steroid and oral antihistamines. Resolving erythema was the only symptom at three weeks. A. altissima, also known as the 'tree of heaven' has known toxins in its bark, leaves and flowers but is also commonly used in folk medicine. Two previous cases of contact dermatitis are reported in the literature but not with acute photo documentation of the lesions or with surgical referral. This demonstrates an important lesson that debridement would not be the appropriate management despite the initial presentation. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. 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.

  13. [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.

  14. A formidable task: Population analysis predicts a deficit of 2000 cardiothoracic surgeons by 2030.

    Science.gov (United States)

    Williams, Thomas E; Sun, Benjamin; Ross, Patrick; Thomas, Andrew M

    2010-04-01

    To estimate the cardiovascular workforce needed by 2030 to meet the needs of our population and to quantify its costs. Our field is changing. The volume of surgery and the nature of the surgery are changing. The nation's population grew from 227,000,000 to 282,000,000 between 1980 and 2000, and by 2030 the population is estimated to be 364,000,000. At the same time, the applications for fellowship in our specialty are decreasing at an alarming rate. The American Board of Thoracic Surgery has certified 4500 cardiothoracic surgeons since 1975, but only 1300 in the last 10 years. The US Department of Health and Human Services predicts only 3620 full-time cardiothoracic surgeons in 2020. Will we have enough cardiovascular and thoracic surgeons? Retrospective examination of the pertinent literature and with a modified Richard Cooper's economic trend analysis, a population algorithm with a ratio of physicians to population of 1.42 per 100,000. Each thoracic surgeon is predicted to practice 30 years from Board certification to retirement. The Balanced Budget Act will not be revised; therefore, we will certify 100 graduates from our programs per year. The assumed salaries will be 50,000 dollars with benefits of 30% and 15,000 dollars of additional Direct Medical Education costs. The population in 2030 will be 364,000,000 with 5169 cardiothoracic surgeons needed at that time. Unfortunately, there will be approximately only 3200 cardiothoracic surgeons in practice with a shortage of approximately 2000. To maintain our current status per 100,000 population from 2011 to 2030, we will have to train 4000 residents. The total person years would be approximately 28,000. The cost for this is more than 2,000,000,000 dollars. The annual cost for this training prorated over 20 years would be more than 110,000,000 dollars. We must train approximately 4000 surgeons, an extra 100 per year, in our specialty to meet the needs of the population by 2030. That will cost approximately 2

  15. 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.

  16. Trends in scientific publications of Indian spine surgeons over 14 years (2000-2013).

    Science.gov (United States)

    Kanna, Rishi Mugesh; Falavigna, Asdrubal; da Silva, Pedro Guarise; Quadros, Francine Wurzius; Merlin, Luiz Henrique; Radaelli, Lucas; Guyot, Juan Pablo; Dozza, Diego; Riew, Daniel K; Martins, Délio; Yoshiharu, Kawaguchi; Rajasekaran, S

    2016-01-01

    The number and quality of scientific publications reflects the standards of scientific research in a country. However, the contribution of Indian spine surgeons toward global publications is unknown. The goal is to study the publications of Indian spine surgeons between 2000 and 2013. A literature search of the publications by Indian spine surgeons was performed using MEDLINE. The search terms used were India and several spine-related terminologies. The main information of the selected papers including the year of publication, scientific journal, type of pathology studied, Neurosurgical or Orthopedic Department where the study was done, type of study, and the type of article was analyzed. A total of 4459 articles were identified using MEDLINE and after exclusion, 507 articles were analyzed. A growth of 440% in the number of publications was observed in the period between 2009 and 2013, during which 60.15% of the articles were published. Clinical studies (n = 492; 97.04) were the most common types of articles, followed by experimental studies and other types. The Neurosurgery department published the majority of the articles (58.2%). The three most common pathologies studied were spinal tumors (17.35%), surgical technique (15.4%), and spinal infection (15.2%). The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.

  17. 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.

  18. 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

  19. A high-performance and low cost SERS substrate of plasmonic nanopillars on plastic film fabricated by nanoimprint lithography with AAO template

    Science.gov (United States)

    Liu, Long; Zhang, Qian; Lu, Yuanshen; Du, Wei; Li, Bin; Cui, Yushuang; Yuan, Changsheng; Zhan, Peng; Ge, Haixiong; Wang, Zhenling; Chen, Yanfeng

    2017-06-01

    As a powerful spectroscopy technique, surface-enhanced Raman scattering (SERS) can provide non-destructive and sensitive characterization down to a single molecular level. Aiming to the main challenges of high-performance SERS-active substrates for their real-world applications involving the ultra-sensitive and reproducible signals detection and signal uniformity with large-area, herein, a facile and reliable strategy based on combination of thermal imprinting polycarbonate (PC) film with porous anodic aluminum oxide (AAO) mold and E-beam evaporation of gold is provided to fabricate a high-quality SERS-active substrate consisting of ultra-dense hot-spots with large-area uniformity. Two kinds of sub-10 nm gaps were obtained, including the nanogaps between the neighboring gold coated PC-nanopillars and those between gold on the top of the nanopillars and that on the base, which actually build up a three-dimensional (3D) hot-spot network for high-performance SERS detection. The effect of structural parameters on SERS enhancement was investigated numerically and experimentally, and by optimizing the structural parameters, a remarkable average SERS enhancement factor up to of 1.4×108 is achieved and it shows an excellent reproducibility with a relative standard deviation of 18%, which allows for enhanced practicability in the application of quantitative biochemical detection.

  20. Spitzer IRAC observations of newly-discovered planetary nebulae from the Macquarie-AAO-Strasbourg H-alpha Planetary Nebula Project

    CERN Document Server

    Cohen, Martin; Green, Anne J; Murphy, Tara; Miszalski, Brent; Frew, David J; Meade, Marilyn R; Babler, Brian; Indebetouw, Remy; Whitney, Barbara A; Watson, Christer; Churchwell, Edward B; Watson, Douglas F

    2007-01-01

    We compare H-alpha, radio continuum, and Spitzer Space Telescope (SST) images of 58 planetary nebulae (PNe) recently discovered by the Macquarie-AAO-Strasbo- urg H-alpha PN Project (MASH) of the SuperCOSMOS H-alpha Survey. Using InfraRed Array Camera (IRAC) data we define the IR colors of PNe and demonstrate good isolation between these colors and those of many other types of astronomical object. The only substantive contamination of PNe in the color-color plane we illustrate is due to YSOs. However, this ambiguity is readily resolved by the unique optical characteristics of PNe and their environs. We also examine the relationships between optical and MIR morphologies from 3.6 to 8.0um and explore the ratio of mid-infrared (MIR) to radio nebular fluxes, which is a valuable discriminant between thermal and nonthermal emission. MASH emphasizes late evolutionary stages of PNe compared with previous catalogs, enabling study of the changes in MIR and radio flux that attend the aging process. Spatially integrated M...

  1. 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

  2. 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.

  3. Analysis of Scientific Papers Included in the Sciences Citation Index Expanded Written by South Korean Plastic Surgeons: 2001-2010

    Directory of Open Access Journals (Sweden)

    Ju Young Go

    2012-01-01

    Full Text Available BackgroundThe purpose of our study was to analyze scientific papers published by South Korean plastic surgeons in journals included in the Science Citation Index Expanded (SCIE, and to evaluate the publication and research activities of Korean plastic surgeon.MethodsWe conducted a survey of SCIE papers in the field of plastic surgery published by South Korean authors between 2001 and 2010 using Web of Science software. We further analyzed these results according to the number of publications per year, journals, institution, and type of papers. We also compared the total number of citations to published scientific papers. We analyzed the rank of South Korea among other countries in representative journals.ResultsOverall, 667 papers were published by South Korean authors between 2001 and 2010. The number of publications increased dramatically from 2003 (n=31 to 2010 (n=139. Subsequently, the ten most productive Korean medical colleges were identified. All published papers received 2,311 citations and the citation to paper ratio was 3.49. The rank of Korea among other countries in terms of the number of published papers remained in the top 10 during the recent 10 years.ConclusionsPublication output of Korean plastic surgeon over the last 10 years showed a remarkable growth in terms of quantity and quality. Currently, Korea is among the top six countries in representative plastic surgery journals. Korean plastic surgeons have played a central role in this progress, and it is anticipated that they will continue to do so in the future.

  4. The Library Publishing Coalition: organizing libraries to enhance scholarly publishing

    Directory of Open Access Journals (Sweden)

    Sarah Kalikman Lippincott

    2016-07-01

    Full Text Available Library-based publishing efforts are gaining traction in academic and research libraries across the world, primarily in response to perceived gaps in the scholarly publishing system. Though publishing is a new area of work for libraries, it is often a natural outgrowth of their existing infrastructure and skill sets, leveraging the institutional repository as publishing platform and repositioning librarians’ skills as information managers. For decades, these initiatives were primarily ad hoc and local, limiting the potential for library publishing to effect significant change. In 2013, over 60 academic and research libraries collectively founded the Library Publishing Coalition (LPC, a professional association expressly charged with facilitating knowledge sharing, collaboration and advocacy for this growing field. This article offers an overview of library publishing activity, primarily in the US, followed by an account of the creation and mission of the LPC, the first professional association dedicated wholly to the support of library publishers.

  5. Proficiency assessment of gesture analysis in laparoscopy by means of the surgeon's musculo-skeleton model.

    Science.gov (United States)

    Cavallo, Filippo; Pietrabissa, Andrea; Megali, Giuseppe; Troia, Elena; Sinigaglia, Stefano; Dario, Paolo; Mosca, Franco; Cuschieri, Alfred

    2012-02-01

    This article presents the implementation of surgeon's musculo-skeletal model for gesture analysis in laparoscopy, thereby providing a complete account of the objective metrics needed to evaluate surgical performance and to improve the design of new surgical instruments including robotic instrumentation for surgical procedures. Previous published work has been based exclusively on the kinematics involved whereas, this study is focused on the dynamics and muscle contraction analysis to assess loads on bones and muscle fatigue during simulation of surgical interventions. Nine medical students and 2 fully trained surgeons participated in the experimental sessions using a virtual laparoscopic simulator. Movement was acquired by means of an Optical Localization System and processed by means of the biomechanical software platform ADAMS-LifeMOD. The musculo-skeletal analysis allows calculation of how the muscles are used and their respective mean work during the exercises. Results, relative to biceps and trapezius for left and right arm, clearly demonstrate different proficiencies between surgeons and medical students and highlight differences in using different surgical instruments and assumption of different postures. The model provides data on the evaluation of biomechanical parameters of surgical gesture not only in kinematic terms but also includes analysis of the dynamics of muscle contraction analysis during surgical manipulations.

  6. Neurosurgeons in Japan Are Exclusively Brain Surgeons.

    Science.gov (United States)

    Asamoto, Shunji

    2017-03-01

    In Japan, neurosurgeons have traditionally mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is 1 of the many subspecialties in the neurosurgical field in Japan. Most patients with neurological deficits or suspected neurological diseases see board-certified neurosurgeons directly in Japan, not through referrals from family physicians or specialists in other fields. Problems originating in the spine and spinal cord have been overlooked or misdiagnosed in these situations. Neurosurgeons in Japan must rethink the educational program to include advanced trauma life support and spinal surgery. Copyright © 2016. Published by Elsevier Inc.

  7. 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.

  8. 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.

  9. 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 ...

  10. 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

  11. [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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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....

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. THE TYPES OF PUBLISHING SLOGANS

    National Research Council Canada - National Science Library

    Ryzhov Konstantin Germanovich

    2015-01-01

    The author of the article focuses his attention on publishing slogans which are posted on 100 present-day Russian publishing houses' official websites and have not yet been studied in the special literature...

  6. The publisher journey for OUP

    Directory of Open Access Journals (Sweden)

    Rhodri Jackson

    2014-04-01

    Full Text Available The journey towards open access (OA monograph publishing is incomplete. Since the publication of the Finch Report and in an environment of improving funding for OA monographs, publishers have made tentative moves into the OA monograph space, but there are a number of questions to be answered before one or more truly successful and sustainable business models can be identified. Oxford University Press (OUP is a large monograph publisher, and has been publishing OA journals for a decade. It is only in the last year though that OUP has made significant moves towards OA monograph publishing, participating in the OAPEN-UK project and considering other options. The challenge for OUP and the publishing industry is to work with authors, funders and other interested parties to develop OA monograph publishing options which work for all involved and safeguard the future of a crucial element of the scholarly publishing landscape.

  7. Neighborhoods, Published in 2003, Freelance.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Neighborhoods dataset, was produced all or in part from Published Reports/Deeds information as of 2003. Data by this publisher are often provided in State Plane...

  8. 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.

  9. Seven Tips for Publishing Books

    Science.gov (United States)

    Kumashiro, Kevin K.

    2004-01-01

    The publishing industry in the field of education is undergoing several profound changes. New publishers are emerging while established publishers are merging. More book series (that is, books on a certain topic that are approved and mentored by one or more established scholars in the field) are being created. Alternative paths are becoming more…

  10. 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

  11. 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.

  12. What comes first? Publishing business or publishing studies?

    Directory of Open Access Journals (Sweden)

    Josipa Selthofer

    2015-07-01

    Full Text Available The aim of this paper is to analyze and compare publishing studies, their programmes at the undergraduate and graduate levels and scholars involved in the teaching of publishing courses at the top universities around the world and in Croatia. Since traditional publishing business is rapidly changing, new skills and new jobs are involved in it. The main research question is: Can modern publishing studies produce a modern publisher? Or, is it the other way around? The hypothesis of the paper is that scholars involved in the teaching of publishing courses at the top universities around the world have a background in publishing business. So, can they prepare their students for the future and can their students gain competencies they need to compete in a confusing world of digital authors and electronic books? The research methods used were content analysis and comparison. Research sample included 36 university publishing programmes at the undergraduate and graduate level worldwide (24 MA, 12 BA. The research sample was limited mainly to the English-speaking countries. In most non-English-speaking countries, it was difficult to analyse the programme curriculum in the native language because the programme and course description did not exit. In the data gathering phase, a customized web application was used for content analysis. The application has three main sections: a list of websites to evaluate, a visual representation of the uploaded website and a list of characteristics grouped by categories for quantifying data. About twenty years ago, publishing was not considered a separate scientific branch in Croatia. Publishing studies are therefore a new phenomenon to both scholars and publishers in Croatia. To create a new, ideal publishing course, can we simply copy global trends or is it better to create something of our own?

  13. 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.

  14. THE QUALITY CRITERIA AND SELF-PUBLISHING IN SCIENTIFIC PUBLISHING

    Directory of Open Access Journals (Sweden)

    Almudena Mangas-Vega

    2015-11-01

    Full Text Available Self-publishing is a growing phenomenon in recent years. It is a process that goes beyond a simple change of leader in the publication, since it involves also a change of role of agents that were consolidated over time. A self-published work does not have to mean lack of quality, so it is important to define parameters and indicators that help its evaluation and identify who has the responsibility of those criteria. The article shows these aspects from the possibilities for cross-platform publishing and concludes with an analysis of the aspects that can be considered in assessing the quality of self-publishing.

  15. 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

  16. [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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. AAO Observer - August 2011 Edition

    CERN Document Server

    Brough, Sarah

    2011-01-01

    This edition of the Australian Astronomical Observatory Observer contains articles on the commissioning of the new SAMI instrument giving the first hexabundle galaxy spectra; galaxy parameter variations across and through the 6dFGS Fundamental Plane; an introduction to the new Dragonfly stellar interferometer; an update on the RAdial VElocity (RAVE) survey at half a million spectra; the Magellanic Quasars Survey; the Integrated Photonic Spectrograph's first look at the heart of the Scorpion; using AAOMega to measure the age of the young open cluster IC2602; making MANIFEST fibres for the Giant Magellan Telescope and a Voyage through Filaments of Galaxies. The Observer also contains thoughts on diversity in the astronomy community and reports on the recent Supernovae and their Host Galaxies conference and the 2011 Science Meets Parliament. In addition there are the usual features of the AUSGO Corner, Epping News and Letter from Coona.

  2. Sir Victor Horsley: pioneer craniopharyngioma surgeon.

    Science.gov (United States)

    Pascual, José M; Prieto, Ruth; Mazzarello, Paolo

    2015-07-01

    Sir Victor Horsley (1857-1916) is considered to be the pioneer of pituitary surgery. He is known to have performed the first surgical operation on the pituitary gland in 1889, and in 1906 he stated that he had operated on 10 patients with pituitary tumors. He did not publish the details of these procedures nor did he provide evidence of the pathology of the pituitary lesions operated on. Four of the patients underwent surgery at the National Hospital for Neurology and Neurosurgery (Queen Square, London), and the records of those cases were recently retrieved and analyzed by members of the hospital staff. The remaining cases corresponded to private operations whose records were presumably kept in Horsley's personal notebooks, most of which have been lost. In this paper, the authors have investigated the only scientific monograph providing a complete account of the pituitary surgeries that Horsley performed in his private practice, La Patologia Chirurgica dell'Ipofisi (Surgical Pathology of the Hypophysis), written in 1911 by Giovanni Verga, Italian assistant professor of anatomy at the University of Pavia. They have traced the life and work of this little-known physician who contributed to the preservation of Horsley's legacy in pituitary surgery. Within Verga's pituitary treatise, a full transcription of Horsley's notes is provided for 10 pituitary cases, including the patients' clinical symptoms, surgical techniques employed, intraoperative findings, and the outcome of surgery. The descriptions of the topographical and macroscopic features of two of the lesions correspond unmistakably to the features of craniopharyngiomas, one of the squamous-papillary type and one of the adamantinomatous type. The former lesion was found on necropsy after the patient's sudden death following a temporal osteoplastic craniectomy. Surgical removal of the lesion in the latter case, with the assumed nature of an adamantinomatous craniopharyngioma, was successful. According to the

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. [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.

  8. 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.…

  9. Accelerometer Measurement of Head Movement During Laparoscopic Surgery as a Tool to Evaluate Skill Development of Surgeons.

    Science.gov (United States)

    Viriyasiripong, Sarayuth; Lopez, Asis; Mandava, Sree Harsha; Lai, Weil R; Mitchell, Gregory C; Boonjindasup, Aaron; Powers, Mary K; Silberstein, Jonathan L; Lee, Benjamin R

    2016-01-01

    vertical axis (p = 0.078) and horizontal axis (p = 0.077) in the peg transfer task. This may be in response to the ease of the task. The analysis of the forward-backward axis or depth perception also showed no significant differences between groups. Accelerometer-based motion analysis of head movement appears to be a useful tool to evaluate laparoscopic skill development of surgeons in terms of their economy of motion, and it could potentially be used for ergonomic assessment of training in the future, and progression on the learning curve. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. 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

  12. Comics, Copyright and Academic Publishing

    Directory of Open Access Journals (Sweden)

    Ronan Deazley

    2014-05-01

    Full Text Available This article considers the extent to which UK-based academics can rely upon the copyright regime to reproduce extracts and excerpts from published comics and graphic novels without having to ask the copyright owner of those works for permission. In doing so, it invites readers to engage with a broader debate about the nature, demands and process of academic publishing.

  13. The Decision to Publish Electronically.

    Science.gov (United States)

    Craig, Gary

    1983-01-01

    Argues that decision to publish a given intellectual product "electronically" is a business decision based on customer needs, available format alternatives, current business climate, and variety of already existing factors. Publishers are most influenced by customers' acceptance of new products and their own role as intermediaries in…

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. The handbook of journal publishing

    CERN Document Server

    Morris, Sally; LaFrenier, Douglas; Reich, Margaret

    2013-01-01

    The Handbook of Journal Publishing is a comprehensive reference work written by experienced professionals, covering all aspects of journal publishing, both online and in print. Journals are crucial to scholarly communication, but changes in recent years in the way journals are produced, financed, and used make this an especially turbulent and challenging time for journal publishers - and for authors, readers, and librarians. The Handbook offers a thorough guide to the journal publishing process, from editing and production through marketing, sales, and fulfilment, with chapters on management, finances, metrics, copyright, and ethical issues. It provides a wealth of practical tools, including checklists, sample documents, worked examples, alternative scenarios, and extensive lists of resources, which readers can use in their day-to-day work. Between them, the authors have been involved in every aspect of journal publishing over several decades and bring to the text their experience working for a wide range of ...

  1. 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.

  2. The SERS Detection of SudanⅠby Using AAO as Template to Prepare the Substrate%利用AAO模板制备SERS基底检测SudanⅠ

    Institute of Scientific and Technical Information of China (English)

    潘晓会; 张芹; 郭伟; 陈发河

    2015-01-01

    The large‐scale controllable ,ordered two‐dimensional arrays of gold nanostructure with hot‐spot were prepared to‐gether with chemical molecules were modified on the surface to concentrate Sudan Ⅰwithin the zone of the SERS effect ,which lead to analytical detection of SudanⅠin high resolution .The vapor of gold was deposed on anodic aluminum oxide(AAO)tem‐plate by ~200 nm thickness to replicate its nanochannels ,and the negative structure i .e .large‐scale ordered gold nano‐hemi‐sphere array ,was obtained after the removal of the template of AAO by NaOH solution .Au nano‐hemisphere array was modi‐fied by 1‐Dodecanethiol which can be self‐assembled monolayer on the surface and concentrate Sudan Ⅰ within the zone of the SERS detection ,which can facilitate the measurement of Sudan Ⅰ .Due to the order and regularity of Au nano‐hemisphere array , the signal of SudanⅠin the range of laser illumination is stable and uniform ,and the quantitative analysis of SudanⅠwas real‐ized .The SERS intensity of SudanⅠis logistic proportional to the concentration in the range of 10-7 to 5 × 10-4 mol・L -1 .The corresponding correlation coefficient of the liner equation is 0.99 ,the recoveries of SudanⅠare between 77% ~117% .The limit of detection for SudanⅠis 4 × 10-8 mol・L -1 ,comparable to that of HPLC of Chinese national standard method .%通过模板法制备大面积、可控的、可重复的、热点集中的金纳米结构阵列,并在纳米结构阵列上通过化学修饰分子,吸附更多苏丹红Ⅰ分子至金纳米的SERS增强区域,实现其高灵敏的表面增强拉曼分析检测。以多孔阳极氧化铝为模板,通过真空蒸镀金,约200 nm厚度,复制氧化铝的孔洞结构,用碱液将氧化铝模板腐蚀去除,可得到氧化铝模板的互补结构,即大面积的、均匀的金半球纳米结构阵列。在金纳米结构阵列上修饰十二硫醇,硫醇巯基端与纳米金相

  3. [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.

  4. Surgeon's view of the skull base from the lateral approach.

    Science.gov (United States)

    Goldenberg, R A

    1984-12-01

    This paper presents the surgical anatomy of the skull base and infratemporal fossa. The information has been derived from the author's own experience in surgical and cadaver dissection, standard anatomical references, and selected experience of other skull base surgeons. Because the lateral approach has become the utilitarian method of exposure, the intricate detailed anatomy is demonstrated from this view at five levels of dissection, so the surgeon may gain a practical understanding of the surgical relationship of critical structures. Consistent anatomical landmarks can be used by the surgeon in the location of these critical structures. The styloid process, sphenoidal spine, and middle meningeal artery identify the internal carotid artery as it enters the carotid canal. The bony or fibrous septum that divides the jugular foramen into neural and vascular compartments may be used to better identify nerves IX, X, and XI. The zygomatic root is useful for location of the middle fossa dura. The lateral pterygoid plate leads directly to the foramen ovale. The increased precision of dissection permitted by use of the microscope requires an increased level of knowledge of anatomical structures in this area. It is hoped that the information presented in this paper will assist surgeons in the meticulous and thorough removal of skull base tumors and in the preservation of neural and vascular structures that are presently being sacrificed.

  5. 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.

  6. 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.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    perform valid abdominal ultrasound examinations of patients referred with acute abdominal pain. METHODS: Patients referred with acute abdominal pain had an ultrasound examination by a surgeon in training as well as by an experienced consultant radiologist whose results served as the gold standard. All...

  8. 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.

  9. [Collaboration between geriatricians and orthopaedic surgeons on elderly patients].

    Science.gov (United States)

    Damsgaard, Else Marie; Borris, Lars; Duus, Benn; van der Mark, Susanne

    2013-10-07

    Close collaboration between geriatricians and orthopaedic surgeons on elderly patients with hip fractures reduces mortality, the number of complications, and the length of hospital stay and increases the functional abilities of the patients. In some Danish hospitals the two groups of doctors work closely together, in others there are few or no geriatricians.

  10. Clubfoot: An Orthopaedic Surgeon Describes Clubfoot and Current Treatment Methods

    Science.gov (United States)

    Vitale, Michael

    2007-01-01

    As an orthopaedic surgeon who has treated numerous cases of clubfoot in his career, the author knows that it takes exceptional parents to deal with the challenges of having a child born with a clubfoot. However, it should be noted that a clubfoot diagnosis does not mean a life of pain, deformity, and disability for a child. Today's treatment…

  11. Optimal Brain Surgeon on Artificial Neural Networks in

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    AIM: Ultrasound has a well-established role in the diagnostic assessment of acute abdominal pain where some ultrasonically easily-accessible organs account for several diagnostic possibilities. The objective of the present study was to evaluate whether surgeons without ultrasound experience could...

  13. HIV-positive status among surgeons - an ethical dilemma

    African Journals Online (AJOL)

    2006-08-11

    Aug 11, 2006 ... HIV I AIDS is a manageable disease with a reasonable expectation that affected ... the potential risk of an HIV-positive surgeon transmitting .... much-publicised Florida (USA) dentist transmitting HIV to a patient,? There has ...

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

    DEFF Research Database (Denmark)

    Jalaliniya, Shahram; Pederson, Thomas

    2015-01-01

    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...

  15. Cutting around corners: Endo-Periscope increases surgeon's scope

    NARCIS (Netherlands)

    Van Kasteren, J.

    2001-01-01

    Many surgeons find it difficult to perform laparoscopies, operations performed inside the abdominal cavity without opening the abdominal wall. These keyhole operations are particularly taxing due to a lack of depth perception and impaired hand-eye coordination. Consequently, the method has been used

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

    African Journals Online (AJOL)

    hi-tech

    Subjects: One hundred and sixty seven surgeons(study group)and l93 ... Nigeria. The aim of this study is to determine the prevalence ... MATERIALS AND METHODS ..... C.J. Immune status in preschool children born after mass hepatitis B.

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

    Science.gov (United States)

    Renshaw, Domeena C.

    2003-01-01

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

  18. Hydrography, Published in unknown, SWGRC.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hydrography dataset, was produced all or in part from Road Centerline Files information as of unknown. Data by this publisher are often provided in Geographic...

  19. The Simple Publishing Interface (SPI)

    NARCIS (Netherlands)

    Ternier, Stefaan; Massart, David; Totschnig, Michael; Klerkx, Joris; Duval, Erik

    2010-01-01

    Ternier, S., Massart, D., Totschnig, M., Klerkx, J., & Duval, E. (2010). The Simple Publishing Interface (SPI). D-Lib Magazine, September/October 2010, Volume 16 Number 9/10, doi:10.1045/september2010-ternier

  20. The Simple Publishing Interface (SPI)

    NARCIS (Netherlands)

    Ternier, Stefaan; Massart, David; Totschnig, Michael; Klerkx, Joris; Duval, Erik

    2010-01-01

    Ternier, S., Massart, D., Totschnig, M., Klerkx, J., & Duval, E. (2010). The Simple Publishing Interface (SPI). D-Lib Magazine, September/October 2010, Volume 16 Number 9/10, doi:10.1045/september2010-ternier

  1. Published journal article with data

    Data.gov (United States)

    U.S. Environmental Protection Agency — published journal article. This dataset is associated with the following publication: Schumacher, B., J. Zimmerman, J. Elliot, and G. Swanson. The Effect of...

  2. Minimalist transcatheter aortic valve replacement: The new standard for surgeons and cardiologists using transfemoral access?

    Science.gov (United States)

    Jensen, Hanna A; Condado, Jose F; Devireddy, Chandan; Binongo, Jose; Leshnower, Bradley G; Babaliaros, Vasilis; Sarin, Eric L; Lerakis, Stamatios; Guyton, Robert A; Stewart, James P; Syed, Amjadullah Q; Mavromatis, Kreton; Kaebnick, Brian; Rajaei, Mohammad Hossein; Tsai, Lillian L; Rahman, Ayaz; Simone, Amy; Keegan, Patricia; Block, Peter C; Thourani, Vinod H

    2015-10-01

    A minimalist approach for transcatheter aortic valve replacement (MA-TAVR) utilizing transfemoral access under conscious sedation and transthoracic echocardiography is increasing in popularity. This relatively novel technique may necessitate a learning period to achieve proficiency in performing a successful and safe procedure. This report evaluates our MA-TAVR cohort with specific characterization between our early, midterm, and recent experience. We retrospectively reviewed 151 consecutive patients who underwent MA-TAVR with surgeons and interventionists equally as primary operator at Emory University between May 2012 and July 2014. Our institution had performed 300 TAVR procedures before implementation of MA-TAVR. Patient characteristics and early outcomes were compared using Valve Academic Research Consortium 2 definitions among 3 groups: group 1 included the first 50 patients, group 2 included patients 51 to 100, and group 3 included patients 101 to 151. Median age for all patients was 84 years and similar among groups. The majority of patients were men (56%) and the median ejection fraction for all patients was 55% (interquartile range, 38.0%-60.0%). The majority of patients were high-risk surgical candidates with a median Society of Thoracic Surgeons Predicted Risk of Mortality of 10.0% and similar among groups. The overall major stroke rate was 3.3%, major vascular complications occurred in 3% of patients, and greater-than-mild paravalvular leak rate was 7%. In-hospital mortality and morbidity were similar among all 3 groups. In a high-volume TAVR center, transition to MA-TAVR is feasible with acceptable outcomes and a diminutive procedural learning curve. We advocate for TAVR centers to actively pursue the minimalist technique with equal representation by cardiologists and surgeons. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  3. American College of Surgeons National Surgical Quality Improvement Program Pediatric: a phase 1 report.

    Science.gov (United States)

    Raval, Mehul V; Dillon, Peter W; Bruny, Jennifer L; Ko, Clifford Y; Hall, Bruce L; Moss, R Lawrence; Oldham, Keith T; Richards, Karen E; Vinocur, Charles D; Ziegler, Moritz M

    2011-01-01

    There has been a long-standing desire to implement a multi-institutional, multispecialty program to address surgical quality improvement for children. This report documents results of the initial phase of the American College of Surgeons National Surgical Quality Improvement Program Pediatric. From October 2008 to December 2009, patients from 4 pediatric referral centers were sampled using American College of Surgeons National Surgical Quality Improvement Program methodology tailored to children. A total of 7,287 patients were sampled, representing general/thoracic surgery (n = 2,237; 30.7%), otolaryngology (n = 1,687; 23.2%), orthopaedic surgery (n = 1,367; 18.8%), urology (n = 893; 12.3%), neurosurgery (n = 697; 9.6%), and plastic surgery (n = 406; 5.6%). Overall mortality rate detected was 0.3% and 287 (3.9%) patients had postoperative occurrences. After accounting for demographic, preoperative, and operative factors, occurrences were 4 times more likely in those undergoing inpatient versus outpatient procedures (odds ratio [OR] = 4.71; 95% CI, 3.01-7.35). Other factors associated with higher likelihood of postoperative occurrences included nutritional/immune history, such as preoperative weight loss/chronic steroid use (OR = 1.49; 95% CI, 1.03-2.15), as well as physiologic compromise, such as sepsis/inotrope use before surgery (OR = 1.68; 95% CI, 1.10-1.95). Operative factors associated with occurrences included multiple procedures under the same anesthetic (OR = 1.58; 95% CI, 1.21-2.06) and American Society of Anesthesiologists classification category 4/5 versus 1 (OR = 5.74; 95% CI, 2.94-11.24). Specialty complication rates varied from 1.5% for otolaryngology to 9.0% for neurosurgery (p Pediatric has the potential to identify outcomes of children's surgical care that can be targeted for quality improvement efforts. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Improving surgeon utilization in an orthopedic department using simulation modeling

    Directory of Open Access Journals (Sweden)

    Simwita YW

    2016-10-01

    Full Text Available Yusta W Simwita, Berit I Helgheim Department of Logistics, Molde University College, Molde, Norway Purpose: Worldwide more than two billion people lack appropriate access to surgical services due to mismatch between existing human resource and patient demands. Improving utilization of existing workforce capacity can reduce the existing gap between surgical demand and available workforce capacity. In this paper, the authors use discrete event simulation to explore the care process at an orthopedic department. Our main focus is improving utilization of surgeons while minimizing patient wait time.Methods: The authors collaborated with orthopedic department personnel to map the current operations of orthopedic care process in order to identify factors that influence poor surgeons utilization and high patient waiting time. The authors used an observational approach to collect data. The developed model was validated by comparing the simulation output with the actual patient data that were collected from the studied orthopedic care process. The authors developed a proposal scenario to show how to improve surgeon utilization.Results: The simulation results showed that if ancillary services could be performed before the start of clinic examination services, the orthopedic care process could be highly improved. That is, improved surgeon utilization and reduced patient waiting time. Simulation results demonstrate that with improved surgeon utilizations, up to 55% increase of future demand can be accommodated without patients reaching current waiting time at this clinic, thus, improving patient access to health care services.Conclusion: This study shows how simulation modeling can be used to improve health care processes. This study was limited to a single care process; however the findings can be applied to improve other orthopedic care process with similar operational characteristics. Keywords: waiting time, patient, health care process

  5. THE TYPES OF PUBLISHING SLOGANS

    Directory of Open Access Journals (Sweden)

    Ryzhov Konstantin Germanovich

    2015-03-01

    Full Text Available The author of the article focuses his attention on publishing slogans which are posted on 100 present-day Russian publishing houses' official websites and have not yet been studied in the special literature. The author has developed his own classification of publishing slogans based on the results of analysis and considering the current scientific views on the classification of slogans. The examined items are classified into autonomous and text-dependent according to interrelationship with an advertising text; marketable, corporative and mixed according to a presentation subject; rational, emotional and complex depending on the method of influence upon a recipient; slogan-presentation, slogan-assurance, slogan-identifier, slogan-appraisal, slogan-appeal depending on the communicative strategy; slogans consisting of one sentence and of two or more sentences; Russian and foreign ones. The analysis of the slogans of all kinds presented in the actual material allowed the author to determine the dominant features of the Russian publishing slogan which is an autonomous sentence in relation to the advertising text. In spite of that, the slogan shows the publishing output, influences the recipient emotionally, actualizes the communicative strategy of publishing house presentation of its distinguishing features, gives assurance to the target audience and distinguishes the advertised subject among competitors.

  6. Influence of surgeon experience, hospital volume, and specialty designation on outcomes in pediatric surgery: a systematic review.

    Science.gov (United States)

    McAteer, Jarod P; LaRiviere, Cabrini A; Drugas, George T; Abdullah, Fizan; Oldham, Keith T; Goldin, Adam B

    2013-05-01

    Analyses of volume-outcome relationships in adult surgery have found that hospital and physician characteristics affect patient outcomes, such as length of stay, hospital charges, complications, and mortality. Similar investigations in children's surgical specialties are fewer in number, and their conclusions are less clear. To review the evidence regarding surgeon or hospital experience and their influence on outcomes in children's surgery. A MEDLINE and EMBASE search was conducted for English-language studies published from January 1, 1980, through April 13, 2012. Titles and abstracts were screened in a standardized manner by 2 reviewers. Studies selected for inclusion had to use a measure of hospital or surgeon experience as a predictor variable and had to report postoperative outcomes as dependent response variables. Included studies were reviewed with regard to methodologic quality, and study results were extracted. Sixty-three studies were reviewed. Significant heterogeneity was detected in exposure definitions, outcome measures, and risk adjustment, with the greatest heterogeneity seen in appendectomy studies. Various exposure levels were examined: hospital level in 48 (68%) studies, surgeon level in 11 (17%), and both in 9 (14%). Nineteen percent of studies did not adjust for confounding, and 57% did not adjust for sample clustering. The most consistent methods and reproducible results were seen in the pediatric cardiac surgical literature. Forty-nine studies (78%) showed positive correlation between experience and most primary outcomes, but differences in outcomes and exposure definitions made comparisons between studies difficult. In general, hospital-level factors tended to correlate with outcomes for high-complexity procedures, whereas surgeon-level factors tended to correlate with outcomes for more common procedures. Data on experience-related outcomes in children's surgery are limited in number and vary widely in methodologic quality. Future studies

  7. [Surgeons-anesthetists relations: From an individual responsibility of the surgeon to a shared responsibility with the anesthetist].

    Science.gov (United States)

    Cohen, Philip; Slim, Karem; Soulier, Laure; Theissen, Alexandre

    2017-05-01

    Throughout the perioperative period, anesthetists and surgeons jointly provide care for patients. The advances in medicine and surgery, the practice of perioperative quality medicine and the recent application of enhanced recovery program after surgery have necessitated strengthening the place of each in its area of expertise while developing the spirit team and communication. Thus, alongside the surgeon who was once considered the head of the surgical team, the anesthetist's role has been to consolidate for the management of the surgical patient and had his spot empower themselves in the eye of the patient with the birth an own contract with the patient (due in particular to the obligation to preanesthetic consultation by the decree of December 5, 1994). This has led to a new division of responsibility between these actors: jurisprudence has abandoned the exclusive responsibility of the surgeon, devoted own responsibility of the anesthetist with a division (if any) of responsibility between the anesthetist and the surgeon. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Incidence of Complications During Initial Experience with Revision of the Agility and Agility LP Total Ankle Replacement Systems: A Single Surgeon's Learning Curve Experience.

    Science.gov (United States)

    Roukis, Thomas S; Simonson, Devin C

    2015-10-01

    As the frequency in which foot and ankle surgeons are performing primary total ankle replacement (TAR) continues to build, revision TAR will likely become more commonplace, creating a need for an established benchmark by which to evaluate the safety of revision TAR as determined by the incidence of complications. Currently, no published data exist on the incidence of intraoperative and early postoperative complications during revision of the Agility or Agility LP Total Ankle Replacement Systems during the surgeon learning curve period; therefore, the authors sought to determine this incidence during the senior author's learning curve period.

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

    Science.gov (United States)

    Rogers, B O

    2001-01-01

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

  10. 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.

  11. 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.

  12. A novel flight surgeon training model at a joint military and civilian surgical residency program.

    Science.gov (United States)

    DeSoucy, Erik S; Zakaluzny, Scott A; Galante, Joseph M

    2017-07-01

    Graduating military preliminary interns are often required to fill flight surgeon billets. General surgery preliminary interns get experience evaluating surgical and trauma patients, but receive very little training in primary care and flight medicine. At a joint military and civilian training program, we developed a supplemental curriculum to help transition our interns into flight medicine. From 2013 to 2016, we developed a lecture series focused on aerospace medicine, primary care, and specialty topics including dermatology, ophthalmology, orthopedics, pediatrics, psychiatry, and women's health. During the 2016 iteration attended by 10 interns, pre- and post-participation 10-item Likert scale surveys were administered. Questions focused on perceived preparedness for primary care role and overall enthusiasm for flight medicine. Open-ended surveys from 2013 to 2016 were also used to gauge the effect of the curriculum. The composite number of agreement responses (indicating increased comfort with presented material) increased 63% after course completion. Disagreement responses and neutral responses decreased 78% and 30%, respectively. Open-ended surveys from 14 participants showed an overall positive impression of the curriculum with all indicating it aided their transition to flight medicine. Survey responses indicate an overall perceived benefit from participation in the curriculum with more confidence in primary care topics and improved transition to a flight medicine tour. This model for supplemental aerospace medicine and primary care didactics should be integrated into any residency program responsible for training military preliminary interns who may serve as flight surgeons. Published by Elsevier Inc.

  13. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel.

    Science.gov (United States)

    Okoshi, Kae; Kobayashi, Katsutoshi; Kinoshita, Koichi; Tomizawa, Yasuko; Hasegawa, Suguru; Sakai, Yoshiharu

    2015-08-01

    Although surgical smoke contains potentially hazardous substances, such as cellular material, blood fragments, microorganisms, toxic gases and vapors, many operating rooms (ORs) do not provide protection from exposure to it. This article reviews the hazards of surgical smoke and the means of protecting OR personnel. Our objectives are to promote surgeons' acceptance to adopt measures to minimize the hazards. Depending on its components, surgical smoke can increase the risk of acute and chronic pulmonary conditions, cause acute headaches; irritation and soreness of the eyes, nose and throat; dermatitis and colic. Transmission of infectious disease may occur if bacterial or viral fragments present in the smoke are inhaled. The presence of carcinogens in surgical smoke and their mutagenic effects are also of concern. This review summarizes previously published reports and data regarding the toxic components of surgical smoke, the possible adverse effects on the health of operating room personnel and measures that can be used to minimize exposure to prevent respiratory problems. To reduce the hazards, surgical smoke should be removed by an evacuation system. Surgeons should assess the potential dangers of surgical smoke and encourage the use of evacuation devices to minimize potential health hazards to both themselves and other OR personnel.

  14. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons.

    Science.gov (United States)

    Brown, Deanna G; Wilkerson, Eric C; Love, W Elliot

    2015-03-01

    Dermatologic surgeons will increasingly encounter patients on novel oral antiplatelet and anticoagulant medications. We conducted a complete overview of the pharmacokinetics, pharmacodynamics, and side effects of traditional and novel oral anticoagulant and antiplatelet therapies along with dietary supplements with anticoagulant or antiplatelet properties. A PubMed search was completed for "aspirin," "warfarin," "clopidogrel," "dabigatran," "rivaroxaban," "apixaban," "prasugrel," and "ticagrelor." Review articles and publications emphasizing perioperative management of oral anticoagulant or antiplatelet medications were selected. An additional PubMed search was completed for "hemorrhage," "bleeding," and "thrombosis" in conjunction with "dermatology," "dermatologic surgery," and "cutaneous surgery." Aspirin, clopidogrel, and warfarin have shortfalls in dosing, monitoring, and efficacy. Several trials show superior efficacy with dabigatran, rivaroxaban, and apixaban, with equal or reduced risk of bleeding compared with warfarin. Prasugrel and ticagrelor may be associated with an increased bleeding risk. Many over-the-counter medications also have anticoagulant properties with associated bleeding risks that cannot be overlooked. There are few publications evaluating the novel oral anticoagulants' effects on outpatient surgical procedures. Novel anticoagulant and antiplatelet drugs are revolutionizing therapy for cardiovascular diseases. As these medications become more prevalent, dermatologists and dermatologic surgeons must be mindful of the bleeding risk that will apply in our everyday practices. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Leonardo Fioravanti (1517-1588): a barber-surgeon who influenced the development of reconstructive surgery.

    Science.gov (United States)

    Santoni-Rugiu, P; Mazzola, R

    1997-02-01

    Surgery in the Middle Ages was practiced by individuals belonging to the guild of barbers, with no basic medical education. The transformation into a scientific branch of medicine began in the sixteenth century. In this process, a great role was the one played by Leonardo Fioravanti. He was a Doctor in Medicine graduated from the University of Bologna. A controversial man, he was also an innovation in many fields of medicine, such as prevention of diseases, pharmacology, therapy, etc., and he was a surgeon himself. On the way back from one of the last Crusades, he visited the Vianeos brothers in Calabria, and he was able to learn from them the technique for reconstructing the nose that had been devised by Antonio Branca in the previous century and still practiced only by barber-surgeons. He published his experience in a book that probably inspired the contemporary, Gaspare Tagliacozzi, Professor at the University of Bologna, and allowed him to become acquainted with this kind of reconstructive surgery. Tagliacozzi understood the value of the method described by Fioravanti and transformed a barber-surgery technique into a remarkable chapter of scientific surgery by divulging in the academic circles the principles of the pedicled flap, which have been the basis for development of modern plastic surgery.

  16. 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.

  17. EDITORIAL AND PUBLISHER'S NOTE: BIPM to Publish Metrologia

    Science.gov (United States)

    Blackburn, D.

    1990-01-01

    Beginning in January of next year Metrologia will be published by the Bureau International des Poids et Mesures. This does not mean that a new journal is being created: externally the journal may have changed a little, but internally any changes will be of form rather than of substance. Metrologia was intended originally as a vehicle that would permit the metrological community to communicate progress in fundamental scientific measurements, to report original experiments and techniques in the area of secondary measurement, to review work in specialist fields and to disseminate the decisions of the Comité International des Poids et Mesures. The promotion of these activities remains the central objective of editorial policy. The separation from our friends in Springer-Verlag is one we view with some regret and not a little trepidation. On the days when things were not going well in the editorial office at the BIPM it was always a source of comfort to remember the willingness and professionalism with which our colleagues at Springer-Verlag supported the production and distribution of the journal. For some time, however, it has been felt at the BIPM that the Bureau should take direct responsibility for all aspects of Metrologia. This feeling led to discussions on the future of the journal and in June to the decision to separate. For those of us at the BIPM, the change represents an occasion to review the activities and priorities of the journal and so to revivify it. Our hope is to retain the best features of the existing Metrologia and to add to them others which will both expand the readership and bring to the journal a yet greater fraction of the finest articles on the topic of precise measurement. Publisher's Note The first issue of Metrologia was published in 1965. That issue, as have been all others since, was published by Springer-Verlag "under the Auspices of the International Committee for Weights and Measures". This phrase is the public expression of what

  18. Presurgical hand antisepsis: concepts and current habits of veterinary surgeons.

    Science.gov (United States)

    Verwilghen, Denis; Grulke, Sigrid; Kampf, Günter

    2011-07-01

    To assess current habits for surgical hand preparation among veterinary surgical specialists and to compare data with current guidelines for hand asepsis techniques. Survey of veterinary surgical specialists. Diplomates of the American (ACVS) and European Colleges of Veterinary Surgeons (ECVS). An internet-based survey of hand preparation methods before surgical procedures was conducted of 1300 listed ACVS and ECVS Diplomates. A 42.6% response rate was obtained. Approximately, 80% of respondents use disinfecting soaps as a primary method for hand antisepsis. Of those, 81% use chlorhexidine-based scrubs and 7% use a neutral soap followed by a hydroalcoholic solution. Contrary to current recommendations of the World Health Organization and scientific evidence supporting use of hydro-alcoholic rubs for presurgical hand preparation, veterinary surgical specialists still use surgical scrub solutions containing disinfecting soaps. © Copyright 2011 by The American College of Veterinary Surgeons.

  19. 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.

  20. Surgeon Design Interface for Patient-Specific Concentric Tube Robots.

    Science.gov (United States)

    Morimoto, Tania K; Greer, Joseph D; Hsieh, Michael H; Okamura, Allison M

    2016-06-01

    Concentric tube robots have potential for use in a wide variety of surgical procedures due to their small size, dexterity, and ability to move in highly curved paths. Unlike most existing clinical robots, the design of these robots can be developed and manufactured on a patient- and procedure-specific basis. The design of concentric tube robots typically requires significant computation and optimization, and it remains unclear how the surgeon should be involved. We propose to use a virtual reality-based design environment for surgeons to easily and intuitively visualize and design a set of concentric tube robots for a specific patient and procedure. In this paper, we describe a novel patient-specific design process in the context of the virtual reality interface. We also show a resulting concentric tube robot design, created by a pediatric urologist to access a kidney stone in a pediatric patient.

  1. The orthopaedic surgeon and manufacturing industry relationship. Ethical guidelines.

    Science.gov (United States)

    Lim, E V; Aquino, N J

    1999-11-01

    Orthopaedic surgery has progressed over the years because of innovative work of pioneering orthopaedic surgeons; new developments in internal fixation techniques and implants codeveloped with the orthopaedic manufacturing industry have improved treatment greatly. This article analyzes and reviews the relationship of orthopaedic surgeons to the orthopaedic implant industry, analyzing three broad categories of the relationship: (1) physicians receiving gifts from industry; (2) the orthopaedic industry's financial support of educational and research endeavors of academic trauma and other centers; and (3) the relationship of the industry with innovators in the field of orthopaedic surgery by retainer fees, royalties, and stock options from industry. The ethical relationship requires: (1) putting the patient's concerns first above vested interests; (2) an awareness of a potential for abuse; and (3) a level of awareness of the relationship and the ability to explain and inculcate this relationship in the teaching program of young residents to maintain the high standards that have been set.

  2. [Gastrointestinal surgeons should master the adjuvant therapy of colorectal cancer].

    Science.gov (United States)

    Gu, Jin; Chen, Pengju

    2015-10-01

    The diagnosis and treatment of colorectal cancer is one of the main diseases of gastrointestinal surgeons. It is very important to master the adjuvant chemotherapy of colorectal cancer for gastrointestinal surgeons. In recent years, with the development of a number of clinical trials and the appearance of new drugs, fluorouracil combined with oxaliplatin had been established as the standard regimen of adjuvant chemotherapy for colorectal cancer. In the current guidelines, stage III( colon cancer is the indication for adjuvant chemotherapy, while stage II( colon cancer should receive adjuvant chemotherapy is uncertain. Unlike colon cancer, adjuvant therapy of rectal cancer is not evidence-based. Especially, the indication and duration of adjuvant chemotherapy for rectal cancer after neoadjuvant chemoradiotherapy remain controversial. Adjuvant therapy of colorectal cancer still needs further investigation.

  3. Digital Publishing: Imperfect, but Improving

    Science.gov (United States)

    Boettcher, Judith V.

    2007-01-01

    Digital publishing is a field lurching along many paths and alleyways of experimentation. For their potential influence, however, recent approaches bear watching. In this article, the author shares the story of Jason on his personal decision-making struggles on using digital versions against conventional textbooks. The author also discusses…

  4. Publishing of Research in Librarianship.

    Science.gov (United States)

    Magrill, Rose Mary

    1984-01-01

    Review of trends during past 20 years in publishing of research and research results in librarianship in United States notes three characteristics of effective system of scholarly communication: access (bibliographies and indexes, research-alert columns, annual reviews); entry (journals, monographs, textbooks and readers, conference proceedings,…

  5. U.S. plastic surgeons who contributed to the Revue de Chirurgie Plastique and the Revue de Chirurgie Structive (1931-1938): "Giants" in our specialty.

    Science.gov (United States)

    Rogers, B O

    1999-01-01

    The Revue de Chirurgie Plastique and the Revue de Chirurgie Structive, Brussels (1931-1938), edited by Maurice Coelst, M.D. from Brussels, were the first, full-fledged medical publications specifically devoted to plastic, reconstructive, and aesthetic surgery. Publishing original articles by J.W. Maliniac, J. Eastman Sheehan, and brief summaries of papers read at plastic surgery societies by C.R. Straatsma, L.A. Peer, G. Aufricht, and other well-known American plastic surgeons, these Revues drew attention to surgeons, most of whom were responsible for organizing the American Society of Plastic and Reconstructive Surgeons in 1931, the same year in which the Revue de Chirurgie Plastique first appeared.

  6. Online reviews of orthopedic surgeons: an emerging trend.

    Science.gov (United States)

    Frost, Chelsea; Mesfin, Addisu

    2015-04-01

    Various websites are dedicated to rating physicians. The goals of this study were to: (1) evaluate the prevalence of orthopedic surgeon ratings on physician rating websites in the United States and (2) evaluate factors that may affect ratings, such as sex, practice sector (academic or private), years of practice, and geographic location. A total of 557 orthopedic surgeons selected from the 30 most populated US cities were enrolled. The study period was June 1 to July 31, 2013. Practice type (academic vs private), sex, geographic location, and years since completion of training were evaluated. For each orthopedic surgeon, numeric ratings from 7 physician rating websites were collected. The ratings were standardized on a scale of 0 to 100. Written reviews were also collected and categorized as positive or negative. Of the 557 orthopedic surgeons, 525 (94.3%) were rated at least once on 1 of the physician rating websites. The average rating was 71.4. The study included 39 female physicians (7.4%) and 486 male physicians (92.6%). There were 204 (38.9%) physicians in academic practice and 321 (61.1%) in private practice. The greatest number of physicians, 281 (50.4%), practiced in the South and Southeast, whereas 276 (49.6%) practiced in the West, Midwest, and Northeast. Those in academic practice had significantly higher ratings (74.4 vs 71.1; P<.007). No significant difference based on sex (72.5 male physicians vs 70.2 female physicians; P=.17) or geographic location (P=.11) were noted. Most comments (64.6%) were positive or extremely positive. Physicians who were in practice for 6 to 10 years had significantly higher ratings (76.9, P<.01) than those in practice for 0 to 5 years (70.5) or for 21 or more years (70.7).

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    -Technical Skills for Surgeons in Denmark tool to stimulate feedback conversations. Audio recordings of post-operation feedback conversations were collected. Trainees and supervisors provided questionnaire responses on the usefulness and comprehensiveness of the feedback. The feedback conversations were...... qualitatively analyzed for content and feedback style. Usefulness was investigated using a scale from 1 to 5 and written comments were qualitatively analyzed. RESULTS: Six trainees and six supervisors participated in eight feedback conversations. Eighty questionnaires (response rate 83 percent) were collected...

  8. Credentialing and privileging for the oral and maxillofacial surgeon.

    Science.gov (United States)

    Nelson, Steven R

    2008-02-01

    Understanding the credentialing and privileging process is important for all practitioners. Whether applying to a medical staff for the first time, participating in the reappointment process, applying for new privileges, or challenging a clinical privilege denial, the practitioner needs to understand the process and know his or her rights. This article should assist the oral and maxillofacial surgeon and the organizations providing credentials and privileges to make the process less difficult and more efficient.

  9. Left-handed surgical instruments - a guide for cardiac surgeons.

    Science.gov (United States)

    Burdett, Clare; Theakston, Maureen; Dunning, Joel; Goodwin, Andrew; Kendall, Simon William Henry

    2016-08-19

    For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.

  10. Sarcoidosis in a dental surgeon: a case report

    Directory of Open Access Journals (Sweden)

    Mattia Daniele

    2010-08-01

    Full Text Available Abstract Introduction Although the causes of sarcoidosis are still unknown, past and current studies have provided evidence that this disease may be associated with occupational exposure to specific environmental agents. We describe a case of sarcoidosis in a dental surgeon with long exposure to inorganic dusts. To the best of our knowledge, this is the first report of this kind in the literature. Case presentation At the beginning of 2000, a 52-year-old Caucasian man, who worked as a dental surgeon, presented with shortness of breath during exercise, cough and retrosternal pain. After diagnosis of sarcoidosis, a scanning electronic microscopy with X-ray microanalysis of biopsy specimens was used in order to determine whether the disease could be traced to an occupational environmental agent. Results showed the presence of inorganic dust particles within sarcoidotic granulomas, and demonstrated that the material detected was identical to that found in a powder used by our patient for several years. Conclusions Although these results cannot be considered as definitive proof, they do however provide strong evidence that this disease may be associated with material used by dental surgeons.

  11. Improving operating theatre communication between the orthopaedics surgeon and radiographer.

    Science.gov (United States)

    Yeo, Cheng Hong; Gordon, Robert; Nusem, Iulian

    2014-05-01

    This study was designed to assess the importance of communication between surgeons and radiographers in the operation of image intensifiers during orthopaedic surgery. This study was designed and conducted as single-centre, observational study. Fifteen medical officers and 15 radiographers were involved in this study. Each of the 15 radiographers was assigned to a medical officer. The 15 pairs were then each given a task to simulate achieving 'perfect circles' on fluoroscopy for distal locking of an intramedullary nail. The time taken for the surgeon to verbally instruct the radiographer how to position the image intensifier in order to achieve 'perfect circles' was recorded. The overall time taken to perform the task, and total number of images taken was recorded before and after a terminology system to manoeuvre image intensifier was introduced to the pairs. The mean time taken for the pairs to achieve perfect circles after the introduction of the manoeuvre terminology showed statistically significant reduction from 212 to 97 s (t = 4.212, df = 88, P radiographer, can reduce the time to acquire the desired images, and requires less radiation exposure in the process. © 2013 Royal Australasian College of Surgeons.

  12. 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.

  13. Team Work on Burn And Surgeon as a Team Leader

    Directory of Open Access Journals (Sweden)

    Huseyin Karagoz

    2013-02-01

    Full Text Available Burn traumas are a type of trauma that causes adverse changes in all the functions of the organism. Multi-disciplinary approaches are of great importance in the treatment of burn traumas. Among those involved in the treatment of burns are people of many branches such as surgeons, infection specialists, rehabilitation specialists, psychiatrists, and nurses. And there is a need for a single specialist in charge to coordinate the disciplines in the stage of organizing to treatment. The person to take on this task is often a surgeon specialized in burns. Research has shown that auxiliary personnel involved in burn treatment in Turkey are in need of training on up-to-date information. The surgeon in charge should actively participate in research and training activities, and train the relevant personnel through knowledge transfer so that burn treatment could remain effective in the light of current developments, which would be the fundamental way for burn centers to take their technique- and skill-based practices further. [TAF Prev Med Bull 2013; 12(1.000: 111-114

  14. The surgeon skill set in minimally invasive total knee arthroplasty.

    Science.gov (United States)

    Rosenberg, Aaron G

    2006-07-01

    The traditional didactic approach to improving the skill set of surgeons has been shown to have minimal impact. Surgeons, like other adults, learn best by doing, by practicing what they do. and by challenging themselves to take on increasingly difficult scenarios. To be effective, surgical practice requires deconstruction of a procedure into key elements, each of which is repeated until optimal results are achieved before moving on to the next element. Given the multifactorial nature of a procedure such as minimally invasive surgery for total knee arthroplasty, surgeons need to introduce incremental changes into their operating environment to allow for realistic self-assessment during postoperative self-debriefing. One technique, visualization, can be used for virtual practice. In the future, surgical simulators may allow for true virtual practice as well as systematic recording of results. However, psychomotor skills are only one component of surgical success. Intuition and innovation are also key, but these components are more difficult to teach and to learn. The key ingredient to successful practice and ultimate self-improvement in surgery, as in other pursuits in life, is that a person be self-motivated and competitive and have a strong desire to improve coupled with appropriate practice routines that can lead to improvement.

  15. 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.

  16. Project Muskan : Social responsibility of the plastic surgeon

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

    Full Text Available Although exact statistics are not available, Indian plastic surgeons see around 7,00,000-8,00,000 burn admissions annually with around 10,00,000 cleft patients yet to be operated. In spite of this voluminous load, India does not have national health programs for the various deformities Indian plastic surgeons typically treat. As Plastic Surgeons, it is our social responsibility to treat these patients and bring ′ muskan ′ (smile in Hindi back into their lives. Project Muskan was initiated as an innovative model for targeting these patients and is probably one of its kind in the field of plastic surgery in our country. It is unique because it is a perfect collaboration of government institutions, a Non Government Organization (NGO, and cooperative sectors providing free health care at the doorstep. Identification of the patients was done with the help of the extensive milk dairy network in the state of Gujarat. Provision of transport and other facilities was done by the NGOs and quality health care provision was taken care of by the government hospital. Project Muskan started from a single village but now covers around 3000 villages and tribal areas of Gujarat. It is a system that can be easily reproducible in all hospitals and has reestablished the faith of the common man in government institutes.

  17. Fate of abstracts presented at Association of Paediatric Surgeons of Nigeria annual meetings

    Directory of Open Access Journals (Sweden)

    Abdulrasheed A Nasir

    2012-01-01

    Full Text Available Background: The purpose of this study was to examine the characteristics of abstracts presented at the annual scientific meetings of Association of Paediatric Surgeons of Nigeria and their final publication rate. Materials and Methods: All abstracts accepted for presentation at the Association of Paediatric Surgeons of Nigeria meetings from 2004 to 2009 were identified from literature, search engines and other online materials. Abstracts accepted for the meetings but not presented during the meetings were excluded. Results: A total of 153 abstracts were examined, of which 52 (34% resulted in publication in peer-reviewed journals. Median time from presentation to publication was 2 years (range 1-5 years. The median number of abstracts presented per year was 30 (range 25-40. About three quarters of abstracts were presented by consultants (114, 74.5% and 39 (25.4% by surgical trainees. Approximately three-quarters of the abstracts were case series (111, 75.8%. Case reports accounted for 22.8% of the abstracts. Thirty-two (39.5% of 81 retrospective studies, 8/31 (25.8% prospective studies, and 11/35 (31.4% case reports were converted to full publication (P = 0.403. Abstracts on surgical infection, paediatric surgical oncology, and gastrointestinal tract had the highest publication rates (54.5% [6/11], 46.2% [6/13], and 33.3% [22/66], respectively, P = 0.237. The largest numbers of the reports were published in the African Journal of Paediatric Surgery (16 of 48; 33%, the official Journal of the Association. Conclusions: Only a third of presented abstracts were subsequently published in peer-reviewed journals. Effort to encourage the publication rates of presented abstracts by improving quality of research work as well as encouraging preconference submission of full-length articles for accepted abstracts, for publication in a conference supplement of the Association′s journal is advised.

  18. Consultant outcomes publication and surgical training: Consensus recommendations by the association of surgeons in training.

    Science.gov (United States)

    Mohan, Helen M; Gokani, Vimal J; Williams, Adam P; Harries, Rhiannon L

    2016-11-01

    Consultant Outcomes Publication (COP) has the longest history in cardiothoracic surgery, where it was introduced in 2005. Subsequently COP has been broadened to include all surgical specialties in NHS England in 2013-14. The Association of Surgeons in Training (ASiT) fully supports efforts to improve patient care and trust in the profession and is keen to overcome potential unintended adverse effects of COP. Identification of these adverse effects is the first step in this process: Firstly, there is a risk that COP may lead to reluctance by consultants to provide trainees with the necessary appropriate primary operator experience to become skilled consultant surgeons for the future. Secondly, COP may lead to inappropriately cautious case selection. This adjusted case mix affects both patients who are denied operations, and also limits the complexity of the case mix to which surgical trainees are exposed. Thirdly, COP undermines efforts to train surgical trainees in non-technical skills and human factors, simply obliterating the critical role of the multidisciplinary team and organisational processes in determining outcomes. This tunnel vision masks opportunities to improve patient care and outcomes at a unit level. It also misinforms the public as to the root causes of adverse events by failing to identify care process deficiencies. Finally, for safe surgical care, graduate retention and morale is important - COP may lead to high calibre trainees opting out of surgical careers, or opting to work abroad. The negative effects of COP on surgical training and trainees must be addressed as high quality surgical training and retention of high calibre graduates is essential for excellent patient care. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  19. 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 ...

  20. Acellular Dermal Matrix in Reconstructive Breast Surgery: Survey of Current Practice among Plastic Surgeons

    Directory of Open Access Journals (Sweden)

    Ahmed M. S. Ibrahim, MD

    2015-04-01

    Conclusions: Plastic surgeons currently use ADM in breast reconstruction for both immediate and staged procedures. Of those responding, a majority of plastic surgeons will incorporate drains and use postoperative antibiotics for more than 48 hours.

  1. [What do orthopedic surgeons need to know from radiologists?].

    Science.gov (United States)

    Portabella, F; Pablos, O; Agulló, J L

    2012-09-01

    The diagnosis of tumors and pseudotumors depends on three pillars: the clinician, the radiologist, and the pathologist. The first two can establish a presumptive diagnosis on the basis of the clinical presentation and findings on complementary tests, whereas the pathologist will have to reach the definitive diagnosis after analyzing the biopsy specimens. Obviously, the clinician and radiologist should reach a consensus regarding the diagnostic orientation; however, for this to happen there must be a relationship between the two professionals and they must work together for the benefit of the patient. Orthopedic surgeons, like any other group of specialists, would like to have radiologists working in their own center who are dedicated to the organ/system they treat, in this case the locomotor apparatus, and who can provide them with their opinion about the different images obtained. This point is very important and especially so for tumors, because this type of disease is uncommon and few specialists are dedicated to it. For this reason, when faced with a lesion that has the characteristics of a tumor, orthopedic surgeons would like radiologists to give the most accurate description of the images as possible, defining the characteristics of benignity or malignancy of the process as well as indicating the risk of fracture in a metastatic lesion. On the other hand, orthopedic surgeons would ask for a clear and comprehensible description of the images obtained in complementary tests, because orthopedic surgeons have less experience in this type of images and they are often difficult to interpret. Another aspect that is often mentioned in discussions among orthopedic surgeons is the importance of having a radiology department that performs interventional procedures. Radiologists that perform interventional procedures can facilitate our work very much, both in the diagnosis and in the treatment of certain bone tumors. Finally, we would like to stress the importance of

  2. 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

  3. 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

  4. Publishing papers in international journals

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ INTRODUCTIONThere is increasing pressure for scientists in all countries, including China,to publish their research in international journals.This is necessary for personal careers,as well as for the reputations of universities and other research organizations.Additionally,with the continued growth in international scientific research and the speed with which advances are being made,and active and successful researcher needs to take part in the global circulation of results and information on new technologies.

  5. Plastic Surgeons' Opinions of Facial Surgery for Individuals with Down Syndrome.

    Science.gov (United States)

    May, Deborah C.; Turnbull, Nancy

    1992-01-01

    One hundred plastic surgeons responded to a survey on opinions toward facial plastic surgery for individuals with Down's syndrome. Twenty-four of the surgeons had performed the surgery. Surgeons indicated appropriate circumstances for the surgery, consent requirements, degree of understanding expected of the patient, and degree of discomfort…

  6. Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications.

    Science.gov (United States)

    Lim, Peter C; Crane, John T; English, Eric J; Farnam, Richard W; Garza, Devin M; Winter, Marc L; Rozeboom, Jerry L

    2016-06-01

    To compare perioperative outcomes between robotic-assisted benign hysterectomies and abdominal, vaginal, and laparoscopic hysterectomies when performed by high-volume surgeons. A multicenter data analysis compared 30-day outcomes from consecutive robotic-assisted hysterectomies performed by high-volume surgeons (≥60 prior procedures) at nine centers with records retrieved from the Premier Perspective database for abdominal, vaginal, and laparoscopic hysterectomies performed by high-volume gynecologic surgeons. Data on benign hysterectomy disorders from January 1, 2012 to September 30, 2013 were included. Data from 2300 robotic-assisted, 9745 abdominal, 8121 vaginal, and 11 952 laparoscopic hysterectomies were included. The robotic-assisted patient cohort had a significantly higher rate of adhesive disease compared with the vaginal (Plaparoscopic cohorts (Pobesity than the vaginal (Plaparoscopic cohorts (P250g) than the abdominal (Plaparoscopic cohorts (P=0.017). The robotic-assisted cohort experienced significantly fewer intraoperative complications than the abdominal (Physterectomy provided improved outcomes compared with abdominal, vaginal, and laparoscopic hysterectomy. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Open access to scientific publishing

    Directory of Open Access Journals (Sweden)

    Janne Beate Reitan

    2016-12-01

    Full Text Available Interest in open access (OA to scientific publications is steadily increasing, both in Norway and internationally. From the outset, FORMakademisk has been published as a digital journal, and it was one of the first to offer OA in Norway. We have since the beginning used Open Journal Systems (OJS as publishing software. OJS is part of the Public Knowledge Project (PKP, which was created by Canadian John Willinsky and colleagues at the Faculty of Education at the University of British Columbia in 1998. The first version of OJS came as an open source software in 2001. The programme is free for everyone to use and is part of a larger collective movement wherein knowledge is shared. When FORMakademisk started in 2008, we received much help from the journal Acta Didactic (n.d. at the University of Oslo, which had started the year before us. They had also translated the programme to Norwegian. From the start, we were able to publish in both Norwegian and English. Other journals have used FORMakademisk as a model and source of inspiration when starting or when converting from subscription-based print journals to electronic OA, including the Journal of Norwegian Media Researchers [Norsk medietidsskrift]. It is in this way that the movement around PKP works and continues to grow to provide free access to research. As the articles are OA, they are also easily accessible to non-scientists. We also emphasise that the language should be readily available, although it should maintain a high scientific quality. Often there may be two sides of the same coin. We on the editorial team are now looking forward to adopting the newly developed OJS 3 this spring, with many new features and an improved design for users, including authors, peer reviewers, editors and readers.

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

    Science.gov (United States)

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

    2011-04-01

    In 2010, the world witnessed 32 wars and other armed conflicts. Epidemiological analyses of mechanisms and patterns of injury of soldiers sent into these conflicts can be utilised to identify the surgical expertise that is required in a combat setting providing important parameters to adjust medical infrastructure and training requirements for future Military Surgeons. Today in 2011, the German Bundeswehr runs a combat support hospital (role 3) in Mazar-e-Sharif in Northern Afghanistan providing a multidisciplinary capability profile. Furthermore, there are two role 2 medical treatment facilities (rescue centres) in Kunduz and Feyzabad for life-saving procedures and damage control operations in order to enable rapid evacuation to a higher level of care. Epidemiological analyses of injury patterns and mechanisms have shown that 2,299 soldiers of the coalition forces have been killed in Afghanistan until January 15, 2011. Of these, 21.4% died in non-hostile action (2010). The leading causes of injury were explosive devices (up to 60%) followed by gunshot wounds. Chest or abdominal injuries (40%) and traumatic brain injuries (35%) were the main causes of death for soldiers killed in action. The analysis of all surgical procedures performed in Northern Afghanistan demonstrates that most of the patients who underwent surgery until 2009 were local civilians. Most of these operations involved osteosynthesis and soft tissue debridement. Due to the recently aggravated tactical situation within the theatre, a significant increase of mass casualty situations and combat-related injuries was noticed. The casualties in this military conflict present with injury patterns that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialisation, the deployed military surgeon needs to acquire and maintain a wide range of skills including a variety of surgical fields. In order to create this kind of military surgeon, the so-called DUO plus model for

  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. Health care delivery and the training of surgeons.

    Science.gov (United States)

    MacLean, L D

    1993-09-01

    Most countries have mastered the art of cost containment by global budgeting for public expenditure. It is not as yet clear whether the other option, managed care, or managed competition will accomplish cost control in America. Robert Evans, a Canadian health care expert, remains skeptical. He says, "HMO's are the future, always have been and always will be." With few exceptions, the amount spent on health care is not a function of the system but of the gross domestic product per person. Great Britain is below the line expected for expenditure, which may be due to truly impressive waiting lists. The United States is above the line, which is probably related to the overhead costs to administer the system and the strong demand by patients for prompt and highly sophisticated diagnostic measures and treatments. Canada is on the line, but no other country has subscribed to the Canadian veto on private insurance. Reform or changes are occurring in all countries and will continue to do so. For example, we are as terrified of managed care in Canada as you are of our brand of socialized insurance. We distrust practice by protocol just as you abhor waiting lists. From my perspective as a surgeon, I envision an ideal system that would cover all citizens, would maintain choice of surgeon by patients, would provide mechanisms for cost containment that would have the active and continuous participation of the medical profession, and would provide for research and development. Any alteration in health care delivery in the United States that compromises biomedical research and development will be a retrogressive, expensive step that could adversely affect the health of nations everywhere. Finally, a continuing priority of our training programs must be to ensure that the surgeon participating in this system continues to treat each patient as an individual with concern for his or her own needs.

  11. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels;

    2015-01-01

    INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all...

  12. 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...

  13. 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.

  14. Hemophilia: What the Oral and Maxillofacial Surgeon Needs to Know.

    Science.gov (United States)

    Smith, Julie Ann

    2016-11-01

    Hemophilia will be encountered in the oral and maxillofacial surgeon's office. A thorough understanding of hemophilia is necessary to safely care for these patients. One must understand the severity of the patient's hemophilia as well as whether or not inhibitors are present. The patient's surgical management will be influenced by these two factors. In addition to the possible need to transfuse factors or desmopressin, special care must be taken perioperatively to avoid bleeding complications. This article reviews the overall management of hemophilia A and B as well as the specific perioperative management of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Posttraumatic stress disorder: a primer for trauma surgeons.

    Science.gov (United States)

    Roberts, Jennifer C; deRoon-Cassini, Terri A; Brasel, Karen J

    2010-07-01

    In 1980, posttraumatic stress disorder (PTSD) officially became classified as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Since then, there has been increasing recognition that PTSD is a prevalent disorder that may have significant impact on the quality of life for survivors of traumatic events. More recently, methodologically sound research has begun to provide important insight into this disorder. The following review serves to provide the trauma surgeons information on PTSD in terms of its diagnosis, prevalence, risk factors, treatment strategies, and outcomes, with the goal of minimizing the sequelae of PTSD and maximizing postinjury quality of life.

  16. Improvised explosive devices and the oral and maxillofacial surgeon.

    Science.gov (United States)

    Goksel, Tamer

    2005-08-01

    Improvised explosive devices have created a new class of casualties that presents a unique surgical challenge for oral and maxillofacial surgeons. The injury pattern and severity are different from those seen in conventional trauma patients. Because of battlefield circumstances, patients are sometimes delayed significantly in their transport to a trauma center, and they frequently arrive at a trauma center with hypotension, hypothermia, and acidosis. Definitive care is delayed while the hemodynamic status and life-threatening injuries are stabilized. Hospital triage protocols must be well established in advance to prepare a timely response to the mass casualty event. Proper resource use is an ever-evolving challenge for hospital staff during these times.

  17. Global plastic surgeons images depicted in motion pictures.

    Science.gov (United States)

    Hwang, Se Jin; Park, Sowhey; Hwang, Kun

    2013-03-01

    Motion pictures are made to entertain and enlighten people, but they are viewed differently by different people. What one considers to be a tearjerker may induce giggles in another. We have gained added interest in this because our professional pictures contain plastic surgery in their venue. We have recently reviewed 21 motion pictures that were made from 1928 to 2006 and that includes plastic surgical procedures in their content. As a habit, we tried to analyze them from a surgical point of view. About one third (35.7%) of the patients were criminals, whereas 14.3% of them were spies. One third of the procedures were done by illegitimate "surgeons," whereas a quarter of the procedures (25%) were performed by renowned surgeons. Surgeons who were in love with the patients did the rest (25%) of the operations. The complication rate was 14.3%; the surgery was successful in 85.7% of cases, but were the patients happy with the results? This was not the case in the movies. Only 7.7% were happy; 14.5 % of them were eminently unhappy. Why the discrepancy? It is difficult to analyze the minds of the people in the film, but considering that the majority of the characters in the films were rather unsavory, one may deduce that a crooked mind functions differently. Motion pictures have advanced greatly in the past several decades with the advent of improved mechanical and electronic devices, and plastic surgery as also advanced in tandem. This surgical field has become a common procedure in our daily life. It is readily available and mostly painless. However, the public sees it in only one way, that is, that the performing physicians are highly compensated. Very few consider the efforts and the suffering that accompanies each and every surgical procedure as it is performed. Perhaps, it is too much to hope for a day that will come when we will see a film that portrays the mental anguish that accompanies each and every procedure the plastic surgeon makes.

  18. Introduction to concepts in leadership for the surgeon.

    Science.gov (United States)

    Mrkonjic, Linda; Grondin, Sean C

    2011-08-01

    As surgeons progress through their careers, they are often entrusted with leadership roles in administration, education, research, and patient management. Insights into one's own personality type and leadership style as well as an understanding of the value of emotional intelligence are critical for success. Knowledge of group dynamics and team leading; networking; techniques in leading, changing, and innovation; as well as proficiency in negotiation and conflict resolution are also essential to the development of leadership skills. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Changing Sources of Published Information

    Science.gov (United States)

    Abt, Helmut A.

    1995-04-01

    We looked at the types of references in papers published during the first month of 1972, 1982, and 1992 in the Astrophysical Journal and Astronomy & Astrophysics; also those published in the former journal during the first half-years of 1952 and 1962. Some of the results are qualitatively predictable, such as the decrease (from 12% to 1%) in references to observatory publications and inhouse technical reports, and the increase (from 1% to 10%) in references to conference papers. But what are surprising are (1) the low (less than 3%) reference rate to preprints, showing that they are not replacing journal papers (78%) as the primary source for reliable information, (2) the low (1%) reference rate to theses, showing that they are not cited more frequently than average research papers, (3) the low (1%) reference rate to review papers, showing that contrary to popular belief, very few people cite review papers instead of the original research papers, and (4) the slightly decreasing reference rate (from 6% to 4%) to monographs, showing that despite their greatly increased publication rate, they are gradually being quoted less for research use (as contrasted to tutorial use). (SECTION: Astronomical Sociology)

  20. Open Access Publishing with Drupal

    Directory of Open Access Journals (Sweden)

    Nina McHale

    2011-10-01

    Full Text Available In January 2009, the Colorado Association of Libraries (CAL suspended publication of its print quarterly journal, Colorado Libraries, as a cost-saving measure in a time of fiscal uncertainty. Printing and mailing the journal to its 1300 members cost CAL more than $26,000 per year. Publication of the journal was placed on an indefinite hiatus until the editorial staff proposed an online, open access format a year later. The benefits to migrating to open access included: significantly lower costs; a green platform; instant availability of content; a greater level of access to users with disabilities; and a higher level of visibility of the journal and the association. The editorial staff chose Drupal, including the E-journal module, and while Drupal is notorious for its steep learning curve—which exacerbated delays to content that had been created before the publishing hiatus—the fourth electronic issue was published recently at coloradolibrariesjournal.org. This article will discuss both the benefits and challenges of transitioning to an open access model and the choice Drupal as a platform over other more established journal software options.

  1. Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

    Science.gov (United States)

    Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

    2017-10-01

    accounted for the largest proportion of costs (55%), followed by supplies (12%), bed (12%), and operating room (10%). Total medical center CM for all FEVAR services was $492,521. Average surgeon reimbursements per FEVAR from 2011 to 2015 increased from $1601 to $2480 while the surgeon payment denial rate declined from 50% to 0%. Surgeon-led negotiations with the Centers for Medicare & Medicaid Services during 2015 resulted in a 27% increase in physician reimbursement for the remainder of 2015 ($2480 vs $3068/case) and a 91% increase in reimbursement from 2011 ($1601 vs $3068). Assistant surgeon reimbursement also increased ($266 vs $764). Concomitant FEVAR-related procedures generated an additional $27,347 in surgeon reimbursement. Physician leadership in the coding, billing, and contractual negotiations for FEVAR results in a positive medical center CM and increased physician reimbursement. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  2. Published papers on telepathology projects

    Directory of Open Access Journals (Sweden)

    Sadrieh Hajesmaeel-Gohari

    2015-10-01

    Full Text Available Introduction: Although many studies have been conducted in the telepathology field in recent years, a systematic review that examines studies in a comparative manner has not yet been undertaken. This paper aims to review the published papers on telepathology projects and compare them in several aspects such as telepathology method,telecommunication method, clinical outcome, etc. Method: This is a systematic review study. PubMed database was used to find the studies published in the past ten years (2004–2014. The 71 final related papers were evaluated. Data were extracted from these studies based on the following items: country, national (in country or international (between countries, frozen section or slide, body part, type of camera used, telecommunication method, telepathology method, clinical outcome, cost evaluation, satisfaction evaluation and the description of consultation providers and receivers. Data were analyzed using descriptive analysis. Results: Results showed that most of the studies were performed in developed countries on a national level, on slide and on a specific body part. In most studies, a Nikon camera was used to take images. Online methods were the most used telecommunication method in the studies, while store and forward was the most used telepathology method. Clinical outcome of many studies showed that telepathology is a reliable and accurate method for consultation. More than half of the studies considered the cost, and most of them showed that a telepathology system is cost effective. Few studies evaluated satisfaction of the participants. In most studies, the telepathology project was undertaken between pathologists. Conclusion: Although there is enough evidence to suggest that telepathology is an effective way of consultation between pathologists, there are still some areas that should be addressed and for which there is a lack of convincing evidence. For example, pathologist satisfaction, cost evaluation

  3. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  4. 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.

  5. The Affordable Care Act: a primer for plastic surgeons.

    Science.gov (United States)

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

  6. 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

  7. Can double gloves improve surgeon-patient barrier efficiency?

    Science.gov (United States)

    Sadat-Ali, Mir; Al-Habdan, Ibrahim; AlBluwi, Mohammed; Corea, J Ran; Al-Othman, Abdallah; Shriyan, Devidas; Moussa, Mohammed; AlDhakheel, Dhakheel; AlOmran, Abdallah

    2006-01-01

    The aim of this study was to compare double gloves (DGs) with single gloves (SGs) during orthopedic and trauma surgery in prevention of blood contact between patients and surgeons. DGs and SGs were collected after orthopedic operations, tested for size, site, and number of perforations. Medical records were reviewed for age, sex, type of operation, duration, and postoperative wound infection. Data were compared using t-test with level of statistical significance at P < 0.05. Five hundred seven operations yielded 1204 DGs and 830 pairs SGs. In DGs, perforations were detected in 220 outer glove and 39 inner glove (10.7%). In SGs, 226 perforations were detected (13.3%). The incidence of perforations in inner gloves of the double indicator glove was 1.6% (P < 0.001). During surgery, perforations were recognized in DGs in 67% compared with 12% in SGs (P < 0.005). This study confirms that DGs form an efficient barrier between patients and surgeons.

  8. Arthur Rainsford Mowlem (1902-1986), plastic surgeon.

    Science.gov (United States)

    Griffiths, Richard W

    2013-08-01

    Arthur Rainsford Mowlem, the junior of the 'big four' plastic surgeons, with Harold Delf Gillies, Thomas Pomfret Kilner and Archibald Hector McIndoe, came to prominence managing casualties of the Second World War. Rainsford Mowlem's ancestor was John Mowlem, the creator of the construction firm. Rainsford worked his passage to the United Kingdom from New Zealand in 1927 and did not return to New Zealand but retired at the age of 60 to enjoy 23 more years in Spain. He was the driving force between 1934 and 1939 at the Plastic Surgery Unit at St James's Hospital, Balham, and instigated the North London Plastic Surgery Unit at Hill End, St Albans, from 1939 to 1953 and subsequently developed the Unit after moving to Mount Vernon Hospital, Northwood, Middlesex. After successfully hosting the International Meeting of Plastic Surgeons in London in 1959, he received recognition and honours in America but soon afterwards he surprised colleagues by retiring in 1962. Despite his significant contributions, he did not receive national honours but his life outside surgery was active including Trusteeship of the Mowlem Estate at Swanage in Dorset for 40 years.

  9. Role of ENT Surgeon in Managing Battle Trauma During Deployment.

    Science.gov (United States)

    Rajguru, Renu

    2013-01-01

    With technological improvements in body armour and increasing use of improvised explosive devices, it is the injuries to head, face and neck are the cause for maximum fatalities as military personnel are surviving wounds that would have otherwise been fatal. The priorities of battlefield surgical treatment are to save life, eyesight and limbs and then to give the best functional and aesthetic outcome for other wounds. Modern day battlefields pose unique demands on the deployed surgical teams and management of head and neck wounds demands multispecialty approach. Optimal result will depend on teamwork of head and neck trauma management team, which should also include otolaryngologist. Data collected by various deployed HFN surgical teams is studied and quoted in the article to give factual figures. Otorhinolaryngology becomes a crucial sub-speciality in the care of the injured and military otorhinolaryngologists need to be trained and deployed accordingly. The otolaryngologist's clinical knowledge base and surgical domain allows the ENT surgeon to uniquely contribute in response to mass casualty incident. Military planners need to recognize the felt need and respond by deploying teams of specialist head and neck surgeons which should also include otorhinolaryngologists.

  10. Imaging of bone tumors for the musculoskeletal oncologic surgeon

    Energy Technology Data Exchange (ETDEWEB)

    Errani, C., E-mail: costantino.errani@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Kreshak, J., E-mail: j.kreshak@yahoo.com [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Ruggieri, P., E-mail: pietro.ruggieri@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Alberghini, M., E-mail: marco.alberghini@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Picci, P., E-mail: piero.picci@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Vanel, D., E-mail: daniel.vanel@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2013-12-01

    The appropriate diagnosis and treatment of bone tumors requires close collaboration between different medical specialists. Imaging plays a key role throughout the process. Radiographic detection of a bone tumor is usually not challenging. Accurate diagnosis is often possible from physical examination, history, and standard radiographs. The location of the lesion in the bone and the skeleton, its size and margins, the presence and type of periosteal reaction, and any mineralization all help determine diagnosis. Other imaging modalities contribute to the formation of a diagnosis but are more critical for staging, evaluation of response to treatment, surgical planning, and follow-up.When necessary, biopsy is often radioguided, and should be performed in consultation with the surgeon performing the definitive operative procedure. CT is optimal for characterization of the bone involvement and for evaluation of pulmonary metastases. MRI is highly accurate in determining the intraosseous extent of tumor and for assessing soft tissue, joint, and vascular involvement. FDG-PET imaging is becoming increasingly useful for the staging of tumors, assessing response to neoadjuvant treatment, and detecting relapses.Refinement of these and other imaging modalities and the development of new technologies such as image fusion for computer-navigated bone tumor surgery will help surgeons produce a detailed and reliable preoperative plan, especially in challenging sites such as the pelvis and spine.

  11. Students to Surgeons: Increasing Matriculation in Surgical Specialties.

    Science.gov (United States)

    Grover, Karan; Agarwal, Prateek; Agarwal, Nitin; Tabakin, Marcia D; Swan, Kenneth G

    2016-12-01

    Introduction Our nation suffers from a shortage in surgeons. This deficiency must be addressed at the medical student level. Increasing faculty and resident interaction with junior students augments surgical interest. Our surgical interest group has recently redefined its role to address these concerns. Methods A multifocal approach has been implemented to increase interest in the surgical specialties. Each academic year, senior students recruit first and second year students to our group to establish early exposure. Members receive didactic presentations from surgical faculty, addressing various topics, on a biweekly basis. In addition, scrubbing, knot-tying, and suturing workshops address technical skills throughout the semester. Membership and match data were collated and analyzed. Results Over the past 5 years, the enrollment in the student interest group increased significantly from 112 to 150. Accordingly, we have observed a parallel increase in the number of students who have successfully matched into surgical residencies. A record number of students (37) from the class of 2013 matched into surgical specialties, representing an 85% increase over the last decade. After creating bylaws and electing societal officers, the group has been recognized by the school's Student Council and given financial support. At present, the group is fiscally solvent with support from the institution, surgery department, and faculty. Conclusion As the demand for surgeons increases so too does the need to increase student interest in surgery. Our school has been successful because of our surgical interest group, and we encourage other schools to adopt a similar approach. © The Author(s) 2016.

  12. 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.

  13. Hip resurfacing: a large, US single-surgeon series.

    Science.gov (United States)

    Brooks, P J

    2016-01-01

    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system.

  14. [What rhinoplasty surgeons should know about body dysmorphic disorder (BDD)].

    Science.gov (United States)

    Reichert, M; Scheithauer, M; Hoffmann, T K; Hellings, P; Picavet, V

    2014-08-01

    Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by an excessive concern with a non-existing or slight defect in physical appearance. BDD patients frequently show impaired judgment regarding the psychiatric origin of their concerns and often seek aesthetic treatment to resolve their appearance concerns. The central position of the nose in the face makes the nose one of the most common areas of concern in patients with BDD. Thus, aesthetic rhinoplasty is suspected to be one of the most frequently requested and performed surgical procedures in this population. However, there is a growing consensus that BDD should be considered a contraindication for aesthetic rhinoplasty, as favourable outcome is unlike [1-5]. In order to prevent patients from undergoing unsatisfying surgery and in the context of the increasing importance of medico-legal arguments, the rhinoplasty surgeon should be familiar with BDD. This article provides a focused review of issues pertaining to BDD that are relevant to the rhinoplasty surgeon. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Smartphone, Smart Surgeon, what about a 'Smart Logbook'?

    Science.gov (United States)

    Adam, A; Spencer, K; Moon, S; Jacub, I

    2016-06-01

    Mobile phone applications (Apps) have become a vital assistant to medical personnel in today's technologically advanced era. The utility of Apps with case logbook capabilities has not yet been explored. To assess and evaluate all currently available surgical and procedural case logbook Apps. A comprehensive search was conducted in April 2015 on the Android Play Store, iTunes (Apple App Store, iOS), and BlackBerry World for surgical and/or procedural logbooks. The search terms'surgical logbook', 'logbook', 'procedure logbook' and 'surgical log' were used. Apps which could not be utilized as a surgical/procedural logbook were excluded. Each App was individually assessed and rated using preset criteria, by the unit consultant, registrars, and medical officer. In total, 2 740 Apps were assessed. After applying our exclusion criteria, only 16 Apps were relevant, and 11 suitable for critical review. Data sizes ranged from 510Kb to 12.2Mb. Costing of the Apps ranged from ZAR 0.00 to ZAR 105.32. The overall study scores revealed the following top five rated Apps: Surgical Logbook by Surgilog; Surgeon Logbook Pro; Surgery Notebook, Surgical Logbook, and Universal Logbook. The current mobile Apps available are efficient in replacing traditional case logbooks. The use of the 'Smart Logbook' may become common practice in the life of the modern-day surgeon.

  16. 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.

  17. Surgeon-Reported Needs for Improved Training in Identifying and Managing Free Flap Compromise.

    Science.gov (United States)

    McMillan, Catherine; D'Hondt, Veerle; Marshall, Alexandra H; Binhammer, Paul; Lipa, Joan; Snell, Laura

    2017-07-01

    Background This study examined the need for improved training in the identification and management of free flap (FF) compromise and assessed a potential role for simulated scenario training. Methods Online needs assessment surveys were completed by plastic surgeons and a subsample with expertise in microsurgery education participated in focus groups. Data were analyzed using descriptive statistics and mixed qualitative methods. Results In this study, 77 surgeons completed surveys and 11 experts participated in one of two focus groups. Forty-nine (64%) participants were educators, 65 and 45% of which reported having an insufficient volume of FF cases to adequately teach the management and identification of compromise, respectively. Forty-three percent of educators felt that graduating residents are not adequately prepared to manage FF compromise independently. Exposure to normal and abnormal FF cases was felt to be critical for effective training by focus group participants. Experts identified low failure rates, communication issues, and challenging teaching conditions as current barriers to training. Most educators (74%) felt that simulated scenario training would be "very useful" or "extremely useful" to current residents. Focus groups highlighted the need for a widely accepted algorithm for re-exploration and salvage on which to base the development of a training adjunct consisting of simulated scenarios. Conclusion Trainee exposure to FF compromise is inadequate in existing plastic surgery programs. Early exposure, high case volume, and a standardized algorithmic approach to management with a focus on decision making may improve training. Simulated scenario training may be valuable in addressing current barriers. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Core competencies for hair restoration surgeons recommended by the International Society of Hair Restoration Surgery.

    Science.gov (United States)

    Puig, Carlos J; Beehner, Michael L; Cotterill, Paul C; Elliott, Vance W; Haber, Robert S; Harris, James A; Martinick, Jennifer H; Niedbalski, Robert P; Rose, Paul; Rousso, Daniel E; Shapiro, Ronald L

    2009-03-01

    Because hair restoration surgery has changed so significantly, the International Society of Hair Restoration Surgery (ISHRS) recently developed and published a Core Curriculum for Hair Restoration Surgery (CCHRS). The ISHRS organized a task force to develop training programs that would not only present the CCHRS but also provide the practical experience necessary to allow a physician to practice safe, aesthetically sound hair restoration surgery. The task force recognized early on that identification of core competencies for hair restoration surgeons was essential to guiding the development of these training experiences. This article presents the competencies that have been identified. The intent of the Core Competencies for Hair Restoration Surgery is to outline the knowledge and skills that are essential to accurately diagnose and treat hair loss, to ensure patient safety, and to optimize aesthetic results. The ISHRS hopes that all existing surgery and dermatology training programs teaching hair restoration surgery procedures will find the Core Competencies useful in developing their curriculums. The Core Competencies were developed through an organized review of the CCHRS by a team of experienced hair restoration surgeons and educators and reviewed and approved by the ISHRS Board of Governors. The diversity of these competencies demonstrate that contemporary hair restoration surgery is a specialty requiring knowledge of several medical disciplines, including genetics, endocrinology, dermatology, tissue preservation, and surgery. The International Society of Hair Restoration Surgery believes identification of these Core Competencies is an important contribution to physician education in hair restoration surgery, and physicians who demonstrate competency in these skills will satisfy patients with contemporary results in a safe environment.

  19. Obesity increases operating room time for lobectomy in the society of thoracic surgeons database.

    Science.gov (United States)

    St Julien, Jamii B; Aldrich, Melinda C; Sheng, Shubin; Deppen, Stephen A; Burfeind, William R; Putnam, Joe B; Lambright, Eric S; Nesbitt, Jonathan C; Grogan, Eric L

    2012-12-01

    Obesity has become a major epidemic in the United States. Although research suggests obesity does not increase major morbidity or mortality after thoracic operations, it likely results in greater use of health care resources. We examined all patients in The Society of Thoracic Surgeons General Thoracic Surgery database with primary lung cancer who underwent lobectomy from 2006 to 2010. We investigated the impact of body mass index (BMI) on total operating room time using a linear mixed-effects regression model and multiple imputations to account for missing data. Secondary outcomes included postoperative length of stay and 30-day mortality. Covariates included age, sex, race, forced expiratory volume, smoking status, Zubrod score, prior chemotherapy or radiation, steroid use, number of comorbidities, surgical approach, hospital lobectomy volume, hospital percent obesity, and the addition of mediastinoscopy or wedge resection. A total of 19,337 patients were included. The mean BMI was 27.3 kg/m2, with 4,898 patients (25.3%) having a BMI of 30 kg/m2 or greater. The mean total operating room time, length of stay, and 30-day mortality were 240 minutes, 6.7 days, and 1.8%, respectively. For every 10-unit increase in BMI, mean operating room time increased by 7.2 minutes (range, 4.8 to 8.4 minutes; pobese patients did not affect the association between BMI and operative time. Body mass index was not associated with 30-day mortality or increased length of stay. Increased BMI is associated with increased total operating room time, regardless of institutional experience with obese patients. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Observation of clinical teaching: interest in a faculty development program for surgeons.

    Science.gov (United States)

    Peyre, Sarah E; Frankl, Susan E; Thorndike, Mary; Breen, Elizabeth M

    2011-01-01

    Observation of clinical teaching is a powerful tool to develop faculty teaching skills. However, the process of being observed can be intimidating for any educator. Our aim is to assess interest in an Observation of Teaching Program within an academic surgical department. An electronic survey asking faculty to indicate interest in participation in a faculty development program that consists of a peer, expert, and/or cross-disciplinary physician observation of teaching was used. Faculty members were also asked whether they would like to observe other faculty as part of a peer-review track. The results were compiled for descriptive statistical analysis. Electronic survey. In all, 46 faculty, all of whom have assigned medical student and resident teaching responsibilities, were introduced to the Observation of Teaching Program and surveyed on their interest in participating. A total of 87% (40/46) of faculty responded after 2 e-mails and 75% (30/40) indicated interest in the Observation of Teaching Program. All faculty who responded positively indicated interest in expert review (30/30), 90% (27/30) in peer review, 87% (26/30) in surgeon review, and 83% (25/30) in cross-disciplinary physician review. A total of 48% (19/40) indicated interest in observing others. Of those who were not interested in the Observation of Teaching Program, restrictions on time (4/10), not enough clinical care responsibilities (2/10), not wanting to be watched (2/10), and program did not seem effective (1/10) were cited as reasons for not participating. Surgical faculty are interested in being observed and receiving feedback about their clinical teaching by experts, peers, colleagues, and cross-disciplinary physicians. Professional development programs for surgeons should consider observation as a teaching methodology. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro

    2013-11-01

    The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

  2. The status and models of digital publishing

    OpenAIRE

    Cong, Ting

    2010-01-01

    This Thesis examines the current impact of digital technology upon certain aspects of the publishing industry, especially the e-book industry. It reviews the key developments in globally digital publishing and sums up several publishing models of digital contents.

  3. Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives

    Science.gov (United States)

    O’Connor, Bonnie; Pollner, Fran; Fugh-Berman, Adriane

    2016-01-01

    Background Industry payments to surgeons have received public attention, but little is known about the relationships between surgeons and medical device representatives. Medical device representatives ("device reps") have become an integral part of operating room personnel. The effect of their presence on patient care deserves discussion. Study Design We conducted a qualitative, ethnographic study to explore relationships between surgeons and medical device representatives, and characterize industry involvement in the training of surgeons. We used group and individual open-ended interviews to gain insight into the beliefs, values, and perspectives of surgeons and device reps. We conducted two focus groups, one with ear, nose, and throat surgeons, and one with hospital-based attending orthopedic surgeons. We also conducted individual interviews with three former or current medical device representatives, a director of a surgical residency program at an academic medical center, and a medical assistant for a multi-physician orthopedic practice. Results While surgeons view themselves as indisputably in charge, device reps work hard to make themselves unobtrusively indispensable in order to establish and maintain influence, and to imbue the products they provide with personalized services that foster a surgeon's loyalty to the reps and their companies. Surgeons view industry-funded training opportunities as a necessary service. Device reps and some surgeons believe that reps benefit patient care, by increasing efficiency and mitigating deficiencies among operating room personnel (including the surgeons themselves). Conclusions Our study raises ethical questions about the reliance of surgeons on device reps and device companies for education and surgical assistance and practical concerns regarding existing levels of competence among OR personnel. PMID:27486992

  4. A/A/O工艺脱氮除磷运行效果分析%Analysis on running effect for biological nitrogen and phosphorus removal of A/A/O technology

    Institute of Scientific and Technical Information of China (English)

    李曈; 郝瑞霞; 刘峰; 刘京

    2011-01-01

    为提高城市污水处理厂科学运行管理水平和出水质量,通过对某污水处理厂污水处理工艺的沿程采样分析,对比分析了A/A/O工艺脱氮除磷效果与工艺运行控制参数之间的相关关系。结果表明,A/A/O工艺对总氮去除率为83.2%,出水中氮的形态主要为硝酸盐氮;出水中总磷浓度基本达到一级A标准,总磷去除率在86.3%以上;缺氧段具有明显的反硝化聚磷作用;脱氮除磷效果与污泥负荷有反向变化关系,泥龄对磷的去除效果影响明显,当污泥负荷控制在0.15kg BOD5/(kg MLVSS.d)左右,泥龄控制在10~12 d时,可以同时%In order to improve the scientific management level and effluent quality of a municipal wastewater treatment plant(WWTP),the relationship between nitrogen and phosphorus removal effect and operating parameters of the A/A/O technology was studied by sampling and analyzing along the process in WWTP of Beijing.The results showed that the total nitrogen removal rate was 83.2%,and the main form of nitrogen was nitrate nitrogen in effluent.The TP concentration in effluent could reach the 1 grade A level of national discharging standard in China basically,and the TP removal rate was over 86.3%.The denitrifying phosphorus removal played a remarkable role in the anoxic phase of A/A/O process.The relationship between nitrogen and phosphorus removal effect and sludge loading expressed inverse variation.Sludge retain time(SRT) had an obvious impact on phosphorus removal.When the sludge loading was about 0.15 kg BOD5/(kg MLVSS·d)and the SRT was about 10~12 d in A/A/O process,nitrogen and phosphorus removal rates were up to 81% and 88%,respectively.There was an inverse variation relationship between the phosphorus accumulation and the sludge emission capacities in the wastewater treatment system.When the sludge emission capacities maintained about 2~2.5 percent of influent,phosphorus removal can be controlled in the stable and

  5. Study of the Role of Porous AAO Template for Synthesizing Nano-materials by Chemical Vapor Deposition Method%阳极多孔三氧化二铝模板孔对化学蒸气沉积合成纳米材料的作用研究

    Institute of Scientific and Technical Information of China (English)

    权铭会; 郑昌熙; 黄芝贤; 申容淑; 朴钟允

    2009-01-01

    在各种化学蒸气沉积生长排列整齐的纳米材料的合成方法中,阳极三氧化二铝(AAO)模板被广泛采用主要由于容易通过电压和阳极氧化时间来控制其孔径.这里,我们表征存在/不存在催化剂时生长在AAO模板上的碳纳米管和氧化物材料的生长机理.我们还研究了在合成密集整齐排列的纳米结构生长过程中氢气的还原效应.实验结果显示AAO模板本身促进Ga2O3生长机理,氧化物催化剂氢化还原提高了碳纳米管的生长速率和结晶度.氢化还原中使用AAO模板可以很好地控制排列整齐的纳米材料的直径和密度.%Among various synthesis methods for aligned nanostmcture materials growth using chemical vapor deposition (CVD), an anodic aluminum oxide (AAO) template has been widely use because of its easy controlling of pore diameter by voltage and anodized time. In this study, we characterized growth mechanism of carbon nanotubes and oxide nano-materials on AAO template with/without catalyst. Also, we investigated reduction effects of hydrogen gas in the synthesis processes for well aligned and densely grown nanostmctures. Those experimental results showed that AAO template itself ignited VS growth mechanism for Ga2O3,and hydrogen reduction of oxide catalysts improved the growth rate and crystallinity of CNTs. Using AAO template with hydrogen reduction, we can control the diameter and density of well aligned nanostructure materials.

  6. 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.

  7. Disaster management among pediatric surgeons: preparedness, training and involvement.

    Science.gov (United States)

    Chokshi, Nikunj K; Behar, Solomon; Nager, Alan L; Dorey, Fred; Upperman, Jeffrey S

    2008-01-01

    Contemporary events in the United States (eg, September 2001, school shootings), Europe (eg, Madrid train bombings), and the Middle East have raised awareness of mass casualty events and the need for a capable disaster response. Recent natural disasters have highlighted the poor preparation and infrastructure in place to respond to mass casualty events. In response, public health policy makers and emergency planners developed plans and prepared emergency response systems. Emergency response providers include first responders, a subset of emergency professionals, including firemen, law enforcement, paramedics, who respond to the incident scene and first receivers, a set of healthcare workers who receive the disaster victims at hospital facilities. The role of pediatric surgeons in mass casualty emergency response plans remains undefined. The authors hypothesize that pediatric surgeons' training and experience will predict their willingness and ability to be activated first receivers. The objective of our study was to determine the baseline experience, preparedness, willingness, and availability of pediatric surgeons to participate as activated first receivers. After institutional review board approval, the authors conducted an anonymous online survey of members of the American Pediatric Surgical Association in 2007. The authors explored four domains in this survey: (1) demographics, (2) disaster experience and perceived preparedness, (3) attitudes regarding responsibility and willingness to participate in a disaster response, and (4) availability to participate in a disaster response. The authors performed univariate and bivariate analyses to determine significance. Finally, the authors conducted a logistic regression to determine whether experience or preparedness factors affected the respondent's availability or willingness to respond to a disaster as a first receiver The authors sent 725 invitations and received 265 (36.6 percent) completed surveys. Overall, the

  8. 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

  9. Old Disease…New Location…Surgeons Be Alerted

    Directory of Open Access Journals (Sweden)

    K. B. Ashok

    2011-04-01

    Full Text Available Echinococcus granulosus causes a zoonotic infection called Cystic Echinococcosis (CE. Surgeons meet with hydatid cysts of the liver and lungs with reasonable frequency. However hydatid cyst may appear in other parts of the body too.A 30 yrs old lady presented with a smooth slow-growing subcutaneous nodule on the anteromedial side of the right thigh with no detectable primary site in the liver or lung. The case subsequently diagnosed as hydatid cyst of muscle and radical surgery was done under coverage of anihelminthic drug.The common practice in this type of case is to do FNAC taking the lesion to be a soft tissue neoplasm. The aim of this case presentation is to make aware of the fact that in a case of diffuse non-tender swelling with history of gradual increase in size hydatid cyst also has to be considered in the differential diagnosis.

  10. How Many Presentations Are Published as Full Papers?

    Directory of Open Access Journals (Sweden)

    Kyu Jin Chung

    2012-05-01

    Full Text Available Background The publication rate of presentations at medical international meetings hasranged from 11% to 78% with an average of 45%. To date, there are no studies about thefinal rate of publications at scientific meetings associated with plastic surgery from Korea.The present authors investigated the publication rate among the presentations at meetingsassociated with plastic surgery.Methods The titles and authors of the abstracts from oral and poster presentations werecollected from the program books of the Congress of the Korean Society of Plastic andReconstructive Surgeons (CKSPRS for 2005 to 2007 (58th-63rd. All of the abstracts presentedwere searched for using PubMed, KoreaMed, KMbase, and Google Scholar. The titles, keywords from the titles, and the authors’ names were then entered in database programs. Theparameters reviewed included the publication rate, type of presentation including runningtime, affiliation, subspecialty, time to publication, and publication journal.Results A total of 1,176 abstracts presented at the CKSPRS from 2005 to 2007 wereevaluated. 38.7% of the abstracts, of which oral presentations accounted for 41.0% and posterpresentations 34.8%, were published as full papers. The mean time to publication was 15.04months. Among journals of publication, the Journal of the Korean Society of Plastic andReconstructive Surgeons was most used.Conclusions Brilliant ideas and innovative approaches are being discussed at CKSPRS. The38.7% publication rate found from this research appeared a bit lower than the average rateof medical meetings. If these valuable presentations are not available as full papers, theresearch would be a waste of time and effort.

  11. Clinical Core Competency Training for NASA Flight Surgeons

    Science.gov (United States)

    Polk, J. D.; Schmid, Josef; Hurst, Victor, IV; Doerr, Harold K.; Doerr, Harold K.

    2007-01-01

    Introduction: The cohort of NASA flight surgeons (FS) is a very accomplished group with varied clinical backgrounds; however, the NASA Flight Surgeon Office has identified that the extremely demanding schedule of this cohort prevents many of these physicians from practicing clinical medicine on a regular basis. In an effort to improve clinical competency, the NASA FS Office has dedicated one day a week for the FS to receive clinical training. Each week, an FS is assigned to one of five clinical settings, one being medical patient simulation. The Medical Operations Support Team (MOST) was tasked to develop curricula using medical patient simulation that would meet the clinical and operational needs of the NASA FS Office. Methods: The MOST met with the Lead FS and Training Lead FS to identify those core competencies most important to the FS cohort. The MOST presented core competency standards from the American Colleges of Emergency Medicine and Internal Medicine as a basis for developing the training. Results: The MOST identified those clinical areas that could be best demonstrated and taught using medical patient simulation, in particular, using high fidelity human patient simulators. Curricula are currently being developed and additional classes will be implemented to instruct the FS cohort. The curricula will incorporate several environments for instruction, including lab-based and simulated microgravity-based environments. Discussion: The response from the NASA FS cohort to the initial introductory class has been positive. As a result of this effort, the MOST has identified three types of training to meet the clinical needs of the FS Office; clinical core competency training, individual clinical refresher training, and just-in-time training (specific for post-ISS Expedition landings). The MOST is continuing to work with the FS Office to augment the clinical training for the FS cohort, including the integration of Web-based learning.

  12. Publication Productivity of Early-Career Orthopedic Trauma Surgeons.

    Science.gov (United States)

    Hake, Mark E; Lee, John J; Goulet, James A

    2016-01-01

    The goals of this study were to: (1) define the publication productivity of early-career orthopedic trauma surgeons over time; (2) compare the early-career publication productivity of recent orthopedic trauma fellowship graduates vs their more senior colleagues; and (3) determine the proportion of fellowship graduates who meet the Orthopaedic Trauma Association (OTA) publication criteria for active membership early in their careers. Orthopedic trauma fellowship graduates from 1982 to 2007 were analyzed. A literature search was performed for each fellow's publications for the 6-year period beginning the year of fellowship graduation. Publication productivity was compared between early and recent groups of graduates, 1987 to 1991 and 2003 to 2007, respectively. Fulfillment of OTA publication criteria was determined. Seventy-nine percent of graduates contributed to 1 or more publications. The recent group produced more total publications per graduate (4.06 vs 3.29, P=.01) and more coauthor publications (2.60 vs 2.04, P=.019) than the early group. The number of first-author publications did not differ between groups (1.46 vs 1.25, P=.26). A greater percentage of the recent group met current OTA publication criteria compared with the early group (51% vs 35%, P=.04). The findings showed that recent orthopedic trauma graduates had increased publication productivity compared with their more senior colleagues, although a proportion had not qualified for active OTA membership 6 years into their career. Overall, these data are encouraging and suggest that young orthopedic trauma surgeons remain committed to sustaining a high level of academic excellence.

  13. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena; Rose, Michael; Bentzon, Niels;

    2015-01-01

    surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all......INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...

  14. The Once and Future Publishing Library

    Science.gov (United States)

    Okerson, Ann; Holzman, Alex

    2015-01-01

    The report explores the revitalization of library publishing and its possible future, and examines elements that influence the success and sustainability of library publishing initiatives. The authors trace the history of library publishing and factors that have transformed the publishing landscape, and describe several significant library-press…

  15. Writing and Publishing: The Librarian's Handbook

    Science.gov (United States)

    Smallwood, Carol, Ed.

    2010-01-01

    Have you ever considered writing or reviewing for the library community? Are you interested in publishing a book on your favorite author or hobby? Do you need to write and publish for tenure? If so, "Writing and Publishing" is for you. Practical how-to guidance covering fiction, poetry, children's books/magazines, self-publishing, literary agents,…

  16. Utility of recorded guided imagery and relaxing music in reducing patient pain and anxiety, and surgeon anxiety, during cutaneous surgical procedures: A single-blinded randomized controlled trial.

    Science.gov (United States)

    Alam, Murad; Roongpisuthipong, Wanjarus; Kim, Natalie A; Goyal, Amita; Swary, Jillian H; Brindise, Renata T; Iyengar, Sanjana; Pace, Natalie; West, Dennis P; Polavarapu, Mahesh; Yoo, Simon

    2016-09-01

    Guided imagery and music can reportedly reduce pain and anxiety during surgery, but no comparative study has been performed for cutaneous surgery to our knowledge. We sought to determine whether short-contact recorded guided imagery or relaxing music could reduce patient pain and anxiety, and surgeon anxiety, during cutaneous surgical procedures. Subjects were adults undergoing excisional surgery for basal and squamous cell carcinoma. Randomization was to guided imagery (n = 50), relaxing music (n = 54), or control group (n = 51). Primary outcomes were pain and anxiety measured using visual analog scale and 6-item short-form of the State-Trait Anxiety Inventory, respectively. Secondary outcomes were anxiety of surgeons measured by the 6-item short-form of the State-Trait Anxiety Inventory and physical stress of patients conveyed by vital signs, respectively. There were no significant differences in subjects' pain, anxiety, blood pressure, and pulse rate across groups. In the recorded guided imagery and the relaxing music group, surgeon anxiety was significantly lower than in the control group. Patients could not be blinded. Short-contact recorded guided imagery and relaxing music appear not to reduce patient pain and anxiety during excisional procedures under local anesthetic. However, surgeon anxiety may be reduced when patients are listening to such recordings. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  17. 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.

  18. Curative to palliative care-transition and communication issues: Surgeons perspective

    Directory of Open Access Journals (Sweden)

    S V Suryanarayana Deo

    2013-01-01

    Full Text Available Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.

  19. Curative to palliative care-transition and communication issues: surgeons perspective.

    Science.gov (United States)

    Suryanarayana Deo, Sv; Thejus, T

    2013-05-01

    Transition of a cancer patient from curative to palliative stage is one of the most difficult and challenging phases of cancer care both from patient and physician point of view. Most of the time the treating surgeons are expected to facilitate this transition but due to a number of reasons surgeons often fail to fulfill this crucial responsibility. This article highlights the various issues involved in the transition phase from a surgeons perspective.

  20. Jean Falcon (1491-1541), a great surgeon and anatomist of the 16th century.

    Science.gov (United States)

    Tsoucalas, Gregory; Karamanou, Marianna; Piagkou, Maria; Skandalakis, Panagiotis; Androutsos, George

    2013-01-01

    Jean Falcon, an Aragon native, became a famous surgeon at the Faculty of Montpellier. He was a Royal physician, wealthy enough to live a luxurious life and treat influential patients. His lectures were legendary, and his works gave him fame among the surgeons' class. Of all his manuscripts stands the "Guidon", which became an anatomical surgeons' handbook, worthy of reference from the scientific community for centuries.

  1. Work-related musculoskeletal disorders among dental surgeons: A pilot study

    Directory of Open Access Journals (Sweden)

    Abdul Rahim Shaik

    2011-01-01

    Full Text Available Aim: To describe the work-related musculoskeletal disorders among on-job dental surgeons. Objectives: To identify the musculoskeletal disorders in terms of perception of pain and stiffness experienced by the dental surgeons due to the rigors of dental work, to determine the prevailing working environment with particular reference to dental work station in relation to musculoskeletal disorders, and to find the association between pain and stiffness experienced by the dental surgeons and the selected socio-demographic variables. Materials and Methods: The study was conducted on 30 graduated dental surgeons having a work experience of 1 year or more, post graduates and faculty members of various specialties at Yenepoya Dental College Hospital, Mangalore. The subjects were selected randomly from the hospital and they were given closed-ended questionnaire to find out perception of pain and stiffness experienced in the past 6 months. The observation of the working environment was done by walk-through observational survey. Results: The study showed that 6.6% dental surgeons always experienced shoulder pain, while 83.3% dental surgeons sometimes experienced back pain and 70% sometimes experienced neck pain. Majority of the dental surgeons (73.3% experienced stiffness in the back and 23.3% experienced severe pain in their neck. It was observed that the number of patients attended per day by the dental surgeons had a significant association (P = 0.024 with the pain they experienced in their hip/thigh region. The frequency of pain experienced by the dental surgeons in the hip/thigh and knee joints also showed a significant association (P = 0.037 with the height of the dental surgeons. Conclusion: The study revealed that various socio-demographic variables contributed to the musculoskeletal disorders experienced by the dental surgeons. However, the number of patients attended per day by the dental surgeons vis-à-vis pain experienced in the back, wrist, and

  2. 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.

  3. Psychological and Physical Stress in Surgeons Operating in a Standard or Modern Operating Room

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Gögenür, Ismayil

    2010-01-01

    Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...... psychological and physiological stress in experienced laparoscopic surgeons. Methods: This was a prospective case-controlled study including 10 experienced surgeons. Surgery was performed in 2 different ORs: a standard room and a modern room (OR1-suite, Karl Storz). The surgeons filled out questionnaires...

  4. The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    K Gnassingbé

    2011-01-01

    Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons′ directory was used to identify paediatric surgeons in the Francophone′s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros (€ (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

  5. Gender differences in the professional and private lives of plastic surgeons.

    Science.gov (United States)

    Halperin, Terri J; Werler, Martha M; Mulliken, John B

    2010-06-01

    There are over 700 female members in the American Society of Plastic Surgeons. The purpose of this study was to assess possible differences between female and male plastic surgeons with respect to their practice characteristics, duration of practice, and some aspects of their private lives. We designed a 41 question survey to compare the practice features and personal demographics of female and male members of the American Society of Plastic Surgeons. A total of 1498 questionnaires were sent via e-mail to all female members (n = 687) and a random cohort of male members (n = 811). The respondents were age stratified by decade and their responses were compared by gender using chi tests. The overall response rate was 36.3%: 337 females (49%) and 207 males (25.5%) (P plastic surgeons were more than twice as likely as female plastic surgeons to earn an income greater than $400,000 per year (P plastic surgeons are significantly more likely to be unmarried, to postpone having children or be childless, as compared to their male counterparts. Furthermore, female plastic surgeons have a lower income than their male colleagues despite similar hours and practice profile. Nevertheless, female plastic surgeons appear to have similar career satisfaction and are no more likely to retire earlier or more frequently than male plastic surgeons.

  6. 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

  7. Analysis and Counter-measures of the AAO Technological Process with Acid Effluent%AAO工艺出水pH值偏酸问题分析及对策

    Institute of Scientific and Technical Information of China (English)

    李金浩

    2009-01-01

    某污水处理厂AAO工艺出水存在着pH值偏低的问题.通过对比历史数据和缺氧反硝化试验,研究了以进厂污水作为碳源的反硝化脱氮的能力及碳氮比对脱氮的影响,并通过碱度平衡核算,分析了硝化和反硝化段的情况,查找出了出水碱度不足pH偏酸的原因,提出了快捷、行之有效的控制方案.%This paper analyzes the anoxic/anaerobic/aerobic process(AAO)technological process with acid pH Value of effluent.By comparing recorded data and anoxic de-nitrification test,it studies the de-nitrification capability of sewage as carbon source,as well as how the carbon and nitrogen affect the de-nitrification capability.Through assessing the alkalinity balance accounting,the situation of nitrification and de-nitrification was analyzed,to figure out why the pH Value is to be acid.Finally,practicable schemes tO control the pH Value Were presented.

  8. 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

  9. What I learned from predatory publishers.

    Science.gov (United States)

    Beall, Jeffrey

    2017-06-15

    This article is a first-hand account of the author's work identifying and listing predatory publishers from 2012 to 2017. Predatory publishers use the gold (author pays) open access model and aim to generate as much revenue as possible, often foregoing a proper peer review. The paper details how predatory publishers came to exist and shows how they were largely enabled and condoned by the open-access social movement, the scholarly publishing industry, and academic librarians. The author describes tactics predatory publishers used to attempt to be removed from his lists, details the damage predatory journals cause to science, and comments on the future of scholarly publishing.

  10. A speech nasoendoscopy-based surgeon's decision for correction of velopharyngeal insufficiency following adenotonsillectomy.

    Science.gov (United States)

    Askar, Sherif M; Abou-Elsaad, Tamer S

    2014-02-01

    Both sphincter pharyngoplasty (SP) and pharyngeal flap (PF) procedures have gained popularity among surgeons as effective surgical management for velopharyngeal insufficiency (VPI). Different centers prefer either SP or PF and have published their results to support this preference. But is one technique superior to the other? To answer this question, we have adopted the concept of differential therapeutic management, based on detailed assessment of velopharyngeal function. According to this assessment either SP or PF was performed for management of VPI (secondary to adenotonsillectomy). The aim of this work is to evaluate and compare the surgical results after SP and PF (based on the preoperative nasoendoscopy and phoniatrics' evaluation). This study was conducted on 31 patients with persistent hypernasality after adenotonsillectomy. All patients were subjected to perceptual speech evaluation and nasoendoscopic examination. According to this evaluation and data analysis, 18 patients were operated by SP and 13 patients underwent PF. Statistically, highly significant improvements were found when comparing pre- versus postoperative perceptual speech evaluation following both SP and PF (P speech evaluation following both techniques, statistically non-significant differences were reported (P > 0.05). Preoperative differential diagnosis of VPI using perceptual speech assessment and nasoendoscopy of the velopharynx allows for tailored surgical management with either SP or PF. Both SP and PF procedures could yield good surgical outcomes, when patients are properly selected and the technique is chosen according to preoperative assessment.

  11. Exploiting opportunities for leadership development of surgeons within the operating theatre.

    Science.gov (United States)

    Suliman, Amna; Klaber, Robert E; Warren, Oliver J

    2013-01-01

    It is increasingly recognised that leadership skills are a key requirement in being successful in surgery, regardless of speciality and at all levels of experience and seniority. Where the emphasis was previously on technical ability, knowledge and diagnostic acumen, we now know that non-technical skills such as communication and leadership contribute significantly to patient safety, experience and outcomes, and should be valued. The operating theatre is a unique micro-environment which is often busier, noisier, more stressful and more physically demanding than the clinic or ward setting. As a result surgeons and their trainers, who are striving to develop leadership skills require an in-depth awareness of the challenges in this environment and the opportunities that arise from them to develop leadership effectively. This article outlines why leadership learning is so beneficial in the operating theatre, both for the team and the patient as well as what elements of daily routine activity such as the WHO checklist use, list-planning and audit can be exploited to transform the average busy operating theatre into a rich, learning environment for future leaders in surgery. Copyright © 2012. Published by Elsevier Ltd.

  12. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2016 Update on Research.

    Science.gov (United States)

    Jacobs, Marshall L; Jacobs, Jeffrey P; Pasquali, Sara K; Hill, Kevin D; Hornik, Christoph; O'Brien, Sean M; Shahian, David M; Habib, Robert H; Edwards, Fred H

    2016-09-01

    The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) is the largest congenital and pediatric cardiac surgical clinical data registry in the world. With more than 400,000 total operations from nearly all centers performing pediatric and congenital heart operations in North America, the STS CHSD is an unparalleled platform for clinical investigation, outcomes research, and quality improvement activities in this subspecialty. In 2015, several major original publications reported analyses of data in the CHSD pertaining to specific diagnostic and procedural groups, age-defined cohorts, or the entire population of patients in the database. Additional publications reported the most recent development, evaluation, and application of metrics for quality measurement and reporting of pediatric and congenital heart operation outcomes. This use of the STS CHSD for outcomes research and for quality measurement continues to expand as database participation and the available wealth of data in it continue to grow. This article reviews outcomes research and quality improvement articles published in 2015 based on STS CHSD data.

  13. Discussing harm-causing errors with patients: an ethics primer for plastic surgeons.

    Science.gov (United States)

    Vercler, Christian J; Buchman, Steven R; Chung, Kevin C

    2015-02-01

    Plastic surgery is a field that demands perfection, yet despite our best efforts errors occur every day. Most errors are minor, but occasionally patients are harmed by our mistakes. Although there is a strong ethical requirement for full disclosure of medical errors, data suggest that surgeons have a difficult time disclosing errors and apologizing. "Conventional wisdom" has been to avoid frank discussion of errors with patients. This concept is fueled by the fear of litigation and the notion that any expression of apology leads to malpractice suits. Recently, there has been an increase in the literature pointing to the inadequacy of this approach. Policies that require disclosure of harm-causing medical errors to the patient and the family, apology, and an offer of compensation cultivate the transparency necessary for quality improvement efforts as well as the positive moral development of trainees. There is little published in the plastic surgery literature regarding error disclosure to provide guidance to practitioners. In this article, we will review the ethical, therapeutic, and practical issues involved in discussing the error with the patient and apologizing by presenting a representative case. This primer will provide an understanding of the definition of medical error, the ethical support of error disclosure, the barriers to disclosure, and how to overcome those barriers.

  14. Non-physician cataract surgeons in Sub-Saharan Africa: situation analysis.

    Science.gov (United States)

    Lewallen, Susan; Etya'ale, Daniel; Kello, Amir Bedri; Courtright, Paul

    2012-11-01

    Non-physician cataract surgeons (NPCS) provide cataract surgical services in some Sub-Saharan African (SSA) countries. However, their training, placement, legal framework and supervision have not been documented. We sought to do so to inform decision-making regarding future training. Standard questionnaires were sent to national eye coordinators and other ophthalmologic leaders in Africa to collect information. Face-to-face interviews were conducted at training programmes in Ethiopia, Tanzania and Kenya, and email interviews were conducted with directors at training programmes in the Gambia and Malawi. Responses were provided for 31/39 (79%) countries to which questionnaires were sent. These countries represent about 90% of the population of SSA. Overall, 17 countries have one or more NPCS; two-thirds of the total 245 NPCS are found in only three countries. Thirty-six percent of NPCS work alone, but a formal functioning supervision system was reported to be present in only one country. The training centres are similar and face similar challenges. There is considerable variation across SSA in the use and acceptance of NPCS. The placement and support of NPCS after training generally does not follow expectations, and training centres have little role in this. Overall, there was no consensus on whether the cadre, as it is currently viewed, is necessary, desirable or will contribute to addressing cataract surgical needs in SSA. © 2012 Blackwell Publishing Ltd.

  15. Types of Open Access Publishers in Scopus

    Directory of Open Access Journals (Sweden)

    David Solomon

    2013-05-01

    Full Text Available This study assessed characteristics of publishers who published 2010 open access (OA journals indexed in Scopus. Publishers were categorized into six types; professional, society, university, scholar/researcher, government, and other organizations. Type of publisher was broken down by number of journals/articles published in 2010, funding model, location, discipline and whether the journal was born or converted to OA. Universities and societies accounted for 50% of the journals and 43% of the articles published. Professional publisher accounted for a third of the journals and 42% of the articles. With the exception of professional and scholar/researcher publishers, most journals were originally subscription journals that made at least their digital version freely available. Arts, humanities and social science journals are largely published by societies and universities outside the major publishing countries. Professional OA publishing is most common in biomedicine, mathematics, the sciences and engineering. Approximately a quarter of the journals are hosted on national/international platforms, in Latin America, Eastern Europe and Asia largely published by universities and societies without the need for publishing fees. This type of collaboration between governments, universities and/or societies may be an effective means of expanding open access publications.

  16. Training Surgeons and Anesthesiologists to Facilitate End-of-Life Conversations With Patients and Families: A Systematic Review of Existing Educational Models.

    Science.gov (United States)

    Bakke, Katherine E; Miranda, Stephen P; Castillo-Angeles, Manuel; Cauley, Christy E; Lilley, Elizabeth J; Bernacki, Rachelle; Bader, Angela M; Urman, Richard D; Cooper, Zara

    2017-09-19

    Despite caring for patients near the end-of-life (EOL), surgeons and anesthesiologists report low confidence in their ability to facilitate EOL conversations. This discrepancy exists despite competency requirements and professional medical society recommendations. The objective of this systematic review is to identify articles describing EOL communication training available to surgeons and anesthesiologists, and to assess their methodological rigor to inform future curricular design and evaluation. This PRISMA-concordant systematic review identified English-language articles from PubMed, EMBASE, and manual review. Eligible articles included viewpoint pieces, and observational, qualitative, or case studies that featured an educational intervention for surgeons or anesthesiologists on EOL communication skills. Data on the study objective, setting, design, participants, intervention, and results were extracted and analyzed. The Newcastle-Ottawa Scale was used to assess methodological quality. Database and manual search returned 2710 articles. A total of 2268 studies were screened by title and abstract, 46 reviewed in full-text, and 16 included in the final analysis. Fifteen studies were conducted exclusively in academic hospitals. Two studies included attending surgeons as participants; all others featured residents, fellows, or a mix thereof. Fifteen studies used simulated role-playing to teach and assess EOL communication skills. Measured outcomes included knowledge, attitudes, confidence, self-rated or observer-rated communication skills, and curriculum feedback; significance of results varied widely. Most studies lacked adequate methodological quality and appropriate control groups to be confident about the significance and applicability of their results. There are few quality studies evaluating EOL communication training for surgeons and anesthesiologists. These programs frequently use role-playing to teach and assess EOL communication skills. More studies are

  17. Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery.

    Science.gov (United States)

    Sorenson, Rebecca; Scott, Ingrid U; Tucker, Steven H; Chinchilli, Vernon M; Papachristou, George C

    2016-02-01

    To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Cross-sectional study of anonymous survey results. An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Sixty-seven (57.2%) of 117 confirmed survey recipients participated. Thirty-six (62.1%) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6% would place a primary anterior chamber IOL (AC IOL), 29.3% would place a primary scleral-fixated PC IOL, and 5.3% would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3%). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2%) and scleral-fixated PC IOLs (41.7%). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7% cited a decreased risk for long-term complications as their reason for IOL choice; 50.0% of surgeons who favored primary AC IOLs cited avoidance of a second surgery. In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. The Role of Plastic Surgeons in Advancing Development Global.

    Science.gov (United States)

    Broer, P Niclas; Jenny, Hillary E; Ng-Kamstra, Joshua S; Juran, Sabrina

    2016-05-01

    In September 2015, the international community came together to agree on the 2030 Agenda for Sustainable Development, a plan of action for people, the planet, and prosperity. Ambitious and far-reaching as they are, they are built on three keystones: the elimination of extreme poverty, fighting climate change, and a commitment to fighting injustice and inequality. Critical to the achievement of the Agenda is the global realization of access to safe, affordable surgical and anesthesia care when needed. The landmark report by the Lancet Commission on Global Surgery estimated that between 28 and 32 percent of the global burden of disease is amenable to surgical treatment. However, as many as five billion people lack access to safe, timely, and affordable surgical care, a burden felt most severely in low- and middle-income countries (LMICs). Surgery, and specifically plastic surgery, should be incorporated into the international development and humanitarian agenda. As a community of care providers dedicated to the restoration of the form and function of the human body, plastics surgeons have a collective opportunity to contribute to global development, making the world more equitable and helping to reduce extreme poverty. As surgical disease comprises a significant burden of disease and surgery can be delivered in a cost-effective manner, surgery must be considered a public health priority.

  20. Day-care hypospadias surgery: Single surgeon experience

    Directory of Open Access Journals (Sweden)

    Chandrasekharam V.V.S.S

    2007-01-01

    Full Text Available Aim: To report the results of the early discharge of children after hypospadias repair with an indwelling catheter. Materials and Methods: To facilitate early the discharge of children after hypospadias repair, the author adopted the technique of draining the indwelling urinary catheter into diapers in children undergoing this operation. Home catheter care was taught to the mother; the dressings and catheters were subsequently managed in the outpatient clinic. Results: Over a 2-year period, 43 children were managed by this technique and were sent home within 24-48 h after the operation with an indwelling catheter. Minor problems requiring outpatient visits to the surgeon occurred in nine (20% children after discharge from the hospital. All the nine children were successfully managed as outpatients and no child required rehospitalisation. The catheter remained in position for 5 days in all the children. The overall results were satisfactory with an acceptable (7% fistula rate. Conclusions: It is possible to reduce the duration of the hospital stay of children after hypospadias repair without compromising on the final results.

  1. 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.

  2. 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

  3. Recognizing surgeon's actions during suture operations from video sequences

    Science.gov (United States)

    Li, Ye; Ohya, Jun; Chiba, Toshio; Xu, Rong; Yamashita, Hiromasa

    2014-03-01

    Because of the shortage of nurses in the world, the realization of a robotic nurse that can support surgeries autonomously is very important. More specifically, the robotic nurse should be able to autonomously recognize different situations of surgeries so that the robotic nurse can pass necessary surgical tools to the medical doctors in a timely manner. This paper proposes and explores methods that can classify suture and tying actions during suture operations from the video sequence that observes the surgery scene that includes the surgeon's hands. First, the proposed method uses skin pixel detection and foreground extraction to detect the hand area. Then, interest points are randomly chosen from the hand area so that their 3D SIFT descriptors are computed. A word vocabulary is built by applying hierarchical K-means to these descriptors, and the words' frequency histogram, which corresponds to the feature space, is computed. Finally, to classify the actions, either SVM (Support Vector Machine), Nearest Neighbor rule (NN) for the feature space or a method that combines "sliding window" with NN is performed. We collect 53 suture videos and 53 tying videos to build the training set and to test the proposed method experimentally. It turns out that the NN gives higher than 90% accuracies, which are better recognition than SVM. Negative actions, which are different from either suture or tying action, are recognized with quite good accuracies, while "Sliding window" did not show significant improvements for suture and tying and cannot recognize negative actions.

  4. Association of Surgeons in Training Conference: Cardiff 2012.

    Science.gov (United States)

    Khera, G; Wild, J R L; Fitzgerald, J E F

    2012-01-01

    The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. With a membership of over 2000 surgical trainees from all ten surgical specialities, the association provides support at both regional and national levels throughout the United Kingdom and Republic of Ireland. Originally founded in 1976, ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges, and speciality associations. The 2012 Annual Conference in Cardiff City Hall brought together nearly 700 delegates for an educational weekend programme with expert guest speakers. Clinical updates were complimented by debates on current training in surgery, and the weekend included 6 pre-conference courses covering a diverse range of topics including laparoscopic skills, surgical drawing and a masterclass in journal club. A record number of 1168 abstract submissions were received and those successful competed for 18 awards representing £3500 in trainee prizes and bursaries. As the only national surgical trainee meeting for all specialities, ASiT continues to grow and we look forward to an even larger and more successful conference next year.

  5. Textbook Publishing: The Political and Economic Influences.

    Science.gov (United States)

    Apple, Michael W.

    1989-01-01

    This article focuses on the political and economic realities surrounding textbook publishing. A discussion of the publishing industry includes an examination of industry decision makers and the influence of profit. State textbook adoption policies are also explored. (IAH)

  6. Landfills, Landfills, Published in 2003, Taylor County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Landfills dataset, was produced all or in part from Published Reports/Deeds information as of 2003. It is described as 'Landfills'. Data by this publisher are...

  7. Soils, Soils, Published in 2004, Taylor County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Soils dataset, was produced all or in part from Published Reports/Deeds information as of 2004. It is described as 'Soils'. Data by this publisher are often...

  8. Framing the consultation: the role of the referral in surgeon-patient consultations.

    Science.gov (United States)

    White, Sarah J; Stubbe, Maria H; Macdonald, Lindsay M; Dowell, Anthony C; Dew, Kevin P; Gardner, Rod

    2014-01-01

    This study describes and analyzes the impact of the referral process on communication at the beginning of surgeon-patient consultations. We used conversation analysis to analyze the opening interactional activities of surgeon-patient consultations in New Zealand. This study focuses on 20 video-recorded consultations recorded between 2004 and 2006. Participants in surgeon-patient consultations began referred consultations by discussing the referral letter in what we have termed "referral recognition sequences." These sequences are coconstructed activities that can be implicit or explicit and address the minimized epistemic distance between surgeons and patients that is caused by the referral process. These sequences can be simple or complex, and this complexity may be determined by the quality of the referral letter received. Acknowledgment of the referral letter assists in achieving alignment between surgeon, patient, and referring doctor regarding the presenting problem. If this alignment is not achieved, progressivity of the consultation is affected, as there is disagreement as to why the patient is seeing the surgeon. This research shows that to assist in the progressivity of surgeon-patient consultations, referral letters should be clear and patients made aware of the reason for referral. Surgeons should also overtly address the minimized epistemic distance caused by the referral letter to ensure patients present their problems in full.

  9. Qualitative Study of Surgeons Using a Wearable Personal Assistant in Surgeries and Ward Rounds

    DEFF Research Database (Denmark)

    Jalaliniya, Shahram; Pederson, Thomas

    2016-01-01

    In this paper, we report on the utility of a wearable personal assistant (WPA) for orthopedic surgeons in hospitals. A prototype of the WPA was developed on the Google Glass platform for supporting surgeons in three different scenarios: 1) touch-less interaction with medical images in surgery room...

  10. Da Vinci© Skills Simulator™: is an early selection of talented console surgeons possible?

    Science.gov (United States)

    Meier, Mark; Horton, Kevin; John, Hubert

    2016-12-01

    To investigate whether the learning curve of robotic surgery simulator training depends on the probands' characteristics, such as age and prior experience, we conducted a study of six distinct proband groups, using the da Vinci Skills Simulator: experienced urological robotic surgeons, surgeons with experience as da Vinci tableside assistants, urological surgeons with laparoscopic experience, urological surgeons without laparoscopic experience, and complete novices aged 25 and younger and 40 and older. The results showed that all experienced robotic surgeons reached expert level (>90 %, as defined previously in the literature) within the first three repetitions and remained on a high level of performance. All other groups performed worse. Tableside assistants, laparoscopically experienced surgeons, and younger novices showed a better performance in all exercises than surgeons without laparoscopic experience and older novices. A linear mixed-effects model analysis demonstrated no significant difference in learning curves between proband groups in all exercises except the RW1 exercise for the younger proband group. In summary, we found that performance in robotic surgery, measured by performance scores in three virtual simulator modules using the EndoWrist techniques, was dependent on age and prior experience with robotic and laparoscopic surgery. However, and most importantly, the learning curve was not significantly affected by these factors. This suggests that the da Vinci Skills Simulator™ is a useful practice tool for everyone learning or performing robotic surgery, and that early selection of talented surgeons is neither possible nor necessary.

  11. 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…

  12. Trauma Collaborative Care Intervention: Effect on Surgeon Confidence in Managing Psychosocial Complications After Orthopaedic Trauma.

    Science.gov (United States)

    Wegener, Stephen T; Carroll, Eben A; Gary, Joshua L; McKinley, Todd O; OʼToole, Robert V; Sietsema, Debra L; Castillo, Renan C; Frey, Katherine P; Scharfstein, Daniel O; Huang, Yanjie; Collins, Susan C J; MacKenzie, Ellen J

    2017-08-01

    The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. Prospective cohort design. Level-I trauma centers. Attending surgeons and fellows (N = 95 Pre and N = 82 Post). Self-report 10-item measure of surgeon confidence in managing psychosocial issues associated with trauma and perceived availability of support resources. Analyses, performed on the entire sample and repeated on the subset of 52 surgeons who responded to the survey at both times points, found surgeons at intervention sites experienced a significantly greater positive improvement (P < 0.05) in their (1) belief that they have strategies to help orthopaedic trauma patients change their psychosocial situation; (2) confidence in making appropriate referrals for orthopaedic trauma patients with psychosocial problems; and (3) belief that they have access to information to guide the management of psychosocial issues related to recovery. Initial data suggest that the establishment of the TCC program can improve surgeons' perceived availability of resources and their confidence in managing the psychosocial sequelae after injury. Further studies will be required to determine if this translates into beneficial patient effects. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  13. A comparison of surgeon's postural muscle activity during robotic-assisted and laparoscopic rectal surgery.

    Science.gov (United States)

    Szeto, Grace P Y; Poon, Jensen T C; Law, Wai-Lun

    2013-09-01

    This study compared the muscular activity in the surgeon's neck and upper limbs during robotic-assisted laparoscopic (R-Lap) surgery and conventional laparoscopic (C-Lap) surgery. Two surgeons performed the same procedure of R-Lap and C-Lap low anterior resection, and real-time surface electromyography was recorded in bilateral cervical erector spinae, upper trapezius (UT) and anterior deltoid muscles for over 60 min in each procedure. In one surgeon, forearm muscle activities were also recorded during robotic surgery. Similar levels of cervical muscle activity were demonstrated in both types of surgery. One surgeon showed much higher activity in the left UT muscle during robotic surgery. In the second surgeon, C-Lap was associated with much higher levels of muscle activity in both UT muscles. This may be related to the bilateral abducted arm posture required in maneuvering the laparoscopic instruments. In the forearm region, the "ulnaris" muscles for wrist flexion and extension bilaterally showed high amplitudes during robotic-assisted surgery. Robotic-assisted surgery seemed to demand a higher level of muscle work in the forearm region while greater efforts of shoulder muscles were involved during laparoscopic surgery. There are also individual variations in postural habits and motor control that can affect the muscle activation patterns. This study demonstrated a method of objectively examining the surgeon's physical workload during real-time surgery in the operating theatre, and further research should explore the surgeon's workload in a larger group of surgeons performing different surgical procedures.

  14. A language for effective communication between surgeons and radiographers in trauma theatre.

    Science.gov (United States)

    Chaganti, S; Kumar, D; Patil, S; Alderman, P

    2009-09-01

    The advent of the image intensifier has revolutionised trauma surgery since its development in 1955. The manufacturers have given names to various movements of the machine in the operating manual but it has not been popular among orthopaedic surgeons or radiographers. Lack of knowledge of names of various movements and ambiguity in command often leads to confusion between the surgeon and the radiographer regarding which way to move the image intensifier. A questionnaire-based study was conducted to assess the efficacy of communication between orthopaedic surgeons and radiographers while using the image intensifier intra-operatively. Diagrams depicting the movements of the image intensifier were used in the questionnaire. Fifty questionnaires were given to orthopaedic surgeons and 50 to radiographers to name the various movements. Ninety questionnaires were returned, 45 from surgeons and 45 from radiographers. Five questionnaires from surgeons and five from radiographers were returned blank. Of those responding, 97% could name the vertical movement, 68% the horizontal movement, 12% the swivel and 29% the angulation movement. None could name the orbital movement. Even though orthopaedic surgeons do not operate the image intensifier themselves, knowledge of the movements of the image intensifier and their names can improve the efficacy of communication between surgeons and radiographers. A common language and precision in command can avoid confusion and has the potential to improve theatre time utilisation. The nomenclature of various movements of the image intensifier has been described and possible precise commands for various movements have been postulated.

  15. 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.

  16. 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...

  17. Effects of publishing industry and reading culture

    OpenAIRE

    Maja Breznik

    2003-01-01

    The author presents some results form the research on publishing and librarianship, which was carried out in frame of the Peace Institute in Ljubljana from 2001 till 2003. The research focused on the reading cultures cultivated by Slovene publishers through their publishing programs and on the reading preferences in Slovene public libraries. The results of the research derive from samples of the Slovene annual publishing production in year 2000 and circulation numbers of these publications in...

  18. Crystallographic publishing in the electronic age

    Science.gov (United States)

    Strickland, P. R.; McMahon, B.

    2008-01-01

    The journal publishing activities of the IUCr over the past 60 years are described, together with the new technological, economic and cultural challenges faced by the journals. Particular emphasis is placed on the role of innovative publishing technologies in ensuring the quality of the published information and in providing effective access to the data underpinning the scientific results.

  19. The Future of Scholarly Journal Publishing.

    Science.gov (United States)

    Oppenheim, Charles; Greenhalgh, Clare; Rowland, Fytton

    2000-01-01

    Surveys the recent literature on scholarly publishing and its conversion to the electronic medium. Presents results of a questionnaire survey of the United Kingdom-based scholarly publishing industry. Results suggest publishers are moving quickly towards use of the Internet as a major medium for distribution, though they do not expect an early…

  20. The Changing Business of Scholarly Publishing.

    Science.gov (United States)

    Hunter, Karen

    1993-01-01

    Discussion of changes and trends in scholarly publishing highlights monographs; journals; user-centered publishing; electronic products and services, including adding value, marketing strategies, and new pricing systems; changing attitudes regarding copyright; trends in publishing industry reorganization; and impacts on research libraries. (LRW)

  1. Trade Publishing: A Report from the Front.

    Science.gov (United States)

    Fister, Barbara

    2001-01-01

    Reports on the current condition of trade publishing and its future prospects based on interviews with editors, publishers, agents, and others. Discusses academic libraries and the future of trade publishing, including questions relating to electronic books, intellectual property, and social and economic benefits of sharing information…

  2. 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

  3. Daniel Mollière (1848-1890): the French anatomist-surgeon who introduced Robin's pioneering osteoclast for the genu valgum observed in adolescents.

    Science.gov (United States)

    Tsoucalas, Gregory; Karamanou, Marianna; Sgantzos, Markos; Androutsos, George

    2015-08-01

    Inside the pages of the French medical treatises of the 19th century a forgotten osteoclast apparatus for the genu valgum observed in adolescents remained hidden waiting to be unearthed. It was Victor Robin's osteoclast, which has been used by the supreme French anatomist and surgeon Daniel Mollière. With the purpose to share a significant heritage on orthopaedics, a thorough research of the literature of the era was conducted. Our study resulted in the illumination of both Mollière's prolific figure and osteoclast's impact on orthopaedic surgery at that time. Having in mind Mollière's perseverance towards surgical apparatuses, his antiseptic measures inside his operating theatre, his published treatises, his surgical skills, we may effortlessly conclude that he stands among Lyon's best surgeons with an important contribution to orthopaedics.

  4. Surgical management of acute cholecystitis. Results of a nation-wide survey among Spanish surgeons.

    Science.gov (United States)

    Badia, Josep M; Nve, Esther; Jimeno, Jaime; Guirao, Xavier; Figueras, Joan; Arias-Díaz, Javier

    2014-10-01

    There is a wide variability in the management of acute cholecystitis. A survey among the members of the Spanish Association of Surgeons (AEC) analyzed the preferences of Spanish surgeons for its surgical management. The majority of the 771 responders didn't declare any subspecialty (41.6%), 21% were HPB surgeons, followed by colorectal and upper-GI specialities. Early cholecystectomy during the first admission is the preferred method of management of 92.3% of surgeons, but only 42.7% succeed in adopting this practice. The most frequent reasons for changing their preferred practice were: Patients not fit for surgery (43.6%) and lack of availability of emergency operating room (35.2%). A total of 88.9% perform surgery laparoscopically. The majority of AEC surgeons advise index admission cholecystectomy for acute cholecystitis, although only half of them succeed in its actual implementation. There is room for improvement in the management of acute cholecystitis in Spanish hospitals.

  5. Social Media as a Platform for Surgical Learning: Use and Engagement Patterns Among Robotic Surgeons.

    Science.gov (United States)

    Myers, Christopher G; Kudsi, Omar Yusef; Ghaferi, Amir A

    2017-08-29

    : In response to technological advances and growing dispersion of surgical practice around the globe, social media platforms have emerged in recent years as channels for surgeons to share experiences, ask questions, and learn from one another. To better understand surgeons' engagement with these platforms, we analyzed data from a closed-membership Facebook group for robotic surgeons. Our analysis revealed that surgeons posted more frequently on midweek days, and further that text posts received significantly more comments, and significantly fewer "likes," than posts containing links, photos, or videos. We discuss the implications of these use and engagement patterns for the viability of social media platforms as tools for surgeons to learn vicariously from their peers' experiences and expertise.

  6. Technical modifications for laparoscopic cholecystectomy by the left-handed surgeon.

    Science.gov (United States)

    Herrero-Segura, Antonio; López-Tomassetti Fernández, Eudaldo M; Medina-Arana, Vicente

    2007-10-01

    There is a complete paucity of literature for left-handed surgeons. Some studies revealed that left-handed surgical residents have lesser operating skills and some surgeons have considered leaving surgery at some point in their career owing to laterality-related frustrations. Most important, whereas minimally invasive surgical techniques have had a profound impact on the treatment of diseased gallbladder, these procedures do not eliminate laterality related to the discomfort of left-handed surgeons. Usually, left-handed surgeons must teach themselves a procedure. They must make modifications and learn some technical tips to make a more comfortable, convenient, and safe intervention. The aim of this study was to describe some modifications made by a left-handed surgeon to perform 52 safe laparoscopic cholecystectomies with standard right-handed instruments in our hospital. These surgical steps could be used in a reproducible way to minimize the recurring difficulties of left-handed learners in a surgical residency program.

  7. Measuring surgeon performance of sentinel lymph node biopsy in breast cancer treatment by cumulative sum analysis.

    Science.gov (United States)

    Lerch, Lindsey; Donald, James C; Olivotto, Ivo A; Lesperance, Mary; van der Westhuizen, Nick; Rusnak, Conrad; Biberdorf, Darren; Ross, Alison; Hayashi, Allen

    2007-05-01

    This study was performed to determine if surgeons' performance of sentinel lymph node biopsy (SLNB) for breast cancer varied with time and to devise a method to continuously evaluate that performance. We retrospectively examined the SLNB experience of 13 community surgeons performing 765 SLNBs and 579 concomitant axillary dissections. False-negative rates (FNRs) were assessed for individuals and cohorts defined by caseload. Performance with time was assessed using cumulative sum (CUSUM) analysis. Overall, the SLN identification rate was 94.3%, and FNR was 5.3%. Each surgeon demonstrated variation in identification rate and/or FNR with time. CUSUM analysis provided an effective means to demonstrate when surgeon variation breached performance standards. Surgeon performance of SLNB varied with time, independent of case load. CUSUM may prove to be a useful statistical tool to evaluate performance before adopting stand-alone SLNB.

  8. The registry of anomalous aortic origin of the coronary artery of the Congenital Heart Surgeons' Society.

    Science.gov (United States)

    Brothers, Julie A; Gaynor, J William; Jacobs, Jeffrey P; Caldarone, Christopher; Jegatheeswaran, Anusha; Jacobs, Marshall L

    2010-12-01

    The anomalous aortic origin of a coronary artery from the wrong sinus of Valsalva with interarterial, intramural, and/or intraconal course is a rare congenital anomaly that is associated with a high risk of sudden death in children. The Congenital Heart Surgeons' Society established the Registry of Anomalous Aortic Origin of the Coronary Artery to help determine the outcome of children and young adults managed with surgical intervention versus observation and to test the hypothesis that subsets of patients with anomalous aortic origin of a coronary artery can be identified in whom the risk of intervention is less than the risk of observation. All institutional members of the Congenital Heart Surgeons' Society were recruited for participation. The registry consists of a retrospective cohort of patients diagnosed between 1 January, 1998 and 20 January, 2009 and a prospective, population-based cohort of patients newly diagnosed from 21 January, 2009 onwards. Baseline demographics, diagnoses, and results of tests will be obtained through a review of the medical records. Annual follow-up data will be collected. Data will be analysed for different factors of risk at diagnosis, different strategies of treatment, and the impact of both on the outcomes of the patients. As of June 2010, 28 institutions had applied for approval from their institutional review board and 16 institutions had received approval from their institutional review board. Seventy-four patients have enrolled to date. We hope to use the established Pediatric Cardiomyopathy Registry as a guide to successful implementation, with a cooperative effort between institutions. The overall purpose of the Registry of Anomalous Aortic Origin of the Coronary Artery is to determine the outcome of surgical intervention versus observation in children and young adults with anomalous aortic origin of a coronary artery, and to describe the natural and "unnatural" history of these patients over the course of their lifetime

  9. How did the surgeons treat neonates with imperforate anus in the eighteenth century?

    Science.gov (United States)

    Yesildag, Ebru; Muñiz, Rubén Martínez; Buyukunal, S N Cenk

    2010-12-01

    Anorectal malformations (ARMS) are one of those challenging topics of pediatric surgery. The developments in assessing and approaching patients with these anomalies have been made in the last decades and the methods described in older textbooks functioned as a guide in planning these attempts (Kiely and Peña in Pediatric surgery, Mosby, Missouri, pp 1425-1449, 1998; Grosfeld in Anorectal malformations in children, Springer-Verlag, Berlin, pp 3-15, 2006). The aim of this study is to present the attitude of a surgeon of eighteenth century to the treatment of anorectal malformations, and the evolution in the history of the anomaly. The part about imperforate anus in a textbook of surgery, found in a second-hand bookstore, was translated. The description and the classification of the anomaly, the methods of approaching these cases together with some case reports were presented and compared with today's practice. The historical background of the anomaly was evaluated not only with regard to the book of Heister specifically but also to the other data obtained in the literature. The anomaly was reported to be "not rarely" observed. The obstetricians were warned to examine a newborn baby completely for early diagnosis. The classification of the anomaly was made according to the properties of the membrane covering the anus but prompt treatment, initiating with its simple excision, was suggested in all types. Better results in cases whose anus was covered with a thin, delicate membrane were reported. The results show that routine neonatal examination for all babies was recommended in this Textbook of Surgery which had been published 260 years ago. The physical deterioration due to delay was well described. A broad classification of imperforate anus was made and successful outcome in low-type anomalies of today was reported with some case samples. It is clear that all the efforts starting from Soranus until today improved the understanding of the anomaly. Combining previous

  10. Jaques-Louis Reverdin (1842-1929): the surgeon and the needle.

    Science.gov (United States)

    Fariña-Pérez, Luis A

    2010-05-01

    With the development and rise of abdominal laparoscopic techniques, the old Reverdin needle has had a revival, because it proved to be useful for the endoscopic closure of laparoscopic access ports, in order to lower the incidence of incisional hernias. Several new modifications of the Reverdin needle, with different names, are in the market now. This new use of an old instrument, prompted a review of the life and work of Jaques-Louis Reverdin, the Swiss surgeon trained in Paris and founder of the modern Swiss surgery. Biographical and bibliographical review of Jaques-MLouis Reverdin and his contributions to surgery Jaques-Louis Reverdin (1842-1929), born in Geneva, completed his medical studies in Paris, where he practised in several well-known hospitals such as La Pitié (with Goselin), Saint Louis (with Guérin), Lariboisiére, and Necker (with Guyon). In 1869 he published and presented in several meetings, a pioneering experience of successful free skin graft procedure, that is still performed in some cases and constitutes the first organ transplantation. In 1870 he presented his doctoral thesis "Etude sur l'uréthrotomie interne" with the expeience of his master Guyon (63 operations), gaining the Civiale prize and the bronze medal of the Paris Faculty of Medicine. He returned back to Geneva in 1872 to begin a long surgical practice and Faculty teaching, and he made seminal contributions to the knowledge of thyroid diseases, in particular on the clinical presentation of function deficiency following exeresis of the thyroid gland ( postoperative myxoedema). His contributions paralleled that made by Theodor Kocher in Bern, the surgeon that received in solitary the Nobel prize for these studies in 1909. With Jean6hyphen;Louis Prevost and Constant Picot, they founded the "Revue medicale de la Suisse romande", the most important Swiss medical journal of the 20th century. He is remembered in the field of Urology for a special needle designed to pass through a suture

  11. 解读美国《耳鸣临床应用指南》%Interpretation of the AAO-HSN Clinical Practice Guideline:Tinnitus

    Institute of Scientific and Technical Information of China (English)

    贺璐; 王国鹏; 龚树生

    2016-01-01

    Clinical Practice Guideline: Tinnitus was published as a supplement to the Otolaryngology-Head and Neck Surgery in October 2014. It is the first guideline for tinnitus evaluation and treatment, composed by 23 authors. The purpose of this guideline is to provide evidence-based recommendations for clinicians managing patients with tinnitus. The target patient population is limited to adults (18 years and older) with primary tinnitus that is persistent and bothersome. This article aims at giving an interpretation of the guideline in connection with the development of tinnitus management in China.%2014年10月美国《Otolaryngology-Head and Neck Surgery》杂志增刊发表了《耳鸣临床应用指南(Clinical Practice Guideline:Tinnitus)》。该《指南》由David E. Tunkel等23位学者共同制定,是首部用于评估和治疗慢性耳鸣的指南,旨在为从事耳鸣研究与治疗的专业人员提供基于循证医学证据的建议。《指南》涉及的患者群体是患有持续失代偿性的原发性耳鸣患者(18岁及以上)。本文试结合我国目前耳鸣诊治现状将该《指南》作一解读。

  12. Effects of publishing industry and reading culture

    Directory of Open Access Journals (Sweden)

    Maja Breznik

    2003-01-01

    Full Text Available The author presents some results form the research on publishing and librarianship, which was carried out in frame of the Peace Institute in Ljubljana from 2001 till 2003. The research focused on the reading cultures cultivated by Slovene publishers through their publishing programs and on the reading preferences in Slovene public libraries. The results of the research derive from samples of the Slovene annual publishing production in year 2000 and circulation numbers of these publications in Slovene public libraries in year 2001. The author presents the field of publishing and the basic characterisitics of the contemporary »publishing industry«, naming them »the mono-culture of publishing programs«. She also analyses certain influences of the publishing industry on reading cultures in public libraries, especially the strongest, the culture of reading anglosaxon bestsellers. State interventions in the publishing field are evaluated with comparison of the subsidised and nonsubsidised publication titles. By this comparison it was found that state subsidies do not enchroach on the »natural balance« of the publishing market, but only enable the publication of more serious works, which would otherwise probably not be published at all since the »publishing industry« is not capable of accepting the risks for such publishing. The author finds that small, nonprofit publishers, publishing subsidised book titles, are in deprivileged position, being cut off from distribution routes and even public institutions, such as public libraries, do not favour them. Acqiuisition policies of public libraries prefer to serve the simple tastes of their readers and therefore buy more commercial titles, even at the cost of subsidised ones.

  13. 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

  14. 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.

  15. 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

  16. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  17. 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

  18. A study of the prevalence of musculoskeletal disorders in surgeons performing minimally invasive surgery.

    Science.gov (United States)

    Gutierrez-Diez, Maria C; Benito-Gonzalez, Maria A; Sancibrian, Ramon; Gandarillas-Gonzalez, Marco A; Redondo-Figuero, Carlos; Manuel-Palazuelos, Jose C

    2017-09-15

    Minimally invasive surgery (MIS) has shown significant benefits for patients and healthcare systems. However, due to the poor ergonomic adaptation of operating rooms and surgical instruments, most surgeons suffer from pain caused by musculoskeletal disorders (MSDs). A descriptive survey on MIS surgeons working in different surgical specialties has been carried out in Hospital Valdecilla (Spain). The aim is to determine the prevalence of MSDs using a personal interview and the standardized Nordic questionnaire. The study determines the prevalence of MSDs in different parts of the body and their relationship with epidemiological and labor variables. A questionnaire was filled out by 129 surgeons. 90% of surgeons reported MSDs. The higher prevalence appears in the most experienced surgeons. The most affected zones are the lower back (54%), neck (51%), upper back (44%), lower extremities (42%), right shoulder (29%) and right hand (28%). The prevalence of MSDs is higher in MIS surgeons than in any other occupational group. The most vulnerable group is experienced surgeons and there is a potential risk that symptoms will be increased in the future. Muscle strength is revealed as a protective factor against MSDs.

  19. Evaluation of pain measurement practices and opinions of peripheral nerve surgeons.

    Science.gov (United States)

    Novak, Christine B; Anastakis, Dimitri J; Beaton, Dorcas E; Katz, Joel

    2009-12-01

    The purpose of this study was to evaluate the opinions and practices of peripheral nerve surgeons regarding assessment and treatment of pain in patients following nerve injury. Surgeons with expertise in upper extremity peripheral nerve injuries and members of an international peripheral nerve society were sent an introductory letter and electronic survey by email (n = 133). Seventy members responded to the survey (49%) and 59 surgeons completed the survey (44%). For patients referred for motor or sensory dysfunction, 31 surgeons (52%) indicated that they always formally assess pain. In patients referred for pain, 44 surgeons (75%) quantitatively assess pain using a verbal scale (n = 24) or verbal numeric scale (n = 36). The most frequent factors considered very important in the development of chronic neuropathic pain were psychosocial factors (64%), mechanism of injury (59%), workers' compensation or litigation (54%), and iatrogenic injury (48%). In patients more than 6 months following injury, surgeons frequently see: cold sensitivity (54%), decreased motor function (42%), paraesthesia or numbness (41%), fear of returning to work (22%), neuropathic pain (20%), and emotional or psychological distress (17%). Only 52% of surgeons who responded to the survey always evaluate pain in patients referred for motor or sensory dysfunction. Pain assessment most frequently includes verbal patient response, and assessment of psychosocial factors is rarely included. Predominately, patient-related factors were considered important in the development of chronic neuropathic pain.

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

    Science.gov (United States)

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

    2016-01-01

    Objectives The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. Methods A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Results Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. Conclusions The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use. PMID:27516473