Sample records for surgeons fifty years

  1. The next fifty years

    International Nuclear Information System (INIS)

    Scaldwell, Reg


    The General Manager of the reactor division of Centronics, a world class manufacturer of reactor control systems and radiation detectors, describes its achievements and looks forward to speculate on what the next fifty years may mean in terms of technological development. Tables are given of the locations of Centronics Fission Chambers and of reactors controlled with Centronic Detectors. (UK)

  2. Fifty years after Hiroshima

    International Nuclear Information System (INIS)

    Imai, R.


    Any discussion of the nuclear-proliferation regime in the post-Cold War era, its present role and expected function in the future must take into account the outcome of the New York Non-proliferation Treaty Review Conference held in 1995, and the four factors that shaped the twentieth century: fascism and communism, nuclear energy and environmental concerns, as well as the interaction between them. none of the factors can be handled within the boundaries of a single state. After fifty years of nuclear competition both for military and energy generation purposes, international conferences on disarmament, Non-proliferation Treaty, Comprehensive Test Ban Treaty, START negotiations and agreements, there are still remaining nuclear issues. Population growth, energy demands and supplies, all related to global environmental changes must be taken into account

  3. Fifty Years of Insulin

    African Journals Online (AJOL)

    has since saved millions of lives throughout the world. The year 197I is the 50th anniversary of Banting's historic discovery. The story of insulin ... He found no evidence of injury. An impaired ... Prize in medicine for his discovery of insulin.

  4. Fifty years of ILO

    International Nuclear Information System (INIS)


    'Poverty anywhere constitutes a danger to prosperity everywhere. This is the motto of the International Labour Organisation (ILO) which in June this year was celebrating the 50th anniversary of its foundation. It was initiated to advance the cause of social justice as a way of contributing to peace. (author)

  5. Fifty years of ILO

    Energy Technology Data Exchange (ETDEWEB)



    'Poverty anywhere constitutes a danger to prosperity everywhere. This is the motto of the International Labour Organisation (ILO) which in June this year was celebrating the 50th anniversary of its foundation. It was initiated to advance the cause of social justice as a way of contributing to peace. (author)

  6. PAs: Fifty years young. (United States)

    Mandel, Ellen D; North, Shannon


    The PA profession is 50 years young. Practicing PAs and current students hail from several generational categories ranging from Builders to Generation Z. This article reviews how different generations may have experienced PA program expansion, professional identity, state licensing, and prescription delegation. The authors sampled a cohort of PA program applicants about their views on what evokes optimism and concern for the PA profession. These themes mirror the recently paved professional road, while posing the all-important question: What construction lies on the horizon?

  7. Fifty years of Erlangen radiochemistry

    International Nuclear Information System (INIS)

    Morell, W.


    On June 29, 2006, the Radiochemical Laboratory of AREVA NP GmbH (formerly Siemens AG) in Erlangen celebrated its fiftieth anniversary. The occasion was marked by an event attended by more than 1,000 guests, among them Werner Gebauhr, the 85-year-old founder and first head of the Laboratory; the Managing Directors of AREVA NP GmbH, Ralf Gueldner and Ruediger Steuerlein; representatives of universities, research institutions, power utilities, and public authorities. The present head of the Radiochemical Laboratory, Wilfred Morell, sketched the highlights of the work performed over the past fifty years, which ranged from solid-state and very-high-purity materials technologies to development and service activities for nuclear technology. Manfred Erve, head of the Technical Center of AREVA NP GmbH, of which the Radiochemical Laboratory is a part, emphasized the changes in priorities over the past fifty years, which had always been met successfully by Radiochemistry. In the scientific part of the event, Wolfgang Schwarz (E.ON Kernkraftwerk GmbH, KKW Isar), Ulf Ilg (EnBW Kraftwerk AG, KKW Philippsburg), and Hans-Josef Allelein (Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH) explained 3 major subject areas in which Erlangen Radio-chemistry over many years has contributed basic findings (see other articles in this atw issue). On the occasion of the anniversary, a comprehensive booklet was published under the title of '50 Jahre Radiochemie Erlangen - 1956-2006'. (orig.)

  8. Fifty years with nuclear fission

    International Nuclear Information System (INIS)

    Behrens, J.W.; Carlson, A.D.


    The news of the discovery of nucler fission, by Otto Hahn and Fritz Strassmann in Germany, was brought to the United States by Niels Bohr in January 1939. Since its discovery, the United States, and the world for that matter, has never been the same. It therefore seemed appropriate to acknowledge the fiftieth anniversary of its discovery by holding a topical meeting entitled, ''Fifty years with nuclear fission,'' in the United States during the year 1989. The objective of the meeting was to bring together pioneers of the nuclear industry and other scientists and engineers to report on reminiscences of the past and on the more recent developments in fission science and technology. The conference highlighted the early pioneers of the nuclear industry by dedicating a full day (April 26), consisting of two plenary sessions, at the National Academy of Sciences (NAS) in Washington, DC. More recent developments in fission science and technology in addition to historical reflections were topics for two full days of sessions (April 27 and 28) at the main sites of the NIST in Gaithersburg, Maryland. The wide range of topics covered by Volume 2 of this topical meeting included plenary invited, and contributed sessions entitled, Nuclear fission -- a prospective; reactors II; fission science II; medical and industrial applications by by-products; reactors and safeguards; general research, instrumentation, and by-products; and fission data, astrophysics, and space applications. The individual papers have been cataloged separately

  9. Fifty years with nuclear fission

    International Nuclear Information System (INIS)

    Behrens, J.W.; Carlson, A.D.


    The news of the discovery of nuclear fission, by Otto Hahn and Fritz Strassmann in Germany, was brought to the United States by Niels Bohr in January 1939. Since its discovery, the United States, and the world for that matter, has never been the same. It therefore seemed appropriate to acknowledge the fifieth anniversary of its discovery by holding a topical meeting entitled, ''Fifty Years with Nuclear Fission,'' in the United States during the year 1989. The objective of the meeting was to bring together pioneers of the nuclear industry and other scientists and engineers to report on reminiscences of the past and on the more recent development in fission science and technology. The conference highlighted the early pioneers of the nuclear industry by dedicated a full day (April 26), consisting of two plenary sessions, at the National Academy of Sciences (NAS) in Washington, DC. More recent developments in fission science and technology in addition to historical reflections were topics for two fully days of sessions (April 27 and 28) at the main site of the NIST in Gaithersburg, Maryland. The wide range of topics covered in this Volume 1 by this topical meeting included plenary invited, and contributed sessions entitled: Preclude to the First Chain Reaction -- 1932 to 1942; Early Fission Research -- Nuclear Structure and Spontaneous Fission; 50 Years of Fission, Science, and Technology; Nuclear Reactors, Secure Energy for the Future; Reactors 1; Fission Science 1; Safeguards and Space Applications; Fission Data; Nuclear Fission -- Its Various Aspects; Theory and Experiments in Support of Theory; Reactors and Safeguards; and General Research, Instrumentation, and By-Product. The individual papers have been cataloged separately

  10. Fifty years of polymer science

    NARCIS (Netherlands)

    Du Prez, Filip; Hoogenboom, Richard; Klumperman, Bert; Meier, Michael; Monteiro, Michael; Müller, Alejandro; Vancso, Gyula J.


    The European Polymer Journal (EPJ) has been serving the scientific community for 50 years, which makes it one of the older macromolecular journals with a broad focus. Since its launch 50 years ago, EPJ has provided a distinguished forum for publications in polymer research, including chemistry,

  11. Fifty years of radiological protection

    International Nuclear Information System (INIS)


    On 21 March 1957, the Steering Committee for Nuclear Energy of the Organisation for European Economic Co-operation established the Working Party on Public Health and Safety. From this early date onwards, radiological protection formed a central part of the work of what was to become the OECD Nuclear Energy Agency. Now, 50 years later, the Committee on Radiation Protection and Public Health (CRPPH) has commissioned this historical review of half a century of work and accomplishments. Over this period, the key topics in radiological protection have been identified, debated and addressed by the CRPPH. This report brings this history to life, presenting the major questions in the context of their time, and of the personalities who worked to address them. The developments and views of the past condition how we are able to assess and manage radiological risks today, as well as how we may adjust to challenges that will or could emerge in the coming years. This heritage is thus an important element for the CRPPH to consider as it looks forward to its next 50 years of accomplishments. (author)

  12. Fifty years of symmetry operations

    International Nuclear Information System (INIS)

    Wigner, E.P.


    The author begins by discussing the application of symmetry principles in classical physics, which began 150 years ago. He then offers a few remarks on the essence of these principles and their role in the structure of physics; events, laws of nature, and invariance principles - kinematic and then dynamic - are treated. After this general discussion of the various types of symmetries, he considers the fundamental differences in their application in classical and quantum physics; the symmetry principles have greater effectiveness in quantum theory. After a few critical remarks of a general nature on the invariance principles, the author reviews the application of symmetry principles in various areas of quantum mechanics: atomic spectra, molecular physics, solid state physics, nuclear physics, and particle physics. He notes that the role of the different symmetries recognized to be approximate provide the most interesting conclusions

  13. Fifty years of radiochemical tracers

    International Nuclear Information System (INIS)

    Evans, E.A.


    During the past 50 years radiochemical tracers, usually in the form of isotopically labelled organic compounds, have been essential tools to further advance our knowledge at the frontiers of a great variety of scientific developments in the life sciences. This plenary lecture reviews necessarily selected highlights in the synthesis and applications of such radiochemical tracers. Included are examples where important advances, made possible by using radiochemicals, have contributed to improving the quality of life on this planet. The principal radioisotopes involved, 14 C, 3 H, 35 S, 32 P, 125 I, are all relatively safe to handle and are commercially available at maximum theoretical specific activity (carrier free). The compounds labeled with these radioisotopes are used in many fields of research which include biosynthesis and biotechnology studies, cell biology, drug metabolism, clinical research and environmental applications, and are briefly reviewed. (author). 55 refs

  14. Homo cyborg: fifty years old

    Directory of Open Access Journals (Sweden)

    Chris Hables Gray


    Full Text Available While the term “cyborg” is only 50 years old, the process that has produced cyborgization is much older: the evolution of the human. Humans have evolved to modify ourselves and our environment, especially through evolving culture and the technologies it creates. Culture is part of nature. Today’s mundane i-cyborgs, military drones, intimate human-machine merging and genetic engineering are a result of this; which in turn produce feelings of uncanniness, hubris, and fear. Contemporary politics must take this complex dynamic into account if we are to secure a sustainable, survivable, future for ourselves and our descendents. Social experiments such as Burning Man are a prefiguration of the kinds of (self conscious techno-social creativity needed.

  15. Vannevar Bush: Fifty Years Later (United States)

    Lagowski, J. J.


    It is ironic that the 50th anniversary year of Vannevar Bush's Report to President Truman entitled "Science the Endless Frontier", which put into motion the eminently successful current system of education of scientists in this country occurs at a time when serious questions are being asked about the usefulness of that very system. Bush viewed his proposal to establish a national research foundation (later to be called the National Science Foundation) as a "social compact." Judgment of scientific merit would be delegated to expert peers in return for scientific progress, which would ultimately benefit the nation in terms of scientific needs--military security, economic productivity, and enhanced quality of life. Bush wanted the funding of basic research intertwined with training, and preferred to use universities for this purpose rather than industrial or national labs. Bush viewed college and university scientists as teachers and investigators. He believed university-based research would uniquely encourage and engage the next generation of scientists as no other institutional arrangement could. Bush did not trust industry's commitment to basic research, an instinct that proved prophetic. The academic reserve of scientists (PhD's in training and postdoctoral students) that existed before World War II, and upon which the United States could draw for its needs, which were primarily associated with defense efforts, was probably one of the defining factors in Bush's suggested strategy. Currently, that reserve of talent has gotten so large that it is the obvious throttle in the pipeline slowing the continued development of the university research enterprise. Since 1977, the rate at which we have trained new scientists exceeds an average of 4% annually. Since 1987, the "science work force"--PhD's--has grown at three times the rate of the general labor supply. Temporary positions for postdoctoral scientists have grown even faster (over 5% per year since 1989). To compound

  16. Fifty years of Technical Cooperation

    International Nuclear Information System (INIS)


    The International Atomic Energy Agency (IAEA) was established in Vienna in 1957. The Statute of the IAEA, approved by 81 nations, founded the organization on three pillars: nuclear verification; safety and security; and the transfer of technology. Today, these three pillars still remain at the heart of the organization's work. However, the way in which the IAEA carries out this work, particularly with regard to technology transfer, has changed greatly over the years. When the IAEA opened for business, nuclear science and technology were in their infancy. Many Member States had no nuclear capacity at all. The IAEA's 'technical assistance' programme, as it was then known, was modest. Early projects were small in scale and short lived, focusing mainly on building human capacities and creating institutions and facilities that would support the introduction of nuclear technology in a safe and effective manner. Today, the picture is more complex. Instead of merely offering assistance, the IAEA focuses on cooperation for sustainable socioeconomic development, building on the skills and infrastructure that Member States have acquired over the past five decades. Member States are full partners in the process, guiding the IAEA's technical cooperation activities, setting national and regional priorities, and offering training opportunities and technical support to the IAEA and to other Member States. Technical cooperation between developing countries is facilitated and supported through regional cooperative agreements. Regional centres of expertise play an important role in sharing the benefits of nuclear science and technology among Member States

  17. Fifty years of shear zones (United States)

    Graham, Rodney


    We are here, of course, because 1967 saw the publication of John Ramsay's famous book. Two years later a memorable field trip from Imperial College to the Outer Hebrides saw John on a bleak headland on the coast of North Uist where a relatively undeformed metadolerite within Lewisian (Precambrian) gneisses contained ductile shear zones with metamorphic fabrics in amphibolite facies. One particular outcrop was very special - a shear zone cutting otherwise completely isotropic, undeformed metadolerite, with an incremental foliation starting to develop at 45° to the deformation zone, and increasing in intensity as it approached the shear direction. Here was proof of the process of simple shear under ductile metamorphic conditions - the principles of simple shear outlined in John Ramsay's 1967 book clearly visible in nature, and verified by Ramsay's mathematical proofs in the eventual paper (Ramsay and Graham, 1970). Later work on the Lewisian on the mainland of Scotland, in South Harris, in Africa, and elsewhere applied Ramsay's simple shear principles more liberally, more imprecisely and on larger scale than at Caisteal Odair, but in retrospect it documented what seems now to be the generality of mid and lower crustal deformation. Deep seismic reflection data show us that on passive margins hyper-stretched continental crust (whether or not cloaked by Seaward Dipping Reflectors) seems to have collapsed onto the mantle. Crustal faults mostly sole out at or above the mantle - so the Moho is a detachment- an 'outer marginal detachment', if you like, and, of course, it must be a ductile shear. On non-volcanic margins this shear zone forms the first formed ocean floor before true sea floor spreading gets going to create real oceanic crust. Gianreto Manatschal, Marcel Lemoine and others realised that the serpentinites described in parts of the Alps are exposed remnants of this ductile shear zone. Associated ophicalcite breccias tell of sea floor exposure, while high

  18. Fifty years of nuclear magnetic resonance

    International Nuclear Information System (INIS)

    Martinez Valderrama, Juan Crisostomo


    Short information about the main developments of nuclear magnetic resonance during their fifty existence years is presented. Beside two examples of application (HETCOR and INADEQUATE) to the structural determination of organic compounds are described

  19. Information Systems Curricula: A Fifty Year Journey (United States)

    Longenecker, Herbert E., Jr.; Feinstein, David; Clark, Jon D.


    This article presents the results of research to explore the nature of changes in skills over a fifty year period spanning the life of Information Systems model curricula. Work begun in 1999 was expanded both backwards in time, as well as forwards to 2012 to define skills relevant to Information Systems curricula. The work in 1999 was based on job…

  20. Fifty years ago - nuclear physics at Cambridge

    International Nuclear Information System (INIS)

    Burcham, W.E.


    Fifty years ago, the Cavendish saw the first nuclear transformations using artificially accelerated particles, and was soon to provide confirmation of the discovery of the positron. In 1932, the Cavendish Laboratory under the guiding hand of Rutherford was a world focus for research and with these discoveries saw the birth of modern particle physics. (orig.).

  1. First Fifty Years of Chemoresistive Gas Sensors

    Directory of Open Access Journals (Sweden)

    Giovanni Neri


    Full Text Available The first fifty years of chemoresistive sensors for gas detection are here reviewed, focusing on the main scientific and technological innovations that have occurred in the field over the course of these years. A look at advances made in fundamental and applied research and leading to the development of actual high performance chemoresistive devices is presented. The approaches devoted to the synthesis of novel semiconducting materials with unprecedented nanostructure and gas-sensing properties have been also presented. Perspectives on new technologies and future applications of chemoresistive gas sensors have also been highlighted.

  2. Nuclear fission discovered fifty years ago

    International Nuclear Information System (INIS)

    Weis, M.


    Fifty years ago, Otto Hahn, Lise Meitner and Fritz Strassmann discovered the process of nuclear fission which, more than other scientific discoveries to date, profoundly has changed the world and continues to influence our life significantly: This discovery made the up to then incontestable physicists' view of the atom as an inseparable whole suddenly shatter to pieces. It has brought about the invaluable advantages of a peaceful utilization of nuclear energy, and at the same time put scientists in the position to build the most terrible weapon ever, threatening mankind and earth with complete destruction. All this certainly is reason enough to recall the scientists, their work and the spirit of the time. (orig.) [de

  3. Fifty years of 'Atoms for Peace'

    International Nuclear Information System (INIS)

    Heller, W.


    Fifty years ago, on December 8, 1953, the then U.S. President, Dwight D. Eisenhower, in his famous speech before the General Assembly of the United Nations proclaimed his 'Atoms for Peace' program, which was to initiate a policy of international cooperation. The event had been preceded by a policy of the United States intended to guarantee to the United States the monopoly in the production and use of nuclear weapons, which ultimately failed because of the resistance of the Soviet Union. The doctrine of a technological monopoly in the nuclear field was to be changed in favor of cooperative ventures under the rigorous control of the United States. The 1954 Atomic Energy Act clearly formulated the will to cooperate. Following a U.S. initiative, the International Atomic Energy Agency (IAEA) was founded in 1956 to assist in transfers of nuclear technology and assume controlling functions to prevent abuse for non-peaceful purposes. Quite a number of countries used the 'Atoms for Peace' offer to develop nuclear power in very close cooperation with American industry and depending on U.S. nuclear fuel supply. On the whole, 'Atoms for Peace' has paved the way to a worldwide peaceful use of nuclear power. (orig.)

  4. The Kramers problem: Fifty years of development

    International Nuclear Information System (INIS)

    Mel'nikov, V.O.


    In the last fifty years the seminal work by Kramers of 1940 has been greatly extended both by elaboration of new theoretical approaches and through applications to new experimental systems. The most interesting case turns out to be the regime of weak-to-medium damping, in which case the Fokker-Planck equation can be reduced to an equation or to a system of integral equations of the Wiener-Hopf type. Exact solutions can then be given for the escape rate from single- and double-well potentials. This general scheme can be naturally extended to include quantum penetration through a semiclassical barrier and the effect of quantum noise. Finally, we consider the Brownian motion in a tilted washboard potential using Josephson junctions as an illustrative example. In that context we calculate (i) fluctuation-induced voltage-current characteristics, (ii) the lifetime of a zero-voltage state, (iii) the lifetime of the running state, (iv) partial probabilities of the phase jumps by 2πn (n is an integer) and (v) retrapping current distribution in both classical and quantum regimes. (author). 61 refs, 17 figs

  5. Fifty years after Hiroshima and Nagasaki

    International Nuclear Information System (INIS)

    Nishiwaki, Y.


    factors such as those mentioned above must be considered in interpreting the effect of the atomic bombing, instead of ascribing all the effects solely to ionizing radiation. Fifty years ago, in 1945, the first three atomic bombs in human history were produced by the United States; one of these bombs was exploded experimentally at the testing ground in the desert 80 km from Alamogordo, New Mexico, on 16 July. The remaining two were used against Japan; the one called L ittle Boy , using Uranium 235 was dropped on Hiroshima on 6 August, the other F at Man , using Plutonium 239 on Nagasaki on 9 August, 1945

  6. Fifty years of science, memories, and events

    CERN Multimedia


    In 2004 CERN celebrates its 50th anniversary. More precisely, on Wednesday 29 September 2004, the signature of the convention that established CERN will be 50 years old. During this special year, CERN's public web site will host a celebratory Fiftieth Anniversary web site.

  7. Fifty years of driving safety research. (United States)

    Lee, John D


    This brief review covers the 50 years of driving-related research published in Human Factors, its contribution to driving safety, and emerging challenges. Many factors affect driving safety, making it difficult to assess the impact of specific factors such as driver age, cell phone distractions, or collision warnings. The author considers the research themes associated with the approximately 270 articles on driving published in Human Factors in the past 50 years. To a large extent, current and past research has explored similar themes and concepts. Many articles published in the first 25 years focused on issues such as driver impairment, individual differences, and perceptual limits. Articles published in the past 25 years address similar issues but also point toward vehicle technology that can exacerbate or mitigate the negative effect of these issues. Conceptual and computational models have played an important role in this research. Improved crash-worthiness has contributed to substantial improvements in driving safety over the past 50 years, but future improvements will depend on enhancing driver performance and perhaps, more important, improving driver behavior. Developing models to guide this research will become more challenging as new technology enters the vehicle and shifts the focus from driver performance to driver behavior. Over the past 50 years, Human Factors has accumulated a large base of driving-related research that remains relevant for many of today's design and policy concerns.

  8. Fifty years of allergy: 1965-2015. (United States)

    Campbell, Dianne E; Mehr, Sam


    The last 50 years in allergy could almost be considered the first 50 years. Over this time period, we have witnessed the emergence of allergy as a subspecialty, have seen and continue to observe a tremendous change in prevalence of allergic disease and have gained insight into the mechanisms that underlie allergic predisposition and disease manifestation. We have improved the care of children with many forms of allergic disease and now sit poised to be able to alter the natural history of allergic disease with the use of specific immunotherapy. There is much left to do in the next 50 years including understanding what underlies both the predisposition to atopic disease and its natural resolution and identifying the environmental cofactors involved in the 'allergic epidemic' and therefore targets for effective primary prevention. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Environment and Change, The Next Fifty Years. (United States)

    Ewald, William R., Jr.

    As the second of three volumes published in connection with the American Institute of Planners' two-year study program, this book offers realistic goals toward which urban planning must direct itself if human society is to fulfill its need and capability for advancement. It stresses the fact that the nation can no longer afford the haphazard urban…

  10. Fifty years of atoms for peace

    International Nuclear Information System (INIS)

    Airey, P.; Tuniz, C.


    The nuclear community around the world will be marking the 50th anniversary of President Eisenhower's Atoms for Peace Speech on 8 December 2003. The Lawrence Livermore National Laboratory is organising a series of seminars in the US, Japan and France which will culminate in consensus statement Atoms for Peace after 50 Years; New Challenges and Opportunities. A separate initiative has seen the foundation of the World Nuclear University with the mission to strengthen international institutions to guide the ongoing development of the peaceful nuclear technology. The challenge for the nuclear community over the next 50 years is to redefine and recommit to the old vision in a new world challenged by new dimensions in national security, by environmental degradation and by the impacts of population pressures coupled with predicted climate change

  11. Fifty years of progress in acoustic phonetics (United States)

    Stevens, Kenneth N.


    Three events that occurred 50 or 60 years ago shaped the study of acoustic phonetics, and in the following few decades these events influenced research and applications in speech disorders, speech development, speech synthesis, speech recognition, and other subareas in speech communication. These events were: (1) the source-filter theory of speech production (Chiba and Kajiyama; Fant); (2) the development of the sound spectrograph and its interpretation (Potter, Kopp, and Green; Joos); and (3) the birth of research that related distinctive features to acoustic patterns (Jakobson, Fant, and Halle). Following these events there has been systematic exploration of the articulatory, acoustic, and perceptual bases of phonological categories, and some quantification of the sources of variability in the transformation of this phonological representation of speech into its acoustic manifestations. This effort has been enhanced by studies of how children acquire language in spite of this variability and by research on speech disorders. Gaps in our knowledge of this inherent variability in speech have limited the directions of applications such as synthesis and recognition of speech, and have led to the implementation of data-driven techniques rather than theoretical principles. Some examples of advances in our knowledge, and limitations of this knowledge, are reviewed.

  12. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki


    Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

  13. Fifty years of German nuclear legislation

    International Nuclear Information System (INIS)

    Heller, W.


    The political situation and the state of legislation after World War II make it difficult to pinpoint a precise date of origin of German nuclear legislation. The restrictions imposed by the Allied High Commission (AHC) without any exception put a ban on the production of uranium and thorium metal as well as the construction of nuclear reactors. These restrictions were lifted expressly when the German Atomic Energy Act (AtG) entered into force on January 1, 1960, i.e. much later than the formal step of gaining sovereignty, which was marked by the protocol of May 5, 1955 terminating the Occupation Statute. In October 1955, the German federal government established the then Federal Ministry for Atomic Matters also in an attempt to reconnect to developments in nuclear fission in other parts of the Western world. To supersede the AHC law, the German federal government in December 1956 publicized a draft Atomic Energy Act. It is safe, therefore, to consider that year the starting point of German atomic legislation. This step was followed by deliberations preparatory to the adoption of the Atomic Energy Act. In 1957, however, adoption failed because no two-thirds majority was reached to amend the Basic Law, i.e. the Constitution. As a consequence, some federal states saw the need to adopt state legislation to regulate this area. On December 3, 1959, a new draft Atomic Energy Act was adopted by the German federal parliament after the second and third readings - coupled with an amendment to the Basic Law on that same day - with the votes of the opposition and with one abstention. (orig.)

  14. Atoms for Peace after Fifty Years

    International Nuclear Information System (INIS)

    Joeck, N.; Lehman, R.; Vergino, E.; Schock, R.


    President Eisenhower's hopes for nuclear technology still resonate, but the challenges to fulfilling them are much different today. On December 8, 1953, President Eisenhower, returning from his meeting with the leaders of Britain and France at the Bermuda Summit, flew directly to New York to address the United Nations General Assembly. His presentation, known afterwards as the ''Atoms for Peace'' speech, was bold, broad, and visionary. Eisenhower highlighted dangers associated with the further spread of nuclear weapons and the end of the thermonuclear monopoly, but the president also pointed to opportunities. Earlier that year, Stalin had died and the Korean War armistice was signed. Talks on reunification of Austria were about to begin. The speech sought East-West engagement and outlined a framework for reducing nuclear threats to security while enhancing the civilian benefits of nuclear technology. One specific proposal offered to place surplus military fissile material under the control of an ''international atomic energy agency'' to be used for peaceful purposes, especially economic development. Eisenhower clearly recognized the complex interrelationships between different nuclear technologies and the risks and the benefits that accrue from each. The widespread use of civilian nuclear technology and absence of any use of a nuclear weapon during the next half-century reflects success in his approach. Today, the world faces choices about nuclear technology that have their parallels in the Eisenhower calculus and its legacy. Although his specific fissile material proposal was never implemented, his broader themes gave impetus to agreements such as the nuclear Non-Proliferation Treaty (NPT) and institutions such as the International Atomic Energy Agency (IAEA). The resulting governance process has promoted some and restricted other nuclear technology. Perhaps even more influential was Eisenhower's overarching recommendation that we try to reduce the risks and seek

  15. Fifty Years of Lightning Observations from Space (United States)

    Christian, H. J., Jr.


    Some of the earliest satellites, starting with OSO (1965), ARIEL (1967), and RAE (1968), detected lightning using either optical and RF sensors, although that was not their intent. One of the earliest instruments designed to detect lightning was the PBE (1977). The use of space to study lightning activity has exploded since these early days. The advent of focal-plane imaging arrays made it possible to develop high performance optical lightning sensors. Prior to the use of charged-coupled devices (CCD), most space-based lightning sensors used only a few photo-diodes, which limited the location accuracy and detection efficiency (DE) of the instruments. With CCDs, one can limit the field of view of each detector (pixel), and thus improve the signal to noise ratio over single-detectors that summed the light reflected from many clouds with the lightning produced by a single cloud. This pixelization enabled daytime DE to increase from a few percent to close to 90%. The OTD (1995), and the LIS (1997), were the first lightning sensors to utilize focal-plane arrays. Together they detected global lightning activity for more than twenty years, providing the first detailed information on the distribution of global lightning and its variability. The FORTE satellite was launched shortly after LIS, and became the first dedicated satellite to simultaneously measure RF and optical lightning emissions. It too used a CCD focal plane to detect and locate lightning. In November 2016, the GLM became the first lightning instrument in geostationary orbit. Shortly thereafter, China placed its GLI in orbit. Lightning sensors in geostationary orbit significantly increase the value of space-based observations. For the first time, lightning activity can be monitored continuously, over large areas of the Earth with high, uniform DE and location accuracy. In addition to observing standard lightning, a number of sensors have been placed in orbit to detect transient luminous events and

  16. Fifty years of Jaynes-Cummings physics (United States)

    Greentree, Andrew D.; Koch, Jens; Larson, Jonas


    electromagnetic modes, arrays of coupled cavities [5-7], and optomechanical systems [8] have further enriched the physics of the Jaynes-Cummings model. From the early interests in masers and the consistent quantum description of radiation and atom-photon interaction, the Jaynes-Cummings model has evolved into a cornerstone of quantum state engineering [9]. The authors of this editorial had not been born when Jaynes and Cummings wrote their remarkable paper. It is, therefore, a special honour for us to be able to draw the reader's attention to the accompanying reminiscence contributed by Frederick Cummings where he gives us a glimpse of the early history of the Jaynes-Cummings model from his perspective [11]. By now, the original 1963 paper by Jaynes and Cummings has gathered numerous citations and, at the time of writing, the number of articles involving Jaynes-Cummings physics is approaching 15 000.1 This special issue does not attempt to review this impressive wealth of research. The interested reader, however, is urged to consult the definitive article by Shore and Knight [10] for a comprehensive review of the first 30 years of Jaynes-Cummings physics. The collection of 26 papers presented in this issue, showcases a snapshot of some of the most recent and continuing research devoted to Jaynes-Cummings physics. We begin our special issue with Professor Cumming's recollections [11]. We then have six papers on quantum information aspects of the Jaynes-Cummings model [12-17]. The next topic includes seven papers on the Dicke and generalized Jaynes-Cummings models [18-24], followed by six papers on circuit QED, which is one of the most important experimental frameworks for Jaynes-Cummings systems [25-30]. Finally, we have six papers on the extension to many cavities, the Jaynes-Cummings-Hubbard model [31-36]. The snapshot of research captured in this special issue illustrates the unifying language provided by the Jaynes-Cummings model, tying together research in a number of

  17. EDITORIAL: Semiconductor lasers: the first fifty years Semiconductor lasers: the first fifty years (United States)

    Calvez, S.; Adams, M. J.


    Anniversaries call for celebrations. Since it is now fifty years since the first semiconductor lasers were reported, it is highly appropriate to celebrate this anniversary with a Special Issue dedicated to the topic. The semiconductor laser now has a major effect on our daily lives since it has been a key enabler in the development of optical fibre communications (and hence the internet and e-mail), optical storage (CDs, DVDs, etc) and barcode scanners. In the early 1960s it was impossible for most people (with the exception of very few visionaries) to foresee any of these future developments, and the first applications identified were for military purposes (range-finders, target markers, etc). Of course, many of the subsequent laser applications were made possible by developments in semiconductor materials, in the associated growth and fabrication technology, and in the increased understanding of the underlying fundamental physics. These developments continue today, so that the subject of semiconductor lasers, although mature, is in good health and continues to grow. Hence, we can be confident that the pervasive influence of semiconductor lasers will continue to develop as optoelectronics technology makes further advances into other sectors such as healthcare, security and a whole host of applications based on the global imperatives to reduce energy consumption, minimise environmental impact and conserve resources. The papers in this Special Issue are intended to tell some of the story of the last fifty years of laser development as well as to provide evidence of the current state of semiconductor laser research. Hence, there are a number of papers where the early developments are recalled by authors who played prominent parts in the story, followed by a selection of papers from authors who are active in today's exciting research. The twenty-fifth anniversary of the semiconductor laser was celebrated by the publication of a number of papers dealing with the early

  18. Fifty years of Cuba's medical diplomacy: from idealism to pragmatism. (United States)

    Feinsilver, Julie M


    Medical diplomacy, the collaboration between countries to simultaneously produce health benefits and improve relations, has been a cornerstone of Cuban foreign policy since the outset of the revolution fifty years ago. It has helped Cuba garner symbolic capital (goodwill, influence, and prestige) well beyond what would have been possible for a small, developing country, and it has contributed to making Cuba a player on the world stage. In recent years, medical diplomacy has been instrumental in providing considerable material capital (aid, credit, and trade), as the oil-for-doctors deals with Venezuela demonstrates. This has helped keep the revolution afloat in trying economic times. What began as the implementation of the one of the core values of the revolution, namely health as a basic human right for all peoples, has continued as both an idealistic and a pragmatic pursuit. This article examines the factors that enabled Cuba to conduct medical diplomacy over the past fifty years, the rationale behind the conduct of this type of soft power politics, the results of that effort, and the mix of idealism and pragmatism that has characterized the experience. Moreover, it presents a typology of medical diplomacy that Cuba has used over the past fifty years.

  19. Nuclear spin: Fifty years of ups and downs

    Energy Technology Data Exchange (ETDEWEB)

    Pines, A. [Lawrence Berkeley National Lab., CA (United States)


    Rumors of its demise notwithstanding, nuclear magnetic resonance (NMR) continues to flourish fifty years after our birth. The lecture will be a reminiscence about moments of excitation, coherence and relaxation in the history of NMR which produced, among other developments, spin echoes and time reversal, Fourier transform and multidimensional spectroscopy, magnetic resonance imaging, and high resolution solid state NMR. Applications of modern NMR spectroscopy cut across the boundaries of physics, chemistry, materials, biology and medicine.

  20. Fifty years of sociological leadership at Social Science and Medicine. (United States)

    Timmermans, Stefan; Tietbohl, Caroline


    In this review article, we examine some of the conceptual contributions of sociology of health and illness over the past fifty years. Specifically, we focus on research dealing with medicalization, the management of stigma, research on adherence and compliance, and patient-doctor interaction. We show how these themes that originated within sociology, diffused in other disciplines. Sociology in Social Science and Medicine started as an applied research tradition but morphed into a robust, stand-alone social science tradition. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Fifty years in fusion and the way forward

    International Nuclear Information System (INIS)

    Jacquinot, J.


    This particular 'Fusion Pioneers Memorial lecture' was given 50 years after the first historical FEC conference in 1958. It was a unique occasion to perform a global reflection on thermonuclear fusion which is summarized in this paper. We first consider the case for fusion energy then move on to the scientific achievements during the past five decades. Finally, the lessons drawn from the past give a framework to consider the challenges ahead of us. The 1958 pioneers had the vision of the vital importance of international collaboration to succeed in this unique endeavour. Fifty years later, this vision has amply proven its worth. Looking at the way forward, this vision constitutes a strong basis to harness fusion energy in the decades to come.

  2. Fifty years of mathematical physics selected works of Ludwig Faddeev

    CERN Document Server

    Faddeev, Ludwig; Niemi, Antti J


    This unique volume summarizes with a historical perspective several of the major scientific achievements of Ludwig Faddeev, with a foreword by Nobel Laureate C N Yang. The volume that spans over fifty years of Faddeev's career begins where he started his own scientific research, in the subject of scattering theory and the three-body problem. It then continues to describe Faddeev's contributions to automorphic functions, followed by an extensive account of his many fundamental contributions to quantum field theory including his original article on ghosts with Popov. Faddeev's contributions to soliton theory and integrable models are then described, followed by a survey of his work on quantum groups. The final scientific section is devoted to Faddeev's contemporary research including articles on his long-term interest in constructing knotted solitons and understanding confinement. The volume concludes with his personal view on science and mathematical physics in particular.

  3. The fifty-year-old woman and midlife stress. (United States)

    Campbell, S

    It has been assumed that the fifties are a relatively stable decade; however, women in their fifties are susceptible to many stresses, internal and external. The possibilities of widowhood, divorce, or poverty, combined with intra- and interpersonal strains, make this a time of insecurity about aging for many women. Some suggestions as to why women nonetheless cope successfully with aging are considered.

  4. The anomaly of Marquesan ceramics : a fifty year retrospective

    International Nuclear Information System (INIS)

    Allen, M.S.; Dickinson, W.R.; Huebert, J.M.


    Fifty years ago pioneering archaeologist Robert Suggs reported a small number of pottery sherds from the Marquesas Islands. The first such finds in East Polynesia, at the time they were considered indicative of both a Marquesan homeland and local ceramic manufacture. In the intervening years, additional sherds have been recovered from three other Marquesan localities resulting in a total of 14 specimens. Prior petrographic studies demonstrate unambiguously that some derive from Fiji. Others have been interpreted historically as representative of an indigenous Marquesan ceramic industry. Here we bring together key petrographic analyses from Polynesia, recent chronological assessments of the Marquesan sequence, and insights from new field research to reassess the origins and chronology of Marquesan pottery. We suggest that there is little support for an indigenous Marquesan ceramic industry, and most likely all of the specimens are imports. With respect to the timing of ceramic arrivals, three hypotheses are explored: 1) with founding settlers, 2) as a component of long-distance exchange networks operating between the 12th to 16th centuries AD, or 3) as late prehistoric or historic imports. The preponderance of evidence points to the second alternative, although the other two cannot be completely discounted for the assemblage as a whole. (author). 63 refs., 5 figs., 3 tabs.

  5. The Proton Synchrotron, going strong at fifty years

    CERN Multimedia

    Django Manglunki

    It was on the evening of 24 November 1959 that an incredulous Hildred Blewett, on detachment to CERN from the Brookhaven laboratory, exclaimed “Yes! We’re through transition!” The first beam of ten billion protons had not only broken through the 5.2 GeV barrier but gone on all the way to 24 GeV, the machine’s top energy at that time.   An operational screenshot from the PS, taken on its 50th anniversary. The three white peaks depict different phases (cycles) of the PS’s operation. In the first and third cycle, the PS is producing a very low-intensity beam for LHC commissioning. In the second cycle, protons are being spilled out for use in the East Area. Fifty years ago the PS, the first strong-focusing proton synchrotron using alternating gradient technology, first began to circulate beams at an unprecedented level of energy. Over the years, a complex of linear and circular accelerators and storage rings grew up around the PS. In the mid-1990s ...

  6. Fifty years of hemodialysis access literature: The fifty most cited publications in the medical literature. (United States)

    Skripochnik, Edvard; O'Connor, David J; Trestman, Eric B; Lipsitz, Evan C; Scher, Larry A


    Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014. Articles were selected based on a subject search and were ranked according to the number of times they were cited in the medical literature. Results The 50 most frequently cited articles were selected for further analysis and the number of annual publications was tracked. The landmark publication by Dr Brescia et al. was unequivocally the most cited article dealing with hemodialysis access (1109 citations). The subject matter of the papers included AV fistula and graft (9), hemodialysis catheter (9), complications and outcomes (24), and other topics (8). Most articles were published in nephrology journals (33), with fewer in surgery (7), medicine (7), and radiology (3) journals. Of the 17 journals represented, Kidney International was the clear leader, publishing 18 articles. There has been an exponential rise in the frequency of publications regarding dialysis access with 42 of 50 analyzed papers being authored after 1990. Conclusion As the number of patients on hemodialysis has increased dramatically over the past five decades, there has been a commensurate increase in the overall number of publications related to hemodialysis access.

  7. Fifty years of fuzzy logic and its applications

    CERN Document Server

    Rishe, Naphtali; Kandel, Abraham


    This book presents a comprehensive report on the evolution of Fuzzy Logic since its formulation in Lotfi Zadeh’s seminal paper on “fuzzy sets,” published in 1965. In addition, it features a stimulating sampling from the broad field of research and development inspired by Zadeh’s paper. The chapters, written by pioneers and prominent scholars in the field, show how fuzzy sets have been successfully applied to artificial intelligence, control theory, inference, and reasoning. The book also reports on theoretical issues; features recent applications of Fuzzy Logic in the fields of neural networks, clustering, data mining, and software testing; and highlights an important paradigm shift caused by Fuzzy Logic in the area of uncertainty management. Conceived by the editors as an academic celebration of the fifty years’ anniversary of the 1965 paper, this work is a must-have for students and researchers willing to get an inspiring picture of the potentialities, limitations, achievements and accomplishments...

  8. Student Interviews Fifty Years Later: An Oral History



    The Regional History Project at UC Santa Cruz has rich collections of interviews with generations of narrators, ranging across the administration, faculty, and staff. In the early years of the campus, founding director Elizabeth Spedding Calciano conducted two rounds of interviews focused on the student experience at what was then the newest campus of the University of California. Those interviews, conducted in 1967 and 1969 as the campus was still adding a new college every year, give a wind...

  9. Fifty years of CERN history in the spotlight

    CERN Document Server


    The programme of events for CERN's Golden Jubilee year was officially unveiled at a press conference on 8 March. The first of these events took place the following day, when the Swiss commemorative postage stamp issued in the Laboratory's honour went on sale in post offices throughout Switzerland.

  10. Fifty years of invasion ecology: The legacy of Charles Elton

    Czech Academy of Sciences Publication Activity Database

    Richardson, D. M.; Pyšek, Petr


    Roč. 14, č. 2 (2008), s. 161-168 ISSN 1366-9516 R&D Projects: GA MŠk(CZ) LC06073 Institutional research plan: CEZ:AV0Z60050516 Keywords : bibliometric analysis * biological invasions * citation analysis Subject RIV: EF - Botanics Impact factor: 3.446, year: 2008

  11. Fifty years of Tsetse control in Tanzania: challenges and prospects ...

    African Journals Online (AJOL)

    Even after 50 years of independence, Human African Trypanosomiasis (HAT) or Sleeping Sickness is still one of the major public health problems with about 300 cases being reported annually. Tsetse control has been sporadic and uncoordinated hence no tangible results have been accrued since independence despite ...

  12. Fifty Years of Boundary-Layer Theory and Experiment (United States)

    Dryden, Hugh L.


    The year 1954 marked the 50th anniversary of the Prandtl boundary-layer theory from which we may date the beginning of man's understanding of the dynamics of real fluids. A backward look at this aspect of the history of the last 50 years may be instructive. This paper (1) attempts to compress the events of those 50 years into a few thousand words, to tell in this brief space the interesting story of the development of a new concept, its slow acceptance and growth, its spread from group to group within its country of origin, and its diffusion to other countries of the world. The original brief paper of Prandtl (2) was presented at the Third International Mathematical Congress at Heidelberg in 1904 and published in the following year. It was an attempt to explain the d'Alembert paradox, namely, that the neglect of the small friction of air in the theory resulted in the prediction of zero resistance to motion. Prandtl set himself the task of computing the motion of a fluid of small friction, so small that its effect could be neglected everywhere except where large velocity differences were present or a cumulative effect of friction occurred This led to the concept of boundary layer, or transition layer, near the wall of a body immersed in a fluid stream in which the velocity rises from zero to the free-stream value. It is interesting that Prandtl used the term Grenzsehicht (boundary layer) only once and the term Ubergangsschicht (transition layer) seven times in the brief article. Later writers also used Reibungsschicht (friction layer), but most writers today use Grenzschicht (boundary layer).

  13. Bibliometric analysis of fifty years of physica status solidi

    Energy Technology Data Exchange (ETDEWEB)

    Marx, Werner [Max Planck Institute for Solid State Research, Stuttgart (Germany); Hoffmann, Dieter [Max Planck Institute for the History of Sciences, Berlin (Germany)


    Bibliometric methods are used to analyze quantitatively the journal physica status solidi (pss) 50 years after its inception. First, the coverage of the journal by the relevant citation indices accessible under the Web of Science (WoS) and the field-specific INSPEC database is examined. The number of papers published per year by the journal as a whole and by the specific pss series is given. The time evolution of the pss output in terms of papers per year is compared with the output evolution of some major competing journals in the field of condensed-matter physics. The top-12 most frequently cited pss papers published within the complete time period 1961-2010 and within the two separate time periods 1974-1989 and 1990-2010 (before and after the German reunification) are listed. The citation time curves (citation history) of the three most frequently cited pss papers are presented. Furthermore, the Journal Impact Factors (JIFs) of the pss journal series (a) and (b) are discussed and their time evolution is shown. Moreover, the distribution of the pss papers over their document types and the authors is given. The countries of authors are ranked for the complete time period 1961-2010 as well as for the time periods 1973-1989 and 1990-2010. The complete ensemble of the citing papers of the pss papers is analyzed and discussed. The journals citing most often the pss papers published in the year 2000 are listed. Finally, the distribution of the pss papers over the various subject areas and classification terms based on the INSPEC database is tabled. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  14. DMPD: Fifty years of interferon research: aiming at a moving target. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available mmunity. 2006 Sep;25(3):343-8. (.png) (.svg) (.html) (.csml) Show Fifty years of interferon research: aiming at a moving target. Pubm...edID 16979566 Title Fifty years of interferon research: aiming at a moving target.

  15. Fifty years of IAA History Symposia (1967-2016) (United States)

    Skoog, A. Ingemar; Hall, R. Cargill


    The International Academy of Astronautics (IAA) Symposia on the History of Rocketry and Astronautics have been held annually at the International Astronautical Congresses since 1967. During these past 50 years nearly 800 papers have been presented and subsequently published in the proceedings. With a 20-year rule imposed for historical presentations, the first 10 symposia concentrated on pre-World War II and early 1950s activities. A surprisingly large number of papers on early, less well-known Soviet-Russian contributions to rocketry and astronautics were presented in the first symposia, despite the ongoing Space Race between the U.S and USSR. Another important element in these symposia involved memoir papers offered by pre- and post-war rocket and astronautics pioneers from many countries, and the participation of many of these pioneers in person. In sum, the history of national space and rocket projects from some 40 countries were presented over the years in IAA History Symposia. These 50 symposia have provided a platform for scholars and professional and non-professional historians to meet and discuss the history of rocketry and astronautics, and to personally interview many space pioneers, most of whom today are deceased. Their personal recollections have since been shared with a large audience. Over time, IAA history papers divided into recognizable periods: ancient times through the 19th century, and the 20th and 21st centuries, which separate among actions and events that took place before 1945, in 1945 to 1957, and after 1957 (which marked the beginning of the space age). Proceedings of the IAA History Symposia have been published in English, ultimately in the History Series of the American Astronautical Society (AAS) and its publishing arm, Univelt Inc., under an agreement secured with the IAA. This paper presents an overview of the IAA History Symposia. It examines the early years of the history committee and its first symposium, the evolution of

  16. Fifty years of fuel quality and vehicle emissions

    Energy Technology Data Exchange (ETDEWEB)

    Rose, K. [CONCAWE, Brussels (Belgium)


    In the late 1970s, with growing emphasis on urban air quality in Europe, CONCAWE embarked on new research related to fuels and vehicles. After only a few years, it became clear that fuel properties and specifications would be increasingly important to the future of the European refining industry, and considerable research was completed in the 1970s to better understand the impact of fuel composition on vehicle performance and emissions. This early work led to the formation of the first Fuels and Emissions Management Group (FEMG) in 1982, almost 20 years after the formation of the CONCAWE Association. Since these early days, FEMG has been responsible for ensuring CONCAWE's strategic outlook on future vehicle and fuel developments, monitoring regulatory and vehicle developments, and overseeing a diverse portfolio of fuel quality and vehicle emissions research. Since the 1980s, tremendous progress has been made in improving European air quality, in part by reducing emissions from road transport and other sectors, and major improvements in European fuel qualities have contributed to these reductions. Nevertheless, many challenges are still ahead, especially further reductions in pollutant emissions from vehicles while also reducing greenhouse gas (GHG) emissions from transport. In the near-term, these GHG reductions will largely come from improvements in engine and vehicle fuel consumption and by blending of GHG-reducing bio-blending components. Dealing with these challenges to fuel quality and performance will require a continuing focus on CONCAWE's founding principles: sound science, cost effectiveness and transparency.

  17. Perspectives on Erving Goffman's "Asylums" fifty years on. (United States)

    Adlam, John; Gill, Irwin; Glackin, Shane N; Kelly, Brendan D; Scanlon, Christopher; Mac Suibhne, Seamus


    Erving Goffman's "Asylums" is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines.

  18. Changes in sunflower breeding over the last fifty years

    Directory of Open Access Journals (Sweden)

    Vear Felicity


    Full Text Available This article discusses changes in sunflower breeding objectives since the introduction of hybrid varieties 50 years ago. After a reminder of the importance of some early programmes, Canadian in particular, the present situation for each breeding objective is compared with those encountered earlier. Breeding for yield has changed from maximum possible yield under intensive agriculture to yield with resistance to abiotic stresses, moderate droughts and shallow soils in particular, helped by collaboration with agronomists to produce crop models. Breeding for oil has changed from quantity to quality and the value of seed meal is again becoming economically important. Necessary disease resistances vary with agronomic practises and selection pressure on pathogens according to varietal genetics. The possibilities of new types of sunflower are also discussed. Advances in genomics will change breeding procedures, but with rapidly changing molecular techniques, international collaboration is particularly important.


    Bayraktar, Ulas D.; Bashir, Qaiser; Qazilbash, Muzaffar; Champlin, Richard E.; Ciurea, Stefan O.


    Melphalan remains the most widely used agent in preparative regimens for hematopoietic stem-cell transplantation. From its initial discovery more than 50 years ago, it has been gradually incorporated in the conditioning regimens for both autologous and allogeneic transplantation due to its myeloablative properties and broad antitumor effects as a DNA alkylating agent. Melphalan remains the mainstay conditioning for multiple myeloma and lymphomas; and has been used successfully in preparative regimens of a variety of other hematological and non-hematological malignancies. The addition of newer agents to conditioning like bortezomib or lenalidomide for myeloma, or clofarabine for myeloid malignancies, may improve antitumor effects for transplantation, while in combination with alemtuzumab may represent a backbone for future cellular therapy due to reliable engraftment and low toxicity profile. This review summarizes the development and the current use of this remarkable drug in hematopoietic stem-cell transplantation. PMID:22922522

  20. Fifty years of federal radioactive waste management: Policies and practices

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, R.G.


    This report provides a chronological history of policies and practices relating to the management of radioactive waste for which the US Atomic Energy Commission and its successor agencies, the Energy Research and Development Administration and the Department of Energy, have been responsible since the enactment of the Atomic Energy Act in 1946. The defense programs and capabilities that the Commission inherited in 1947 are briefly described. The Commission undertook a dramatic expansion nationwide of its physical facilities and program capabilities over the five years beginning in 1947. While the nuclear defense activities continued to be a major portion of the Atomic Energy Commission`s program, there was added in 1955 the Atoms for Peace program that spawned a multiplicity of peaceful use applications for nuclear energy, e.g., the civilian nuclear power program and its associated nuclear fuel cycle; a variety of industrial applications; and medical research, diagnostic, and therapeutic applications. All of these nuclear programs and activities generated large volumes of radioactive waste that had to be managed in a manner that was safe for the workers, the public, and the environment. The management of these materials, which varied significantly in their physical, chemical, and radiological characteristics, involved to varying degrees the following phases of the waste management system life cycle: waste characterization, storage, treatment, and disposal, with appropriate transportation linkages. One of the benefits of reviewing the history of the waste management program policies and practices if the opportunity it provides for identifying the lessons learned over the years. Examples are summarized at the end of the report and are listed in no particular order of importance.

  1. Fifty years of federal radioactive waste management: Policies and practices

    International Nuclear Information System (INIS)

    Bradley, R.G.


    This report provides a chronological history of policies and practices relating to the management of radioactive waste for which the US Atomic Energy Commission and its successor agencies, the Energy Research and Development Administration and the Department of Energy, have been responsible since the enactment of the Atomic Energy Act in 1946. The defense programs and capabilities that the Commission inherited in 1947 are briefly described. The Commission undertook a dramatic expansion nationwide of its physical facilities and program capabilities over the five years beginning in 1947. While the nuclear defense activities continued to be a major portion of the Atomic Energy Commission's program, there was added in 1955 the Atoms for Peace program that spawned a multiplicity of peaceful use applications for nuclear energy, e.g., the civilian nuclear power program and its associated nuclear fuel cycle; a variety of industrial applications; and medical research, diagnostic, and therapeutic applications. All of these nuclear programs and activities generated large volumes of radioactive waste that had to be managed in a manner that was safe for the workers, the public, and the environment. The management of these materials, which varied significantly in their physical, chemical, and radiological characteristics, involved to varying degrees the following phases of the waste management system life cycle: waste characterization, storage, treatment, and disposal, with appropriate transportation linkages. One of the benefits of reviewing the history of the waste management program policies and practices if the opportunity it provides for identifying the lessons learned over the years. Examples are summarized at the end of the report and are listed in no particular order of importance

  2. Fifty years of progress in speech coding standards (United States)

    Cox, Richard


    Over the past 50 years, speech coding has taken root worldwide. Early applications were for the military and transmission for telephone networks. The military gave equal priority to intelligibility and low bit rate. The telephone network gave priority to high quality and low delay. These illustrate three of the four areas in which requirements must be set for any speech coder application: bit rate, quality, delay, and complexity. While the military could afford relatively expensive terminal equipment for secure communications, the telephone network needed low cost for massive deployment in switches and transmission equipment worldwide. Today speech coders are at the heart of the wireless phones and telephone answering systems we use every day. In addition to the technology and technical invention that has occurred, standards make it possible for all these different systems to interoperate. The primary areas of standardization are the public switched telephone network, wireless telephony, and secure telephony for government and military applications. With the advent of IP telephony there are additional standardization efforts and challenges. In this talk the progress in all areas is reviewed as well as a reflection on Jim Flanagan's impact on this field during the past half century.

  3. Fifty years of atomic time-keeping at VNIIFTRI

    International Nuclear Information System (INIS)

    Domnin, Y.; Gaigerov, B.; Koshelyaevsky, N.; Poushkin, S.; Rusin, F.; Tatarenkov, V.; Yolkin, G.


    Time metrology in Russia in the second half of the twentieth century has been marked, as in other advanced countries, by the rapid development of time and frequency quantum standards and the beginning of atomic time-keeping. This brief review presents the main developments and studies in time and frequency measurement, and the improvement of accuracy and atomic time-keeping at the VNIIFTRI-the National Metrology Institute keeping primary time and frequency standards and ensuring unification of measurement. The milestones along the way have been the ammonia and hydrogen masers, primary caesium beam and fountain standards and laser frequency standards. For many years, VNIIFTRI was the only world laboratory that applied hydrogen-maser clock ensembles for time-keeping. VNIIFTRI's work on international laser standard frequency comparisons and absolute frequency measurements contributed greatly to the adoption by the CIPM of a highly accurate value for the He-Ne/CH 4 laser frequency. VNIIFTRI and the VNIIM were the first to establish a united time, frequency and length standard. (authors)

  4. Fifty years of atomic time-keeping at VNIIFTRI

    Energy Technology Data Exchange (ETDEWEB)

    Domnin, Y.; Gaigerov, B.; Koshelyaevsky, N.; Poushkin, S.; Rusin, F.; Tatarenkov, V.; Yolkin, G. [VNIIFTRI (Russian Federation)


    Time metrology in Russia in the second half of the twentieth century has been marked, as in other advanced countries, by the rapid development of time and frequency quantum standards and the beginning of atomic time-keeping. This brief review presents the main developments and studies in time and frequency measurement, and the improvement of accuracy and atomic time-keeping at the VNIIFTRI-the National Metrology Institute keeping primary time and frequency standards and ensuring unification of measurement. The milestones along the way have been the ammonia and hydrogen masers, primary caesium beam and fountain standards and laser frequency standards. For many years, VNIIFTRI was the only world laboratory that applied hydrogen-maser clock ensembles for time-keeping. VNIIFTRI's work on international laser standard frequency comparisons and absolute frequency measurements contributed greatly to the adoption by the CIPM of a highly accurate value for the He-Ne/CH{sub 4} laser frequency. VNIIFTRI and the VNIIM were the first to establish a united time, frequency and length standard. (authors)

  5. Fifty years of atomic time-keeping at VNIIFTRI (United States)

    Domnin, Yu; Gaigerov, B.; Koshelyaevsky, N.; Poushkin, S.; Rusin, F.; Tatarenkov, V.; Yolkin, G.


    Time metrology in Russia in the second half of the twentieth century has been marked, as in other advanced countries, by the rapid development of time and frequency quantum standards and the beginning of atomic time-keeping. This brief review presents the main developments and studies in time and frequency measurement, and the improvement of accuracy and atomic time-keeping at the VNIIFTRI—the National Metrology Institute keeping primary time and frequency standards and ensuring unification of measurement. The milestones along the way have been the ammonia and hydrogen masers, primary caesium beam and fountain standards and laser frequency standards. For many years, VNIIFTRI was the only world laboratory that applied hydrogen-maser clock ensembles for time-keeping. VNIIFTRI's work on international laser standard frequency comparisons and absolute frequency measurements contributed greatly to the adoption by the CIPM of a highly accurate value for the He-Ne/CH4 laser frequency. VNIIFTRI and the VNIIM were the first to establish a united time, frequency and length standard.

  6. Nuclear chemistry fifty years after the discovery of artificial radioactivity

    International Nuclear Information System (INIS)

    Lefort, M.


    In January 1934, the observation and the chemical identification of radiophosphorus as a reaction product in the bombardment of Aluminium by alpha particles have been the first step of a new scientific branch: Nuclear Chemistry. We describe here how this discovery in itself contains the frame of all the development which has followed. It consisted in four stages, each of them being a crucial starting point. The first one is the possibility for a total balance of the nuclear reaction in the exit channels, so that reaction mechanisms can be studied. The second, the most important perhaps, is the opening of nuclear synthesis. Nuclear chemists can now interfere into nuclear matter and instead of staying as observers of the radioactive decays of natural isotopes, they were able to build up a numerous chart of various nuclear species, going step by step further and further away from the nuclear stability conditions. The third aspect of the discovery was the appearance of a new mode of radioactive decay with the production of the first particle an antimater. 50 years later, the instability due to a much larger excess of protons is known to induce the proton emission radioactivity for new species like 109 I or 115 Cs, in the vicinity of proton unstability. Finally, the last point, so fertile for the future, was the observation of a neutron in the exit channel, so that neutron fluxes could result from alpha induced nuclear reactions and became such a strong tool for the production of transuranium elements and for nuclear fission. In the present survey, the wide interest of the second point, i.e. the nuclear synthesis, is emphasized, as well as the huge change in the technical methods

  7. Fifty Years of Water Sensitive Urban Design, Salisbury, South Australia

    Institute of Scientific and Technical Information of China (English)

    John C.Radcliffe; Declan Page; Bruce Naumann; Peter Dillon


    Australia has developed extensive policies and guidelines for the management of its water.The City of Salisbury,located within metropolitan Adelaide,South Australia,developed rapidly through urbanisation from the 1970s.Water sensitive urban design principles were adopted to maximise the use of the increased run-off generated by urbanisation and ameliorate flood risk.Managed aquifer recharge was introduced for storing remediated low-salinity stormwater by aquifer storage and recovery (ASR) in a brackish aquifer for subsequent irrigation.This paper outlines how a municipal government has progressively adopted principles of Water Sensitive Urban Design during its development within a framework of evolving national water policies.Salisbury's success with stormwater harvesting led to the formation of a pioneering water business that includes linking projects from nine sites to provide a non-potable supply of 5 × 106 m3 ·year-1.These installations hosted a number of applied research projects addressing well configuration,water quality,reliability and economics and facilitated the evaluation of its system as a potential potable water source.The evaluation showed that while untreated stormwater contained contaminants,subsurface storage and end-use controls were sufficient to make recovered water safe for public open space irrigation,and with chlorination,acceptable for third pipe supplies.Drinking water quality could be achieved by adding microfiltration,disinfection with UV and chlorination.The costs that would need to be expended to achieve drinking water safety standards were found to be considerably less than the cost of establishing dual pipe distribution systems.The full cost of supply was determined to be AUD$1.57 m-3 for non-potable water for public open space irrigation,much cheaper than mains water,AUD $3.45 m-3 at that time.Producing and storing potable water was found to cost AUD$1.96 to $2.24 m-3.

  8. Fifty Years of THERP and Human Reliability Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring


    In 1962 at a Human Factors Society symposium, Alan Swain presented a paper introducing a Technique for Human Error Rate Prediction (THERP). This was followed in 1963 by a Sandia Laboratories monograph outlining basic human error quantification using THERP and, in 1964, by a special journal edition of Human Factors on quantification of human performance. Throughout the 1960s, Swain and his colleagues focused on collecting human performance data for the Sandia Human Error Rate Bank (SHERB), primarily in connection with supporting the reliability of nuclear weapons assembly in the US. In 1969, Swain met with Jens Rasmussen of Risø National Laboratory and discussed the applicability of THERP to nuclear power applications. By 1975, in WASH-1400, Swain had articulated the use of THERP for nuclear power applications, and the approach was finalized in the watershed publication of the NUREG/CR-1278 in 1983. THERP is now 50 years old, and remains the most well known and most widely used HRA method. In this paper, the author discusses the history of THERP, based on published reports and personal communication and interviews with Swain. The author also outlines the significance of THERP. The foundations of human reliability analysis are found in THERP: human failure events, task analysis, performance shaping factors, human error probabilities, dependence, event trees, recovery, and pre- and post-initiating events were all introduced in THERP. While THERP is not without its detractors, and it is showing signs of its age in the face of newer technological applications, the longevity of THERP is a testament of its tremendous significance. THERP started the field of human reliability analysis. This paper concludes with a discussion of THERP in the context of newer methods, which can be seen as extensions of or departures from Swain’s pioneering work.

  9. Serving the Nation for Fifty Years: 1952 - 2002 Lawrence Livermore National Laboratory [LLNL], Fifty Years of Accomplishments (United States)


    For 50 years, Lawrence Livermore National Laboratory has been making history and making a difference. The outstanding efforts by a dedicated work force have led to many remarkable accomplishments. Creative individuals and interdisciplinary teams at the Laboratory have sought breakthrough advances to strengthen national security and to help meet other enduring national needs. The Laboratory's rich history includes many interwoven stories -- from the first nuclear test failure to accomplishments meeting today's challenges. Many stories are tied to Livermore's national security mission, which has evolved to include ensuring the safety, security, and reliability of the nation's nuclear weapons without conducting nuclear tests and preventing the proliferation and use of weapons of mass destruction. Throughout its history and in its wide range of research activities, Livermore has achieved breakthroughs in applied and basic science, remarkable feats of engineering, and extraordinary advances in experimental and computational capabilities. From the many stories to tell, one has been selected for each year of the Laboratory's history. Together, these stories give a sense of the Laboratory -- its lasting focus on important missions, dedication to scientific and technical excellence, and drive to made the world more secure and a better place to live.

  10. Productivity change of surgeons in an academic year. (United States)

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


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

  11. Laser applications for energy. Fifty years since advent of laser and next thirty years

    International Nuclear Information System (INIS)

    Nakai, Sadao


    The utilization of light has been changed since the advent of lasers about fifty years ago. Now in the twenty first century, laser science is being applied in every industry as the fundamental technology. In the recent years, remarkable progresses have been made in the semiconductor lasers of high power and wide wavelength region. The amazing developments of ceramics laser materials like YAG and nonlinear optics materials of organic crystals have been achieved as well as the big progress in the fiber lasers. It is also to be pointed out that very high power ultra short laser pulses have become available. In the field of power photonics, which is based on the power semiconductor lasers, fiber lasers and new laser materials, various industrial applications are expected to be constructed further in civil engineering, manufacturing technology, agricultural and biological applications, medical utilization and space sciences. It is expected, by the development of ultra short pulse and ultra high mean power lasers, that particle accelerations, ultra high density sciences, nuclear fusion neutron sources and laser fusion power reactors are to be advanced drastically. Recent development and future prospects of high power lasers are illustrated. Lasers are now regarded as one of the key technologies in line with the national policy toward the creation of innovative industries. Realization of the laser fusion reactor is the most challenging target in the coming thirty years. (S. Funahashi)

  12. Deterrence, denuclearization, and proliferation: Alternative visions of the next fifty years

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, R.F. II


    The great library of Alexandria may have contained fewer volumes than the number which have been written on the subject of nuclear weapons in the Cold War. With the end of the Cold War, a new nuclear library is in the making. Much thought is being given to the next steps in nuclear policy, strategy, forces, arms control, and nonproliferation. For this very distinguished conference, however, I have been asked to look further ahead indeed, forward fifty-years. Prognostication is always a risky business. Detailed predictions beyond the shortest duration are difficult to label as ``scientific`` even in the social sciences. Forecasting ahead fifty years in an age of ever accelerating change would seem to be hopeless. Projecting the future of nuclear weapons, however, may not be as complex as one might think. Detailing the future fifty years from now is not necessary. We want to inform upcoming decisions by examining the possibilities, not write a history in advance of what is to happen. Our look forward con benefit from a brief look back fifty years. In retrospect, those years passed quickly, and with each additional year, analysts make them appear more simple than they seemed at the time. This paper contributes further to this process of oversimplification, as we say, ``for heuristic purposes.`` When in doubt, I have erred on the side of being provocative.

  13. Deterrence, denuclearization, and proliferation: Alternative visions of the next fifty years

    International Nuclear Information System (INIS)

    Lehman, R.F. II.


    The great library of Alexandria may have contained fewer volumes than the number which have been written on the subject of nuclear weapons in the Cold War. With the end of the Cold War, a new nuclear library is in the making. Much thought is being given to the next steps in nuclear policy, strategy, forces, arms control, and nonproliferation. For this very distinguished conference, however, I have been asked to look further ahead indeed, forward fifty-years. Prognostication is always a risky business. Detailed predictions beyond the shortest duration are difficult to label as ''scientific'' even in the social sciences. Forecasting ahead fifty years in an age of ever accelerating change would seem to be hopeless. Projecting the future of nuclear weapons, however, may not be as complex as one might think. Detailing the future fifty years from now is not necessary. We want to inform upcoming decisions by examining the possibilities, not write a history in advance of what is to happen. Our look forward con benefit from a brief look back fifty years. In retrospect, those years passed quickly, and with each additional year, analysts make them appear more simple than they seemed at the time. This paper contributes further to this process of oversimplification, as we say, ''for heuristic purposes.'' When in doubt, I have erred on the side of being provocative

  14. What history tells us XIII. Fifty years of the Central Dogma

    Indian Academy of Sciences (India)


    May 14, 2008 ... Home; Journals; Journal of Biosciences; Volume 33; Issue 2. What history tells us XIII. Fifty years of the Central Dogma. Michel Morange. Series Volume 33 Issue 2 June 2008 pp 171-175. Fulltext. Click here to view fulltext PDF. Permanent link: ...

  15. Fifty years of continuous improvement: (What has DOE done for analytical chemistry?)

    Energy Technology Data Exchange (ETDEWEB)

    Shults, W.D.


    Over the past fifty years, analytical scientist within the DOE complex have had a tremendous impact on the field of analytical chemistry. This paper suggests six ``high impact`` research/development areas that either originated within or were brought to maturity within the DOE laboratories. ``High impact`` means they lead to new subdisciplines or to new ways of doing business.

  16. Domain analysis of computational science - Fifty years of a scientific computing group

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, M.


    I employed bibliometric- and historical-methods to study the domain of the Scientific Computing group at Brookhaven National Laboratory (BNL) for an extended period of fifty years, from 1958 to 2007. I noted and confirmed the growing emergence of interdisciplinarity within the group. I also identified a strong, consistent mathematics and physics orientation within it.

  17. The history of fifty years of institute of electrical engineers 1947-1996

    International Nuclear Information System (INIS)


    This book starts with the survey of a century of Korea electrical industry. It includes a business of electric power and electrical machinery industry. Next, it deals with the survey of fifty years of Korea institute electrical engineers. Then, it enumerates the articles of association, organization, board members, the role of the administrative organization, study and institute business activities in detail.

  18. Fifty years of entomological publications in the Revista de Biología Tropical. (United States)

    Hanson, Paul


    Over its fifty year history nearly twenty percent of the papers published in the Revista de Biología Tropical have been about insects and arachnids. In the 1950's papers on arthropods of medical importance were dominant, in the 1960's there was a poliferation of papers on bees, and in more recent years the subjects have become increasingly diverse. In terms of nationality of contributing authors, the journal appears to have become increasingly international in later years.

  19. Fifty years experiences in nuclear engineering education at Tokyo Institute of Technology

    International Nuclear Information System (INIS)

    Fujii, Yasuhiko; Saito, Masaki; Aritomi, Masanori


    Nuclear engineering education has been initiated in 1957 at the graduate school of Tokyo Institute of Technology. Educational activities have been conducted for fifty years under the support of the Research Laboratory for Nuclear Reactors. In the past fifty years, about 1000 Master students and 200 Doctoral students and 200 Doctoral students graduated from our Nuclear Engineering Department at Tokyo Institute of Technology. Many of them found their jobs in nuclear industries and institutes. International course of nuclear engineering was initiated in 1994, and so far about 90 students from 15 overseas countries have graduated from our Master and Doctoral Programs. In 2003, our proposal of 'Innovative Nuclear Energy System for the Sustainable World' was adopted as the Center of Excellent Program sponsored by Ministry of Education, Science and Technology. Recently a collaborative education network has been developed among Kanazawa University, Fukui University, Ibaraki University, Okayama University, Tokyo Institute of Technology and Japan Atomic Energy Agency. (author)

  20. L'etat, c'est moi. Fifty years of history and philosophy of evolutionary biology. (United States)

    Ruse, Michael


    I reflect on my fifty-year history as a philosopher of biology, showing how it has taken me from rather narrow analytic studies, through the history of ideas, and now on to issues to do with science and religion. I argue that moral concerns were and still are a major motivation behind what I do and write. Copyright: © 2016 by Fabrizio Serra editore, Pisa · Roma.

  1. The Henderson Question? The Melbourne Institute and fifty years of welfare policy


    R. G. Gregory


    We discuss selected research contributions of the Melbourne Institute of Applied Economics and Social Research, to fifty years of welfare policy for those of work force age and focus particularly on the policy focus of R. F. Henderson, the inaugural director. Following the spirit of his 1960s poverty research, government, in the mid-1970s, doubled unemployment allowances in real terms and increased pensions by approximately forty per cent. Both income support payments were to be indexed by av...

  2. One hundred and fifty years of combustion of fossil hydrocarbons: The emergent alternatives

    International Nuclear Information System (INIS)

    Laine, Jorge


    After one hundred fifty years of drilling first commercial petroleum wells that led to the intensive use of liquid fuels to move transport vehicles, we are arriving at the peak of the world-wide petroleum reserves. Yet, we still have a good portion for spending, with the hope that the consequences will be better than in the first part, which has implied several wars and deteriorations of the environment. This assay brings a review about the history of fossil fuels and with the prospective of the emergent energetic alternatives, placing emphasis on bioenergy as an alternative for the transition between the actual combustion age and the new age of clean energy.

  3. The continuous time random walk, still trendy: fifty-year history, state of art and outlook (United States)

    Kutner, Ryszard; Masoliver, Jaume


    In this article we demonstrate the very inspiring role of the continuous-time random walk (CTRW) formalism, the numerous modifications permitted by its flexibility, its various applications, and the promising perspectives in the various fields of knowledge. A short review of significant achievements and possibilities is given. However, this review is still far from completeness. We focused on a pivotal role of CTRWs mainly in anomalous stochastic processes discovered in physics and beyond. This article plays the role of an extended announcement of the Eur. Phys. J. B Special Issue [open-calls-for-papers/123-epj-b/1090-ctrw-50-years-on">] containing articles which show incredible possibilities of the CTRWs. Contribution to the Topical Issue "Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

  4. The Research of Dr. Joanne Simpson: Fifty Years Investigating Hurricanes, Tropical Clouds and Cloud Systems (United States)

    Tao, W. -K.; Halverson, J.; Adler, R.; Garstang, M.; Houze, R., Jr.; LeMone, M.; Pielke, R., Sr.; Woodley, W.; O'C.Starr, David (Technical Monitor)


    This AMS Meteorological Monographs is dedicated to Dr. Joanne Simpson for her many pioneering research efforts in tropical meteorology during her fifty-year career. Dr. Simpson's major areas of scientific research involved the "hot tower" hypothesis and its role in hurricanes, structure and maintenance of trade winds, air-sea interaction, and observations and the mechanism for hurricanes and waterspouts. She was also a pioneer in cloud modeling with the first one-dimensional model and had the first cumulus model on a computer. She also played a major role in planning and leading observational experiments on convective cloud systems. The launch of the Tropical Rainfall Measuring Mission (TRMM) satellite, a joint U.S.-Japan project, in November of 1997 made it possible for quantitative measurements of tropical rainfall to be obtained on a continuous basis over the entire global tropics. Dr. Simpson was the TRAM Project Scientist from 1986 until its launch in 1997. Her efforts during this crucial period ensured that the mission was both well planned scientifically and well engineered as well as within budget. In this paper, Dr. J. Simpson's nine specific accomplishments during her fifty-year career: (1) hot tower hypothesis, (2) hurricanes, (3) airflow and clouds over heated islands, (4) cloud models, (5) trade winds and their role in cumulus development, (6) air-sea interaction, (7) cloud-cloud interactions and mergers, (8) waterspouts, and (9) TRMM science, will be described and discussed.

  5. Fifty years of fat: news coverage of trends that predate obesity prevalence. (United States)

    Davis, Brennan; Wansink, Brian


    Obesity prevalence has risen in fifty years. While people generally expect media mentions of health risks like obesity prevalence to follow health risk trends, food consumption trends may precede obesity prevalence trends. Therefore, this research investigates whether media mentions of food predate obesity prevalence. Fifty years of non-advertising articles in the New York Times (and 17 years for the London Times) are coded for the mention of less healthy (5 salty and 5 sweet snacks) and healthy (5 fruits and 5 vegetables) food items by year and then associated with annual obesity prevalence in subsequent years. Time-series generalized linear models test whether food-related mentions predate or postdate obesity prevalence in each country. United States obesity prevalence is positively associated with New York Times mentions of sweet snacks (b = 55.2, CI = 42.4 to 68.1, p = .000) and negatively associated with mentions of fruits (b = -71.28, CI -91.5 to -51.1, p = .000) and vegetables (b = -13.6, CI = -17.5 to -9.6, p = .000). Similar results are found for the United Kingdom and The London Times. Importantly, the "obesity followed mentions" models are stronger than the "obesity preceded mentions" models. It may be possible to estimate a nation's future obesity prevalence (e.g., three years from now) based on how frequently national media mention sweet snacks (positively related) and vegetables or fruits (negatively related) today. This may provide public health officials and epidemiologists with new tools to more quickly assess the effectiveness of current obesity interventions based on what is mentioned in the media today.

  6. Nuclear power: A look at the future. International Conference on Fifty Years of Nuclear Power: The Next Fifty Years, 27 June 2004, Moscow, Russia

    International Nuclear Information System (INIS)

    ElBaradei, M.


    other electricity sources. Critical Issues in Shaping the Future are: Carbon Emissions and the Growth in Demand; Security of Supply; Public Perceptions and Misconceptions: Shaping National Choices; Performance in Addressing Key Concerns: Nuclear Safety, Management and Disposal of Spent Nuclear Fuel, Nuclear Security, Technological and Policy Innovation, Fuel for Transportation (Growing Interest in the Potential for a 'Hydrogen Economy'). Although it is difficult to predict with any confidence what the next fifty years holds for nuclear power, the factors that will shape the future of nuclear power are relatively evident, and action should ne taken to address those factors, to enhance the prospects that nuclear energy remains a viable source of safe, secure and environmentally benign energy

  7. The richness of discovery : Amoco's first fifty years in Canada (1948-1998)

    International Nuclear Information System (INIS)

    McKenzie-Brown, P.


    A review of Amoco's first fifty years of operations in Canada, including investments, discoveries, and policies was presented. While no claim is made for this attractively produced slim volume to be a definitive history, it does manage to shed light on some of the great achievements and outstanding deeds of the people behind the company. The book provides a glimpse into how Amoco contributed to the growth of the Canadian petroleum industry in diverse areas including the manufacturing sector, the petroleum service sector, oil field technology, oil field infrastructure and petrochemical development. The company enjoyed spectacular success during the 1950s and 1960s. As evidence of that success, in 1997 Amoco Canada was the largest Canadian producer and exporter of natural gas and NGLs, the largest cold producer of heavy oil, the second largest in situ producer of heavy oil, and one of the 10 largest producers of conventional oil. refs., tabs., figs

  8. Gauge evolution of elementary particles physics during the last fifty years

    International Nuclear Information System (INIS)

    Khodjaev, L.Sh


    Gauge evolution of the elementary particle physics has been remarked by outstanding and exiting discoveries during the last fifty years of X X century. We review a new tendency in the development of the modern elementary particle physics. The phenomenological basis for the formulation of Standard Model has been reviewed. The Standard Model based on the fundamental postulates has been formulated. The concept of the fundamental symmetries has been introduced to look for not fundamental particles but fundamental symmetries. The Standard Model is renormalizable and therefore potentially consistent in all energy scales. The Standard Model in principle can describe the properties of the Universe beginning at 10 -43 sec. after Big Bang. In searching of more general theory obvious program is to searching the first of all global symmetries and then learn consequences connected with the localization of these global symmetries

  9. Venice: Fifty years after the great flood of November 4, 1966 (United States)

    Rizzoli, P. M.


    Fifty years ago Venice and its lagoon suffered the most devastating flood in their millennial history. The causes of the increasingly recurring floods will be examined, namely the man-induced subsidence in the period 1925-1970 and the storm surges of the Adriatic sea. The engineering solution designed for their protection , named the MOSE system, will be discussed in detail. The MOSE was started in 2003 and is near completion. It consists of four barriers , invisible in normal conditions, which will close the inlets to the lagoon under the prediction of a forthcoming flood. Finally, the perspective of the MOSE capability of protecting the city under scenarios of future global sea level rise will be assessed. This assessment must critically take into account that Venice and its lagoon are confined in the northernmost corner of the semi-enclosed, marginal Mediterranean sea for which the uncertainties of future sea level rise greatly exceed the uncertainties of the global averages.

  10. Organ Transplantation and the Uniform Anatomical Gift Act: A Fifty-Year Perspective. (United States)

    Sadler, Blair L; Sadler, Alfred M


    Fifty years ago this summer, the Uniform Anatomical Gift Act was adopted by the National Conference of Commissioners on Uniform State Laws and approved by the American Bar Association. The UAGA has provided a sound and stable legal platform on which to base an effective nationwide organ donation system. The cardinal principles of altruism, autonomy, and public trust are still important. At a time when confidence and trust in our government and many private institutions has declined, maintaining trust and confidence in our health care system and its commitment to "first, do no harm" has never been more important. Any policies that override these core ethical principles could cause irreparable damage to the public's faith in our transplant system. While progress has been made to increase organ registration and the number of organs transplanted, much more must be done to realize the potential of life-saving therapy without jeopardizing ethical principles. © 2018 The Hastings Center.

  11. Fifty Years of Burn Care at Shriners Hospitals for Children, Galveston. (United States)

    Čapek, Karel D; Culnan, Derek M; Desai, Manubhai H; Herndon, David N


    More than 50 years ago, Shriners Hospitals for Children expanded their philanthropy to include care for burned children. In so doing, the effects of their work weightily expanded from rehabilitation and quality of life outcomes to include survival proper. As the first facility dedicated to the care of burned children, originally designated the Shriners Burn Institute, the Galveston hospital remains the cornerstone of this endeavor. Shriners maintains charitable pediatric hospitals, provide care irrespective of the patient's or the family's ability to pay, and promote research. The sole criterion for admission at Shriners Hospitals for Children is the determination by a surgeon at a Shriners hospital that "the child's trouble may be corrected or improved." This philanthropic effort to provide medical care for children is one expression of the human commonality recognized by Shriners. In this article, we provide some background information on how this hospital came into existence as well as a global summary of its interventions toward greater survival and more complete rehabilitation of burned children. Based on the findings presented herein, we assert that there is less suffering and less loss of life due to childhood burns today than in previous years. We attribute much of this improvement to the simple voluntary collective decision by Shriners to provide alms for burned children.

  12. Fifty years of herbicide research: comparing the discovery of trifluralin and halauxifen-methyl. (United States)

    Epp, Jeffrey B; Schmitzer, Paul R; Crouse, Gary D


    Fifty years separate the commercialization of the herbicides trifluralin and halauxifen-methyl. Despite the vast degree of technological change that occurred over that time frame, some aspects of their discovery stories are remarkably similar. For example, both herbicides were prepared very early in the iterative discovery process and both were developed from known lead compound structures by hypothesis-driven research efforts without the use of in vitro assays or computer-aided molecular design. However, there are aspects of the halauxifen-methyl and trifluralin discovery stories that are substantially different. For example, the chemical technology required for the cost-effective production of halauxifen-methyl simply did not exist just two decades prior to its commercial launch. By contrast, the chemical technology required for the cost-effective production of trifluralin was reported in the chemical literature more than two decades prior to its commercial launch. In addition, changes in regulatory environment since the early 1960s ensured that their respective discovery to commercial launch stories would also differ in substantial ways. Ultimately, the time and cost required to develop and register halauxifen-methyl demanded a global initial business case while the lower registration hurdles that trifluralin cleared enabled a narrow initial business case mainly focused on the USA. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  13. Age-dependent salt hypertension in Dahl rats: fifty years of research. (United States)

    Zicha, J; Dobešová, Z; Vokurková, M; Rauchová, H; Hojná, S; Kadlecová, M; Behuliak, M; Vaněčková, I; Kuneš, J


    Fifty years ago, Lewis K. Dahl has presented a new model of salt hypertension - salt-sensitive and salt-resistant Dahl rats. Twenty years later, John P. Rapp has published the first and so far the only comprehensive review on this rat model covering numerous aspects of pathophysiology and genetics of salt hypertension. When we summarized 25 years of our own research on Dahl/Rapp rats, we have realized the need to outline principal abnormalities of this model, to show their interactions at different levels of the organism and to highlight the ontogenetic aspects of salt hypertension development. Our attention was focused on some cellular aspects (cell membrane function, ion transport, cell calcium handling), intra- and extrarenal factors affecting renal function and/or renal injury, local and systemic effects of renin-angiotensin-aldosterone system, endothelial and smooth muscle changes responsible for abnormal vascular contraction or relaxation, altered balance between various vasoconstrictor and vasodilator systems in blood pressure maintenance as well as on the central nervous and peripheral mechanisms involved in the regulation of circulatory homeostasis. We also searched for the age-dependent impact of environmental and pharmacological interventions, which modify the development of high blood pressure and/or organ damage, if they influence the salt-sensitive organism in particular critical periods of development (developmental windows). Thus, severe self-sustaining salt hypertension in young Dahl rats is characterized by pronounced dysbalance between augmented sympathetic hyperactivity and relative nitric oxide deficiency, attenuated baroreflex as well as by a major increase of residual blood pressure indicating profound remodeling of resistance vessels. Salt hypertension development in young but not in adult Dahl rats can be attenuated by preventive increase of potassium or calcium intake. On the contrary, moderate salt hypertension in adult Dahl rats is

  14. Emerging frontiers of pharmacy education in Saudi Arabia: The metamorphosis in the last fifty years. (United States)

    Asiri, Yousif A


    The trends in the quality of biomedical education in pharmacy schools have witnessed significant changes in the 21st century. With the advent of continuous revision and standardization processes of medical curricula throughout the world, the focus has been on imparting quality education. This pedagogic paradigm has shifted to pharmacy schools. In Saudi Arabia, the concept of "medical and pharmacy education" is relatively new as mainstream pharmacy curriculum and universities were established only half a century ago. This period has seen major changes in the dimension of "pharmacy education" to keep pace with the education systems in the United States and Europe. As our knowledge and perceptions about pharmaceuticals change with time, this motivates educators to search for better teaching alternatives to the ever increasing number of enthusiastic and budding pharmacists. Recently, the academic system in Saudi Arabian Pharmacy has adopted a more clinically-oriented Pharm. D. curriculum. This paper deals with the major changes from the inception of a small pharmacy faculty in 1959, the College of Pharmacy at the King Saud University, Riyadh, to the model of progress and a prototype of pharmacy colleges in Saudi Arabia. The fifty year chronological array can be regarded as an epitome of progress in pharmacy education in Saudi Arabia from its traditional curriculum to the modern day Pharm. D. curriculum with a high population growth and expanding health care sector, the demand for qualified pharmacists is growing and is projected to grow considerably in the future. The number of pharmacy graduates is increasing each year by many folds and to meet the needs the system lays stress upon a constant revising and updating of the current curriculum from a global perspective.

  15. Fifty Years of Safeguards under the EURATOM Treaty. A Regulatory Review

    International Nuclear Information System (INIS)

    Patel, B.; Chare, P.


    March 2007 marked the 50th anniversary of the signing of one of the founding treaties of the European Community. The EURATOM Treaty has its origins at a time when the stability of energy supplies in Europe was a major concern. Recently, much debate has centred on the possible reform or repeal of some parts of the treaty, given that its original aim was to promote and oversee the development of nuclear energy in Europe. This debate has focused attention on the future contribution of nuclear power to increasing energy demands in an enlarged Europe. However, despite these issues there is near universal agreement that the EURATOM Treaty has played a vital role in the protection of European citizens through the controls required for nuclear materials. Chapter 7 of the treaty (Safeguards) confers wide regulatory powers to the European Commission to ensure that civil nuclear materials are not diverted from their intended use as declared by the operators. This paper describes the early period of operation of the safeguards inspectorate, and gives statistics on the numbers and types of inspections carried out by the EURATOM inspectors, and discusses from an operational point of view the value of inspection activities. Further, a critical appraisal of Articles 77-85 within Chapter 7 is made. The paper also considers those safeguards requirements that are important to strengthen, in order to maintain a strong regulatory system to oversee future challenges, particularly in the context of increasing decommissioning activities within Europe. It is noteworthy that fifty-years after the founding of the treaty, many of the concerns about security of energy supply have re-emerged. It is a measure of the vision and forward thinking of its founders that the treaty has successfully overseen the safe and secure development of nuclear power in Europe (which currently provides a third of its electricity needs) and despite the many changes and developments that have occurred, that the

  16. Celebrating fifty years of research and applications in reminiscence and life review: State of the art and new directions

    NARCIS (Netherlands)

    Westerhof, Gerben Johan; Bohlmeijer, Ernst Thomas


    Fifty years ago, psychiatrist Robert Butler (1963) published an influential article on the recollection and evaluation of personal memories in later life. We discuss the major insights and applications in psychological gerontology that were inspired by Butler. Reminiscence and life review serve to

  17. [Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years]. (United States)

    Chen, Jian-guo; Zhu, Jian; Zhang, Yong-hui; Chen, Yong-sheng; Ding, Lu-lu; Lu, Jian-hua; Zhu, Yuan-rong


    To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China. Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared. The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0





    The trajectory of Singapore's population size and composition can be mapped out with its progression through the various phases of demographic transition from high birth and death rates in the post-war years to very low birth and death rates today, all within the context of rapid economic and social development that has taken place in the past 50 years. Population planning has been integral in Singapore's national development strategy, balancing the economy's needs for more and better qualifi...

  19. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton

    DEFF Research Database (Denmark)

    Bech, P; Bech, P


    as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first...... placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without...

  20. Fifty-Year Trends in the Chemical Industry: What Do They Mean for Chemical Education? (United States)

    Tolman, Chadwick A.; Parshall, George W.


    Describes major changes that have occurred in the chemical industry over the last 50 years including trends in the development of products and processes, changes in chemical manufacturing, the globalization of business, and modifications of research laboratory practices. Discusses implications for chemistry education and predictions for future…

  1. Rosalind Franklin: The Woman Scientist of DNA It is fifty years since ...

    Indian Academy of Sciences (India)


    awarded the Nobel Prize as it is not given posthu- mously. ... photographs are among the most beautiful of any substance ... during World War II, and Franklin investigated why some ... fered her only a three-year fellowship, with nei- ther rank ...

  2. The Kitty Genovese Story in Introductory Psychology Textbooks: Fifty Years Later (United States)

    Griggs, Richard A.


    Given the many inaccuracies in the original "New York Times" 38-witnesses version of the Kitty Genovese story, this study examined the accuracy of this story in current introductory psychology textbooks, 50 years later. Recent studies have shown that there is no evidence for the following three key features of the original story: (1)…

  3. Open oakwoods facing modern threats: Will they survive the next fifty years?

    Czech Academy of Sciences Publication Activity Database

    Chudomelová, Markéta; Hédl, Radim; Zouhar, V.; Szabó, Péter


    Roč. 210, Part A (2017), s. 163-173 ISSN 0006-3207 R&D Projects: GA ČR GA17-09283S EU Projects: European Commission(XE) 278065 - LONGWOOD Institutional support: RVO:67985939 Keywords : community change * open oakwoods * canopy closure Subject RIV: EH - Ecology, Behaviour OBOR OECD: Ecology Impact factor: 4.022, year: 2016

  4. Fifty years of solid-phase extraction in water analysis--historical development and overview. (United States)

    Liska, I


    The use of an appropriate sample handling technique is a must in an analysis of organic micropollutants in water. The efforts to use a solid phase for the recovery of analytes from a water matrix prior to their detection have a long history. Since the first experimental trials using activated carbon filters that were performed 50 years ago, solid-phase extraction (SPE) has become an established sample preparation technique. The initial experimental applications of SPE resulted in widespread use of this technique in current water analysis and also to adoption of SPE into standardized analytical methods. During the decades of its evolution, chromatographers became aware of the advantages of SPE and, despite many innovations that appeared in the last decade, new SPE developments are still expected in the future. A brief overview of 50 years of the history of the use of SPE in organic trace analysis of water is given in presented paper.

  5. Introduction to the focus issue: fifty years of chaos: applied and theoretical. (United States)

    Hikihara, Takashi; Holmes, Philip; Kambe, Tsutomu; Rega, Giuseppe


    The discovery of deterministic chaos in the late nineteenth century, its subsequent study, and the development of mathematical and computational methods for its analysis have substantially influenced the sciences. Chaos is, however, only one phenomenon in the larger area of dynamical systems theory. This Focus Issue collects 13 papers, from authors and research groups representing the mathematical, physical, and biological sciences, that were presented at a symposium held at Kyoto University from November 28 to December 2, 2011. The symposium, sponsored by the International Union of Theoretical and Applied Mechanics, was called 50 Years of Chaos: Applied and Theoretical. Following some historical remarks to provide a background for the last 50 years, and for chaos, this Introduction surveys the papers and identifies some common themes that appear in them and in the theory of dynamical systems.

  6. Financial requirements and manpower needs of nuclear energetics for the next fifty years

    International Nuclear Information System (INIS)

    Spital'nik, Dzh.


    Forecasts on financial and manpower requirements of rich and poor countries for NPPs construction by 2050 showed that the NPPs capacities will increase from 320 up to 2500 GW, whereby the ratio between the rich and poor countries will constitute approximately 2:1. Investments in NPPs construction will equal from 1600 up to 2700 billions dollars. Global need in manpower for NPPs will constitute by 2050 240000 man/year

  7. The urban and territorial planning during the last fifty years in mexico


    Ortiz Macedo, Luis


    The urban and territorial planning in Mexico started late, and always federal, state and local governments haven’t been able to forecast the long term issues, but instead the long seventy years in which the governors were supported by the Partido Revolucionario Institucional (PRI) started urban structures that were never finished by their successors. However, depending on successive Secretaries of State planning programs have been made relying on national and international specialists, but th...

  8. Trends in scientific publications of Indian spine surgeons over 14 years (2000–2013

    Directory of Open Access Journals (Sweden)

    Rishi Mugesh Kanna


    Conclusion: 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.

  9. Carbon Stocks across a Fifty Year Chronosequence of Rubber Plantations in Tropical China

    Directory of Open Access Journals (Sweden)

    Chenggang Liu


    Full Text Available Transition from forest to rubber (Hevea brasiliensis Muell. Arg. plantation has occurred in tropical China for decades. Rubber has been planted on 1 million ha to provide raw materials to the rubber industry. The role of various-aged rubber plantations in carbon (C sequestration remains unclear. The biomass C accumulation including latex C and C distribution in soil of five different-aged stands (7, 13, 19, 25 and 47 years old were examined. The total biomass C stock (TBC and total net primary productivity (NPPtotal, whether with or without latex C, had a close quadratic relationship with stand age. Regardless of stand age, around 68% of the C was stored in aboveground biomass, and NPPlatex contributed to approximately 18% of C sequestration. Soil organic carbon stock in the 100-cm depth remained relatively stable, but it lost about 16.8 Mg ha−1 with stand age. The total ecosystem C stock (TEC across stands averaged 159.6, 174.4, 229.6, 238.1 and 291.9 Mg ha−1, respectively, of which more than 45% was stored in the soil. However, biomass would become the major C sink rather than soil over a maximal rubber life expectancy. Regression analysis showed that TEC for rubber plantation at 22 years is comparable to a baseline of 230.4 Mg ha−1 for tropical forest in China, and would reach the maximum value at around 54 years. Therefore, rubber plantation can be considered as alternative land use without affecting net forest ecosystem C storage. In addition to the potential C gains, a full set of ecosystem and economic properties have to be quantified in order to assess the trade-offs associated with forest-to-rubber transition.

  10. Age-dependent salt hypertension in Dahl rats: fifty years of research

    Czech Academy of Sciences Publication Activity Database

    Zicha, Josef; Dobešová, Zdenka; Vokurková, Martina; Rauchová, Hana; Hojná, Silvie; Kadlecová, Michaela; Behuliak, Michal; Vaněčková, Ivana; Kuneš, Jaroslav


    Roč. 61, Suppl.1 (2012), S35-S87 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) 1M0510; GA ČR(CZ) GA305/09/0336; GA ČR(CZ) GAP304/12/0259 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : blood pressure * cell membrane transport * hemodynamics * vasoactive systems * cell calcium handling Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 1.531, year: 2012

  11. A vision for the second fifty years of nuclear energy. Vision and strategies

    International Nuclear Information System (INIS)

    Hori, M.


    The paper is the Polish issue of the report worked out by International Nuclear Societies Council published in 1996. The report contains the experts opinion on development of nuclear energy and applications of radiation techniques and sources worldwide during the next 50 years. The worldwide energy demand prognosis as well as needs of different branches of industry, agriculture, medicine, etc. have been taken into account. The broad spectrum of aspects (safety assurance, economy, environmental impacts) connected with nuclear technology utilization has been also discussed

  12. The 1953 Stanley L. Miller Experiment: Fifty Years of Prebiotic Organic Chemistry (United States)

    Lazcano, Antonio; Bada, Jeffrey L.


    The field of prebiotic chemistry effectively began with a publication in Science 50 years ago by Stanley L. Miller on the spark discharge synthesis of amino acids and other compounds using a mixture of reduced gases that were thought to represent the components of the atmosphere on the primitive Earth. On the anniversary of this landmark publication, we provide here an accounting of the events leading to the publication of the paper. We also discuss the historical aspects that lead up to the landmark Miller experiment.

  13. A Fifty-Year Sustainability Assessment of Italian Agro-Forest Districts

    Directory of Open Access Journals (Sweden)

    Fabio Recanatesi


    Full Text Available As cropland management and land use shifted towards more intensive practices, global land degradation increased drastically. Understanding relationships between ecological and socioeconomic drivers of soil and landscape degradation within these landscapes in economically dynamic contexts such as the Mediterranean region, requires multi-target and multi-scalar approaches covering long-term periods. This study provides an original approach for identifying desertification risk drivers and sustainable land management strategies within Italian agro-forest districts. An Environmental Sensitivity Area (ESA approach, based on four thematic indicators (climate, soil, vegetation and land-use and a composite index of desertification risk (ESAI, was used to evaluate changes in soil vulnerability and landscape degradation between the years 1960 and 2010. A multivariate model was developed to identify the most relevant drivers causing changes in land susceptibility at the district scale. Larger districts, and those with a higher proportion of their total surface area classified as agro-forest, had a significantly lower increase in land susceptibility to degradation during the 50 years when compared with the remaining districts. We conclude that preserving economic viability and ecological connectivity of traditional, extensive agricultural systems is a key measure to mitigate the desertification risk in the Mediterranean region.

  14. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton. (United States)

    Bech, P


    From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without success. Using modern psychometric methods, the solution to this problem is a simple matter of reallocating the Hamilton scale items according to the scientific hypothesis under examination. Hamilton's original intention, to measure the global burden of the symptoms experienced by the patients with affective disorders, is in agreement with the DSM-IV and ICD-10 classification systems. Scale reliability and obtainment of valid information from patients and their relatives were the most important clinimetric innovations to be developed by Hamilton. Max Hamilton therefore belongs to the very exclusive family of eminent physicians celebrated by this journal with a tribute. 2009 S. Karger AG, Basel.

  15. One hundred and fifty years of Coulomb stress history along the California-Nevada border, USA (United States)

    Verdecchia, Alessandro; Carena, Sara


    The region north of the Garlock Fault between the Sierra Nevada and Death Valley has experienced at least eight Mw ≥ 6 earthquakes in historical times, beginning with the 1872, Mw 7.5, Owens Valley earthquake. Furthermore, since 1978, the Long Valley Caldera has been undergoing periods of unrest, with earthquake swarms and resurgence. Our goal is to determine whether the 1872 Owens Valley earthquake and the caldera unrest have influenced the evolution of seismicity in the area. We model the evolution of coseismic, postseismic, and interseismic Coulomb stress change (Coulomb failure stress (ΔCFS)) in the region due to both Mw ≥ 6 earthquakes and caldera inflation in the last 150 years. Our results show that the 1872 Owens Valley earthquake has an important influence on subsequent events, strongly encouraging faulting in northern Owens Valley while inhibiting it elsewhere. There is also a correlation between caldera inflation and seismicity in northern Owens Valley, evidenced by the west-to-east migration of earthquakes from the Long Valley Caldera toward the White Mountains immediately following the 1978 caldera inflation event. Finally, we show that a total ΔCFS increase of up to 30 bars in the last 150 years has occurred on part of the White Mountains fault, making it a possible candidate for the next major earthquake in this region.

  16. White paper on science and technology, 1995. Fifty years of postwar science and technology in Japan

    International Nuclear Information System (INIS)


    This August marks 50 years since the end of World War II. Japan emerged from the ruins to overcome the post-war devastation to achieve a high level of economic growth and become the second largest economy in the world. Science and technology have played major roles as a driving force behind this quest for prosperity. However, it seems as though true prosperity is not necessarily being enjoyed by citizens of Japan today. Japan is becoming an aging society. To realize a truly rich and prosperous society in which people can live comfortably, it is important to further raise the level of science and technology. It is also necessary to ensure this development by revitalizing the economy, and to continue to utilize science and technology as an endless resource to create assets for society as a whole which will be inherited by future generations. With this viewpoint in mind, this White Paper looks back on Japan's scientific and technological development over the last 50 years, and considers the future of science and technology with a view toward realizing the true prosperity for its people. It is our hope that this White Paper will be helpful for considering the scientific and technological activities needed to bring about a Japan whose people are truly prosperous, and we will, as a government, continually increase our efforts toward the promotion of science and technology. (J.P.N.)

  17. Oil prices touch fifty year low - industry gears up for further cuts in operating costs

    International Nuclear Information System (INIS)



    International crude oil prices hit a 50-year low (inflation adjusted) in December 1998. Prices are now lower than in 1973 and are expected to remain low for several years; so much so that the future of production activities are under threat. The paper goes on to discuss the UK Government's initiative to tackle the problem and of the activities of the CRINE (Cost Reduction in the New Era) Network to reduce operating costs. The Government Oil and Gas Task Force aimed to develop strategies to reduce the cost base of UK gas and oil operations and recommend action by Government and/or the industry by summer 1999. The concern is that current costs of production on the UK continental shelf will make new offshore development uneconomic. A meeting in January 1999 agreed six key areas for action. The work of the Task Force overlaps that of Crine which, since 1992 has been working to drive down capital costs of developing oil and gas fields by innovative approaches including cooperation between companies. (UK)

  18. Fifty years of levelling measurements at Askja volcano, Iceland: New Bayesian interpretations of a unique dataset (United States)

    Barnie, Talfan; Sigmundsson, Freysteinn; Sturkell, Erik


    The year 2016 marks the 50th anniversary of the start of geodetic levelling surveys at Askja volcano in the Northern Volcanic Zone of Iceland. Askja has produced frequent basaltic fissural eruptions and rarer silicic caldera forming eruptions during the Holocene, the most recent of each type in 1961 and 1875 respectively. The potential for widespread disruption from larger eruptions and the popularity of the site with tourists makes Askja an important target for observation. Geodetic monitoring started in 1966 with the installation of a 12 station survey line on the 1961 lava flow, which provided a stable, extensive surface close to the putative source of magma. This was infilled and extended over the following two decades to give a finished levelling line of 35 stations spaced approximately 50 m apart (Tryggvason, Nordic Volcanological Institute, 1989). With the exception of the period 1972 to 1983, this line has been surveyed every year, providing a unique record of post eruptive deformation at a spreading rift segment capable of capturing magma motions at depth and any potential recharging in anticipation of future activity. The levelling has so far revealed that after an initial period of complicated inflations and deflations the volcano settled into a pattern of slowly decaying deflation from 1983 onwards (Sturkell and Sigmundsson, JGR, 105, 2000), a pattern that has been confirmed by newer geodetic techniques as they have become available (e.g. Pagli et al., JVGR, 152, 2005). The strength of the levelling data at Askja is its long time span, high accuracy and same measurement type over a period of 50 years. However, the small extent of the levelling line limits the power of the network to resolve changes in the magma plumbing system and requires the addition of constraints from other sources. This lends itself to Bayesian modelling techniques where assumptions are made explicit as priors and uncertainties in retrieved parameters can be comprehensibly modelled

  19. Fifty years of mapping the Balkan flora for Atlas Florae Europaeae

    Directory of Open Access Journals (Sweden)

    Uotila Pertti


    Full Text Available Atlas Florae Europaeae (AFE, a programme for mapping the distribution of vascular plants in Europe, was launched in 1965 as a collaborative effort between European botanists. A historical review of the mapping for AFE in the Balkan countries, cited in the last volume (16 from 2013 as Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Former Yugoslav Republic (F. Y. R. of Macedonia, Greece, Kosovo, Montenegro, Serbia, Slovenia, and Turkey (European part, is presented and achievements and problems discussed. The special challenges facing mapping of the Balkan area during the past 50 years include the extremely rich flora, diverse and mountainous relief, political and economic difficulties, inaccessibility of available data, and scarcity of botanists contributing and collecting data for mapping.

  20. [Fifty years of population growth and absorbing manual labor in Brazil, 1950-2000]. (United States)

    Paiva, P D


    The economically active population has grown rapidly in Brazil, resulting either from population growth or increased female participation in the work force. This rhythm of growth will continue at least until the end of this century. The authors suggest that the impact of the recent decline in fertility will be moderate and will only affect the younger age groups. Despite the rapid growth of employment in the processing industry, the relative size of the so-called informal sector has remained stable since 1950. It is further predicted that, given the economically active population's rate of growth and the decrease in employment in agriculture, there will be a great demand for urban employment in the next 20 years.

  1. Legend and legacy: Fifty years of defense production at the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, M.S.


    Today, the Hanford Site is engaged in the largest waste cleanup effort ever undertaken in human history. That in itself makes the endeavor historic and unique. The Hanford Site has been designated the ``flagship`` of Department of Energy (DOE) waste remediation endeavors. And, just as the wartime Hanford Project remains unmatched in history, no counterpart exists for the current waste cleanup enterprise. This report provides a summary of the extensive historical record, however, which does give a partial road map. The science of environmental monitoring pioneered at the Hanford Site, and records of this type are the most complete of any in the world, from private companies or public agencies, for the early years of Site operations. The Hanford Site was unique for establishing a detailed, scientific, and multi-faceted environmental monitoring program.

  2. Cognitive function fifty-six years after surgical treatment of temporal lobe epilepsy: A case study

    Directory of Open Access Journals (Sweden)

    Sarah Jane Banks


    Our investigation at 56 postoperative years focused on cognitive skills, with some emphasis on learning and memory; a clinical examination was also performed, and the anatomical extent of the resection was determined on 3-Tesla magnetic resonance imaging. Four age- and IQ-appropriate women were tested as healthy control subjects. The patient showed material-specific impairments in language and verbal memory compared with the control subjects and also compared with her own earlier performance, but her performance on other cognitive tasks did not differ from that of the control subjects. Thus, her specific deficits had worsened over time, and she was also impaired compared with healthy individuals of her age, but her deficits remained confined to the verbal sphere, consistent with her temporal lobe seizure focus and surgery.

  3. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning. (United States)

    van Ginneken, Bram


    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant technology for tackling CAD in the lungs, generally producing better results than do classical rule-based approaches, and how the field is now rapidly changing: in the last few years, we have seen how even better results can be obtained with deep learning. The key differences among rule-based processing, machine learning, and deep learning are summarized and illustrated for various applications of CAD in the chest.

  4. Legend and legacy: Fifty years of defense production at the Hanford Site

    International Nuclear Information System (INIS)

    Gerber, M.S.


    Today, the Hanford Site is engaged in the largest waste cleanup effort ever undertaken in human history. That in itself makes the endeavor historic and unique. The Hanford Site has been designated the ''flagship'' of Department of Energy (DOE) waste remediation endeavors. And, just as the wartime Hanford Project remains unmatched in history, no counterpart exists for the current waste cleanup enterprise. This report provides a summary of the extensive historical record, however, which does give a partial road map. The science of environmental monitoring pioneered at the Hanford Site, and records of this type are the most complete of any in the world, from private companies or public agencies, for the early years of Site operations. The Hanford Site was unique for establishing a detailed, scientific, and multi-faceted environmental monitoring program

  5. [Fifty years of psychiatry at the interface between psyche and soma: a SWOT analysis]. (United States)

    van Houdenhove, B; Luyten, P


    During the past 50 years the border area between psychiatry and somatic medicine has undergone remarkable changes. Theories have become better-founded, both psychologically and neurobiologically, research has become more sophisticated, and liaison-psychiatrists and health psychiatrist/behavioural medicine psychologists have played an increasingly active role in this domain. At the beginning of the 21st century modern psychosomatic medicine is facing new challenges; these include how to create a workable diagnostic classification system, how to instruct and educate both health professionals and lay-persons to an adequate level, how to utilize innovative research paradigms without having recourse to reductionism and how to implement in medical practice treatments that are geared to the needs of the individual patient.

  6. One hundred and fifty years of sprint and distance running – Past trends and future prospects (United States)

    Weiss, Martin; Newman, Alexandra; Whitmore, Ceri; Weiss, Stephan


    Abstract Sprint and distance running have experienced remarkable performance improvements over the past century. Attempts to forecast running performances share an almost similarly long history but have relied so far on relatively short data series. Here, we compile a comprehensive set of season-best performances for eight Olympically contested running events. With this data set, we conduct (1) an exponential time series analysis and (2) a power-law experience curve analysis to quantify the rate of past performance improvements and to forecast future performances until the year 2100. We find that the sprint and distance running performances of women and men improve exponentially with time and converge at yearly rates of 4% ± 3% and 2% ± 2%, respectively, towards their asymptotic limits. Running performances can also be modelled with the experience curve approach, yielding learning rates of 3% ± 1% and 6% ± 2% for the women's and men's events, respectively. Long-term trends suggest that: (1) women will continue to run 10–20% slower than men, (2) 9.50 s over 100 m dash may only be broken at the end of this century and (3) several middle- and long-distance records may be broken within the next two to three decades. The prospects of witnessing a sub-2 hour marathon before 2100 remain inconclusive. Our results should be interpreted cautiously as forecasting human behaviour is intrinsically uncertain. The future season-best sprint and distance running performances will continue to scatter around the trends identified here and may yield unexpected improvements of standing world records. PMID:26088705

  7. Fifty years dynamics of Russian forests: Impacts on the earth system (United States)

    Shvidenko, Anatoly; Schepaschenko, Dmitry; Kraxner, Florian


    The paper presents a succinct history of Russian forests during the time period of 1960-2010 and reanalysis of their impacts on global carbon and nitrogen cycles. We present dynamics of land cover change (including major categories of forest land) and biometric characteristics of forests (species composition, age structure, growing stock volume etc.) based on reconciling all relevant information (data of forest and land inventories, official forest management statistics, multi-sensor remote sensing products, data of forest pathological monitoring etc.). Completeness and reliability of background information was different during the period of the study. Forest inventory data and official statistics were partially modified based on relevant auxiliary information and used for 1960-2000. The analysis for 2001-2010 was provided with a crucial use of multi-sensor remote sensing data. For this last period a hybrid forest mask was developed at resolution of 230m by integration of 8 remote sensing products and using geographical weighted regression and data of crowdsourcing. During the considered 50 years forested areas of Russia substantially increased by middle of 1990s and slightly declined (at about 5%) after. Indicators needed for assessment of carbon and nitrogen cycles of forest ecosystems were defined for the entire period (aggregated estimates by decades for 1960-2000 and yearly for 2001-2010) based on unified methodology with some peculiarities following from availability of information. Major results were obtained by landscape-ecosystem method that uses as comprehensive as possible empirical and semi-empirical information on ecosystems and landscapes in form of an Integrated Land Information System and complimentary combines pool- and flux-based methods. We discuss and quantify major drivers of forest cover change (socio-economic, environmental and climatic) including forest management (harvest, reforestation and afforestation), impacts of seasonal weather on

  8. Fifty-year trends in a box turtle population in Maryland (United States)

    Hall, R.J.; Henry, P.F.P.; Bunck, C.M.


    A survey conducted in 1995 investigated long term declines reported in a population of box turtles Terrapene Carolina monitored each decade since 1945 in bottomland hardwood forest at the Patuxent Wildlife Research Center, Maryland. Methods duplicated past surveys in most respects, but were supplemented by radiotelemetry and a survey of dominant vegetation. Seventy different turtles were found on the 11.8 ha study area, a decline of >75% since peak populations were recorded in 1955. Searchers were less efficient in 1995 than in 1945-1975 for a variety of possible reasons. Among turtles recorded, approximately equal numbers persisted from each of the past five decades, with some individuals surviving >70 years. A sex ratio strongly favoring males was first recorded in 1975 and continued in 1995, but juveniles and subadults were found in greater proportion in 1995 than in any other survey. Six of nine radio-marked turtles left the bottomland study area and migrated to the adjoining bluffs to hibernate, suggesting more extensive movements and perhaps less stable home ranges than formerly thought. Age structure of trees indicated a gradual change to more shade-tolerant species. Examination of rates of change from survey data suggested that major losses probably resulted from changes in hydrology that exacerbated flooding in 1972, with recovery only beginning in 1995 and perhaps limited both by repeated flood events and successional changes in the forest. Slow recovery from losses may indicate that populations of the species would respond poorly to exploitation.

  9. Fifty years of population growth and absorption of labor in Brazil: from 1950 to 2000. (United States)

    Paiva, P D


    For a long time, the Brazilian population has grown at a relatively high rate, and only recently has the process of demographic transition intensified in the country. While the associated decline in fertility could result in a future decline in the size of the working-age population, it could also lead to an increase in female participation in the labor market. Brazil's economy is performing well, with gross domestic product (GDP) growing at an average annual rate of 7.1% during 1947-80. Marked growth in industrial employment opportunities has accompanied this growth in GDP. The size of the informal sector, however, has not decreased in similar proportion, while the 1981-83 economic crisis caused urban employment levels to drop, especially in industry and construction. Moreover, the level of rural-urban migration has increased and the agricultural employment index has fallen. The author evaluates past growth trends of the Economically Active Population (EAP) and of employment in Brazil, and assesses the potential growth of the labor force until the year 2000.

  10. Fifty years old, and still going strong: Transmission electron optical studies of materials

    International Nuclear Information System (INIS)

    Brown, L.M.


    Highlights in the history of transmission electron microscopy and scanning transmission electron microscopy include the introduction of diffraction contrast, resolution of periodic lattices by phase contrast and incoherent imaging via the high-angle annular dark-field detector. Convergent-beam electron diffraction and analytical electron microscopy, especially the application of energy-dispersive X-ray and electron energy-loss spectrometry, have provided structural and chemical information in addition to strain contrast from lattice defects. From the outset, novel specimen stages and improvements to aid the operator enhanced the electron-optical engineering provided by the instrument makers. The spatial resolution achieved was mainly determined by the way the instrument was used, and not by the basic resolution limit set by the electron optics. However, the application of computer controlled correction of spherical (and higher order) aberration has resulted in a new generation of instruments capable of sub-Angstrom point-to-point resolution. This improved performance, combined with electron energy-loss spectrometry, promises genuine three-dimensional determination of atomic and electronic structure: an indispensable weapon in the battle to fabricate and control useful nanostructures. The uncertainty principle now fundamentally restricts some of the observations one can make, but much more technical development over the next decades must occur before one can say that the techniques of electron-optical imaging of material structure have reached their fundamental limitations. One can expect remarkable progress over the next few years

  11. Science that connects the past and the future. Fifty years of 14C dating

    International Nuclear Information System (INIS)

    Imamura, M.


    Major contribution of radiochemistry in archaeological sciences is the dating which provides the most essential information in studies of prehistory. In particular the method of 14 C dating revolutionized the theory of civilization in the world. In this talk I will review 50 years of 14 C dating, techniques and applications, and then the possibilities in contemporary world. The technical developments are featured by ultra-sensitive method of accelerator mass spectrometry in 1977 and its developments, and an introduction of international calibration datasets for 14 C dates started in 1986. Both contributed greatly to improvements in versatility and precision for dating. As for the applications, several interesting topics are reviewed such as the origin of agriculture and its propagation in the western world, the oldest pottery production in Japanese archipelago and its relation to world climate, paddy-rice agriculture and its propagation in Japanese archipelago. Since 14 C studies in nature is also well known as key information on carbon dynamics in earth's surface, it may be said that 14 C play an extraordinary role in understanding our past, present and the future. (author)


    Directory of Open Access Journals (Sweden)

    Angelo Rolla


    Full Text Available Data collected in over 50 years' activity at the C.N.R. meteorological station of Pallanza were analysed to see whether any changes have taken place in some climatic elements and to quantify the extent of such changes. A statistical analysis of the respective historical series was performed on nine meteorological parameters (solar radiation, insolation, air temperature, atmospheric pressure, humidity, cloud cover, precipitation, evaporation and wind, and on two other strictly limnological features: the level of Lago Maggiore and its water temperature at six different depths. In particular, we evaluated the means and the extremes (maxima and minima on an annual, seasonal, monthly and daily level, with the results presented uniformly for all the parameters, also in graphic form. We especially highlighted the trend lines, even though they were not always statistically significant owing to the extreme variability of the meteorological data; in the absence of statistical validity, their significance is an approximate indication of their increasing or decreasing trend. Results showed that insolation, air temperature and atmospheric pressure had increased markedly over time, at least on an annual level, with the trends for solar radiation, humidity and cloud cover also showing an increase, though very slight. Evaporation and wind showed a steady, marked decrease, while precipitation and lake level were essentially stable. Water temperature showed a more varied picture, with the temperature of the topmost levels (to a depth of 10 m continuing to increase.

  13. Fifty years of HgCdTe at Texas Instruments and beyond (United States)

    Kinch, Michael A.


    Work on HgCdTe began at Texas Instruments in the early 1960s, and continued through 1997 when TI's defense business was sold first to Raytheon, and subsequently in 1998 to DRS Technologies. This presentation traces the history of HgCdTe's evolution throughout this timeframe to the present day, as viewed through the eyes of the author and several of his TI contemporaries who have survived the experience. The materials technology will be traced from the early days of bulk growth by the solid state recrystalization technique, through the traveling heater method of growth, to liquid phase epitaxy from large Te-rich melts, to vapor phase growth by molecular beam epitaxy and metal organic chemical vapor deposition. The evolution of detector device architectures at TI over the years will be discussed, from the early, successful days of photoconductors and the Common Module System, through the somewhat problematic and relatively unsuccessful foray into charge coupled and charge injection devices for 2nd generation FPAs for the Javelin program, to the outstandingly successful development of the vertically integrated photodiode (VIP) and high density VIP FPA architectures for mono-color and multi-color 3rd generation systems. The versatile, and unique nature of this infrared semiconductor materials system will be highlighted by reference to current work at DRS Technologies into electron avalanche photodiodes (EAPDs), for use in active/passive IR systems, and high operating temperature (HOT) detectors, which threaten to eventually offer BLIP photon detection at uncooled operating temperatures, over the whole IR spectrum from 1 to 12um.

  14. Comparing Socialist and Post-Socialist Television Culture. Fifty Years of Television in Croatia

    Directory of Open Access Journals (Sweden)

    Zrinjka Peruško


    Full Text Available This article builds a theoretical model for comparative analysis of media culture based on the notion of genre, and applies it to a comparative analysis of television as a cultural form in socialist and post-socialist Croatia. The paper explores how the shares and generic composition of program modes of information, entertainment and fiction change in time, and how the contribution of different genres to program flow and modes varies with the changes of political, economic and technological context. Longitudinal trends in television flows are comparatively evaluated in relation to trends in genre developments in Europe and their relationship to the changes in the cultural role of television. The results show a decrease in the information and an increase in the fiction mode between socialism and democracy, with some similarities of the Croatian and western television culture in relation to genre and mode composition and flow, albeit with a belated introduction of neo television genres. Notwithstanding the limited freedom of expression and ideological content, which necessarily influenced socialist media culture, television as a cultural form in Croatia developed in concert with the global program flows. The article is based on original content analysis of television schedules where the unit of analysis is a televisions program listing. The analogue television universe is represented by longitudinal data for 1959, 1969, 1979, 1989, 1999, and 2009. The stratified systematic sample (N=3934 for each chosen year consists of two constructed weeks from a universe of all listed programs broadcast on all free to air television channels with a national reach license.

  15. Homo cyborg: fifty years old Homo Ciborg: Cincuenta años después

    Directory of Open Access Journals (Sweden)

    Chris Hables Gray


    Full Text Available While the term “cyborg” is only 50 years old, the process that has produced cyborgization is much older: the evolution of the human. Humans have evolved to modify ourselves and our environment, especially through evolving culture and the technologies it creates. Culture is part of nature. Today’s mundane i-cyborgs, military drones, intimate human-machine merging and genetic engineering are a result of this; which in turn produce feelings of uncanniness, hubris, and fear. Contemporary politics must take this complex dynamic into account if we are to secure a sustainable, survivable, future for ourselves and our descendents. Social experiments such as Burning Man are a prefiguration of the kinds of (self conscious techno-social creativity needed.Mientras la terminología “ciborg” tiene apenas 50 años, son mucho más antiguos los procesos de “ciborgización”: la evolución humana. Los humanos evolucionaron para modificar su entorno y a sí mismos, especialmente a través de la cultura y las tecnologías. La cultura es parte de la naturaleza. De ella resultan los i-ciborgs mundanos de la actualidad,  los aviones militares no tripulados, la fusión íntima humano-máquina y la ingeniería genética: lo que a su vez produce sensaciones de inquietud, arrogancia y miedo. La política contemporánea debe de considerar si estamos asegurando un futuro sostenible y vivible para nuestros descendientes. Algunos experimentos sociales como el Burning Man son una prefiguración de esta necesidad creativa por la concienciación tecno-social.

  16. Ocean climate coupling in the tropical Pacific Ocean over the past fifty years: implications and feedbacks

    International Nuclear Information System (INIS)

    Wang, Xiujun; Murtugudde, Ragu; Busalacchi, Antonio J.


    Full text: The tropical Pacific plays an important role in climate because of its significant air-sea exchanges of heat, freshwater, and carbon dioxide (C02), and because of its direct linkage to climate variability. There are two dominant modes of climate variability in the Tropics: the El Nino-Southern Oscillation (ENSO) phenomenon and the Pacific Decadal Oscillation (PDO). There has been strong evidence of ENSO and PDO impacts on tropical Pacific physics and biogeochemistry, including heat content, ocean circulation (McPhaden and Zhang 2002), and carbon fluxes (Feely ef al. 2006; Wang ef al. 2006). In this study, we apply a basin-scale ocean circulation-ecosystem-carbon model (Wang ef al. 2006) to study the responses of the tropical Pacific ecosystem, biogeochemistry and carbon cycle to climate forcing over the past 50 years. The model produces strong spatial and temporal variability in surface nutrient concentration, phytoplankton biomass, carbon uptake, and sea-to-air C02 flux, which are largely associated with the ENSO phenomenon. In particular, the size of the tropical Pacific C02 source is large during the ENSO cold phase but small during the ENSO warm phase. There are significant decadal variations in tropical Pacific carbon fluxes, reflecting physical and biogeochemical changes associated with the 1977 and 1997/98 PDO shifts. The 1977 regime shift caused 1 0 C warming in sea surface temperature and -50% reduction in surface iron concentration in the Niho3.4 area, leading to decreased biological activity. While there is a large decrease in phytoplankton growth and biomass, reduction in carbon uptake is smaller than expected, due to phytoplankton photoadaption, which increases the carbon to chlorophyll ratio in the upper euphotic zone and enhances sub-surface production. Photoadaption also results in clearer water near the surface, leading to less heating near the ocean surface and allowing more solar radiation to penetrate the subsurface. Our studies

  17. The big and little of fifty years of Moessbauer spectroscopy at Argonne

    International Nuclear Information System (INIS)

    Westfall, C.


    Using radioactive materials obtained by chance, a turntable employing gears from Heidelberg's mechanical toy shops, and other minimal equipment available in post World War II Germany, in 1959 Rudolf Moessbauer confirmed his suspicion that his graduate research had yielded ground-breaking results. He published his conclusion: an atomic nucleus in a crystal undergoes negligible recoil when it emits a low energy gamma ray and provides the entire energy to the gamma ray. In the beginning Moessbauer's news might have been dismissed. As Argonne nuclear physicist Gilbert Perlow noted: ''Everybody knew that nuclei were supposed to recoil when emitting gamma rays--people made those measurements every day''. If any such effect existed, why had no one noticed it before? The notion that some nuclei would not recoil was ''completely crazy'', in the words of the eminent University of Illinois condensed matter physicist Frederich Seitz. Intrigued, however, nuclear physicists as well as condensed matter (or solid state) physicists in various locations--but particularly at the Atomic Energy Research Establishment at Harwell in Britain and at Argonne and Los Alamos in the U.S.--found themselves pondering the Moessbauer spectra with its nuclear and solid state properties starting in late 1959. After an exciting year during which Moessbauer's ideas were confirmed and extended, the physics community concluded that Moessbauer was right. Moessbauer won the Nobel Prize for his work in 1961. In the 1960s and 1970s Argonne physicists produced an increasingly clear picture of the properties of matter using the spectroscopy ushered in by Moessbauer. The scale of this traditional Moessbauer spectroscopy, which required a radioactive source and other simple equipment, began quite modestly by Argonne standards. For example Argonne hosted traditional Moessbauer spectroscopy research using mostly existing equipment in the early days and equipment that cost $100,000 by the 1970s alongside work at

  18. The big and little of fifty years of Moessbauer spectroscopy at Argonne.

    Energy Technology Data Exchange (ETDEWEB)

    Westfall, C.


    Using radioactive materials obtained by chance, a turntable employing gears from Heidelberg's mechanical toy shops, and other minimal equipment available in post World War II Germany, in 1959 Rudolf Moessbauer confirmed his suspicion that his graduate research had yielded ground-breaking results. He published his conclusion: an atomic nucleus in a crystal undergoes negligible recoil when it emits a low energy gamma ray and provides the entire energy to the gamma ray. In the beginning Moessbauer's news might have been dismissed. As Argonne nuclear physicist Gilbert Perlow noted: ''Everybody knew that nuclei were supposed to recoil when emitting gamma rays--people made those measurements every day''. If any such effect existed, why had no one noticed it before? The notion that some nuclei would not recoil was ''completely crazy'', in the words of the eminent University of Illinois condensed matter physicist Frederich Seitz. Intrigued, however, nuclear physicists as well as condensed matter (or solid state) physicists in various locations--but particularly at the Atomic Energy Research Establishment at Harwell in Britain and at Argonne and Los Alamos in the U.S.--found themselves pondering the Moessbauer spectra with its nuclear and solid state properties starting in late 1959. After an exciting year during which Moessbauer's ideas were confirmed and extended, the physics community concluded that Moessbauer was right. Moessbauer won the Nobel Prize for his work in 1961. In the 1960s and 1970s Argonne physicists produced an increasingly clear picture of the properties of matter using the spectroscopy ushered in by Moessbauer. The scale of this traditional Moessbauer spectroscopy, which required a radioactive source and other simple equipment, began quite modestly by Argonne standards. For example Argonne hosted traditional Moessbauer spectroscopy research using mostly existing equipment in the early days and

  19. [Fifty years of the Polish School of Medicine at the University of Edinburgh (1941-1991)]. (United States)

    Tomaszewski, W


    The Polish School of Medicine at the University of Edinburgh started in 1941 on the initiative of the University. It was destined for soldier-students in the Polish Forces in Great Britain. This academic institution, unique in the history of universities, was a joint Scottish-Polish enterprise. An Agreement was concluded between the Polish Government in London and the University of Edinburgh. The School was an independent Polish academic institution and, at the same time, an integral part of the University of Edinburgh. The students matriculated at the University. The University provided all the laboratory and clinical facilities necessary for teaching. Due to a lack of Polish professors for some chairs a few of them were held by Scottish professors. Attached to them were Polish lecturers but the examinations were then held in English. The diploma, originally valid only in Poland, became recognised in Great Britain following an Act of Parliament in 1947. There were 337 students, a number of them women. 227 obtained the degree M.B., Ch.B. The war ended in 1945. The School continued up till 1949. Poland was not free. The Nazi occupation of Poland was replaced by Soviet domination which was to last for over 40 years. Only 22 of the graduates returned home, about 100 settled in G. Britain, another 100 dispersed world wide. The "magnanimous gesture" of the University of Edinburgh was thereafter remembered with gratitude by the members of the Polish School. In 1961, on the occasion of the 20th anniversary of the School, the first reunion of the graduates was organised in Birmingham for those settled in Gr. Britain. The success of the reunion prompted decision on organising annual "English" gatherings of the Polish graduates in Gr. Britain. The first world reunion of the graduates took place in Edinburgh in 1966, attracting a large number of participants on this occasion of the 25th anniversary of the School. That immensely successful anniversary of the Polish School

  20. Normalization Fifty Years Beyond

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Tøssebro, Jan; Teittinen, Antti


    toward larger group homes and congregations, inequality across municipalities, marketization, and new public management, but also an increasing emphasis on consumer rights and the use of the personal assistance scheme in services for people with ID. The authors conclude that diverging trends coexist...

  1. Florence Richardson Wyckoff (1905-1997), Fifty Years of Grassroots Social ActivismVolume III: Watsonville Years 1960-1985


    Wyckoff, Florence Richardson; Jarrell, Randall


    Florence Wyckoff's three-volume oral history documents her remarkable, lifelong work as a social activist, during which she has become nationally recognized as an advocate of migrant families and children. From the depression years through the 1970s, she pursued grassroots, democratic, community-building efforts in the service of improving public health standards and providing health care, education, and housing for migrant families. Major legislative milestones in her career of advocacy were...

  2. From conditioning to learning communities: implications of fifty years of research in e-learning interaction design

    Directory of Open Access Journals (Sweden)

    Andrew Ravenscroft


    Full Text Available This paper will consider e-learning in terms of the underlying learning processes and interactions that are stimulated, supported or favoured by new media and the contexts or communities in which it is used. We will review and critique a selection of research and development from the past fifty years that has linked pedagogical and learning theory to the design of innovative e-learning systems and activities, and discuss their implications. It will include approaches that are, essentially, behaviourist (Skinner and Gagné, cognitivist (Pask, Piaget and Papert, situated (Lave, Wenger and Seely-Brown, socioconstructivist (Vygotsky, socio-cultural (Nardi and Engestrom and community-based (Wenger and Preece. Emerging from this review is the argument that effective elearning usually requires, or involves, high-quality educational discourse, that leads to, at the least, improved knowledge, and at the best, conceptual development and improved understanding. To achieve this I argue that we need to adopt a more holistic approach to design that synthesizes features of the included approaches, leading to a framework that emphasizes the relationships between cognitive changes, dialogue processes and the communities, or contexts for e-learning.

  3. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

    Directory of Open Access Journals (Sweden)

    Diego Pozza


    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

  4. A leadership development program for surgeons: First-year participant evaluation. (United States)

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


    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.

  5. An Ode to Stuart Hall's "The Supply of Demand": The Case of Post-Secondary Education in Ontario Fifty Years Later (United States)

    FitzGerald Murphy, Maggie


    Despite the fact that over fifty years have passed since its publication, Stuart Hall's article "The Supply of Demand" (1960), is remarkably relevant today. The central message that society must not be blinded by "prosperity" such that it no longer envisions and demands a better world is especially pertinent in light of the…

  6. The First 100 Years of American College of Surgeons Presidential Addresses. (United States)

    Ghanem, Omar M; Heitmiller, Richard F


    We reviewed the first 100 years of presidential addresses delivered at the fall congress of the American College of Surgeons (ACS). Our hypothesis was that these addresses would be an excellent indicator of the College's position on surgical policy, ethics, methods, and education. All ACS presidential addresses from 1913 to 2013 were identified through the ACS archives website. This included the presenter, title, year, and citation if published in a peer reviewed journal. The text of each address was obtained from the ACS archives, or from the listed citations. Addresses were then classified into 1 of 6 subgroups based on content-surgical credo, medical innovation, medical education, surgical history, business and legal, and personal tribute. The 100-year period was divided into 5 interval each of 20-year and the frequency of each category was graphed over time. There were 111 ACS presidential addresses delivered in the study period. Distribution by category was surgical credo (57%), surgical history (14%), medical innovation (10%), medical education (8%), business and legal (6%), and personal tributes (5%). The frequency of surgical credo has remained stable over time. Business and legal emerged as a new category in 1975. The other topics had low, but stable frequency. ACS presidential addresses do reflect the College's position on surgical policy and practice. The college has remained consistent in serving its members, maintaining, and defining the role of its organization, the qualifications for membership, and the expectations for the professional conduct of its members. Copyright © 2016. Published by Elsevier Inc.

  7. Deutsches Atomforum turns fifty

    International Nuclear Information System (INIS)

    Geisler, Maja


    Fifty years ago, the Deutsches Atomforum e. V. was founded to promote the peaceful uses of nuclear power in Germany. On July 1, 2009, the organization celebrated its fiftieth birthday in Berlin. The anniversary was celebrated in the Berlin electricity plant, Germany's oldest existing building for commercial electricity generation. DAtF President Dr. Walter Hohlefelder welcomed some 200 high-ranking guests from politics, industry, and from the nuclear community, above all, the Chancellor of the Federal Republic of Germany, Dr. Angela Merkel, and, as keynote speaker, Professor Dr. Arnulf Baring. (orig.)

  8. Fifty years ago, the black coal mine Barsinghausen was shut down; Vor 50 Jahren wurde das Steinkohlenbergwerk Barsinghausen stillgelegt

    Energy Technology Data Exchange (ETDEWEB)

    Boden, Konrad


    In the year 1957, the black coal mine Barsinghausen of the former Preussag AG was shut down. Under this aspect, the author of the contribution under consideration recalls this event. Substantial aspects of this contribution are: (a) The mine in the year 1955; (b) How did it come to the shutdown? (c) Reactions in the publicity; (d) Settlement of alternative industry; (e) Works council; (f) Social plan; (g) Where is the staff?.

  9. An Interview with Joe McMann: Lessons Learned from Fifty Years of Observing Hardware and Human Behavior (United States)

    McMann, Joe


    Pica Kahn conducted "An Interview with Joe McMann: Lessons Learned in Human and Hardware Behavior" on August 16, 2011. With more than 40 years of experience in the aerospace industry, McMann has gained a wealth of knowledge. This presentation focused on lessons learned in human and hardware behavior. During his many years in the industry, McMann observed that the hardware development process was intertwined with human influences, which impacted the outcome of the product.

  10. 'Suddenly the First Fifty Years of My Life Made Sense': Experiences of Older People with Autism (United States)

    Hickey, Aoife; Crabtree, Jason; Stott, Joshua


    Research on the experience of growing older with autism is very limited. In this study, 13 people with autism aged over 50 years participated in semi-structured interviews about their experiences of diagnosis, social support and getting older. Interviews were analysed using thematic analysis. Three overarching themes were generated: difference,…

  11. Oak Ridge National Laboratory [ORNL] Review, Vol. 25, Nos. 3 and 4, 1992 [The First Fifty Years (United States)

    Krause, C.(ed.)


    In observation of the 50th anniversary of Oak Ridge National Laboratory, this special double issue of the Review contains a history of the Laboratory, complete with photographs, drawings, and short accompanying articles. Table of contents include: Wartime Laboratory; High-flux Years; Accelerating Projects; Olympian Feats; Balancing Act; Responding to Social Needs; Energy Technologies; Diversity and Sharing; Global Outreach; Epilogue

  12. The Meta-Analysis of Clinical Judgment Project: Fifty-Six Years of Accumulated Research on Clinical Versus Statistical Prediction (United States)

    Aegisdottir, Stefania; White, Michael J.; Spengler, Paul M.; Maugherman, Alan S.; Anderson, Linda A.; Cook, Robert S.; Nichols, Cassandra N.; Lampropoulos, Georgios K.; Walker, Blain S.; Cohen, Genna; Rush, Jeffrey D.


    Clinical predictions made by mental health practitioners are compared with those using statistical approaches. Sixty-seven studies were identified from a comprehensive search of 56 years of research; 92 effect sizes were derived from these studies. The overall effect of clinical versus statistical prediction showed a somewhat greater accuracy for…

  13. Rhode Island hurricanes and tropical storms: A fifty-six year summary 1936-1991. Technical memo

    International Nuclear Information System (INIS)

    Vallee, D.R.


    The paper was compiled to provide a general overview of all tropical cyclone activity near Rhode Island since 1936. The year of 1936 is arbitrary, chosen mainly to include a 'not so well known' system prior to the well documented Great New England Hurricane of 1938. Thirty-one such storms have affected the state in the past 56 years, either making landfall along the coast of southern New England, or passing close enough over the offshore waters to spread tropical storm or hurricane force conditions into the area. The intensities of these systems have ranged from weak, disorganized tropical storms to full fledged major hurricanes. The one feature common to almost all of the storms was a rapid acceleration toward Rhode Island, which greatly reduced the time to prepare and evacuate

  14. Pile burning creates a fifty-year legacy of openings in regenerating lodgepole pine forests in Colorado (United States)

    Charles C. Rhoades; Paula J. Fornwalt


    Pile burning is a common means of disposing the woody residues of logging and for post-harvest site preparation operations, in spite of the practice’s potential negative effects. To examine the long-term implications of this practice we established a 50-year sequence of pile burns within recovering clear cuts in lodgepole pine forests. We compared tree, shrub and...

  15. Journal of Limnology Vol. 65 (Suppl. 1): The climate of Lago Maggiore area during the last fifty years


    Giussani, Gianluigi; Bertoni, Roberto


    Data collected in over 50 years' activity at the C.N.R. meteorological station of Pallanza were analysed to see whether any changes have taken place in some climatic elements and to quantify the extent of such changes. A statistical analysis of the respective historical series was performed on nine meteorological parameters (solar radiation, insolation, air temperature, atmospheric pressure, humidity, cloud cover, precipitation, evaporation and wind), and on two other strictly limnological fe...

  16. Proceedings of the International Symposium on Advances in Nuclear Physics. Fifty Years of Institutional Physics Research in Romania

    International Nuclear Information System (INIS)

    Poenaru, Dorin; Stoica, Sabin


    This Symposium was devoted to the cerebration of 50 years of Institutional Physics Research in Romania. The inaugural talk was given by professor W. Greiner on development in fission, fusion, cluster radioactivity and the extension of the periodic system of elements. Seven divisions followed on the items: super heavy nuclei (4 talks); new fission modes (4 talks); astrophysics and cosmic rays (5 talks); particle and high energy physics (6 talks); hadronic matter (6 talks); nuclear structure and reactions (13 talks); atomic physics (4 talks); applications and history. Many of these talks highlighted the substantial Romanian contributions to the scientific achievements in these fields

  17. A vision for the second fifty years of nuclear energy. Vision and strategies; Wizja drugiego piecdziesieciolecia energetyki jadrowej

    Energy Technology Data Exchange (ETDEWEB)

    Hori, M. [International Nuclear Societies Council (Poland)] [and others


    The paper is the Polish issue of the report worked out by International Nuclear Societies Council published in 1996. The report contains the experts opinion on development of nuclear energy and applications of radiation techniques and sources worldwide during the next 50 years. The worldwide energy demand prognosis as well as needs of different branches of industry, agriculture, medicine, etc. have been taken into account. The broad spectrum of aspects (safety assurance, economy, environmental impacts) connected with nuclear technology utilization has been also discussed. Transl., 24 refs, 6 figs, 6 tabs.

  18. Suicides in Serbia at the beginning of the 21st century and trends in the past fifty years

    Directory of Open Access Journals (Sweden)

    Penev Goran


    Full Text Available In 2006 in Serbia, 1444 persons committed suicide (19.5 per 100.000 population. Compared to the early 50s of the 20th century, the number of suicides has nearly doubled, but there has been a moderate decrease in the last 15 years. Similar, but somewhat more moderate tendencies are noted in the change of the value of the suicide rates. The lowest suicide rates were recorded during the 1950s, around 12 per 100.000, and the highest in the last decade of the 20th century when the rate reached 20 suicides per 100.000 inhabitants. The highest suicide rate is among the elderly, and there is also a noticeable tendency of increase in the share of the elderly in the total number of suicides, which is primarily the consequence of intense demographic aging. With youth, the last thirty years note a decline of both the number of suicides and the value of the suicide rates. The number of young people aged 15-24 who have committed suicide in 2006 is less than half of the number from 1971 (decreased from 150 to 66, and the values of suicide rates are also significantly low (decreased from 11.5 to 6.9 per 100.000. Despite certain changes in the values of age-specific suicide rates achieved in the last 50 years, their age patterns of suicide mortality can be characterized as stable. Men are dominant among persons who have committed suicide, with double the number of women, and the highest recorded value of the suicide rate of women never surpassed the value of the lowest suicide rate in men. In terms of marital status, the total rate of suicides is highest with widowers then divorced persons, married persons, and lowest rates are with celibates. In all four groups, suicide rates are at least 3 times higher for men. There is also a clear connection between the level of education and suicide rates for both sexes, with the suicide rate decreasing with higher educational level. In terms of total suicide rate, Serbia is currently in the top half of the European list of

  19. Fifty years of violent war deaths from Vietnam to Bosnia: analysis of data from the world health survey programme. (United States)

    Obermeyer, Ziad; Murray, Christopher J L; Gakidou, Emmanuela


    To provide an accurate estimate of violent war deaths. Analysis of survey data on mortality, adjusted for sampling bias and censoring, from nationally representative surveys designed to measure population health. Estimated deaths compared with estimates in database of passive reports. 2002-3 World health surveys, in which information was collected from one respondent per household about sibling deaths, including whether such deaths resulted from war injuries. Estimated deaths from war injuries in 13 countries over 50 years. From 1955 to 2002, data from the surveys indicated an estimated 5.4 million violent war deaths (95% confidence interval 3.0 to 8.7 million) in 13 countries, ranging from 7000 in the Republic of Congo [corrected] to 3.8 million in Vietnam. From 1995 to 2002 survey data indicate 36,000 war deaths annually (16,000 to 71,000) in the 13 countries studied. Data from passive surveillance, however, indicated a figure of only a third of this. On the basis of the relation between world health survey data and passive reports, we estimate 378,000 globalwar deaths annually from 1985-94, the last years for which complete passive surveillance data were available. The use of data on sibling history from peacetime population surveys can retrospectively estimate mortality from war. War causes more deaths than previously estimated, and there is no evidence to support a recent decline in war deaths.

  20. Fifty years on: against the stigmatising myths, taboos and traditions embedded within the Suicide Act 1961 (UK). (United States)

    Shaw, Julia J A


    Although assisted suicide carries a maximum of 14 years imprisonment in England, courts and juries have historically demonstrated a reluctance to convict, most specifically in relation to those travelling abroad to accompany a terminally ill person seeking assisted dying. The possibility of prosecution is still present, however, and there have recently been a number of challenges to the law on assisted dying. During the consultation period of the Coroners and Justice Act 2009 (UK) an amendment was proposed that would have legalised, among other things, assisting suicide overseas. However, it was voted down by peers who believed it to be dangerously radical. In 2008 a multiple sclerosis sufferer requested a clear policy statement, should her partner help her to seek assisted dying abroad in the future. After her application was initially rejected, Mrs Purdy was granted leave to appeal and following a favourable ruling by the House of Lords in 2009, the Director of Public Prosecutions clarified the law on assisted suicide, introducing a Full Code Test which includes the consideration of "public interest factors". Although the new guidelines are not a direct threat to the 50-year-old Suicide Act 1961 (UK), it is clearly an historic development: the latest in a series of high-profile cases and debates which have taken place over the last decade. It is suggested that English law on assisted dying continues to rely on a range of inappropriate concepts, taboos and superstitions, and it is from this perspective that the implications for future legislative reform are addressed.

  1. Summary of Symposium on Cloud Systems, Hurricanes and TRMM: Celebration of Dr. Joanne Simpson's Career, The First Fifty Years (United States)

    Tao, W.-K.; Adler, R.; Braun, S.; Einaudi, F.; Ferrier, B.; Halverson, J.; Heymsfield, G.; Kummerow, C.; Negri, A.; Kakar, R.; hide


    A symposium celebrating the first 50 years of Dr. Joanne Simpson's career took place at the NASA/Goddard Space Flight Center from December 1 - 3, 1999. This symposium consisted of presentations that focused on: historical and personal points of view concerning Dr. Simpson's research career, her interactions with the American Meteorological Society, and her leadership in TRMM; scientific interactions with Dr. Simpson that influenced personal research; research related to observations and modeling of clouds, cloud systems and hurricanes; and research related to the Tropical Rainfall Measuring Mission (TRMM). There were a total of 36 presentations and 103 participants from the US, Japan and Australia. The specific presentations during the symposium are summarized in this paper.

  2. A fifty year record of winter glacier melt events in southern Chile, 38°–42°S

    International Nuclear Information System (INIS)

    Brock, Ben W; Burger, Flavia; Montecinos, Aldo; Rivera, Andrés


    Little is known about the frequency and potential mass balance impact of winter glacier melt events. In this study, daily atmospheric temperature soundings from the Puerto Montt radiosonde (41.43°S) are used to reconstruct winter melting events at the glacier equilibrium line altitude in the 38°–42°S region of southern Chile, between 1960 and 2010. The representativeness of the radiosonde temperatures to near-surface glacier temperatures is demonstrated using meteorological records from close to the equilibrium line on two glaciers in the region over five winters. Using a degree-day model we estimate an average of 0.28 m of melt and 21 melt days in the 15 June–15 September period each year, with high inter-annual variability. The majority of melt events are associated with midlatitude migratory high pressure systems crossing Chile and northwesterly flows, that force adiabatic compression and warm advection, respectively. There are no trends in the frequency or magnitude of melt events over the period of record, but the annual frequency of winter melt days shows a significant, although rather weak and probably non-linear, relationship to late winter and early spring values of a multivariate El Niño Southern Oscillation Index (MEI). (letter)

  3. Fifty years of coiled-coils and alpha-helical bundles: a close relationship between sequence and structure. (United States)

    Parry, David A D; Fraser, R D Bruce; Squire, John M


    alpha-Helical coiled coils are remarkable for the diversity of related conformations that they adopt in both fibrous and globular proteins, and for the range of functions that they exhibit. The coiled coils are based on a heptad (7-residue), hendecad (11-residue) or a related quasi-repeat of apolar residues in the sequences of the alpha-helical regions involved. Most of these, however, display one or more sequence discontinuities known as stutters or stammers. The resulting coiled coils vary in length, in the number of chains participating, in the relative polarity of the contributing alpha-helical regions (parallel or antiparallel), and in the pitch length and handedness of the supercoil (left- or right-handed). Functionally, the concept that a coiled coil can act only as a static rod is no longer valid, and the range of roles that these structures have now been shown to exhibit has expanded rapidly in recent years. An important development has been the recognition that the delightful simplicity that exists between sequence and structure, and between structure and function, allows coiled coils with specialized features to be designed de novo.

  4. Fifty Years of Flight Research: An Annotated Bibliography of Technical Publications of NASA Dryden Flight Research Center, 1946-1996 (United States)

    Fisher, David F.


    Titles, authors, report numbers, and abstracts are given for more than 2200 unclassified and unrestricted technical reports and papers published from September 1946 to December 1996 by NASA Dryden Flight Research Center and its predecessor organizations. These technical reports and papers describe and give the results of 50 years of flight research performed by the NACA and NASA, from the X-1 and other early X-airplanes, to the X-15, Space Shuttle, X-29 Forward Swept Wing, and X-31 aircraft. Some of the other research airplanes tested were the D-558, phase 1 and 2; M-2, HL-10 and X-24 lifting bodies; Digital Fly-By-Wire and Supercritical Wing F-8; XB-70; YF-12; AFTI F-111 TACT and MAW; F-15 HiDEC; F-18 High Alpha Research Vehicle, and F-18 Systems Research Aircraft. The citations of reports and papers are listed in chronological order, with author and aircraft indices. In addition, in the appendices, citations of 233 contractor reports, more than 200 UCLA Flight System Research Center reports and 25 video tapes are included.

  5. Fifty years of Brazilian Dental Materials Group: scientific contributions of dental materials field evaluated by systematic review (United States)

    ROSA, Wellington Luiz de Oliveira; SILVA, Tiago Machado; LIMA, Giana da Silveira; SILVA, Adriana Fernandes; PIVA, Evandro


    ABSTRACT Objective A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. Material and Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma) statement. Searches were performed until December 2014 in six databases: MedLine (PubMed), Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI - Instituto Nacional de Propriedade Industrial) was screened in order to get an overview of Brazilian technological development in the dental materials field. Two reviewers independently analyzed the documents. Only studies and patents related to dental materials were included in this review. Data regarding the material category, dental specialty, number of documents and patents, filiation countries, and the number of citations were tabulated and analyzed in Microsoft Office Excel (Microsoft Corporation, Redmond, Washington, United States). Results A total of 115,806 studies and 53 patents were related to dental materials and were included in this review. Brazil had 8% affiliation in studies related to dental materials, and the majority of the papers published were related to dental implants (1,137 papers), synthetic resins (681 papers), dental cements (440 papers), dental alloys (392 papers) and dental adhesives (361 papers). The Brazilian technological development with patented dental materials was smaller than the scientific production. The most patented type of material was dental alloys (11 patents), followed by dental implants (8 patents) and composite resins (7 patents). Conclusions Dental materials science has had a substantial number of records, demonstrating an important presence in scientific and technological development of dentistry. In addition, it is important to approximate the relationship between academia and industry to expand the technological development in

  6. Fifty years of Brazilian Dental Materials Group: scientific contributions of dental materials field evaluated by systematic review. (United States)

    Rosa, Wellington Luiz de Oliveira; Silva, Tiago Machado; Lima, Giana da Silveira; Silva, Adriana Fernandes; Piva, Evandro


    A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma) statement. Searches were performed until December 2014 in six databases: MedLine (PubMed), Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI - Instituto Nacional de Propriedade Industrial) was screened in order to get an overview of Brazilian technological development in the dental materials field. Two reviewers independently analyzed the documents. Only studies and patents related to dental materials were included in this review. Data regarding the material category, dental specialty, number of documents and patents, filiation countries, and the number of citations were tabulated and analyzed in Microsoft Office Excel (Microsoft Corporation, Redmond, Washington, United States). A total of 115,806 studies and 53 patents were related to dental materials and were included in this review. Brazil had 8% affiliation in studies related to dental materials, and the majority of the papers published were related to dental implants (1,137 papers), synthetic resins (681 papers), dental cements (440 papers), dental alloys (392 papers) and dental adhesives (361 papers). The Brazilian technological development with patented dental materials was smaller than the scientific production. The most patented type of material was dental alloys (11 patents), followed by dental implants (8 patents) and composite resins (7 patents). Dental materials science has had a substantial number of records, demonstrating an important presence in scientific and technological development of dentistry. In addition, it is important to approximate the relationship between academia and industry to expand the technological development in countries such as Brazil.

  7. Radiation Protection in Slovenia Over the Past Fifty Years (1963-2013) and the Slovenian Society of Radiation Protection

    International Nuclear Information System (INIS)

    Omahen, G.; Krizman, M.J.


    The use of the ionizing radiation sources in Slovenia started as early as 1900 when X-ray device was put in operation; the first radioactive source was used two years later. Artificial radioactive sources were introduced from 1954 onwards. The use of radioactive sources in industry started in the middle of the 1950's when industrial radiography was introduced due to strong metal industry in Slovenia. Four nuclear facilities were built in Slovenia: the research reactor TRIGA (1966), the Krško nuclear power plant (1983), the mining and milling uranium complex at Žirovski Vrh (1984) and the low and intermediate level radioactive waste storage (1986). The infrastructure of radiation protection (RP) in the former Yugoslavia was established as late as the first Law on RP was adopted in 1959, the competent authorities were defined and technical support organisations for RP were designated. But the whole infrastructure could not follow the rapid development of nuclear industry and the extent uses of sources. After joining EU, the changes in legislation made a significant shift ahead in radiation protection, as regards the quality of the implementation of radiation protection measures as the intensity of administrative and inspection controls. Slovenian Radiation Protection Society was established in 1981 during the 11th symposium of the Yugoslav Radiation Protection Society. The role of the Slovenian Society for Radiation Protection has never been significant, mostly due to a small critical mass of membership. This is sometimes advantageous since everyone knows each other and can easily come with the problem to be solved. This feature reduces the need for the Society to be active as a formal association. The main role of the Society is the distribution of actual information on RP and related important events.(author)

  8. [Fifty years of residency in Psychiatry at the University of Montreal: relevance and necessity of the Residents' Association]. (United States)

    Thibault, Alexis


    In the context of the fiftieth anniversary celebrations of the Département de psychiatrie de l'Université de Montréal, the present article offers to retrace the history of the Psychiatry Resident's Association (ARPUM). Since the Association's activities and demands reflected the concerns of the time, a depiction of the Residency Program and exploration of the historical and administrative context, in each key period, is also undertaken. Multiple psychiatrists from every decade, who were once active members of the Association, were interviewed and asked to describe the Residency Program at their time, with its positive and negative aspects, based on their own personal experience as a resident, but also as a member of the organization. The interviewees were also invited to share their recollections of the various Association's demands, representations, activities and functioning, depending on the issues and periods. Various private and public archives were also used, in order to contextualize the residents' experiences and the Association's work. A brief exploration of the historical and political context that led to the creation of the organization is explained. Training and working conditions of residents at that time are reported, enabling the understanding of the first demands when the group was born. Historical jumps are then proposed, from decades to decades, in order to depict key issues, whether they were academic, clinical or organizational, through which the Association worked, over the evolution of the Residency Program. The internal functioning and its occasional problems throughout the years are also described, as is the role in organizing social and educational events. The Residency Program is in constant mutation, and the Association has played its part in shaping the psychiatric training at the Université de Montréal. Multiple positive and tangible impacts were and are still made possible from the collaborative work between the Département de

  9. The National Institute of Research and Development for Isotopic and Molecular Technologies at Cluj - Napoca - Fifty Years of Experience

    International Nuclear Information System (INIS)

    Vasaru, Gh.


    , 15 N, has been separated for the first time by means of a cascade of 4 columns of 10 m total length. Later on a 19 column cascade was used to obtained 13 C. By using the same method the neon isotopes ( 20 Ne, 22 Ne) were separated obtaining enrichment levels of up to 99%. Similar enrichment levels were obtained for 36 Ar, 78 Kr and 86 Kr. A special effort was devoted to enrichment of 15 N, up to 99.8%, with a production yield of 1000 g/year, an isotope largely used in agricultural research and required on external market. The report presents also the separation methodologies for other isotopes. In direct connection with the isotope separation works extremely high precision isotopic and chemical analytical methods for extreme concentration were developed. High performance mass spectrometers were also devised, the institute becoming the most important producer of such equipment in this country. Routine deuterium analyses at Heavy Water plant at Drobeta- Turnu Severin are carried out with high precision mass spectrometers produced at ITIM. Finally, the report presents the works on novel applications of stable isotopes separated or enriched at ITIM

  10. Fifty Years of Matter Waves (United States)

    Medicus, Heinrich A.


    Discusses the origin of de Broglie's concept and its influences on his contemporaries, notably on Einstein, Schrodinger, Elsasser, Davisson, and Thomson. Indicates that the theory served not only as the starting point of quantum mechanics, but also opened new experimental possibilities. Historical inaccuracies are corrected with new material…

  11. Fifty years of genetic load

    International Nuclear Information System (INIS)

    Wallace, B.


    This book discusses the radiation effects on Drosophila. It was originally thought that irradiating Drosophila would decrease the average fitness of the population, thereby leading to information about the detrimental effects of mutations. Surprisingly, the fitness of the irradiated population turned out to be higher than that of the control population. The original motivation for the experiment was as a test of genetic load theory. The average fitness of a population is depressed by deleterious alleles held in the population by the balance between mutation and natural selection. The depression is called the genetic load of the population. The load dose not depend on the magnitude of the deleterious effect of alleles, but only on the mutation rate

  12. Fifty years of pacemaker advancements. (United States)

    Steinhaus, David


    A 1957 power blackout in Minnesota prompted C. Walton Lillehei, MD, a pioneer in open heart surgery, to ask Earl Bakken, the co-founder of Medtronic, Inc., to create a battery-operated pacemaker for pediatric patients. That conversation led to the development of the first external battery-operated pacemaker. That first bulky device is far removed from the tiny implantable computers available to heart patients today. Now, the size of two silver dollars stacked on top of one another, a pacemaker is prescribed for a person whose heart beats too slowly or pauses irregularly. Slightly larger devices have more recently evolved from pacing and regulating the heartbeat to being able to provide therapeutic high voltage shocks when needed to stop runaway fast heart rates, recording heart activity, and other physiologic functions, even resynchronizing the heart's chambers-all while providing information on the patient's condition and device performance to the doctor remotely or in the office.

  13. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

    Directory of Open Access Journals (Sweden)

    Ahmet Barış Durukan


    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  14. The experience of artificial urinary sphincter implantation by a single surgeon in 15 years. (United States)

    Shen, Yuan-Chi; Chiang, Po-Hui


    Artificial urinary sphincter (AUS) is the gold standard treatment for urinary incontinence owing to sphincter incompetence. We reviewed our experience in AUS implantation. From 1995 to 2009, 19 patients underwent 25 AUS implantations performed by a single surgeon. The cause of incontinence was sphincter incompetence, which was secondary to prostate surgery, neurogenic bladder, radiation, and post-traumatic urethral lesion. Twenty-three prostheses were placed in the bulbar urethra for male patients: 11 AUS cuffs were placed through the perineal approach and 12 through the penoscrotal approach. Two procedures were applied over the bladder neck for the female patients. Through a retrospective review of charts, continence and complications were analyzed. The mean follow-up time was 50.0 ± 42.9 months (range: 2-146 months). There were 16 successful surgeries (64%), and these patients were free from the need for a pad. In eight surgeries (32%), the devices were removed due to infection, while one implantation (4%) was unsuccessful due to perforation into the bulbar urethra. There was a statistically significant difference (p = 0.024) in failure rates between patients who received radiotherapy (100%) and other patients (22.7%). There was no statistically significant difference in dry and revision rates (p > 0.05) between the perineal and penoscrotal approach. Accordingly, over half of the patients with total incontinence benefitted from AUS implantation. In consideration of the high failure rate for patients receiving radiotherapy, caution should be exercised in the use of implantation. Secondary implantation has a satisfactory success rate in selected patients. The same success rate was noted for both perineal and penoscrotal approaches. Copyright © 2013. Published by Elsevier B.V.

  15. Two-year Outcomes from a Single Surgeon's Learning Curve Experience of Oblique Lateral Interbody Fusion without Intraoperative Neuromonitoring. (United States)

    Woods, Kamal; Fonseca, Ahtziri; Miller, Larry E


    Introduction Oblique lumbar interbody fusion (OLIF) is a newer procedure that avoids the psoas and lumbosacral plexus due to its oblique trajectory into the retroperitoneal space. While early experience with OLIF is reassuring, the longer-term clinical efficacy has not been well established. The purpose of this study was to describe two-year clinical outcomes with OLIF performed by a single surgeon during the learning curve without the aid of the neuromonitoring. Materials and methods Chart review was performed for the consecutive patients who underwent OLIF by a single surgeon. Back pain severity on a visual analog scale (VAS) and Oswestry Disability Index (ODI) were collected preoperatively and postoperatively at six weeks, three months, six months, one year and two years. Results A total of 21 patients (38 levels) were included in this study. The indications for surgery were degenerative disc disease (n=10, 47.6%), spondylolisthesis (n=9, 42.9%) and spinal stenosis (n=6, 28.6%). The median operating room time was 351 minutes (interquartile range (IQR): 279-406 minutes), blood loss was 40 ml (IQR: 30-150 ml), and hospital stay was 2.0 days (IQR: 1.0-3.5 days). The complication rate was 9.5%, both venous injuries. There were no other perioperative complications. Back pain severity decreased by 70%, on average, over two years (p safe and clinically efficacious for up to two years. The complication rate in this cohort is similar to other published OLIF series and appears acceptable when compared to the lateral lumbar interbody fusion (LLIF) and the anterior lumbar interbody fusion (ALIF). No motor or sensory deficits were observed in this study, supporting the premise that the neuromonitoring is unnecessary in OLIF.

  16. Robotic mitral valve operations by experienced surgeons are cost-neutral and durable at 1 year. (United States)

    Coyan, Garrett; Wei, Lawrence M; Althouse, Andrew; Roberts, Harold G; Schauble, Drew; Murashita, Takashi; Cook, Chris C; Rankin, J Scott; Badhwar, Vinay


    Robotic mitral valve surgery has potential advantages in patient satisfaction and 30-day outcome. Cost concerns and repair durability limit wider adoption of robotic technology. This study examined detailed cost differences between robotic and sternotomy techniques in relation to outcomes and durability following robotic mitral program initiation. Between April 2013 and October 2015, 30-day and 1-year outcomes of 328 consecutive patients undergoing robotic or sternotomy mitral valve repair or replacement by experienced surgeons were examined. Multivariable logistic regression informed propensity matching to derive a cohort of 182 patients. Echocardiographic follow-up was completed at 1 year in all robotic patients. Detailed activity-based cost accounting was applied to include direct, semidirect, and indirect costs with special respect to robotic depreciation, maintenance, and supplies. A quantitative analysis of all hospital costs was applied directly to each patient encounter for comparative financial analyses. Mean predicted risk of mortality was similar in both the robotic (n = 91) and sternotomy (n = 91) groups (0.9% vs 0.8%; P > .431). The total costs of robotic mitral operations were similar to those of sternotomy ($27,662 vs $28,241; P = .273). Early direct costs were higher in the robotic group. There was a marked increase in late indirect cost with the sternotomy cohort related to increased length of stay, transfusion requirements, and readmission rates. Robotic repair technique was associated with no echocardiographic recurrence greater than trace to only mild regurgitation at 1 year. Experienced mitral surgeons can initiate a robotic program in a cost-neutral manner that maintains clinical outcome integrity as well as repair durability. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  17. [The competent surgeon. Bridging the gap between undergraduate final year and postgraduate surgery training]. (United States)

    Kadmon, M; Ganschow, P; Gillen, S; Hofmann, H S; Braune, N; Johannink, J; Kühn, P; Buhr, H J; Berberat, P O


    Competency-based frameworks rely on relevant professional competency rather than formal regulations. The transitional phase between final year undergraduate and common trunk postgraduate medical training is characterized by an increase of professional responsibility whereby previously acquired knowledge, skills and abilities have to be merged and applied to patients. Undergraduate and postgraduate training programs should ensure a successive transfer of responsibility for medical practice to final year students and young residents depending on individual competence. The concept of entrustable professional activities (EPA) represents a curricular concept based on concrete medical tasks which may be assigned to the responsibility of the trainee.

  18. [One hundred years of the Association of Surgeons in the Netherlands. V. Traumatology

    NARCIS (Netherlands)

    Goris, R.J.A.


    Traumatology in the Netherlands gained considerable momentum during the last years of the twentieth century. This breakthrough was due to the creation of ten trauma care centres, each with its own 'mobile medical team'. Additionally, four of these centres dispose of a helicopter for rapid transport

  19. Commentary: An Introduction to Leadership Self-Assessment at the Society of Neurological Surgeons Post-Graduate Year 1 Boot Camp: Observations and Commentary. (United States)

    Hunt, Matthew A; Heilman, Carl B; Shutran, Max; Wu, Julian K


    Recent trends in graduate medical education have emphasized the mastery of nontechnical skills, especially leadership, for neurosurgical trainees. Accordingly, we introduced leadership development and self-awareness training to interns attending the Society of Neurological Surgeons Post-Graduate Year 1 Boot Camp in the Northeast (New England/New York/New Jersey) region in 2015. Feedback about the session was collected from interns. While neurosurgical interns conveyed a desire to receive more information on improving their leadership skills, most indicated that guidance seemed to be lacking in this critical area. We discuss some of the professional development needs uncovered during this process. Copyright © 2017 by the Congress of Neurological Surgeons.

  20. Practice patterns and job satisfaction in fellowship-trained endocrine surgeons. (United States)

    Tsinberg, Michael; Duh, Quan-Yang; Cisco, Robin M; Gosnell, Jessica E; Scholten, Anouk; Clark, Orlo H; Shen, Wen T


    Debates about the difficult job market for young endocrine surgeons are ongoing. This study aimed to analyze the practice patterns and work-related satisfaction levels of recently trained endocrine surgeons. An anonymous survey was utilized. Participants were divided into 3 groups: "Young" (5 years). Fifty-six of 78 surgeons (72%) responded to the survey. Time in practice ranged from 1 to 9 years (mean, 3.9 ± 0.28). Forty-five (80%) described their practice as academic. Participants performed 244.1 ± 17.8 operations within the last year; 75.4 ± 3.3% were endocrine cases. More surgeons in the "young" group have academic practices (92%) and joined established endocrine surgery groups (54%) versus older surgeons (67% and 42%; P = .05). Of surgeons in the "young" group, 4% started their own practice versus 33% in the "older" group (P = .04). Level of satisfaction with financial compensation (3.2 on a 4-point scale versus 2.9) and lifestyle (3.6 vs 3.1) was also higher in the younger group (P = .009). Despite widespread speculation about scarcity of academic jobs after fellowship, recently trained endocrine surgeons are more likely to practice in academic settings and join established endocrine surgery practices when compared with older surgeons. Overall satisfaction level is higher among recently trained surgeons. Copyright © 2012 Mosby, Inc. All rights reserved.

  1. Years Versus Days Between Successive Surgeries, After an Initial Outpatient Procedure, for the Median Patient Versus the Median Surgeon in the State of Iowa. (United States)

    Dexter, Franklin; Jarvie, Craig; Epstein, Richard H


    Previously, we studied the relative importance of different institutional interventions that the largest hospital in Iowa could take to grow the anesthesia department's outpatient surgical care. Most (>50%) patients having elective surgery had not previously had surgery at the hospital. Patient perioperative experience was unimportant for influencing total anesthesia workload and numbers of patients. More important was the availability of surgical clinic appointments within several days. These results would be generalizable if the median time from surgery to a patient's next surgical procedure was large (eg, >2 years), among all hospitals in Iowa with outpatient surgery, and without regard to the hospital where the next procedure was performed. There were 37,172 surgical cases at hospital outpatient departments of any of the 117 hospitals in Iowa from July 1, 2013, to September 30, 2013. Data extracted about each case included its intraoperative work relative value units. The 37,172 cases were matched to all inpatient and outpatient records for the next 2 years statewide using patient linkage identifiers; from these were determined whether the patient had surgery again within 2 years. Furthermore, the cases' 1820 surgeons were matched to the surgeon's next outpatient or inpatient case, both including and excluding other cases performed on the date of the original case. By patient, the median time to their next surgical case, either outpatient or inpatient, exceeded 2 years, tested with weighting by intraoperative relative value units and repeated when unweighted (both P 2 years for patients versus 1 day for surgeons. Thus, although patients' experiences are an important attribute of quality of care, surgeons' experiences are orders of magnitude more important from the vantage point of marketing and growth of an anesthesia practice.

  2. Il clima dell'areale del Lago Maggiore durante gli ultimi cinquant'anni (The climate of Lago Maggiore area during the last fifty years)


    Ambrosetti, Walter; Barbanti, Luigi; Rolla, Angelo


    Data collected in over 50 years' activity at the C.N.R. meteorological station of Pallanza were analysed to see whether any changes have taken place in some climatic elements and to quantify the extent of such changes. A statistical analysis of the respective historical series was performed on nine meteorological parameters (solar radiation, insolation, air temperature, atmospheric pressure, humidity, cloud cover, precipitation, evaporation and wind), and on two other strictly limnological fe...

  3. Changes in drought tolerance in maize associated with fifty years of breeding for yield in the US Corn Belt [Zea mays L.

    International Nuclear Information System (INIS)

    Campos, H.; Cooper, M.; Edmeades, G.O.; Löffler, C.; Schussler, J.R.; Ibanez, M.


    Understanding the changes underlying past breeding progress may help to focus research efforts and accelerate future genetic gains. The major abiotic stress affecting maize production on a worldwide basis is drought. We addressed the improvements in drought tolerance over a 50-year period of hybrid breeding by evaluating, under targeted stress conditions, a set of 18 Pioneer-brand hybrids that had been released during the 1953-2001 period. Stress treatments were designed as overlapping windows of water deficit covering the pre-flowering to late grain filling development stages. Data were collected on grain yield, yield components and anthesis-silking interval (ASI) and were analyzed using a linear mixed model approach. Genetic gain was measured as the slope of the regression of the trait on the year of hybrid release. Significant, positive genetic gains of varying magnitude were observed for grain yield in all windows of stress evaluated. The largest genetic gains for grain yield were observed under conditions of full irrigation and severe flowering stress. ASI and barrenness, especially under stress at flowering, were significantly reduced by selection. Though flowering remains the most susceptible stage to drought in maize, selection has reduced its negative effects and susceptibility during early grain filling is now of similar importance in many modern hybrids. Yield under drought at flowering has more than kept pace with the increase in yield potential because of the emphasis breeders have placed on improved floral synchrony [it

  4. Long-term trends in sodium and chloride in the Mohawk River, New York: the effect of fifty years of road-salt application

    International Nuclear Information System (INIS)

    Godwin, K.S.; Hafner, S.D.; Buff, M.F.


    Sodium and chloride have increased in the last 50 years in this river ecosystem. - Ecological studies have demonstrated the adverse effects of road-salt, primarily NaCl, on water quality, flora, and fauna. In this study, we quantified changes in ionic composition and solute flux of water draining the Mohawk River Basin (9103 km 2 ) in New York State, from 1952 to 1998. Using various statistical, graphical, and modeling techniques, we showed that concentrations of Na + and Cl - have increased by 130 and 243%, respectively, while other constituents have decreased or remained constant. The use of de-icing salt on roads within the watershed, which we estimate at 39 kg km -2 day -1 , appears to be the primary mechanism responsible for reported increases, accounting for the increase in NaCl export from 16 to 46 kg km -2 day -1 over the 47-year period. Moreover, despite population decline within this rural upstate watershed, increased environmental stewardship, and The Clean Water Act, concentrations of Na + and Cl - still increased during the 1990s

  5. Fifty-three years' experience with randomized clinical trials of emergency portacaval shunt for bleeding esophageal varices in Cirrhosis: 1958-2011. (United States)

    Orloff, Marshall J


    Emergency treatment of bleeding esophageal varices (BEV) consists mainly of endoscopic and pharmacologic measures, with transjugular intrahepatic portal-systemic shunt (TIPS) performed when bleeding is not controlled. Surgical shunt has been relegated to salvage. At the University of California, San Diego, Medical Center, our group has conducted 10 studies of emergency portacaval shunt (EPCS) during 46 years. To describe 2 randomized clinical trials (RCTs) conducted from 1988 to 2011 in unselected consecutive patients who received emergency treatment for BEV. In RCT No. 1, a total of 211 unselected consecutive patients with cirrhosis and acute BEV were randomized to emergency endoscopic sclerotherapy (EEST) (n=106) or EPCS (n=105). In RCT No. 2, a total of 154 unselected consecutive patients with cirrhosis and acute BEV were randomized to TIPS (n=78) or EPCS (n=76). Diagnostic workup was completed within 6 hours of initial contact, and primary treatment was initiated within 8 to 12 hours. Regular follow-up for up to 10 years was accomplished in 100% of the patients. In RCT No. 1, EEST or EPCS; in RCT No. 2, TIPS or EPCS. The 2 groups were compared with regard to survival, control of bleeding, portal-systemic encephalopathy, and direct cost of care. RESULTS Distribution in Child risk classes was almost identical. One-third of patients were in Child class C. Permanent control of bleeding was achieved by EEST in only 20% of the patients and by TIPS in only 22%. In contrast, EPCS permanently controlled bleeding in 97% and 100% of the patients in RCT No. 2 and RCT No. 1, respectively (Pcases. Recurrent portal-systemic encephalopathy developed in 35% of the patients who underwent EEST and 61% of those who received TIPS. In contrast, portal-systemic encephalopathy occurred in 15% of the patients who received EPCS in RCT No. 1 and 21% of those in RCT No. 2. Direct costs of care were 5 to 7 times greater in the EEST ($168100) and TIPS ($264800) groups than in the EPCS

  6. The 1.3-m Robotically Controlled Telescope (RCT) at Kitt Peak - A Fifty year old dream Realized: Telescope Characteristics, Current Research and Education Progr (United States)

    Guinan, Edward; Gelderman, Richard; Strolger, Louis-Gregory; Carini, Michael T.; McGruder, Charles, III; Campbell, Rachel; Walter, Donald K.; Davis, Donald R.; Tedesco, Edward F.; Engle, Scott G.


    The 1.3 m Robotically Controlled Telescope (RCT) on Kitt Peak has a rich history, including its role as a prototype for remotely controlled telescopes during the 1960s. As such, the RCT could be considered one of the first - Telescopes from Afar. The telescope, originally called the Remotely Controlled Telescope, has been renamed the Robotically Controlled Telescope to reflect the change in operational control and mode of use. The RCT was a conceptual precursor of today's robotic telescopes, but the actual operation of a remotely controlled telescope was technologically premature for its time, and was subsequently manually operated primarily to conduct optical and infrared observations as well being used as a test bed for new spectroscopic and photometric instruments. In 1995 budget constraints forced the closing of the telescope as part of the Kitt Peak National Observatory (KPNO), following nearly 30 years of distinguished service to KPNO. A request for proposals to operate this telescope was issued to the science community. The RCT consortium, lead by Western Kentucky University, was the successful proposer for operation of the telescope. After several difficult years of retrofitting, refurbishing, and automating the telecope and observatory dome, the telescope has returned to routine science operations in November 2009. The RCT has operated smoothly since that time, with no major interruptions. Observations of objects of interest to the consortium partners (including: comets & asteroids, variable & binary stars, exoplanets, supernovae, quasars & blazars) are being routinely obtained and evaluated. One of the distinguishing features of the RCT is that it is an autonomous observatory designed to handle diverse optical imaging and photometry programs. These include being able to automatically deal with a wide range of observing parameters such as -integration time, sky conditions, repetitions, return visits, filters, air mass, non-sidereal objects, transients etc

  7. Long-term trends in sodium and chloride in the Mohawk River, New York: the effect of fifty years of road-salt application. (United States)

    Godwin, K S; Hafner, S D; Buff, M F


    Ecological studies have demonstrated the adverse effects of road-salt, primarily NaCl, on water quality, flora, and fauna. In this study, we quantified changes in ionic composition and solute flux of water draining the Mohawk River Basin (9103 km(2)) in New York State, from 1952 to 1998. Using various statistical, graphical, and modeling techniques, we showed that concentrations ofNa+ and Cl- have increased by 130 and 243%, respectively, while other constituents have decreased or remained constant. The use of de-icing salt on roads within the watershed, which we estimate at 39 kg km(-2) day(-1), appears to be the primary mechanism responsible for reported increases, accounting for the increase in NaCl export from 16 to 46 kg km(-2) day(-1) over the 47-year period.Moreover, despite population decline within this rural upstate watershed, increased environmental stewardship, and The Clean Water Act, concentrations of Na+ and Cl- still increased during the 1990s.

  8. [Effects of fire recurrence on fire behaviour in cork oak woodlands (Quercus suber L.) and Mediterranean shrublands over the last fifty years]. (United States)

    Schaffhauser, Alice; Pimont, François; Curt, Thomas; Cassagne, Nathalie; Dupuy, Jean-Luc; Tatoni, Thierry


    Past fire recurrence impacts the vegetation structure, and it is consequently hypothesized to alter its future fire behaviour. We examined the fire behaviour in shrubland-forest mosaics of southeastern France, which were organized along a range of fire frequency (0 to 3-4 fires along the past 50 years) and had different time intervals between fires. The mosaic was dominated by Quercus suber L. and Erica-Cistus shrubland communities. We described the vegetation structure through measurements of tree height, base of tree crown or shrub layer, mean diameter, cover, plant water content and bulk density. We used the physical model Firetec to simulate the fire behaviour. Fire intensity, fire spread, plant water content and biomass loss varied significantly according to fire recurrence and vegetation structure, mainly linked to the time since the last fire, then the number of fires. These results confirm that past fire recurrence affects future fire behaviour, with multi-layered vegetation (particularly high shrublands) producing more intense fires, contrary to submature Quercus woodlands that have not burnt since 1959 and that are unlikely to reburn. Further simulations, with more vegetation scenes according to shrub and canopy covers, will complete this study in order to discuss the fire propagation risk in heterogeneous vegetation, particularly in the Mediterranean area, with a view to a local management of these ecosystems. Copyright © 2015 Académie des sciences. Published by Elsevier SAS. All rights reserved.

  9. The Impossible Sustainability of the Bay of Brest? Fifty Years of Ecosystem Changes, Interdisciplinary Knowledge Construction and Key Questions at the Science-Policy-Community Interface

    Directory of Open Access Journals (Sweden)

    Olivier Ragueneau


    Full Text Available In this contribution, the study of the Bay of Brest ecosystem changes over the past 50 years is used to explore the construction of interdisciplinary knowledge and raise key questions that now need to be tackled at the science-policy-communities interface. The Bay of Brest is subject to a combination of several aspects of global change, including excessive nutrient inputs from watersheds and the proliferation of invasive species. These perturbations strongly interact, affecting positively or negatively the ecosystem functioning, with important impacts on human activities. We first relate a cascade of events over these five decades, linking farming activities, nitrogen, and silicon biogeochemical cycles, hydrodynamics of the Bay, the proliferation of an exotic benthic suspension feeder, the development of the Great scallop fisheries and the high biodiversity in maerl beds. The cascade leads to today's situation where toxic phytoplankton blooms become recurrent in the Bay, preventing the fishery of the great scallop and forcing the fishermen community to switch pray and alter the maerl habitat and the benthic biodiversity it hosts, despite the many scientific alerts and the protection of this habitat. In the second section, we relate the construction of the interdisciplinary knowledge without which scientists would never have been able to describe these changes in the Bay. Interdisciplinarity construction is described, first among natural sciences (NS and then, between natural sciences and human and social sciences (HSS. We finally ask key questions at the science-policy interface regarding this unsustainable trend of the Bay: How is this possible, despite decades of joint work between scientists and fishermen? Is adaptive co-management a sufficient condition for a sustainable management of an ecosystem? How do the different groups (i.e., farmers, fishermen, scientists, environmentalists, with their diverse interests, take charge of this situation

  10. School Finance: Fifty Years of Expansion. (United States)

    Guthrie, James W.


    Analyzes the increases in per-pupil expenditures in elementary and secondary education since World War II and discusses factors contributing to the increase. A significant cause is the 86% inflation-adjusted increase in teacher salaries between 1949-50 and 1971-72, although teacher salaries have increased little since that time. (SLD)

  11. The Pentagon: The First Fifty Years (United States)


    Secretary of War Stimson reviewed it. Initially "skeptical," Stimson finally concurrcd. He wrote in his diary that "it will cost a lot of money, but it will...wrote in his diary : "It struck me as so fantastic that I did not express myself to him, but I told Somervell afterwards... I should absolutely refuse to...8217l Jill10 i"Il LtW ILI il Ih( "IM Ol*110 II )’(1 ol11 ,(\\ o n u l tl,1 + Rivci Eqttancc At ’M AyA I’wP e Pentagon Lore The Pentagon entered into

  12. Chemists in Rijeka Together for Fifty Years

    Directory of Open Access Journals (Sweden)

    Milin, C.


    Full Text Available Whatever part of the World you come from, when you come to Rijeka you came to the heart of Europe. Rijeka is waiting for you with the scent of its sea and the hospitality of its people. Rijeka is a town of unusual, turbulent and intersected history. At the end of the IX Century the area of Rijeka was one of the most powerful industrial zones in Europe. Prof. Eugen Cerkovnikov, Ph. D., a much-respected chemist, first Head of the Department for Chemistry and Biochemistry on the then newly established Medical School in Rijeka, launched the initiative to form a branch-office of the Croatian Chemist Society in Rijeka. On 18 January, 1958 in the Big Classroom of the Medical School in Rijeka the Founding Assembly was held, and many respected scientists of that period were present.In 1960, the Rijeka branch-office of the Croatian Chemist Society merged with the Society of Chemists and Technologists and in 1973 the Biochemists section joined. In the five decades of its existence, the love towards chemistry, biochemistry, molecular biology, technology and chemical engineering, the love towards the basis of natural sciences and the wish to educate new, progressive generations formed the mission of the Society. The Society does not want to be closed in a guild organisation; its aim is to open its doors towards all those striving to progress.Former presidents of the Society were: Eugen Cerkovnikov (1958-1974, Marijan Kolombo (1974-1980, Josip Šilipeter (1980-1984, Marinko Oršia (1984-1996 i Nikola Bla?evia (1996-; and each one of them marked his era. Transitional circumstances have shut down forever many, until recently, extremely powerful industries in Rijeka. Today, Rijeka is searching for new paths, and we believe that our Society will continue to work on and give its contribution to this search.

  13. Sandia National Laboratories: The First Fifty Years

    Energy Technology Data Exchange (ETDEWEB)



    On Nov. 1, 1999, Sandia National Laboratories celebrates its 50th birthday. Although Sandia has its roots in the World War II-era Manhattan Project, Sandia began operating as a separate nuclear weapons engineering laboratory under the management of AT&T on Nov. 1, 1949. Today the lab employs more than 7,000 people at its two sites in Albuquerque and Livermore, California, and has research and development missions in national security, energy and environmental technologies, and U.S. economic competitiveness. Lockheed Martin Corporation operates Sandia for the US. Department of Energy.

  14. The Fifty Year Rehabilitation of the Egg

    Directory of Open Access Journals (Sweden)

    Donald J. McNamara


    Full Text Available The 1968 American Heart Association announced a dietary recommendation that all individuals consume less than 300 mg of dietary cholesterol per day and no more than three whole eggs per week. This recommendation has not only significantly impacted the dietary patterns of the population, but also resulted in the public limiting a highly nutritious and affordable source of high quality nutrients, including choline which was limited in the diets of most individuals. The egg industry addressed the egg issue with research documenting the minimal effect of egg intake on plasma lipoprotein levels, as well as research verifying the importance of egg nutrients in a variety of issues related to health promotion. In 2015 dietary cholesterol and egg restrictions have been dropped by most health promotion agencies worldwide and recommended to be dropped from the 2015 Dietary Guidelines for Americans.

  15. Strategies for the next fifty years

    International Nuclear Information System (INIS)


    This report presents a professional, global and unrestricted overview of the nuclear energy development and using, and the worldwide related research. The document also presents the strategies for the next half-century

  16. Fifty Years of HF Doppler Observations

    Directory of Open Access Journals (Sweden)

    T Ogawa


    Full Text Available High frequency Doppler observations of the ionosphere began in August of 1957 in Kyoto. The number of the observation points worldwide were about 40 in 1980 and are about 20 at present. By this method the movement of the ionosphere reflection height and electron density below the height can be observed. Such variations are occurred by a wide variety of sources.

  17. Immunotoxicology: fifty years of global scientific progress. (United States)

    McKarns, Susan C; Kerkvliet, Nancy I; Dean, Jack H; Bonn, Michael B; Cohen, Mitchell D; Franko, Jennifer; Laiosa, Michael D; Lawrence, B Paige; Luebke, Robert W; Luster, Michael I; Miller, Patrick G; Palmer, Rachel K; Pfau, Jean C; Raman, Priyadarshini; Regal, Jean F; Rodgers, Kathleen E; Schondelmeyer, Rio S; Zhang, Xiaochu; Burns-Naas, Leigh Ann


    The Immunotoxicology Specialty Section of the Society of Toxicology (SOT) celebrated the 50(th) Anniversary of the SOT by constructing a poster to highlight the milestones of Immunotoxicology during that half-century period. This poster was assembled by an ad hoc committee and intertwines in words, citations, graphics, and photographs our attempts to capture a timeline reference of the development and progressive movement of immunotoxicology across the globe. This poster was displayed during the 50(th) Annual SOT Meeting in Washington DC in March, 2011. The poster can be accessed by any Reader at the SOT Website via the link We dedicate this poster to all of the founders and the scientists that followed them who have made the discipline of Immunotoxicology what it is today.

  18. Fifty Years of Physics of Living Systems. (United States)

    Latash, Mark L


    The equilibrium-point hypothesis and its more recent version, the referent configuration hypothesis, represent the physical approach to the neural control of action. This hypothesis can be naturally combined with the idea of hierarchical control of movements and of synergic organization of the abundant systems involved in all actions. Any action starts with defining trajectories of a few referent coordinates for a handful of salient task-specific variables. Further, referent coordinates at hierarchically lower levels emerge down to thresholds of the tonic stretch reflex for the participating muscles. Stability of performance with respect to salient variables is reflected in the structure of inter-trial variance and phenomena of motor equivalence. Three lines of recent research within this framework are reviewed. First, synergic adjustments of the referent coordinate and apparent stiffness have been demonstrated during finger force production supporting the main idea of control with referent coordinates. Second, the notion of unintentional voluntary movements has been introduced reflecting unintentional drifts in referent coordinates. Two types of unintentional movements have been observed with different characteristic times. Third, this framework has been applied to studies of impaired movements in neurological patients. Overall, the physical approach searching for laws of nature underlying biological movement has been highly stimulating and productive.

  19. Fifty Years of Scholarship in Media Ethics (United States)

    Christians, Clifford G.


    Describes changing attitudes toward the role of mass media ethics, as reflected in the literature. Available from: Journal of Communication, The Annenberg School of Communications, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, $15.00 yr; $4.00 sc. (KS)

  20. History * Autobiography * Growth: (Fifty Years since Dartmouth) (United States)

    Doecke, Brenton


    This essay explores how my professional experiences as an English educator have been shaped by the values and beliefs that are typically associated with the Dartmouth Seminar of 1966 as they were presented by John Dixon in his immensely influential report of that seminar, "Growth Through English." Rather than seeing "Growth"…

  1. Fifty years chlorpromazine: a historical perspective. (United States)

    Ban, Thomas A


    Chlorpromazine was synthesized in December 1951 in the laboratories of Rhône-Poiulenc, and became available on prescription in France in November 1952. Its effectiveness was reflected in the transformation of disturbed wards; its commercial success stimulated the development of other psychotropic drugs. Recognition of chemical mediation at the site of the synapse, followed by the introduction of the spectrophotofluorimeter first, and receptor assays subsequently, led to the demonstration that chlorpromazine blocks dopamine receptors. Treatment with chlorpromazine focused attention on the heterogeneity of schizophrenia in terms of responsiveness to treatment. By the mid-1980s there was sufficient evidence to believe that resolving this heterogeneity is a prerequisite for developing more effective treatments. Chlorpromazine was instrumental in the development of neuropsychopharmacology, a new discipline dedicated to the study of mental pathology with the employment of centrally acting drugs.

  2. Atoms for peace plus fifty

    International Nuclear Information System (INIS)

    Eisenhower, S.


    One of Dwight Eisenhower's most significant political legacies stemmed from his management of the nuclear question. Five decades after Eisenhower's 'Atoms for Peace' speech before the United Nations, the nuclear dilemma persists but the world is a different, and I would submit, a better place today than it might have been had that vision not been articulated, or its proposals not advanced. The 'Atoms for Peace' speech had a number of objectives, but it is over arching goal was to propose a set of ideas, a nuclear strategy, which would call on the Soviets to cooperate internationally for the betterment of mankind. This would reengage the Soviets in discussions on nuclear matters at a time when arms control talks had stalled, but it would also offer hope, and a practical set of ideas, to the developing world. 'Atoms for Peace' spawned many developments, including the establishment of the International Atomic Energy Agency, and eventually the Nuclear Non-Proliferation Treaty. While 'Atoms for Peace', as well as the institutions it created, has come under fire in recent years, it is hard to imagine what the world would have been like without it. Largely through the international Atomic Energy Agency, nations around the world have participated in research and development programs, including the use of nuclear energy in important civilian applications. Nuclear electric power accounts for nearly one-fifth of the world's electricity - reducing global tensions by replacing oil in many applications, and providing much of the world's electricity that is generated without the release of greenhouse gases or other destructive emissions. Many other nuclear and radiation-related technologies, especially radiopharmaceuticals and medical advances involving radiation, have resulted in large part from research spawned by 'Atoms for Peace'. Millions of lives have been saved in the process. While the 'nuclear dilemma' remains a challenge almost as complex as it was fifty years ago, the

  3. Surgical capacity building in Timor-Leste: a review of the first 15 years of the Royal Australasian College of Surgeons-led Australian Aid programme. (United States)

    Guest, Glenn D; Scott, David F; Xavier, Joao P; Martins, Nelson; Vreede, Eric; Chennal, Antony; Moss, Daliah; Watters, David A


    Timor-Leste suffered a destructive withdrawal by the Indonesian military in 1999, leaving only 20 Timorese-based doctors and no practising specialists for a population of 700 000 that has now grown to 1.2 million. This article assesses the outcomes and impact of Royal Australasian College of Surgeons (RACS) specialist medical support from 2001 to 2015. Three programmes were designed collaboratively with the Timor-Leste Ministry of Health and Australian Aid. The RACS team began to provide 24/7 resident surgical and anaesthesia services in the capital, Dili, from July 2001. The arrival of the Chinese and Cuban Medical Teams provided a medical workforce, and the Cubans initiated undergraduate medical training for about 1000 nationals both in Cuba and in Timor-Leste, whilst RACS focused on specialist medical training. Australian Aid provided AUD$20 million through three continuous programmes over 15 years. In the first 10 years over 10 000 operations were performed. Initially only 10% of operations were done by trainees but this reached 77% by 2010. Twenty-one nurse anaesthetists were trained in-country, sufficient to cover the needs of each hospital. Seven Timorese doctors gained specialist qualifications (five surgery, one ophthalmology and one anaesthesia) from regional medical schools in Papua New Guinea, Fiji, Indonesia and Malaysia. They introduced local specialist and family medicine diploma programmes for the Cuban graduates. Timor-Leste has developed increasing levels of surgical and anaesthetic self-sufficiency through multi-level collaboration between the Ministry of Health, Universidade Nacional de Timor Lorosa'e, and sustained, consistent support from external donors including Australian Aid, Cuba and RACS. © 2016 Royal Australasian College of Surgeons.

  4. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F


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

  5. Radiological imaging of congenital hand anomalies - a 6-year single-centre experience and what the hand surgeons want to know

    International Nuclear Information System (INIS)

    Gerety, E.L.; Hopper, M.A.; Grant, I.


    Congenital hand anomalies present a rare but important physical and emotional challenge for children and parents. Radiological imaging is important for accurate diagnosis, to aid decision making and to monitor changes in the growing hand. The goal of any treatment is to help the child achieve his/her maximum potential, to provide a useful hand with attention to cosmesis. We investigated the range of congenital hand anomalies imaged in a tertiary referral centre. We examined the timing of imaging and the key clinical questions. The radiology imaging system was searched retrospectively for radiographs of congenital hand anomalies over a 6-year period. The images were reviewed and patient demographics, diagnosis and other imaging recorded. Over 6 years, 85 patients had imaging. Twenty-three patients had bilateral problems and 11 had recognised syndromes. The most common abnormalities imaged were duplicated thumbs (28 %), followed by syndactyly (18 %). Children were first imaged as early as 1 day old, with the median age of initial imaging 12 months. Thumb duplication and syndactyly are the most common conditions for which radiographs are requested at our hospital, although overall syndactyly is considered the most common congenital hand anomaly. For a variety of reasons, children are often imaged very early, before review by the Specialist in Children's Hand Surgery (despite surgery being unlikely before 1 year of age.) We discuss the classification systems and specific issues that hand surgeons want to know from the radiologists. (orig.)

  6. Radiological imaging of congenital hand anomalies - a 6-year single-centre experience and what the hand surgeons want to know

    Energy Technology Data Exchange (ETDEWEB)

    Gerety, E.L.; Hopper, M.A. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Grant, I. [Cambridge University Hospitals NHS Foundation Trust, Department of Plastic Surgery, Cambridge (United Kingdom)


    Congenital hand anomalies present a rare but important physical and emotional challenge for children and parents. Radiological imaging is important for accurate diagnosis, to aid decision making and to monitor changes in the growing hand. The goal of any treatment is to help the child achieve his/her maximum potential, to provide a useful hand with attention to cosmesis. We investigated the range of congenital hand anomalies imaged in a tertiary referral centre. We examined the timing of imaging and the key clinical questions. The radiology imaging system was searched retrospectively for radiographs of congenital hand anomalies over a 6-year period. The images were reviewed and patient demographics, diagnosis and other imaging recorded. Over 6 years, 85 patients had imaging. Twenty-three patients had bilateral problems and 11 had recognised syndromes. The most common abnormalities imaged were duplicated thumbs (28 %), followed by syndactyly (18 %). Children were first imaged as early as 1 day old, with the median age of initial imaging 12 months. Thumb duplication and syndactyly are the most common conditions for which radiographs are requested at our hospital, although overall syndactyly is considered the most common congenital hand anomaly. For a variety of reasons, children are often imaged very early, before review by the Specialist in Children's Hand Surgery (despite surgery being unlikely before 1 year of age.) We discuss the classification systems and specific issues that hand surgeons want to know from the radiologists. (orig.)

  7. Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners. (United States)

    Routly, J E; Taylor, I R; Turner, R; McKernan, E J; Dobson, H


    Postal surveys or personal interviews of 76 recent veterinary graduates and their 49 employers were undertaken to establish their perceptions of good practice when integrating a new graduate into a business and their preferred methods of assessment and development. Practice type and location were the main influences on graduates looking for their first job. Interviews were mostly informal. Employers expected basic veterinary competence and candidates expected good quality support. Most graduates (93 per cent) had their own consultations on the first day. During early consultations 2 per cent of senior vets accompanied the new graduate, 95 per cent of practices provided senior back-up either in person or by telephone but in 3 per cent no back-up was available. Most new graduates (90 per cent) were satisfied with their workload. Three-fifths were on-call within the first week, and 95 per cent within a month. Graduates received calls directly in 45 per cent of practices, in 9 per cent seniors screened the calls, and the remainder used a third party. Assistance from experienced lay staff varied greatly. Discussion of problems was mainly informal. There was little spontaneous feedback and problems resulted from inadequate communication. One in three new graduates left their first job within two years, and one in six identified lack of support, heavy workload, stress or clashes with staff as a primary reason. This high turnover was a problem for employers. From the new graduates' perspectives, initial problems included: being on call (59 per cent), financial aspects (47 per cent) and surgery (43 per cent). Communicating with clients and learning to prioritise jobs were also difficult. New graduates took longer over procedures (79 per cent of employers commented) and required extra back-up (91 per cent) both of which reduced income (59 per cent). Nearly all the seniors felt that their current new graduates had coped 'quite well', although it was claimed that new graduates

  8. [The surgeon and deontology]. (United States)

    Sucila, Antanas


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

  9. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    International Nuclear Information System (INIS)

    Khan, Atif J.; Vicini, Frank A.; Beitsch, Peter; Goyal, Sharad; Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard; Lyden, Maureen; Haffty, Bruce G.


    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher’s exact test was performed to correlate age (≤70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors ≤2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  10. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Atif J., E-mail: [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Vicini, Frank A.; Beitsch, Peter [American Society of Breast Surgeons, Columbia, MD (United States); Goyal, Sharad [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard [American Society of Breast Surgeons, Columbia, MD (United States); Lyden, Maureen [BioStat International, Inc., Tampa, FL (United States); Haffty, Bruce G. [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); American Society of Breast Surgeons, Columbia, MD (United States)


    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  11. Risk of ionising radiation to trainee orthopaedic surgeons. (United States)

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


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

  12. The Surgeon and Advocacy

    African Journals Online (AJOL)

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

  13. Civil Surgeon Info (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...

  14. Society of Thoracic Surgeons (United States)

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

  15. Society of Laparoendoscopic Surgeons (United States)

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

  16. Burnout and career satisfaction among American surgeons. (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


    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.

  17. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad


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

  18. Mentorship as Experienced by Women Surgeons in Japan. (United States)

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


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

  19. Fifty consecutive pancreatectomies without mortality

    Directory of Open Access Journals (Sweden)

    Enio Campos Amico

    Full Text Available Objective: to report the group's experience with a series of patients undergoing pancreatic resection presenting null mortality rates. Methods: we prospectively studied 50 consecutive patients undergoing pancreatic resections for peri-ampullary or pancreatic diseases. Main local complications were defined according to international criteria. In-hospital mortality was defined as death occurring in the first 90 postoperative days. Results: patients' age ranged between 16 and 90 years (average: 53.3. We found anemia (Hb < 12g/dl and preoperative jaundice in 38% and 40% of cases, respectively. Most patients presented with peri-ampullary tumors (66%. The most common surgical procedure was the Kausch - Whipple operation (70%. Six patients (12% needed to undergo resection of a segment of the mesenteric-portal axis. The mean operative time was 445.1 minutes. Twenty two patients (44% showed no clinical complications and presented mean hospital stay of 10.3 days. The most frequent complications were pancreatic fistula (56%, delayed gastric emptying (17.1% and bleeding (16%. Conclusion : within the last three decades, pancreatic resection is still considered a challenge, especially outside large specialized centers. Nevertheless, even in our country (Brazil, teams seasoned in such procedure can reach low mortality rates.

  20. A protocol for the retina surgeon's safe initial intravitreal injections. (United States)

    Frenkel, Ronald E P; Haji, Shamim A; La, Melvin; Frenkel, Max P C; Reyes, Angela


    To determine the safety of a surgeon's initial consecutive intravitreal injections using a specific protocol and to review the complications that may be attributed to the injection procedure. A retrospective chart review. Fifty-nine patients (30 females, 29 males) received intravitreal injections of pegaptanib, bevacizumab, or ranibizumab as part of their treatment for neovascular age-related macular degeneration. The average patient age was 80 years. Twenty-two patients were diagnosed with or suspected of having glaucoma. Each patient received an average of 5.8 injections. The charts of 59 patients who received a total of 345 intravitreal injections (104 pegaptanib, 74 bevacizumab, 167 ranibizumab) were reviewed. All injections were performed in an office-based setting. Povidone-iodine, topical antibiotics, and eye speculum were used as part of the pre injection procedure. Vision and intraocular pressure were evaluated immediately following each injection. Incidence of post injection complications, including but not limited to endophthalmitis, retinal detachment, traumatic cataract, and vitreous hemorrhage. There were no cases of endophthalmitis, toxic reactions, traumatic cataracts, retinal detachment, or vitreous hemorrhage. There was one case each of lid swelling, transient floaters, retinal pigment epithelial tear, corneal edema, and corneal abrasion. There were five cases of transient no light perception following pegaptanib injections. The incidence of serious complications was very low for the intravitreal injections given. A surgeon's initial intravitreal injections may be performed with a very high degree of safety using this protocol.

  1. Stress in surgeons. (United States)

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


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

  2. Surgeons' vision rewarded. (United States)

    Baillie, Jonathan


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

  3. Current trends in chaperone use by plastic and reconstructive surgeons. (United States)

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


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

  4. Business knowledge in surgeons. (United States)

    Satiani, Bhagwan


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

  5. Surgeon-performed ultrasonography

    DEFF Research Database (Denmark)

    Todsen, Tobias


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

  6. [Improving the surgeon's image: introduction]. (United States)

    Tajima, Tomoo


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

  7. Opportunities in Total Knee Arthroplasty: Worldwide Surgeons' Perspective. (United States)

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


    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. The American oil industry and the Fifty-Fifty Agreement of 1950

    International Nuclear Information System (INIS)

    Anderson, T.H.


    This paper traces the history of the Fifty-fifty Agreement of 1950, and the role of the American oil industry in that agreement. Regardless of the definition one chooses for the term foreign policy, it can now be argued with considerable force that the Fifty-fifty Agreement was, in fact, the product of American foreign policy. Defining the term narrowly as the enunciated policy of the Executive Branch of Government on matters outside the national boundary, it is clear that a consistent policy had been in place for a long time supporting exactly the type of action which was taken hear. Defining the term broadly, as the defacto cumulative thrust of all competing interest groups within a nation-state (both governmental and private) outside the national boundary, makes the assertion even more clear. Including Aramco and the parent companies in the equation leaves little doubt that the Fifty-fifty Agreement was the product of American foreign policy

  9. An Analysis of Future Publications, Career Choices, and Practice Characteristics of Research Presenters at an American College of Surgeons State Conference: A 15-Year Review. (United States)

    Ahmad, Humera F; Jarman, Benjamin T; Kallies, Kara J; Shapiro, Stephen B

    The Accreditation Council for Graduate Medical Education requires scholarly activity within general surgery residency programs. The association between in-training research presentations and postgraduation publications is unknown. We hypothesized that surgical trainee presentations at an American College of Surgeons (ACS) state chapter meeting resulted in peer-reviewed publications and future scholarly activity. The ACS Wisconsin state chapter meeting agendas from 2000 to 2014 were reviewed to identify all trainees who delivered podium presentations. A literature search was completed for subsequent publications. Program coordinators were queried and an electronic search was performed to determine practice location and type for each residency graduate. Wisconsin state chapter ACS meeting. General surgery residents, fellows, and medical students in Wisconsin. There were 288 podium presentations by trainees (76% residents, 20% medical students, and 4% fellows). Presentations were clinical (79.5%) and basic science (20.5%). There were 204 unique presenters; 25% presented at subsequent meetings. Of these unique presenters, 46% published their research and 31% published additional research after residency. Among presenters who completed residency or fellowship (N = 119), 34% practiced in a university setting, and 61% practiced in a community setting; 31% practiced in Wisconsin. When comparing clinical vs basic science presenters, there was no difference in fellowship completion (37% vs 44%; p = 0.190) or practice type (38% vs 46% in a university setting; p = 0.397). Repeat presenters were more likely to pursue a fellowship vs those presenting once (76% vs 37%; p = 0.001). Research presentations by surgical trainees at an ACS state chapter meeting frequently led to peer-reviewed publications. Presenters were likely to pursue research opportunities after residency. Repeat presenters were more likely to pursue a fellowship. ACS Wisconsin chapter meetings provide an

  10. Columbia physics in the fifties: Untold tales

    Directory of Open Access Journals (Sweden)

    J. Sucher


    Full Text Available Eyvind Wichmann and I were both graduate students at Columbia University in the fifties, a decade of remarkable creativity by a star-studded physics faculty, which included some ten Nobel Laureates. I share some reminiscences about our time there and explain the role played in our relationship by an eightball.

  11. German Atomic Energy Act turns fifty

    International Nuclear Information System (INIS)

    Schneider, Horst


    The German Atomic Energy Act entered into force on January 1, 1960. It turns fifty at the beginning of 2010. Is this a reason to celebrate or rather the opposite? Lawyers, in principle, can view old pieces of legislation from 2 perspectives: On the one hand, aged laws are treated in a spirit of veneration and are celebrated as proven. On the other hand, an anniversary of this kind can be a welcome reason for demands to abolish or, at least, fundamentally renew that law. Over the past half century, the German Atomic Energy Act went through stormy and varied phases both of a legal and a political character. Its 50 th anniversary is likely to spark off very conflicting evaluations as well. A review of legal history shows that the German or, rather, the Federal German Atomic Energy Act (AtG) was not a first-of-its-kind piece of legislation but stemmed from the 1957 EURATOM Treaty, in a way representing a latecomer of that treaty. The Atomic Energy Act experienced a number of important developments throughout its history: - In 1975, compulsory licensing of fuel element factories was introduced. - The back end of the fuel cycle, especially final storage, were incorporated in the Atomic Energy Act comprehensively first in 1976. - In 1985, legislators decided in favor of unlimited nuclear liability. - In 1994 and 1998, only some innovations in special items were introduced under the headings of environmental impact assessment and suitability for repository storage because the controversy about nuclear power did not permit a fundamental alignment towards a more comprehensive modern safety law. - The decision to opt out of the peaceful uses of nuclear power in 2002 drew the final line so far of decisions about directions of nuclear law in a major amendment. In parallel, the decisions by the Federal Constitutional Court and the Federal Administrative Court in the late 1970s and, above all, the 1980s provided important assistance which has remained valid to this day. What is

  12. Assessment, surgeon, and society. (United States)

    Norcini, John; Talati, Jamsheer


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

  13. Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study. (United States)

    Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H


    To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

  14. Satisfactory patient-based outcomes after surgical treatment for idiopathic clubfoot: includes surgeon's individualized technique. (United States)

    Mahan, Susan T; Spencer, Samantha A; Kasser, James R


    Treatment of idiopathic clubfoot has shifted towards Ponseti technique, but previously surgical management was standard. Outcomes of surgery have varied, with many authors reporting discouraging results. Our purpose was to evaluate a single surgeon's series of children with idiopathic clubfoot treated with a la carte posteromedial and lateral releases using the Pediatric Outcomes Data Collection Instrument (PODCI) with a minimum of 2-year follow-up. A total of 148 patients with idiopathic clubfoot treated surgically by a single surgeon over 15 years were identified, and mailed PODCI questionnaires. Fifty percent of the patients were located and responded, resulting in 74 complete questionnaires. Median age at surgery was 10 months (range, 5.3 to 84.7 mo), male sex 53/74 (71.6%), bilateral surgery 31/74 (41.9%), and average follow-up of 9.7 years. PODCI responses were compared with previously published normal healthy controls using t test for each separate category. Included in the methods is the individual surgeon's operative technique. In PODCIs where a parent reports for their child or adolescent, there was no difference between our data and the healthy controls in any of the 5 categories. In PODCI where an adolescent self-reports, there was no difference in 4 of 5 categories; significant difference was only found between our data (mean = 95.2; SD = 7.427) and normal controls (mean = 86.3; SD = 12.5) in Happiness Scale (P = 0.0031). In this group of idiopathic clubfoot patients, treated with judicious posteromedial release by a single surgeon, primarily when surgery was treatment of choice for clubfoot, patient-based outcomes are not different from their normal healthy peers through childhood and adolescence. While Ponseti treatment has since become the treatment of choice for clubfoot, surgical treatment, in some hands, has led to satisfactory results. Level III.

  15. Description of a Method to Obtain Complete One-Year Follow-Up in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. (United States)

    Wooley, Jordan; Neatherlin, Holly; Mahoney, Cecile; Squiers, John J; Tabachnick, Deborah; Suresh, Mitta; Huff, Eleanor; Basra, Sukhdeep S; DiMaio, J Michael; Brown, David L; Mack, Michael J; Holper, Elizabeth M


    The Centers for Medicare and Medicaid Services National Coverage Determination requires centers performing transcatheter aortic valve implantation (TAVI) to report clinical outcomes up to 1 year. Many sites encounter challenges in obtaining complete 1-year follow-up. We report our process to address this challenge. A multidisciplinary process involving clinical personnel, data and quality managers, and research coordinators was initiated to collect TAVI data at baseline, 30 days, and 1 year. This process included (1) planned clinical follow-up of all patients at 30 days and 1 year; (2) query of health-care system-wide integrated data warehouse (IDW) to ascertain last date of clinical contact within the system for all patients; (3) online obituary search, cross-referencing for unique patient identifiers to determine if mortality occurred in remaining unknown patients; and (4) phone calls to remaining unknown patients or patients' families. Between January 2012 and December 2016, 744 patients underwent TAVI. All 744 patients were eligible for 30-day follow-up and 546 were eligible for 1-year follow-up. At routine clinical follow-up of 22 of 744 (3%) patients at 30 days and 180 of 546 (33%) patients at 1 year had unknown survival status. The integrated data warehouse query confirmed status-alive for an additional 1 of 22 patients at 30 days (55%) and 91 of 180 patients at 1 year (51%). Obituaries were identified for 23 of 180 additional patients at 1 year (13%). Phone contact identified the remaining unknown patients at 30 days and 1 year, resulting in 100% known survival status for patients at 30 days (744 of 744) and at 1 year (546 of 546). In conclusion, using a comprehensive approach, we were able to determine survival status in 100% of patients who underwent TAVI. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Young transplant surgeons and NIH funding. (United States)

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


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

  17. Summary of fifty years research on the late effects of atomic bomb irradiation in Japan with special reference to possible similar late effects by nuclear weapons tests in Semipalatinsk

    International Nuclear Information System (INIS)

    Tomonaga, M.


    The investigation clearly demonstrated statistically significant increases of risks for acute myeloid and lymphoid leukemia, chronic myeloid leukemia, and solid tumors including thyroid cancer, gastrointestinal cancers, lung cancer, hepatoma and skin cancer. The excess relative risks was highest for acute lymphoid leukemia, followed by chronic myeloid leukemia, acute myeloid leukemia, and solid cancer. The increased risk for leukemia has almost completely disappeared after 50 years, whereas the risks for cancers are apparently persisting giving a great threat to general health of atomic bomb survivors. These observations can be directly referred to the possible late effects of the acute and chronic exposure to irradiation caused by nuclear tests in Semipalatinsk region. Recent dose-estimation efforts by Kazakhstan, US and Japanese scientists indicated that there had been Hiroshima/Nagasaki atomic bomb equivalent high-dose exposure in some residents around the test sites. Some researchers suggested increased risks for malignant diseases such as leukemia and cancers. Unfortunately there was a lack of high-quality statistics in the Semipalatinsk survey, providing a considerable difficulty in interpreting the estimated incidences of such malignant diseases

  18. Do Orthopaedic Surgeons Acknowledge Uncertainty? (United States)

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


    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

  19. Lack of generalizability of observational studies' findings for turnover time reduction and growth in surgery based on the State of Iowa, where from one year to the next, most growth was attributable to surgeons performing only a few cases per week. (United States)

    Dexter, Franklin; Jarvie, Craig; Epstein, Richard H


    Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads. Observational cohort study. 116 hospitals in Iowa with inpatient or outpatient surgery from July 1, 2013 through June 30, 2015. Surgeons in Iowa, each with a unique identifier among hospitals. The independent variable was the number of inpatient and outpatient cases that each surgeon performed each week during the first fiscal year beginning July 1, 2013. The dependent variables were surgeons' number of inpatient and outpatient surgical cases, and intraoperative work relative value units (RVU's) for outpatient cases, during the second fiscal year. The average hospital in Iowa had less than half of its growth from year 1 to year 2 in numbers of cases among surgeons who performed >2 cases per week in the baseline year (23.0%±2.5% [SE], P2 cases per week at other hospitals in the state during that year (24.4%±2.6%, P<0.0001). Less than half the growth in RVU's was among those surgeons (21.3%±2.5%, P<0.0001). Most (≥50%) annual growth in surgery, both based on the number of total inpatient and outpatient surgical cases, and on the total outpatient RVU's, was attributable to surgeons who performed 2 or fewer cases per week at each hospital statewide during the preceding year. Therefore, the strategic priority should be to assure that the many low-caseload surgeons have access to convenient OR time (e.g., by allocating sufficient OR time, and assigning surgeon blocks, in a mathematically sound, evidence-based way). Although reducing turnover times and anesthesia-controlled times to promote growth will be beneficial for a few surgeons, the effect on total caseload will be small. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Fifty challenging problems in probability with solutions

    CERN Document Server

    Mosteller, Frederick


    Can you solve the problem of ""The Unfair Subway""? Marvin gets off work at random times between 3 and 5 p.m. His mother lives uptown, his girlfriend downtown. He takes the first subway that comes in either direction and eats dinner with the one he is delivered to. His mother complains that he never comes to see her, but he says she has a 50-50 chance. He has had dinner with her twice in the last 20 working days. Explain. Marvin's adventures in probability are one of the fifty intriguing puzzles that illustrate both elementary ad advanced aspects of probability, each problem designed to chall

  1. Surgeon-performed ultrasonography. (United States)

    Todsen, Tobias


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

  2. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R


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

  3. The use of circular external fixators in the management of lower limb trauma in Dublin: a single surgeon's 20-year experience. (United States)

    O'Neill, B J; Fox, C M; Molloy, A P; O'hEireamhoin, S; Moore, D P


    It has been estimated that approximately 520,000 injury presentations are made to Irish accident and emergency departments each year. Fractures account for 20 % of these injuries. Circular external fixators (frames) have been shown to be a safe and effective method of treatment for long bone fractures where internal fixation is impossible or in-advisable. We present the outcomes of all frames applied at our institution for stabilisation of acute fractures over a 20-year period. We retrospectively reviewed a prospectively compiled database of all frames applied in our institution and identified all frames which were applied for acute lower limb trauma. We identified 68 fractures in 63 patients. There were 11 femoral fractures and 57 tibial fractures. All fractures were classified using the AO Classification system, and most fractures were Type C fractures. We used an Ilizarov frame for 53 fractures and a Taylor Spatial Frame for 15 fractures. The mean time in frame was 365 days for a femoral fracture and 230 days for a tibial fracture. There were five tibial non-unions giving an overall union rate of 93 %. Factors associated with non-union included high-energy trauma and cigarette smoking. The vast majority of lower limb fractures can be treated using 'conventional' methods. Complex fractures which are not amenable to open reduction and internal fixation or cast immobilisation can be treated in a frame with excellent results. The paucity of published reports regarding the use of frames for complex trauma reflects the under-utilisation of the technique.

  4. The surgeon and casemix. (United States)

    Hart, J A; Wallace, D


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

  5. Fifty Years of A-Level Mathematics: Have Standards Changed? (United States)

    Jones, Ian; Wheadon, Chris; Humphries, Sara; Inglis, Matthew


    Advanced-level (A-level) mathematics is a high-profile qualification taken by many school leavers in England, Wales, Northern Ireland and around the world as preparation for university study. Concern has been expressed in these countries that standards in A-level mathematics have declined over time, and that school leavers enter university or the…

  6. Tribology - friction, lubrication and wear: fifty years on. 2 v

    International Nuclear Information System (INIS)


    The paper presents the proceedings of the International Tribology Conference held in London (United Kingdom), 1987, and organised by the Institution of Mechanical Engineers. The aim of the conference was to address the current status and future developments in all aspects of tribology. The conference proceedings contained 121 papers, and the sessions were structured under six headings: hydrodynamic, elastohydrodynamic and mixed lubrication; friction and wear; contact mechanics; materials; design and applications; and lubricants. Four papers were chosen for INIS and indexed separately. (U.K.)

  7. Theoretical nuclear fission: The evolution of the first fifty years

    International Nuclear Information System (INIS)

    Griffin, J.J.


    The evolution of the dynamical theory of nuclear fission is reviewed through four recognizable major phases. Its conceptual structure was from the outset shaped by the Bohr-Wheeler idea of the nucleus as a liquid drop. On the other hand, today's nuclear drop is a system which has under study repeatedly revealed remarkable and unexpected properties, especially with respect to the dependence of its energy upon its shape. Although some of these special properties arise from quantal effects, the theory of fission is still expressed largely in terms of classical dynamics. This situation leaves open the question whether our theoretical success flows entirely from physical truth or in part from the great phenomenological flexibility of the drop model. It leads one also to wonder whether in the next phase connections with the quantal many-body dynamics might finally find a firm place in the theory, and tie its predictions quantitatively to the deeper microscopic reality

  8. Fifty years of CFD for room air distribution

    DEFF Research Database (Denmark)

    Nielsen, Peter Vilhelm


    the principle behind CFD, the development in numerical schemes, turbulence models and the importance of the increased computer size since the 1970s. Special attention is given to the selection of the correct governing equations, to the understanding of low turbulent flow, to the selection of turbulence models...

  9. MAYAK production association ``the fifty year old secret'' (United States)

    Chikshov, A. I.; Glagolenko, Y. V.; Malykh, Y. A.; Langley, Roger; Latham, Ian


    This paper details the history, production capability, facilities and capacity of MAYAK Production Association. The paper also gives technical details of reactors, storage ponds and handling facilities used for fabrication of Co-60 and Cs-137 sources for Gamma Irradiation Plants and other applications, and describes the quality assurance system and methods.

  10. The lure of local SETI: Fifty years of field experiments (United States)

    Ailleris, Philippe


    With the commemoration in October 2007 of the Sputnik launch, space exploration celebrated its 50th anniversary. Despite impressive technological and scientific achievements the fascination for space has weakened during the last decades. One contributing factor has been the gradual disappearance of mankind's hope of discovering extraterrestrial life within its close neighbourhood. In striking contrast and since the middle of the 20th century, a non-negligible proportion of the population have already concluded that intelligent beings from other worlds do exist and visit Earth through space vehicles popularly called Unidentified Flying Objects (UFOs). In light of the continuous public interest for the UFO enigma symbolized by the recent widely diffused media announcements on the release of French and English governmental files; and considering the approach of broadening the strategies of the "Active SETI" approach and the existence of a rich multi-disciplinary UFO documentation of potential interest for SETI; this paper describes some past scientific attempts to demonstrate the physical reality of the phenomena and potentially the presence on Earth of probes of extraterrestrial origin. Details of the different instrumented field studies deployed by scientists and organizations during the period 1950-1990 in the USA, Canada and Europe are provided. In conclusion it will be argued that while continuing the current radio/optical SETI searches, there is the necessity to maintain sustaining attention to the topic of anomalous aerospace phenomena and to develop new rigorous research approaches.

  11. Anniversary Paper: Nuclear medicine: Fifty years and still counting

    International Nuclear Information System (INIS)

    Williams, Lawrence E.


    The history, present status, and possible future of nuclear medicine are presented. Beginning with development of the rectilinear scanner and gamma camera, evolution to the present forms of hybrid technology such as single photon emission computed tomography/computed tomography (CT) and positron emission tomography/CT is described. Both imaging and therapy are considered and the recent improvements in dose estimation using hybrid technologies are discussed. Future developments listed include novel radiopharmaceuticals created using short chains of nucleic acids and varieties of nanostructures. Patient-specific radiotherapy is an eventual outcome of this work. Possible application to proving the targeting of potential chemotherapeutics is also indicated

  12. International conference on fifty years research in nuclear fission

    International Nuclear Information System (INIS)


    These proceedings contain extended abstracts of the papers presented at the named conference. They deal with static properties of fission, instrumentation for fission studies, fission in compound-nucleus reactions, fission dynamics, fission-like heavy ion reactions, and fusion reactions. See hints under the relevant topics. (HSI)

  13. Fifty years of illumination about the natural levels of adaptation

    DEFF Research Database (Denmark)

    Boomsma, Jacobus Jan


    A visionary Darwinian ahead of his time, George C. Williams developed in his 1966 book Adaptation and Natural Selection the essentials of a unifying theory of adaptation that remains robust today and has inspired immense progress in understanding how natural selection works.......A visionary Darwinian ahead of his time, George C. Williams developed in his 1966 book Adaptation and Natural Selection the essentials of a unifying theory of adaptation that remains robust today and has inspired immense progress in understanding how natural selection works....

  14. Fifty years of forest hydrology in the Southeast (United States)

    C. Rhett Jackson; Ge Sun; Devendra Amatya; Wayne T. Swank; Mark Riedel; Jim Patric; Tom Williams; Jim M. Vose; Carl Trettin; W. Michael Aust; R. Scott Beasley; Hamlin Williston; George G. Ice


    The forests of the southeastern United States are incredibly valuable and diverse, both for timber production and for the aquatic habitat they provide. These overlapping values and diverse conditions have spawned numerous studies to assess how forest management affects hydrology and water quality. In the mountains, key watershed studies include those conducted at USDA...

  15. [Fifty years of green memory: nursing care for the environment]. (United States)

    Wächter, Maria Isaura Fradera; Piccinini, Gema Conte; Matzenbacher, Nelson Ivo


    This paper describes the activities related to the 50th anniversary celebration of the Nursing School of the Federal University of Rio Grande do Sul, Brazil. It aimed at surveying the trees of the florula of the green area that surrounds the School and rescuing the memory of those who planted each specimen. The orphan trees were offered to the teaching and administrative staff for adoption. Adding up the erva-mate and the pau-brasil trees planted during the celebration, there are a total of 100 trees distributed into 18 families and 29 species out of which 15 are native and 14 are exotic trees. The erva-mate tree and its monument represent the landmark of this significant date.

  16. Metallography at the Met Lab -- The first fifty years

    International Nuclear Information System (INIS)

    Lee, R.H.


    The Met Lab at the University of Chicago was established to build the world's first nuclear reactor. The object was to see if a pile (CP-1) could be built to create a sustained chain reaction, i.e., controlled nuclear fission. New materials of the very best quality were needed and people of many skills worked together to achieve the goal as quickly as possible. This is the story of a select group of people who were scientific and engineering pioneers in this new field. Research continued at new sites on more advanced reactors and cooling systems. Many problems were encountered in the fabrication of reactor components, and metallography was a crucial method of analyzing the reactions and quality of consolidation. 1996 will be the 50th anniversary of the beginning of the National Laboratories, so it is appropriate to commemorate and recall some pioneering achievements

  17. Maternal health in fifty years of Tanzania independence: Challenges ...

    African Journals Online (AJOL)

    High rate of maternal death is one of the major public health concerns in Tanzania. ... had been on a downward trend from 453 to 200 per 100,000 live births. ... Current statistics indicate that maternal mortality ratio has dropped slightly in 2010 ...

  18. Fifty years of studies on environmental radioactivity in Peru

    International Nuclear Information System (INIS)

    Osores, Jose M.; Gonzales, Susana; Martinez, Jorge; Lopez, Edith; Jara, Raul; Anaya, Aurelio


    In May of 1962, due to the explosions carried out by the Commission of Atomic Energy of the United States in the Christmas Island, a group of professionals of the 'Junta de Control de Energia Atomica' of Peru, created in 1957, carried out experimental evaluations of atmospheric radioactivity, obtaining acceptable results regarding those of Naval US Research Laboratory, this was the beginning of the Laboratory of Atmospheric Radioactivity that begins to operate permanently in February of 1964. In 1966, France began a program of nuclear tests in the French Polynesian, generating concern due to the meteorological conditions that could affect the peruvian population. With the support of experts and equipments on the part of the government from France, the Laboratory of Environmental Radioactivity began their activities in August of 1966. At the present time, the Laboratory of Environmental Radioactivity is located in the Nuclear Center RACSO of the 'Instituto Peruano de Energia Nuclear' and it carries out the following programs: Radiological Environmental Surveillance in the Influence Area of the Nuclear Center, Nationwide Radiological Environmental Surveillance, Marine Radiological Environmental Surveillance, Radiological Environmental Surveillance in the Peruvian Antarctic Region and Surveillance of the Radioactive Contamination of Foods. The results of the evaluations of the programs of radiological environmental surveillance, developed nationwide from 1962, show one gradual decrease of the levels of environmental radioactivity. Significant concentrations of Cs-137 and Be-7 were found in the Antarctic region, and, in the area of influence of the nuclear center RACSO, environmental discharges of I-131, Cs-137, Co-60, Cs- 134 and Te-123m were detected, however, the concentrations did not present radiological risk for the population. (author)

  19. History for fifty years of Korea Atomic Energy Research Institute

    Energy Technology Data Exchange (ETDEWEB)



    This introduces establishment, foundation, technical independent, puberty and preview of KAERI. It is divided six chapters, which deals with research and development on nuclear fission and nuclear fusion, cycle of nuclear fuel and research of nuclear safety, nuclear business and technical development, activity on nuclear safe regulation like establishment and role module for nuclear safety center and check of the safety of nuclear power plant, study of radio therapeutics and cancer treatment, development of human resources for nuclear power and training, general management about regulations, organization, person, contract, facility and building, welfare and establishment and activity of labor union.

  20. Fifty-year study of the Peierls-Nabarro stress

    CSIR Research Space (South Africa)

    Nabarro, FRN


    Full Text Available , North-Holland, Amsterdam, 1979, pp. 33. [9] E. Orowan, in: Cyril Stanley Smith (Ed.), The Sorby Centennial Symposium on the History of Metallurgy, Gordon and Breach, New York, 1965, pp. 359. [lo] R.E. Peierls, in: A...

  1. Fifty years of oxacalix[3]arenes: A review

    Directory of Open Access Journals (Sweden)

    Kevin Cottet


    Full Text Available Hexahomotrioxacalix[3]arenes, commonly called oxacalix[3]arenes, were first reported in 1962. Since then, their chemistry has been expanded to include numerous derivatives and complexes. This review describes the syntheses of the parent compounds, their derivatives, and their complexation behaviour towards cations. Extraction data are presented, as are crystal structures of the macrocycles and their complexes with guest species. Applications in fields as diverse as ion selective electrode modifiers, fluorescence sensors, fullerene separations and biomimetic chemistry are described.

  2. The Sociological Imagination and Its Promise Fifty Years Later

    Directory of Open Access Journals (Sweden)

    Carlos Frade


    Full Text Available This paper offers a restatement of Wright Mills’ The Sociological Imagination and tries to judge whether its promise can be credibly renewed today by addressing the question about the present and future possibilities of the social sciences as free forms of enquiry. Relying on Weber, Mills and other thinkers, the paper sustains that the possibilities for a truly free social science essentially depend on three major ‘conditions’: the subjective stance or vocation, the sociological imagination proper, and an independent social science politics, conditions whose apt names can also be ‘love’, ‘insight’ and ‘courage’. An analysis of the presence and strength of each of these conditions in contemporary social science and in academia shows the magnitude of the task faced for the existence of a free social science.

  3. Hashing in computer science fifty years of slicing and dicing

    CERN Document Server

    Konheim, Alan G


    Written by one of the developers of the technology, Hashing is both a historical document on the development of hashing and an analysis of the applications of hashing in a society increasingly concerned with security. The material in this book is based on courses taught by the author, and key points are reinforced in sample problems and an accompanying instructor s manual. Graduate students and researchers in mathematics, cryptography, and security will benefit from this overview of hashing and the complicated mathematics that it requires

  4. Fifty-four Years of Adventures in Infrared Astronomy (United States)

    Becklin, Eric Eric


    My adventures in infrared astronomy started when I was a grad student in 1965 with the discovery of an infrared-bright object (now known as the Becklin-Neugebauer Object) in the Orion Nebula. In 1966, I made the first measurements of the infrared radiation from the center of the Milky Way Galaxy. I was fortunate enough to be able to take advantage of the 2.2 micron sky survey carried out by Neugebauer and Leighton (1969), which produced many remarkable discoveries, the most spectacular being the heavily dust-embedded carbon star IRC+10216, thebrightest object in the sky at 5 microns outside the solar system. In the 1970’s there was a growth in Infrared astronomy with the availability of many new facilities such as the Kuiper Airborne Observatory, (KAO) which I used extensively with Mike Werner and Ian Gatley for many unique observations. In 1977, I moved to Hawaii to work on the NASA IRTF 3- meter telescope. Many discoveries were made, including the first direct measurements of the rings of Jupiter at 2.2 microns (with Gareth Wynn-Williams) and the discovery of the first L dwarf star around a white dwarf (with Ben Zuckerman). In the 1980’s the introduction of large format arrays changed the way we did infrared astronomy. With Ian McLean, I moved to UCLA in 1990 to start the IR lab and get involved in Keck development and science. In 1995, Andrea, Ghez, Mark Morris and I started looking for evidence of a possible massive Black Hole in the Galactic Center. Spectacular observations using the Keck10 meter telescopes with large format near-infrared arrays and adaptive optics led to the confirmation of the presence of such a black hole and an estimate of its mass (4xE6 M (Sun)). In 1996, I began working on the Stratospheric Observatory For Infrared Astronomy (SOFIA) and I will finish my talk by discussing SOFIA observations of the ring of dust and gas orbiting the massive black hole in the center

  5. Fifty-one years of Los Alamos Spacecraft

    Energy Technology Data Exchange (ETDEWEB)

    Fenimore, Edward E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    From 1963 to 2014, the Los Alamos National Laboratory was involved in at least 233 spacecraft. There are probably only one or two institutions in the world that have been involved in so many spacecraft. Los Alamos space exploration started with the Vela satellites for nuclear test detection, but soon expanded to ionospheric research (mostly barium releases), radioisotope thermoelectric generators, solar physics, solar wind, magnetospheres, astrophysics, national security, planetary physics, earth resources, radio propagation in the ionosphere, and cubesats. Here, we present a list of the spacecraft, their purpose, and their launch dates for use during RocketFest

  6. Fifty Years of Institutional Rehabilitation Outcomes: Inventory and Implications. (United States)

    Gibson, David; Fields, Donald L.


    Temporal variability within the record was more easily attributed to the adequacy of past accountability research and to public policy than to program effects, socioeconomic climate, or changing receiver group attitudes. (Author/SEW)

  7. Fifty years later - still not enough early external involvement

    International Nuclear Information System (INIS)

    Lash, T.


    When it comes to nuclear issues, public participation is like the weather: We talk a lot but we do not do anything meaningful about it. This does not need to be the situation, however. If the program leaders were to make an open commitment to listening to the concerns and requests of the public and then changing their programs in response to what they hear, there would be improved programs and greater public support for them. This paper addresses one such nuclear issue: involving the public effectively in decision making about the transportation of spent nuclear fuel

  8. Inner-shell physics after fifty years of quantum mechanics

    International Nuclear Information System (INIS)

    Merzbacher, E.


    A historical view is given of how the development of quantum mechanics has been affected by the information relating to inner shells, gathered by physicists since the early days of atomic physics, and of the impact of quantum mechanics on the physics of inner atomic shells. 25 refs

  9. Fifty years of nuclear fission: Nuclear data and measurements series

    International Nuclear Information System (INIS)

    Lynn, J.E.


    This report is the written version of a colloquium first presented at Argonne National Laboratory in January 1989. The paper begins with an historical preamble about the events leading to the discovery of nuclear fission. This leads naturally to an account of early results and understanding of the fission phenomena. Some of the key concepts in the development of fission theory are then discussed. The main theme of this discussion is the topography of the fission barrier, in which the interplay of the liquid-drop model and nucleon shell effects lead to a wide range of fascinating phenomena encompassing metastable isomers, intermediate-structure effects in fission cross-sections, and large changes in fission product properties. It is shown how study of these changing effects and theoretical calculations of the potential energy of the deformed nucleus have led to broad qualitative understanding of the nature of the fission process. 54 refs., 35 figs

  10. Fifty years of crop protection, 1950-2000

    NARCIS (Netherlands)

    Zadoks, J.C.


    We detected the presence of fructosamine in human and bovine semen. In seminal plasma of healthy normozoospermic men (N = 17) fructosamine was found in 53% of the cases (fru+). In fru+ semen samples the concentration of fructosamine was (mean ± S.E.M., N = 9) 0.45 ± 0.09 mmol/L and varied from 0.15

  11. Fifty years of particle physics at the CEA

    International Nuclear Information System (INIS)

    Turlay, R.


    A historical review of researches at the CEA (and more particularly at Saclay) in particle physics, is presented. Contributions in themes such as polarized targets, bubble chambers, classic and superconductive magnets, etc. resulted in cooperation to the design of various machines such as Van de Graaff accelerator, cyclotron, Saturne, etc. Collaborations between CEA and CERN had led to numerous experiments in high energy physics, such as electronic experiments with the SPS accelerator. CEA was also involved in the intermediate boson discovery on the SppS collision apparatus, and is participating in two CERN's programs, neutrino physics (NOMAD) and CP violation (NA48). CEA is also collaborating with Russian, German and American laboratories in these domains

  12. Coral seas in fifty years: Need for local policies (United States)

    Longley, P.; Cheng, N. S.; Fontaine, R. M.; Horton, K.; Bhattacharya, A.


    Arising stressors from both global and local sources threaten coral reefs, with studies indicating that local and global sources might reduce coral resilience. Local sources include sediment stress and nutrient stress from fishing; global sources include increasing sea surface temperature and ocean acidification. Through an in-depth review and re-analysis of published work, conducted under the scope of a course in the spring of 2017 semester and follow up research over the summer of 2017 and fall of 2017, students in Environmental Studies Course, ENVS 4100: Coral reefs, at the University of Colorado Boulder have developed a framework to initiate a discussion of global and local policies focused on protection of coral reefs. The research aims to assess current threats and suggest mitigation efforts. The paper uses secondary research to analyze impact of ocean acidification on aragonite saturation levels, current thermal stress, nutrient stress, and sediment factors that influence the health of coral and its surrounding ecosystem over the Common Era. Case studies in this paper include the Caribbean and Red Sea coral reefs, due to the variation of the atmosphere, temperature, and human activity in these regions. This paper intends to offer sufficient evidence that will lead to appropriate policy decisions that pertain to reef conservation.

  13. The anatomy lessons of the Amsterdam Guild of Surgeons

    NARCIS (Netherlands)

    IJpma, F.F.A.


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

  14. Surgeon Reliability for the Assessment of Lumbar Spinal Stenosis on MRI: The Impact of Surgeon Experience. (United States)

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


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

  15. Deutsches Atomforum turns fifty; 50 Jahre Deutsches Atomforum

    Energy Technology Data Exchange (ETDEWEB)

    Geisler, Maja [Deutsches Atomforum e.V., Berlin (Germany). Bereich Oeffentlichkeitsarbeit, Informationskreis KernEnergie


    Fifty years ago, the Deutsches Atomforum e. V. was founded to promote the peaceful uses of nuclear power in Germany. On July 1, 2009, the organization celebrated its fiftieth birthday in Berlin. The anniversary was celebrated in the Berlin electricity plant, Germany's oldest existing building for commercial electricity generation. DAtF President Dr. Walter Hohlefelder welcomed some 200 high-ranking guests from politics, industry, and from the nuclear community, above all, the Chancellor of the Federal Republic of Germany, Dr. Angela Merkel, and, as keynote speaker, Professor Dr. Arnulf Baring. (orig.)

  16. Fifty shades of exploitation: Fan labor and Fifty Shades of Grey

    Directory of Open Access Journals (Sweden)

    Bethan Jones


    Full Text Available This exploration of the debates that have taken place in fandom over the ethics of pulling fan fiction and publishing it as original work draws on the notion of the fannish gift economy, which postulates that gifts such as fan fiction and fan art have value in the fannish community because they are designed to create and cement its social structure. Tension exists between fans who subscribe to the notion of a fannish gift economy and those who exploit fandom by using it to sell their pulled-to-publish works. An examination of E. L. James's 2012 Fifty Shades trilogy (comprising the books Fifty Shades of Grey, Fifty Shades Darker, and Fifty Shades Freed, which began as Twilight fan fiction, in addition to Twilight fan art sold through sites such as Redbubble and Etsy, demonstrates a tension between the two modes of fan expression: sale of artworks appears to be an acceptable practice in fandom, but the commercial sale of fan fic, even when marketed as original fiction, is widely contested.

  17. Interdisciplinary evaluation of consecutive patients with unilateral cleft lip and palate at age 6, 15, and 25 years: a concurrent standardized procedure and documentation by plastic surgeon; speech and language pathologist; ear, nose, and throat specialist; and orthodontist. (United States)

    Tindlund, Rolf S; Holmefjord, Anders; Eriksson, Jens-Christian Haug; Johnson, Gunnar E; Vindenes, Hallvard


    To evaluate surgical results, speech, hearing, and craniofacial morphology after primary cleft repair performed from 1973 to 1979. During the years 1972 to 1985, all primary cleft surgeries were performed by 1 plastic surgeon, using Tennison lip closure combined with a periosteoplasty on the clefted alveolus at age 3 months. By mobilizing mucoperiosteal flaps, bony bridges were induced in the alveolar process in approximately 60% of the cases. All patients had the soft palate closed at age 24 months by a pushback technique. All children with complete unilateral clefts without soft tissue bands (unilateral cleft lip and palate) primary operated on 1973 to 1979 were included in the material, except 3 patients with a syndrome and 2 patients of foreign ethnicity. The material involved 30 consecutive patients with unilateral cleft lip and palate (20 boys and 10 girls; 16 left-sided and 14 right-sided clefts) who were operated on. Standardized records including photos, radiographs, lateral cephalograms, plaster model, and recording of speech and hearing were collected according to the treatment protocol at age 6, 15, and approximately 25 years. Evaluation included craniofacial descriptive cephalometric analysis, dentoalveolar morphology, dentofacial aesthetics, speech concerning articulation and nasality, and hearing status. Number of surgical interventions after primary surgery was recorded. Secondary revisions and candidates for orthognathic surgery are reported. Ten consecutive patients (case nos. 11-20) are demonstrated as clinical reports. : This longitudinal study shows how a multidisciplinary evaluation adequate for intercenter comparison can be performed when standardized procedures, registrations, and documentations are available.

  18. Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial in Patients Treated With Accelerated Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Vicini, Frank; Beitsch, Peter; Quiet, Coral; Gittleman, Mark; Zannis, Vic; Fine, Ricky; Whitworth, Pat; Kuerer, Henry; Haffty, Bruce; Keisch, Martin; Lyden, Maureen


    Purpose: To present 5-year data on treatment efficacy, cosmetic results, and toxicities for patients enrolled on the American Society of Breast Surgeons MammoSite breast brachytherapy registry trial. Methods and Materials: A total of 1440 patients (1449 cases) with early-stage breast cancer receiving breast-conserving therapy were treated with the MammoSite device to deliver accelerated partial-breast irradiation (APBI) (34 Gy in 3.4-Gy fractions). Of 1449 cases, 1255 (87%) had invasive breast cancer (IBC) (median size, 10 mm) and 194 (13%) had ductal carcinoma in situ (DCIS) (median size, 8 mm). Median follow-up was 54 months. Results: Thirty-seven cases (2.6%) developed an ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial rate of 3.80% (3.86% for IBC and 3.39% for DCIS). Negative estrogen receptor status (p = 0.0011) was the only clinical, pathologic, or treatment-related variable associated with IBTR for patients with IBC and young age (<50 years; p = 0.0096) and positive margin status (p = 0.0126) in those with DCIS. The percentage of breasts with good/excellent cosmetic results at 60 months (n = 371) was 90.6%. Symptomatic breast seromas were reported in 13.0% of cases, and 2.3% developed fat necrosis. A subset analysis of the first 400 consecutive cases enrolled was performed (352 with IBC, 48 DCIS). With a median follow-up of 60.5 months, the 5-year actuarial rate of IBTR was 3.04%. Conclusion: Treatment efficacy, cosmesis, and toxicity 5 years after treatment with APBI using the MammoSite device are good and similar to those reported with other forms of APBI with similar follow-up.

  19. Thomas Vicary, barber-surgeon. (United States)

    Thomas, Duncan P


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

  20. Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy. (United States)

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


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

  1. The nature of surgeon human capital depreciation. (United States)

    Hockenberry, Jason M; Helmchen, Lorens A


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


    International Nuclear Information System (INIS)

    Puigh, R.J.


    Fifty-five gallon drums are routinely used within the U.S. for the storage and eventual disposal of fissionable materials as Transuranic or low-level waste. To support these operations, criticality safety evaluations are required. A questionnaire was developed and sent to selected Endusers at Hanford, Idaho National Laboratory, Lawrence Livermore National Laboratory, Oak Ridge and the Savannah River Site to solicit current practices. This questionnaire was used to gather information on the kinds of fissionable materials packaged into drums, the models used in performing criticality safety evaluations in support of operations involving these drums, and the limits and controls established for the handling and storage of these drums. The completed questionnaires were reviewed and clarifications solicited through individual communications with each Enduser to obtain more complete and consistent responses. All five sites have similar drum operations involving thousands to tens of thousands of fissionable material waste drums. The primary sources for these drums are legacy (prior operations) and decontamination and decommissioning wastes at all sites except Lawrence Livermore National Laboratory. The results from this survey and our review are discussed in this paper

  3. What Is a Pediatric Heart Surgeon? (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 ...

  4. What Is a Foot and Ankle Surgeon? (United States)

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

  5. ``Fifty-fifty`` - an unexpectedly successful start. Implementation of Agenda 21 results in energy savings in school buildings; ``Fifty-fifty`` - ein erfreulich erfolgreicher Start. Energieeinsparung durch praktizierte Agenda 21 in Schulen

    Energy Technology Data Exchange (ETDEWEB)

    Schafhausen, F. [Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)


    The idea of the `Fifty-Fifty` pilot project was conceived at the environmental department of the Hamburg municipal authority; its implementation took place in close cooperation with the department for schools, the young, and vocational training (`BSJB`). It started in October 94 and was finalized in June 97. After its successful completion, `Fifty-Fifty` meanwhile has the status of a permanent project.- For decades it has been known that public buildings consume added energy (power and heat) as well as water not only because technical devices are lacking or obsolete but also because of negligence and carelessness. `Fifty-Fifty` endeavours to bring about a change. (orig.) [Deutsch] Geschichte des `Fifty-fifty`-Modells: Die Idee wurde von der Hamburger Umweltbehoerde entwickelt und in enger Zusammenarbeit mit der Behoerde fuer Schule, Jugend und Berufsbildung (BSJB) umgesetzt. Der Modellversuch wurde im Oktober 1994 gestartet und im Juni 1997 abgeschlossen. Nach der erfolgreichen Beendigung des Modellversuchs hat `Fifty-fifty` mittlerweile den Status eines Dauerprojekts. Seit Jahrzehnten ist bekannt, dass in oeffentlich genutzten Gebaeuden nicht nur aufgrund fehlender oder veralteter technischer Ausstattung, sondern insbesondere auch wegen eines unsachgemaessen oder gedankenlosen Verhaltens mehr Energie (Strom und Waerme) und mehr Wasser verbraucht werden. `Fifty-fifty` tut etwas dagegen. (orig.)

  6. Smartphones and the plastic surgeon. (United States)

    Al-Hadithy, Nada; Ghosh, Sudip


    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.

  7. Find a Dermatologic Surgeon (United States)

    ... more"> 3 million Americans are diagnosed with skin cancer every year Any suspicious new growths or changes ... CANADA CHILE CHINA COLOMBIA COSTA RICA CYPRUS EGYPT EL SALVADOR FRANCE GEORGIA GERMANY GREECE HOLLAND HONG KONG ...

  8. Description of Mexican Cleft Surgeons' Experience With Foreign Surgical Volunteer Missions in Mexico. (United States)

    Schoenbrunner, Anna R; Kelley, Kristen D; Buckstaff, Taylor; McIntyre, Joyce K; Sigler, Alicia; Gosman, Amanda A


    Mexican cleft surgeons provide multidisciplinary comprehensive cleft lip and palate care to children in Mexico. Many Mexican cleft surgeons have extensive experience with foreign, visiting surgeons. The purpose of this study was to characterize Mexican cleft surgeons' domestic and volunteer practice and to learn more about Mexican cleft surgeons' experience with visiting surgeons. A cross-sectional validated e-mail survey tool was sent to Mexican cleft surgeons through 2 Mexican plastic surgery societies and the Asociación Mexicana de Labio y Paladar Hendido y Anomalías Craneofaciales, the national cleft palate society that includes plastic and maxillofacial surgeons who specialize in cleft surgery. We utilized validated survey methodology, including neutral fact-based questions and repeated e-mails to survey nonresponders to maximize validity of statistical data; response rate was 30.6% (n = 81). Mexican cleft surgeons performed, on average, 37.7 primary palate repairs per year with an overall complication rate of 2.5%; 34.6% (n = 28) of respondents had direct experience with patients operated on by visiting surgeons; 53.6% of these respondents performed corrective surgery because of complications from visiting surgeons. Respondents rated 48% of the functional outcomes of visiting surgeons as "acceptable," whereas 43% rated aesthetic outcomes of visiting surgeons as "poor"; 73.3% of respondents were never paid for the corrective surgeries they performed. Thirty-three percent of Mexican cleft surgeons believe that there is a role for educational collaboration with visiting surgeons. Mexican cleft surgeons have a high volume of primary cleft palate repairs in their domestic practice with good outcomes. Visiting surgeons may play an important role in Mexican cleft care through educational collaborations that complement the strengths of Mexican cleft surgeons.

  9. The lesser spotted pregnant surgeon. (United States)

    Hamilton, L C


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

  10. Mathematical card magic fifty-two new effects

    CERN Document Server

    Mulcahy, Colm


    Mathematical card effects offer both beginning and experienced magicians an opportunity to entertain with a minimum of props. Featuring mostly original creations, Mathematical Card Magic: Fifty-Two New Effects presents an entertaining look at new mathematically based card tricks. Each chapter contains four card effects, generally starting with simple applications of a particular mathematical principle and ending with more complex ones. Practice a handful of the introductory effects and, in no time, you'll establish your reputation as a "mathemagician." Delve a little deeper into each chapter and the mathematics gets more interesting. The author explains the mathematics as needed in an easy-to-follow way. He also provides additional details, background, and suggestions for further explorations.Suitable for recreational math buffs and amateur card lovers or as a text in a first-year seminar, this color book offers a diverse collection of new mathemagic principles and effects.

  11. Diabetes mellitus during pregnancy: a study of fifty cases

    International Nuclear Information System (INIS)

    Randhawa, M. S.; Moin, S.; Shoaib, F.


    To review and critically evaluated the incidence, epidemiology, clinical pattern, diagnosis, management, complications and outcome of diabetes mellitus during pregnancy in hospital based study. Results: Total number of women delivered were 11271. Fifty cases of diabetes mellitus during pregnancy were studied. Mostly the patients were more than 30 years of age, multiparous ladies with gestational diabetes in 80% of cases, Type-II diabetes in 16% and only in 4% Type-I diabetes was reported. Insulin was required in 40% of patients. Eight women out of 50 had spontaneous miscarriage, 5 underwent preterm delivery while 36 reached term with one intrauterine death. Total number of babies delivered alive were 41. There was one stillbirth and 3 neonatal deaths. Conclusion: Management of diabetes mellitus in pregnancy involves teamwork of obstetricians, physicians and neonatologists. (author)

  12. Chevy Corvette: Icon Of American Life In The Fifties

    Directory of Open Access Journals (Sweden)

    Wishnoebroto Wishnoebroto


    Full Text Available Cars not only function simply as a mean of transportation. Like paintings, the design of a car could represent a certain cultural and social phenomenon of a country. The design of Chevrolet (Chevy Corvette is very different compared to its competitors in the 50s. The size, engine, weight, and the materials of this car were chosen based on the assumption that speed and agility is on top of everything. It was not surprising that in the 50s, the year when the first Corvette was designed and launched, The US was involved in a cold war with the Soviets. Arm race and competition to be the first was the major issue and Corvette was the first car that suggests this spirit. This paper tries to show the distinctiveness of Corvette and how it can be used to explain the character of American people in the fifties

  13. Kant and the cosmetic surgeon. (United States)

    Carey, J S


    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.

  14. Cardiac surgeons and the quality movement: the Michigan experience. (United States)

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


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

  15. Nuclear histochemistry: Its history in fifty volumes

    Directory of Open Access Journals (Sweden)

    M.G. Manfredi Romanini


    Full Text Available The fiftieth anniversary of the double helix was marked two years ago. The elucidation of the structure of DNA by Watson and Crick can rightfully be considered to be "the" milestone in modern biology because it has conditioned the explosive growth in our understanding of the molecular mechanisms regulating the structural and functional organization of single cells and multicellular organisms....

  16. The effect of surgeon experience on outcomes of surgery for adolescent idiopathic scoliosis. (United States)

    Cahill, Patrick J; Pahys, Joshua M; Asghar, Jahangir; Yaszay, Burt; Marks, Michelle C; Bastrom, Tracey P; Lonner, Baron S; Shah, Suken A; Shufflebarger, Harry L; Newton, Peter O; Betz, Randal R; Samdani, Amer F


    Single-surgeon series investigating the learning curve involved in surgery for spinal deformity may be confounded by changes in technology and techniques. Our objective with this multicenter, prospective study was to present a cross-sectional analysis of the impact of surgeon experience on surgery for adolescent idiopathic scoliosis. All posterior-only surgical procedures for adolescent idiopathic scoliosis performed in the 2007 to 2008 academic year, with a minimum of two years of patient follow-up, were included. Two groups were created on the basis of surgeon experience: a young surgeons' group, which included patients of surgeons with less than five years of experience, and an experienced surgeons' group, which included patients of surgeons with five or more years of experience. Nine surgeons (four young and five experienced) operated on a total of one hundred and sixty-five patients with adolescent idiopathic scoliosis. The surgeons' experience ranged from less than one year to thirty-six years in practice. The two groups had similar preoperative curve-magnitude measurements, SRS-22 (Scoliosis Research Society-22) scores, and distribution by Lenke curve type. There were significant operative and postoperative differences. The young surgeons fused an average of 1.2 levels more than the experienced surgeons (p = 0.045). The mean intraoperative estimated blood loss (EBL) of the young surgeons' group was more than twice that of the experienced surgeons' group (2042 mL compared with 1013 mL; p self-image (p = 0.008), and function (p adolescent idiopathic scoliosis were significantly and positively correlated with surgeon experience. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  17. Lloyd Berkner: Catalyst for Meteorology's Fabulous Fifties (United States)

    Lewis, J. M.


    In the long sweep of meteorological history - from Aristotle's Meteorologica to the threshold of the third millennium - the 1950s will surely be recognized as a defining decade. The contributions of many individuals were responsible for the combination of vision and institution building that marked this decade and set the stage for explosive development during the subsequent forty years. In the minds of many individuals who were active during those early years, however, one name stands out as a prime mover par excellence: Lloyd Viel Berkner. On May 1, 1957, Berkner addressed the National Press Club. The address was entitled, "Horizons of Meteorology". It reveals Berkner's insights into meteorology from his position as Chairman of the Committee on Meteorology of the National Academy of Sciences, soon to release the path-breaking report, Research and Education in Meteorology (1958). The address also reflects the viewpoint of an individual deeply involved in the International Geophysical Year (IGY). It is an important footnote to meteorological history. We welcome this opportunity to profile Berkner and to discuss "Horizons of Meteorology" in light of meteorology's state-of-affairs in the 1950s and the possible relevance to Berkner's ideas to contemporary issues.

  18. Women surgeons in the new millennium. (United States)

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


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

  19. Digital Footprint of Neurological Surgeons. (United States)

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


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

  20. Social media and the surgeon. (United States)

    Margolin, David A


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

  1. Musculoskeletal Pain in Gynecologic Surgeons (United States)

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


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

  2. Surgeon General's Family Health History Initiative (United States)

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

  3. Non-technical skills of surgical trainees and experienced surgeons. (United States)

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


    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.

  4. 21 CFR 878.4460 - Surgeon's glove. (United States)


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

  5. The Nonwhite Woman Surgeon: A Rare Species. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Ning LI


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

  7. Surgeon preferences regarding antibiotic prophylaxis for ballistic fractures. (United States)

    Marecek, Geoffrey S; Earhart, Jeffrey S; Gardner, Michael J; Davis, Jason; Merk, Bradley R


    Scant evidence exists to support antibiotic use for low velocity ballistic fractures (LVBF). We therefore sought to define current practice patterns. We hypothesized that most surgeons prescribe antibiotics for LVBF, prescribing is not driven by institutional protocols, and that decisions are based on protocols utilized for blunt trauma. A web-based questionnaire was emailed to the membership of the Orthopaedic Trauma Association (OTA). The questionnaire included demographic information and questions about LVBF treatment practices. Two hundred and twenty surgeons responded. One hundred and fifty-four (70 %) respondents worked at a Level-1 trauma center, 176 (80 %) had received fellowship education in orthopaedic trauma and 104 (47 %) treated at least 10 ballistic fractures annually. Responses were analyzed with SAS 9.3 for Windows (SAS Institute Inc, Cary, NC). One hundred eighty-six respondents (86 %) routinely provide antibiotics for LVBF. Those who did not were more apt to do so for intra-articular fractures (8/16, 50 %) and pelvic fractures with visceral injury (10/16, 63 %). Most surgeons (167, 76 %) do not believe the Gustilo-Anderson classification applies to ballistic fractures, and (20/29, 70 %) do not base their antibiotic choice on the classification system. Few institutions (58, 26 %) have protocols guiding antibiotic use for LVBF. Routine antibiotic use for LVBF is common; however, practice is not dictated by institutional protocol. Although antibiotic use generally follows current blunt trauma guidelines, surgeons do not base their treatment decisions the Gustilo-Anderson classification. Given the high rate of antibiotic use for LVBF, further study should focus on providing evidence-based treatment guidelines.

  8. The world's best-known surgeon. (United States)

    Walt, A J


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

  9. Burnout syndrome in oral and maxillofacial surgeons: a critical analysis. (United States)

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


    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.

  10. Influence of median surgeon operative duration on adverse outcomes in bariatric surgery. (United States)

    Reames, Bradley N; Bacal, Daniel; Krell, Robert W; Birkmeyer, John D; Birkmeyer, Nancy J O; Finks, Jonathan F


    Evidence suggests that prolonged operative time adversely affects surgical outcomes. However, whether faster surgeons have better outcomes is unclear, as a surgeon׳s speed could reflect skill and efficiency, but may alternatively reflect haste. This study evaluates whether median surgeon operative time is associated with adverse surgical outcomes after laparoscopic Roux-en-Y gastric bypass. We performed a retrospective cohort study using statewide clinical registry data from the years 2006 to 2012. Surgeons were ranked by their median operative time and grouped into terciles. Multivariable logistic regression with robust standard errors was used to evaluate the influence of median surgeon operative time on 30-day surgical outcomes, adjusting for patient and surgeon characteristics, trainee involvement, concurrent procedures, and the complex interaction between these variables. A total of 16,344 patients underwent surgery during the study period. Compared to surgeons in the fastest tercile, slow surgeons required 53 additional minutes to complete a gastric bypass procedure (median [interquartile range] 139 [133-150] versus 86 [69-91], Ppatient characteristic only, slow surgeons had significantly higher adjusted rates of any complication, prolonged length of stay, emergency department visits or readmissions, and venous thromboembolism (VTE). After further adjustment for surgeon characteristics, resident involvement, and the interaction between these variables, slow surgeons had higher rates of any complication (10.5% versus 7.1%, P=.039), prolonged length of stay (14.0% versus 4.4%, P=.002), and VTE (0.39% versus .22%, P<.001). Median surgeon operative duration is independently associated with adjusted rates of certain adverse outcomes after laparoscopic Roux-en-Y gastric bypass. Improving surgeon efficiency while operating may reduce operative time and improve the safety of bariatric surgery. Copyright © 2015 American Society for Bariatric Surgery. Published by

  11. Las notas al pie en la traducción de Fifty Shades (Footnotes in the Translation of Fifty Shades

    Directory of Open Access Journals (Sweden)

    Xinia Valverde Jara


    Full Text Available Se analiza el recurso de las notas a pie de página insertas en la traducción independiente de literatura comercial en versión digital, de la trilogía Fifty Shades of Grey, Fifty Shades Darker y Fifty Shades Freed, de E. L. James. Se examina el grado de influencia de esos elementos extratextuales, y se concluye que todos ellos, organizados en un complejo proceso de traducción, en especial los del contexto de llegada, condicionan la estrategia traductológica. Abstract This study examines the use of footnotes as a translation strategy in the independent translation of commercial literature in digital format, based on the trilogy written by E. L. James, Fifty Shades of Grey, Fifty Shades Darker and Fifty Shades Freed. The analysis measures the influence of these extratextual elements within the complex translation process, specifically those of the target language context, and it is concluded that they condition the translation strategies used.

  12. Projections of Demand for Cardiovascular Surgery and Supply of Surgeons. (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


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

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

    Directory of Open Access Journals (Sweden)

    Jung Jeung Lee


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

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

    Directory of Open Access Journals (Sweden)

    Teusner Dana N


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

  15. Surgeon Scientists Are Disproportionately Affected by Declining NIH Funding Rates. (United States)

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


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

  16. The Glass Houses of Attending Surgeons: An Assessment of Unprofessional Behavior on Facebook Among Practicing Surgeons. (United States)

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


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

  17. Attitudes to teamwork and safety among Italian surgeons and operating room nurses. (United States)

    Prati, Gabriele; Pietrantoni, Luca


    Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.

  18. Surgeon Experience and Complications of Transvaginal Prolapse Mesh. (United States)

    Kelly, Erin C; Winick-Ng, Jennifer; Welk, Blayne


    To measure the proportion of women with transvaginal prolapse mesh complications and their association with surgeon volume. We conducted a retrospective, population-based cohort study of all women who underwent a mesh-based prolapse procedure using administrative data (hospital procedure and physician billing records) between 2002 and 2013 in Ontario, Canada. The primary outcome was surgical revision of the mesh. Primary exposure was surgeon volume: high (greater than the 75th percentile, requiring a median of five [interquartile range 5-6] procedures per year) and very high (greater than the 90th percentile, requiring a median of 13 [interquartile range 11-14] procedures per year) volume mesh implanters were identified each year. Primary analysis was an adjusted Cox proportional hazards model. A total of 5,488 women underwent mesh implantation by 1 of 368 unique surgeons. Median follow-up time was 5.4 (interquartile range 3.0-8.0) years. We found that 218 women (4.0%) underwent mesh reoperation a median of 1.17 (interquartile range 0.58-2.90) years after implantation. The hazard of reoperation for complications was only lower for patients of very high-volume surgeons (3.0% [145/3,001] compared with 4.8% [73/2,447], adjusted hazards ratio 0.59, 95% confidence interval 0.40-0.86). In multivariable modeling, younger age, concomitant hysterectomy, blood transfusion, and increased medical comorbidity were all associated with vaginal mesh reoperation. Approximately 5% of women who underwent mesh-based prolapse surgery required reoperation for a mesh complication within 10 years. The risk of reoperation was lowest for surgeons performing 14 or more procedures per year.

  19. Inventing our future: training the next generation of surgeon innovators. (United States)

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


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

  20. [What Do Young Surgeons Want? Modern Requirements for Senior Surgeons]. (United States)

    Roeth, Anjali A; Mille, Markus


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

  1. 1977 flywheel technology symposium proceedings. [Fifty-two papers

    Energy Technology Data Exchange (ETDEWEB)

    Chang, G.C.; Stone, R.G. (eds.)


    Fifty-two papers, four paper abstracts, and four brief summaries of panel discussions are presented on flywheel energy storage technology. A separate abstract was prepared for each of 41 papers for inclusion in DOE Energy Research Abstracts (ERA). Eleven papers were processed previously for inclusion in the data base. (PMA)

  2. A seasonal variation of the three Leading diagnoses over fifty ...

    African Journals Online (AJOL)

    A seasonal variation of the three Leading diagnoses over fifty months at the Duk Lost. Boys Clinic, South Sudan reed, williama, Dannan, Tomb, Friedman Danielc, MD, Manyok gabrield, Connor Barbarae, MD, reed Davidf, MD. Introduction. The Duk Lost Boys Clinic, a Primary Health Care Clinic in Duk Payuel, is the only ...

  3. Breast imaging: a surgeon's prospective

    International Nuclear Information System (INIS)

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


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

  4. Sexist Attitudes Among Emerging Adult Women Readers of Fifty Shades Fiction. (United States)

    Altenburger, Lauren E; Carotta, Christin L; Bonomi, Amy E; Snyder, Anastasia


    Stereotypical sexist representations of men and women in popular culture reinforce rigid views of masculinity (e.g., males as being strong, in control, masterful, and aggressive) and femininity (e.g., women as being fragile and weak, unassertive, peaceful, irrational, and driven by emotions). The present study examined associations between the fictional series Fifty Shades-one popular culture mechanism that includes pervasive traditional gender role representations-and underlying sexist beliefs among a sample of 715 women ages 18-24 years. Analyses revealed associations between Fifty Shades readership and sexism, as measured through the Ambivalent Sexism Inventory. Namely women who reported reading Fifty Shades had higher levels of ambivalent, benevolent, and hostile sexism. Further, those who interpreted Fifty Shades as "romantic" had higher levels of ambivalent and benevolent sexism. Our findings support prior empirical studies noting associations between interacting with aspects of popular culture, such as television and video games, and individual beliefs and behaviors.

  5. [Louis Ombrédanne (1871-1956) pediatric and plastic surgeon]. (United States)

    Glicenstein, J


    One of the fathers of pediatric surgery in France, Louis Ombrédanne (1871-1956) was a great plastic surgeon. During his residency he was initiated to plastic surgery by Charles Nélaton (1851-1911). Both wrote two books: "La rhinoplastie" and "Les autoplasties", taking stock of these techniques in the early 20th century. In 1906, he was the first to describe the pectoral muscle flap for immediate breast reconstruction after mastectomy. He used this flap in conjunction with an axillo thoracic flap. From 1908 to 1941, Louis Ombrédanne practised pediatric surgery, most of which was devoted in reconstruction of congenital and acquire anomalies. From 1924 to 1941, he was Professor of pediatric surgery at the hospital Enfants-Malades in Paris. In 1907, Louis Ombrédanne created a prototype of an ether inhaler as a safe anesthetic device. The device was successfully used for fifty years in Europe. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Current Use of Methylprednisolone for Acute Spinal Cord Injury by Spine Surgeons of Thailand

    Directory of Open Access Journals (Sweden)

    Sirichai Wilartratsami


    Full Text Available Objective: To determine current decision making in methylprednisolone succinate (MPS administration for acute spinal cord injury (ASCI treatment in Thailand. Methods: A questionnaire was sent to all orthopedic surgeons who attended the annual meeting of the Spine Society of Thailand 2016. The questionnaire had 3 parts of questions including demographic data, opinions in MPS use in general ASCI patients and patients who meet the exclusion criteria in NASCIS III study. Results: Fifty five respondents completed the survey (overall response rate was 27.1 % and there was 78.18% prescribe MPS to ASCI patients. Among them, 40 % prescribe according to NASCIS II and 55.6% NASCIS III. The main reasons for MPS administration are practice standard (38.6%, effectiveness (31.8% and liability issue (22.7%. In patients who met the exclusion criteria of NASCIS III, most respondents do not prescribe any steroids in patients who had age below 14 years old (42.2%, pregnancy (77.8%, severe underlying disease (72.7%, body weight more than 109 kg (40.9%, gunshot injury (59.1% and previous spinal cord injury (46.5%. Interestingly, there were 93.2% prescribed MPS to patients who sustained ACSI more than 8 hours. Conclusion: Because the institutional standard supported MPS use, most participants prescribed MPS in ASCI despite current clinical data from recent studies. Most participants who did not use MPS in patients had exclusion criteria of NASCIS III.

  7. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

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


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

  8. The Future Medical Science and Colorectal Surgeons. (United States)

    Kim, Young Jin


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

  9. Current practice patterns and knowledge among gynecologic surgeons of InterStim® programming after implantation. (United States)

    Hobson, Deslyn T G; Gaskins, Jeremy T; Frazier, LaTisha; Francis, Sean L; Kinman, Casey L; Meriwether, Kate V


    The objective of this study was to describe surgeons' current practices in InterStim® programming after initial implantation and their knowledge of programming parameters. We hypothesized that surgeons performing their own reprogramming would have increased knowledge. We administered a written survey to attendees at the Society of Gynecologic Surgeons Scientific Meeting and analyzed those on which surgeons indicated they offer InterStim® care. The survey queried surgeon characteristics, experience with InterStim® implantation and programming, and clinical opinions regarding reprogramming and tested six knowledge-based questions about programming parameters. Correct response to all six questions was the primary outcome. One hundred and thirty-five of 407 (33%) attendees returned the survey, of which 99 met inclusion criteria. Most respondents (88 of 99; 89%) were between 36 and 60 years, 27 (73%) were women, 76 (77%) practiced in a university setting, and 76 (77%) were trained in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Surgeons who had InterStim® programming training were more likely to perform their own programming [15/46 (32%) vs 6/47 (13%), p = 0.03]. Most answered all knowledge-based questions correctly (62/90, 69%); no surgeon characteristics were significantly associated with this outcome. Most surgeons cited patient comfort (71/80, 89%) and symptom relief (64/80, 80%) as important factors when reprogramming, but no prevalent themes emerged on how and why surgeons change certain programming parameters. Surgeons who had formal InterStim® programming training are more likely to perform programming themselves. No surgeon characteristic was associated with improved programming knowledge. We found that surgeons prioritize patient comfort and symptoms when deciding to reprogram.

  10. Can Surgeon Demographic Factors Predict Postoperative Complication Rates After Elective Spinal Fusion? (United States)

    Chun, Danielle S; Cook, Ralph W; Weiner, Joseph A; Schallmo, Michael S; Barth, Kathryn A; Singh, Sameer K; Freshman, Ryan D; Patel, Alpesh A; Hsu, Wellington K


    Retrospective cohort. Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements. However, there are few studies investigating the association between surgeon demographic factors and complication outcomes after elective spine fusions. A database of US spine surgeons with corresponding postoperative complications data after elective spine fusions was compiled utilizing public data provided by the Centers for Medicare and Medicaid Services (2011-2013) and ProPublica Surgeon Scorecard (2009-2013). Demographic data for each surgeon was collected and consisted of: surgical specialty (orthopedic vs. neurosurgery), years in practice, practice setting (private vs. academic), type of medical degree (MD vs. DO), medical school location (United States vs. foreign), sex, and geographic region of practice. General linear mixed models using a Beta distribution with a logit link and pairwise comparison with post hoc Tukey-Kramer were used to assess the relationship between surgeon demographics and complication rates. 2110 US-practicing spine surgeons who performed spine fusions on 125,787 Medicare patients from 2011 to 2013 met inclusion criteria for this study. None of the surgeon demographic factors analyzed were found to significantly affect overall complication rates in lumbar (posterior approach) or cervical spine fusion. Publicly available complication rates for individual spine surgeons are being utilized by hospital systems and patients to assess aptitude and gauge expectations. The increasing demand for transparency will likely lead to emphasis of these statistics to improve outcomes. We conclude that none of the

  11. Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009. (United States)

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


    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.

  12. Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons. (United States)

    van Rooijen, Stefanus J; Jongen, Audrey Chm; Wu, Zhou-Qiao; Ji, Jia-Fu; Slooter, Gerrit D; Roumen, Rudi Mh; Bouvy, Nicole D


    To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons. Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication. Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: 'extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: 'necrosis of the anastomosis found during reoperation', and 'a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition. There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report 'subclinical' leaks as CAL, which partly explains the higher reported Dutch CAL rates.

  13. Projecting surgeon supply using a dynamic model. (United States)

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


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

  14. Retention of Mohs surgeons in academic dermatology. (United States)

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


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

  15. Surgeon Participation in Early Accountable Care Organizations. (United States)

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


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

  16. Exposure of the orthopaedic surgeon to radiation

    Energy Technology Data Exchange (ETDEWEB)

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


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

  17. Exposure of the orthopaedic surgeon to radiation

    International Nuclear Information System (INIS)

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


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

  18. Lifelong Learning for the Hand Surgeon. (United States)

    Adkinson, Joshua M; Chung, Kevin C


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

  19. Leadership theory: implications for developing dental surgeons in primary care? (United States)

    Willcocks, S


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

  20. Surgeon Influence on Variation in Receipt of Contralateral Prophylactic Mastectomy for Women With Breast Cancer. (United States)

    Katz, Steven J; Hawley, Sarah T; Hamilton, Ann S; Ward, Kevin C; Morrow, Monica; Jagsi, Reshma; Hofer, Timothy P


    Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but we know little about the influence of surgeons on variability of the procedure in the community. To quantify the influence of the attending surgeon on rates of CPM and clinician attitudes that explained it. In this population-based survey study, we identified 7810 women with stages 0 to II breast cancer treated in 2013 to 2015 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County. Surveys were sent approximately 2 months after surgery. Surveys were also sent to 488 attending surgeons identified by the patients. We conducted multilevel analyses to examine the impact of surgeon influence on variations in patient receipt of CPM using information from patient and surgeon surveys merged to Surveillance, Epidemiology, and End Results data. A total of 5080 women responded to the survey (70% response rate), and 377 surgeons responded (77% response rate). The mean (SD) age of responding women was 61.9 (11) years; 28% had an increased risk of second primary cancer, and 16% received CPM. Half of surgeons (52%) practiced for more than 20 years and 30% treated more than 50 new patients with breast cancer annually. Attending surgeon explained a large amount (20%) of the variation in CPM, controlling for patient factors. The odds of a patient receiving CPM increased almost 3-fold (odds ratio, 2.8; 95% CI, 2.1-3.4) if she saw a surgeon with a practice approach 1 SD above a surgeon with the mean CPM rate (independent of age, diagnosis date, BRCA status, and risk of second primary). One-quarter (25%) of the surgeon influence was explained by attending attitudes about initial recommendations for surgery and responses to patient requests for CPM. The estimated rate of CPM was 34% for surgeons who least favored initial breast conservation and were least reluctant to perform CPM vs 4% for surgeons who most favored initial breast conservation and were most

  1. Surveyed opinion of American trauma surgeons in management of colon injuries. (United States)

    Eshraghi, N; Mullins, R J; Mayberry, J C; Brand, D M; Crass, R A; Trunkey, D D


    Primary repair or resection and anastomosis of colon wounds have been advocated in many recent studies, but the proportion of trauma surgeons accepting these recommendations is unknown. To determine the current preferences of American trauma surgeons for colon injury management. Four hundred forty-nine members of the American Association for the Surgery of Trauma were surveyed regarding their preferred management of eight types of colon wounds among three options: diverting colostomy (DC), primary repair (PR), or resection and anastomosis (RA). The influence of selected patient factors and surgeons' characteristics on the choice of management was also surveyed. Seventy-three percent of surgeons completed the survey. Ninety-eight percent chose PR for at least one type of injury. Thirty percent never selected DC. High-velocity gunshot wound was the only injury for which the majority (54%) would perform DC. More than 55% of the surgeons favored RA when the isolated colon injury was a contusion with possible devascularization, laceration greater than 50% of the diameter, or transection. Surgeons who managed five or fewer colon wounds per year chose DC more frequently (p colon wounds per year. The prevailing opinion of trauma surgeons favors primary repair or resection of colon injuries, including anastomosis of unprepared bowel. Surgeons who manage fewer colon wounds prefer colostomy more frequently.

  2. The medicolegal landscape of spine surgery: how do surgeons fare? (United States)

    Makhni, Melvin C; Park, Paul J; Jimenez, Jesus; Saifi, Comron; Caldwell, Jon-Michael; Ha, Alex; Figueroa-Santana, Bianca; Lehman, Ronald A; Weidenbaum, Mark


    Because of the limited and confidential nature of most legal data, scarce literature is available to physicians about reasons for litigation in spine surgery. To optimally compensate patients while protecting physicians, further understanding of the medicolegal landscape is needed for high-risk procedures such as spine surgery. Based on these, surgeons can explore ways to better protect both their patients and themselves. To characterize the current medicolegal environment of spine surgery by analyzing a recent dataset of malpractice litigation. A retrospective study. All malpractice cases involving spine surgery available to public query between the years of 2010 and 2014. Case outcome for spine surgery malpractice cases between the years of 2010 and 2014. WestlawNext was used to analyze spine surgery malpractice cases at the state and federal level between the years 2010 and 2014. WestlawNext is a subscription-based, legal search engine that contains publicly available federal and state court records. All monetary values were inflation adjusted for 2016. One hundred three malpractice cases were categorized by case descriptors and outcome measures. Claims were categorized as either intraoperative complaints or preoperative complaints. Rulings in favor of the defendant (surgeon) were noted in 75% (77 of 103) of the cases. Lack of informed consent was cited in 34% of cases. For the 26 cases won by the plaintiff, the average amount in settlement was $2,384,775 versus $3,945,456 in cases brought before a jury. Cases involving consent averaged a compensation of $2,029,884, whereas cases involving only intraoperative complaints averaged a compensation of $3,667,530. A significant correlation was seen between increased compensation for plaintiffs and cases involving orthopedic surgeons (p=.020) or nerve injury (p=.005). Wrong-level surgery may be associated with lower plaintiff compensation (p=.055). The length of cases resulting in defense verdicts averaged 5.51 years

  3. Surgeon-patient communication during awake procedures. (United States)

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


    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.

  4. The Internet and the paediatric surgeon. (United States)

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


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

  5. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

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

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

  6. Income, productivity, and satisfaction of breast surgeons. (United States)

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


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

  7. Canadian cardiac surgeons' perspectives on biomedical innovation. (United States)

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


    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.

  8. The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work-Home Balance. (United States)

    Bentz, Michael L


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

  9. Cardiothoracic and Vascular Surgeons Achieve High Rates of K-Award Conversion Into R01 Funding. (United States)

    Narahari, Adishesh K; Mehaffey, J Hunter; Hawkins, Robert B; Baderdinni, Pranav K; Chandrabhatla, Anirudha S; Tribble, Curtis G; Kron, Irving L; Roeser, Mark E; Walters, Dustin M; Ailawadi, Gorav


    Obtaining National Institutes of Health (NIH) R01 funding remains extremely difficult. The utility of career development grants (K awards) for achieving the goal of R01 funding remains debated, particularly for surgeon-scientists. We examined the success rate for cardiothoracic and vascular (CTV) surgeons compared to other specialties in converting K-level grants into R01 equivalents. All K (K08 and K23) grants awarded to surgeons by the NIH between 1992-2017 were identified through NIH RePORTER, an online database combining funding, publications, and patents. Only grants awarded to CTV surgeons were included. Grants active within the past year were excluded. Mann-Whitney U-tests and Chi-squared tests were used to compare groups. A total of 62 K grants awarded to CTV surgeons were identified during this period. Sixteen grants were still active within the last year and excluded from analysis. Twenty-two (48%) of the remaining K awardees successfully transitioned to an R01 or equivalent grant. Awardees with successful conversion published 9 publications per K grant compared to 4 publications for those who did not convert successfully (p=0.01). The median time for successful conversion to an R grant was 5.0 years after the K award start date. Importantly, the 10-year conversion rate to R01 was equal for CTV surgeons compared to other clinician-investigators (52.6% vs 42.5%). CTV surgeons have an equal 10-year conversion rate to first R01 award compared to other clinicians. These data suggest that NIH achieves a good return on investment when funding CTV surgeon-scientists with K-level funding. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Career and lifestyle satisfaction among surgeons: what really matters? The National Lifestyles in Surgery Today Survey. (United States)

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


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

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

    LENUS (Irish Health Repository)

    McHugh, S M


    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.

  12. Assessing the Impact of Surgeon Experience on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy: Results of Four High-Volume Surgeons. (United States)

    Fossati, Nicola; Di Trapani, Ettore; Gandaglia, Giorgio; Dell'Oglio, Paolo; Umari, Paolo; Buffi, Nicolò Maria; Guazzoni, Giorgio; Mottrie, Alexander; Gaboardi, Franco; Montorsi, Francesco; Briganti, Alberto; Suardi, Nazareno


    To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery. Covariates consisted of patient age, Charlson comorbidity index, preoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), nerve-sparing surgery (none vs unilateral vs bilateral), and preoperative risk groups (low- vs intermediate- vs high risk). The number of cases performed by each surgeon was 541, 413, 411, and 112, respectively. Median follow-up was 24 months (inter-quartile range: 18, 40). The UC recovery rate at 1 year after surgery was 82%. At multivariable analyses, surgeon experience represented an independent predictor of UC recovery (hazard ratio: 1.02, p < 0.001). The surgical learning curve was similar among surgeons, moving linearly from ∼60% of UC rate at the initial cases to almost 90% after more than 400 procedures. In patients undergoing RARP, surgeon experience is a significant predictor of UC recovery. The surgical learning curve of UC recovery does not reach a plateau even after more than 100 cases, suggesting a continuous improvement of the surgical technique. These findings deserve attention for patient counseling and future comparative studies evaluating functional outcomes after RARP.

  13. The effects of tenure and promotion on surgeon productivity. (United States)

    Lam, Adam; Heslin, Martin J; Tzeng, Ching-Wei D; Chen, Herbert


    Studies investigating the impact of promotion and tenure on surgeon productivity are lacking. The aim of this study is to elucidate the relationship of promotion and tenure to surgeon productivity. We reviewed data for the Department of Surgery at our institution. Relative value units (RVUs) billed per year, publications per year, and grant funding per year were used to assess productivity from 2010 to 2016. We analyzed tenure-track (TT) and non-tenure-track (NT) surgeons and compared the productivity within these groups by rank: assistant professor (ASST), associate professor (ASSOC), and full professor (FULL). Kruskal-Wallis and Mann-Whitney U tests were used to assess significance and relationships between the groups. A TT faculty was promoted if they produced more research, with the highest publication rates in TT FULL. TT faculty publishing rates increased from ASST to ASSOC (1 versus 2, P = 0.006) and from ASSOC to FULL (2 versus 4, P production (RVUs) was highest between TT ASSOC and NT FULL. TT faculty increased productivity between ASST and ASSOC (7023 versus 8384, P = 0.001) and decreased between ASSOC and FULL (8384 versus 6877, P production and grant funding, whereas NT FULL has the highest clinical production. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Case scheduling preferences of one Surgeon's cataract surgery patients. (United States)

    Dexter, Franklin; Birchansky, Lee; Bernstein, James M; Wachtel, Ruth E


    The increase in the number of operating rooms nationwide in the United States may reflect preferences of patients for scheduling of outpatient surgery. Yet, little is known of the importance that patients place on scheduling convenience and flexibility. Fifty cataract surgery patients seen by a surgeon at his main office during a 6-mo period responded to a marketing survey. All the patients had Medicare insurance and supplemental insurance permitting surgery at any facility. A telephone questionnaire included four vignettes describing different choices in the scheduling of cataract surgery. Respondents were asked how far they would be willing to travel for one option instead of another. For example, "Your surgery will be on Thursday in three weeks at 2 pm. You can drink water until 9 am. You arrive at 10 am, because your surgery might start early. If you travel farther, you would arrive at 8 am for 9 am surgery." The median (50th percentile) additional travel time was 60 min (lower 95% confidence bound >or=52 min) for each of four options: to receive care on a day chosen by the patient instead of assigned by the physician, to receive care at a single site instead of both the surgeon's office and a surgery center at a different location, to combine the examination and the surgery into a single visit instead of two visits, and to have surgery in the morning instead of the afternoon. The patients of this ophthalmologist placed a high value on convenience and flexibility in scheduling their surgery. In general, this would be achievable only if many operating rooms were available each morning.

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

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


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

  16. Designing a leadership development program for surgeons. (United States)

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


    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.

  17. Albert Ross Tilley: The legacy of a Canadian plastic surgeon. (United States)

    Mowbrey, Kevin


    The present article chronicles the career of Dr Albert Ross Tilley, one of the most important Canadian plastic surgeons of the 20th century. Tilley is most well known for his innovations of burn management during World War II and his treatment of a group of burn patients known affectionately as the 'Guinea Pig Club'. In addition to the superb surgical skills he applied to the physical wounds of his patients, Tilley was also a pioneer of caring for the emotional and psychological afflictions suffered by many airmen of World War II. As one of the founding fathers of the Canadian Society of Plastic Surgeons, Tilley's work was instrumental in establishing the specialty and ensured its prosperity for years to come. Serving in the capacity of leader, educator and innovator, Tilley remains one of Canada's most decorated physicians, and his body of work encompasses contributions to the medical field that remain significant and beneficial to patient care to this day.

  18. Sarcoidosis in a dental surgeon: a case report

    Directory of Open Access Journals (Sweden)

    Mattia Daniele


    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.

  19. Does surgeon volume matter in the outcome of endoscopic inguinal hernia repair? (United States)

    Köckerling, F; Bittner, R; Kraft, B; Hukauf, M; Kuthe, A; Schug-Pass, C


    For open and endoscopic inguinal hernia surgery, it has been demonstrated that low-volume surgeons with fewer than 25 and 30 procedures, respectively, per year are associated with significantly more recurrences than high-volume surgeons with 25 and 30 or more procedures, respectively, per year. This paper now explores the relationship between the caseload and the outcome based on the data from the Herniamed Registry. The prospective data of patients in the Herniamed Registry were analyzed using the inclusion criteria minimum age of 16 years, male patient, primary unilateral inguinal hernia, TEP or TAPP techniques and availability of data on 1-year follow-up. In total, 16,290 patients were enrolled between September 1, 2009, and February 1, 2014. Of the participating surgeons, 466 (87.6 %) had carried out fewer than 25 endoscopic/laparoscopic operations (low-volume surgeons) and 66 (12.4 %) surgeons 25 or more operations (high-volume surgeons) per year. Univariable (1.03 vs. 0.73 %; p = 0.047) and multivariable analysis [OR 1.494 (1.065-2.115); p = 0.023] revealed that low-volume surgeons had a significantly higher recurrence rate compared with the high-volume surgeons, although that difference was small. Multivariable analysis also showed that pain on exertion was negatively affected by a lower caseload <25 [OR 1.191 (1.062-1.337); p = 0.003]. While here, too, the difference was small, the fact that in that group there was a greater proportion of patients with small hernia defect sizes may have also played a role since the risk in that group was higher. In this analysis, no evidence was found that pain at rest [OR 1.052 (0.903-1.226); p = 0.516] or chronic pain requiring treatment [OR 1.108 (0.903-1.361); p = 0.326] were influenced by the surgeon volume. As confirmed by previously published studies, the data in the Herniamed Registry also demonstrated that the endoscopic/laparoscopic inguinal hernia surgery caseload impacted the outcome. However

  20. Surgeon-reported conflict with intensivists about postoperative goals of care. (United States)

    Paul Olson, Terrah J; Brasel, Karen J; Redmann, Andrew J; Alexander, G Caleb; Schwarze, Margaret L


    To examine surgeons' experiences of conflict with intensivists and nurses about goals of care for their postoperative patients. Cross-sectional incentivized US mail-based survey. Private and academic surgical practices. A total of 2100 vascular, neurologic, and cardiothoracic surgeons. Surgeon-reported rates of conflict with intensivists and nurses about goals of care for patients with poor postsurgical outcomes. The adjusted response rate was 55.6%. Forty-three percent of surgeons reported sometimes or always experiencing conflict about postoperative goals of care with intensivists, and 43% reported conflict with nurses. Younger surgeons reported higher rates of conflict than older surgeons with both intensivists (57% vs 32%; P = .001) and nurses (48% vs 33%; P = .001). Surgeons practicing in closed intensive care units reported more frequent conflict than those practicing in open intensive care units (60% vs 41%; P = .005). On multivariate analysis, the odds of reporting conflict with intensivists were 2.5 times higher for surgeons with fewer years of experience compared with their older colleagues (odds ratio, 2.5; 95% CI, 1.6-3.8) and 70% higher for reporting conflict with nurses (odds ratio, 1.7; 95% CI, 1.1-2.6). The odds of reporting conflict with intensivists about goals of postoperative care were 40% lower for surgeons who primarily managed their intensive care unit patients than for those who worked in a closed unit (odds ratio, 0.60; 95% CI, 0.40-0.96). Surgeons regularly experience conflict with critical care clinicians about goals of care for patients with poor postoperative outcomes. Higher rates of conflict are associated with less experience and working in a closed intensive care unit.

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

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


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

  2. Nuclear magnetic resonance evaluation of fifty children with cancer

    International Nuclear Information System (INIS)

    Cohen, M.D.; Klatte, E.C.; Smith, J.A.; Carr, B.E.; Martin-Simmerman, P.


    Fifty children with cancer have been studied by MR. The patients studied include ten with lymphoma, nine with neuroblastoma, five with rhabdomyosarcoma, six with leukemia, five with Ewings sarcoma, four with Wilms tumor and several with other miscellaneous tumors. The results of scanning show that MR is well tolerated by children. Primary tumor has been identified in every case. Metastases have been identified in many patients. MR has proved helpful in identifying the organ of origin of a tumor. Because of excellent vessel visualization it is helpful in planning surgical resection of a tumor. In addition, in a number of patients MR has proved helpful in monitoring the response of tumor to nonsurgical therapy. With continued improvement in image quality it is believed that MR has a major role to play in pediatric tumor imaging [fr

  3. The decision book fifty models for strategic thinking

    CERN Document Server

    Krogerus, Mikael


    Most of us face the same questions every day: What do I want? And how can I get it? How can I live more happily and work more efficiently? A worldwide bestseller, The Decision Book distils into a single volume the fifty best decision-making models used on MBA courses and elsewhere that will help you tackle these important questions - from the well known (the Eisenhower matrix for time management) to the less familiar but equally useful (the Swiss Cheese model). It will even show you how to remember everything you will have learned by the end of it. Stylish and compact, this little black book is a powerful asset. Whether you need to plot a presentation, assess someone's business idea or get to know yourself better, this unique guide will help you simplify any problem and take steps towards the right decision.

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

    NARCIS (Netherlands)

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


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

  5. Concurrent Surgery and the Role of the Pediatric Attending Surgeon: Comparing Parents' and Surgeons' Expectations. (United States)

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


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

  6. Effects of surgeon variability on oncologic and functional outcomes in a population-based setting. (United States)

    Carlsson, Sigrid; Berglund, Anders; Sjoberg, Daniel; Khatami, Ali; Stranne, Johan; Bergdahl, Svante; Lodding, Pär; Aus, Gunnar; Vickers, Andrew; Hugosson, Jonas


    Oncologic and functional outcomes after radical prostatectomy (RP) can vary between surgeons to a greater extent than is expected by chance. We sought to examine the effects of surgeon variation on functional and oncologic outcomes for patients undergoing RP for prostate cancer in a European center. The study comprised 1,280 men who underwent open retropubic RP performed by one of nine surgeons at an academic institution in Sweden between 2001 and 2008. Potency and continence outcomes were measured preoperatively and 18 months postoperatively by patient-administered questionnaires. Biochemical recurrence (BCR) was defined as a prostate-specific antigen (PSA) value > 0.2 ng/mL with at least one confirmatory rise. Multivariable random effect models were used to evaluate heterogeneity between surgeons, adjusting for case mix (age, PSA, pathological stage and grade), year of surgery, and surgical experience. Of 679 men potent at baseline, 647 provided data at 18 months with 122 (19%) reporting potency. We found no evidence for heterogeneity of potency outcomes between surgeons (P = 1). The continence rate for patients at 18 months was 85%, with 836 of the 979 patients who provided data reporting continence. There was statistically significant heterogeneity between surgeons (P = 0.001). We did not find evidence of an association between surgeons' adjusted probabilities of functional recovery and 5-year probability of freedom from BCR. Our data support previous studies regarding a large heterogeneity among surgeons in continence outcomes for patients undergoing RP. This indicates that some patients are receiving sub-optimal care. Quality assurance measures involving performance feedback, should be considered. When surgeons are aware of their outcomes, they can improve them to provide better care to patients.

  7. Surgeon specialization and use of sentinel lymph node biopsy for breast cancer (United States)

    Yen, Tina W.F.; Laud, Purushuttom W.; Sparapani, Rodney A.; Nattinger, Ann B.


    IMPORTANCE Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in clinically node-negative breast cancer patients. It is not known whether SLNB rates differ by surgeon expertise. If surgeons with less breast cancer expertise are less likely to offer SLNB to clinically node-negative patients, this practice pattern could lead to unnecessary axillary lymph node dissections (ALND) and lymphedema. OBJECTIVE To explore potential measures of surgical expertise (including a novel objective specialization measure – percentage of a surgeon’s operations devoted to breast cancer determined from claims) on the use of SLNB for invasive breast cancer. DESIGN Population-based prospective cohort study. Patient, tumor, treatment and surgeon characteristics were examined. SETTING California, Florida, Illinois PARTICIPANTS Elderly (65+ years) women identified from Medicare claims as having had incident invasive breast cancer surgery in 2003. MAIN OUTCOME MEASURES Type of axillary surgery performed. RESULTS Of the 1,703 women treated by 863 different surgeons, 56% underwent an initial SLNB, 37% initial ALND and 6% no axillary surgery. The median annual surgeon Medicare volume of breast cancer cases was 6 (range: 1.5–57); the median surgeon percentage of breast cancer cases was 4.6% (range: 0.7%–100%). After multivariable adjustment of patient and surgeon factors, women operated on by surgeons with higher volumes and percentages of breast cancer cases had a higher likelihood of undergoing SLNB. Specifically, women were most likely to undergo SLNB if operated on by high volume surgeons (regardless of percentage) or by lower volume surgeons with a high percentage of cases devoted to breast cancer. In addition, membership in the American Society of Breast Surgeons (OR 1.98, CI 1.51–2.60) and Society of Surgical Oncology (OR 1.59, CI 1.09–2.30) were independent predictors of women undergoing an initial SLNB. CONCLUSIONS AND RELEVANCE Patients treated

  8. Risk adjustment for case mix and the effect of surgeon volume on morbidity. (United States)

    Maas, Matthew B; Jaff, Michael R; Rordorf, Guy A


    Retrospective studies of large administrative databases have shown higher mortality for procedures performed by low-volume surgeons, but the adequacy of risk adjustment in those studies is in doubt. To determine whether the relationship between surgeon volume and outcomes is an artifact of case mix using a prospective sample of carotid endarterectomy cases. Observational cohort study from January 1, 2008, through December 31, 2010, with preoperative, immediate postoperative, and 30-day postoperative assessments acquired by independent monitors. Urban, tertiary academic medical center. All 841 patients who underwent carotid endarterectomy performed by a vascular surgeon or cerebrovascular neurosurgeon at the institution. Carotid endarterectomy without another concurrent surgery. Stroke, death, and other surgical complications occurring within 30 days of surgery along with other case data. A low-volume surgeon performed 40 or fewer cases per year. Variables used in a comparison administrative database study, as well as variables identified by our univariate analysis, were used for adjusted analyses to assess for an association between low-volume surgeons and the rate of stroke and death as well as other complications. RESULTS The rate of stroke and death was 6.9% for low-volume surgeons and 2.0% for high-volume surgeons (P = .001). Complications were similarly higher (13.4% vs 7.2%, P = .008). Low-volume surgeons performed more nonelective cases. Low-volume surgeons were significantly associated with stroke and death in the unadjusted analysis as well as after adjustment with variables used in the administrative database study (odds ratio, 3.61; 95% CI, 1.70-7.67, and odds ratio, 3.68; 95% CI, 1.72-7.89, respectively). However, adjusting for the significant disparity of American Society of Anesthesiologists Physical Status classification in case mix eliminated the effect of surgeon volume on the rate of stroke and death (odds ratio, 1.65; 95% CI, 0.59-4.64) and other

  9. Preoperative and Postoperative Nomograms Incorporating Surgeon Experience for Clinically Localized Prostate Cancer (United States)

    Kattan, Michael W.; Vickers, Andrew J.; Yu, Changhong; Bianco, Fernando J.; Cronin, Angel M.; Eastham, James A.; Klein, Eric A.; Reuther, Alwyn M.; Pontes, Jose Edson; Scardino, Peter T.


    BACKGROUND Accurate preoperative and postoperative risk assessment has been critical for counseling patients regarding radical prostatectomy for clinically localized prostate cancer. In addition to other treatment modalities, neoadjuvant or adjuvant therapies have been considered. The growing literature suggested that the experience of the surgeon may affect the risk of prostate cancer recurrence. The purpose of this study was to develop and internally validate nomograms to predict the probability of recurrence, both preoperatively and postoperatively, with adjustment for standard parameters plus surgeon experience. METHODS The study cohort included 7724 eligible prostate cancer patients treated with radical prostatectomy by 1 of 72 surgeons. For each patient, surgeon experience was coded as the total number of cases conducted by the surgeon before the patient’s operation. Multivariable Cox proportional hazards regression models were developed to predict recurrence. Discrimination and calibration of the models was assessed following bootstrapping methods, and the models were presented as nomograms. RESULTS In this combined series, the 10-year probability of recurrence was 23.9%. The nomograms were quite discriminating (preoperative concordance index, 0.767; postoperative concordance index, 0.812). Calibration appeared to be very good for each. Surgeon experience seemed to have a quite modest effect, especially postoperatively. CONCLUSIONS Nomograms have been developed that consider the surgeon’s experience as a predictor. The tools appeared to predict reasonably well but were somewhat little improved with the addition of surgeon experience as a predictor variable. PMID:19156928

  10. Surgeons' physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. (United States)

    Lee, G I; Lee, M R; Green, I; Allaf, M; Marohn, M R


    It is commonly believed that robotic surgery systems provide surgeons with an ergonomically sound work environment; however, the actual experience of surgeons practicing robotic surgery (RS) has not been thoroughly researched. In this ergonomics survey study, we investigated surgeons' physical symptom reports and their association with factors including demographics, specialties, and robotic systems. Four hundred and thirty-two surgeons regularly practicing RS completed this comprehensive survey comprising 20 questions in four categories: demographics, systems, ergonomics, and physical symptoms. Chi-square and multinomial logistic regression analyses were used for statistical analysis. Two hundred and thirty-six surgeons (56.1 %) reported physical symptoms or discomfort. Among those symptoms, neck stiffness, finger, and eye fatigues were the most common. With the newest robot, eye symptom rate was considerably reduced, while neck and finger symptoms did not improve significantly. A high rate of lower back stiffness was correlated with higher annual robotic case volume, and eye symptoms were more common with longer years practicing robotic surgery (p ergonomic settings reported lower symptom report rates. Symptoms were not correlated with age and gender. Although RS provides relatively better ergonomics, this study demonstrates that 56.1 % of regularly practicing robotic surgeons still experience related physical symptoms or discomfort. In addition to system improvement, surgeon education in optimizing the ergonomic settings may be necessary to maximize the ergonomic benefits in RS.

  11. Cardiac Surgeons after Vacation: Refreshed or Rusty? (United States)

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


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

  12. Perspectives of Orthopedic Surgeons on Racial/Ethnic Disparities in Care. (United States)

    Adelani, Muyibat A; O'Connor, Mary I


    Racial/ethnic disparities in healthcare, including orthopedics, have been extensively documented. However, the level of knowledge among orthopedic surgeons regarding racial/ethnic disparities is unknown. The purpose of this study is to determine the views of orthopedic surgeons on (1) the extent of racial/ethnic disparities in orthopedic care, (2) patient and system factors that may contribute, and (3) the potential role of orthopedic surgeons in the reduction of disparities. Three hundred five members of the American Orthopaedic Association completed a survey to assess their knowledge of racial/ethnic disparities and their perceptions about the underlying causes. Twelve percent of respondents believe that patients often receive different care based on race/ethnicity in healthcare in general, while 9 % believe that differences exist in orthopedic care in general, 3 % believe that differences exist within their hospitals/clinics, and 1 % reported differences in their own practices. Despite this, 68 % acknowledge that there is evidence of disparities in orthopedic care. Fifty-one percent believe that a lack of insurance significantly contributes to disparities. Thirty-five percent believe that diversification of the orthopedic workforce would be a "very effective" strategy in addressing disparities, while 25 % percent believe that research would be "very effective" and 24 % believe that surgeon education would be "very effective." Awareness regarding racial/ethnic disparities in musculoskeletal care is low among orthopedic surgeons. Additionally, respondents were more likely to acknowledge disparities within the practices of others than their own. Increased diversity, research, and education may help improve knowledge of this problem.

  13. Variations in Practice Patterns among Neurosurgeons and Orthopaedic Surgeons in the Management of Spinal Disorders. (United States)

    Hussain, Manzar; Nasir, Sadaf; Moed, Amber; Murtaza, Ghulam


    This is a case series. We wanted to identify variations in the practice patterns among neurosurgeons and orthopedic surgeons for the management of spinal disorders. Spinal disorders are common in the clinical practice of both neurosurgeons and orthopedic surgeons. It has been observed that despite the availability of various guidelines, there is lack of consensus among surgeons about the management of various disorders. A questionnaire was distributed, either directly or via e-mail, to the both the neurosurgeons and orthopedic surgeons who worked at 5 tertiary care centers within a single region of Korea. The surgeons were working either in private practice or in academic institutions. The details of the questionnaire included demographic details and the specialty (orthopedic/neurosurgeon). The surgeons were classified according to the level of experience as up to 5 years, 6-10 years and > 10 years. Questions were asked about the approach to lumbar discectomy (fragmentectomy or aggressive disc removal), using steroids for treating discitis, the fusion preference for spondylolisthesis, the role of an orthosis after fusion, the preferred surgical approach for spinal stenosis, the operative approach for spinal trauma (early within 72 hours or late > 72 hours) and the role of surgery in complete spinal cord injury. The data was analyzed using SPSS ver 16. p-values neurosurgeons and 10 were orthopedic surgeons. Statistically significant differences were observed for the management of spinal stenosis, spondylolisthesis, using an orthosis after fusion, the type of lumbar discectomy and the value of surgical intervention after complete spinal cord injury. Our results suggest that there continues to exist a statistically significant lack of consensus among neurosurgeons and orthopedic spine surgeons when considering using an orthosis after fusion, the type of discectomy and the value of intervention after complete spinal injury.

  14. The vascular surgery workforce: a survey of consultant vascular surgeons in the UK, 2014. (United States)

    Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G


    The purpose of this study was to describe the demographics, training, and practice characteristics of consultant vascular surgeons across the UK to provide an assessment of current, and inform future prediction of workforce needs. A questionnaire was developed using a modified Delphi process to generate questionnaire items. The questionnaire was emailed to all consultant vascular surgeons (n = 450) in the UK who were members of the Vascular Society of Great Britain & Ireland. 352 consultant vascular surgeons from 95 hospital trusts across the UK completed the survey (78% response rate). The mean age was 50.6 years old, the majority (62%) were mid-career, but 24% were above the age of 55. Currently, 92% are men and only 8% women. 93% work full-time, with 60% working >50 hours, and 21% working >60 hours per week. The average team was 5 to 6 (range 2-10) vascular surgeons, with 23% working in a large team of ≥8. 17% still work in small teams of ≤3. Over 90% of consultant vascular surgeons perform the major index vascular surgery procedures (aneurysm repair, carotid endarterectomy, infra-inguinal bypass, amputation). While 84% perform standard endovascular abdominal aortic aneurysm repair (EVAR), <50% perform more complex endovascular aortic therapy. The majority of vascular surgeons "like their job" (85%) and are "satisfied" (69%) with their job. 34% of consultant vascular surgeons indicated they were "extremely likely" to retire within the next 10 years. This study provides the first detailed analysis of the new specialty of vascular surgery as practiced in the UK. There is a need to plan for a significant expansion in the consultant vascular surgeon workforce in the UK over the next 10 years to maintain the status quo. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  15. Choosing a Surgeon: An Exploratory Study of Factors Influencing Selection of a Gender Affirmation Surgeon. (United States)

    Ettner, Randi; Ettner, Frederic; White, Tonya


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

  16. Patient Reactions to Surgeon Recommendations About Contralateral Prophylactic Mastectomy for Treatment of Breast Cancer. (United States)

    Katz, Steven J; Janz, Nancy K; Abrahamse, Paul; Wallner, Lauren P; Hawley, Sarah T; An, Lawrence C; Ward, Kevin C; Hamilton, Ann S; Morrow, Monica; Jagsi, Reshma


    Guidelines assert that contralateral prophylactic mastectomy (CPM) should be discouraged in patients without an elevated risk for a second primary breast cancer. However, little is known about the impact of surgeons discouraging CPM on patient care satisfaction or decisions to seek treatment from another clinician. To examine the association between patient report of first-surgeon recommendation against CPM and the extent of discussion about it with 3 outcomes: patient satisfaction with surgery decisions, receipt of a second opinion, and receipt of surgery by a second surgeon. This population-based survey study was conducted in Georgia and California. We identified 3880 women with stages 0 to II breast cancer treated in 2013-2014 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County. Surveys were sent approximately 2 months after surgery (71% response rate, n = 2578). In this analysis conducted from February to May 2016, we included patients with unilateral breast cancer who considered CPM (n = 1140). Patients were selected between July 2013 and September 2014. We examined report of surgeon recommendations, level of discussion about CPM, satisfaction with surgical decision making, receipt of second surgical opinion, and surgery from a second surgeon. The mean (SD) age of patients included in this study was 56 (10.6) years. About one-quarter of patients (26.7%; n = 304) reported that their first surgeon recommended against CPM and 30.1% (n = 343) reported no substantial discussion about CPM. Dissatisfaction with surgery decision was uncommon (7.6%; n = 130), controlling for clinical and demographic characteristics. One-fifth of patients (20.6%; n = 304) had a second opinion about surgical options and 9.8% (n = 158) had surgery performed by a second surgeon. Dissatisfaction was very low (3.9%; n = 42) among patients who reported that their surgeon did not recommend against CPM but

  17. Quality improvement 101 for surgeons: Navigating the alphabet soup. (United States)

    Santore, Matthew T; Islam, Saleem


    It is a fundamental value of the surgical profession to improve care for its patients. In the last 100 years, the principles of prospective quality improvement have started to work their way into the traditional method of retrospective case review in morbidity and mortality conference. This article summarizes the history of "improvement science" and its intersection with the field of surgery. It attempts to clarify the principles and jargon that may be new or confusing to surgeons with a different vocabulary and experience. This is done to bring the significant power and resources of improvement science to the traditional efforts to improve surgical care. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Conflict resolution: practical principles for surgeons. (United States)

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


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

  19. Smart apps for the smart plastic surgeon

    Directory of Open Access Journals (Sweden)

    Aniketh Venkataram


    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.

  20. Professionalism and Commercialism on Cosmetic Surgeons' Websites. (United States)

    Park, Sung-Yeon; Park, SangHee


    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.

  1. Clinical decision making: how surgeons do it. (United States)

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


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

  2. Meeting Increasing Demands for Rural General Surgeons. (United States)

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


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

  3. Muscular variations during axillary dissection: A clinical study in fifty patients

    Directory of Open Access Journals (Sweden)



    Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4% with axillary arch and one patient (2% with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer.

  4. A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons. (United States)

    Chung, Eric; Wang, Run; Ralph, David; Levine, Laurence; Brock, Gerald


    Despite published guidelines on Peyronie's disease (PD), there are limited data on actual surgical practice among surgeons. To evaluate the surgical practice patterns in PD among surgeons from different continents and members of various sexual medicine societies. An anonymous survey on various pre-, intra-, and postoperative aspects of PD surgical care was distributed in printed format during International Society of Sexual Medicine meetings and as an online survey to International Society of Sexual Medicine members. 390 surgeons responded to the survey, with great variations in pre-, intra-, and postoperative strategies in PD surgical care. Most surgeons performed fewer than 10 penile plications and 10 graft surgeries per year. Modified Nesbit plication was the preferred option by most surgeons. Surgeons who received fellowship training were more likely to perform autologous than allograft surgery (odds ratio = 1.79, 95% CI = 1.13-2.82, P = .01). The use of penile color duplex ultrasound was inconsistently performed, with higher-volume surgeons (ie, >20 cases operated a year) more likely to use this diagnostic modality (odds ratio = 70.18, 95% CI = 20.99-234.6, P worldwide survey study has the potential to assist in the formation of a new practice guideline and serve as the basis for future prospective multinational studies. This is one of the largest surveys on PD practice and, to our knowledge, the only survey conducted across various sexual medicine societies, with the inclusion of many high-volume and experienced PD surgeons. This also is the 1st study to comprehensively evaluate many key aspects in surgical practice patterns for PD. However, the categorization on the questionnaire used in this survey was not designed to allow for direct comparison given the possibility of some surgeons with dual society memberships, reporting biases, large CIs in outcomes, different patient demographics, and cultural acceptance. There is great variation in surgical

  5. Factors Associated With Financial Relationships Between Spine Surgeons and Industry: An Analysis of the Open Payments Database. (United States)

    Weiner, Joseph A; Cook, Ralph W; Hashmi, Sohaib; Schallmo, Michael S; Chun, Danielle S; Barth, Kathryn A; Singh, Sameer K; Patel, Alpesh A; Hsu, Wellington K


    A retrospective review of Centers for Medicare and Medicaid Services Database. Utilizing Open Payments data, we aimed to determine the prevalence of industry payments to orthopedic and neurospine surgeons, report the magnitude of those relationships, and help outline the surgeon demographic factors associated with industry relationships. Previous Open Payments data revealed that orthopedic surgeons receive the highest value of industry payments. No study has investigated the financial relationship between spine surgeons and industry using the most recent release of Open Payments data. A database of 5898 spine surgeons in the United States was derived from the Open Payments website. Demographic data were collected, including the type of residency training, years of experience, practice setting, type of medical degree, place of training, gender, and region of practice. Multivariate generalized linear mixed models were utilized to determine the relationship between demographics and industry payments. A total of 5898 spine surgeons met inclusion criteria. About 91.6% of surgeons reported at least one financial relationship with industry. The median total value of payments was $994.07. Surgeons receiving over $1,000,000 from industry during the reporting period represented 6.6% of the database and accounted for 83.5% of the total value exchanged. Orthopedic training (P regression analysis revealed a strong inverse relationship between years of experience and number of payments from industry (r = -0.967, P Financial relationships between spine surgeons and industry are highly prevalent. Surgeon demographics have a significant association with industry-surgeon financial relationships. Our reported value of payments did not include ownership or research payments and thus likely underestimates the magnitude of these financial relationships. 3.

  6. Work experiences, professional development and career prospects of New Zealand dental house surgeons. (United States)

    Kim, Jenny J; Antoun, Joseph S


    New dental graduates compete for house surgeon positions every year, despite little being known about the work experience gained from such posts. The main objectives of this study were to identify the nature of house surgeons' work experiences, their continued professional development (CPD) opportunities and the impact of hospital experience on their future career pathways. A questionnaire was mailed to all 31 New Zealand dental house surgeons (response rate 100%). The majority of house surgeons (77.4%) found hospital work enjoyable, with nearly all (93.5%) perceiving themselves as better clinicians from their experience. Oral surgery, restorative dentistry, special needs dentistry and removable prosthodontics were the most commonly practised areas. The average weekly number of working hours was 42.3 hours for a normal week and 61.8 hours for an on-call week. Stress levels during on-call work were significantly higher than during day-to-day hospital work (p career, with nearly 13% wishing to return to a New Zealand hospital in the future. A dental house surgeon position remains an attractive choice and offers an enjoyable experience for young graduates. Hospitals provide ample CPD opportunities and appear to play an influential role in a house surgeon's career pathway.

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

    International Nuclear Information System (INIS)

    Najafi, Massoome; Ebrahimi, Mandana; Kaviani, Ahmad; Hashemi, Esmat; Montazeri, Ali


    There appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran. A structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences. In all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS) and this was significantly associated with their breast cancer case load (P < 0.01). There were no associations between BCS practice and the other variables studied. The most frequent reasons for not performing BCS were uncertainty about conservative therapy results (46%), uncertainty about the quality of available radiotherapy services (32%), and the probability of patients' non-compliance in radiotherapy (32%). The findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance)

  8. Chronic stress and coping among cardiac surgeons: a single center study

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos


    Full Text Available Introduction: Cardiac surgeons stress may impair their quality of life and professional practice. Objective: To assess perceived chronic stress and coping strategies among cardiac surgeons. Methods: Twenty-two cardiac surgeons answered two self-assessment questionnaires, the Trier Inventory for Chronic Stress and the German SGV for coping strategies. Results: Participants mean age was 40±14.1 years and 13 were male; eight were senior physicians and 14 were residents. Mean values for the Trier Inventory for Chronic Stress were within the normal range. Unexperienced physicians had significantly higher levels of dissatisfaction at work, lack of social recognition, and isolation (P<0.05. Coping strategies such as play down, distraction from situation, and substitutional satisfaction were also significantly more frequent among unexperienced surgeons. "Negative" stress-coping strategies occur more often in experienced than in younger colleagues (P=0.029. Female surgeons felt more exposed to overwork (P=0.04 and social stress (P=0.03. Conclusion: Cardiac surgeons show a tendency to high perception of chronic stress phenomena and vulnerability for negative coping strategies.

  9. Worth the "Likes"? The Use of Facebook among Plastic Surgeons and Its Perceived Impact. (United States)

    Chang, Jessica B; Woo, Shoshana L; Cederna, Paul S


    Facebook is the leading online media platform used by plastic surgeons. This study examined Facebook use among plastic surgeons and its perceived impact. A survey on Facebook use was distributed to two groups of plastic surgeons: 500 with professional Facebook pages and 500 without Facebook pages. Responses were stripped of identifying information and analyzed for statistical significance (p Facebook reported a negative impact on their practice, whereas 57 percent reported a very positive or positive impact. There was no correlation with perceived impact and number of "likes." Perceived advantages of Facebook included facilitation of patient feedback/communication (77 percent) and increased practice exposure (67 percent). Many surgeons (15 to 36 percent) did not follow the direct impact of Facebook on their practices. Some reported that Facebook was responsible for only one to 50 professional Web site hits and less than 5 percent of their new patient referrals in the past year. Estimated conversion-to-surgery rates were highly variable for Facebook users and nonusers. Most Facebook nonusers (67 percent) expected a "neutral" impact, expressing more concerns about unsolicited advertising (51 percent) and wasting time (47 percent). Plastic surgeons tend to perceive Facebook's impact on their practices as positive, but most do not track its direct effects on professional Web site hits, new referrals, or conversion-to-surgery rates. Plastic surgeons using Facebook are encouraged to monitor these parameters to determine whether its continued use is actually worthwhile.

  10. Surgeons' work engagement: influencing factors and relations to job and life satisfaction. (United States)

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


    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.

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

    African Journals Online (AJOL)

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


    African Journals Online (AJOL)

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

  13. Patient Attitudes Toward Orthopedic Surgeon Ownership of Related Ancillary Businesses. (United States)

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


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

  14. How surgeons make decisions when the evidence is inconclusive

    NARCIS (Netherlands)

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


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

  15. Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan. (United States)

    Mori, Toshiyuki; Kimura, Taizo; Kitajima, Masaki


    The Japan Society for Endoscopic Surgery (JSES) has established an Endoscopic Surgical Skill Qualification System and started examination in 2004. Non-edited videotapes were assessed by two judges in a double-blinded fashion with strict criteria. Two kinds of criteria, namely common and procedure-specific, were prepared. The common criteria were designed to evaluate set-ups, autonomy of the operator, display of the surgical field, recognition of surgical anatomy, co-operation of the surgical team. The procedure-specific criteria were made to assess the operation in a step-by-step fashion. In total, out of 1.114 surgeons who were assessed by this qualification system over a period of four years, 537 (48.2%) have been accredited. The qualification rate in each surgical field has remained at the same level of 40 to 50% to date. Inter-rater agreement of two judges was low at 0.31 in the first year, but improved with revision of the criteria and consensus meetings. Surgeons assessed by this system as qualified experienced less frequent complications when compared to those who failed. This system has impacted on the improvement and standardization of laparoscopic surgery in Japan.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  17. Anomalous aortic origin of a coronary artery: a report from the Congenital Heart Surgeons Society Registry. (United States)

    Poynter, Jeffrey A; Williams, William G; McIntyre, Susan; Brothers, Julie A; Jacobs, Marshall L


    Anomalous aortic origin of a coronary artery (AAOCA) is a common congenital heart lesion that may be rarely associated with myocardial ischemia and sudden death in the young. Evidence-based criteria for managing young patients with AAOCA are lacking. The Congenital Heart Surgeons Society (CHSS) established a multicenter registry of patients with AAOCA aged ≤30 years to develop these criteria. All institutional members of the CHSS are eligible to enroll patients. Patients were enrolled retrospectively if diagnosis of AAOCA occurred between January 1, 1998, and January 20, 2009, and prospectively from January 20, 2009 forward. The first phase of analysis explored possible associations between demographics, symptoms, coronary anatomy, and management using correlation analysis and logistic regression. As of June 2012, 198 patients were enrolled from CHSS member institutions (median age at diagnosis = 10.2 years; 64% male). Data were extracted from clinical records. Fifty-four percent were symptomatic at presentation (most commonly chest pain, N = 78). The AAOCA was diagnosed at autopsy in two patients who presented with sudden death (one with anomalous aortic origin of the left coronary artery [AAOLCA]; one with a single ostium above a commissure giving rise to both left and right coronary arteries). Imaging reports documented anomalous aortic origin of the right coronary artery (AAORCA) in 144 patients, AAOLCA in 51 patients, and AAOLCA/AAORCA in 1 patient. Surgery or autopsy without surgery was performed in 106 patients (71 AAORCA [67%]; 31 AAOLCA [29%]; and 4 AAORCA/AAOLCA [4%]) at a median age of 12.6 years. Overall, 52% of patients with AAORCA versus 67% with AAOLCA had surgery. Most surgical operative reports described an intramural segment of the coronary artery with anomalous origin. Surgery correlated with symptoms, older age, and presence of an intramural segment in the setting of AAOLCA. Management decisions, including surgical referral, are associated

  18. Selection and Classification of United States Military Officers: A fifty-Year Bibliography (1937-1986) (United States)


    orientation in Naval aviation cadets. Journal of Educational Psychology , 45, 91-109. 908 Creelman , J.A. (1954). An analysis of the physical fitness index...International Index to Periodicals. (e) Military Testing Association Proceedings, and (f) Psychological Abstracts. The research organizations of the armed...Texas, can trace its beginning to a number of Psychological Research Units of the Medical Division of the United States Army Air Corps. Some of the

  19. Fifty Years since the Coleman Report: Rethinking the Relationship between Schools and Inequality (United States)

    Downey, Douglas B.; Condron, Dennis J.


    In the half century since the 1966 Coleman Report, scholars have yet to develop a consensus regarding the relationship between schools and inequality. The Coleman Report suggested that schools play little role in generating achievement gaps, but social scientists have identified many ways in which schools provide better learning environments to…

  20. Fifty years contribution to research and technological development of Argentina. Part 7

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the seventh part of a short history of the National Atomic Energy Commission (CNEA). The future of the nuclear activities in the country is outlined, mainly of those related to the energy generation. The completion of the Atucha II nuclear power plant now under construction is supported. (author)

  1. Fifty years contribution to research and technological development of Argentina. Part 4

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the forth part of a short history of the National Atomic Energy Commission (CNEA). The activities concerning the radioactive waste management are reviewed as well as the research and development programs in the sciences related to nuclear energy. (author)

  2. Fifty years contribution to research and technological development of Argentina. Part 1

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the first part of a short history of the Argentine National Atomic Energy Commission (CNEA). The activities concerning the fuel cycle are reviewed. The uranium production as well as the manufacturing of nuclear fuel elements is described. (author)

  3. Fifty years contribution to research and technological development of Argentina. Part 3

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    This paper is the third part of a short history of the National Atomic Energy Commission (CNEA). The activities concerning the radioisotope and radiation applications are reviewed as well as the radiation protection program

  4. Fifty years contribution to research and technological development of Argentina. Part 6

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the sixth part of a short history of the National Atomic Energy Commission (CNEA). The international relations and the nuclear technology exports of the CNEA are reviewed. A short description of the Argentine nuclear centers and nuclear enterprises is also given. The present structure of the CNEA is briefly outlined. (author)

  5. Fifty years contribution to research and technological development of Argentina. Part 5

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the fifth part of a short history of the National Atomic Energy Commission (CNEA). The activities concerning the development of the institutional infrastructure and the education and training activities are reviewed as well as the legal and regulatory aspects of nuclear energy in Argentina. (author)

  6. Fifty years contribution to research and technological development of Argentina. Part 2

    International Nuclear Information System (INIS)

    Aguirre, Fernando; Boselli, Alfredo; Colangelo, Luis J.; Coll, Jorge A.; Espejo, Hector; Mattei, Clara E.; Ornstein, Roberto M.; Palacios, Tulio A.; Radicella, Renato; Rodrigo, Felix


    The paper is the second part of a short history of the Argentine National Atomic Energy Commission (CNEA). The activities concerning research reactors are reviewed as well as the nuclear power program. The heavy water program is also is described. (author)

  7. Reforecasting the ENSO Events in the Past Fifty-Seven Years (1958-2014) (United States)

    Huang, B.; Shin, C. S.; Shukla, J.; Marx, L.; Balmaseda, M.; Halder, S.; Dirmeyer, P.; Kinter, J. L.


    A set of ensemble seasonal reforecasts for 1958-2014 is conducted using the National Centers for Environmental Prediction (NCEP) Climate Forecast System, version 2 (CFSv2), initialized with observation-based ocean, atmosphere, land and sea ice reanalyses, including the Eu­ropean Centre for Medium-Range Weather Forecasts (ECMWF) global ocean reanalysis version 4, the ERA-40 atmospheric reanalysis, the NCEP CFS Reanalysis for atmosphere, land and sea ice, and the NASA Global Land Data Assimilation System reanalysis version 2.0 for land. The purpose is to examine a long and continuous seasonal reforecast dataset from a modern seasonal forecast system to be used by the research community. In comparison with other current reforecasts, this dataset allows us to evaluate the degree to which El Niño and Southern Oscillation (ENSO) events can be predicted, using a larger sample of events. Furthermore, we can directly compare the predictability of the ENSO events in 1960s-70s with the more widely studied ENSO events occurring since the 1980s to examine the state-of-the-art seasonal forecast system's capability at different phases of global climate change and multidecadal variability. A major concern is whether the seasonal reforecasts before 1979 have useful skill when there were fewer ocean observations. Our preliminary examination of the reforecasts shows that, although the reforecasts have lower skill in predicting the SST anomalies in the North Pacific and North Atlantic before 1979, the prediction skill of the ENSO onset and development for 1958-1978 is comparable to that for 1979-2014. The skill of the earlier predictions declines faster in the ENSO decaying phase because the reforecasts initialized after the summer season persistently predict lingering wind and SST anomalies in the eastern equatorial Pacific during the decaying phase of several major ENSO events in the 1960s-70s. Since the 1980s, the reforecasts initialized in fall overestimate the peak SST anomalies in strong El Niño events. Both facts imply that the model air-sea feedback is overly active in the eastern Pacific before ENSO termination, likely induced by the model warm bias in the eastern Pacific during boreal winter and spring.

  8. [National Academy of Medicine, one hundred and fifty-four academic year]. (United States)

    Mansilla-Olivares, Armando


    El incalculable valor que atesora la Academia Nacional de Medicina, su enorme influencia y repercusión sobre la toma de decisiones médico-científico-epidemiológicas, radica única y exclusivamente en el dominio del conocimiento, la mente científica y el talento de todos y cada uno de sus miembros, desde su fundación en 1864 hasta nuestros días.

  9. Fifty years of discovery of alpha-fetoprotein as the first tumor marker

    Directory of Open Access Journals (Sweden)

    Nikulina Dina


    Full Text Available Alpha-fetoprotein represents the most prominent oncobiomarker, widely used in the diagnosis of hepatocellular carcinoma for monitoring of tumor progression, presence of metastasis, assessment of cancer prognosis and successful antitumor therapeutic measures. Yuri Semenovich Tatarinov is a Russian scientist who first published antigen specific for human hepatocellular carcinoma in 1963. To commemorate the 50th anniversary of the discovery of alpha-fetoprotein, 9th International Scientific- Practical Conference entitled “Achievements of fundamental science and translational medicine capabilities in solving actual problems of practical public health”, was held from May 6-8th, 2013 in Astrakhan, Russia. The conference was held in memory of historical scientific work of Yuri Semenovich Tatarinov. [Projekat Ministarstva nauke Republike Srbije, br. 175056

  10. FIFTY YEARS OF YANG-MILLS THEORIES: A Phenomenological Point of View (United States)

    de Rújula, Alvaro

    On the occasion of the celebration of the first half-century of Yang-Mills theories, I am contributing a personal recollection of how the subject, in its early times, confronted physical reality, that is, its "phenomenology". There is nothing original in this work, except, perhaps, my own points of view. But I hope that the older practitioners of the field will find here grounds form nostalgia, or good reasons to disagree with me. Younger addicts may learn that history does not resemble at all what is reflected in current textbooks: it was orders of magnitude more fascinating.

  11. How Development Assistance from France and the United Kingdom Has Evolved: Fifty Years on from Decolonisation

    Directory of Open Access Journals (Sweden)

    François Pacquement


    Full Text Available France and the United Kingdom are influential backers when it comes to the global governance of aid to developing countries. A short history of the contributions made by these former colonial powers to ODA is presented, covering the institutions concerned, strategies conducted and funding provided. These institutions have undergone complex changes since the initial phase of making “improvements” in the colonies up until recent reforms. Their ambitious strategies, grounded on considerable research, have received attention from a multilateral audience, turning the colonial question into a global issue. The vision of aid in both France and the UK is broader than is conveyed by the calculations that are carried out by the OECD’s DAC. Though subject to political contingencies, aid from these countries amounts to a substantial contribution that seeks to respond to various development needs.

  12. Fifty years of plutonium exposure to the Manhattan Project plutonium workers: an update. (United States)

    Voelz, G L; Lawrence, J N; Johnson, E R


    Twenty-six white male workers who did the original plutonium research and development work at Los Alamos have been examined periodically over the past 50 y to identify possible health effects from internal plutonium depositions. Their effective doses range from 0.1 to 7.2 Sv with a median value of 1.25 Sv. As of the end of 1994, 7 individuals have died compared with an expected 16 deaths based on mortality rates of U.S. white males in the general population. The standardized mortality ratio (SMR) is 0.43. When compared with 876 unexposed Los Alamos workers of the same period, the plutonium worker's mortality rate was also not elevated (SMR = 0.77). The 19 living persons have diseases and physical changes characteristic of a male population with a median age of 72 y (range = 69 to 86 y). Eight of the twenty-six workers have been diagnosed as having one or more cancers, which is within the expected range. The underlying cause of death in three of the seven deceased persons was from cancer, namely cancer of prostate, lung, and bone. Mortality from all cancers was not statistically elevated. The effective doses from plutonium to these individuals are compared with current radiation protection guidelines.

  13. Fifty years working to improve food and nutrition in Central America

    Directory of Open Access Journals (Sweden)


    Full Text Available El Instituto de Nutrición de Centroamérica y Panamá (INCAP, un centro especializado de la Organización Panamericana de la Salud con sede en la ciudad de Guatemala (Guatemala, cumple este año medio siglo de trabajo dedicado a mejorar la alimentación y nutrición en Centroamérica. El Instituto ha conseguido importantes logros en diferentes áreas, que incluyen la investigación, la cooperación técnica, la formación y la diseminación de información científica y técnica.

  14. Fifty Years of Research in ARDS. Respiratory Mechanics in Acute Respiratory Distress Syndrome. (United States)

    Henderson, William R; Chen, Lu; Amato, Marcelo B P; Brochard, Laurent J


    Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, although lifesaving, is associated with new iatrogenic injury. Current best practice involves the use of small Vt, low plateau and driving pressures, and high levels of positive end-expiratory pressure. Collectively, these interventions are termed "lung-protective ventilation." Recent investigations suggest that individualized measurements of pulmonary mechanical variables rather than population-based ventilation prescriptions may be used to set the ventilator with the potential to improve outcomes beyond those achieved with standard lung protective ventilation. This review outlines the measurement and application of clinically applicable pulmonary mechanical concepts, such as plateau pressures, driving pressure, transpulmonary pressures, stress index, and measurement of strain. In addition, the concept of the "baby lung" and the utility of dynamic in addition to static measures of pulmonary mechanical variables are discussed.

  15. The jewel on the mountaintop the European Southern Observatory through fifty years

    CERN Document Server

    Madsen, Claus


    Authored by ESO senior advisor Claus Madsen, the present book comprises 576 action-packed pages of ESO history and dramatic stories about the people behind the organisation. This is the ultimate historical account about ESO and its telescopes in the southern hemisphere, but also about a truly remarkable European success story in research. Spanning the range from the first telescopes to the future platforms of the next generation, it shows how the improvement of the telescopes leads to a continuously changing view of the Universe. With 150 photos and illustrations. Produced especially for ESO's

  16. The Armed Forces Epidemiological Board: Its First Fifty Years, 1940-1990 (United States)


    measles; (9 mumps; (g) diphtheria and tetanus toxoids; (I) enteric infections such as bacillary dysentery, Shigella, Sahnonella typhosa, Vibrio cholerae ...pestis that followed the kissing of the dead. Once he remarked that a patient in New Mexico did not die of plague but of "too many antibiotics." Another...interests shifted to hog cholera and the f’eld of virology. This interest continued for the next thirty-eight y’ears. A key obs,’.%ation (with Dr. Paul

  17. International Nuclear Societies Council vision for the second fifty years of nuclear energy

    International Nuclear Information System (INIS)

    Hatcher, S.R.


    A vision of the future is presented in the context of ongoing social and technological development. The most compelling moral and ethical issue facing the world at the close of the 20th Century is to help the peoples of the poorer countries in their struggle for a reasonable quality of life, while at the same time they face a dramatic increase in their population. The new society will need vastly more energy than the world of today. It will need all supply options that can provide the energy in an economic environmentally sustainable manner. Nuclear energy will be a vital element in this supply pattern, provided that it continues to demonstrate the imperatives of safe operation and economic competitiveness. Other applications of nuclear energy will add their own impact to the improving quality of life. 5 refs., 1 fig

  18. Perspective: Fifty years of density-functional theory in chemical physics

    Energy Technology Data Exchange (ETDEWEB)

    Becke, Axel D., E-mail: [Department of Chemistry, Dalhousie University, 6274 Coburg Rd., P.O. Box 15000, Halifax, Nova Scotia B3H 4R2 (Canada)


    Since its formal inception in 1964–1965, Kohn-Sham density-functional theory (KS-DFT) has become the most popular electronic structure method in computational physics and chemistry. Its popularity stems from its beautifully simple conceptual framework and computational elegance. The rise of KS-DFT in chemical physics began in earnest in the mid 1980s, when crucial developments in its exchange-correlation term gave the theory predictive power competitive with well-developed wave-function methods. Today KS-DFT finds itself under increasing pressure to deliver higher and higher accuracy and to adapt to ever more challenging problems. If we are not mindful, however, these pressures may submerge the theory in the wave-function sea. KS-DFT might be lost. I am hopeful the Kohn-Sham philosophical, theoretical, and computational framework can be preserved. This Perspective outlines the history, basic concepts, and present status of KS-DFT in chemical physics, and offers suggestions for its future development.

  19. Pasolini fifty years ago: «Mi è tornata la fantasia del narratore»

    Directory of Open Access Journals (Sweden)

    Alfredo Barberis


    Full Text Available An interview with Pier Paolo Pasolini by Alfredo Barberi, published by «il Giorno» in 1964 and since then only republished once in a now exrtemely rare collection by Oronzo Panageli.

  20. IAEA fifty years: more than just safeguards. Interview with Professor Werner Burkart

    International Nuclear Information System (INIS)



    Professor Werner Burkart, IAEA Deputy Director General and head of the Nuclear Sciences and Applications Division, comments upon matters associated with the fiftieth anniversary of the International Atomic Energy Agency (IAEA). The Agency was founded on July 29, 1957. Today it is a worldwide organization of the United Nations with 144 member countries and manifold duties in the field of nuclear power utilization. The mandate of IAEA is based on the 'Atoms for Peace' initiative, its essence being support of all member countries in the use of nuclear power as long as IAEA safeguards on the spot ensure that no military aims are pursued in those activities. The safeguards work serves to prevent military uses. IAEA recommendations for a global nuclear safety culture, the so-called Safety Standards, are employed by member countries as a basis of legislation and ordinances. The emerging renaissance of nuclear power will be accompanied by the IAEA especially with regard to the important aspects of harmonization, safeguards, safety, security, and readiness for emergencies. The interview took place in Vienna on September 20, 2007. The questions were asked by the President of the Swiss Nuclear Forum, Dr. Bruno Pellaud, former Deputy Director General of IAEA. (orig.)

  1. Perspective: Fifty years of density-functional theory in chemical physics

    International Nuclear Information System (INIS)

    Becke, Axel D.


    Since its formal inception in 1964–1965, Kohn-Sham density-functional theory (KS-DFT) has become the most popular electronic structure method in computational physics and chemistry. Its popularity stems from its beautifully simple conceptual framework and computational elegance. The rise of KS-DFT in chemical physics began in earnest in the mid 1980s, when crucial developments in its exchange-correlation term gave the theory predictive power competitive with well-developed wave-function methods. Today KS-DFT finds itself under increasing pressure to deliver higher and higher accuracy and to adapt to ever more challenging problems. If we are not mindful, however, these pressures may submerge the theory in the wave-function sea. KS-DFT might be lost. I am hopeful the Kohn-Sham philosophical, theoretical, and computational framework can be preserved. This Perspective outlines the history, basic concepts, and present status of KS-DFT in chemical physics, and offers suggestions for its future development

  2. CASTLE BRAVO: Fifty Years of Legend and Lore. A Guide to Off-Site Radiation Exposures (United States)


    depressions , may grow rapidly from small beginnings—from small perturbations in a broad, unstable air stream—has led to the suggestion that the...Hygiene and Toxicology 25(7)253–274. ——. 1974. Paper presented in Radiology Centennial . Radiology Centennial , Inc., Reston, VA. Fehner, T. R., and F. G

  3. History of initial fifty years of ARIES: A Major National Indian Facility for Optical Observations (United States)

    Sanwal, Basant Ballabh; Pandey, Anil Kumar; Uddin, Wahab; Kumar, Brijesh; Joshi, Santosh


    The idea of starting an astronomical observatory in the state of Uttar Pradesh in India germinated through the initiative of a scholarly statesman Babu Sampurnanandji. His interest in astrology coupled with his academic bent of mind got him interested in modern astronomy. Being then Education Minister and later Chief Minister of Uttar Pradesh, he established an astronomical observatory at Varanasi on April 20, 1954. Later on it was shifted to Manora Peak, Nainital. Four reflectors were commissioned at Manora Peak. For solar research an H alpha petrol unit and a horizontal solar spectrograph was setup. A detailed project report for installation of a 4-m class optical telescope was prepared indigenously in late 1980, however, the project could not take off. With the generous support of the Department of Science and Technology, the institute established a 3.6-m new technology optical telescope and a 1.3-m wide field optical telescope at a new observing site called Devasthal. Now a 4-m liquid mirror telescope is also being installed at the same observing site. I present here a brief journey of the observatory beginning right from its birth in 1954 till now.

  4. Fifty years of chasing lizards: new insights advance optimal escape theory. (United States)

    Samia, Diogo S M; Blumstein, Daniel T; Stankowich, Theodore; Cooper, William E


    Systematic reviews and meta-analyses often examine data from diverse taxa to identify general patterns of effect sizes. Meta-analyses that focus on identifying generalisations in a single taxon are also valuable because species in a taxon are more likely to share similar unique constraints. We conducted a comprehensive phylogenetic meta-analysis of flight initiation distance in lizards. Flight initiation distance (FID) is a common metric used to quantify risk-taking and has previously been shown to reflect adaptive decision-making. The past decade has seen an explosion of studies focused on quantifying FID in lizards, and, because lizards occur in a wide range of habitats, are ecologically diverse, and are typically smaller and differ physiologically from the better studied mammals and birds, they are worthy of detailed examination. We found that variables that reflect the costs or benefits of flight (being engaged in social interactions, having food available) as well as certain predator effects (predator size and approach speed) had large effects on FID in the directions predicted by optimal escape theory. Variables that were associated with morphology (with the exception of crypsis) and physiology had relatively small effects, whereas habitat selection factors typically had moderate to large effect sizes. Lizards, like other taxa, are very sensitive to the costs of flight. © 2015 Cambridge Philosophical Society.

  5. Fifty Interesting Years: Higher Education Funding and Financial Management 1961-2011 (United States)

    Williams, Gareth


    During the half century of the AUA's existence UK universities have experienced the fastest rate of growth and most far-reaching changes in their history. Funding arrangements in particular have changed radically. Since 1961 the finance office has been transformed from a small group of bean counters into a key management group at the heart of all…

  6. An Appreciation of Clinton B. Ford and the AAVSO of Fifty Years Ago (United States)

    Hull, T.


    This is a rather personal story about Clinton B. Ford, my boyhood mentor in astronomy, and about the influence of the AAVSO and Clint on my life and career. While much has been written on Clint, this addresses the man, and his kindness. Naturally I joined the AAVSO (a little early, I was fifteen) and attended the AAVSO 50th Annual Meeting at Harvard College Observatory. Remembrance of Clint and the 50th Annual Meeting is given.

  7. Educating the Educators: A Fifty-Year Retrospective of Religious Education in the Catholic Context (United States)

    Gilmour, Peter


    The progressive spirit of the Second Vatican Council (1962-1965) spawned a myriad of graduate departments of religious education in American Catholic colleges and universities. These departments evolved to include other master degrees (e.g., pastoral studies, pastoral counseling, divinity, spirituality, and social justice). As the numbers of…

  8. The Premise of Black Inferiority: An Enduring Obstacle Fifty Years Post-"Brown" (United States)

    O'Connor, Carla


    Gloria Ladson-Billings explains in her chapter that, in part, the promise of "Brown v. Board of Education" has not been realized because it was premised on black inferiority. She elaborates that "instead of addressing the underlying pathology of the defendant--White supremacy"--the evidence, case, and accordant ruling…

  9. Fifty-thousand-year vegetation and climate history of Noel Kempff Mercado National Park, Bolivian Amazon (United States)

    Burbridge, Rachel E.; Mayle, Francis E.; Killeen, Timothy J.


    Pollen and charcoal records from two large, shallow lakes reveal that throughout most of the past 50,000 yr Noel Kempff Mercado National Park, in northeastern lowland Bolivia (southwestern Amazon Basin), was predominantly covered by savannas and seasonally dry semideciduous forests. Lowered atmospheric CO 2 concentrations, in combination with a longer dry season, caused expansion of dry forests and savannas during the last glacial period, especially at the last glacial maximum. These ecosystems persisted until the mid-Holocene, although they underwent significant species reassortment. Forest communities containing a mixture of evergreen and semideciduous species began to expand between 6000 and 3000 14C yr B.P. Humid evergreen rain forests expanded to cover most of the area within the past 2000 14C yr B.P., coincident with a reduction in fire frequencies. Comparisons between modern pollen spectra and vegetation reveal that the Moraceae-dominated rain forest pollen spectra likely have a regional source area at least 2-3 km beyond the lake shore, whereas the grass- and sedge-dominated savanna pollen spectra likely have a predominantly local source area. The Holocene vegetation changes are consistent with independent paleoprecipitation records from the Bolivian Altiplano and paleovegetation records from other parts of southwestern Amazonia. The progressive expansion in rain forests through the Holocene can be largely attributed to enhanced convective activity over Amazonia, due to greater seasonality of insolation in the Southern Hemisphere tropics driven by the precession cycle according to the Milankovitch Astronomical Theory.

  10. Fifty years of advances in sarcoma treatment: moving the needle from conventional chemotherapy to targeted therapy. (United States)

    Patel, Shreyaskumar R


    Much of the progress in systemic therapy for sarcomas was accomplished in the first half of the last 5 decades. Various chemotherapeutic agents were tested in the 70s through the 80s and became part of the standard of care for this patient population. During the decade of the 90s, dose intensification became feasible as a result of improved supportive care and the availability of growth factors, thus maximizing the therapeutic potential of this class of agents. However, response rates and survival plateaued and it became obvious that newer and mechanistically different agents were needed to improve the therapeutic index and gain further enhancement of outcomes. Since early 2000, primarily inspired by the experience with imatinib in gastrointestinal stromal tumors (GISTs), several targeted therapies have been tested in sarcomas with modest success. The major limitations encountered include the lack of drivers and actionable targets for bone and soft tissue sarcomas with complex genomic profiles. Continued investigations and sequencing of larger numbers of these rare and heterogeneous malignancies could shed some light on a path toward improved outcomes.

  11. Fifty Years of Quasars From Early Observations and Ideas to Future Research

    CERN Document Server

    Marziani, Paola; Sulentic, Jack


    The 50th anniversary of the discovery of quasars in 1963 presents an interesting opportunity to ask questions about the current state of quasar research. Formatted as a series of interviews with noted researchers in the field, each of them asked to address a specific set of questions covering topics selected by the editors, this book deals with the historical development of quasar research and discusses how advances in instrumentation and computational capabilities have benefitted quasar astronomy and have changed our basic understanding of quasars. In the last part of the book the interviews address the current topic of the role of quasars in galaxy evolution. They summarise open issues in understanding active galactic nuclei and quasars and present an outlook regarding what future observational facilities both on the ground and in space might reveal. Its interview format, the fascinating topic of quasars and black holes, and the lively recollections and at times controversial views of the contributors make ...

  12. Fifty Years of Research in ARDS. Gas Exchange in Acute Respiratory Distress Syndrome. (United States)

    Radermacher, Peter; Maggiore, Salvatore Maurizio; Mercat, Alain


    Acute respiratory distress syndrome (ARDS) is characterized by severe impairment of gas exchange. Hypoxemia is mainly due to intrapulmonary shunt, whereas increased alveolar dead space explains the alteration of CO 2 clearance. Assessment of the severity of gas exchange impairment is a requisite for the characterization of the syndrome and the evaluation of its severity. Confounding factors linked to hemodynamic status can greatly influence the relationship between the severity of lung injury and the degree of hypoxemia and/or the effects of ventilator settings on gas exchange. Apart from situations of rescue treatment, targeting optimal gas exchange in ARDS has become less of a priority compared with prevention of injury. A complex question for clinicians is to understand when improvement in oxygenation and alveolar ventilation is related to a lower degree or risk of injury for the lungs. In this regard, a full understanding of gas exchange mechanism in ARDS is imperative for individualized symptomatic support of patients with ARDS.

  13. fifty years of oil exploration in nigeria: the paradox of plenty

    African Journals Online (AJOL)


    against corruption. KEYWORDS: Resource curse, Nigeria, Oil and Gas, GDP, Infrastructure, Corruption. INTRODUCTION. The history of oil exploration in Nigeria ..... as the country failed to invest in the downstream sector of the petroleum industry. Table 4: Economic Indicators as at 2003. Parameters. Brazil. Mexico. Ghana.

  14. A Pictorial History of the Drury College Student: The First Fifty Years (United States)

    Maddux, Mindy


    Established in 1873, Drury College in Springfield, Missouri, provided a unique experience for their undergraduate students. A limited amount of research has been conducted on the institution but no work has been done to specifically look at the undergraduate student experience. Using archival research methods and information from literature on…

  15. Fifty years of Yang-Mills Theories: a phenomenological point of view

    CERN Document Server

    De Rújula, Alvaro


    On the occasion of the celebration of the first half-century of Yang--Mills theories, I am contributing a personal recollection of how the subject, in its early times, confronted physical reality, that is, its "phenomenology". There is nothing original in this work, except, perhaps, my own points of view. But I hope that the older practitioners of the field will find here grounds for nostalgia, or good reasons to disagree with me. Younger addicts may learn that history does not resemble at all what is reflected in current textbooks: it was orders of magnitude more fascinating.

  16. Isotopes and innovation: MDS Nordion's first fifty years, 1946-1996

    International Nuclear Information System (INIS)

    Litt, P.


    Few people realize that Canada leads in the world in the production of radio isotopes, the raw material of nuclear medicine and high-tech scanners, and in their use in medicine and industry. In Isotopes and Innovation the author gives an in-depth look at MDS Nordion, a company that started as the radium sales department of Eldorado Mining and Refining, the Canadian uranium producer that was a key strategic resource for the Allies during the race to build the nuclear bomb, and went on to become the world?s leading producer of radioisotopes. When radium began to be used as a cancer treatment, Eldorado quickly became familiar with the medical marketplace and adept at developing products that could solve clinical problems and, more important, save lives. When Canadian nuclear reactors at Chalk River began producing radioisotopes that outperformed radium, Eldorado's radium sales department was transferred to a new crown corporation, Atomic Energy of Canada Limited, created to manage Canada's nuclear research establishment. The new company developed many useful applications for radioisotopes, including cobalt-60 cancer therapy machines and industrial sterilization plants. Bought by Medical Data Services Inc. in the early 1990s, MDS Nordion was a runaway success, creator and sole proprietor of several market-leading products. Isotopes and Innovation describes how a company capitalized on the byproducts of Canada's unique nuclear research program to attain a commanding international position in extremely specialized and demanding high-tech markets, a saga in which innovative research and enterprising global marketing have brought commercial success and saved countless lives around the world

  17. Draft Budget of the Organization for the Fifty-First Financial Year 2005

    CERN Document Server


    A sa réunion du 15 septembre 2004 , le Comité des finances a recommandé au Conseil d'approuver le projet préliminaire de budget 2005 aux prix de 2004. La présente version tient compte des transferts du budget 2004 présentés dans le document "Budget 2004 - Transferts et dépassements de crédits" , du prélèvement dans la réserve pour imprévus pour le LHC indiqué dans le document "Réserve pour imprévus pour le LHC" et de divers ajustements mineurs. En conséquence, il est demandé au Comité des finances de recommander au Conseil d'approuver les modifications par rapport au projet préliminaire de budget 2005 présentées dans les tableaux de l'annexe 1.

  18. Fifty years of Fanger's equation: Is there anything to discover yet?

    DEFF Research Database (Denmark)

    d'Ambrosio Alfano, Francesca Romana; Palella, Boris Igor; Riccio, Giuseppe


    This short communication to the Editor is completely devoted to a recent paper published by Broday et al. (2017) in which a comparative analysis of methods for determining the clothing surface temperature is reported. Contrarily to what our colleagues have found, we will demonstrate that the algo......This short communication to the Editor is completely devoted to a recent paper published by Broday et al. (2017) in which a comparative analysis of methods for determining the clothing surface temperature is reported. Contrarily to what our colleagues have found, we will demonstrate...

  19. Fifty Years of Mountain Passes: A Perspective on Dan Janzen's Classic Article. (United States)

    Sheldon, Kimberly S; Huey, Raymond B; Kaspari, Michael; Sanders, Nathan J


    In 1967, Dan Janzen published "Why Mountain Passes Are Higher in the Tropics" in The American Naturalist. Janzen's seminal article has captured the attention of generations of biologists and continues to inspire theoretical and empirical work. The underlying assumptions and derived predictions are broadly synthetic and widely applicable. Consequently, Janzen's "seasonality hypothesis" has proven relevant to physiology, climate change, ecology, and evolution. To celebrate the fiftieth anniversary of this highly influential article, we highlight the past, present, and future of this work and include a unique historical perspective from Janzen himself.

  20. Isotopes and innovation: MDS Nordion's first fifty years, 1946-1996

    Energy Technology Data Exchange (ETDEWEB)

    Litt, P


    Few people realize that Canada leads in the world in the production of radio isotopes, the raw material of nuclear medicine and high-tech scanners, and in their use in medicine and industry. In Isotopes and Innovation the author gives an in-depth look at MDS Nordion, a company that started as the radium sales department of Eldorado Mining and Refining, the Canadian uranium producer that was a key strategic resource for the Allies during the race to build the nuclear bomb, and went on to become the world?s leading producer of radioisotopes. When radium began to be used as a cancer treatment, Eldorado quickly became familiar with the medical marketplace and adept at developing products that could solve clinical problems and, more important, save lives. When Canadian nuclear reactors at Chalk River began producing radioisotopes that outperformed radium, Eldorado's radium sales department was transferred to a new crown corporation, Atomic Energy of Canada Limited, created to manage Canada's nuclear research establishment. The new company developed many useful applications for radioisotopes, including cobalt-60 cancer therapy machines and industrial sterilization plants. Bought by Medical Data Services Inc. in the early 1990s, MDS Nordion was a runaway success, creator and sole proprietor of several market-leading products. Isotopes and Innovation describes how a company capitalized on the byproducts of Canada's unique nuclear research program to attain a commanding international position in extremely specialized and demanding high-tech markets, a saga in which innovative research and enterprising global marketing have brought commercial success and saved countless lives around the world.

  1. The Biggest Aspidistra in the World; A Personal Celebration of Fifty Years of the BBC. (United States)

    Black, Peter

    This book is a personal recollection of the history of the British Broadcasting Corporation (BBC), written as a celebration of the BBC's fiftieth anniversary in 1972. The emphasis is on programs and people rather than policies. It is divided into roughly three periods: prewar, war, and postwar. The author writes, "The object is to remind…

  2. Fifty years of atmospheric radioactivity monitoring by the German Meteorological Service

    International Nuclear Information System (INIS)


    At a commemorative event at the Langen Training and Congress Center on 8 and 9 June 2005 it was brought to the attention of the audience that the German Meteorological Service has been charged with the sovereign task of monitoring atmospheric radioactivity since 8 August 1955. The purpose of this commission at the time was to measure traces of radioactivity in the atmosphere and precipitation and make forecasts on the movement of radioactive air masses. This was motivated by the above-ground nuclear tests carried out by the USA and the Soviet Union and the resulting measurable increase in atmospheric radioactivity levels. Equipped as it was with the necessary infrastructure the German Meteorological Service offered to take on this monitoring task. The importance of being able to assess the meteorological situation and provide data on radioactivity levels in the atmosphere and precipitation became apparent in 1986 after the reactor disaster of Chernobyl. When the Law on Preventive Radiation Protection was enacted in 1986 it was therefore only logical for the German Meteorological Service's commission to monitor atmospheric radioactivity levels to be renewed

  3. Normalization Fifty Years Beyond--Current Trends in the Nordic Countries (United States)

    Tossebro, Jan; Bonfils, Inge S.; Teittinen, Antti; Tideman, Magnus; Traustadottir, Rannveig; Vesala, Hannu T.


    The authors discuss recent developments in services for people with intellectual disabilities (ID) in the Nordic countries. They note that all of the countries saw important reforms during the 1990s, regarding both deinstitutionalization and decentralization. However, they posit that the litmus test of the reforms is not what happens during reform…

  4. Cryogenics for high-energy particle accelerators: highlights from the first fifty years

    CERN Document Server



    Applied superconductivity has become a key technology for high-energy particle accelerators, allowing to reach higher beam energy while containing size, capital expenditure and operating costs. Large and powerful cryogenic systems are therefore ancillary to low-temperature superconducting accelerator devices – magnets and high-frequency cavities – distributed over multi-kilometre distances and operating generally close to the normal boiling point of helium, but also above 4.2 K in supercritical and down to below 2 K in superfluid. Additionally, low-temperature operation in accelerators may also be required by considerations of ultra-high vacuum, limited stored energy and beam stability. We discuss the rationale for cryogenics in high-energy particle accelerators, review its development over the past half-century and present its outlook in future large projects, with reference to the main engineering domains of cryostat design and heat loads, cooling schemes, efficient power refrigeration and cryogenic flu...

  5. Truth in Reform: Reversing Fifty Years of Information Suppression in Burma (United States)


    suit with a broader offering that includes next generation 3G services and legacy 2G services that are more affordable to most Burmese citizens. 46...with the same effect during the 2007 Saffron Revolution, when citizen journalists used grainy mobile phone video, Burmese Internet cafes, and web...Internet controls were not technically sophisticated, the government quickly resorted to a complete block on mobile and Internet access during the 2007

  6. Comparison of Complications and Surgical Outcomes of Adolescent Idiopathic Scoliosis Between Junior Attending Surgeons and Senior Attending Surgeons. (United States)

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


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

  7. Surgeons' motivation for choice of workplace. (United States)

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


    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.

  8. Assessment of surgeon fatigue by surgical simulators

    Directory of Open Access Journals (Sweden)

    Tuwairqi K


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

  9. American Society of Maxillofacial Surgeons 2006 to 2016: Another Decade of Excellence in Education and Research. (United States)

    Doumit, Gaby; Totonchi, Ali; Wexler, Andy; Gosain, Arun K


    Over the past 10 years, the American Society of Maxillofacial Surgeons (ASMS) has continued to advance to meet its mission of being the premier organization to represent maxillofacial and pediatric plastic surgery in the United States. These advances are focused on education of its members, to include the American Society of Maxillofacial Surgeons basic course, the preconference symposium, the annual meeting, two basic maxillofacial courses per year, advanced maxillofacial courses, a boot camp for craniofacial fellows, a cleft course, quarterly webinars, sponsored fellowships, a visiting professorship, and the ASMS journal. In addition, the ASMS has continued to advance as the premier national organization representing maxillofacial and pediatric plastic surgery in the United States, thereby positioning the organization as a primary advocate for these surgical specialties. Outreach of the ASMS has grown over the past decade and now includes representatives to the American Society of Plastic Surgeons/Plastic Surgery Foundation, the American Board of Plastic Surgeons, the American Medical Association, and most recently a seat as a governor with the American College of Surgeons. The ASMS has also initiated an annual Summer Leadership Seminar to explore topics of relevance in a changing health care environment. The present report outlines the major initiatives of the ASMS over the past 10 years.

  10. Suturing the gender gap: Income, marriage, and parenthood among Japanese Surgeons. (United States)

    Okoshi, Kae; Nomura, Kyoko; Taka, Fumiaki; Fukami, Kayo; Tomizawa, Yasuko; Kinoshita, Koichi; Tominaga, Ryuji


    In Japan, gender inequality between males and females in the medical profession still exists. We examined gender gaps in surgeons' incomes. Among 8,316 surgeons who participated in a 2012 survey by the Japan Surgical Society, 546 women and 1,092 men within the same postgraduation year were selected randomly with a female-to-male sampling ratio of 1:2 (mean age, 36 years; mean time since graduation, 10.6 years). Average annual income was 9.2 million JPY for women and 11.3 million JPY for men (P men remained 1.5 million JPY greater after adjusting for gender, age, marital status, number of children, number of beds, current position, and working hours (Model 1). In Model 2, in which 2 statistical interaction terms between annual income and gender with marital status and number of children were added together with variables in Model 1, both interactions became significant, and the gender effect became nonsignificant. For men, average annual income increased by 1.1 million JPY (P women, annual income decreased by 0.73 million JPY per child (P = .0005). Male surgeons earn more than female surgeons, even after adjusting for other factors that influenced a surgeon's salary. In addition, married men earn more than unmarried men, but no such trend is observed for women. Furthermore, as the number of children increases, annual income increases for men but decreases for women. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. What expects orthopedic surgeon from bone scan?

    International Nuclear Information System (INIS)

    Sutter, B.; Cazenave, A.


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

  12. The First Fifty ABO Blood Group Incompatible Kidney Transplantations: The Rotterdam Experience

    Directory of Open Access Journals (Sweden)

    Madelon van Agteren


    Full Text Available This study describes the single center experience and long-term results of ABOi kidney transplantation using a pretransplantation protocol involving immunoadsorption combined with rituximab, intravenous immunoglobulins, and triple immune suppression. Fifty patients received an ABOi kidney transplant in the period from 2006 to 2012 with a follow-up of at least one year. Eleven antibody mediated rejections were noted of which 5 were mixed antibody and cellular mediated rejections. Nine cellular mediated rejections were recorded. Two grafts were lost due to rejection in the first year. One-year graft survival of the ABOi grafts was comparable to 100 matched ABO compatible renal grafts, 96% versus 99%. At 5-year follow-up, the graft survival was 90% in the ABOi versus 97% in the control group. Posttransplantation immunoadsorption was not an essential part of the protocol and no association was found between antibody titers and subsequent graft rejection. Steroids could be withdrawn safely 3 months after transplantation. Adverse events specifically related to the ABOi protocol were not observed. The currently used ABOi protocol shows good short and midterm results despite a high rate of antibody mediated rejections in the first years after the start of the program.

  13. Perspectives of being spouse, parent, and surgeon. (United States)

    Murtha, Yvonne


    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.

  14. Work-life balance of female versus male surgeons in Hong Kong based on findings of a questionnaire designed by a Japanese surgeon. (United States)

    Kwong, Ava; Chau, Wai Wang; Kawase, K


    We evaluated the attitudes of female and male surgeons in Hong Kong to work, personal life, and work-life balance, through a questionnaire survey. We sent an online questionnaire survey designed by a female Japanese surgeon to 142 female surgeons practicing in Hong Kong, while its customized version was sent to 953 of their male counterparts. "Home life" and "Work" were the first and second priorities for both the women and the men. More of the female surgeons reported that they could not find enough time to participate in community activities (p = 0.038) or rest (p = 0.024). Both reported moderate satisfaction at work (p = 0.114) and in their life outside work (p = 0.346), as well as equality at home (p = 0.548) and at work (p = 0.177). Of the men, 89 % agreed with the necessity for granting paternity leave and reported that they would like to work part-time during the child-rearing years (p = 0.013). The number of female surgeons involved in key roles is increasing in parallel with the increasing number of female medical students. The introduction of paternity leave for male surgeons is an important concern. The issues of work-life balance may need to be addressed to attract more talent into an important specialty in Hong Kong and this is likely to apply to other parts of Asia as well.

  15. Louisa Garrett Anderson (1873-1943), surgeon and suffragette. (United States)

    Geddes, Jennian F


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


    Rasool, Ahsan; Sabir, Sabir; Ashlaq, Muhammad; Farooq, Umer; Khan, Muhammad Zatmar; Khan, Faisal Yousaf


    Gilbert's syndrome (often abbreviated as GS) is most common hereditary cause of mild unconjugated (indirect) hyperbilirubinemia. Various studies have been published depicting clinical and pharmacological effects of Gilbert's syndrome (GS). However GS as a sign of precaution for physician and surgeons has not been clearly established. A systematic study of the available literature was done. Key words of Gilbert's syndrome, hyperbilirubinemia and clinical and pharmacological aspects of GS were searched using PubMed as search engine. Considering the study done in last 40 years, 375 articles were obtained and their abstracts were studied. The criterion for selecting the articles for through study was based on their close relevance with the topic. Thus 40 articles and 2 case reports were thoroughly studied. It was concluded that Gilbert's syndrome has immense clinical importance because the mild hyperbilirubinemia can be mistaken for a sign of occult, chronic, or progressive liver disease. GS is associated with lack of detoxification of few drugs. It is related with spherocytosis, cholithiasis, haemolytic anaemia, intra-operative toxicity, irinotecan toxicity, schizophrenia and problems in morphine metabolism. It also has profound phenotypic effect as well. The bilirubin level of a GS individual can rise abnormally high in various conditions in a person having Gilbert's syndrome. This can mislead the physicians and surgeons towards false diagnosis. Therefore proper diagnosis of GS should be ascertained in order to avoid the concealed adversities of this syndrome.

  17. The Effect of Personality on Occupational Stress in Veterinary Surgeons. (United States)

    Dawson, Briony F Y; Thompson, Neill J

    Statistics show that veterinary surgeons are in one of the professions with the highest suicide rates. This indicates the sector has significant well-being issues, with high levels of occupational stress and burnout. Previous research has focused on environmental factors in isolation, overlooking the influence of personality. This study aimed to establish that personality is a better predictor of occupational stress than environment. UK veterinary surgeons (n=311) completed an online survey composed of three questionnaires; the NEO Five-Factor Inventory, the Maslach Burnout Inventory, and the Job Stress Survey. Multiple regression analysis revealed that personality is a better predictor of occupational stress than environment (poccupational stress (pstress are depression (p=.002) and anger hostility (p=.005). Demographic factors such as the number of years the veterinarian has been qualified acted as a mediator between depression and occupational stress (poccupational stress (p=.028). Overall findings suggest that newly qualified veterinarians are at greater risk of suffering from high levels of occupational stress than those well established in the profession, and that veterinarians with higher levels of depression and anger hostility are likely to experience greater levels of occupational stress. Implications highlight the need for greater awareness of potentially susceptible personality traits in the veterinary admissions process. This would allow for the identification of those at risk and the implementation of interventions.

  18. Complications of bariatric surgery--What the general surgeon needs to know. (United States)

    Healy, Paul; Clarke, Christopher; Reynolds, Ian; Arumugasamy, Mayilone; McNamara, Deborah


    Obesity is an important cause of physical and psychosocial morbidity and it places a significant burden on health system costs and resources. Worldwide an estimated 200 million people over 20 years are obese and in the U.K. the Department of Health report that 61.3% of people in the U.K. are either overweight or obese. Surgery for obesity (bariatric surgery) is being performed with increasing frequency in specialist centres both in the U.K. and Ireland and abroad due to the phenomenon of health tourism. Its role and success in treating medical conditions such as diabetes mellitus and hypertension in obese patients will likely lead to an even greater number of bariatric surgery procedures being performed. Patients with early postoperative complications may be managed in specialist centres but patients with later complications, occurring months or years after surgery, may present to local surgical units for assessment and management. This review will highlight the late complications of the 3 most commonly performed bariatric surgery procedures that the emergency general surgeon may encounter. It will also highlight the complications that require urgent intervention by the emergency general surgeon and those that can be safely referred to a bariatric surgeon for further management after initial assessment and investigations. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  19. [Influence of surgeon specialization upon the results of colon cancer surgery. Usefulness of propensity scores]. (United States)

    Martínez-Ramos, D; Escrig-Sos, J; Miralles-Tena, J M; Rivadulla-Serrano, M I; Daroca-José, J M; Salvador Sanchís, J L


    surgeon influence on colorectal cancer surgery outcomes has been repeatedly studied in the scientific literature, but conclusions have been contradictory. Here we study whether surgeon specialization is a determinant factor for outcome in these patients. The importance of propensity scores (PS) in surgical research is also studied. a retrospective study was performed and medical records were reviewed for 236 patients who were intervened for colon cancer in Castellon General Hospital (Spain). Cases were divided into two groups (specialist and non-specialist surgeons), and both 5-year surveillance and disease free survival were compared. Comparisons were first made with no adjustments, and then subsequently using PS analysis. the initial (non-adjusted) analysis was clearly favourable for the specialist surgeon group (5-year surveillance, 64.3 vs. 79.3%, p = 0.028). After adjusting for PS no statistical significance was obtained. surgeon specialization had no significant impact on patient outcome after colon cancer surgery. Propensity score analysis is an important tool in the analysis of surgical non-randomized studies, particularly when events under scrutiny are rare.

  20. A Study on Musculoskeletal Disorders and Personal and Occupational Risk Factors among Surgeons

    Directory of Open Access Journals (Sweden)

    A Tirgar


    Full Text Available Background and purpose: Surgery is a high risk profession owing to musculoskeletal disorders (MSDs. Fine and precise operations cause surgeons to adopt prolonged fixed posture. As there is limited information in this region, the purpose of this study was to determine the frequency of MSDs and personal and occupational risk factors among surgeons in Babol (a northern city in Iran. Materials and methods: This cross-sectional study was conducted on 45 surgeons during 2011 using a questionnaire in three parts including: Demographic and occupational data, Nordic standardized musculoskeletal disorders questionnaire (NMQ, and Body Discomfort Assessment technique. The working posture during operation was assessed by Rapid Entire Body Assessment (REBA. The data were analyzed using descriptive statistical indexes and chi- square test, and a p<0.05 was considered as significant. Results: According to the data, the mean of work experience was 19.9±6 years, and the mean of work hours was 54.2±14 (ranged 20-80 hours per week. Ninety five percent of surgeons reported experiencing one or more MSDs symptoms during the previous year. Neck pain (66.7% and low back pain (LBP (51% was the more frequent reported complaint. The results showed a significant statistical difference between LBP with weekly regular exercise and work experience. Conclusion: The results indicate that MSDs are the common problems among the surgeons and they are at risk because of their personal and occupational conditions. So, ergonomics interventions in order to prevent MSDs are recommended.

  1. Research articles published by Korean spine surgeons: Scientific progress and the increase in spine surgery. (United States)

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


    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. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Impact of surgeon subspecialty training on surgical outcomes in open globe injuries

    Directory of Open Access Journals (Sweden)

    Han IC


    Full Text Available Ian C Han,1 Sidharth Puri,1 Jiangxia Wang,2 Shameema Sikder1 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, 2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Purpose: The purpose of this study was to evaluate whether subspecialty training of the initial treating surgeon affects visual acuity and surgical outcomes in patients with open globe injuries.Design: This study is a single-institution, retrospective case series.Methods: The charts of adult patients with open globe injuries requiring surgical repair at the Wilmer Eye Institute between July 1, 2007 and July 1, 2012 were retrospectively reviewed. Clinical findings at presentation were recorded, and details of initial repair and follow-up surgeries were analyzed. Differences in visual acuity and surgical outcomes were compared based on subspecialty training of the initial surgeon.Results: The charts of 282 adult patients were analyzed, and 193 eyes had at least 6 months of follow-up for analysis. Eighty-six eyes (44.6% required follow-up surgery within the first year, and 39 eyes (20.2% were enucleated. Eyes initially treated by a vitreoretinal (VR surgeon were 2.3 times (P=0.003 more likely to improve by one Ocular Trauma Score (OTS visual acuity category and 1.9 times (P=0.027 more likely to have at least one more follow-up surgery at 6 months compared to eyes treated by non-VR surgeons. Patients with more anterior injuries treated by a VR surgeon were more likely to improve by one OTS visual acuity category compared to those treated by non-VR surgeons (P=0.004 and 0.016 for Zones I and II, respectively. There was no difference in visual acuity outcomes for eyes with posterior injuries (P=0.515 for Zone III.Conclusion: Eyes initially treated by a VR surgeon are more likely to improve by one OTS visual acuity category than those initially treated by a non-VR surgeon. However, patients initially treated by a VR surgeon also undergo more

  3. The Prevalence of Cosmetic Facial Plastic Procedures among Facial Plastic Surgeons. (United States)

    Moayer, Roxana; Sand, Jordan P; Han, Albert; Nabili, Vishad; Keller, Gregory S


    This is the first study to report on the prevalence of cosmetic facial plastic surgery use among facial plastic surgeons. The aim of this study is to determine the frequency with which facial plastic surgeons have cosmetic procedures themselves. A secondary aim is to determine whether trends in usage of cosmetic facial procedures among facial plastic surgeons are similar to that of nonsurgeons. The study design was an anonymous, five-question, Internet survey distributed via email set in a single academic institution. Board-certified members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) were included in this study. Self-reported history of cosmetic facial plastic surgery or minimally invasive procedures were recorded. The survey also queried participants for demographic data. A total of 216 members of the AAFPRS responded to the questionnaire. Ninety percent of respondents were male ( n  = 192) and 10.3% were female ( n  = 22). Thirty-three percent of respondents were aged 31 to 40 years ( n  = 70), 25% were aged 41 to 50 years ( n  = 53), 21.4% were aged 51 to 60 years ( n  = 46), and 20.5% were older than 60 years ( n  = 44). Thirty-six percent of respondents had a surgical cosmetic facial procedure and 75% has at least one minimally invasive cosmetic facial procedure. Facial plastic surgeons are frequent users of cosmetic facial plastic surgery. This finding may be due to access, knowledge base, values, or attitudes. By better understanding surgeon attitudes toward facial plastic surgery, we can improve communication with patients and delivery of care. This study is a first step in understanding use of facial plastic procedures among facial plastic surgeons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Burnout in the Plastic Surgeon: Implications and Interventions. (United States)

    Prendergast, Christina; Ketteler, Erika; Evans, Gregory


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

  5. Surgeon influence on receipt of contralateral prophylactic mastectomy: Does it matter who you see for breast cancer surgery? (United States)

    Katz, Steven J.; Hawley, Sarah T.; Hamilton, Ann S.; Ward, Kevin C.; Morrow, Monica; Jagsi, Reshma; Hofer, Timothy P.


    Importance Rates of contralateral prophylactic mastectomy (CPM) have markedly increased but we know little about the influence of surgeons on variability of the procedure in the community. Objective To quantify the influence of attending surgeon on rates of CPM and clinician attitudes that explained it. Design and Setting Population-based survey study in Georgia and Los Angeles County. Participants We identified 7810 women with stages 0-II breast cancer treated in 2013–15 through the Surveillance, Epidemiology, and End Results (SEER) registries of Georgia and Los Angeles County. Surveys were sent approximately 2 months after surgery, (70% response rate, n=5080). Surveys were also sent to 488 attending surgeons identified by the patients, of whom 377 responded (77% response rate). Main Outcomes and Measures We conducted multilevel analyses to examine the impact of surgeon influence on variations in patient receipt of CPM using information from patient and surgeon surveys merged to SEER data. Results The patient mean age was 62; 30% had an increased risk of 2nd primary cancer, and 16% received CPM. Half of surgeons (52%) practiced for >20 years and 30% treated >50 new breast cancer patients annually. Attending surgeon explained a large amount (20%) of the variation in CPM controlling for patient factors. The odds of a patient receiving CPM increased almost 3-fold (OR 2.8, 95% CI 2.1,3.4) if she saw a surgeon with a practice approach one standard deviation above a surgeon with the average CPM rate (independent of age, diagnosis date, BRCA status and risk of 2nd primary). One quarter (25%) of the surgeon influence was explained by attending attitudes about initial recommendations for surgery and responses to patient requests for CPM. The estimated rate of CPM was 34% for surgeons who least favored initial breast conservation and were least reluctant to perform CPM vs 4% for surgeons who most favored initial breast conservation and were most reluctant to perform CPM

  6. Gender differences in the professional and private lives of plastic surgeons. (United States)

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


    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 women had no children, as compared to 11.5% of men (P Men also tended to have more children than their female counterparts, across all age groups. The majority of women (58.8%) delayed child-rearing until after residency, as compared to only 25.7% of men (P earn an income greater than $400,000 per year (P < 0.001). Of 39 respondents who stated that they were no longer practicing, 21 (54%) were male and 18 (46%) were female (P = NS). Female 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.

  7. Symmetry and conservation laws in particle physics in the fifties

    International Nuclear Information System (INIS)

    Michel, L.


    This paper puzzles over why symmetry, so central to particle physics today, was so little attended to in the 1950s when the need for it was becoming profound, with the notion of parity violation and other break-downs in conservation laws, such as angular momentum and charge conjugation. Group theory, including Lie groups, would also have helped understanding of the particle physics discoveries of the 1950s such as strange particles, resonances, and associated production. They were adopted ten years too late by the physics community. (UK)

  8. A mathematical medley fifty easy pieces on mathematics

    CERN Document Server

    Szpiro, George G


    Szpiro's book provides a delightful, well-written, eclectic selection of mathematical tidbits that makes excellent airplane reading for anyone with an interest in mathematics, regardless of their mathematical background. Excellent gift material. -Keith Devlin, Stanford University, author of The Unfinished Game and The Language of Mathematics It is great to have collected in one volume the many varied, insightful and often surprising mathematical stories that George Szpiro has written in his mathematical columns for the newspapers through the years. -Marcus du Sautoy, Oxford University, author

  9. Publication Productivity of Early-Career Orthopedic Trauma Surgeons. (United States)

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


    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. Copyright 2016, SLACK Incorporated.

  10. Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States. (United States)

    Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R


    To investigate recent trends in the orthopaedic trauma workforce and to assess whether supply of orthopaedic trauma surgeons (OTS) matches the demand for their skills. Supply estimated using Orthopaedic Trauma Association (OTA) membership and American Academy of Orthopaedic Surgeons census data. The annual number of operative pelvic and acetabular fractures reported by American College of Surgeons verified trauma centers in the National Trauma Data Bank (NTDB) was used as a surrogate of demand. Because surrogates were used, the annual rate of change in OTA membership versus rate of change in operative injuries per NTDB center was compared. From 2002 to 2012, reported operative pelvic and acetabular injuries increased by an average of 21.0% per year. The number of reporting trauma centers increased by 27.2% per year. The number of OTA members increased each year except in 2009, with mean annual increase of 9.8%. The mean number of orthopaedic surgeons per NTDB center increased from 7.98 to 8.58, an average of 1.5% per year. The annual number of operative pelvic and acetabular fractures per NTDB center decreased from 27.1 in 2002 to 19.03 in 2012, down 2.0% per year. In the United States, from 2002 to 2012, the number of OTS trended upward, whereas operative pelvic and acetabular cases per reporting NTDB center declined. These trends suggest a net loss of such cases per OTS over this period.

  11. Should advertising by aesthetic surgeons be permitted?

    Directory of Open Access Journals (Sweden)

    Neeraj Nagpal


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

  12. Norman Bethune, Canadian surgeon: his Chinese connection. (United States)

    Summers, G V


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

  13. The Colima Economy from fifties to the eighties

    Directory of Open Access Journals (Sweden)

    José Luis Villa Aguijosa


    Full Text Available The economic development of Colima, from 50s to 80s decades, was characterized for three stages which are differentiated for some certain features given by the roll that plays the economic sectors from the behaviour of some basic indicators of economic activities like port, agricultural, tourism, mining and industry, an for the economic strategy proposed during these years.In the 50s and 60s years, the economic of Colima took two fundamental characteristics which transcendent to the 70s decade: the supremacy in the participation in the agricultural sector in the gross state product, specialy given with impulse of the industrialization agricultural, and the mining activation, transforming in the base of economic development to Colima. The second stage, is in the 70s decade, and is characterized by the dynamic that industrial stage takes above other sectors with more slowly growing tax, besides it is characterized for one reduction of the growth tax of the gross estate product.The characteristics of economic development of Colima during these years are: standstill of the agricultural activity, trade and services, growth of industry, the urbanization and new economic profile, and makes the bases from the new economic profile of the 80s, in the context of the trade opening. The economy of Colima presented a regional polarization of the activities, a deficient communications and transports, a tourist potential misuse, an important growing of the industrial activities, and the necessity to expand the potential of the Manzanillo port and their big expectatives in the Mexican pacific, and an important growing of an industrial sector highly polarized. This panorama impacted in the profile of the development of Colima in the next decade.The third moment which crosses the economic of Colima, and is presented in the decade of the 80s, is characterized by the beginning of an economic model based in the planning which ;designs; an integrated Colima to the

  14. Sylvia Plath's The Bell Jar: a Mirror of American Fifties

    Directory of Open Access Journals (Sweden)

    Ghandeharion A.


    Full Text Available With its portrayal of a talented yet frustrated young American woman in the 1950s, Sylvia Plath's The Bell Jar (1963 depicts the experiences of a nineteen-year-old girl before her mental breakdown. Benefitting from a Friedanian second wave feminism, this paper aims to trace the root of disappointment and identity crisis in Plath's heroine, Esther Greenwood. It is understood that besides being a personal issue, her frustration is the outcome of sociocultural factors. The lack of role models and the contradictory messages sent by the media lead to her anxiety, disillusionment, and uncertainty. The Bell Jar proposes a solution: it is indeed possible for a woman to hold a fulfilling career and at the same time be a caring wife and a loving mother. And this is the answer Esther tries to figure out at a time when the boundaries between the domestic sphere and the outside world are clearly defined for women.

  15. Sylvia Plath's The Bell Jar: a Mirror of American Fifties

    Directory of Open Access Journals (Sweden)

    Ghandeharion, A.


    Full Text Available With its portrayal of a talented yet frustrated young American woman in the 1950s, Sylvia Plath's The Bell Jar (1963 depicts the experiences of a nineteen-year-old girl before her mental breakdown. Benefitting from a Friedanian second wave feminism, this paper aims to trace the root of disappointment and identity crisis in Plath's heroine, Esther Greenwood. It is understood that besides being a personal issue, her frustration is the outcome of sociocultural factors. The lack of role models and the contradictory messages sent by the media lead to her anxiety, disillusionment, and uncertainty. The Bell Jar proposes a solution: it is indeed possible for a woman to hold a fulfilling career and at the same time be a caring wife and a loving mother. And this is the answer Esther tries to figure out at a time when the boundaries between the domestic sphere and the outside world are clearly defined for women.

  16. Trauma surgeon personality and job satisfaction: results from a national survey. (United States)

    Foulkrod, Kelli H; Field, Craig; Brown, Carlos V R


    Personality is correlated with job satisfaction, whereas job satisfaction is linked to performance. This study examines personality of practicing trauma surgeons in relation to their job satisfaction. The dominant theory in personality research is the five-factor model, which includes: extraversion, agreeableness, conscientiousness, emotional stability, and openness. The sample was identified from American Association for Surgery of Trauma, Eastern Association for Surgery of Trauma, and Western Trauma Association membership. A web-based survey of demographics and empirically supported measures was created. Four hundred and twelve trauma surgeons (49 +/- 14-years-old, 85% male) completed the survey. When comparing satisfied to unsatisfied trauma surgeons on personality variables, extraversion (5.0 +/- 1.6 vs 4.4 +/- 1.6, P = 0.014) and emotional stability (5.8 +/- 1.1 vs 5.4 +/- 1.2, P = 0.007) were significantly higher in satisfied surgeons. Moderate correlations were found for job satisfaction with emotional stability (r = 0.20, P personality variables highlighted the significance of emotional stability and extraversion in prediction of job satisfaction. Extraversion and emotional stability are the most significant personality factors to job satisfaction of trauma surgeons. These findings may have important implications for surgical resident recruitment, job performance, and retention.

  17. The decisive role of the patient-side surgeon in robotic surgery. (United States)

    Sgarbura, Olivia; Vasilescu, Catalin


    Minimally invasive technology literature is mainly concerned about the feasibility of the robotic procedures and the performance of the console surgeon. However, few of these technologies could be applied without a well-trained team. Our goal was to demonstrate that robotic surgery depends more on the patient-side assistant surgeon's abilities than has been previously reported. In our department, 280 interventions in digestive, thoracic, and gynecological surgery were performed since the acquisition of the robotic equipment. There are three teams trained in robotic surgery with three console surgeons and four certified patient-side surgeons. Four more patient-side assistants were trained at our center. Trocar placement, docking and undocking of the robot, insertion of the laparoscopic instruments, and hemostatic maneuvers with various devices were quantified and compared. Assistants trained by using animal or cadaver surgery are more comfortable with the robotic instruments handling and with docking and undocking of the robot. Assistants who finalized their residency or attend their final year are more accurate with the insertion of the laparoscopic instrument to the targeted organ and more skillful with LigaSure or clip applier devices. Interventions that require vivid participation of the assistants have shorter assistant-depending time intervals at the end of the learning curve than at the beginning. Robotic surgery is a team effort and is greatly dependant on the performance of assistant surgeons. Interventions that have the benefit of a trained team are more rapid and secure.

  18. The fifty highest cited papers in anterior cruciate ligament injury. (United States)

    Vielgut, Ines; Dauwe, Jan; Leithner, Andreas; Holzer, Lukas A


    The anterior cruciate ligament (ACL) is one of the most common injured knee ligaments and at the same time, one of the most frequent injuries seen in the sport orthopaedic practice. Due to the clinical relevance of ACL injuries, numerous papers focussing on this topic including biomechanical-, basic science-, clinical- or animal studies, were published. The purpose of this study was to determine the most frequently cited scientific articles which address this subject, establish a ranking of the 50 highest cited papers and analyse them according to their characteristics. The 50 highest cited articles related to Anterior Cruciate Ligament Injury were searched in Thomson ISI Web of Science® by the use of defined search terms. All types of scientific papers with reference to our topic were ranked according to the absolute number of citations and analyzed for the following characteristics: journal title, year of publication, number of citations, citation density, geographic origin, article type and level of evidence. The 50 highest cited articles had up to 1624 citations. The top ten papers on this topic were cited 600 times at least. Most papers were published in the American Journal of Sports Medicine. The publication years spanned from 1941 to 2007, with the 1990s and 2000s accounting for half of the articles (n = 25). Seven countries contributed to the top 50 list, with the USA having by far the most contribution (n = 40). The majority of articles could be attributed to the category "Clinical Science & Outcome". Most of them represent a high level of evidence. Scientific articles in the field of ACL injury are highly cited. The majority of these articles are clinical studies that have a high level of evidence. Although most of the articles were published between 1990 and 2007, the highest cited articles in absolute and relative numbers were published in the early 1980s. These articles contain well established scoring- or classification systems. The

  19. [Surgeon 2.0: the challenge is on the Web]. (United States)

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


    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. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  20. No Circadian Variation in Surgeons' Ability to Diagnose Acute Appendicitis

    DEFF Research Database (Denmark)

    Jørgensen, Anders Bech; Amirian, Ilda; Kehlet Watt, Sara


    OBJECTIVE: To examine if there were circadian variations in surgeons' ability to diagnose acute appendicitis. DESIGN: Retrospective database study of all patients admitted to an acute surgical procedure under the potential diagnosis of acute appendicitis in a 4-year period. The day was divided...... patients were included. There were no age limitations or selection in sex. RESULTS: There was no significant difference in the ability to diagnose appendicitis in day-evening hours vs night hours (p = 0.391), nor was any significant difference found on weekdays (Monday-Thursday) vs weekends (Friday...... of imaging had no effect on the ability to diagnose appendicitis. Male sex showed a higher probability of the diagnosis being appendicitis compared with other or no pathology (odds ratio: 3.094; p

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

    Directory of Open Access Journals (Sweden)

    Meenakshi Dawar


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

  2. Solving the surgeon ergonomic crisis with surgical exosuit. (United States)

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


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

  3. Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout. (United States)

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


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

  4. [Management abilities of the head surgeon: essential for survival!]. (United States)

    Jähne, J


    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.

  5. Equal Pay for Equal Work: Medicare Procedure Volume and Reimbursement for Male and Female Surgeons Performing Total Knee and Total Hip Arthroplasty. (United States)

    Holliday, Emma B; Brady, Christina; Pipkin, William C; Somerson, Jeremy S


    The observed sex gap in physician salary has been the topic of much recent debate in the United States, but it has not been well-described among orthopaedic surgeons. The objective of this study was to evaluate for sex differences in Medicare claim volume and reimbursement among orthopaedic surgeons. The Medicare Provider Utilization and Payment Public Use File was used to compare claim volume and reimbursement between female and male orthopaedic surgeons in 2013. Data were extracted for each billing code per orthopaedic surgeon in the year 2013 for total claims, surgical claims, total knee arthroplasty (TKA) claims, and total hip arthroplasty (THA) claims. A total of 20,546 orthopaedic surgeons who treated traditional Medicare patients were included in the initial analysis. Claim volume and reimbursement received were approximately twofold higher for all claims and more than threefold higher for surgical claims for male surgeons when compared with female surgeons (p 10 TKAs and THAs, respectively, in 2013 for Medicare patients and were included in the subset analyses. Although male surgeons performed a higher mean number of TKAs than female surgeons (mean and standard deviation, 37 ± 33 compared with 26 ± 17, respectively, p men and women for TKA or THA ($1,135 ± $228 compared with $1,137 ± $184 for TKA, respectively, p = 0.380; $1,049 ± $226 compared with $1,043 ± $266 for THA, respectively, p = 0.310). Female surgeons had a lower number of total claims and reimbursements compared with male surgeons. However, among surgeons who performed >10 THAs and TKAs, there were no sex differences in the mean reimbursement payment per surgeon. The number of women in orthopaedics is rising, and there is much interest in how their productivity and compensation compare with their male counterparts.

  6. The impact of surgeon volume on colostomy reversal outcomes after Hartmann's procedure for diverticulitis. (United States)

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Hensley, Bradley J; Iannuzzi, James C; Noyes, Katia; Monson, John R T; Fleming, Fergal J


    Colostomy reversal after Hartmann's procedure for diverticulitis is a morbid procedure, and studies investigating factors associated with outcomes are lacking. This study identifies patient, surgeon, and hospital-level factors associated with perioperative outcomes after stoma reversal. The Statewide Planning and Research Cooperative System was queried for urgent/emergency Hartmann's procedures for diverticulitis between 2000-2012 in New York State and subsequent colostomy reversal within 1 year of the procedure. Surgeon and hospital volume were categorized into tertiles based on the annual number of colorectal resections performed each year. Bivariate and mixed-effects analyses were used to assess the association between patient, surgeon, and hospital-level factors and perioperative outcomes after colostomy reversal, including a laparoscopic approach; duration of stay; intensive care unit admission; complications; mortality; and 30-day, unscheduled readmission. Among 10,487 patients who underwent Hartmann's procedure and survived to discharge, 63% had the colostomy reversed within 1 year. After controlling for patient, surgeon, and hospital-level factors, high-volume surgeons (≥40 colorectal resections/yr) were independently associated with higher odds of a laparoscopic approach (unadjusted rates: 14% vs 7.6%; adjusted odds ratio = 1.84, 95% confidence interval = 1.12, 3.00), shorter duration of stay (median: 6 versus 7 days; adjusted incidence rate ratio = 0.87, 95% confidence interval = 0.81, 0.95), and lower odds of 90-day mortality (unadjusted rates: 0.4% vs 1.0%; adjusted odds ratio = 0.30, 95% confidence interval = 0.10, 0.88) compared with low-volume surgeons (1-15 colorectal resections/yr). High-volume surgeons are associated with better perioperative outcomes and lower health care utilization after Hartmann's reversal for diverticulitis. These findings support referral to high-volume surgeons for colostomy reversal. Copyright © 2016

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

    Tricot, Jean-pierre


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

  8. "Double crap!" abuse and harmed identity in Fifty Shades of Grey. (United States)

    Bonomi, Amy E; Altenburger, Lauren E; Walton, Nicole L


    While intimate partner violence (IPV) affects 25% of women and impairs health, current societal conditions-including the normalization of abuse in popular culture such as novels, film, and music-create the context to support such violence. Fifty Shades of Grey, a best-selling novel, depicts a "romantic" and "erotic" relationship involving 28-year-old megamillionaire, Christian Grey, and a 22-year-old college student, Anastasia Steele. We argue that the relationship is characterized by IPV, which is harmful to Anastasia. All authors engaged in iterative readings of the text, and wrote narrative summaries to elucidate themes. Validity checks included double review of the first eight chapters of the novel to establish consistency in our analysis approach, iterative discussions in-person and electronically to arbitrate discrepancies, and review of our analysis with other abuse and sexual practice experts. To characterize IPV, we used the U.S. Centers for Disease Control and Prevention's definitions of emotional abuse (intimidation/threats; isolation; stalking; and humiliation) and sexual violence (forced sex acts/contact against a person's will, including using alcohol/drugs or intimidation/pressure). To characterize harm, we used Smith's conceptualizations of perceived threat, managing, altered identity, yearning, entrapment, and disempowerment experienced by abused women. Emotional abuse is present in nearly every interaction, including: stalking (Christian deliberately follows Anastasia and appears in unusual places, uses a phone and computer to track Anastasia's whereabouts, and delivers expensive gifts); intimidation (Christian uses intimidating verbal and nonverbal behaviors, such as routinely commanding Anastasia to eat and threatening to punish her); and isolation (Christian limits Anastasia's social contact). Sexual violence is pervasive-including using alcohol to compromise Anastasia's consent, as well as intimidation (Christian initiates sexual encounters

  9. Impact of Different Surgeons on Dental Implant Failure. (United States)

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

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

  10. Predictors, Quality Markers, and Economics of Volunteering Internationally: Results from a Comprehensive Survey of American Society of Plastic Surgeons Members. (United States)

    McIntyre, Joyce K; Schoenbrunner, Anna R; Kelley, Kristen D; Gosman, Amanda A


    Plastic surgeons have a long history of international volunteer work. To date, there have been no outcome-based studies among surgeons who volunteer internationally. The purpose of this study was to describe predictors of volunteering, clinical quality markers, and economics of international volunteering among American plastic surgeons. A cross-sectional validated e-mail survey tool was sent to all board-certified plastic surgeons by the American Society of Plastic Surgeons. The survey response rate was 15 percent (745 total individuals), of which 283 respondents traveled within the past 5 years. Analysis was performed in R. Stepwise multivariate logistic regression was performed to determine the predictors of death/complication. Respondents reported high use of medical records, follow-up care, and host affiliation. Fewer than half of all respondents reported use of international safety surgery guidelines, and the majority of respondents reported volunteering abroad outside of their scope of practice. The majority of children younger than 5 years were not cared for by a pediatric anesthesiologist. The majority of participants reported personally spending more than $1000 on their last trip and performing surgery estimated to be worth on average $28,000 each. International surgical volunteer trips attempt to ease the global burden of surgical disease. The authors' study reports variation in quality of care provided on these trips. Most significantly, the majority of children younger than 5 years were not cared for by a pediatric anesthesiologist, and many plastic surgeons operated outside of their scope of practice.

  11. A comparison of case volumes among urologic surgeons identified on an industry-sponsored website to an all provider peer group. (United States)

    See, William A; Jacobson, Kenneth; Derus, Sue; Langenstroer, Peter


    Industry-sponsored websites for robotic surgery direct to surgeons listed as performing specific robotic surgical procedures. The purpose of this study was to compare average annual, surgeon-specific, case volumes for those procedures for which they were listed as performing on the commercial website with the volumes of all providers performing these same procedures across a defined geographic region. A list of providers within the state of Wisconsin cited as performing specific urologic procedures was obtained through the Intuitive Surgical website 〈〉. Surgeon-specific annual case volumes from 2009 to 2013 for these same cases were obtained for all Wisconsin providers through DataBay Resources (Warrendale, PA) based on International classification of diseases-9 codes. Procedural activity was rank ordered, and surgeons were placed in "volume deciles" derived from the total annual number of cases performed by all surgeons. The distribution of commercially listed surgeon volumes, both 5-year average and most recent year, was compared with the average and 2013 volumes of all surgeons performing a specific procedure. A total of 35 individual urologic surgeons listed as performing robotic surgery in Wisconsin were identified through a "search" using the Intuitive Surgical website. Specific procedure analysis returned 5, 12, 9, and 15 surgeon names for cystectomy, partial nephrectomy, radical nephrectomy, and prostatectomy, respectively. This compared with the total number of surgeons who had performed the listed procedure in Wisconsin at least 1 time during the prior 5 years of 123, 153, 242, and 165, respectively. When distributed by surgeon-volume deciles, surgeons listed on industry-sponsored sites varied widely in their respective volume decile. More than half of site-listed, procedure-specific surgeons fell below the fifth decile for surgeon volume. Data analysis based solely on 2013 case volumes had no effect on

  12. Richard von Volkmann: surgeon and Renaissance man. (United States)

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


    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.

  13. [Surgeons and Neurosurgeons as Nobel Prize Winners]. (United States)

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

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

  14. Nanotechnology tolls the bell for plastic surgeons. (United States)

    Salehahmadi, Zeinab; Hajiliasgari, Fatemeh


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

  15. Augmented reality for the surgeon: Systematic review. (United States)

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


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

  16. British surgeons' experiences of mandatory online workplace-based assessment. (United States)

    Pereira, Erlick A C; Dean, Benjamin J F


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

  17. The pioneering contribution of italian surgeons to skull base surgery. (United States)

    Priola, Stefano M; Raffa, Giovanni; Abbritti, Rosaria V; Merlo, Lucia; Angileri, Filippo F; La Torre, Domenico; Conti, Alfredo; Germanò, Antonino; Tomasello, Francesco


    The origin of neurosurgery as a modern, successful, and separate branch of surgery could be dated back to the end of the 19th century. The most important development of surgery occurred in Europe, particularly in Italy, where there was a unique environment, allowing brilliant open-minded surgeons to perform, with success, neurosurgical operations. Neurosurgery began at the skull base. In everyday practice, we still pay tribute to early Italian neuroanatomists and pioneer neurosurgeons who represented a starting point in a new, obscure, and still challenging field of medicine and surgery during their times. In this paper, we report at a glance the contributions of Tito Vanzetti from Padua (1809-1888), for his operation on a destructive skull base cyst that had, indeed, an intracranial expansion; of Davide Giordano (1864-1954) from Venice, who described the first transnasal approach to the pituitary gland; and, most importantly, of Francesco Durante from Messina (1844-1934), who was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. They carried out the first detailed reported surgical excision of intracranial lesions at the skull base, diagnosed only through clinical signs; used many of the advances of the 19th century; and conceived and performed new operative strategies and approaches. Their operations were radical enough to allow the patient to survive the surgery and, in the case of Durante, for the first time, to obtain more than 12 years of good survival at a time when a tumor of this type would have been fatal. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Patient, surgeon, and hospital disparities associated with benign hysterectomy approach and perioperative complications. (United States)

    Mehta, Ambar; Xu, Tim; Hutfless, Susan; Makary, Martin A; Sinno, Abdulrahman K; Tanner, Edward J; Stone, Rebecca L; Wang, Karen; Fader, Amanda N


    Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary US hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these 2 factors with patient, surgeon, and hospital characteristics. We sought to describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications. Hysterectomies performed for benign indications by general gynecologists from July 2012 through September 2014 were analyzed in the all-payer Maryland Health Services Cost Review Commission database. We excluded hysterectomies performed by gynecologic oncologists, reproductive endocrinologists, and female pelvic medicine and reconstructive surgeons. We included both open hysterectomies and those performed by minimally invasive surgery, which included vaginal hysterectomies. Perioperative complications were defined using the Agency for Healthcare Research and Quality patient safety indicators. Surgeon hysterectomy volume during the 2-year study period was analyzed (0-5 cases annually = very low, 6-10 = low, 11-20 = medium, and ≥21 = high). We utilized logistic regression and negative binomial regression to identify patient, surgeon, and hospital characteristics associated with minimally invasive surgery utilization and perioperative complications, respectively. A total of 5660 hospitalizations were identified during the study period. Most patients (61.5%) had an open hysterectomy; 38.5% underwent a minimally invasive surgery procedure (25.1% robotic, 46.6% laparoscopic, 28.3% vaginal). Most surgeons (68.2%) were very low- or low-volume surgeons. Factors associated with a lower likelihood of undergoing minimally

  19. Decreased heart rate variability in surgeons during night shifts

    DEFF Research Database (Denmark)

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


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

  20. Surgeons' Leadership Styles and Team Behavior in the Operating Room. (United States)

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


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