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Sample records for surgeons operating theatre

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

    Science.gov (United States)

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

    2014-05-01

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

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

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  4. Optimizing the operating theatre environment.

    Science.gov (United States)

    Wong, Shing W; Smith, Richard; Crowe, Phil

    2010-12-01

    The operating theatre is a complex place. There are many potential factors which can interfere with surgery and predispose to errors. Optimizing the operating theatre environment can enhance surgeon performance, which can ultimately improve patient outcomes. These factors include the physical environment (such as noise and light), human factors (such as ergonomics), and surgeon-related factors (such as fatigue and stress). As individual factors, they may not affect surgical outcome but in combination, they may exert a significant influence. The evidence for some of these working environment factors are examined individually. Optimizing the operating environment may have a potentially more significant impact on overall surgical outcome than improving individual surgical skill.

  5. Video prototype of the interactive operating theatre

    DEFF Research Database (Denmark)

    2004-01-01

    Building capture and access (C&A) applications for use in the operation theatre differs greatly from C&A applications built to support other settings e.g. meeting rooms or classrooms. Based on field studies of surgical operations, this paper explores how to design C&A applications for the operation...... theatre. Based on the findings from our field work, we have built the ActiveTheatre, a C&A prototype. ActiveTheatre is built to support collaboration in and around the operating theatre, to capture events instead of automatically capturing eve- rything, and to be integrated with existing applications...... already present in the operation theatre. The ActiveTheatre prototype has been developed in close co- operation with surgeons and nurses at a local hospital. The work on the proto- type and our initial evaluations have provided an insight into how to design, capture and access applications that are going...

  6. Music and communication in the operating theatre.

    Science.gov (United States)

    Weldon, Sharon-Marie; Korkiakangas, Terhi; Bezemer, Jeff; Kneebone, Roger

    2015-12-01

    To observe the extent and the detail with which playing music can impact on communication in the operating theatre. According to the cited sources, music is played in 53-72% of surgical operations performed. Noise levels in the operating theatre already exceed World Health Organisation recommendations. There is currently a divide in opinions on the playing of music in operating theatres, with few studies conducted and no policies or guidance provided. An ethnographic observational study of teamwork in operating theatres through video recordings. Quantitative and qualitative data analysis approaches were used. This study was conducted between 2012-2013 in the UK. Video recordings of 20 operations over six months in two operating theatres were captured. The recordings were divided into music and non-music playing cases. Each case was logged using a request/response sequence identified through interactional analysis. Statistical analysis, using a χ(2) , explored the difference between the proportion of request repetitions and whether music was playing or not. Further interactional analysis was conducted for each request repetition. Request/response observations (N = 5203) were documented. A chi-square test revealed that repeated requests were five times more likely to occur in cases that played music than those that did not. A repeated request can add 4-68 seconds each to operation time and increased tensions due to frustration at ineffective communication. Music played in the operating theatre can interfere with team communication, yet is seldom recognized as a potential safety hazard. Decisions around whether music is played and around the choice of music and its volume, are determined largely by surgeons. Frank discussions between clinicians, managers, patients and governing bodies should be encouraged for recommendations and guidance to be developed. © 2015 John Wiley & Sons Ltd.

  7. Ensuring cleanliness in operating theatres.

    Science.gov (United States)

    Charkowska, Anna

    2008-01-01

    High cleanliness of a hospital environment is necessary to ensure safe working conditions for the medical staff, a correct process of hospitalization and to protect hospital visitors, an aspect rarely mentioned. A supply of air cleaned in highly-effective air filters to hospital wards with air conditioning systems and exhaust of infected air will help in maintaining the required standards of cleanliness. This article presents information on recommended classes of air and surface cleanliness, with special focus on operating theatres and suites.

  8. Daniel Mollière (1848-1890), the French anatomist and surgeon, and his encounters with nosocomial infections in the operating theatre.

    Science.gov (United States)

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

    2016-09-01

    Daniel Mollière, was a French anatomist and surgeon, born in Lyon, who succeeded in his short life in making his mark in surgery. He was a prolific writer who left a series of medical treatises and a committed surgeon who was responsible for various significant innovative apparatuses in the medical sper. As he lived in an era when the role of microbe had already been recognized, he was among the first to use antisepsis and install extreme measures against microbes, both in the air and on the skin'. Fountains with fresh clean water, carbonic acid, cross ventilation, medical blouses, combined with Valette's apparatus for the dressing of amputations, were some of his precautions to reduce surgical infections and post-operative mortality.

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

    Science.gov (United States)

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

    2009-09-01

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

  10. Influence of music on operation theatre staff

    Directory of Open Access Journals (Sweden)

    Shyjumon George

    2011-01-01

    Full Text Available Background and Objective: The purpose of the study was to evaluate the perception of influence of music among surgeons, anesthesiologist and nurses in our hospital as well as to critically evaluate whether music can be used as an aid in improving the work efficiency of medical personnel in the operation theatre (OT. Materials and Methods: A prospective, questionnaire-based cross-sectional study was conducted. A total of 100 randomly selected subjects were interviewed, which included 44 surgeons, 25 anesthesiologists and 31 nurses. Statistical package for social sciences (SPSS Windows Version 16 software was used for statistical evaluation. Results: Most of the OT medical personnel were found to be aware of the beneficial effects of music, with 87% consenting to the playing of music in the OT. It was also found that most participants agreed to have heard music on a regular basis in the OT, while 17% had heard it whenever they have been to the OT. Conclusions: Majority of the respondent′s preferred playing music in the OT which helped them relax. It improved the cognitive function of the listeners and created a sense of well being among the people and elevated mood in them. Music helped in reducing the autonomic reactivity of theatre personnel in stressful surgeries allowing them to approach their surgeries in a more thoughtful and relaxed manner. Qualitative, objective and comprehensive effect of specific music types varied with different individuals. Music can aid in improving the work efficiency of medical personnel in the OT. The study has reinforced the beneficial effects of playing music in the OT outweighing its deleterious outcomes.

  11. [Coats of arms of the Amsterdam Surgeons' Guild in the dome of the Anatomy Theatre].

    Science.gov (United States)

    van Gulik, Thomas M; Ijpma, Frank F A; Middelkoop, Norbert E

    2014-01-01

    In 1731, Cornelis Troost (1696-1750) painted three wardens of the surgeons' guild in Amsterdam. We know their names from the family coats of arms shown on the wall behind them. The same coats of arms and names are painted in the dome of the Anatomy Theatre in the 'Waag', the former weighing house at the Nieuwmarkt in Amsterdam, which also housed the board room of the surgeons' guild. The 84 coats of arms in the beautifully restored dome are a testimony of the rich history of the surgeons' guild.

  12. A Scheduling Problem for Hospital Operating Theatre

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    Sufahani, Suliadi F; Ismail, Zuhaimy

    2012-01-01

    This paper provides a classification of real scheduling problems. Various ways have been examined and described on the problem. Scheduling problem faces a tremendous challenges and difficulties in order to meet the preferences of the consumer. Dealing with scheduling problem is complicated, inefficient and time-consuming. This study aims to develop a mathematical model for scheduling the operating theatre during peak and off peak time. Scheduling problem is a well known optimization problem and the goal is to find the best possible optimal solution. In this paper, we used integer linear programming technique for scheduling problem in a high level of synthesis. In addition, time and resource constrained scheduling was used. An optimal result was fully obtained by using the software GLPK/AMPL. This model can be adopted to solve other scheduling problems, such as the Lecture Theatre, Cinemas and Work Shift.

  13. Rethinking theatre in modern operating rooms.

    Science.gov (United States)

    Riley, Robin; Manias, Elizabeth

    2005-03-01

    Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.

  14. Operating theatre nurses' perceptions of competence: a focus group study.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy; Wallis, Marianne; Chang, Hsiao-Yun Annie; Werder, Helen

    2009-05-01

    This paper is a report of a study exploring nurses' perceptions of the components of competence in the operating theatre. Competency Standards for operating theatre practice are used in some countries to guide clinical and professional behaviours. The need for competence assessment has been enshrined, but the conceptualization and agreement about what signifies competence in Operating Theatre has been lacking. Three focus groups were conducted with 27 operating theatre nurses in three major metropolitan hospitals in Queensland, Australia. Interviews were audio taped and field notes were taken. Data were collected during 2008. Thematic analysis was performed. From the analysis of the textual data, three themes were identified: 'coalescence of theoretical, practical, situational and aesthetic knowledge within a technocratic environment'; 'the importance of highly developed communication skills among teams of divergent personalities and situations'; and 'managing and coordinating the flow of the list'. These findings have identified that competence in respect to components of knowledge, teamwork and communication, and the ability to coordinate and manage are important and should be incorporated in operating theatre Competency Standards. Additionally, findings may assist in the development of an instrument to measure operating nurses' perceived competence.

  15. Influence of music on operation theatre staff

    National Research Council Canada - National Science Library

    George, Shyjumon; Ahmed, Shafiq; Mammen, Kim J; John, George Mathews

    2011-01-01

    The purpose of the study was to evaluate the perception of influence of music among surgeons, anesthesiologist and nurses in our hospital as well as to critically evaluate whether music can be used...

  16. Evaluation of computer flow modelling in operating theatres

    NARCIS (Netherlands)

    Lemaire, A.D.; Ham, P.J.; Luscuere, P.G.

    1996-01-01

    Nowadays most Operating Theatres (OT's) in the Netherlands have a certain standard configuration to guarantee good control of airflows and by doing so keep the risk of infections from airborne contaminants low. It is, however, the question if this risk is low enougii. A correct answer can only be fo

  17. Self moving patients to the operation theatre - a pilot study

    DEFF Research Database (Denmark)

    Qvarfordh, Anna Pernilla; Rovsing, Marie Louise; Esbensen, Bente Appel

    2010-01-01

    The purpose of this pilot study was to investigate patients' satisfaction with walking to the operation theatre instead of being driven in a bed or wheel chair, and to identify the need for information. In total, 75 patients (aged 15-83 years) participated in the study. A questionnaire...

  18. Bacterial control through contamination control in operating theatres

    NARCIS (Netherlands)

    Luscuere, P.G.

    1996-01-01

    Nowadays Operating Theatres (OT's) are well established for normai surgical use in modernised world. The application of downflow systems is some 20 years old and besides incremental improvements the concept is stil) the same as from the start. The two most common concepts are based on filtered air

  19. Operating theatre quality and prevention of surgical site infections.

    Science.gov (United States)

    Spagnolo, A M; Ottria, G; Amicizia, D; Perdelli, F; Cristina, M L

    2013-09-01

    Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres.

  20. The productive operating theatre and lean thinking systems.

    Science.gov (United States)

    Kasivisvanathan, R; Chekairi, A

    2014-11-01

    The concept of 'lean thinking' first originated in the manufacturing industry as a means of improving productivity whilst maintaining quality through eliminating wasteful processes. The purpose of this article is to demonstrate how the principles of 'lean thinking' are relevant to healthcare and the operating theatre, with reference to our own institutional experience.

  1. Novel utilization of 3D technology and the hybrid operating theatre: Peri-operative assessment of posterior sterno-clavicular dislocation using cone beam CT

    Science.gov (United States)

    Crowhurst, James A; Campbell, Douglas; Whitby, Mark; Pathmanathan, Pavthrun

    2013-01-01

    A patient with a medial and posterior dislocation of the right sterno-clavicular (SC) joint and displacement of the trachea and brachiocephalic artery by the medial head of the clavicle underwent general anaesthetic in the operating theatre for an open reduction procedure. The surgeon initially attempted a closed reduction, but this required imaging to check SC alignment. The patient was transferred to an adjacent hybrid operating theatre for imaging. Cone beam computed tomography (CBCT) was performed, which successfully demonstrated a significant reduction in the dislocation of the SC joint. The trachea and brachiocephalic artery were no longer compressed or displaced. This case study demonstrates an alternative to the patient being transferred to the medical imaging department for multi-slice CT. It also describes a novel use of the hybrid operating theatre and its CBCT capabilities. PMID:26229610

  2. Novel utilization of 3D technology and the hybrid operating theatre: Peri-operative assessment of posterior sterno-clavicular dislocation using cone beam CT

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    Crowhurst, James A; Campbell, Douglas; Whitby, Mark; Pathmanathan, Pavthrun [The Prince Charles Hospital, Rode Road, Chermside, Queensland (Australia)

    2013-06-15

    A patient with a medial and posterior dislocation of the right sterno-clavicular (SC) joint and displacement of the trachea and brachiocephalic artery by the medial head of the clavicle underwent general anaesthetic in the operating theatre for an open reduction procedure. The surgeon initially attempted a closed reduction, but this required imaging to check SC alignment. The patient was transferred to an adjacent hybrid operating theatre for imaging. Cone beam computed tomography (CBCT) was performed, which successfully demonstrated a significant reduction in the dislocation of the SC joint. The trachea and brachiocephalic artery were no longer compressed or displaced. This case study demonstrates an alternative to the patient being transferred to the medical imaging department for multi-slice CT. It also describes a novel use of the hybrid operating theatre and its CBCT capabilities.

  3. Infection control hazards associated with the use of forced-air warming in operating theatres.

    Science.gov (United States)

    Wood, A M; Moss, C; Keenan, A; Reed, M R; Leaper, D J

    2014-11-01

    A review is presented of the published experimental and clinical research into the infection control hazards of using forced air-warming (FAW) in operating theatres to prevent inadvertent hypothermia. This evidence has been reviewed with emphasis on the use of ultra-clean ventilation, any interaction it has with different types of patient warming (and FAW in particular), and any related increased risk of surgical site infection (SSI). We conclude that FAW does contaminate ultra-clean air ventilation; however, there appears to be no definite link to an increased risk of SSI based on current research. Nevertheless, whereas this remains unproven, we recommend that surgeons should at least consider alternative patient-warming systems in areas where contamination of the operative field may be critical. Although this is not a systematic review of acceptable randomized controlled clinical trials, which do not exist, it does identify that there is a need for definitive research in this field.

  4. Operational research in the management of the operating theatre: a survey.

    Science.gov (United States)

    Guerriero, Francesca; Guido, Rosita

    2011-03-01

    Operating theatre represents one of the most critical and expensive hospital resources since a high percentage of the hospital admissions is due to surgical interventions. The main objectives are to guarantee the optimal utilization of medical resources, the delivery of surgery at the right time, the maximisation of profitability (i.e., patient flow) without incurring additional costs or excessive patient waiting time. The operating theatre management is a process very complex: the use of mathematical and simulation models, and quantitative techniques plays, thus a crucial role. The main aim of this paper is to provide a structured literature review on how Operational Research can be applied to the surgical planning and scheduling processes. A particular attention is on the published papers that present the most interesting mathematical (optimization and simulation) models and solution approaches developed to address the problems arising in operating theatres. Directions for future researches are also highlighted.

  5. Safety in the Operating Theatre | a Multi Factor Approach for Patients and Teams

    NARCIS (Netherlands)

    Wauben, L.S.G.L.

    2010-01-01

    Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this

  6. Safety in the Operating Theatre | a Multi Factor Approach for Patients and Teams

    NARCIS (Netherlands)

    Wauben, L.S.G.L.

    2010-01-01

    Due to the advances in high-tech technology in the operating theatre, the increased number of persons involved, and the increased complexity of surgical procedures, medical errors are inflicted. To answer the main question: How to improve patient safety in the operating theatre during surgery? this

  7. The surgeon and his tools-the case for a focused orthopaedic theatre induction programme

    Directory of Open Access Journals (Sweden)

    Wong Shaun KS

    2008-10-01

    Full Text Available Abstract Background Induction programme for trainee doctors in the UK generally do not focus on the surgical aspects of their jobs. In this context we decided to conduct a telephonic survey among the hospitals belonging to three orthopaedic training regions in the UK from the point of view of the diversity of instrumentations and implants used for index procedures. Results We chose four index trauma & orthopaedic procedures (Total hip replacement, total knee replacement, intramedullary nailing and external fixator systems for long bone fractures. A telephonic survey was done in six NHS trust hospitals which were part of an orthopaedic training rotation (2 from England, 2 from Wales and 2 from Scotland. In total there were 39 different instrumentation systems for these 4 index procedures in the 6 trusts (see table 1. These comprise 12 Total hip replacement (THR systems, 14 total knee replacement (TKR systems, 9 intra-medullary nailing systems, and 4 external fixator systems. The number of different systems for each trust ranged from 7 to 19. There is a vast array of implants and instrumentation systems in each trust, as highlighted by our survey. The surgical tools are not the same in each hospitals. This situation is more complicated when trainees move to new hospitals as part of training rotations. Table 1 Number of implants/instrumentations used in each of the 6 UK trusts (3 training regions. IMPLANT E1 E2 W1 W2 S1 S2 Total Knee Replacement 4 5 2 4 3 2 Total Hip Replacement 3 4 3 6 3 3 Intramnedullary nailing 2 1 1 6 2 3 External fixators 2 3 2 2 1 1 TOTAL 11 13 8 18 9 9 E = England, W = Wales, S = Scotland Conclusion In view of this we feel that more focused theatre based induction programmes for higher surgical trainees is advocated in each hospital trust so trainees can familiarise themselves with the tools available to them. This could include discussion with the consultants and senior theatre staff along with representatives from the

  8. The effects of surgeons and anesthesiologists on operating room efficiency

    Directory of Open Access Journals (Sweden)

    Nessa Timoney

    2016-09-01

    Conclusion: In some procedures types a significant part of the variability in operative time is due to the interaction between the surgeon and anesthesiologist. Reviewing operative records should allow identification of efficient/inefficient combinations.

  9. Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report.

    Science.gov (United States)

    Southorn, T; Norrish, A R; Gardner, K; Baxandall, R

    2013-06-01

    Currently, there are very few provisions for recycling in theatres. We measured the weight of clinical waste for several orthopaedic operations. This waste was then examined and sorted into domestic waste and clinical waste. With staff education it is possible to reduce the amount of clinical waste generated by the operating theatre by roughly 50%. A greater awareness of disposal options leads to a reduction in waste disposed of by incineration.

  10. Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview

    Directory of Open Access Journals (Sweden)

    Kidd Jane

    2006-02-01

    Full Text Available Abstract Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview Background Communication programmes are well established in nurse education. The focus of programmes is most often on communicating with patients with less attention paid to inter-professional communication or skills essential for working in specialised settings. Although there are many anecdotal reports of communication within the operating theatre, there are few empirical studies. This paper explores communication behaviours for effective practice in the operating theatre as perceived by nurses and serves as a basis for developing training. Methods A focus group interview was conducted with seven experienced theatre nurses from a large London teaching hospital. The interview explored their perceptions of the key as well as unique features of effective communication skills in the operating theatre. Data was transcribed and thematically analysed until agreement was achieved by the two authors. Results There was largely consensus on the skills deemed necessary for effective practice including listening, clarity of speech and being polite. Significant influences on the nature of communication included conflict in role perception and organisational issues. Nurses were often expected to work outside of their role which either directly or indirectly created barriers for effective communication. Perceptions of a lack of collaborative team effort also influenced communication. Conclusion Although fundamental communication skills were identified for effective practice in the operating theatre, there were significant barriers to their use because of confusion over clarity of roles (especially nurses' roles and the implications for teamwork. Nurses were dissatisfied with several aspects of communication. Future studies should explore the breadth and depth of this dissatisfaction in other operating theatres, its impact on morale and importantly

  11. Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview

    Science.gov (United States)

    Nestel, Debra; Kidd, Jane

    2006-01-01

    Abstract Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview Background Communication programmes are well established in nurse education. The focus of programmes is most often on communicating with patients with less attention paid to inter-professional communication or skills essential for working in specialised settings. Although there are many anecdotal reports of communication within the operating theatre, there are few empirical studies. This paper explores communication behaviours for effective practice in the operating theatre as perceived by nurses and serves as a basis for developing training. Methods A focus group interview was conducted with seven experienced theatre nurses from a large London teaching hospital. The interview explored their perceptions of the key as well as unique features of effective communication skills in the operating theatre. Data was transcribed and thematically analysed until agreement was achieved by the two authors. Results There was largely consensus on the skills deemed necessary for effective practice including listening, clarity of speech and being polite. Significant influences on the nature of communication included conflict in role perception and organisational issues. Nurses were often expected to work outside of their role which either directly or indirectly created barriers for effective communication. Perceptions of a lack of collaborative team effort also influenced communication. Conclusion Although fundamental communication skills were identified for effective practice in the operating theatre, there were significant barriers to their use because of confusion over clarity of roles (especially nurses' roles) and the implications for teamwork. Nurses were dissatisfied with several aspects of communication. Future studies should explore the breadth and depth of this dissatisfaction in other operating theatres, its impact on morale and importantly on patient safety

  12. Effectiveness and efficiency of the two trolley system as an infection control mechanism in the operating theatre.

    Science.gov (United States)

    Tuisawana, Viliame

    2009-11-01

    A good infection control manager understands the need to prevent a complete cycle of infection. The Infection Control Working Group Manual of Fiji, emphasised that the Cycle of Infection is the series of stage in which infection is spread. Operating theatres have infection control protocols. Most equipments and instruments used in operating theatre circulate within the theatre. The theatre trolleys are a main component in managing an operating theatre but the least recognised. This paper reviews the effectiveness and efficiency of the current two-trolley system as an infection control mechanism in theatre. The paper will discuss infection control using the current trolley system in relation to the layout of Labasa Hospital operating theatre, human resource, equipment standard and random swab results. The following are random swab results of theatre equipments taken by the Infection Control Nurse from 2006 to 2008. The Labasa Hospital Infection Committee have discouraged random swab sample from mid 2008 based on new guidelines on infection control. The two trolley system, in which an allocated outside trolley transports patients from the ward to a semi-sterile area in theatre. The inside trolley which transports the patient to the operating table. The two trolley system means more trolleys, extra staffs for lifting, additional handling of very sick patients, congestion and delay in taking patients to operating table in theatres should be considered. The one-trolley system in theatre greatly reduces the chances of manually lifting patients, thus reducing the risk of patient injury from fall and risk of back injuries to nurses. There are other evident based practices which can compliment the one trolley system for an effective infection control mechanism in theatres. The Fiji Infection Control Manual (2002) emphases the importance of regularly cleaning the environment and equipments in theatre but there is never a mention about using a two trolley system as an

  13. Listen while you work? The attitude of healthcare professionals to music in the operating theatre.

    Science.gov (United States)

    Faraj, A A; Wright, A P; Haneef, J H S; Jones, A

    2014-09-01

    Although the playing of music is commonplace in the operating theatre, there is nothing in the literature examining whether staff feel this is beneficial. Questionnaires were distributed amongst a random selection of staff in practice at a district general hospital: medical staff from a range of surgical specialities, anaesthetists, and all grades of perioperative staff (nurse/operating department practitioners/healthcare assistants) were encouraged to participate. There were 121 health professionals in total working in the operating theatres. The authors compared the responses to each question amongst the respondents, to check for the tendency to correlate. Out of the 52 health professionals who responded, 36 stated that music is played in their theatre either every day, or two to three times a week. Only five respondents felt that this was too often. Fifteen percent of medical staff were of the opinion that the nursing staff controlled the choice of music. Nursing staff were almost evenly split in thinking that nursing staff, surgical staff and the whole theatre team controlled the choice of music. The majority of both nursing and medical staff felt that they enjoyed their work more and performed better when music was played in theatre. The study concluded that the majority of theatre staff found listening to music while they work a positive experience. The potential for music to have a distracting or detrimental effect on a minority of individuals should always be considered.

  14. performless: the operation of l'informe in postdramatic theatre

    NARCIS (Netherlands)

    Georgelou, K.

    2011-01-01

    This thesis discusses radical aesthetic strategies that appear in postdramatic performances, with the aim to examine how they 'work' and what their impact is. More precisely, it looks at particular strategies from recent performances by the Italian theatre company Socìetas Raffaello Sanzio and by th

  15. COMPARISON OF TWO METHODS OF OPERATING THEATRE PLANNING: APPLICATION IN BELGIAN HOSPITAL

    Institute of Scientific and Technical Information of China (English)

    Sondes CHAABANE; Nadine MESKENS; Alain GUINET; Marius LAURENT

    2008-01-01

    Operating Theatre is the centre of the hospital management's efforts. It constitutes the most expensive sector with more than 10% of the intended operating budget of the hospital. To reduce the costs while maintaining a good quality of care, one of the solutions is to improve the existent planning and scheduling methods by improving the services and surgical specialty coordination or finding the best estimation of surgical case durations. The other solution is to construct an effective surgical case plan and schedule. The operating theatre planning and scheduling is the two important steps, which aim to make a surgical case programming with an objective of obtaining a realizable and efficient surgical case schedule. This paper focuses on the first step, the operating theatre planning problem. Two planning methods are introduced and compared. Real data of a Belgian university hospital "Tivoli" are used for the experiments.

  16. Operating theatre related syncope in medical students: a cross sectional study.

    Science.gov (United States)

    Jamjoom, A A B; Nikkar-Esfahani, A; Fitzgerald, J E F

    2009-03-10

    Observing surgical procedures is a beneficial educational experience for medical students during their surgical placements. Anecdotal evidence suggests that operating theatre related syncope may have detrimental effects on students' views of this. Our study examines the frequency and causes of such syncope, together with effects on career intentions, and practical steps to avoid its occurrence. All penultimate and final year students at a large UK medical school were surveyed using the University IT system supplemented by personal approach. A 20-item anonymous questionnaire was distributed and results were analysed using the Statistical Package for Social Sciences, version 15.0 (Chicago, Illinois, USA). Of the 630 clinical students surveyed, 77 responded with details of at least one near or actual operating theatre syncope (12%). A statistically significant gender difference existed for syncopal/near-syncopal episodes (male 12%; female 88%), p course students with the remaining 78% undergraduate. Mean age was 23-years (range 20 - 45). Of the 77 reactors, 44 (57%) reported an intention to pursue a surgical career. Of this group, 7 (9%) reported being discouraged by syncopal episodes in the operating theatre. The most prevalent contributory factors were reported as hot temperature (n = 61, 79%), prolonged standing (n = 56, 73%), wearing a surgical mask (n = 36, 47%) and the smell of diathermy (n = 18, 23%). The most frequently reported measures that students found helpful in reducing the occurrence of syncopal episodes were eating and drinking prior to attending theatre (n = 47, 61%), and moving their legs whilst standing (n = 14, 18%). Our study shows that operating theatre related syncope among medical students is common, and we establish useful risk factors and practical steps that have been used to prevent its occurrence. Our study also highlights the detrimental effect of this on the career intentions of medical students interested in surgery. Based on these

  17. Bacterial contamination of surgical scrub suits worn outside the operating theatre: a randomised crossover study.

    Science.gov (United States)

    Hee, H I; Lee, S; Chia, S N; Lu, Q S; Liew, A P Q; Ng, A

    2014-08-01

    In this study, we aimed to evaluate the bacterial contamination of surgical scrub suits worn outside the operating theatre. We randomised 16 anaesthetists on separate occasions into one of 3 groups: restricted to the operating theatre only; theatre and surgical wards; and theatre and departmental office. For each group, sample fabric pieces attached to the chest, waist and hip areas of each suit were removed at 150 min intervals between 08:30 and 16:00 on the day of study, and sent for microbiological assessment. Mean bacterial counts increased significantly over the course of the working day (p = 0.036), and were lower in the chest compared to the hip (p = 0.007) and waist areas (p = 0.016). The mean (SD) bacterial counts, expressed as colony-forming units per cm(2) at 16:00 on the day of study, were 25.2 (43.5) for those restricted to theatre and 18.5 (25.9) and 17.9 (31.0) for those allowed out to visit the ward and office, respectively (p = 0.370). We conclude that visits to ward and office did not significantly increase bacterial contamination of scrub suits.

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

    Science.gov (United States)

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

    2017-03-01

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

  19. Novel ways to explore surgical interventions in randomised controlled trials: applying case study methodology in the operating theatre.

    Science.gov (United States)

    Blencowe, Natalie S; Blazeby, Jane M; Donovan, Jenny L; Mills, Nicola

    2015-12-28

    Multi-centre randomised controlled trials (RCTs) in surgery are challenging. It is particularly difficult to establish standards of surgery and ensure that interventions are delivered as intended. This study developed and tested methods for identifying the key components of surgical interventions and standardising interventions within RCTs. Qualitative case studies of surgical interventions were undertaken within the internal pilot phase of a surgical RCT for obesity (the By-Band study). Each case study involved video data capture and non-participant observation of gastric bypass surgery in the operating theatre and interviews with surgeons. Methods were developed to transcribe and synchronise data from video recordings with observational data to identify key intervention components, which were then explored in the interviews with surgeons. Eight qualitative case studies were undertaken. A novel combination of video data capture, observation and interview data identified variations in intervention delivery between surgeons and centres. Although surgeons agreed that the most critical intervention component was the size and shape of the gastric pouch, there was no consensus regarding other aspects of the procedure. They conceded that evidence about the 'best way' to perform bypass was lacking and, combined with the pragmatic nature of the By-Band study, agreed that strict standardisation of bypass might not be required. This study has developed and tested methods for understanding how surgical interventions are designed and delivered delivered in RCTs. Applying these methods more widely may help identify key components of interventions to be delivered by surgeons in trials, enabling monitoring of key components and adherence to the protocol. These methods are now being tested in the context of other surgical RCTs. Current Controlled Trials ISRCTN00786323 , 05/09/2011.

  20. Promoting Inter-Professional Teamwork and Learning--The Case of a Surgical Operating Theatre

    Science.gov (United States)

    Collin, Kaija; Paloniemi, Susanna; Mecklin, Jukka-Pekka

    2010-01-01

    Hospitals, and surgical operating theatres (OTs) in particular, are environments in which inter-professional teamwork and learning are essential to secure patient safety and effective practice. However, it has been revealed in many studies that inter-professional collaborative work in hospital organisations faces many challenges and constraints.…

  1. Operating theatre related syncope in medical students: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Fitzgerald JEF

    2009-03-01

    Full Text Available Abstract Background Observing surgical procedures is a beneficial educational experience for medical students during their surgical placements. Anecdotal evidence suggests that operating theatre related syncope may have detrimental effects on students' views of this. Our study examines the frequency and causes of such syncope, together with effects on career intentions, and practical steps to avoid its occurrence. Methods All penultimate and final year students at a large UK medical school were surveyed using the University IT system supplemented by personal approach. A 20-item anonymous questionnaire was distributed and results were analysed using the Statistical Package for Social Sciences, version 15.0 (Chicago, Illinois, USA. Results Of the 630 clinical students surveyed, 77 responded with details of at least one near or actual operating theatre syncope (12%. A statistically significant gender difference existed for syncopal/near-syncopal episodes (male 12%; female 88%, p Conclusion Our study shows that operating theatre related syncope among medical students is common, and we establish useful risk factors and practical steps that have been used to prevent its occurrence. Our study also highlights the detrimental effect of this on the career intentions of medical students interested in surgery. Based on these findings, we recommend that dedicated time should be set aside in surgical teaching to address this issue prior to students attending the operating theatre.

  2. Occupational exposure to noise in maxillofacial operating theatres: an initial prospective study.

    Science.gov (United States)

    Tay, Brian Diaz; Prabhu, I S; Cousin, C H S; Cousin, G C S

    2016-01-01

    Exposure to excessive noise could impair surgical performance and communication, and lead to long-term hearing loss, but it is only recently that studies on occupational exposure to noise in operating theatres have been published. The aim of this prospective study was to assess mean and peak levels of noise during maxillofacial operations. We found that both were comparable to those in other surgical specialties such as orthopaedics in which power tools are used.

  3. Use of Multimedia Message Service Technology in the Operation Theatre: A Case Report

    Directory of Open Access Journals (Sweden)

    Anurag Tewari

    2008-01-01

    Full Text Available The use of mobile phones has long been controversial in the operation theatres citing various incidences wherein aberration of the electronic equipments has occurred due to their use. We hereby report a case where we used mobile phone to capture a dysrrhythmia occurring intra-operatively in a patient via multimedia messaging service (MMS technology, and sending it to the consultant in charge and a cardiologist via multimedia messaging service(MMS technology and taking immediate remedial action.

  4. Air-conditioning vs. presence of pathogenic fungi in hospital operating theatre environment.

    Science.gov (United States)

    Gniadek, Agnieszka; Macura, Anna B

    2011-01-01

    Infections related to modern surgical procedures present a difficult problem for contemporary medicine. Infections acquired during surgery represent a risk factor related to therapeutical interventions. Eradication of microorganisms from hospital operating theatre environment may contribute to reduction of infections as the laminar flow air-conditioning considerably reduces the number of microorganisms in the hospital environment. The objective of the study was to evaluate the occurrence of fungi in air-conditioned operating theatre rooms. The study was carried out in one of the hospitals in Krak6w during December 2009. Indoor air samples and imprints from the walls were collected from five operating theatre rooms. A total of fifty indoor air samples were collected with a MAS-100 device, and twenty five imprints from the walls were collected using a Count Tact method. Fungal growth was observed in 48 air samples; the average numbers of fungi were within the range of 5-100 c.f.u. in one cubic metre of the air. Fungi were detected only in four samples of the wall imprints; the number of fungi was 0.01 c.f.u. per one square centimetre of the surface. The mould genus Aspergillus was most frequently isolated, and the species A. fumigatus and A. versicolor were the dominating ones. To ensure microbiological cleanness of hospital operating theatre, the air-conditioning system should be properly maintained. Domination of the Aspergillus fungi in indoor air as well as increase in the number of moulds in the samples taken in evenings (p < 0.05) may suggest that the room decontamination procedures were neglected.

  5. [Dampness in an electric plug as a cause of electricity failure in an operation theatre].

    Science.gov (United States)

    Andersen, C; Pold, R; Nielsen, H D

    2000-02-07

    Two cases of electricity failure in an operation theatre during open heart surgery are discussed. The fuse for the patient monitor, ventilator, surgery instruments and heart lung machine was blown. Short-circuit was established because of humidity in the plug of the heater for fluid and blood. We recommend sealed or founded plugs and that anaesthesia equipment should not be used as an electrical supply for other electronic apparatus.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  7. [Military psychiatry in a theatre of operations: on mission in Mali].

    Science.gov (United States)

    Colas, Marie-Dominique

    2015-01-01

    The recent missions of military psychiatrists in the theatres of operation underline the reactivity of the French healthcare system, focused on the expertise of the combat unit doctor. Operation Serval in Mali illustrates in particular the methods of medical-psychological support in exceptional situations, across a vast geographical area and in very difficult climatic conditions. The concept of "forward psychiatry" has a particularly important role to play in the early screening and treatment of psychological disorders in order to preserve the operational capacity of the deployed personnel.

  8. Accreditation and quality approach in operating theatre departments: the French approach.

    Science.gov (United States)

    Soudée, M

    2005-01-01

    Since 1996, French health establishments are subjected to a process of evaluating the quality of care, called "accreditation". This process was controlled by ANAES, which, after January 1st, 2005 became the Haute Autorité de Santé (HAS). The accreditation is characterized by a dual process of self-assessment and external audit, leading to four levels of accreditation. In spite of requiring a time-consuming methodology, this approach provides an important means of consolidating the development of the quality approach and re-stimulating the compliance of establishments with standards of safety and vigilance. The professional teams of many French operating theatre departments have been able to use the regulatory and restricting framework of accreditation to organize quality approaches specific to the operative system, supported by the organizational structures of the department such as the operating suite committee, departmental boards and the steering group. Based on quality guidelines including a commitment from the manager and operating suite committee, as well as a quality flow chart and a quality system, these teams describe the main procedures for running the operating theatre. They also organize the follow-up of incidents and undesirable events, along with the risks and points to watch. Audits of the operative system are planned on a regular basis. The second version of the accreditation process considerably reinforces the assessment of professional practices by evaluating the relevance, the risks and the methods of managing care for pathologies. It will make it possible to implement assessments of the health care provided by operating theatre departments and will reinforce the importance of search for quality.

  9. Modeling and Management of Variation in the Operating Theatre

    NARCIS (Netherlands)

    P.S. Stepaniak (Pieter)

    2010-01-01

    textabstractAfter having worked in the profit industry, I continued my career in 2004 as a manager of operating rooms (ORs) in a large general teaching hospital in Rotterdam. My experiences in industry management taught me to work efficiently, effectively and to excel in service to every customer an

  10. [Difficulties in implementing a surgical check list in operating theatres].

    Science.gov (United States)

    Soria-Aledo, Víctor; Da Silva, ZeNewton Andre; Saturno, Pedro J; Grau-Polan, Marina; Carrillo-Alcaraz, Andrés

    2012-03-01

    To assess the level of implementation and the factors associated with the compliance to the surgical check list (SCL) proposed by the WHO, in surgery departments in public hospitals in the Murcia Region of Spain. A retrospective cross-sectional study was conducted using a random, non-proportional, and stratified sample in each hospital. The sample size was established as 10 cases per centre, with a total of 90 surgical operations. The data analysis included the percentage of compliance of the variables of interest (presence of an SCL and the compliance to it, complete, by sections and by items) at regional level, according to hospital, hospital groups, depending on the size; the type of anaesthesia (local, regional or general); the work shift (morning or afternoon); as well as the age and sex of the surgery patients. The check list was found in the medical records in 75 cases (83.33%; confidence interval [CI]: 78.7% - 87.5%), and complied with in full in 25 cases (27.8%; 95% CI: 18.5% - 37.0%). The percentage of items complied with was 70.1% (95% CI: 67.9%-72.2%). The percentage compliance varied by hospital, from 35.8% to 98.9%. The logistic regression analysis showed significance in the variables such as, the size of the hospital (the list was more likely to be complied with in small and medium hospitals) and operations with local anaesthetic as a negative predictive factor of compliance. The SCL is used, but is not always complied with, and not homogeneously in all its sections. There is also significant variation between the public hospitals in the Murcia Region of Spain. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

  11. [Microbial air purity in hospitals. Operating theatres with air conditioning system].

    Science.gov (United States)

    Krogulski, Adam; Szczotko, Maciej

    2010-01-01

    The aim of this study was to show the influence of air conditioning control for microbial contamination of air inside the operating theatres equipped with correctly working air-conditioning system. This work was based on the results of bacteria and fungi concentration in hospital air obtained since 2001. Assays of microbial air purity conducted on atmospheric air in parallel with indoor air demonstrated that air filters applied in air-conditioning systems worked correctly in every case. To show the problem of fluctuation of bacteria concentration more precisely, every sequences of single results from successive measure series were examined independently.

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

    Science.gov (United States)

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

    2014-03-01

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

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

    DEFF Research Database (Denmark)

    Klein, M.; Andersen, L.P.H.; Alamili, M.

    2010-01-01

    concerning physical and psychological wellbeing before and after surgery and had their heart rate variability registered during surgery. Results: Preoperative to postoperative physical strain and pain measurements revealed a systematical difference with 14 of 15 parameters favoring the modern OR. Two...... of these parameters reached statistical significance. We did not find any significant differences in the subjective parameters of surgeon satisfaction or the measured heart rate variability parameters. Conclusions: Physical strain on the surgeon was reduced when performing laparoscopic cholecystectomy in a modern......Purpose: There have been no studies examining the effect of optimized ergonomic and technical environment on the psychological and physiological stress of the surgeon. The aim of this study was to examine whether optimized ergonomics and technical aids within a modern operating room (OR) affect...

  14. The reduction of pollution. A simple approach to the reduction of pollution in the dental operating theatre.

    Science.gov (United States)

    Johnstone, R D; Willis, B A; Vaughan, R S

    1977-09-01

    This paper describes the construction and evaluation of a simple anti-pollution device for use with the McKesson nasal mask for dental anaesthesia. The device is attached to the expiratory valve of the mask and spilled halothane vapour is adsorbed onto activated charcoal. In theatre use, comparing similar dental anaesthesia sessions, it resulted in a reduction of approximately 78% in the mean halothane concentration (vol./vol.) at a point equidistant from the expiratory valve as the faces of surgeon and anaesthetist. This percentage reduction was consistent with the weight gained by the activated charcoal container (Cardiff 'Aldasorber') compared with the weight of halothane vapourised.

  15. Sinonasal adenoid cystic carcinoma following formaldehyde exposure in the operating theatre.

    Science.gov (United States)

    Sandvik, Anniken; Klingen, Tor Audun; Langård, Sverre

    2014-01-01

    We present a case report of an auxiliary nurse who developed an adenoid cystic carcinoma in her left maxillary sinus following occupational exposure to formaldehyde in the operating theatre. Currently, the epidemiological evidence that formaldehyde can cause cancer in humans is considered to be limited. Previous case-control-studies of formaldehyde and sinonasal cancer have mainly investigated subjects who were concomitantly exposed to wood dust, a known risk factor to the development of sinonasal adenocarcinoma of intestinal type. Our case report presents a patient who has developed an adenoid cystic carcinoma following exposure to formaldehyde. We suggest that the occupational physician remains alert to formaldehyde as an occupational hazard among health care workers.

  16. Microbial contamination of operating Theatre at Ayder Referral Hospital, Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Tewelde Tesfaye

    2015-10-01

    Full Text Available Background: Microbial contamination of the Operating Theatre (OT had continued to increase the prevalence of nosocomial infections. Aim: This study was conducted to assess the level of microbial contamination and to determine the antimicrobial resistance of the bacterial isolates. Settle plate’s method was used for air sample collection while swab method was used to collect samples from surfaces and other articles in the major OT. Collected samples were transported and microbiologically processed using standard procedures. Findings: One hundred twenty air, 36 article and 12 surface samples were taken for microbiological evaluation. The highest level of microbial contamination was detected in the OT air before proper cleaning-fumigation as compared to after the intervention. Moreover, microbial growth was found on surfaces and semi-critical articles. On the other hand articles which were sterilized by autoclave showed no microbial growth. There were five types of bacteria isolated with the highest prevalence of coagulase negative Staphylococci (68; 53.5% followed by Staphylococcus aureus (42; 33.1%. Methicillin resistance S. aureus (MRSA account for 7.7% of the S. aureus isolates. The highest resistance was found against penicillin G and ampicillin with a resistance rate of 52.7%, and 44.5% respectively. Multidrug resistance was observed among 23(36.5% of the bacterial isolates. Conclusion: In general, the results indicate proper cleaning-fumigation of operating theatre significantly reduced the microbial contamination, and bacterial strains such as CoNS, and S. aureus have a greater propensity to cause contamination in OT. Therefore, efforts should be made to ensure strict infection control practices in the OT.

  17. Effects of disruptive surgeon behavior in the operating room.

    Science.gov (United States)

    Cochran, Amalia; Elder, William B

    2015-01-01

    Surgeons are the physician group most commonly identified as "disruptive physicians." The aim of this study was to develop a conceptual model of the results of disruptive surgeon behavior and to identify the coping strategies used by perioperative staff. Perspectives of 19 individuals of diverse occupations in the perioperative setting were drawn together using a grounded theory methodology. Effects of disruptive behavior described by participants included shift in attention from the patient to the surgeon, increased mistakes during procedures, deterrence from careers in surgery, and diminished respect for surgeons. Individual coping strategies employed in the face of intimidation include talking to colleagues, externalizing the behavior, avoidance of perpetrators, and warning others. Using grounded theory analysis, we were able to elucidate the impact of disruptive surgeon behavior in the perioperative environment. This conceptual model may be used to understand and counter the negative effects of manipulation and intimidation of hospital staff and trainees and to build on current programmatic strengths to improve surgical environments and training. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Per-operative X-ray radiotherapy: personnel radiation protection in the operating theatre suite; Radiotherapie peroperatoire par rayons X: radioprotection du personnel au bloc operatoire

    Energy Technology Data Exchange (ETDEWEB)

    Lisbona, A.; Josset-Gaudaire, S.; Brunet, G.; Delpon, G. [ICO Centre Rene-Gauducheau, Saint-Herblain (France)

    2011-10-15

    The authors report the radioprotection study required in the exploitation authorization file associated with the putting into service of the Zeiss Meditec Intrabeam system. After having evoked the characteristics of this equipment (power, dose rate, treatment duration) and some characteristics of the building, they report the results of the zoning and workstation study. Two situations have assessed: the operator is present in the operating theatre suite behind a leaded screens, or stands outside of the operating theatre suite. The received dose is assessed on a basis of 50 treatments a year. Dose rate levels comply with personnel radiation protection requirements. Short communication

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

    Directory of Open Access Journals (Sweden)

    Volkan Yüksel

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

  20. Surgical smoke - a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units.

    Science.gov (United States)

    Hill, D S; O'Neill, J K; Powell, R J; Oliver, D W

    2012-07-01

    Surgeons and operating theatre personnel are routinely exposed to the surgical smoke plume generated through thermal tissue destruction. This represents a significant chemical and biological hazard and has been shown to be as mutagenic as cigarette smoke. It has previously been reported that ablation of 1 g of tissue produces a smoke plume with an equivalent mutagenicity to six unfiltered cigarettes. We studied six human and 78 porcine tissue samples to find the mass of tissue ablated during 5 min of monopolar diathermy. The total daily duration of diathermy use in a plastic surgery theatre was electronically recorded over a two-month period. On average the smoke produced daily was equivalent to 27-30 cigarettes. Our survey of smoke extractor use in UK plastic surgery units revealed that only 66% of units had these devices available. The Health and Safety Executive recommend specialist smoke extractor use, however they are not universally utilised. Surgical smoke inhalation is an occupational hazard in the operating department. Our study provides data to quantify this exposure. We hope this evidence can be used together with current legislation to make the use of surgical smoke extractors mandatory to protect all personnel in the operating theatre.

  1. The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre.

    Science.gov (United States)

    McCulloch, P; Mishra, A; Handa, A; Dale, T; Hirst, G; Catchpole, K

    2009-04-01

    Unintended harm to patients in operating theatres is common. Correlations have been demonstrated between teamwork skills and error rates in theatres. This was a single-institution uncontrolled before-after study of the effects of "non-technical" skills training on attitudes, teamwork, technical performance and clinical outcome in laparoscopic cholecystectomy (LC) and carotid endarterectomy (CEA) operations. The setting was the theatre suite of a UK teaching hospital. Attitudes were measured using the Safety Attitudes Questionnaire (SAQ). Teamwork was scored using the Oxford Non-Technical Skills (NOTECHS) method. Operative technical errors (OTEs), non-operative procedural errors (NOPEs), complications, operating time and length of hospital stay (LOS) were recorded. A 9 h classroom non-technical skills course based on aviation "Crew Resource Management" (CRM) was offered to all staff, followed by 3 months of twice-weekly coaching from CRM experts. Forty-eight procedures (26 LC and 22 CEA) were studied before intervention, and 55 (32 and 23) afterwards. Non-technical skills and attitudes improved after training (NOTECHS increase 37.0 to 38.7, t = -2.35, p = 0.021, SAQ teamwork climate increase 64.1 to 69.2, t = -2.95, p = 0.007). OTEs declined from 1.73 to 0.98 (u = 1071, p = 0.009), and NOPEs from 8.48 to 5.16 per operation (t = 4.383, pbenefit.

  2. Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

    Science.gov (United States)

    Romano, Francesco; Gustén, Jan; De Antonellis, Stefano; Joppolo, Cesare M.

    2017-01-01

    Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems. PMID:28146089

  3. Microbial air monitoring in the operating theatres of Salam Center for Cardiac Surgery in Khartoum (Sudan

    Directory of Open Access Journals (Sweden)

    Margherita Scapaticci

    2012-06-01

    Full Text Available The seriousness of postoperative infections and the increased susceptibility of patients undergoing cardiac surgery increase the demand for the operating theatre (OT asepsis to prevent bacterial infections. In fact, the organisms carried by the air reach the wound after having sedimented onto sterile field. The air represents a critical point for quality control of air filtration systems, for sanitization procedures and for the evolution of hygienic features of the OT environment.Aim of the study is to evaluate the prevalence of microorganisms found in the operating rooms (OR air monitoring in the Salam Center for Cardiac Surgery of Khartoum (Sudan between July 2008 and March 2009.The specimens were collected every month in two different times: “OR at rest” (after sanitization and “OR operational”, using sedimentation method (Fisher 1972. Results showed that each sample collected at rest had IMA (index of microbial air contamination < 5CFU/plt, whereas the bacterial growth was between 25 and 50 CFU/plt when the samples had been collected in the same places during operating activities.This indicate the effectiveness of sanitization procedures and confirm that people working in OT are an important source of bacteria causing postoperative infections. Coagulase negative Staphylococci, Gram negative bacillus and Staphylococcus aureus spp. were the predominant organisms isolated.

  4. Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

    Directory of Open Access Journals (Sweden)

    Francesco Romano

    2017-01-01

    Full Text Available Air cleanliness in operating theatres (OTs is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.

  5. Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres.

    Science.gov (United States)

    Romano, Francesco; Gustén, Jan; De Antonellis, Stefano; Joppolo, Cesare M

    2017-01-30

    Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel's exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.

  6. Safety in the operating theatre--a transition to systems-based care.

    Science.gov (United States)

    Weiser, Thomas G; Porter, Michael P; Maier, Ronald V

    2013-03-01

    All surgeons want the best, safest care for their patients, but providing this requires the complex coordination of multiple disciplines to ensure that all elements of care are timely, appropriate, and well organized. Quality-improvement initiatives are beginning to lead to improvements in the quality of care and coordination amongst teams in the operating room. As the population ages and patients present with more complex disease pathology, the demands for efficient systematization will increase. Although evidence suggests that postoperative mortality rates are declining, there is substantial room for improvement. Multiple quality metrics are used as surrogates for safe care, but surgical teams--including surgeons, anaesthetists, and nurses--must think beyond these simple interventions if they are to effectively communicate and coordinate in the face of increasing demands.

  7. Monitoring the anaesthetist in the operating theatre - professional competence and patient safety.

    Science.gov (United States)

    Larsson, J

    2017-01-01

    This article about competence and patient safety in anaesthesia was inspired by a statement in the 2015 AAGBI guidelines on monitoring during anaesthesia: 'the presence of an appropriately trained and experienced anaesthetist is important for patient safety during anaesthesia'. The review starts with a structured description of competence, presenting five dimensions of it; the first two dimensions are identical with the two classical attributes of competence, practical skills and theoretical knowledge. Concerning skills, the value of aiming for a high level of proficiency early in a traning programme is pointed out, and deliberate practice is given as an example of a pedagogical model where aiming for excellence is a core idea. For theoretical knowledge, the value of a deep approach to learning physiology and basic sciences is stressed. The third dimension (anaesthetists' non-technical skills), represents skills necessary for good team-work in the operating theatre. The two last dimensions of competence are the understanding of work and intuitive expert knowing. Understanding work means being aware of what the work is about, appreciating the different aspects of the anaesthetist's job. Intuitive expert knowing, lastly, concerns the tacit dimension of knowledge and skills, which enables professional experts to quickly find a working solution for most clinical problems. The final part of the review is about the 'when' and 'how' of competence assessment. The main message is the importance of assessing the competence of clinically active anaesthetists regularly during their whole career. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  8. Is fumigation enough for air conditioning units in operation theatres and Intensive care units?

    Directory of Open Access Journals (Sweden)

    Anasua Deb

    2016-05-01

    Full Text Available Background: Strict asepsis is necessary in operating theatres (OT and intensive care units (ICU as the patients undergo invasive procedures. The filters of contaminated air conditioning (AC units provide a niche for proliferation of fungi and production of fungal spores. Methods: The routine procedure for maintenance of sterile atmosphere in our hospital, i.e. fumigation and mopping walls with disinfectants often fail to address these fungal spores of the AC filters. We therefore carried out a surveillance of the ACs in ICUs and OTs to find the level of contamination with fungal spores and also to improvise on intervention strategies to tackle the problem. Over 3 months period, 34 ACs from 7 OTs and 2 ICUs were screened by taking 2 swabs from each AC which were then tested for the presence of fungal spores as per standard methods. Results: The contamination rate was 88.2% before fumigation and 76.9% after fumigation. The fungal spore contamination rate was reduced to 20% (1 out of 5 ACs after servicing of the ACs was done. Aspergillus spp. was the most common fungal isolate. Conclusion: Based on the observations, we recommend regular servicing of the ACs as well as wet mopping of the ducts with sporicidal solution at regular intervals. [Int J Res Med Sci 2016; 4(5.000: 1583-1589

  9. Leo Doyle, master surgeon.

    Science.gov (United States)

    Vellar, I

    2000-10-01

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

  10. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

    Science.gov (United States)

    Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

    2010-01-01

    Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

  11. Air sampling procedures to evaluate microbial contamination: a comparison between active and passive methods in operating theatres

    Directory of Open Access Journals (Sweden)

    Napoli Christian

    2012-08-01

    Full Text Available Abstract Background Since air can play a central role as a reservoir for microorganisms, in controlled environments such as operating theatres regular microbial monitoring is useful to measure air quality and identify critical situations. The aim of this study is to assess microbial contamination levels in operating theatres using both an active and a passive sampling method and then to assess if there is a correlation between the results of the two different sampling methods. Methods The study was performed in 32 turbulent air flow operating theatres of a University Hospital in Southern Italy. Active sampling was carried out using the Surface Air System and passive sampling with settle plates, in accordance with ISO 14698. The Total Viable Count (TVC was evaluated at rest (in the morning before the beginning of surgical activity and in operational (during surgery. Results The mean TVC at rest was 12.4 CFU/m3 and 722.5 CFU/m2/h for active and passive samplings respectively. The mean in operational TVC was 93.8 CFU/m3 (SD = 52.69; range = 22-256 and 10496.5 CFU/m2/h (SD = 7460.5; range = 1415.5-25479.7 for active and passive samplings respectively. Statistical analysis confirmed that the two methods correlate in a comparable way with the quality of air. Conclusion It is possible to conclude that both methods can be used for general monitoring of air contamination, such as routine surveillance programs. However, the choice must be made between one or the other to obtain specific information.

  12. Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

    2006-01-01

    Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should......OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior...

  13. Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Krasheninnikoff, Michael

    2006-01-01

    Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should......OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal...... rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior...

  14. Google Glass in the Operating Room: The Plastic Surgeon's Perspective.

    Science.gov (United States)

    Sinkin, Jeremy C; Rahman, Omar F; Nahabedian, Maurice Y

    2016-07-01

    New technologies and innovations are common in the delivery of modern health care. Google Glass is one such device gaining increased attention in medical specialties. The authors surveyed residents and attending physicians in the Department of Plastic Surgery, MedStar Georgetown University Hospital, on their experience using Google Glass in the operating room. Ease of use, quality of images, gaze disruption, and distraction during surgery were measured. Overall, subjects found the device to be comfortable and satisfying to wear and use during surgery to capture images of good quality. Despite some identified weaknesses, Google Glass is a unique technology with a promising plastic surgical application in the operating room.

  15. Best practice: surgeon driven application in pelvic operations

    Directory of Open Access Journals (Sweden)

    Krueger Thilo B.

    2016-09-01

    Full Text Available In applied biomedical engineering and medical industry the transfer of established technology towards customers’ needs is essential for successful development and therefore business opportunities. In chronological order, we can show the transfer of scientific results of neurophysiological research into an existing neuromonitoring system and product which can be used by non-experts in medical technology in the operating room environment. All neurophysiology functions were realized in an intuitive graphical user interface. To stimulate the autonomous nerves, a specialized parameter paradigm was used, different from motor nerve stimulation. In the background, a complex signal processing algorithm recorded smooth muscle and bladder manometry data in synchronized time and automatically detected neurophysiological signals. The acquired data was then presented in real-time. With this effort a complex scientific task could be simplified to a Yes/No statement to the end-user. Beside all the reduction of complexity, the scientific challenge was still obtained, as raw-data is still possible to be recorded.

  16. Spatial awareness in robotic theatre.

    Science.gov (United States)

    Ark, Sandip; Williams, Joanne

    2016-03-01

    As surgical and anaesthetic procedures become more complex, operating theatres need to be larger and multi-purpose to accommodate specialist equipment such as the Da Vinci Robot. The Da Vinci theatre at The Royal Wolverhampton NHS trust (RWT) is a modern theatre equipped and designed specifically for robotic surgery. When we first began to perform robotic surgery at RWT we faced many challenges on how to maximise the space available to us, whilst striving to minimise the chance of desterilisation.

  17. A study to assess the influence of interprofessional point of care simulation training on safety culture in the operating theatre environment of a university teaching hospital.

    Science.gov (United States)

    Hinde, Theresa; Gale, Thomas; Anderson, Ian; Roberts, Martin; Sice, Paul

    2016-01-01

    Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.

  18. Workflow Driven Decision Support Systems: A case of an intra-operative visualization system for surgeons

    NARCIS (Netherlands)

    Jalote-Parmar, A.

    2009-01-01

    Inadequate visualization during Minimally Invasive Surgeries (MIS) has led several technology research labs to develop decision support systems such as Intra-operative Visualization Systems (IVS). IVS focuses on providing surgeons with real-time imaging support to improve task visualization and

  19. Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings.

    Science.gov (United States)

    Badran, K; Ansari, S; Al Sam, R; Al Husami, Y; Iyer, A

    2016-01-01

    This study aimed to compare the interpretations of temporal bone computed tomography scans by an otologist and a radiologist with a special interest in temporal bone imaging. It also aimed to determine the usefulness of this imaging modality. A head and neck radiologist and an otologist separately reported pre-operative computed tomography images using a structured proforma. The reports were then compared with operative findings to determine their accuracy and differences in interpretations. Forty-eight patients who underwent pre-operative computed tomography scans in a 30-month period were identified. Six patients were excluded because complete operative findings had not been recorded. Positive and negative predictive values and accuracy of the anatomical and pathological findings were calculated for 42 patients by both reporters. The accuracy was found to be less than 80 per cent, except for identification of the tegmen and lateral semicircular canal erosion. Overall, there was no significant difference in interpretations of computed tomography scans between reporters. There was a slight difference in interpretation for tympanic membrane retraction, facial canal erosion and lateral semicircular canal fistula and/or erosion. Pre-operative computed tomography scanning of the temporal bone is useful for predicting anatomy for surgical planning in patients with chronic otitis media, but its reliability remains questionable.

  20. Outcomes of Concurrent Operations: Results From the American College of Surgeons' National Surgical Quality Improvement Program.

    Science.gov (United States)

    Liu, Jason B; Berian, Julia R; Ban, Kristen A; Liu, Yaoming; Cohen, Mark E; Angelos, Peter; Matthews, Jeffrey B; Hoyt, David B; Hall, Bruce L; Ko, Clifford Y

    2017-09-01

    To determine whether concurrently performed operations are associated with an increased risk for adverse events. Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety. Propensity-score-matched cohorts were constructed to compare death or serious morbidity (DSM), unplanned reoperation, and unplanned readmission in concurrent versus non-concurrent operations. Multilevel hierarchical regression was used to account for the clustered nature of the data while controlling for procedure and case mix. There were 1430 (32.3%) surgeons from 390 (77.7%) hospitals who performed 12,010 (2.3%) concurrent operations. Plastic surgery (n = 393 [13.7%]), otolaryngology (n = 470 [11.2%]), and neurosurgery (n = 2067 [8.4%]) were specialties with the highest proportion of concurrent operations. Spine procedures were the most frequent concurrent procedures overall (n = 2059/12,010 [17.1%]). Unadjusted rates of DSM (9.0% vs 7.1%; P continuous self-regulation and proactive disclosure to patients.

  1. Reducing returns to theatre for neck of femur fracture patients.

    Science.gov (United States)

    Graham, Selina; Dahill, Mark; Robinson, Derek

    2017-01-01

    The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians. The plan-do-study-act model for improvement was used to reduce rates of returns to theatre for wound ooze. Interventions included cyclical teaching during each trainee rotation, updated inductions, posters, email reminders and scrub team involvement to open the protocol sutures unprompted. The primary outcome measure was returns to theatre for wound complications. Baseline data showed 4 returns to theatre over a two month period (4.40% of patients). Length of stay for each patient affected by wound ooze was also compared to the departmental mean. In the 6 month intervention period there was one return to theatre (0.36% of patients). The observed reduction saved the department an estimated £13,831 in length of stay alone. The standardisation of wound closure protocol, with continued reinforcement to all members of the multidisciplinary team, improves patient outcome in this group. Mobilising a group of clinicians across a variety of specialities, with one common goal, is highly effective for patients, improves multidisciplinary working and reduces cost.

  2. A family operation: plastic surgeons who perform aesthetic surgery on spouses or other family members.

    Science.gov (United States)

    Slavin, Sara A; Slavin, Sumner A; Goldwyn, Robert M

    2010-03-01

    The purpose of this study was to investigate whether plastic surgeons would perform elective cosmetic surgery on spouses or other family members and how many have done so, the type of procedures, the circumstances under which the surgery took place, and the results. Participants were 465 members of the American Society for Aesthetic Plastic Surgery, representing 30.7 percent of the overall sample pool of 1513 members recruited through anonymous, voluntary participation in an online survey. Approximately half (51.8 percent) were 51 to 65 years old, most were men (91.2 percent), and most were from large urban areas; respondents had been in practice for 1 to 40 years. The plastic surgeons who returned the survey were comfortable performing elective cosmetic procedures on family members, the majority having already done so. Eighty-eight percent reported they would operate on a spouse or other family member, and 83.9 percent reported they already had. The main motivation (67 percent) was their belief that they were the best surgeon for the procedure. The most commonly listed operations were rhinoplasty, abdominoplasty, eyelidplasty, face lift, breast augmentation, and liposuction. Patients included spouses, children, parents, cousins, and in-laws, ranging from teenaged males to women in their 70s. The overwhelming majority (94.2 percent) reported no complications, and 99.5 percent believed the patients were satisfied with their outcome. Survey participants are comfortable with the idea of performing elective cosmetic procedures on family members. Regardless of the invasiveness of the procedure or their relationship with the patient, respondents reported no complications and a high level of patient satisfaction anomalous for any patient-surgeon sample, suggesting that surgeons who operate on family members hold confident opinions of their surgical skills and results.

  3. Object theatre

    DEFF Research Database (Denmark)

    Ryöppy, Merja; Heiberg, Andreas

    2015-01-01

    possibilities to emerge. We present a study in which the Object Theatre approach is applied to redesign socially shared everyday products that are located in public places. This project demonstrates how Object Theatre offers a broad perspective form which to explore and present product interactions....... In particular, it emphasises the understanding of a product by relating and changing perspectives, and takes into account context of use and diverse social settings....

  4. Beyond the Theatre of Military Operations: the Monuments of the Crimean War in Simferopol and Bakhchisaray

    Directory of Open Access Journals (Sweden)

    Nikolay A. Syedin

    2016-12-01

    Full Text Available The article is devoted to the events that took place on the Crimean peninsula during the Eastern War (1853-1856 beyond the main battle fields. The author describes overall picture of what was happening in the Crimean cities on the background of heroic defense of Sevastopol, names cities which experienced invasion and tells about the consequences of their occupation. The article mainly focuses on Simferopol and Bakhchisaray as the front-line cities that played a significant role in defense of Sevastopol and experienced all the consequences of military actions on the Crimean peninsula. The author names the famous participants of the Crimean War whose lives were closely connected with those cities, and tells about historical monuments related to the events of those years. The aforementioned participants include the famous writers L. N. Tolstoy and N. V. Berg, who spent significant amount of time in those cities during the war. Another personality that draws the author’s close attention is N.I. Pirogov, a surgeon whose professional activity on the peninsula at that time was tightly connected with Simferopol. The article also tells about active participants of military operations – generals P.A. Vrevskiy and P.V. Veimarn who lost their lives during the battle at the Chornaya river and were buried in Bakhchisaray. The author believes that knowledge of events that were happening on the entire territory of the Crimean peninsula substantially improves our understanding of the scale of the Crimean War, reveals the drama of the War and its impact on nations, cities and individuals – whether well-known to us or not – and provides additional material for patriotic education. The article describes in detail the work on preservation of memorials of the Crimean War and promotes the attitude of care towards the monuments located all over the Crimean peninsula.

  5. Determination of contamination of a chemical warfare-proof operating theatre with volatile anaesthetic agents and assessment of anaesthetic gas scavenging systems.

    Science.gov (United States)

    Yoganathan, S; Johnston, I G; Parnell, C J; Houghton, I T; Restall, J

    1991-11-01

    Three types of anaesthetic waste scavenging systems (active antipollution system, Papworth Block passive system and activated charcoal absorber system) were compared with a non-scavenging control to assess their effectiveness in reducing waste halothane concentrations in a chemical warfare-proof operating theatre. All three systems were found to reduce the level of pollution significantly.

  6. People's Theatre in Amerika.

    Science.gov (United States)

    Taylor, Karen Malpede

    A history of the people's theatre movement in this country from the early 1920s to the early 1970s, this book deals with the structural and thematic connections between the radical theatre of the twenties and thirties and current work of such revolutionary theatres as the Living Theatre, Open Theatre, Bread and Puppet Theatre, El Teatro Campesino,…

  7. People's Theatre in Amerika.

    Science.gov (United States)

    Taylor, Karen Malpede

    A history of the people's theatre movement in this country from the early 1920s to the early 1970s, this book deals with the structural and thematic connections between the radical theatre of the twenties and thirties and current work of such revolutionary theatres as the Living Theatre, Open Theatre, Bread and Puppet Theatre, El Teatro Campesino,…

  8. Spine surgeon's kinematics during discectomy, part II: operating table height and visualization methods, including microscope.

    Science.gov (United States)

    Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2014-05-01

    Surgeon spine angle during surgery was studied ergonomically and the kinematics of the surgeon's spine was related with musculoskeletal fatigue and pain. Spine angles varied depending on operation table height and visualization method, and in a previous paper we showed that the use of a loupe and a table height at the midpoint between the umbilicus and the sternum are optimal for reducing musculoskeletal loading. However, no studies have previously included a microscope as a possible visualization method. The objective of this study is to assess differences in surgeon spine angles depending on operating table height and visualization method, including microscope. We enrolled 18 experienced spine surgeons for this study, who each performed a discectomy using a spine surgery simulator. Three different methods were used to visualize the surgical field (naked eye, loupe, microscope) and three different operating table heights (anterior superior iliac spine, umbilicus, the midpoint between the umbilicus and the sternum) were studied. Whole spine angles were compared for three different views during the discectomy simulation: midline, ipsilateral, and contralateral. A 16-camera optoelectronic motion analysis system was used, and 16 markers were placed from the head to the pelvis. Lumbar lordosis, thoracic kyphosis, cervical lordosis, and occipital angle were compared between the different operating table heights and visualization methods as well as a natural standing position. Whole spine angles differed significantly depending on visualization method. All parameters were closer to natural standing values when discectomy was performed with a microscope, and there were no differences between the naked eye and the loupe. Whole spine angles were also found to differ from the natural standing position depending on operating table height, and became closer to natural standing position values as the operating table height increased, independent of the visualization method

  9. Backstage in the theatre.

    Science.gov (United States)

    Tanner, J; Timmons, S

    2000-10-01

    Observations undertaken in the operating theatre suggested that the social environment, and certain forms of staff behaviour could be explained using the space analysis developed by Erving Goffman (1969) in The Presentation of Self in Everyday Life. In the study reported in this paper the theatre department was found to be a strongly 'backstage' area. However, it was also found that there were limits to this analysis, and these are explained within this article. Some practical suggestions as to how this analysis might be helpful in the management of health care institutions and the education of health care professionals are made.

  10. Using a videogame to facilitate nursing and medical students' first visit to the operating theatre. A randomized controlled trial.

    Science.gov (United States)

    Del Blanco, Ángel; Torrente, Javier; Fernández-Manjón, Baltasar; Ruiz, Pedro; Giner, Manuel

    2017-08-01

    First experiences in the operating theatre with real patients are always stressful and intimidating for students. We hypothesized that a game-like simulation could improve perceptions and performance of novices. A videogame was developed, combining pictures and short videos, by which students are interactively instructed on acting at the surgical block. Moreover, the game includes detailed descriptive information. After playing, students are given feedback on their performance. A randomized controlled trial was conducted with 132 nursing and medical students with no previous experience in surgery. Sixty two (47.0%) were allocated to a control group (CG) and 70 (53.0%) to an experimental group (EG). Subjects in EG played the game the day prior to their first experience in the theatre; CG had no access to the application. On the day after their experience at surgery, all students filled in a questionnaire in a 7-point Likert format collecting subjective data about their experience in the surgical block. Four constructs related to students' feelings, emotions and attitudes were measured through self-reported subjective scales, i.e. C1: fear to make mistakes, C2: perceived knowledge on how to behave, C3: perceived errors committed, and C4: attitude/behaviour towards patients and staff. The main research question was formulated as follows: do students show differences in constructs C1-C4 by exposure to the game? EG reported statistically significant higher scores on the four aspects measured than CG (p<0.05; Mann-Whitney U tests; Cohen's d standardized effect size d1=0.30; d2=1.05; d3=0.39; d4=0.49). Results show clear evidence that the exposure to the game-like simulation had a significant positive effect on all the constructs. After their first visit to the theatre, students in EG showed less fear (C1) and also perceived to have committed fewer errors (C3), while they showed higher perceived knowledge (C2) and a more collaborative attitude (C4). Copyright © 2017

  11. Numerical simulation of the impact of surgeon posture on airborne particle distribution in a turbulent mixing operating theatre

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Afshari, Alireza; Karimipanah, Taghi;

    2016-01-01

    Highlights •Airborne particles released from surgical team members are major sources of surgical site infections. •Effect of surgeon’s posture on particle distribution within the surgical area is not well known and documented. •Mobile laminar units were investigated as an addition to conventional...

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

    Science.gov (United States)

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

    2016-08-19

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

  13. Evaluation of the new C-arm guiding system ClearGuide® in an orthopaedic and trauma operating theatre.

    Science.gov (United States)

    Müller, Marcus Christian; Frege, Sophie; Strauss, Andreas Christian; Gathen, Martin; Windemuth, Michael; Striepens, Eva Nadine

    2017-04-03

    The objective was to evaluate whether the new intraoperative C-arm guiding system ClearGuide® (CG) reduces radiation exposure of the staff in an Orthopaedic and Trauma operation theatre. Data of 95 patients CG was used were retrospectively compared using matched-pair analysis with controls without CG. Radiation dose (RD), fluoroscopic time (FT) and operation time (OT) were analysed in ten types of operative procedures. Use of CG led to a significant reduction (p ≤ 0.05) of the RD in intramedullary nailing and plate fixation of femoral shaft fractures as well as plating of tibia shaft fractures. Concerning FT, use of CG led to a significant reduction (p ≤ 0.05) while performing kyphoplasties and plate fixation of femoral shaft fractures. Regarding OT, no statistical significance was observed. CG as a simple, reproducible and intuitive communication tool for C-arm guidance reduces intraoperative staff radiation exposure especially while fixation of long bone fractures and in spine surgery. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Robotic invasion of operation theatre and associated anaesthetic issues: A review.

    Science.gov (United States)

    Kakar, Prem N; Das, Jyotirmoy; Roy, Preeti Mittal; Pant, Vijaya

    2011-01-01

    A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA) for use in space exploration. Today's medical robotic systems were the brainchild of the United States Department of Defence's desire to decrease war casualties with the development of 'telerobotic surgery'. The 'master-slave' telemanipulator concept was developed for medical use in the early 1990s where the surgeon's (master) manual movements were transmitted to end-effector (slave) instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the 'Patient'. Anaesthesiologists as always must do their part to be the patient's 'best man' in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.

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

    Science.gov (United States)

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

    2012-12-01

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

  16. The relationship between in-hospital mortality, readmission into the intensive care nursing unit and/or operating theatre and nurse staffing levels.

    Science.gov (United States)

    Diya, Luwis; Van den Heede, Koen; Sermeus, Walter; Lesaffre, Emmanuel

    2012-05-01

      The aim of this article was to assess the relationship between (1) in-hospital mortality and/or (2) unplanned readmission to intensive care units or operating theatre and nurse staffing variables.   Adverse events are used as surrogates for patient safety in nurse staffing and patient safety research. A single adverse event cannot adequately capture the multi-dimensional attributes of patient safety; hence, there is a need to consider composite measures. Unplanned readmission into the postoperative Intensive Care nursing unit and/or operating Theatre and in-hospital mortality can be viewed as measures that incorporate the effects of several adverse events.   We conducted a Bayesian multilevel analysis on a subset of the 2003 Belgian Hospital Discharge and Nursing Minimum Data sets. The sample included 9054 patients who underwent coronary artery bypass surgery or heart valve procedures from 28 Belgian acute hospitals. Two proxies of patient safety were considered, namely postoperative in-hospital mortality in the first postoperative intensive care unit and unplanned readmission into the intensive care and/or operating theatre (including mortality beyond the first postoperative intensive care unit) after the first-operative intensive care nursing unit.   There is an association between in-hospital mortality and/or unplanned readmissions and nurse staffing levels, but the relationship is moderated by volume and severity of illness respectively. In addition, the relationship differs between the two endpoints.   Higher nurse staffing levels on postoperative general nursing cardiac surgery units protected patients from unplanned readmission to intensive care units or operating theatre and in-hospital mortality. © 2011 Blackwell Publishing Ltd.

  17. ¿Es posible tener un incendio en un quirófano? Is it possible to have a fire in an operating theatre?

    Directory of Open Access Journals (Sweden)

    Juan José Agún González

    2010-03-01

    Full Text Available Podemos pensar que un quirófano es el Sancta Sanctorum de un Hospital, el sitio más "seguro" dentro del entorno más controlado, en todos los aspectos. Pero, es un hecho contrastado, aunque no siempre difundido, que los incendios en quirófano existen y suelen ser por causas internas al propio quirófano. Durante una intervención quirúrgica tenemos una posibilidad de sufrir un incendio en el momento más peligroso de la vida de un paciente y crear una situación de emergencia en un área crítica. Los objetivos de esta investigación son: - Incidir en la posibilidad de tener un incendio en quirófano. - Analizar las posibilidades del riesgo. - Detectar conductas y elementos peligrosos. - Analizar las medidas preventivas a adoptar.We might think that an operating theatre is the sanctum sanctorum of a Hospital. The 'safest' place within a very much controlled environment in all aspects. But it is a contrasted fact, although not always published, that fires in operating theatres exist and that they are normally caused by situations in the operating theatre itself. During an operation there is the possibility of having a fire in the most dangerous moment for the life of a patient and in the most critical zones of a hospital. The objectives of this research are the following: - To emphasize the possibility of fire in an operating theatre - To analyse the possibilities of risk - To detect hazardous elements and behaviour - To analyse the preventive measures to be adopted

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

    Science.gov (United States)

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

    2015-08-01

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

  19. A comparison study of radiation exposure to patients during EVAR and Dyna CT in an angiosuite vs. an operating theatre.

    Science.gov (United States)

    Bruschi, Andrea; Michelagnoli, Stefano; Chisci, Emiliano; Mazzocchi, Silvia; Panci, Simone; Didona, Annamaria; Ghirelli, Alessandro; Zatelli, Giovanna

    2015-03-01

    The aim of this study was to assess the patient dosimetric impact of endovascular abdominal aortic aneurysm repair (EVAR), both in an operating theatre (OR) and in an angiosuite (AS), with the facility of Dynamic CT (Dyna CT, Siemens AG, Berlin, Germany). One hundred and forty-six consecutive EVAR procedures dating from May 2011 to March 2013 were analysed. These were performed either in an OR (n = 97) using a mobile C-arm or in an AS (n = 49) equipped with a ceiling-mounted angiography system. Air kerma area product (P(KA)) and total air kerma at reference point (K(a,r)) values were reported for all procedures and Dyna CT. Radiation exposure during EVAR was quite low in the majority of patients but nearly 50 % higher if performed in AS vs. OR. Median Dyna CT K(a,r) was the same as an entire EVAR procedure in OR. The higher patient's radiation exposure recorded in the AS should be balanced with the technical advantages given to the EVAR procedure.

  20. Uptake of a team briefing in the operating theatre: a Burkean dramatistic analysis.

    Science.gov (United States)

    Whyte, Sarah; Cartmill, Carrie; Gardezi, Fauzia; Reznick, Richard; Orser, Beverley A; Doran, Diane; Lingard, Lorelei

    2009-12-01

    Communication among healthcare professionals is a focus for research and policy interventions designed to improve patient safety, but the challenges of changing interprofessional communication patterns are rarely described. We present an analysis of 756 preoperative briefings conducted by general surgery teams (anesthesiologists, nurses, and surgeons) at four urban Canadian hospitals in the context of two research studies conducted between August 2004 and December 2007. We ask the questions: how and why did briefings succeed, how and why did they fail, and what did they mean for different participants? Ethnographic fieldnotes documenting the coordination and performance of team briefings were analyzed using Kenneth Burke's concepts of motive and attitude. The language and behaviour of participants were interpreted as purposive and situated actions which reveal perceptions, beliefs and values. Motives and attitudes varied both within and across sites, professions, individuals, and briefings. They were contingent on the organizational, medical and social scenes in which the briefings took place and on participants' multiple perceived purposes for participating (protecting patient safety, exchanging information, engaging with the team, fulfilling professional commitments, participating in research, and meeting social expectations). Participants' attitudes reflected their recognition (or rejection) of specific purposes, the briefings' perceived effectiveness in serving these purposes, and the briefings' perceived alignment (or conflict) with other priorities. Our findings illustrate the intrinsically rhetorical and variable nature of change.

  1. Robotic invasion of operation theatre and associated anaesthetic issues: A review

    Directory of Open Access Journals (Sweden)

    Prem N Kakar

    2011-01-01

    Full Text Available A Robotic device is a powered, computer controlled manipulator with artificial sensing that can be reprogrammed to move and position tools to carry out a wide range of tasks. Robots and Telemanipulators were first developed by the National Aeronautics and Space Administration (NASA for use in space exploration. Today′s medical robotic systems were the brainchild of the United States Department of Defence′s desire to decrease war casualties with the development of ′telerobotic surgery′. The ′master-slave′ telemanipulator concept was developed for medical use in the early 1990s where the surgeon′s (master manual movements were transmitted to end-effector (slave instruments at a remote site. Since then, the field of surgical robotics has undergone massive transformation and the future is even brighter. As expected, any new technique brings with it risks and the possibility of technical difficulties. The person who bears the brunt of complications or benefit from a new invention is the ′Patient′. Anaesthesiologists as always must do their part to be the patient′s ′best man′ in the perioperative period. We should be prepared for screening and selection of patients in a different perspective keeping in mind the steep learning curves of surgeons, long surgical hours, extreme patient positioning and other previously unknown anaesthetic challenges brought about by the surgical robot. In this article we have tried to track the development of surgical robots and consider the unique anaesthetic issues related to robot assisted surgeries.

  2. Optimization and planning of operating theatre activities: an original definition of pathways and process modeling.

    Science.gov (United States)

    Barbagallo, Simone; Corradi, Luca; de Ville de Goyet, Jean; Iannucci, Marina; Porro, Ivan; Rosso, Nicola; Tanfani, Elena; Testi, Angela

    2015-05-17

    The Operating Room (OR) is a key resource of all major hospitals, but it also accounts for up 40% of resource costs. Improving cost effectiveness, while maintaining a quality of care, is a universal objective. These goals imply an optimization of planning and a scheduling of the activities involved. This is highly challenging due to the inherent variable and unpredictable nature of surgery. A Business Process Modeling Notation (BPMN 2.0) was used for the representation of the "OR Process" (being defined as the sequence of all of the elementary steps between "patient ready for surgery" to "patient operated upon") as a general pathway ("path"). The path was then both further standardized as much as possible and, at the same time, keeping all of the key-elements that would allow one to address or define the other steps of planning, and the inherent and wide variability in terms of patient specificity. The path was used to schedule OR activity, room-by-room, and day-by-day, feeding the process from a "waiting list database" and using a mathematical optimization model with the objective of ending up in an optimized planning. The OR process was defined with special attention paid to flows, timing and resource involvement. Standardization involved a dynamics operation and defined an expected operating time for each operation. The optimization model has been implemented and tested on real clinical data. The comparison of the results reported with the real data, shows that by using the optimization model, allows for the scheduling of about 30% more patients than in actual practice, as well as to better exploit the OR efficiency, increasing the average operating room utilization rate up to 20%. The optimization of OR activity planning is essential in order to manage the hospital's waiting list. Optimal planning is facilitated by defining the operation as a standard pathway where all variables are taken into account. By allowing a precise scheduling, it feeds the process of

  3. Safety in the operating theatre--part 1: interpersonal relationships and team performance

    Science.gov (United States)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1995-01-01

    The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.

  4. [Teamwork in the operating theatre. Effect on quality of decision-making].

    Science.gov (United States)

    Gfrörer, R; Schüpfer, G; Schmidt, C E; Bauer, M

    2005-12-01

    German hospitals face growing economic pressure. Due to the reimbursement system with diagnosis-related groups (DRGs), revenues from capitation fees have to be earned by each clinic. This leads to minimization of resources for every single case. Cost effectiveness is also realised through shorter hospital stays, reduction of hospital beds and a steady rise in cases per year. As a consequence, all employees are confronted with an increasing workload. Compensation of these working conditions can be achieved by human engineering. Despite statements from politicians and hospital leadership in order to cope with this situation, reality is far away: overwork, shorter or missing recreation periods, pressure of time and low income of staff members have turned hospitals into a deterring workplace. If satisfaction of elementary needs such as adherence to break times, is not achieved shortly, politicians and hospital leadership will find out that without motivated and satisfied staff there will not be efficient performance. The present article addresses this issue and gives examples for increasing efficiency through motivation. Focus is on cooperation in the operation room, advantages and risks of teamwork and auxiliary measures for improvement. The aim is to underline how complex and fragile working in an operation room proceeds and how little is done to support this process. Finally, examples are described which improve teamwork, motivation, efficiency and efficacy.

  5. Non-technical skills: enhancing safety in operating theatres (and drilling rigs).

    Science.gov (United States)

    Flin, Rhona

    2014-03-01

    On April 20th 2010, a large Transocean drilling rig called the Deepwater Horizon was operating in the Gulf of Mexico to drill the Macondo well, for the oil company BP. The job was six weeks behind schedule and $58 million over budget and had not been without difficulty: it was a high pressure well, 2.5 miles below the seabed. At 5.45 am, the Halliburton cementing engineer sent an email to say: 'We have completed the job and it went well'. At 9.43 pm, 16 hours later, there was a release of hydrocarbons into the well bore and the drilling rig experienced a catastrophic blowout as the high pressure oil and gas escaped onto the rig and into the ocean. The resulting explosions and fire killed 11 of the crew of 126, injured many more and created an enormous oil spill across the Gulf.

  6. [Teamwork in the operating theatre: the German Observational Teamwork Assessment for Surgery (OTAS-D) and its first application in Germany].

    Science.gov (United States)

    Passauer-Baierl, S; Chiapponi, C; Bruns, C J; Weigl, M

    2014-12-01

    The quality of surgical teamwork contributes to performance of the operating theatre team, service quality and patient safety in surgery. Observational tools are a feasible and reliable way to capture and evaluate teamwork in the operating theatre (OT). We introduce the German version of the Observational Teamwork Assessment for Surgery (OTAS-D) and present the first observational results from German OTs. Quality of surgical teamwork was assessed with observational teamwork assessment for surgery (OTAS-D). It evaluates five dimensions of OT teamwork: communication, coordination, cooperation/backup behaviour, leadership, and team monitoring/situation awareness. Each dimension is evaluated for each profession (surgical, nursing, and anaesthesia team) as well for each phase of the procedure (pre-, intra-, and post-operative). We observed n = 63 procedures, mainly in abdominal/general and orthopaedic surgery. Additionally, all OT team members scored their individual evaluation of the intra-operative teamwork (standardised 1-item questions). The OTAS-D evaluations showed meaningful results and differences for the OT professions as well as across the different phases of the procedures. Overall, a medium to good level of the OT teamwork was observed. There were no differences in regard to type of surgery (minimally invasive vs. open) or surgical specialties. With an increased coordination of the surgical team we observed a significantly increased cooperation of the nursing team (r = 0.36, p = 0.004). Concerning the OT staffs self-reports, the surgical and nursing teams reported higher scores for quality of surgical teamwork during the procedure than their anaesthesia team members. No significant relationships between observed quality of OT teamwork and self-reports were found. The German version of OTAS-D is a psychometrically robust method to capture the quality of teamwork in operating theatres. It enables the analyses of teamwork between the surgical

  7. Bacterial Contamination of Anaesthetic and Vasopressor Drugs in the Operating Theatres: Ameliyathanelerde Anestetik ve Vazopressör İlaçların Bakteriyel Kontaminasyonu.

    Science.gov (United States)

    Rueangchira-Urai, Rongrong; Rujirojindakul, Panthila; Geater, Alan Frederick; McNeil, Edward

    2017-02-01

    The aim of this study was to determine the incidence of bacterial and fungal contamination in anaesthetic and vasopressor drugs before and after use in operating theatres. A cross-sectional study was conducted in the operating theatres of a university hospital. We collected 945 samples of three different drugs, namely, propofol, vecuronium and ephedrine, from 20 operating rooms and refrigerators where the unused drugs were stored. Each drug was divided into two groups, the pre-use group and the post-use group. The pre-use drugs were cultured before the patient received the drug. The post-use drugs were cultured after the patient had received the drug or after the drugs had been transferred to other syringes. The culture results were reported as either positive or negative. Out of the 945 drug samples, 26 (2.8%, 95% confidence interval=1.8%-4.0%) gave a positive culture. Of the 317 propofol samples, 20 (6.3%) were found to have bacterial contamination, 11 in the pre-use group and 9 in the post-use group. Of the 318 ephedrine samples, 6 (1.9%) were found to be positive on culture, one in the pre-use group and five in the post-use group. Vecuronium gave no positive cultures. All organisms were non-pathogenic, and no fungal contamination was found. The incidence of bacterial contamination in anaesthetic and vasopressor drugs was 2.8%. Anaesthetic teams must be aware of contamination issues in anaesthetic drugs that have been prepared for later use and, in order to reduce the risk of contamination, they must improve the methods of administering drugs to patients.

  8. Can surgeons think and operate with haptics at the same time?

    Science.gov (United States)

    Cao, Caroline G L; Zhou, Mi; Jones, Daniel B; Schwaitzberg, Steven D

    2007-11-01

    Much effort has been devoted to incorporating haptic feedback into surgical simulators. However, the benefits of haptics for novice trainees in the early stages of learning are not clear. Presumably, novices have less spare attentional resources to attend to haptic cues while learning basic laparoscopic skills. The aim of this study was to determine whether novice surgeons have adequate cognitive resources to attend to haptic information. Thirty surgical residents and attendings performed a TransferPlace task in a simulator, with and without haptics. Cognitive loading was imposed using a mental arithmetic task. Subjects performed 10 trials (five with cognitive loading and five without) with and without haptics. Results showed that all subjects performed significantly slower (27%) when they were cognitively loaded than unloaded, but equally accurately in both cases, suggesting a speed-accuracy tradeoff. On average, subjects performed 36% faster and 97% more accurately with haptics than without, even while cognitively loaded. Haptic feedback can not only enhance performance, but also counter the effect of cognitive load. This effect is greater for more experienced surgeons than less experienced ones, indicating greater spare cognitive capacity in surgeons with more experience.

  9. The Cataract National Dataset electronic multi-centre audit of 55,567 operations: variation in posterior capsule rupture rates between surgeons.

    Science.gov (United States)

    Johnston, R L; Taylor, H; Smith, R; Sparrow, J M

    2010-05-01

    To demonstrate variations in posterior capsule rupture (PCR) rate between surgeons of the same and different grades as a by-product of routine clinical care. NHS departments using electronic medical record (EMR) systems to collect the Cataract National Dataset (CND) were invited to submit data. Data were remotely extracted, anonymised, assessed for conformity and completeness, and analysed for rates of PCR for individual surgeons within each of the three grades. Data were extracted on 55,567 cataract operations performed at 12 NHS trusts by 406 surgeons between November 2001 and July 2006. Data on the grade of 404 of the 406 surgeons who contributed to the study were available for 55,515 cases (99.9%) and were used for this analysis. Variation in PCR rate between surgeons was highest for the most junior grade of surgeon and between those surgeons contributing relatively few cases to the data set. Variation in PCR was lowest among experienced surgeons contributing large numbers of cases to the data set. Considerable variation in PCR rate exists both between and within surgical grades. Routine electronic collection of the CND allows detailed analysis of variations in PCR rates between individual surgeons. To define acceptable limits for this benchmark complication of cataract surgery, further work is needed to adjust surgeons' outcomes for the case mix complexity.

  10. Device Sales Representatives in the Operating Room: Do We Really Need or Want Them? A Survey of Orthopaedic Trauma Surgeons.

    Science.gov (United States)

    Moed, Berton R; Israel, Heidi A

    2017-09-01

    The purposes of this study were to determine the current attitude of orthopaedic trauma surgeons toward device sales representatives (DSRs), especially regarding their presence in the operating room (OR), and to establish the existence of any surgeon generational differences. A survey was created using a 5-point Likert response scale, related to conflict of interest (COI) and attitudes toward DSRs. Participants were solicited from the Orthopaedic Trauma Association database of 384 active members and 127 (33%) completed the survey. Respondents were divided into 2 subcategories (Generation X vs. Baby Boomers). Overall, respondents viewed their DSRs favorably without any perception of COI. However, they perceived their peers as being at risk for COI (P ≤ 0.004). Generation X responders feel that DSRs should be in the OR for all cases, whereas Baby Boomers do not (P < 0.01). With one striking generational difference, most orthopaedic trauma surgeons feel that they need DSRs in the OR. Similar to other physician groups, they also feel that they are not subject to COI from salesman contact that affects their peers. Reasons for this perceived need and any related COI risk, and the opportunities to address both, require further study.

  11. Surgeon point-of-view recording: Using a high-definition head-mounted video camera in the operating room

    Science.gov (United States)

    Nair, Akshay Gopinathan; Kamal, Saurabh; Dave, Tarjani Vivek; Mishra, Kapil; Reddy, Harsha S; Rocca, David Della; Rocca, Robert C Della; Andron, Aleza; Jain, Vandana

    2015-01-01

    Objective: To study the utility of a commercially available small, portable ultra-high definition (HD) camera (GoPro Hero 4) for intraoperative recording. Methods: A head mount was used to fix the camera on the operating surgeon's head. Due care was taken to protect the patient's identity. The recorded video was subsequently edited and used as a teaching tool. This retrospective, noncomparative study was conducted at three tertiary eye care centers. The surgeries recorded were ptosis correction, ectropion correction, dacryocystorhinostomy, angular dermoid excision, enucleation, blepharoplasty and lid tear repair surgery (one each). The recorded videos were reviewed, edited, and checked for clarity, resolution, and reproducibility. Results: The recorded videos were found to be high quality, which allowed for zooming and visualization of the surgical anatomy clearly. Minimal distortion is a drawback that can be effectively addressed during postproduction. The camera, owing to its lightweight and small size, can be mounted on the surgeon's head, thus offering a unique surgeon point-of-view. In our experience, the results were of good quality and reproducible. Conclusions: A head-mounted ultra-HD video recording system is a cheap, high quality, and unobtrusive technique to record surgery and can be a useful teaching tool in external facial and ophthalmic plastic surgery. PMID:26655001

  12. FINANCING THE THEATRE: THE ROLE OF MANAGEMENT AND THE STATE

    Directory of Open Access Journals (Sweden)

    Ivana Bestvina Bukvić

    2016-06-01

    Full Text Available At a time when public funding of culture is being reduced and increasing attention is being paid to profitability, it is essential to apply an entrepreneurial mindset and management principles to the guidance and the financing of cultural institutions. This paper focuses on the theatre funding scheme and presents a survey analysing the structure of funding theatres in Croatia by weighting budgetary and commercial funding, as well as analyses possible measures to be implemented in order to improve the theatre funding model. A survey was conducted in 2015, which found that public theatres are predominantly funded by budgetary resources (62.14%, while the most important part of the revenue and income section of private theatres originates from selling their own products and services (43.99%. Theatres believe that budgetary resources still need to remain the dominant sources of funding, but in order to increase the level of operational excellence, a change of direction would be necessary towards one’s own resources, including donations and sponsorships. At the same time, better solutions in terms of increasing tax incentives and tax deductions for both donations and sponsorships would result in an increase in their importance in the financing of theatres. The impact of state action on the funding and operation of theatres is unquestionable, but in theatres there is a need for developing a working knowledge in the fields of management and entrepreneurship in order to gradually reduce dependence, particularly of public theatres, on state action.

  13. Factors which influence the cardiac surgeon's decision not to operate on patients referred for consideration of surgery

    Directory of Open Access Journals (Sweden)

    Sivaprakasam Rajesh

    2008-02-01

    Full Text Available Abstract Background The aim of this study was to document what proportion of patients referred for consideration of cardiac surgery are turned down, the reasons given for not operating and also to evaluate what happens to those patients who do not undergo surgery. Methods 382 elective patients referred for consideration of cardiac surgery to one of six consultant cardiac surgeons at Wythenshawe Hospital during a one year period from were included in the study. Data for those patients who underwent an operation were collected prospectively in a cardiac surgery database. The case notes of those patients who did not undergo an operation were reviewed to establish reasons given by surgeons for not operating. Patients were followed up to determine vital status at the end of the study period. Results 333 (87.2% patients underwent an operation and 49 (12.8% did not. 68% of patients turned down were thought to be too high-risk. 14% of patients did not fulfill symptomatic or prognostic criteria for surgery and in 8% of patients coronary artery surgery was thought ineffective due to poor distal vessels. 6% of patients declined an operation and 4% were thought to be more suitable for coronary angioplasty. Patients turned down for surgery had more renal dysfunction (p = 0.017, respiratory disease (p Conclusion 12.8% of patients referred for consideration of cardiac surgery did not undergo an operation. Two thirds of patients not accepted for surgery were thought too high risk. Those patients who did not undergo an operation had a significantly worse mortality.

  14. Eduardo Martínez Alonso (1903-72): gallant surgeon who undertook special operations.

    Science.gov (United States)

    Coni, Nicholas

    2010-02-01

    Eduardo Martínez Alonso was of Spanish and Uruguyan extraction and was born in Vigo in Galicia in 1903. Due to his father's occupation, he was educated in the UK and qualified from the University of Liverpool. He returned to Madrid to practise and during the Civil War he found himself in the Republican zone where his connections with the Royal Family brought him under suspicion. Threatened with execution, he escaped to serve as a surgeon in the Nationalist Army. Being bilingual, he was medical adviser to the British Embassy during World War II; because of his allegiance to this country and acting from humanitarian motives, he became a ringleader in a plot to smuggle fugitives from Nazi-occupied Europe across a pro-Axis Spain to safety. When the Gestapo was closing in on him, he was smuggled to the UK via Portugal. He underwent training as a potential undercover agent should Franco take Spain into the war but, when hostilities ceased, he returned to Madrid and became a leading thoracic surgeon.

  15. Peri-Operative Management of Older Adults with Cancer—The Roles of the Surgeon and Geriatrician

    Directory of Open Access Journals (Sweden)

    Ruth Mary Parks

    2015-08-01

    Full Text Available Optimal surgical management of older adults with cancer starts pre-operatively. The surgeon plays a key role in the appropriate selection of patients and procedures, optimisation of their functional status prior to surgery, and provision of more intensive care for those who are at high risk of post-operative complications. The literature, mainly based on retrospective, non-randomised studies, suggests that factors such as age, co-morbidities, pre-operative cognitive function and intensity of the surgical procedure all appear to contribute to the development of post-operative complications. Several studies have shown that a pre-operative geriatric assessment predicts post-operative mortality and morbidity as well as survival in older surgical cancer patients. Geriatricians are used to working in multidisciplinary teams that assess older patients and make individual treatment plans. However, the role of the geriatrician in the surgical oncology setting is not well established. A geriatrician could be a valuable contribution to the treatment team both in the pre-operative stage (patient assessment and pre-operative optimisation and the post-operative stage (patient assessment and treatment of medical complications as well as discharge planning.

  16. Quantification of radiation exposure in the operating theatre during management of common fractures of the upper extremity in children.

    Science.gov (United States)

    Maempel, J F; Stone, O D; Murray, A W

    2016-09-01

    Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year. Results DAP exposure (in cGycm(2)) differed significantly across different procedures (pexposure than grade-2 fixation (1.95cGycm(2)) (p=0.048). Fractures of the wrist or forearm necessitating metalwork fixation resulted in higher exposure than those requiring manipulation only (both pexposures for common procedures utilised in the management of paediatric upper limb trauma were quantified. These findings will be useful to surgeons auditing their practice and quantifying radiation-associated risks to patients. Our data may serve as a basis for implementing protocols designed to improve patient safety.

  17. Where, when and what? A time study of surgeons' work in urology.

    Directory of Open Access Journals (Sweden)

    Jan Wolff

    Full Text Available INTRODUCTION: Staff time is a relevant resource in the delivery of health care interventions. Its measurement is a prerequisite for unit costing but usually complex. The aim of this study was to analyse the distribution of surgeons' work time among types and places of activities. A second aim was to use these data to calculate costs per unit of output. METHODS: A self-reporting work sampling study was carried out at a department of Urology. All of twelve surgeons involved in clinical care participated in a two-week analysis of their work time. RESULTS: A total of 2,485 data-points were collected, representing about 1,242 hours of work time. Surgeons spent the greater part of their work time in direct patient care, but substantial shares were required for documentation and organisation. Assistants were mainly required at the wards and consultants at the operating theatre and the outpatient unit. Staff costs of surgeons were 32 € and 29 € per patient day at the wards, respectively, 1.30 € per minute at the operating theatre and 32 € per visit at the outpatient unit. CONCLUSION: Results provided a basis for costing of health care interventions at the study site. However, future research should focus on the establishment of standardised terminology in order to increase transferability of results.

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

    Science.gov (United States)

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

    2013-09-01

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

  19. Managing risk and expected financial return from selective expansion of operating room capacity: mean-variance analysis of a hospital's portfolio of surgeons.

    Science.gov (United States)

    Dexter, Franklin; Ledolter, Johannes

    2003-07-01

    Surgeons using the same amount of operating room (OR) time differ in their achieved hospital contribution margins (revenue minus variable costs) by >1000%. Thus, to improve the financial return from perioperative facilities, OR strategic decisions should selectively focus additional OR capacity and capital purchasing on a few surgeons or subspecialties. These decisions use estimates of each surgeon's and/or subspecialty's contribution margin per OR hour. The estimates are subject to uncertainty (e.g., from outliers). We account for the uncertainties by using mean-variance portfolio analysis (i.e., quadratic programming). This method characterizes the problem of selectively expanding OR capacity based on the expected financial return and risk of different portfolios of surgeons. The assessment reveals whether the choices, of which surgeons have their OR capacity expanded, are sensitive to the uncertainties in the surgeons' contribution margins per OR hour. Thus, mean-variance analysis reduces the chance of making strategic decisions based on spurious information. We also assess the financial benefit of using mean-variance portfolio analysis when the planned expansion of OR capacity is well diversified over at least several surgeons or subspecialties. Our results show that, in such circumstances, there may be little benefit from further changing the portfolio to reduce its financial risk. Surgeon and subspecialty specific hospital financial data are uncertain, a fact that should be taken into account when making decisions about expanding operating room capacity. We show that mean-variance portfolio analysis can incorporate this uncertainty, thereby guiding operating room management decision-making and reducing the chance of a strategic decision being made based on spurious information.

  20. A comparison of the teamwork attitudes and knowledge of Irish surgeons and U.S Naval aviators.

    Science.gov (United States)

    O'Connor, Paul; Ryan, Stephen; Keogh, Ivan

    2012-10-01

    Poor teamwork skills are contributors to poor performance and mishaps in high risk work settings, including the operating theatre. A questionnaire was used to assess the attitudes towards, and knowledge of, Irish surgeons (n = 72) towards the human factors that contribute to mishaps and poor teamwork in high risk environments. The responses were compared to those obtained from U.S. Naval aviators (n = 552 for the attitude questions, and n = 172 for the knowledge test). U.S. Naval aviators were found to be significantly more knowledgeable, and held attitudes that were significantly more positive towards effective teamworking than the surgeons. Moreover, 78.9% of Senior House Officers and Registrars stated that junior personnel were frequently afraid to speak-up (compared with 31.3% of Consultants). Only 7.3% of surgeons stated that an adequate pre-operative brief team brief was frequently conducted, and only 15% stated that an adequate post-operative team brief was frequently conducted. It is suggested that the human factors training currently provided to surgeons in Ireland is a positive first step. However, there is a need to stress the importance of assertiveness in juniors, listening in seniors, and more reinforcement of good teamworking behaviours in the operating theatre.

  1. Talking About Theatre

    DEFF Research Database (Denmark)

    Hansen, Louise Ejgod; Lindelof, Anja Mølle

    2015-01-01

    Taking as its starting point the Nordic cultural policy debates surrounding audience development, which concentrate either on reaching out to new target groups or on artistic quality, this article suggests that the focus on the audience’s experience of theatre performances has thus far been...... underdeveloped. Through qualitative audience investigations, this article shows how talking about theatre offers a method by which to explore theatre experiences from an audience perspective, and thus provides invaluable knowledge for theatres and cultural politicians in search of larger and broader audiences....... The analysis discusses audience experience with regard to the sensory, the artistic and the symbolic level of two specific Swedish-Danish performances, thereby demonstrating how this approach offers a useful tool for theatrical institutions engaged in audience development....

  2. Ergonomic assessment of the posture of surgeons performing endoscopic transurethral resections in urology

    Directory of Open Access Journals (Sweden)

    Sökeland Jürgen

    2009-10-01

    Full Text Available Abstract Background During transurethral endoscopic prostate and bladder operations the influence of an ergonomic redesign of the arrangement of the operation equipment - including the introduction of a video-assisted resection method ('monitor endoscopy' instead of directly viewing onto the operation area via the endoscope ('direct endoscopy' - was studied with respect to the postures of the surgeons. Methods Postures were analysed on the basis of video recordings of the surgeons performed in the operation theatre during live operations and subsequent visual posture estimation executed by an observer. In particular, head, trunk and arm positions were assigned to posture categories according to a newly developed posture classification schema. 10 urological operations with direct endoscopy and 9 with monitor endoscopy were included. Results Application of direct endoscopy coincides with distinct lateral and sagittal trunk and head inclinations, trunk torsion and strong forearm and upper arm elevations of the surgeons whereas operations with monitor endoscopy were performed with an almost upright head and trunk and hanging arms. The disadvantageous postures observed during direct endoscopy are mainly caused by the necessity to hold the endoscope continuously in close contact with the eye. Conclusion From an ergonomic point of view, application of the video-assisted resection method should be preferred in transurethral endoscopic operations in order to prevent awkward postures of the surgeons and to limit muscular strain and fatigue. Furthermore, the application of the monitor method enables the use of a chair equipped with back support and armrests and benefits the reduction of postural stress.

  3. Theatre of the Ancient Maya

    Science.gov (United States)

    Klein, Maxine

    1971-01-01

    There is at least one Western theatre that the historians consistently overlook. This is the theatre of the Mayan Civilization, one that antedates any other in the Western world by hundreds of years. (Author)

  4. Rescuing the Regent Theatre

    Directory of Open Access Journals (Sweden)

    Louise Blake

    2005-10-01

    Full Text Available Melbourne’s Regent and Plaza theatres opened in Collins Street in 1929. For more than forty years, these grand picture palaces were among Melbourne’s most treasured cinemas, favourites together with the Capitol Theatre in Swanston Street and the State Theatre in Flinders Street. Often called ‘palaces of dreams’, they were part of a glamorous entertainment era, when a night out at the movies was an event, and an afternoon matinee was a treat. Not even the Regent’s two-year closure, as a result of the fire that destroyed the auditorium in 1945, could dampen the enthusiasm of its Melbourne audiences. By the 1960s, however, the grand picture palaces were no longer in vogue and were becoming uneconomical to run. The State Theatre closed in 1962 and was later converted into two theatres. The Capitol closed in 1964, but when it re-opened eighteen months later a shopping arcade had been built in the lower part of the auditorium. After investigating the option of converting the Regent into two theatres, its owner, Hoyts, opted to develop a smaller multi-cinema complex in Bourke Street instead. The company sold the Regent and Plaza theatres to the City of Melbourne in 1969 and in 1970 the doors of the Regent and Plaza closed for what many people thought was the last time. Melbourne City Council bought the Regent and Plaza in order to control development around the site of the proposed City Square on the corner of Swanston and Collins Streets. The theatres seemed destined to fall victim to the wrecker’s ball. But if the 1960s was the decade of development, the 1970s was the decade of preservation. Protests against the demolition of historic buildings occurred around Australia, often with the controversial support of the building unions. The architectural profession debated the issues of preservation versus development of dynamic modern buildings. Both the State and Federal Governments were forced to introduce legislation to protect the nation

  5. [The concentrations of halothane in the operating theatre and its dependance on various methods of removal (author's transl)].

    Science.gov (United States)

    Hövener, B; Link, J

    1976-02-01

    Measurement of halothane concentrations by means of gas chromatography was used to compare the efficiency of 1) a filtration system and 2) ducting of gases into the exhaust of the ventilation system of our operating threatre. The concentrations were found to be lower when the latter method was used. Measurements made subsequently provided data on halothane concentrations occurring during routine service when different methods of anaesthesia were used, with and without ducting of gases into the ventilation exhaust system.

  6. Standard guidelines for setting up a dermatosurgery theatre

    Directory of Open Access Journals (Sweden)

    Rajendran S

    2009-08-01

    Full Text Available Introduction, definition, rationale and scope: Dermatologists in India are now increasingly performing surgical and cosmetic procedures in their practice. This calls for minimum standards at the national level with the main focus of patient safety and hence the guidelines for setting up a dermatosurgical theatre. Facility: The dermatosurgery theatre can be created in either physician′s clinic, or a hospital depending on the procedure to be performed. The dermatosurgery theatre requires careful planning with regards to - location, dimension, shell design, lighting, electrical requirements, operation table, chair, trolley, surgical instruments, sterilization of devices, asepsis and advanced life support. Apart from physical considerations, other considerations including theatre etiquettes, consent for surgery, safety of dermatosurgeon, theatre staff and lastly biomedical waste management should be looked into. These issues are discussed in detail in the recommendations.

  7. Object Theatre in Design Education

    DEFF Research Database (Denmark)

    Buur, Jacob; Friis, Preben

    2015-01-01

    In a quest to improve our design teaching we experiment with the theatre genre of Object Theatre. We employ techniques from object theatre to challenge current thinking about product agency, movement and meaning, the spatial location, and the social settings of products. At the end of the project...

  8. Surgeon point-of-view recording: Using a high-definition head-mounted video camera in the operating room

    Directory of Open Access Journals (Sweden)

    Akshay Gopinathan Nair

    2015-01-01

    Full Text Available Objective: To study the utility of a commercially available small, portable ultra-high definition (HD camera (GoPro Hero 4 for intraoperative recording. Methods: A head mount was used to fix the camera on the operating surgeon′s head. Due care was taken to protect the patient′s identity. The recorded video was subsequently edited and used as a teaching tool. This retrospective, noncomparative study was conducted at three tertiary eye care centers. The surgeries recorded were ptosis correction, ectropion correction, dacryocystorhinostomy, angular dermoid excision, enucleation, blepharoplasty and lid tear repair surgery (one each. The recorded videos were reviewed, edited, and checked for clarity, resolution, and reproducibility. Results: The recorded videos were found to be high quality, which allowed for zooming and visualization of the surgical anatomy clearly. Minimal distortion is a drawback that can be effectively addressed during postproduction. The camera, owing to its lightweight and small size, can be mounted on the surgeon′s head, thus offering a unique surgeon point-of-view. In our experience, the results were of good quality and reproducible. Conclusions: A head-mounted ultra-HD video recording system is a cheap, high quality, and unobtrusive technique to record surgery and can be a useful teaching tool in external facial and ophthalmic plastic surgery.

  9. Organisational Theatre and Polyphony

    DEFF Research Database (Denmark)

    Matula, Linda; Badham, Richard; Meisiek, Stefan

    This paper details the conditions leading up to and influencing an organisational theatre intervention as part of an organisational change program at a newly established cancer clinic. The paper explores the social and political interactions and negotiations shaping the structure and conditions...... of the organisational theatre event. It focuses in particular on the alignments and clashes between the different human resource voices in defining the ‘surface’ formal purpose for the intervention and the embeddedness of such interactions and negotiations in ‘deeper’ cultural and social conditions. The paper provides...... the first in-depth longitudinal study of shaping and negotiation of an organisational theatre event and the ways in which it is influenced by a polyphonic multivocality and takes the form of selective and partial forms of harmonious expression in establishing meaningful cooperation. The paper reveals...

  10. User Ethnography as Theatre

    DEFF Research Database (Denmark)

    Torguet, Rosa; Friis, Preben; Buur, Jacob

    2013-01-01

    This paper discusses the potential of using theatre with professional actors to convey the outcome of ethnographic user studies to industry or academia. Framed in the ongoing discussion within design ethnography of how representations can support the communication of ethnographic findings more...... effectively. The use of theatre within innovation processes can help facilitate the provoking role that an ethnography often plays when presented to organizations. Live performances were used as part of a participatory innovation project in the field of indoor climate with industry partners and academic...

  11. Surgeon compensation and motivation.

    Science.gov (United States)

    Leitch, K K; Walker, P M

    2000-06-01

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

  12. Is surgeon intuition equivalent to models of operative complexity in determining the surgical approach for nephron sparing surgery?

    Directory of Open Access Journals (Sweden)

    Pranav Sharma

    2016-01-01

    Conclusions: RENAL nephrometry score was associated with surgical approach intuitively chosen by an experienced surgeon, but the presence of adherent perinephric fat did not correlate with decision-making.

  13. [Efficient OP management. Suggestions for optimisation of organisation and administration as a basis for establishing statutes for operating theatres].

    Science.gov (United States)

    Geldner, G; Eberhart, L H J; Trunk, S; Dahmen, K G; Reissmann, T; Weiler, T; Bach, A

    2002-09-01

    Economic aspects have gained increasing importance in recent years. The operating room (OR) is the most cost-intensive sector and determines the turnover process of a surgical patient within the hospital. Thus, optimisation of workflow processes is of particular interest for health care providers. If the results of surgery are viewed as a product, everything associated with surgery can be evaluated analogously to a manufacturing process. All steps involved in producing the end-result can and should be analysed with the goal of producing an efficient, economical and quality product. The leadership that physicians can provide to manage this process is important and leads to the introduction of a specialised "OR manager". This position must have the authority to issue directives to all other members of the OR team. An OR management subordinates directly to the administration of the hospital. By integrating and improving management of various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. This paper gives a short introduction into the difficulties of organising an OR. Some suggestions are made to overcome common shortcomings in the daily practise. A proposal for an "OR statute" is presented that should be a basis for discussion within the OR team. It must be modified according to individual needs and prerequisites in every hospital. The single best opportunity for dramatic improvement in effective resource use in surgical services lies in the perioperative process. The management strategy must focus on process measurement using information technology and feed-back implementing modern quality management tools.However, no short-term effects can be expected from these changes. Improvements take about a year and continuous feed-back of all measures must accompany the reorganisation process.

  14. Taking label-free optical spectroscopy techniques into the operating theatre: biopsy needles and surgical guidance probes (Conference Presentation)

    Science.gov (United States)

    Leblond, Frédéric

    2017-02-01

    Recent advances will be described relating to the development and clinical translation of optical spectroscopy techniques designed to guide surgical interventions in brain and prostate oncology applications. The use of molecular imaging guidance systems can enable true intra-operative tissue identification, increasing the effectiveness of cancer surgery and potentially positively impacting patient survival. Surgical resection is a fundamental cancer treatment, but its effectiveness is reduced by the inability to rapidly and accurately identify cancer margins. We will introduce a portable intraoperative label-free multimodal optical spectroscopy system combining intrinsic fluorescence, diffuse reflectance, and Raman spectroscopy that can identify cancer in situ during surgery. We will show that this on-line guidance system can detect primary cancer such as glioma as well as metastatic melanoma and cancer of the lung and colon with an accuracy, sensitivity, and specificity of 97%, 100%, and 93% respectively. Moreover, a method will be presented, along with preliminary tissue classification results, based on the interrogation of whole human prostates from prostatectomies. The development and in vivo validation of an optical brain needle biopsy instrument will be presented demonstrating its ability to detect bulk tumor using Raman spectroscopy with the goal of reducing the number of non-diagnostic samples during a procedure. The extraction of tissue can cause life-threatening hemorrhage because of significant blood vessel injury during the procedure. We will demonstrate that a sub-diffuse optical tomography technique integrated with a commercial biopsy needle can detect the presence of blood vessels to limit the hemorrhage risk.

  15. A Study of VITOM in Pediatric Surgery and Urology: Evaluation of Technology Acceptance and Usability by Operating Team and Surgeon Musculoskeletal Discomfort.

    Science.gov (United States)

    Frykman, Philip K; Freedman, Andrew L; Kane, Timothy D; Cheng, Zhi; Petrosyan, Mikael; Catchpole, Kenneth

    2017-02-01

    We studied operating team acceptability of Video Telescopic Monitor (VITOM(®)) exoscope by exploring the ease of use of the device in two centers. We also assessed factors affecting surgeon musculoskeletal discomfort. We focused on how the operating team interacted with the VITOM system with surrogate measures of usefulness, image quality, ease of use, workload, and setup time. Multivariable linear regression was used to model the relationships between team role, experience, and setup time. Relationships between localized musculoskeletal discomfort and use of VITOM alone, and with loupes, were also analyzed. Four surgeons, 7 surgical techs, 7 circulating nurses, and 13 surgical residents performed 70 pediatric surgical and urological operations. We found that subjective views of each team member were consistently positive with 69%-74% agreed or strongly agreed that VITOM enhanced their ability to perform their job and improved the surgical process. Unexpectedly, the scrub techs and nurses perceived more value and utility of VITOM, presumably because it provides them a view of the operative field that would otherwise be unavailable to them. Team members rated perceptions of image quality highly and workload generally satisfactory. Not surprisingly, setup time decreased with team experience and multivariable modeling showed significant correlations with surgeon and surgical tech experience, but not circulating nurse. An important finding was that surgeon neck discomfort was reduced with use of VITOM alone for magnification, compared with use of loupes and VITOM. The most likely explanation for these findings is improved posture with the neck at a neutral position when viewing the VITOM images, compared with neck flexion with loupes, and thus, a less favorable ergonomic position. This study suggests that there may be small drawbacks associated with VITOM use initially, but these reduce with increased experience and benefit both the surgeon and the rest of the team.

  16. Improving efficiency in robotic theatres in the Royal Wolverhampton NHS Trust: a gynaecology theatres perspective.

    Science.gov (United States)

    Harding, V; Williams, J

    2016-03-01

    Improving efficiency within the operating theatre is always a key concern when running a successful operating list. However, with robotic surgery, this can become paramount. Robotic procedures require a more technical set up, additional planning, and good solid communication within the multidisciplinary team. Efficiency needs to be at the forefront of everyone's mind. Forward planning requires knowledge of the procedures being carried out and adequate training with the robot. Trouble shooting will also improve efficiency in robotic surgery, as being able to expect the unexpected can be a major advantage. This article looks at the hurdles encountered by the theatre team at Royal Wolverhampton Trust at the implementation of the robotic programme, and how the theatre team made adjustments to working practice in order to minimise disruption and maximise efficiency.

  17. Talking About Theatre

    DEFF Research Database (Denmark)

    Hansen, Louise Ejgod; Lindelof, Anja Mølle

    2015-01-01

    Taking as its starting point the Nordic cultural policy debates surrounding audience development, which concentrate either on reaching out to new target groups or on artistic quality, this article suggests that the focus on the audience’s experience of theatre performances has thus far been...

  18. The use of a double heat pipe heat exchanger system for reducing energy consumption of treating ventilation air in an operating theatre. A full year energy consumption model simulation

    Energy Technology Data Exchange (ETDEWEB)

    Yau, Y.H. [Department of Mechanical Engineering, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2008-07-01

    In two earlier papers [Y.H. Yau, Application of a heat pipe heat exchanger to dehumidification enhancement in tropical HVAC systems - a baseline performance characteristics study, International Journal of Thermal Sciences 46 (2) (2007) 164-171; ], two series of experiments were conducted under controlled conditions to establish the baseline performance characteristics of the heat pipe heat exchanger (HPHX). In the present paper, a complete empirical transient systems simulation program model is assembled to estimate the air states as well as the entire typical meteorological year energy consumption of an operating theatre located in Kuala Lumpur, Malaysia. The current heating, ventilating and air conditioning (HVAC) systems for the operating theatre are found to be inherently energy-inefficient and can be further improved with a double heat pipe heat exchanger system. The impact on actual energy consumption of a custom-built Trane Air Handler Unit 0704 2-2MB is simulated with two 8-row heat pipe heat exchanger installed in the heating, ventilating and air conditioning system compared to the existing without HPHX HVAC system. Based on this investigation, the application of a double heat pipe heat exchanger system (Plant E) in the conventional Air Handler Unit operating in a tropical climate is strongly recommended as an efficient mean for humidity control and energy savings to maintain acceptable room conditions per American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) requirements [ASHRAE, ASHRAE Handbook HVAC Applications SI Edition, ASHRAE, Atlanta, GA, USA, 1995]. (author)

  19. Improving the Standard of Operative Notes within an Oral and Maxillofacial Surgery Department, using an Operative Note Proforma.

    Science.gov (United States)

    Payne, Karl; Jones, Keith; Dickenson, Andrew

    2011-09-01

    The operative note needs to be an accurate and legible account of events occurring in the surgeon's theatre. We set out to discover if operative notes within a British District General Oral and Maxillofacial Surgery department adhered to Royal College of Surgeons (England) guidelines. We audited 100 consecutive Oral and Maxillofacial Surgery operations performed within general theatres. As an intervention we designed and piloted a paper based Operative Note Proforma and re-audit was undertaken. Initial audit showed results lacking in certain areas. At re-audit all audit criteria showed improvement. The mean percentage of data point inclusion rose from 76.1 to 98.3% (0.001 Oral and Maxillofacial Surgery.

  20. Customization of a tool to assess Danish surgeons´ non-technical skills in the operating room

    DEFF Research Database (Denmark)

    Spanager, Lene; Lyk-Jensen, Helle Teglgaard; Dieckmann, Peter

    2012-01-01

    Errors in surgery often stem from failure related to non-technical skills such as communication and teamwork. Tools for training and assessment of non-technical skills are needed to ensure safe surgery. The aim of this study was to customize the Non-Technical Skills for Surgeons (NOTSS) rating...

  1. Customization of a tool to assess Danish surgeons´ non-technical skills in the operating room

    DEFF Research Database (Denmark)

    Spanager, Lene; Lyk-Jensen, Helle Teglgaard; Dieckmann, Peter

    2012-01-01

    Errors in surgery often stem from failure related to non-technical skills such as communication and teamwork. Tools for training and assessment of non-technical skills are needed to ensure safe surgery. The aim of this study was to customize the Non-Technical Skills for Surgeons (NOTSS) rating...

  2. 1 COMMUNITY THEATRE AND DEVELOPMENT PRACTICES IN ...

    African Journals Online (AJOL)

    Prof Alex C Asigbo

    Critical Foundations of Community Theatre. Theatre was born societal. ... analysis-which treats theatre as if it were independent of its social ... community predicated on highly participatory methodologies. This ..... discourses. This implies that ...

  3. Acoustics of courtyard theatres

    Institute of Scientific and Technical Information of China (English)

    WANG Jiqing

    2008-01-01

    The traditional Chinese theatre was often built with a courtyard. In such open-top space, the absence of a roof would mean little reverberation and non-diffused sound field.Acoustically the situation is quite different from that of any enclosed space. The refore, theclassic room acoustics, such as Sabine reverberation formula, would no longer be applicable due to the lack of sound reflections from the ceiling. As the parameter of reverberation time T30 shows the decay rate only, it would not properly characterize the prominent change in the fine structure of the echogram, particularly in case of a large reduction of reflections during the decay process. The sense of reverbrance in a courtyard space would differ noticeably from that of the equivalent 3D-T30 in an enclosed space. Based upon the characteristic analysis of the sound field in an open-top space, this paper presents a preliminary study on the acoustics of the courtyard theatres.

  4. Pre-operative antiseptic skin preparation.

    Science.gov (United States)

    Murkin, Claire Elizabeth

    Theatre nurses use antiseptic skin preparation products every day, but little thought seems to be given as to why a surgeon has a particular preference for one antiseptic skin preparation over another - whether it is for its efficacy, safety or application properties. Woodhead et al (2004) states that nurses still work in a ritualistic environment. Rituals are 'any action performed according to custom, without understanding the reasons why it is being practised'. Nursing practice should be evidence-based; nurses should understand the rationale behind the choice of a particular antiseptic, and be knowledgable about the clinical effectiveness of antiseptic's use pre-operatively, to achieve optimum results. This article focuses on the main types of antiseptic skin preparation while highlighting each product's activity and the relevant considerations for choosing the appropriate product for each patient. Theatre staff need to emphasize the importance of skin preparation and the correct application techniques, while educating the scrub team and surgeons with respect to skin preparation.

  5. Creative Inclusion in Community Theatre: A Journey with Odyssey Theatre

    Science.gov (United States)

    Wooster, Roger

    2009-01-01

    What does "inclusion" mean in practice? This article considers the work of Odyssey Theatre, a group of learning-disabled and non-learning-disabled performers as they put together a production with the support of professional theatre workers. Working processes are examined and the balance of empowerment and professional leadership…

  6. Emancipatory Theatre and Performative Didactics

    Directory of Open Access Journals (Sweden)

    Venke Aure

    2013-12-01

    Full Text Available This article is based on several years of empirical observation, gathered from theatre practice, in which Karin B. Bjerkestrand and Anna Songe-Møller developed what is known as “Solidarity Forum Theatre” (SFT, a form of applied drama. This theatre form is based primarily on the Brazilian, Augusto Boal’s, Theatre of the Oppressed (Boal, 2006. Bjerkestrand and Songe-Møller used and further developed Boal’s theatre principle in a collaboration with various immigrant groups and drama-/theatre students. The intention has been to use the liberating potential into which this form of theatre invites us. In this article, Bjerkestrand and Songe-Møller present the theoretical groundwork, the underlying principles, and examples of SFT in action. Some of the participants’ own stories have been used to concretize the liberating aspect that arose in the theatre experiences. In relation to this Solidarity Forum Theatre practice, science theorist and art educator Venke Aure presents epistemological and didactic reflections.

  7. Design Participation As Postdramatic Theatre

    DEFF Research Database (Denmark)

    Ryöppy, Merja; Lima, Patricia; Buur, Jacob

    2015-01-01

    In our struggle to better understand and fa cilitate design participation we have turned our attention to the novel genre of Postdramatic Theatre (Lehmann 2006). In particular, this paper explores the intersections between Postdramatic Theatre and Participatory Innovation (Buur & Mathews 2008). Two...

  8. BRECHT'S EPIC THEATRE AS A MODERN AVANT-GARDE AND ITS INFLUENCE ON POSTMODERN THEATRE/DRAMA

    Directory of Open Access Journals (Sweden)

    Ribut Basuki

    2002-01-01

    Full Text Available As one of the most influential figures in theatre, Bertolt Brecht has stamped his legacy in the world theatre. His search for a new kind of theatre made his theatre a modern avant-garde which has left its traces in postmodern theatres. This paper tries to investigate Brecht's epic theatre as a modern avant-garde and its influence in postmodern theatre. His epic theatre was in fact a revolt against the main stream modern theatre in which Brecht openly declares that theatre should be 'political.' Brecht's theatre was so influential that his theatre becomes reference to the postmodern theatre.

  9. Mentoring surgeons.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

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

  10. Brecht’s epic theatre

    Directory of Open Access Journals (Sweden)

    Emini Z. Emin

    2015-07-01

    Full Text Available Although Brecht’s epic theatre and its system is studied in many schools of theatrical scenic art, in most cases, they are misunderstandings and inaccurate interpretations of this entirely school of specific scenic – drama knowledge. Often, Brecht was accused of his “red” line approach and aesthetic ideology of art, and so, his genius creativity has remained under-shadowed. Not only his knowledge for drama and the art, but also, his study and knowledge for spectators is prominent as well. Moreover, Brecht considers this line of communication as the basis of scenic theatre-arts, because he is fully conscious that there is no theatre without spectator. But, ironically, the Brechtian epic theatre is mostly hitted by being alluded as a the theatre that is used as an instrument for “awareness-education” of mass-spectators, while, in its essence Brechtian theatre attempts to led the spectator towards his freedom. Judgment of (anti socio-cultural values, political, religious, philosophic morals, etc., is a process that is referred to the freedom of thinking. The objective of the epic theatres is to offer the satisfaction by evaluating these (anti values. And evaluation, does not rarely request transformation. Therefore, the transformation that is driven by Brechtian V-effect is not an ideological transformation, as is very often attributed to epic theatre, but it is immanence for critical stand and re-finding of values. The Brecht Theater request to meet with other arts, but, also with knowledge of different scientific fields, it is also named the theatre of science.

  11. The Problem of Theatrical Autonomy : Analysing Theatre as a Social Practice

    NARCIS (Netherlands)

    van den Hoogen, Quirijn Lennert; Edelman, Joshua; Hansen, Louise Ejgod

    2017-01-01

    When we go to the theatre, we understand that we are doing something different. It is not just that sitting and watching others for two hours is different than other daily activities. It is that theatre itself is a particular social setting, obeying its own rules and operating by its own standards.

  12. COOPERATIVE PROFESSIONALISM IN THEATRE ARTS ...

    African Journals Online (AJOL)

    huge financial commitment into theatre production by individuals. It strives to position ..... virtually never take active note in a company (80). Professional .... Thompson, A. A. Jnr. and Strickland, A. J. Strategy Management: Concept and Cases.

  13. Anesthesiologists' and surgeons' perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF) to identify factors that influence physicians' decisions to order pre-operative tests.

    Science.gov (United States)

    Patey, Andrea M; Islam, Rafat; Francis, Jill J; Bryson, Gregory L; Grimshaw, Jeremy M

    2012-06-09

    Routine pre-operative tests for anesthesia management are often ordered by both anesthesiologists and surgeons for healthy patients undergoing low-risk surgery. The Theoretical Domains Framework (TDF) was developed to investigate determinants of behaviour and identify potential behaviour change interventions. In this study, the TDF is used to explore anaesthesiologists' and surgeons' perceptions of ordering routine tests for healthy patients undergoing low-risk surgery. Sixteen clinicians (eleven anesthesiologists and five surgeons) throughout Ontario were recruited. An interview guide based on the TDF was developed to identify beliefs about pre-operative testing practices. Content analysis of physicians' statements into the relevant theoretical domains was performed. Specific beliefs were identified by grouping similar utterances of the interview participants. Relevant domains were identified by noting the frequencies of the beliefs reported, presence of conflicting beliefs, and perceived influence on the performance of the behaviour under investigation. Seven of the twelve domains were identified as likely relevant to changing clinicians' behaviour about pre-operative test ordering for anesthesia management. Key beliefs were identified within these domains including: conflicting comments about who was responsible for the test-ordering (Social/professional role and identity); inability to cancel tests ordered by fellow physicians (Beliefs about capabilities and social influences); and the problem with tests being completed before the anesthesiologists see the patient (Beliefs about capabilities and Environmental context and resources). Often, tests were ordered by an anesthesiologist based on who may be the attending anesthesiologist on the day of surgery while surgeons ordered tests they thought anesthesiologists may need (Social influences). There were also conflicting comments about the potential consequences associated with reducing testing, from negative

  14. Theatre Tempus Tic Tac

    CERN Multimedia

    2008-01-01

    A serious but comical look at time: How long is a quarter of an hour when you’re falling asleep in your theatre seat? What is a minute of silence for a deaf person? What are three minutes for an egg? On the stage an actor covers in one hour (no more, no less!) the questions that are almost bound to arise when we talk about time: linear time/ circular time, absolute time/relative time, history of time measurement, instant/duration, scientific time/conscious time, irreversibility of time, notion of space time… The points of view from which these subjects are explored are varied (as befits such a deep subject!): philosophy, mathematics, history, physics, literature, etc... Thursday, 19 June 2008 at 8.00 p.m. Tempus Tic Tac The Vue sur la mer company with Roland Depauw, produced by Stéphane Verrue The Globe, first floor No specialist knowledge required. Entrance free. To reserve call + 41 (0) 22 767 76 76 http://www...

  15. The hybrid theatre

    Science.gov (United States)

    Gillen, Ron

    2008-02-01

    Ever since the first movie picture house was opened, experiencing the unique cinematic experience has constantly evolved. Technological advances continually guarantee that more changes will happen to create the ultimate cinematic experience. Cinema has been reincarnated time after time, from the first hand cranked silent movie to the modern day Digital Cinema. The technology used to depict the story changes; along with that change is the human thirst for a better transformation, for a more enjoyable, more encompassing, more believable, more immersive, yet simultaneously a more bewitching, entertainment experience. "In this volatile business of ours, we can ill afford to rest on our laurels, even to pause in retrospect. Times and conditions change so rapidly that we must keep our aim constantly focused on the future." --Walt Disney. 1 It has been said that "content is king". By itself, that implies a disservice to the technology that supports it. Without the technology, the content could not exist. In today's digital society; a movie can be downloaded to a handheld playback device the moment it is released. Offering these services at a cheap rate would enable studios to stay ahead of the curve, virtually eliminate video piracy and create the ability to deliver first class uncompromised content. It's only a matter of time when new released movies would be distributed this way too and people are given the choice to view in the comfort of their own homes, hand held device or view at a local theatre.

  16. Science Theatre as dissemination of environmental awareness

    DEFF Research Database (Denmark)

    Chemi, Tatiana; Kastberg, Peter

    2015-01-01

    A community project with the intention of developing specific communication on environmental issues for children age 3-7 allies with a theatre artist and storyteller. The result is a meeting between science and theatre. Theatre, with its borderline praxis between entertainment and reflection offe...

  17. Museum Theatre: Telling Stories through Objects.

    Science.gov (United States)

    Schindel, Dorothy Napp

    2002-01-01

    Explains that Museum Theatre's goal is to teach through drama by using experiential interpretive strategies that bypass the lecture format. Outlines a production of Museum Theatre which helped a museum redefine itself. Concludes that Museum Theatre helps shift the focus of programming from simple object display to an emphasis on the human…

  18. British theatre and performance 1900-1950

    OpenAIRE

    D’Monté, R.

    2015-01-01

    British theatre from 1900-1950 has been subject to radical re-evaluation with plays from the period setting theatres alight and gaining critical acclaim once again; this book explains why, presenting a comprehensive survey of the theatre and how it shaped the work that followed.

  19. Recalling Memories Through Reminiscence Theatre

    Directory of Open Access Journals (Sweden)

    Rikke Gürgens Gjærum

    2013-12-01

    Full Text Available The purpose of this article is to study how a reminiscence theatre production develops dramaturgically, and to discuss what impact it has on the participants who take part in the project “The aged as a resource”. The theatre performance Number Our Days is visually and verbally presented and interpreted in this article. The reader also gets an opportunity to look at film extracts from the performance in electronic form. The theoretical framing is based on a performative mindset, Ryum’s dramaturgic model, Ranciere’s view on the emancipated spectator, Turner and Behrndt’s devising theatre universe, Saldana’s ethnodrama method and Ricoeur’s perspective of the capable and relational human being who builds their own narrative identity through communication.

  20. Monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: Operative outcomes and surgeon preferences, a real-world scenario

    Science.gov (United States)

    Madduri, Vijay Kumar Sarma; Bera, Malay Kumar; Pal, Dilip Kumar

    2016-01-01

    Context: Monopolar transurethral resection of prostate (M-TURP) is considered the gold standard for the management of bladder outlet obstruction due to benign prostatic hyperplasia. Its newly introduced modification, bipolar TURP (B-TURP), promises to overcome its most prominent shortcomings, namely bleeding and dilutional hyponatremia. Literature is conflicting regarding merits of B-TURP over M-TURP. Aims: To find a difference, if any, in perioperative outcomes between M-TURP and B-TURP in a real-wold setting. Settings and Design: Prospective nonrandomized study. Subjects and Methods: Operative outcomes of patients undergoing M-TURP and B-TURP from February 2014 to October 2015 were compared. Statistical Analysis Used: Categorical data were compared by Fischer exact test and numerical data were compared by independent samples Mann–Whitney U-test. P <0.05 was considered statistically significant. Results: The mean size of prostate operated by bipolar technology was significantly greater than those operated by monopolar technology (38.12 ± 9.59 cc vs. 66.49 ± 22.95 cc; P < 0.001). The mean fall in postoperative serum sodium concentration was 0.99 ± 0.76 mEq/L for the B-TURP group as compared to 3.60 ± 2.89 mEq/L for the M-TURP group (P < 0.001). The mean drop in postoperative hemoglobin concentration (P = 0.28) was statistically insignificant, even though larger glands were operated by B-TURP. There were three instances of the transurethral resection (TUR) syndrome in the M-TURP group whereas no TUR syndrome occurred in the B-TURP group. Conclusions: In spite of various contrary viewpoints in literature, surgeons prefer to operate on larger prostates using bipolar technology. B-TURP definitely reduces the incidence of bleeding and dilutional hyponatremia, making it a contender to replace M-TURP as the new gold standard. PMID:27453650

  1. The surgeon and the child.

    Science.gov (United States)

    Klein, Michael D

    2016-01-01

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

  2. How did the ancient Roman Theatres sound?

    DEFF Research Database (Denmark)

    Nielsen, Martin Lisa; Rindel, Jens Holger; Gade, Anders Christian;

    2005-01-01

    state and as they presumably were built in the Roman era; the reconstructed parts of acoustical interest are the stage wall and top colonnade in the open-air theatres and the roof and windows in the Odea. The irregular absorption distribution in these rooms makes them challenging for acoustical......The Roman theatre follows a natural evolution from the Greek theatre combining the acting area and the seating area into a single structure. Modifications of stage, orchestra and seating area have resulted in a considerable improvement in the quality of the acoustics. As a part of the ERATO project......, the acoustics in Roman theatres and Odea (roofed theatres) have been recreated through computer simulations using the Odeon software. Computer models of five Roman theatres have been created based on data from archaeologists, architects and measurements in situ. The theatres have been modelled in their present...

  3. Status of hepatitis B vaccination among surgeons practicing in Ethiopia: a cross sectional study.

    Science.gov (United States)

    Bekele, Abebe; Tadesse, Amezen

    2014-07-01

    Hepatitis B virus (HBV) is a well recognized but under emphasized occupational health hazard in Ethiopia. To assess the vaccination status against Hepatitis B among surgeons practicing in Ethiopia and the reasons for poor adherence to vaccinations. A structured questionnaire was developed using the Qualtrics Survey free software tool and sent to 131 surgeons and surgical residents practicing in 28 hospitals. 98 completed and submitted the online survey. The main outcome measures were vaccination status, recent occupational accidents and reasons for non-vaccination. Ninety-four (95.9%) of the respondents were males, Only 24 (23.5%) were vaccinated against HBV, 18/24 (75%) of whom received the three recommended doses. The main reasons for non vaccination is lack of knowledge about the availability of the vaccine in the country, lack of time and mere negligence. Differences in age, sex, and duration of practice, field of specialty and respondent's institution between vaccinated and unvaccinated were not significant (P > 0.05). Ninety-two (93.9%) believe the vaccination is very useful for the surgeon. 86.4% of the respondents claim they wear double gloves in more than 50% of their operations while 76 (77.6%) had sustained sharp injury over the past one year. 13 (13.25%) of the respondents had taken ART prophylaxis in the past. Despite their strong belief that HBV vaccine is useful, most surgeons are still not vaccinated. As occupational injuries are very common, Hepatitis B vaccination should be a prerequisite for working in the theatre, hence putting the surgeons and surgical patients at reduced risk.

  4. August Strindberg theatre-maker

    DEFF Research Database (Denmark)

    Chemi, Tatiana

    2005-01-01

    Review of the only Italian monographic study based on original texts about August Strindberg: August Strindberg il teatro della vita (August Strindberg the theatre of life), published in 1990 by Laterza and revised and updated in 2003 (publisher: Iperborea, Milano). By one of the most remarkable...

  5. Theatre Applications: Locations, Event, Futurity

    Science.gov (United States)

    Mackey, Sally; Fisher, Amanda Stuart

    2011-01-01

    The three papers and the pictorial essay that follow Rustom Bharucha's keynote all originated at "Theatre Applications" (Central School of Speech and Drama, London, April 2010). One theme of the conference was "cultural geographies of dislocation, place and space"; the three papers and pictorial essay respond to that theme. All…

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

    Science.gov (United States)

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

    2015-08-01

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

  7. Pressure sore prevention pads as an infective source in orthopaedic theatres.

    Science.gov (United States)

    Ranawat, V S; Dowell, J K; Teare, E L

    2004-04-01

    Current theatre practice and protocol involves the use of pressure sore prevention pads in the positioning and support of all patients undergoing orthopaedic surgery. Microbiological swabs were taken from those pads placed adjacent to the operative field immediately before implant surgery. Eleven out of the 13 pads sampled yielded bacterial growth capable of causing deep-seated infection. The transfer of these pads between the designated orthopaedic theatres and the rest of the theatre complex was also noted. We recommend that the use of these pads should be closely reviewed. They should either be used with stricter guidelines for decontamination between use or disposable 'clean' alternatives sought.

  8. [The surgeon at retirement].

    Science.gov (United States)

    Fernández del Castillo-Sánchez, Carlos

    2012-01-01

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

  9. The effect of introducing an in-theatre intra-operative specimen radiography (IOSR) system on the management of palpable breast cancer within a single unit.

    Science.gov (United States)

    Layfield, D M; May, D J; Cutress, R I; Richardson, C; Agrawal, A; Wise, M; Yiangou, C

    2012-08-01

    Intra-operative specimen radiography (IOSR) is used to screen specimens during breast-conserving surgery and attempt to identify incompletely excised lesions. Universal use of IOSR during surgery for impalpable breast cancer is advocated by current guidelines. This study evaluates the role of IOSR during breast-conserving surgery for palpable breast cancer. Two cohorts of patients who underwent wide local excision for palpable breast cancer were identified. Retrospective analysis of histological margins, intra-operative cavity shaves, secondary re-excision rates and specimen weight was completed comparing performance prior to the introduction of IOSR (October 2003-April 2005) with that since its introduction (April 2006-October 2007). 224 Patients were included, 111 in the pre-IOSR cohort (PF) and 113 in the IOSR cohort (F). Patient demographics, tumour size and histology were comparable. No difference in margin involvement prior to intra-operative cavity shaving was noted, PF-26, F-31 (p=0.60). Intra-operative cavity shaves were carried out more frequently in the IOSR group, PF-9, F-32 (p=0.001). When compared with histological findings, IOSR identified margin compromise with sensitivity=58.1%, specificity=80.8%, positive-predictive value=56.25% and negative predictive value=81.9%. Re-operation rate was similar between the 2 groups, PF-26, F-31 (p=0.65). Significantly less tissue was excised following use of IOSR; PF-110g, F-70g (p=0.001). Introduction of IOSR significantly reduced specimen weights without increasing re-excision rates. As volume of breast tissue removed is the most significant determinant of cosmetic outcome following breast-conserving surgery, the use of IOSR should be advocated in the surgical management of palpable breast cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Modelling Preference Heterogeneity for Theatre Tickets

    DEFF Research Database (Denmark)

    Baldin, Andrea; Bille, Trine

    This paper analyzes the behavioural choice for theatre tickets using a rich dataset for 2010-2013 from the sale system of the Royal Danish National Theatre. A consumer who decides to attend a theater production faces multiple sources of price variation that depends on: socio-economic characterist...... attributes is estimated. Understanding theatre-goers' choice behaviour and WTP for the quality of seat and the day of performance is important to policy makers and theatre managers in adopting different pricing and marketing strategies.......This paper analyzes the behavioural choice for theatre tickets using a rich dataset for 2010-2013 from the sale system of the Royal Danish National Theatre. A consumer who decides to attend a theater production faces multiple sources of price variation that depends on: socio...

  11. Reducing cancelled surgery operations in a hospital: brief report

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2016-08-01

    Full Text Available Background: Operation theatre in a hospital requires considerable human and physical resources to deliver surgery services on an agreed schedule. However, operation theatres are sometimes underutilized due to avoidable last minute cancellations of operations. Cancellation of operations on the day of intended surgery results in operation theatre planning difficulties, hospital inefficiency and resource wastage. In addition, it causes stress for patients and their relatives and results in unnecessary hospital staying. Cancellation of planned operations could be avoided by applying appropriate management strategies and techniques. Quality management as an organizational strategy helps enhance hospital departments’ productivity. Methods: This study aimed to reduce cancelled surgeries in Shahid Rajaei Hospital in Tehran using a quality management model. A participatory action research was used for the intervention between April 2013 and March 2014. Information on operations cancelled on the day of surgery obtained each day from the operating theatre list. Using a checklist, the reasons for operations cancellation were identified, investigated and an action plan was developed for its reduction. The plan was implemented using the action research cycle. Results: The number of surgeries increased by 4.06 percent and operations cancellation was reduced by 32.4 percent using the quality management strategy. Surgeon and anesthetist related factors, over-running of previous surgery, changes in patient clinical status and lack of intensive care unit beds were the main reasons for cancelling surgeries. Standardization of processes, proper planning and using anesthetics clinic helped reduce the operations cancellation. Conclusion: Last minute surgeries cancellation is potentially avoidable. Implementing an appropriate quality management model helps enhance hospital departments’ productivity and reduce surgical cancellation.

  12. Narrative Development in Improvisational Theatre

    Science.gov (United States)

    Baumer, Allan; Magerko, Brian

    We have investigated the experience of improvisers as they perform to better understand how narrative is constructed by group performance in improvisational theatre. Our study was conducted with improvisers who would perform improv "games" with each iteration video recorded. Each individual participant was shown the video in a retrospective protocol collection, before reviewing it again in a group interview. This process is meant to elicit information about how the cognition involved develops narrative during an improvisation performance. This paper presents our initial findings related to narrative development in improvisational theatre with an ambition to use these and future analyses in creating improvisational intelligent agents. These findings have demonstrated that the construction of narrative is crafted through the making and accepting of scene-advancing offers, which expert improvisers are more readily capable of performing.

  13. Science Theatre as dissemination of environmental awareness

    DEFF Research Database (Denmark)

    Chemi, Tatiana; Kastberg, Peter

    2015-01-01

    A community project with the intention of developing specific communication on environmental issues for children age 3-7 allies with a theatre artist and storyteller. The result is a meeting between science and theatre. Theatre, with its borderline praxis between entertainment and reflection......) to discuss its clear learning potentials in light of Science Theatre’s specific dramaturgical tools and historical tradition. We maintain that, by means of aesthetic appeal, theatre might be again one of the survival tools human beings need to bridge their lives into the centuries to come....

  14. [One in five surgeons do not wash hands after visiting a toilet - an ethnographic field study].

    Science.gov (United States)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Alamili, Mahdi; Danielsen, Anne Kjærgaard; Rosenberg, Jacob

    2014-12-08

    Non-compliance with regard to hand hygiene is a major problem in the health-care system especially among surgeons and anaesthetists. The purpose of this study was to examine the hand hygiene routines after toilet visits among participants attending an international surgical congress. An observational study was conducted at the American College of Surgeons (ACS) Clinical Congress 2012 and at the American Medical Writers Association (AMWA) Congress 2012 as comparison. The study was performed as an ethnographic field study. A standardized observational matrix was developed for observing whether hand washing (as a surrogate measure of hand hygiene) was performed after toilet visits by observers. Frequencies were compared using Fisher's exact test. A total of 100 persons were observed (80% males). Of the 50 males observed at the ACS meeting, ten males did not use hand hygiene in relation to toilet visits (20%), while only one person at the AMWA meeting out of the 50 observed did not use hand hygiene (2%), p = 0.008. At both congresses only males did not use hand hygiene in relation to toilet visits. One in five surgeons did not wash hands after visiting a toilet. Even though the observed surgeons were not observed in an operating theatre or in a setting that required a distinct degree of hand hygiene, it does reveal a worrying behaviour. It is not known whether this was a conscious act, the result of business, or if it was due to lack of knowledge about the effects of hand hygiene on bacterial transmission. not relevant. This study was neither registered at the National Committee of Health Research nor at Clinical Trials since it did not meet the requirements of registration.

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

    Science.gov (United States)

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

    2011-04-01

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

  16. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU Lu; WANG Yiran

    2015-01-01

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

  17. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU; Lu; WANG; Yiran

    2015-01-01

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

  18. Translating Shakespeare for the theatre Translating Shakespeare for the theatre

    Directory of Open Access Journals (Sweden)

    Jean-Michel Déprats

    2008-04-01

    Full Text Available Translate Shakespeare for the theatre? The question is not purely rhetorical. In his Memoires, Jean Vilar, speaking of his work as an actor, raises the question of whether it is even possible to translate dramatic texts: Macbeth. Whilst learning my part alone at home in the morning, I keep on saying to myself , ‘Never again will I perform translated plays, not even those of Shakespeare.’ Translations either emasculate the original so that the actors may ‘utter’ a French which is straightforward, or at least authentic, or force us to chew up and spit out a stodgy French, weighed down by the burden of the English. My friend Curtis, the translator, can’t help it. Remaining faithful to the original text makes the French prose heavy, but to stray from the original is a crime. So what can we do? (131 This dilemma, so accurately put into words by Vilar, brings us to the question: when translating a Shakespeare play for performance, must we incorporate into our work aims which curtail the usual demands of translation? What is specific about translating for the theatre? Or rather, what demands must a French translation of a dramatic text meet if it is to make performance possible? Translate Shakespeare for the theatre? The question is not purely rhetorical. In his Memoires, Jean Vilar, speaking of his work as an actor, raises the question of whether it is even possible to translate dramatic texts: Macbeth. Whilst learning my part alone at home in the morning, I keep on saying to myself , ‘Never again will I perform translated plays, not even those of Shakespeare.’ Translations either emasculate the original so that the actors may ‘utter’ a French which is straightforward, or at least authentic, or force us to chew up and spit out a stodgy French, weighed down by the burden of the English. My friend Curtis, the translator, can’t help it. Remaining faithful to the original text makes the French prose heavy

  19. Experience of head and neck theatre staff and attitudes to human factors using an aviation-based analysis and classification system--a pilot survey.

    Science.gov (United States)

    Konieczny, Katarzyna M; Seager, Leonie; Scott, Jim; Colbert, Serryth; Dale, Trevor; Brennan, Peter A

    2014-01-01

    The role that human factors have in contributing to air crashes is well known and is included as an essential part of training. Awareness of human factors in surgery is increasingly being recognised but surprisingly few papers have come from head and neck specialties. We circulated a questionnaire on human factors based on an aviation model to 140 head and neck medical and ancillary staff who work in operating theatres in 3 large UK hospitals. Most positive responses were found in the consultant group followed by trainee doctors and support staff. A significant difference was found in the subcategories of Unsafe Supervision (p=0.002) and Preconditions to Unsafe Acts (p=0.001). This work will help to identify multi-system deficiencies that can be corrected, and highlights aspects that may yield the greatest reduction in surgical errors. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. The Underlying Meaning of Absurd Theatre Endgame

    Institute of Scientific and Technical Information of China (English)

    张小康

    2011-01-01

    The absurd theatre denies the meaning of human' s existence and displays absurdity directly with fantastic means.The article is to analyze Beckett' s famous play Endgam by combining characteristics of the absurd theatre,summerizing its writing features and digging up its implied meaning.

  1. Participatory dramaturgy in theatre for development

    African Journals Online (AJOL)

    to the performance itself in theatrical terms, let alone the devising stage, as an ... its potentials for transformation through participatory dramaturgy. Theatre for .... the roles within the creative team are not defined from the outset, the devising ... In the second model of TfD, theatre with the people, animateurs invite a select.

  2. Ethnographic Findings in the Organizational Theatre

    DEFF Research Database (Denmark)

    Buur, Jacob; Torquet, Rosa

    2013-01-01

    In the quest for engaging ethnographic insight in organizations on a more fundamental level than mere ‘innovation drivers’, theatre offers ways of triggering a change in conversations through emotional engagement. This paper discusses the impact of using theatre with professional actors to convey...

  3. How did the ancient Roman Theatres sound?

    DEFF Research Database (Denmark)

    Nielsen, Martin Lisa; Rindel, Jens Holger; Gade, Anders Christian

    2005-01-01

    The Roman theatre follows a natural evolution from the Greek theatre combining the acting area and the seating area into a single structure. Modifications of stage, orchestra and seating area have resulted in a considerable improvement in the quality of the acoustics. As a part of the ERATO project...

  4. Acoustical measurements in ancient Roman theatres

    Science.gov (United States)

    Farnetani, Andrea; Fausti, Patrizio; Pompoli, Roberto; Prodi, Nicola

    2001-05-01

    The Greek and Roman theatres are among the most precious and spectacular items of cultural heritage in the Mediterranean countries. The theatres are famous not only for their impressive architecture, but also for the acoustic qualities. For this reason it is important to consider these theatres as an acoustical heritage and to study their sound field. Within the activities of the ERATO (identification Evaluation and Revival of the Acoustical heritage of ancient Theatres and Odea) project, acoustical measurements were taken in well-preserved ancient Roman theatres at Aspendos (Turkey) and Jerash (Jordan). Roman theatres have an impressive stage building that forms a back wall in the orchestra area, and it was found that, from the analysis of the acoustical parameters, the reverberation time (e.g., 1.7 s at middle frequencies in the theatre of Aspendos) is quite long compared not only with other open-space theatres but also with closed spaces. Contrary to modern halls the clarity is high and this fact, together with a low sound level in most of the seats, gives the sound field a unique character.

  5. Facilitating Learning Spaces in Forum Theatre

    Science.gov (United States)

    Rae, Jan

    2013-01-01

    Purpose: The purpose of this paper is to evaluate the extent to which forum theatre interventions can support non-hierarchical approaches to learning, development and change management initiatives in organisations. Design/methodology/approach: Semi-structured interviews were carried out with theatre consultancies, actors/facilitators,…

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

    Science.gov (United States)

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

    2017-07-01

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

  7. Postdramatic Theatre, 12 years later

    Directory of Open Access Journals (Sweden)

    Hans-Thies Lehmann

    2013-09-01

    Full Text Available This text takes stock of the twelve years of emergence of the practice and term Postdramatic and some of its developments and issues in the performing arts. It discusses the changes through which the contemporary scene has gone since 1999 and consequently the changes we should consider when reading and analysing the concept of postdramatic; among them, the focus on collaborative work; new relations between theatre and society; the focus on dance; and the return of words. Finally, the text raises the question of whether or not the term postdramatic should be reconsidered.

  8. Society of Gynecologic Surgeons

    Science.gov (United States)

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

  9. Find a Surgeon

    Science.gov (United States)

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

  10. Anatomy Live : Performance and the Operating Theatre

    NARCIS (Netherlands)

    2008-01-01

    In de bundel Anatomy Live gaan verschillende wetenschappers in op de relatie tussen de geschiedenis van het anatomische lichaam en het theater. In de openbare ontledingen in het historische anatomische theater van de vroege renaissance werd de basis gelegd voor wat in de daaropvolgende eeuwen het we

  11. Technology Evaluation Report 17. Videoconferencing in Theatre and Performance Studies

    Directory of Open Access Journals (Sweden)

    Mark Childs

    2003-04-01

    Full Text Available Previous reports in this series have indicated the growing acceptance of video-conferencing in education delivery. The current report compares a series of video-conferencing methods in an activity requiring precision of expression and communication: theatre and performance studies. The Accessing and Networking with National and International Expertise (ANNIE project is a two-year project undertaken jointly by the University of Warwick and the University of Kent at Canterbury, running from March 2001 to March 2003. The project's aim is to enhance students' learning experience in theatre studies by enabling access to research-based teaching and to workshops led by practitioners of national and international standing. Various technologies have been used, particularly ISDN video-conferencing, computer-mediated conferencing, and the Internet. This report concludes that video-conferencing methods will gain acceptance in education, as academic schools themselves are able to operate commonly available technology the assistance of specialised service units.

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

    Science.gov (United States)

    Sanders, M A

    1999-11-01

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

  13. The Democratic Potential of Theatre Talks

    DEFF Research Database (Denmark)

    Hansen, Louise Ejgod

    2014-01-01

    of democratization of culture and the democracy theory by James S. Fishkin. The analysis is based on the empirical material of 31 theatre talks carried through as a part of an audience development project and is focused on four different aspects of the democratic potential of theatre: First, how the theatre talks...... approach to a target-oriented approach to audience development in which the content of the performance should be matched with certain audience segments. And fourth, the article points to an outcome of the experience related to the challenging of one own view point and thus expanding ones horizon....

  14. Civil Surgeon Info

    Data.gov (United States)

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

  15. Searching for Surgeons

    Science.gov (United States)

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

  16. Wilfred Trotter: surgeon, philosopher.

    Science.gov (United States)

    Rosen, Irving B

    2006-08-01

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

  17. Society of Thoracic Surgeons

    Science.gov (United States)

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

  18. Theatre

    CERN Multimedia

    Théâtre les 50

    2010-01-01

    MARIONNETTES Compagnie Stella Rossa   Dimanche 12 décembre à 15h et 17h Costanza Solari vient enchanter les grands et les petits à partir de 3 ans avec 4 histoires   Séance de 15 heures : « Une histoire de feu, une histoire de chaleur, une histoire de dragon » Il faut vite faire quelque chose pour réchauffer une grand-mère qui a froid. Après avoir tout essayé, la seule solution pour Mia sera de trouver un dragon qui veuille bien lui céder un peu de son feu… « La princesse et la balle d’or » Il arriva que la balle d’or, au lieu de revenir dans sa main, tomba sur le sol et roula tout droit dans l’eau. La princesse la suivit des yeux, mais la balle disparut : la fontaine était si profonde qu’on n’en voyait pas le fond… Séance de 17 heures : « N...

  19. Theatre

    CERN Multimedia

    Théâtre les 50

    2010-01-01

    Offrez un cadeau culturel   Le Théâtre Les 50 de Saint Jean de Gonville propose des places de théâtre comme cadeau de Noël ou de Nouvel An Les spectacles de janvier :  LA SŒUR CADETTE DE LA POMPADOUR    - ARAGON CHANTE ET PARLE : Ferré, Ferrat, Brassens Vous trouverez tous les détails des spectacles sur le site : www.theatreles50.fr Pour plus de renseignements sur cette offre vous pouvez nous envoyer un mail ou nous téléphoner :  contact@theatreles50.fr  -  00 33 (0)450 56 37 77  

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

    Science.gov (United States)

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

    2013-05-01

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

  1. Modelling Preference Heterogeneity for Theatre Tickets

    DEFF Research Database (Denmark)

    Baldin, Andrea; Bille, Trine

    ) and latent class are proposed in order to model ticket purchase behaviour. These models allow us explicitly to take into account consumers' preference heterogeneity with respect to the attributes associated to each ticket alternative In addition, the distribution of the willingness-to-pay (WTP) of choice...... attributes is estimated. Understanding theatre-goers' choice behaviour and WTP for the quality of seat and the day of performance is important to policy makers and theatre managers in adopting different pricing and marketing strategies.......This paper analyzes the behavioural choice for theatre tickets using a rich dataset for 2010-2013 from the sale system of the Royal Danish National Theatre. A consumer who decides to attend a theater production faces multiple sources of price variation that depends on: socio...

  2. NOTES ON THEATRE OF THE ABSURD

    OpenAIRE

    washington, gene

    2005-01-01

    These are notes from the author's classes on teaching theatre of the absurd: these include plays by Ionesco, Beckett and Stoppard. Some of the author's own absurdist plays, which were part of his pedagogy, are on this website under "Presentations."

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

    Science.gov (United States)

    Iaria, G; Cardillo, A

    2006-05-01

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

  4. Augmented reality to the rescue of the minimally invasive surgeon. The usefulness of the interposition of stereoscopic images in the Da Vinci™ robotic console.

    Science.gov (United States)

    Volonté, Francesco; Buchs, Nicolas C; Pugin, François; Spaltenstein, Joël; Schiltz, Boris; Jung, Minoa; Hagen, Monika; Ratib, Osman; Morel, Philippe

    2013-09-01

    Computerized management of medical information and 3D imaging has become the norm in everyday medical practice. Surgeons exploit these emerging technologies and bring information previously confined to the radiology rooms into the operating theatre. The paper reports the authors' experience with integrated stereoscopic 3D-rendered images in the da Vinci surgeon console. Volume-rendered images were obtained from a standard computed tomography dataset using the OsiriX DICOM workstation. A custom OsiriX plugin was created that permitted the 3D-rendered images to be displayed in the da Vinci surgeon console and to appear stereoscopic. These rendered images were displayed in the robotic console using the TilePro multi-input display. The upper part of the screen shows the real endoscopic surgical field and the bottom shows the stereoscopic 3D-rendered images. These are controlled by a 3D joystick installed on the console, and are updated in real time. Five patients underwent a robotic augmented reality-enhanced procedure. The surgeon was able to switch between the classical endoscopic view and a combined virtual view during the procedure. Subjectively, the addition of the rendered images was considered to be an undeniable help during the dissection phase. With the rapid evolution of robotics, computer-aided surgery is receiving increasing interest. This paper details the authors' experience with 3D-rendered images projected inside the surgical console. The use of this intra-operative mixed reality technology is considered very useful by the surgeon. It has been shown that the usefulness of this technique is a step toward computer-aided surgery that will progress very quickly over the next few years. Copyright © 2012 John Wiley & Sons, Ltd.

  5. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

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

  6. From Mainstream Theatres to Synergy Theatre Project: Black Men's Participation in "Urban" Plays in Prison

    Science.gov (United States)

    Goddard, Lynette

    2013-01-01

    This paper compares how urban-themed black British playwriting can be understood within mainstream and applied theatre contexts. The paper first examines the focus of the mainstream theatre's education packs for productions of Kwame Kwei-Armah's "Elmina's Kitchen" and Roy Williams's "Fallout" before exploring how black men's…

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

    Science.gov (United States)

    Neuhaus, Susan J

    2013-10-01

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

  8. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures.

    Science.gov (United States)

    Romanova, K; Vassileva, J; Alyakov, M

    2015-07-01

    The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens.

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

    Science.gov (United States)

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

    2011-01-01

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

  10. Of dreams and palaces in the theatre within theatre

    Directory of Open Access Journals (Sweden)

    Margaret Rich Greer

    2014-05-01

    Full Text Available Abstract:This article offers an exploration of the relationship between two metaphysical concepts of human existence that are encapsulated in the titles of the two most canonical plays of Pedro Calderón de la Barca: La vida es sueño and El gran teatro del mundo. How these concepts are dramatized by means of the combination of dreams and theater within theatre in Las fortunas de Andromeda y Perseo, Darlo todo y no dar nada, and the Mojiganga de las visiones de la muerte is studied, as are the ideological implications that we can identify in his use of these dramatic formulations. Resumen:En este trabajo, se explora la relación entre los dos conceptos metafísicos de la existencia humana que encapsulan los títulos de las dos obras más canónicas de Pedro Calderón de la Barça: La vida en sueño y El gran teatro del mundo. Se examina cómo se dramatizan por medio de la combinación del sueño y el teatro dentro del teatro en Las fortunas de Andrómeda y Perseo, Darlo todo y no dar nada y la Mojiganga de las visiones de la muerte. Y se considera las implicaciones ideológicas que podemos identificar en estas formulaciones dramáticas en el Barroco español. 

  11. The drama of Ahmed Yerima : studies in Nigerian theatre

    NARCIS (Netherlands)

    Julius-Adeoye, ‘Rantimi Jays

    2013-01-01

    The Drama of Ahmed Yerima. Studies in Nigerian Theatre gives a detailed development of Nigerian theatre from its ritualistic nature in the 16th Century up to the literary form of the 21st century. It looks at the trajectory movement of the theatre through television to cinema and video

  12. Commerce and Entertainment in the Twente Virtual Theatre Environment

    NARCIS (Netherlands)

    Nijholt, A.; Kirner, C.; Kirner, T.G.

    1999-01-01

    In this paper we discuss research on a virtual theatre environment. The theatre has been built using VRML and therefore it can be accessed through World Wide Web. In the environment we employ several agents. The theatre allows navigation input through keyboard function keys and mouse, but there is a

  13. The "Invisible" Drama/Theatre in Education Curriculum in Kenya

    Science.gov (United States)

    Joseph, Christopher Odhiambo

    2016-01-01

    This vignette presents the state of theatre in Education Kenya. The paper argues that though there are several theatre in education like practices, these have not been entrenched in the school curriculum. Theatre in Education finds expression and manifestations outside the mainstream school curriculum for instance in schools and colleges drama…

  14. A Preliminary Investigation of Current Practices in American Youth Theatres.

    Science.gov (United States)

    Regan, F. Scott

    1983-01-01

    Summarizes results of a survey of youth theatres on (1) theatre goals; (2) staff training and courses offered; (3) organization and funds; and (4) teachers' knowledge of actor training, child and adolescent psychology, playwriting trends in children's theatre, and current theoretical writings. (PD)

  15. Antonio Gimbernat y Arbós: an anatomist-surgeon of the Enlightenment (in the 220th anniversary of his "A new method of operating the crural hernia").

    Science.gov (United States)

    Arráez-Aybar, Luis-Alfonso; Bueno-López, José-Luis

    2013-10-01

    This article focuses on Antonio de Gimbernat y Arbós (1734-1816), with particular attention paid to his famous publication "Nuevo método de operar en la hernia crural" (2013 marking its 220 anniversary), which was translated into English by Thomas Beddoe two years later (A new method of operating for the femoral hernia Translated from the Spanish of Don Antonio de Gimbernat, To which are added, with plates by the translator, queries respecting a safer method of performing inoculation). Antonio de Gimbernat y Arbós, a Spanish anatomist and surgeon, was one of the pioneers during the "Age of Dissection" (late 18th Century). He was a man of great willpower, bright, thorough, and unique. From his careful anatomical study in the inguinal region, he made a detailed description of the lacunar ligament, which John Hunter called the Gimbernat's ligament in his honor. Antonio de Gimbernat y Arbós also proposed an advanced treatment for strangulated femoral hernias. He acquired extraordinarily broad surgical skills with therapeutic orientation, conservative, not aggressive, based on the knowledge he had gained through dissection. Furthermore, though this is less well known nowadays, Antonio de Gimbernat y Arbós was also relevant organizer of education and health-services - as it was the custom of the great physician of this time. Consequently, Antonio de Gimbernat y Arbós is truly representative of the great figures of the anatomists-surgeons of the Enlightenment.

  16. [The robotic surgeon training].

    Science.gov (United States)

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

    2015-10-01

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

  17. ARISTOTLE AND BERTOLT BRECHT'S EFFECTS ON ENGLISH THEATRE

    OpenAIRE

    Güney, Ajda

    2011-01-01

    The aim of this study is to interpret the effects to English theatre of Aristotle who defined the first theory of theatre art in the 4th century B.C,and those of Bertolt Brecht who marked upon the 20th century theatre. The most significant theatre theorist of the 20th century, the German playwright, theatre director and commentator Bertolt Brecht, provided outstanding clues to contemporary playwrights. Brecht, who witnessed the two great world wars of human history, conducted his works in ord...

  18. Magnification for the dermatologic surgeon.

    Science.gov (United States)

    Chodkiewicz, Hubert M; Joseph, Aaron K

    2017-06-01

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

  19. Clinical features and management of equine post operative ileus (POI): Survey of Diplomates of the American Colleges of Veterinary Internal Medicine (ACVIM), Veterinary Surgeons (ACVS) and Veterinary Emergency and Critical Care (ACVECC).

    Science.gov (United States)

    Lefebvre, D; Hudson, N P H; Elce, Y A; Blikslager, A; Divers, T J; Handel, I G; Tremaine, W H; Pirie, R S

    2016-11-01

    A recent survey of European Colleges (European College of Equine Internal Medicine [ECEIM] and European College of Veterinary Surgeons [ECVS]) revealed the different strategies implemented by, and some of the challenges facing, European clinicians presented with cases of post operative ileus (POI). It was concluded that further comparative analysis of opinions, canvassed from additional colleges of equine veterinary specialism worldwide, would provide valuable additional insight into current POI knowledge on a more global scale. To report and compare the current strategies favoured by American veterinary specialists when managing POI in horses that underwent emergency colic surgery. Cross-sectional survey. Electronic invitations were sent to 814 Large Animal specialists, including 3 colleges: the American College of Veterinary Internal Medicine (ACVIM), American College of Veterinary Surgeons (ACVS) and the American College of Veterinary Emergency and Critical Care (ACVECC). The response rate was 14% (115/814). The majority of respondents (68%) reported an estimated prevalence range of POI of 0-20%. The presence of reflux on nasogastric intubation was the main criterion used to define POI. A lesion involving the small intestine was considered the main risk factor for POI. Anti-inflammatory drugs, intravenous (i.v.) fluids and antimicrobial drugs were the primary strategies used when managing POI. Flunixin meglumine and i.v. lidocaine were the drugs most commonly used in the treatment of horses with POI. Supplementary management strategies targeted mainly the prevention of post operative adhesions, infection and inflammation. There is a lack of consensus on the clinical definition of POI. Prospective and objective clinical assessment of the effectiveness of the different strategies contained within this and the European survey is necessary in order to identify a standardised approach to the management of equine POI. © 2015 EVJ Ltd.

  20. Renaissance Theatre in a General Education Program.

    Science.gov (United States)

    Lenz, Carolyn R.; Hutchinson, P. William

    A course in Renaissance theatre offered within the general studies curriculum at Rhode Island College introduced students to the field of Jacobean and Elizabethan drama and to the dramatic arts, provided opportunities for students to help produce and act in scenes from several plays, and revealed to them the importance of vivid and detailed…

  1. Family Fathers Lost in Theatre Paradox

    DEFF Research Database (Denmark)

    Kuhlmann, Annelis

    2008-01-01

    Diderot's influence on theatre is well known through The Paradox of Acting (Paradoxe sur le comédien). However, Diderot also wrote a few drames bourgeois, among which is The Family Father (Le Père de famille), which still in Diderot's days was edited in Copenhagen in French, and which in Danish...

  2. Classic Readers Theatre for Young Adults.

    Science.gov (United States)

    Barchers, Suzanne I.; Kroll, Jennifer L.

    This book presents 16 original scripts that have been adapted from classic works of literature for use for readers theatre with young adults and ESL (English as a Second Language) students. Adaptations of the following works are included: "Little Women" (Louisa May Alcott); episodes from "Don Quixote" (Miguel de Cervantes; "The Necklace" (Guy de…

  3. Tianjin Song and Dance Theatre Visits Japan

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    <正>At the invitation of the Japanese Min-On Concert Association, a 47-member troupe of Tianjin Song and Dance Theatre organized and sent by the CPAFFC gave 55 performances in 37 cities of Japan from September 12 to November 25, 2005, attracting an audience of nearly 80,000. The grand dance entitled Golden Glory

  4. Theatre Practice and Social Adjustment in Nigeria

    African Journals Online (AJOL)

    Nneka Umera-Okeke

    The essence of this paper is not the blame game theory but to break new intellectual grounds in the ... quality of life consistent with their own aspirations (p. 2). ... The theatre at all times has provided directions out of difficulties. It serves as ... the process of transmission would always present the challenges. .... and hospitality.

  5. Evolution of the Anatomical Theatre in Padova

    Science.gov (United States)

    Macchi, Veronica; Porzionato, Andrea; Stecco, Carla; Caro, Raffaele

    2014-01-01

    The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in…

  6. Theatre Practice and Social Adjustment in Nigeria

    African Journals Online (AJOL)

    Nneka Umera-Okeke

    adjustments in favour of local processes to drive social and economic development. ... The high rate of unemployment and massive city-drifts are consequences of untenable ... Theatre practice provides social, cultural and material history .... Ofonagoro (1995) explained the role of tourism and culture to national development.

  7. Shakespeare and Reader's Theatre: Fellow Traveling Companions

    Science.gov (United States)

    Ratliff, Gerald Lee

    2010-01-01

    Whether constructed on literary analysis models or inspired by conventional acting theories, Reader's Theatre performance techniques are an invaluable instructional tool available to teachers who want their students to see, hear and feel Shakespeare texts in classroom discussion and performance. These exercises are designed to promote both a…

  8. Does Fibrin Glue Sealant Used During Pancreaticoduodenectomy Reduce Post-Operative Complication? Audit of 100 Consecutive Patients Undergoing Whipple's Procedure by a Single Surgeon

    Directory of Open Access Journals (Sweden)

    Shafiq Rehman

    2016-03-01

    Full Text Available Introduction This study evaluated the effect of fibrin glue applied as a sandwich film between a two layer pancreatico-jejunostomy anastomosis following pancreaticoduodenectomy. Primary end-points were post-operative pancreatic fistulae, overall complication rates and post-operative length of stay. Methods Pancreaticoduodenectomy was performed by fashioning a two layer pancreatico-jejunostomy with or without a glue sealant which when applied, formed a thin film external to the ductal anastomosis but internal to the seromuscularpancreatic parenchymal layer. Results Following audit of 100 consecutive patients undergoing pancreaticoduodenectomy, patients were separated into two groups; those with glue augmented anastomosis [Glue (G N=50] or those without [No Glue (NG, N=50]. Each group was matched with regard to age [median, G=68 years vs. NG=66 years, (P=0.19] and sex (P=0.84. There were no statistically significant differences between the two groups with respect to overall POPF [G N=7(14% vs. NG N=11(22%, (P=0.42], significant complications (Clavien Grade 3 or more, [G N=4(8% vs. NG N=2(4% (P=0.40], or post-operative length of stay [G 13 days vs. NG 14 days, (P=0.90]. In those patients with the highest fistulae risk score, there were significantly more post-operative pancreatic fistulae in the no glue cohort. There was no mortality in either group. Conclusion This study shows that application of sealant glue significantly reduces post-operative pancreatic fistulae in high-risk patients, but does not reduce overall complications or hospital stay following pancreaticoduodenectomy.

  9. Robotics and the pediatric surgeon.

    Science.gov (United States)

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

    2003-06-01

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

  10. Herniation of the cervical disk in plastic surgeons.

    Science.gov (United States)

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

    2012-12-01

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

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

    Science.gov (United States)

    Jähne, J

    2012-04-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Ulf Martin Schilling

    2012-01-01

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

  14. [Results and conclusions from 328 radical operations of rectal carcinoma by one surgeon. Comparative anatomic studies with Brachydanio rerio and Latimeria chalumnae].

    Science.gov (United States)

    Stelzner, F

    1995-12-01

    The continence preserving procedures, even with small margins, have better curative results than amputation of the rectum. Nevertheless marginal continent resections have to take a defective continence into account. In clinical practice this is tolerated. A reason for the reduction of continence is the loss of the corpus cavernosum recti. Comparative anatomical investigations in Brachydanio, a fish species that is transparent in its larva stage, lead to the conclusion, that the rectum remains an abdominal organ even though it is situated in the lesser pelvis. Thus it is strictly separated from the totally differently developed pelvic organ of the urogenital system. This is also proven by the separate anlages of the lymph nodes, lymph and blood vessels. Concerning the continence organ it is referred to the formal sex difference. The female closure mechanism is weaker and more primitive. We could follow this principle back to the Latimeria. For this reason, after deep continent resections, women always are more subject to incontinence, and have to wear nightly pads, at times. We have operated on 328 patients during 1-1-1978 to 2-22-1989. Their curative rates relate to these considerations.

  15. Surgical site infection prevention: the importance of operative duration and blood transfusion--results of the first American College of Surgeons-National Surgical Quality Improvement Program Best Practices Initiative.

    Science.gov (United States)

    Campbell, Darrell A; Henderson, William G; Englesbe, Michael J; Hall, Bruce L; O'Reilly, Michael; Bratzler, Dale; Dellinger, E Patchen; Neumayer, Leigh; Bass, Barbara L; Hutter, Matthew M; Schwartz, James; Ko, Clifford; Itani, Kamal; Steinberg, Steven M; Siperstein, Allan; Sawyer, Robert G; Turner, Douglas J; Khuri, Shukri F

    2008-12-01

    Surgical site infections (SSI) continue to be a significant problem in surgery. The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Best Practices Initiative compared process and structural characteristics among 117 private sector hospitals in an effort to define best practices aimed at preventing SSI. Using standard NSQIP methodologies, we identified 20 low outlier and 13 high outlier hospitals for SSI using data from the ACS-NSQIP in 2006. Each hospital was administered a process of care survey, and site visits were conducted to five hospitals. Comparisons between the low and high outlier hospitals were made with regard to patient characteristics, operative variables, structural variables, and processes of care. Hospitals that were high outliers for SSI had higher trainee-to-bed ratios (0.61 versus 0.25, p site visitors. Overall, low outlier hospitals were smaller, efficient in the delivery of care, and experienced little operative staff turnover. Our findings suggest that evidence-based SSI prevention practices do not easily distinguish well from poorly performing hospitals. But structural and process of care characteristics of hospitals were found to have a significant association with good results.

  16. American 'committed' drama in Slovene theatres

    Directory of Open Access Journals (Sweden)

    Igor Maver

    1994-12-01

    Full Text Available The purpose of this study is essentially to demonstrate that the delayed stagings of American 'committed' plays, written in the thirties and produced in Slovene theatres immediately after World War Two in the late forties and fifties, were often miscontextualized and partly misinterpreted by the literary critics of the period. This was only in the early post-war years largely due to the need to serve the then ruling ideology and to comply with the criteria of Marxist aesthetisc, especially that of a radical social criticism. However, the later stagings particularly of Arthur Miller's and also Tennessee Williams's plays, did not see the same phenomenon, for it was they that assured the popularity of the American post-war drama on Slovene stages and, even more importantly, helped Slovene theatre to come off age in the sixties.

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

    Science.gov (United States)

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

    2004-01-01

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

  18. Performing injustice: human rights and verbatim theatre

    OpenAIRE

    Derbyshire, Harry; Hodson, Loveday

    2008-01-01

    Discusses the theatrical treatment of human rights, by reference to three British productions: Guantanamo: "Honor Bound to Defend Freedom" (2004), My Name is Rachel Corrie (2005) and Called to Account (2007), noting the use of verbatim testimony in such plays. Reviews legal scholarship highlighting the limitations of human rights laws. Considers the theatrical context of each of the plays and the ways in which they represent the status of human rights laws. Comments on the extent of theatre's...

  19. The business acumen of Canadian plastic surgeons.

    Science.gov (United States)

    Bliss, J A; Caputy, G G

    1995-08-01

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

  20. The application of European system for cardiac operative risk evaluation II (EuroSCORE II and Society of Thoracic Surgeons (STS risk-score for risk stratification in Indian patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Deepak Borde

    2013-01-01

    Full Text Available Aims and Objectives: To validate European system for cardiac operative risk evaluation II (EuroSCORE II and Society of Thoracic Surgeons (STS risk-score for predicting mortality and STS risk-score for predicting morbidity in Indian patients after cardiac surgery. Materials and Methods: EuroSCORE II and STS risk-scores were obtained pre-operatively for 498 consecutive patients. The patients were followed for mortality and various morbidities. The calibration of the scoring systems was assessed using Hosmer-Lemeshow test. The discriminative capacity was estimated by area under receiver operating characteristic (ROC curves. Results: The mortality was 1.6%. For EuroSCORE II and STS risk-score C-statics of 5.43 and 6.11 were obtained indicating satisfactory model fit for both the scores. Area under ROC was 0.69 and 0.65 for EuroSCORE II and STS risk-score with P values of 0.068 and 0.15, respectively, indicating poor discriminatory power. Good fit and discrimination was obtained for renal failure, long-stay in hospital, prolonged ventilator support and deep sternal wound infection but the scores failed in predicting risk of reoperation and stroke. Mortality risk was correctly estimated in low ( 5% patients by both scoring systems. Conclusions: EuroSCORE II and STS risk-scores have satisfactory calibration power in Indian patients but their discriminatory power is poor. Mortality risk was over-estimated by both the scoring systems in high-risk patients. The present study highlights the need for forming a national database and formulating risk stratification tools to provide better quality care to cardiac surgical patients in India.

  1. American Society of Plastic Surgeons

    Science.gov (United States)

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

  2. The nature of surgeon human capital depreciation.

    Science.gov (United States)

    Hockenberry, Jason M; Helmchen, Lorens A

    2014-09-01

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

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

    Science.gov (United States)

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

    2017-03-01

    The aim of this research was to understand healthcare professionals' perception of the continued practice of ageing surgeons in Singapore. A quantitative method was chosen for this research to determine healthcare professionals' perception of the practice of ageing surgeons. Ethical approval was obtained from the local ethical review board. A cross-sectional method using a population survey was performed among healthcare professionals in two tertiary institutions and the study was confined to stakeholders in practices of ageing surgeons. The population sampled was limited to nurses in the theatre, anaesthetists, surgeons and geriatricians (physicians). An online questionnaire was designed for the survey that took into consideration the various conceptual frameworks of ageing surgeons' practice that was obtained from a literature review. There were 104 respondents of a population of 350 sampled (theatre nurses, anaesthetists, physicians and surgeons) giving a respondent rate of 30%. The mean age of the participants was 39.7; 72% were doctors (surgeons 34%, physicians 20% and anaesthetists 18%) and 28% nurses. Only 35% agreed with the statement that older surgeons face deterioration in cognitive faculties and 29% remained neutral. A similar trend was seen with the perception that older surgeons face a decline in memory. However, 44% agreed with the statement that older surgeons face a decline in visuospatial ability and another 40% agreed that they had a decline in psychomotor skills and reaction time. Fifty per cent agreed with the statement that they face deterioration in physical abilities. Sixty-three per cent did not think that older surgeons face a decline in reasoning and judgement. Forty-eight per cent believed that older surgeons' vast fund of knowledge and experience could compensate for physical and cognitive changes. Only 13% agreed with the statement that older surgeons have higher surgical mortality. Forty-five per cent agreed that the retirement age

  4. New theatre building at Munich. Wholesome climate; Muenchener Kammerspiele. Gutes Klima im neuen Probengebaeude

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, O. [Ebert-Ingenieure, Muenchen (Germany)

    2002-07-01

    The new rehearsal building of the Muenchener Kammerspiele theatre was planned in an integral process, in which architects, construction engineers, acoustic engineers and users co-operated to achieve an optimum result. [German] Fuer den Neubau des Probengebaeudes der Muenchener Kammerspiele wurde in einem integralen Planungsprozess in enger Kooperation mit Architekten, Tragwerksplaner, Akustiker und Nutzer ein auf die spezifischen Anforderungen als Spielstaette und Probengebaeude abgestimmtes Gebaeude- und Anlagenkonzept erarbeitet. (orig.)

  5. Princess Theatre-Never Forgotten B roadway Theatre%Princess Theatre 不会被历史忘却的百老汇剧院

    Institute of Scientific and Technical Information of China (English)

    卿菁

    2008-01-01

    @@ 曾先后更名为"露西尔7拉·凡恩剧院"(Lucille La Verne Theatre)、"协会剧院"(Assernbly Theatre)、"劳工舞台"(Labor Stage)、"但丁电影院"(CinemaDante)、"小麦特"(Little Met)、"威尔第电影院"(Cine Verdi)的公主剧院(Princess Theatre),虽然在今日的百老汇地图上已无迹可循,但其伟岸身影永留美国音乐剧史.

  6. Drama/Theatre in Education and Theatre as an Academic Discipline ...

    African Journals Online (AJOL)

    user

    2013-07-07

    Jul 7, 2013 ... Department of Theatre and Media Arts. Federal University,Oye Ekiti, ... meaning and functions of drama as an educational tool. Scholars, ..... field and the core sciences or technology oriented discipline in our society today. .... disciplines such as history, social studies, citizenship education language studies ...

  7. Interdisciplinary Teaching of Theatre and Human Rights in Honors

    Science.gov (United States)

    Szasz, Maria

    2017-01-01

    Since spring 2012, the author has taught a 300-level Theatre and Human Rights class in the University of New Mexico Honors College. One of the centerpieces of honors education is careful research and thorough analysis of what is taught and why it is taught. In creating the honors class Theatre and Human Rights, the author explored how she would…

  8. Theatre as a Vehicle for Mobilizing Knowledge in Education

    Science.gov (United States)

    Segedin, Lauren

    2017-01-01

    In the field of education, there has been an increased emphasis on evidence-based practice. Yet, traditional dissemination methods continue to be used. Using more creative and innovative strategies to disseminate research are needed. Theatre is one such method. Stemming from the research on knowledge mobilization and theatre as a method for social…

  9. Emotions as Data in the Act of Jokering Forum Theatre

    Science.gov (United States)

    Hewson, Anne

    2007-01-01

    For three years the author has been using Forum Theatre strategies as a means of experientially exploring classroom management with preservice teachers in a post-degree BEd program. During the third year, the author undertook an arts-based action research project to examine her actions as facilitator, or "Joker", and to explore Forum Theatre's…

  10. Curriculum: The Contradictions in Theatre Education in Brazil

    Science.gov (United States)

    Pompeo Nogueira, Marcia; de Medeiros Pereira, Diego

    2016-01-01

    The history of arts education in Brazil is summarised, based on its contradictions. Some aspects of the Brazilian educational system and the National Curriculum Parameters are presented, in order to identify the predominant approach to theatre education. Three situations of the theatre education landscape in the state of Santa Catarina, southern…

  11. SENIOR THEATRE AN IMPORTANT PART OF SENIOR CULTURE

    Directory of Open Access Journals (Sweden)

    Rosemarie Kurz

    2016-06-01

    Full Text Available The third age is an opportunity and can be used wisely. Going to university, travelling, volunteering or joining a theater group could be possibilities. The article deals with Cultural Implications, and with senior theatre forging ahead in unexpected and adventurous directions. Last not least about the situation of Senior Theatre in Graz, Austria

  12. SENIOR THEATRE AN IMPORTANT PART OF SENIOR CULTURE

    OpenAIRE

    2016-01-01

    The third age is an opportunity and can be used wisely. Going to university, travelling, volunteering or joining a theater group could be possibilities. The article deals with Cultural Implications, and with senior theatre forging ahead in unexpected and adventurous directions. Last not least about the situation of Senior Theatre in Graz, Austria

  13. Deviant service behaviour: Coming soon to a theatre near you?

    NARCIS (Netherlands)

    van Eerde, W.; Peper, P.

    2008-01-01

    Deviant service behaviour (DSB) is examined among employees of a cinema chain in the Netherlands. Behaviours that were reported in interviews with 47 employees of one theatre were phrased as items and were used in a survey conducted in three other theatres of the same chain (n = 115). Virtually all

  14. High School Dinner Theatre: A Fun Way to Raise Funds.

    Science.gov (United States)

    Robert, Harvey

    Citing the success of commercial dinner theatres, this guide is designed to persuade high school drama teachers to try the idea and also to answer questions and help solve problems for those producing a dinner theatre for the first time. The six chapters cover choosing the place, the menu, and the play; ticket sales; advertising and publicity; and…

  15. A Brechtian Theatre Pedagogy for Intercultural Education Research

    Science.gov (United States)

    Frimberger, Katja

    2016-01-01

    The following article explores the potential of Bertolt Brecht's theatre pedagogy for intercultural education research. It is argued that Brecht's pedagogical views on theatre connect to those interculturalists who prioritise the embodied dimensions of intercultural encounters over a competence-driven orientation. Both share a love for aesthetic…

  16. Megan Terry's Plays for Youth at the Omaha Magic Theatre.

    Science.gov (United States)

    Klein, Jeanne

    Nebraska's Omaha Magic Theatre (OMT) and playwright Megan Terry are concerned with producing socially relevant, issue-oriented musical plays, focusing on young people and the adults who influence their emotional lives. OMT's "Theatre of Process" focuses upon the performing artist to develop and test ways to make theater more meaningful,…

  17. Has medical history importance for surgeons?

    Science.gov (United States)

    Wangensteen, O W

    1975-03-01

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

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

    Science.gov (United States)

    Wysocki, A; Dolecki, M

    2001-01-01

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

  19. Druid theatre's economics: the first decade

    Directory of Open Access Journals (Sweden)

    Shelley Troupe

    2010-11-01

    Full Text Available This article considers the relationship between Druid Theatre's productions and its administration during the company's first decade by investigating the links between three features:  the company's fundraising practices; Druid's infrastructure development in terms of personnel and physical space; and the organisation's programming choices.  Druid's artistic partnership with Irish playwright Tom Murphy is also examined as it assisted in launching Druid's international touring when Murphy's Conversations on a Homecoming was the first Druid production to travel outside of the United States/United Kingdom festival circuit.

  20. 3D straight-stick laparoscopy versus 3D robotics for task performance in novice surgeons: a randomised crossover trial.

    Science.gov (United States)

    Shakir, Fevzi; Jan, Haider; Kent, Andrew

    2016-12-01

    The advent of three-dimensional passive stereoscopic imaging has led to the development of 3D laparoscopy. In simulation tasks, a reduction in error rate and performance time is seen with 3D compared to two-dimensional (2D) laparoscopy with both novice and expert surgeons. Robotics utilises 3D and instrument articulation through a console interface. Robotic trials have demonstrated that tasks performed in 3D produced fewer errors and quicker performance times compared with those in 2D. It was therefore perceived that the main advantage of robotic surgery was in fact 3D. Our aim was to compare 3D straight-stick laparoscopic task performance (3D) with robotic 3D (Robot), to determine whether robotic surgery confers additional benefit over and above 3D visualisation. We randomised 20 novice surgeons to perform four validated surgical tasks, either with straight-stick 3D laparoscopy followed by 3D robotic surgery or in the reverse order. The trial was conducted in two fully functional operating theatres. The primary outcome of the study was the error rate as defined for each task, and the secondary outcome was the time taken to complete each task. The participants were asked to perform the tasks as quickly and as accurately as possible. Data were analysed using SPSS version 21. The median error rate for completion of all four tasks with the robot was 2.75 and 5.25 for 3D with a P value robot was 157.1 and 342.5 s for 3D with a P value robotic systems over 3D straight-stick laparoscopy, in terms of reduced error rate and quicker task performance time.

  1. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

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

  2. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

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

  3. 'I was utterly mesmerised': Audience experiences of different theatre types and genres in four European cities

    NARCIS (Netherlands)

    Wilders, M.L.; Toome, H.-L.; Šorli, M.; Szabó, A.; Zijlstra, A.

    2015-01-01

    This article investigates the similarities and differences on how spectators experience theatre performances grouped along large, transnationally present types as Spoken Theatre, Dance Theatre, Musical Theatre and Kleinkunst. Our findings are based on the analysis of the extensive data collected by

  4. A surgeon's quest

    Indian Academy of Sciences (India)

    M S Valiathan

    2008-09-01

    This last part of surgery, namely, operations, is a reflection on the healing art; it is a tacit acknowledgement of the insufficiency of surgery. It is like an armed savage who attempts to get that by force which a civilised man would get by stratagem.

  5. Smartphones and the plastic surgeon.

    Science.gov (United States)

    Al-Hadithy, Nada; Ghosh, Sudip

    2013-06-01

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

  6. Offer - La Comédie theatre

    CERN Multimedia

    Staff Association

    2017-01-01

    The “La Comédie” theatre unveiled its programme for the season 2017–2018. We are delighted to share this brand new, rich and varied programme with you. The “La Comédie” theatre has various discounts for our members Buy 2 subscriptions for the price of 1 : 2 cards “Libertà” for CHF 240.- instead of CHF 480.- Cruise freely through the season with an 8-entry card valid for the shows of your choice. These cards are transferable and can be shared with one or more accompanying persons. 2 cards “Piccolo” for CHF 120 instead of CHF 240.- This card lets you discover 4 shows which are suitable for all audiences (offers valid while stock lasts) Benefit from a reduction of 20 % on a full price ticket during all the season: from CHF 40.- to CHF 24.- ticket instead of CHF 50.- to CHF 30.- depending on the show (Also valid for one accompanying person). Interested in one of these offers? Create an ac...

  7. AGORA 剧院%Theatre Agora

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    The Agora Theatre is part of the masterplan for Lelystad by Adriaan Geuze, which aims to revitalize the pragmatic, sober town centre. The theatre responds to the ongoing mission of reviving and recovering the post- war Dutch new towns by focusing on the archetypal function of a theatre: that of creating a world of artifice and enchantment.%Agora剧院是由Adriaan Geuze负责的莱利斯塔德中心城总体规划项目的一部分,旨在复兴这座冷清的城市,赋予其新的精神面貌。Agora剧院的设计通过关注剧院的根本功能——用各种技巧创造一个魔幻世界,来回应建筑本身承担的使命:战后荷兰城市的再生和复兴。

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

    Science.gov (United States)

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

    1998-01-01

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

  9. 15th Chapter of Surgeons Lecture: Surgeon of the new millennium--surgeon, scientist and scholar.

    Science.gov (United States)

    Tan, S K

    2004-11-01

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

  10. Your Lung Operation: After Your Operation

    Medline Plus

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

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

    Science.gov (United States)

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

    2013-12-01

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

  12. Sir Charles Ballance: pioneer British neurological surgeon.

    Science.gov (United States)

    Stone, J L

    1999-03-01

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

  13. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation Back to Your Lung Operation Your Lung Operation DVD Welcome Your Lung ...

  14. A survey of static and dynamic work postures of operating room staff.

    Science.gov (United States)

    Kant, I J; de Jong, L C; van Rijssen-Moll, M; Borm, P J

    1992-01-01

    Work in health care units is associated with considerable physical strain and many musculoskeletal complaints. Most investigations have concentrated on the work of general hospital nurses; little is known about the physical stress load on other health care workers. We therefore carried out an ergonomic study amongst operating room staff in order to (i) determine the work (posture) stress load on this particular group of health care workers and the effect of static posture on this stress, (ii) identify activities involving poor work postures, and (iii) determine differences between specialties in regard to work posture stress load. The work postures and related work activities of four different groups of staff in operating rooms (surgeons, assistant anaesthesists, instrumentation nurses and circulating nurses) were recorded and evaluated using the specified Ovako Working posture Analysing System (OWAS). Observation during the course of 18 daily surgical programmes (total number of observations: 3714) in the specialties general surgery and ear-nose-throat (ENT) surgery revealed that the work-load according to OWAS for circulating nurses and assistant anaesthesists was not harmful. Some work postures seen among instrumentation nurses and surgeons, however, need improvement. The work posture stress load in these groups is mainly due to the high prevalence of static work postures during the activities "surgery" (surgeons) and "assisting surgery" (instrumentation nurses). Significant differences in ergonomic stress load were observed between general surgeons and ENT surgeons. This survey in operating theatres relates work postures to basic activities and can be used as a starting point from which to improve work conditions in order to reduce or eliminate physical complaints among operating room staff.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  16. [The surgeons civil responsibility insurance].

    Science.gov (United States)

    Santovito, D

    2004-10-01

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

  17. Theatre and Pedagogy: Using Drama in Mental Health Nurse Education.

    Science.gov (United States)

    Wasylko, Yolanda; Stickley, Theodore

    2003-01-01

    Describes how psychodrama, forum theatre, and other forms of drama can facilitate active learning, develop empathy and reflective skills, and foster emotional intelligence in nursing education. Contains 21 references. (SK)

  18. A model of disruptive surgeon behavior in the perioperative environment.

    Science.gov (United States)

    Cochran, Amalia; Elder, William B

    2014-09-01

    Surgeons are the physicians with the highest rates of documented disruptive behavior. We hypothesized that a unified conceptual model of disruptive surgeon behavior could be developed based on specific individual and system factors in the perioperative environment. Semi-structured interviews were conducted with 19 operating room staff of diverse occupations at a single institution. Interviews were analyzed using grounded theory methods. Participants described episodes of disruptive surgeon behavior, personality traits of perpetrators, environmental conditions of power, and situations when disruptive behavior was demonstrated. Verbal hostility and throwing or hitting objects were the most commonly described disruptive behaviors. Participants indicated that surgical training attracts and creates individuals with particular personality traits, including a sense of shame. Interviewees stated this behavior is tolerated because surgeons have unchecked power, have strong money-making capabilities for the institution, and tend to direct disruptive behavior toward the least powerful employees. The most frequent situational stressors were when something went wrong during an operation and working with unfamiliar team members. Each factor group (ie, situational stressors, cultural conditions, and personality factors) was viewed as being necessary, but none of them alone were sufficient to catalyze disruptive behavior events. Disruptive physician behavior has strong implications for the work environment and patient safety. This model can be used by hospitals to better conceptualize conditions that facilitate disruptive surgeon behavior and to establish programs to mitigate conduct that threatens patient safety and employee satisfaction. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    Van Kasteren, J.

    2001-01-01

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

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

    Science.gov (United States)

    Okumura, Meinoshin

    2017-01-01

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

  1. Kant and the cosmetic surgeon.

    Science.gov (United States)

    Carey, J S

    1989-07-01

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

  2. Smartphone apps for orthopaedic surgeons.

    Science.gov (United States)

    Franko, Orrin I

    2011-07-01

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

  3. [Chronic surplus of Japanese cardiac surgeon--ideal nurse practitioner for cardiac surgery, cardiac surgeon's attitude toward the future].

    Science.gov (United States)

    Ikegami, Hirohisa

    2014-03-01

    It is chronically surplus of doctors in the world of cardiac surgery. There are too many cardiac surgeons because cardiac surgery requires a large amount of manpower resources to provide adequate medical services. Many Japanese cardiac surgeons do not have enough opportunity to perform cardiac surgery operations, and many Japanese cardiac surgery residents do not have enough opportunity to learn cardiac surgery operations. There are physician assistants and nurse practitioners in the US. Because they provide a part of medical care to cardiac surgery patients, American cardiac surgeons can focus more energy on operative procedures. Introduction of cardiac surgery specialized nurse practitioner is essential to deliver a high quality medical service as well as to solve chronic problems that Japanese cardiac surgery has had for a long time.

  4. Training cardiac surgeons: the Indiana University experience.

    Science.gov (United States)

    Brown, John W

    2016-12-01

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

  5. Safe surgery: how accurate are we at predicting intra-operative blood loss?

    LENUS (Irish Health Repository)

    2012-02-01

    Introduction Preoperative estimation of intra-operative blood loss by both anaesthetist and operating surgeon is a criterion of the World Health Organization\\'s surgical safety checklist. The checklist requires specific preoperative planning when anticipated blood loss is greater than 500 mL. The aim of this study was to assess the accuracy of surgeons and anaesthetists at predicting intra-operative blood loss. Methods A 6-week prospective study of intermediate and major operations in an academic medical centre was performed. An independent observer interviewed surgical and anaesthetic consultants and registrars, preoperatively asking each to predict expected blood loss in millilitre. Intra-operative blood loss was measured and compared with these predictions. Parameters including the use of anticoagulation and anti-platelet therapy as well as intra-operative hypothermia and hypotension were recorded. Results One hundred sixty-eight operations were included in the study, including 142 elective and 26 emergency operations. Blood loss was predicted to within 500 mL of measured blood loss in 89% of cases. Consultant surgeons tended to underestimate blood loss, doing so in 43% of all cases, while consultant anaesthetists were more likely to overestimate (60% of all operations). Twelve patients (7%) had underestimation of blood loss of more than 500 mL by both surgeon and anaesthetist. Thirty per cent (n = 6\\/20) of patients requiring transfusion of a blood product within 24 hours of surgery had blood loss underestimated by more than 500 mL by both surgeon and anaesthetist. There was no significant difference in prediction between patients on anti-platelet or anticoagulation therapy preoperatively and those not on the said therapies. Conclusion Predicted intra-operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate

  6. Politics in the context of the “Opera question” in the national theatre before the first world war

    Directory of Open Access Journals (Sweden)

    Milanović Biljana

    2012-01-01

    Full Text Available Part of the history of the National Theatre in Belgrade in the decade before the First World War relates to processes of discontinuity in the professionalization and modernization of the musical section in this institution and its repertoire. It had to do with abrupt changes reflected in three short-lived phases: improvements in musical ensemble and opera performances (1906-1909, the annulment of these efforts and results with a return to the old repertoire, and then again a new beginning once more with a fresh attempt to establish the Opera (1913-14. These dynamics were affected by the social and political context. It was dependent on frequent changes of the Theatre’s management staff whose main representatives had mutually conflicting views on important questions concerning the functioning of their institution. Relations between them were strongly marked by contested political motives. Theatre managers were appointed by ministers of education who could also be relieved of their posts, and members of the management staff were always active in political parties. These facts acted as a decisive factor in their communication which was similar to the behaviour and customs of public political life where an opponent is seen as an enemy, not as a partner in solving common problems. Critical and polemical discourses on important aspects of organization and programme strategy of the Theatre were burdened by political rivalry which also found its place in discussions on the cultivation of music. Questions relating to music were considered in a declarative way, so that music was instrumentalized as a means of political empowerment. The facts about music in the National Theatre raise many issues related to aspects of modernization, national identification, transfers of „high“ and popular musical cultures as well as to other problems of social, historical and cultural contexts that were intertwined in the operation of the Theatre. The context of

  7. Surgeons' Emotional Experience of Their Everyday Practice - A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Massimiliano Orri

    Full Text Available Physicians' emotions affect both patient care and personal well-being. Surgeons appear at particularly high risk, as evidenced by the high rate of burnout and the alarming consequences in both their personal lives and professional behavior. The aim of this qualitative study is to explore the emotional experiences of surgeons and their impact on their surgical practice.27 purposively selected liver and pancreatic surgeons from 10 teaching hospitals (23 men, 4 women participated. Inclusion took place until data saturation was reached. Data were collected through individual interviews and thematically analyzed independently by 3 researchers (a psychologist, a psychiatrist, and a surgeon. 7 themes emerged from the analysis, categorized in 3 main or superordinate themes, which described surgeons' emotional experience before, during, and after surgery. Burdensome emotions are present throughout all 3 periods (and invade life outside the hospital-surgeons' own emotions, their perception of patients' emotions, and their entwinement. The interviewees described the range of emotional situations they face (with patients, families, colleagues, the influence of the institutional framework (time pressure and fatigue, cultural pressure to satisfy the ideal image of a surgeon, as well as the emotions they feel (including especially anxiety, fear, distress, guilt, and accountability.Emotions are ubiquitous in surgeons' experience, and their exposure to stress is chronic rather than acute. Considering emotions only in terms of their relations to operative errors (as previous studies have done is limiting. Although complications are quite rare events, the concern for possible complications is an oppressive experience, regardless of whether or not they actually occur.

  8. operation zitadelle (kursk)

    African Journals Online (AJOL)

    Administrator

    military technology (command language) will ensure proper communication within the framework ... The use of military power must be understood within this framework. Baucom ... European, Mediterranean and Russian theatres of operation. ... operations to accomplish a common objective, normally within a given time and.

  9. Simulation-based education and performance assessments for pediatric surgeons.

    Science.gov (United States)

    Barsness, Katherine

    2014-08-01

    Education in the knowledge, skills, and attitudes necessary for a surgeon to perform at an expert level in the operating room, and beyond, must address all potential cognitive and technical performance gaps, professionalism and personal behaviors, and effective team communication. Educational strategies should also seek to replicate the stressors and distractions that might occur during a high-risk operation or critical care event. Finally, education cannot remain fixed in an apprenticeship model of "See one, do one, teach one," whereby patients are exposed to the risk of harm inherent to any learning curve. The majority of these educational goals can be achieved with the addition of simulation-based education (SBE) as a valuable adjunct to traditional training methods. This article will review relevant principles of SBE, explore currently available simulation-based educational tools for pediatric surgeons, and finally make projections for the future of SBE and performance assessments for pediatric surgeons.

  10. Foreign Command of US Forces in Combined Theatre Operations

    Science.gov (United States)

    1994-04-01

    Russell and Jeannette E. Muther , A History of the United Nations h (Washington D.C.: The Brookings Institution 1958), p. 55, footnote 27. China’s UN...York: Praeger Publishers, 1992), p. 16. 12 Richard (New York: The Free Press, 1973), pp. 15-16. 13 See for example Werner J. Feld, Robert S. Jordan...unaccustomed to outsiders." Richard Pyle, ’"Desert Storm IL Saudi Commander Blasts Schwarzkopf Autobiography," Associated Press (New York: October 20

  11. Latent risk factors in operating theatres and intensive care units

    NARCIS (Netherlands)

    Beuzekom, Martie van

    2012-01-01

    The safety of an organization can be improved by investigating and correcting the many processes that shape performance at the “sharp end”. Errors do not occur of themselves, but arise within the context of the work environment. Where the environment is one that makes errors by individuals more

  12. Latent risk factors in operating theatres and intensive care units

    NARCIS (Netherlands)

    Beuzekom, Martie van

    2012-01-01

    The safety of an organization can be improved by investigating and correcting the many processes that shape performance at the “sharp end”. Errors do not occur of themselves, but arise within the context of the work environment. Where the environment is one that makes errors by individuals more like

  13. Latent risk factors in operating theatres and intensive care units

    NARCIS (Netherlands)

    Beuzekom, Martie van

    2012-01-01

    The safety of an organization can be improved by investigating and correcting the many processes that shape performance at the “sharp end”. Errors do not occur of themselves, but arise within the context of the work environment. Where the environment is one that makes errors by individuals more like

  14. Henry Head and the Theatre of Reverie

    Directory of Open Access Journals (Sweden)

    Tiffany Watt-Smith

    2011-04-01

    Full Text Available In 1903, the neurologist Henry Head (1861-1940 embarked on a painful self-experiment, in which he severed the radial nerve of his left arm, and then charted the gradual and faltering return of sensitivity to the limb over the next four and a half years. To directly experience his own sensations, Head entered into a trance-like state of distraction or reverie he called a ‘negative attitude of attention’. This article explores Head’s peculiar technique for looking within, and argues that while introspection was an established strategy in psychological laboratories, Head’s reverie also resonated with techniques associated with actors and theatrical audiences during this period. Viewing psychological self-experimentation through the lens of theatre, this article makes visible aspects of Head’s embodied, affective laboratory encounters, often obscured in accounts of his experiment. At the same time, it proposes that the broader historical and cultural significance of Head’s experiment lies in his attempt to observe himself by producing states of inattention and reverie at will, mental ‘attitudes’ that were themselves the subject of a rapidly evolving debate in scientific and aesthetic circles at the turn of the twentieth century.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  16. Creative Artist: A Journal of Theatre and Media Studies - Vol 10, No ...

    African Journals Online (AJOL)

    Creative Artist: A Journal of Theatre and Media Studies - Vol 10, No 1 (2016). Journal Home > Archives > Vol 10, No 1 (2016) ... Community theatre and development practices in Nyanza Region, Kenya · EMAIL FREE FULL TEXT EMAIL FREE ...

  17. Department of Theatre Arts main stage production, "Her Sexy Outfit," opens April 21

    OpenAIRE

    Adams, Louise

    2009-01-01

    Virginia Tech Department of Theatre Arts presents the hilarious and explosive "Her Sexy Outfit" by Daniel Zippi. This adaptation of "Lysistrata" by the Greek playwright Aristophanes is directed by Department of Theatre Arts faculty member Bob McGrath.

  18. MUTUAL INFLUENCE OF PAINTING, THEATRE AND EVERYDAY LIFE

    Directory of Open Access Journals (Sweden)

    L. G. Suvorova

    2015-01-01

    Full Text Available Basing on the works of Yu.M. Lotman, the author examines the process of interaction between painting and theater, and their mutual influence on the routine. The emphasis is on identifying the peculiarities of the interaction of theatre and painting in the period from the late XVIII – early XIX century. Theatre using expressive means of painting, created new forms of performing arts. The scenery becomes actors, not serving as a background for the actors. Acting technique was also being changed, the dynamics of the movements was changed into the static of dynamic postures. The identification of the scene and the picture led to the emergence of a new genre of "living paintings". Not only the art of painting influenced a theatre, creating new forms, but the theatre influenced painting too, creating a portrait typifying a model in accordance with the traditional theatrical characters. Gradually the boundary between art and commonplace had been crumbling, the theatre entered the life. It turned out that the theatricality of everyday life became the logical result of the considered process. Real life started to be considered as a performance that opened not only new possibilities in the prescribed range of permitted conduct, but also went beyond and was the legislator of individual behaviors, filled everyday reality with events, and thus, made a person free from the control of custom.

  19. Alien: How Operational Art Devoured Strategy

    Science.gov (United States)

    2009-09-01

    time holding his own.”10 He thus describes strategy as the “art of making war on the map [which] comprehends the whole theatre of operations,”11...and comprehensive change, usually for the worse, rested on a Weltanschauung heavily influenced by romanticism , with a consequent lack of desire to...are planned, conducted and sustained within a theatre or area of operations.” 91. A. F. Lykke, “Toward an Understanding of Military Strategy

  20. Methods of recording theatre activity across publicly funded hospitals in Ireland.

    LENUS (Irish Health Repository)

    Cronin, J

    2013-10-13

    A review of theatre activity in all Health Service Executive (HSE) hospitals in Cork and Kerry in 2008 required a manual extraction of theatre activity data from largely paper-based logbooks. A key data management recommendation suggested that "a standardised computerised theatre logbook system be developed in all hospitals in the region". HSE (2010) Reconfiguration of health services for Cork and Kerry-theatre utilisation review. ISBN 978-1-906218-54-6.

  1. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

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

  2. 21 CFR 878.4460 - Surgeon's glove.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2017-07-24

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

  4. Denis Browne: maverick or master surgeon?

    Science.gov (United States)

    Smith, D E

    2000-11-01

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

  5. Acoustic design and research on the auditorium of Shanghai Grand Theatre

    Institute of Scientific and Technical Information of China (English)

    ZHANG Kuisheng

    2000-01-01

    Shanghai Grand Theatre is a great modern theatre with the largest formula, the highest investment, the most advanced technique and excellent acoustic quality in China. This article mainly introduced Shanghai Grand Theatre's characteristics of formula, technical requirements of acoustic design of Auditorium, characteristics of figure design, reverberation control, acoustic simulation research, acoustic performance and subjective evaluation.

  6. The Israeli-Palestinian Conflict through Theatre: A Qualitative Study of Israeli High School Students

    Science.gov (United States)

    Gesser-Edelsburg, Anat

    2012-01-01

    Both theatre artists and educators believe the theatre has many advantages as a vehicle for the promotion of social and political issues. This study examines how the Israeli theatre represents the Israeli-Palestinian conflict and promotes peace and tolerance among young people. The study, conducted between the years 2005 and 2007, included 26…

  7. Theatre/Drama and the Development of the Greek Curriculum: Coercion or Liberty?

    Science.gov (United States)

    Giannouli, Panagiota-Betty

    2016-01-01

    This vignette focuses on Theatre/Drama in the Greek curriculum. Issues for consideration are presented, such as the minimal space for active learning through theatre, the limited opportunity of teachers to work as critical pedagogues and the problematic conceptual framework. A main issue is the fragmented implementation as Theatre/Drama is not…

  8. Synthetic design and the art of virtual reality in theatre and film ...

    African Journals Online (AJOL)

    Synthetic design and the art of virtual reality in theatre and film productions. ... EJOTMAS: Ekpoma Journal of Theatre and Media Arts ... However, in more recent times, occasioned by technological breakthrough, another kind of ... of Virtual Reality and how they influence modern design in both theatre and film productions.

  9. Performing Environmental Change: MED Theatre and the Changing Face of Community-Based Performance Research

    Science.gov (United States)

    Schaefer, Kerrie

    2012-01-01

    This article examines a programme of work produced by community-based theatre company, Manaton and East Dartmoor (MED) Theatre, addressing issues of climate change as they impact on life in rural Devon, UK. After some discussion of MED Theatre's constitution as a community-based company and the group's long-term engagement with the place, history,…

  10. Rethinking Theatre Teacher Education: A National Think Tank for Change-Makers.

    Science.gov (United States)

    Lazarus, Joan

    2002-01-01

    Discusses development of the American Alliance for Theatre and Education's Think Tanks on Theatre Teacher Education. Notes the think tanks were intended to probe important issues, move to a new level of thinking, and hopefully, effect change in individual and collective practice of theatre teacher education. (SG)

  11. Theatre/Drama and the Development of the Greek Curriculum: Coercion or Liberty?

    Science.gov (United States)

    Giannouli, Panagiota-Betty

    2016-01-01

    This vignette focuses on Theatre/Drama in the Greek curriculum. Issues for consideration are presented, such as the minimal space for active learning through theatre, the limited opportunity of teachers to work as critical pedagogues and the problematic conceptual framework. A main issue is the fragmented implementation as Theatre/Drama is not…

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

    Science.gov (United States)

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

    2016-01-01

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

  13. The Safety Prevention in the Theater Management and Operation

    Institute of Scientific and Technical Information of China (English)

    WU Sheng

    2015-01-01

    Take the operation and management experience as examples, the author discussed how to formulate a set of complete and effective equipment management system, operating rules, procedures and standards, as well as the safety prevention and control measures, according to the national or trade related laws and regulations and combining the operation and performance characteristics of theatre management, in order to ensure the safe operation of theatre and stage equipment.

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

    Science.gov (United States)

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

    2016-06-01

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

  15. Surgeons' non-technical skills.

    Science.gov (United States)

    Yule, Steven; Paterson-Brown, Simon

    2012-02-01

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

  16. Musculoskeletal disorders among robotic surgeons: A questionnaire analysis

    Directory of Open Access Journals (Sweden)

    Claudio Giberti

    2014-06-01

    Full Text Available Objective: Robotic surgical systems offer better workplace in order to relieve surgeons from prolonged physical efforts and improve their surgical outcomes. However, robotic surgery could produce musculoskeletal disorders due to the prolonged sitting position of the operator, the fixed position of the console viewer and the movements of the limbs. Until today, no one study has been reported concerning the association between robotics and musculoskeletal pain. The aim of this work was verify the prevalence of musculoskeletal disorders among Italian robotic surgeons. Material and methods: Between July 2011 and April 2012 a modified Standardized Nordic Questionnaire was delivered to thirty-nine Italian robotic centres. Twentytwo surgeons (56% returned the questionnaires but only seventeen questionnaires (43.5% were evaluable. Results: Seven surgeons (41.2% reported musculoskeletal disorders, by since their first use of the robot which significantly persisted during the daily surgical activity (P < 0.001. Regarding the body parts affected, musculoskeletal disorders were mainly reported in the cervical spine (29.4% and in the upper limbs (23.5%. Six surgeons (35.3% defined the robotic console as less comfortable or neither comfortable/uncomfortable with a negative influence on their surgical procedures. Conclusions: In spite of some important limitations, our data showed musculoskeletal disorders due to posture discomfort with negative impact on daily surgical activity among robotic surgeons. These aspects could be due to the lack of ergonomic seat and to the fixed position of the console viewer which could have produced an inadequate spinal posture. The evaluation of these postural factors, in particular the development of an integrated and more ergonomic chair, could further improve the comfort feeling of the surgeon at the console and probably his surgical outcomes.

  17. An experience of science theatre: Earth Science for children

    Science.gov (United States)

    Musacchio, Gemma; Lanza, Tiziana; D'Addezio, Giuliana

    2015-04-01

    The present paper describes an experience of science theatre addressed to children of primary and secondary school, with the main purpose of explaining the Earth interior while raising awareness about natural hazard. We conducted the experience with the help of a theatrical company specialized in shows for children. Several performances have been reiterated in different context, giving us the opportunity of conducting a preliminary survey with public of different ages, even if the show was conceived for children. Results suggest that science theatre while relying on creativity and emotional learning in transmitting knowledge about the Earth and its hazard has the potential to induce in children a positive attitude towards the risks

  18. Was the real Sherlock Holmes a pediatric surgeon?

    Science.gov (United States)

    Raffensperger, John

    2010-07-01

    This article reviews the pioneering efforts of Joseph Bell, the model for Sherlock Holmes, in the surgical care of children during the antiseptic era. I reviewed biographies of Sir Arthur Conan Doyle; the biography of Joseph Bell; his surgical textbook, Edinburgh Medical Journals; and the history of the Royal Edinburgh Hospital for Sick Children. Dr Bell was a colleague of Joseph Lister and one of the first surgeons to apply antiseptic methods to operations involving children. He was the surgeon appointed to the first surgical ward of the Royal Edinburgh Hospital for Sick Children; in that role, he cared for many children with surgical diseases. Dr Joseph Bell, by his compassion for children and his surgical skill, was indeed a pioneer pediatric surgeon. Copyright 2010 Elsevier Inc. All rights reserved.

  19. [Hospitals and surgeons: Madrid 1940].

    Science.gov (United States)

    de Quevedo, Francisco Vázquez

    2007-01-01

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

  20. Chinese medicine and the surgeon.

    Science.gov (United States)

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

    2011-07-01

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

  1. Reporting sharp injuries among Surgeons in Zagazig University Hospitals, Egypt

    Directory of Open Access Journals (Sweden)

    Eman Mohamed Mortada

    2015-12-01

    Full Text Available Background and rationale of the study: Although Sharps injuries are a preventable hazard faced by medical personnel in the operating room yet it continues to be one of the hidden problems among HCP. The potential consequence of such injuries includes transmission of blood-borne pathogens with detrimental effects. Despite the advances in technology and increased awareness of medical staff, annually around 600 thousand to one million workers are affected thus considered as one of the most serious threats facing health care workers specially surgeon.Methodology: a cross sectional study of Zagazig University Hospitals surgical departments. Using a sample composed of 287 surgeons randomly chosen from different surgical departments. A questionnaire assessed in addition to personal and professional characteristics, the history of sharp injuries, types of instrument causing the injury, their post exposure prophylaxis including reporting. The results: There were total 287 surgeons participated in this study. (47% of the respondent surgeons had been exposed to at least one episode of sharp injury in the preceding 3 months and most of the exposures (68% occurred in the operation room. The injury was mainly caused during suturing (83%. The commonest devices, accused in most of the injuries were suturing needle and scalpel (74 and 59%. The majority of the surgeons (62% didn’t report the SI and it was largely explained by the majority of the sampled respondents (89% were not aware of the reporting system existing in their hospital.Conclusions: The most common reason of underreporting  in our study was the lack of awareness that all injuries must be reported.Recommendations: The observed high level of under reporting reflects the need for education on prevention. Our results can guide in planning an education program for the surgeons to increase awareness about dangers of sharp injuries and help improve the reporting strategy  and other potential

  2. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... and Safety Conference MBSAQIP News Contact Us ... College of Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation ...

  3. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... to Participate Resources Webinars for Young Surgeons YFA E-News Resident and Associate Society Resident and Associate ... ACS Leader International Exchange Scholar Program Resources RAS E-News Operation Giving Back Operation Giving Back Operation ...

  4. [Undergraduate Medical Students "On Call" to Assist in Theatre: Analysis of the Financial Aspects and a Mixed-Method Study Exploring Their Motives for Working].

    Science.gov (United States)

    Rabe, C; Ghadimi, M; König, S

    2017-02-01

    Background/Purpose: Surgical patient care has grown in complexity, as hospital workload has continuously increased. We therefore established a pool of "undergraduate medical students on call" to assist in the theatre outside working hours. We aimed to recruit talented students to reduce the burden on physicians and to motivate students into entering surgery. Methods: An exploratory mixed-method study was performed. In a qualitative study, guided interviews were conducted with five students about their reasons for working in the theatre and the results were used to construct an online questionnaire using EvaSys®. This was presented to 16 current and former students in a subsequent quantitative study. Furthermore, the cost of student employment was calculated and compared with physicians' salaries. Results: In 2013 and 2014, 8-9 students worked a total of 1063 and 1211 hours in the theatre, respectively. The difference in salaries between the students and surgical residents was € 28.37 per hour. We calculated that the annual savings were approximately € 60,000. When questioned on their motives during the interview, only a few students emphasised the financial aspects, whereas the majority emphasised the gain in experience. The analysis was based on comparison of the mean values (online survey) with a 4-point Likert scale (1 = high acceptance; 4 = no acceptance). We defined the motives with a mean ≤ 1.3 as primary. Based on this selection, gathering experience, fun/enjoyment, interest in surgery, and the change from studying were considered as distinct motives. In the interviews, students clearly pointed out that teaching and learning opportunities in the theatre were not commonly taken advantage of and that interaction with the surgeons should be improved. Conclusion: Students actively chose to work as assistants in the theatre, for a variety of motives. The financial aspects were subordinate. The concept of students assisting in the theatre is

  5. Identity, Knowledge and Participation: Health Theatre for Children

    Science.gov (United States)

    Grabowski, Dan

    2013-01-01

    Purpose: The main aim of the paper is to explore whether health theatre as a school-based health promotion initiative communicates relevant health knowledge to children and the interrelated processes of identity development, knowledge acquisition and participation. Development of the definition of "health identity" was a subsidiary…

  6. Nomadic Theatre. Staging Movement and Mobility in Contemporary Performance

    NARCIS (Netherlands)

    Groot Nibbelink, L.W.

    2015-01-01

    This study concerns performances that attempt to (physically) mobilise the spectator and rethink the conditions of the stage. Spectators are engaged in promenade performances or walking theatre, for instance, or they traverse the city by bike; they are driven around in wheelchairs or drift across la

  7. The Role of Theatre in a Beginners French Program

    Science.gov (United States)

    Staddon, Sally

    2007-01-01

    In 2004, in response to the need to revise oral practice and assessment in the second semester of Beginners French at Monash University, an eight-week group-based theatre project was developed and trialled. A specially adapted version of Tardieu's absurdist play "Le Guichet" was used to give students the opportunity to focus on oral…

  8. Reflecting on the Challenges of Applied Theatre in Kenya

    Science.gov (United States)

    Okuto, Maxwel; Smith, Bobby

    2017-01-01

    In this article the authors draw on their own experience and research in applied theatre in Kenya in order to reflect on challenges currently facing practitioners working in the country. In order to outline the range of challenges faced by practitioners, issues related to the wider landscapes of government and politics in Kenya are explored,…

  9. Personal Stories in Applied Theatre Contexts: Redefining the Blurred Lines

    Science.gov (United States)

    Kandil, Yasmine

    2016-01-01

    Personal stories have been utilised in a variety of ways in Applied Theatre practices. The author problematises their use when the teller's safety is at stake within a given context. Inspired by neuro-anatomist Jill Bolte-Taylor's process of enlightenment through observing her stroke from the inside out, the author uses her personal experience of…

  10. Wings of Fancy: Using Readers Theatre to Study Fantasy Genre

    Science.gov (United States)

    Garner, Joan

    2006-01-01

    The new Readers Theatre series features scripts for students in grades 4-8. These original scripts are written for the specific purpose of teaching literary genre. Each book is composed of 24-28 scripts, each of which will be keyed to published books, plays, poems or stories in that genre, encouraging students to read the originals in order to…

  11. Refugee Performance: Aesthetic Representation and Accountability in Playback Theatre

    Science.gov (United States)

    Dennis, Rea

    2008-01-01

    This essay seeks to unpack some of the issues concerning representation when performing refugee stories using playback theatre. It questions the reductive influence of narrative structure and, using the framework of "artist as ethnographer," it argues that strong aesthetic production is required to overcome the dampening effect of empathy when…

  12. Community theatre as instrument for community sensitisation and ...

    African Journals Online (AJOL)

    2016-03-28

    Mar 28, 2016 ... be that of the dominant class, this does not prevent other sectors or classes from fostering their own art, guided ... relationship between the playwright and the target audiences. The materials used in the ... This led me to try my hand at theatre in 1991 when I wrote my ... An evaluation of the programme led to.

  13. Readers Theatre: A different approach to English for struggling readers

    Directory of Open Access Journals (Sweden)

    Ion Drew

    2010-09-01

    Full Text Available This article presents a study of the use of Readers Theatre in English lessons with groups of academically-challenged pupils in a Norwegian lower secondary school. The study is based on the teacher’s logs, interviews with the teacher, a questionnaire answered by the pupils, and lesson observations. Readers Theatre, a group reading activity that can be used with a wide range of texts, was successfully incorporated into the curriculum with relatively small ‘fordypning’ (specialisation groups in English. These pupils had opted for more English lessons instead of learning a second foreign language. Most of them struggled with English as their first foreign language and were struggling readers. However, the majority of the pupils experienced Readers Theatre as both enjoyable and educational. The experience had a positive effect on their confidence and motivation to read. It also helped to improve their reading fluency and accuracy, for example pronunciation, and facilitated growth in vocabulary. The experience of practising and performing as a group was especially satisfying and motivating for the pupils involved. The majority were keen to participate in other Readers Theatre projects.

  14. "Making Amends": An Interventionist Theatre Programme with Young Offenders

    Science.gov (United States)

    Turner, Jane

    2007-01-01

    This article discusses a project established at the New Vic Borderlines by Sue Moffat in 1999 titled "Making Amends." It is an example of interventionist theatre undertaken with young offenders. The article draws on theories of restorative justice as well as ideas of learning development found in social constructivism in order to…

  15. The Era of Tadeusz Pawlikowski and Irish Theatre

    Directory of Open Access Journals (Sweden)

    Barry Keane

    2015-07-01

    Full Text Available Tadeusz Pawlikowski was arguably Poland’s greatest theatre director of the fin de siècle. With stints as Theatre Manager in both Kraków and Lwów municipal theatres, Pawlikowski excelled in developing ensemble casts and cultivating audiences without kowtowing to popular tastes. He was also responsible for bringing many western plays to partitioned Poland, and indeed he oversaw theatrical premieres of Oscar Wilde, George Bernard Shaw and John Millington Synge. This paper will look at the production and reception of these plays and will record how there was a growing conviction amongst Polish critics that Irish dramatists would soon make a towering impact on the age. That said, not all the productions were as successful as perhaps they should have been. When in Lwów, Pawlikowski attempted to flood the city with drama and this ambition entailed brief run-throughs and the shortening of texts in order to facilitate the learning of lines. Needless to say, there was little time for work on characterization. Consequently, it was often pointed out that performances had failed to bridge the cultural gap where a foreign piece was concerned. To this end, this paper will assess both the contribution of Tadeusz Pawlikowski to Irish theatre, and the reception and legacy of the productions which took place under his directorial guidance.

  16. Drama and Theatre Education in Canada: A Snapshot

    Science.gov (United States)

    Carter, Mindy R.

    2014-01-01

    This "Note from the Field" provides an overview of what is happening in Kindergarten to University drama and theatre education across Canada. In addition to this snapshot I offer some considerations for extending this discipline and its potential impact on curriculum, policy and practice.

  17. Participatory theatre and mental health recovery: a narrative inquiry.

    Science.gov (United States)

    Torrissen, Wenche; Stickley, Theo

    2017-08-01

    To identify the potential relationship between participation in theatre and mental health recovery. To give voice to the stories told by participants of Teater Vildenvei, a theatre company that has been part of the rehabilitation programme for mental health service users in Oslo since 1995. Twelve narrative interviews were conducted among participants of Teater Vildenvei, and the data were subject to a narrative analysis process following the philosophy of Paul Ricoeur and the specific methods of thematic, event and relational analysis as identified by Riessman. The narratives are considered in the theoretical light of the mental health recovery framework as identified by Leamy et al. Each participant had experienced a transformation in identity; the sense of belonging within the group was perceived as highly important to their mental health; engagement with the theatre company gives people something meaningful to do, a sense of hope and individuals feel empowered. This narrative inquiry gave opportunity for participants to elaborate on their stories of their engagement with Teater Vildenvei. It is through the richness of the data that the depth of the significance of meaning that people ascribe to their stories demonstrates the potential power of participatory theatre for mental health recovery. Because of its effects, people make life-changing and life-saving claims.

  18. 28 The Theatre and Sustainable Human Development: Fumes of ...

    African Journals Online (AJOL)

    comprise Theatre Arts, Music, Dance and Choreography and the electronic media of ... both as a professional enterprise and an academic discipline, and all it entails. This is .... biology, humanity, psychology, politics, economics and so many others which are ... development through the fight for independence and improved.

  19. Sea Songs: Readers Theatre from the South Pacific

    Science.gov (United States)

    Barnes, James

    2004-01-01

    Allow students to experience the richness of Polynesian culture as well as the challenge of dramatic reading with this Readers Theatre resource. During his years of living and teaching in Oamaru, New Zealand, James Barnes became intimately involved in the Maori culture. Through extensive research of the mythology of Polynesia, Barnes succeeded in…

  20. Theatre of Presence - Antero Alli's Paratheatrical ReSearch Lab

    DEFF Research Database (Denmark)

    Isar, Nicoletta

    the oppression, decadence and corruption that has crucified and buried the poetic Imagination" (Antero Alli) This paper will try to unveil one of Antero Alli's paratheatrical experiments in overcoming the death of ritual in theatre. Orphans of Delirium is an intense, living ritual experience, "fluid" in its...

  1. Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience

    Science.gov (United States)

    Banerjee, Praveer K; Jain, Abhineet; Behera, Bikram

    2016-01-01

    Background and Aims: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. Methods: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone. All of them were medically stable with no need of intensive care or mechanical ventilation in post-operative period. Results: Submandibular intubation in all ten patients of panfacial fractures allowed uninterrupted surgical techniques with a secured airway. All patients were reverted to oro-tracheal tube at the end of surgery as immediate maxillomandibular fixation was not necessary. The patients were extubated after recovery from anaesthesia before they left the operating theatre. One patient in the post-operative period had a superficial infection of incision site that responded well to local treatment. No other complications were encountered in the intra-operative or post-operative period. Conclusion: In complex maxillofacial injuries, when oral or nasal intubation hampers surgeon's field of view, submandibular intubation offers an effective alternative to short-term tracheostomy along with small risk potential. There is a need to emphasise its regular application in such cases so that technique can be mastered by both surgeons and anaesthesiologist. PMID:27601740

  2. The advent of the restorative plastic surgeon.

    Science.gov (United States)

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

    2014-01-01

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

  3. American Society of Colon and Rectal Surgeons

    Science.gov (United States)

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

  4. From Corporate Social Responsibility, through Entrepreneurial Orientation, to Knowledge Sharing: A Study in Cai Luong (Renovated Theatre) Theatre Companies

    Science.gov (United States)

    Tuan, Luu Trong

    2015-01-01

    Purpose: This paper aims to examine the role of antecedents such as corporate social responsibility (CSR) and entrepreneurial orientation in the chain effect to knowledge sharing among members of Cai Luong theatre companies in the Vietnamese context. Knowledge sharing contributes to the depth of the knowledge pool of both the individuals and the…

  5. From Corporate Social Responsibility, through Entrepreneurial Orientation, to Knowledge Sharing: A Study in Cai Luong (Renovated Theatre) Theatre Companies

    Science.gov (United States)

    Tuan, Luu Trong

    2015-01-01

    Purpose: This paper aims to examine the role of antecedents such as corporate social responsibility (CSR) and entrepreneurial orientation in the chain effect to knowledge sharing among members of Cai Luong theatre companies in the Vietnamese context. Knowledge sharing contributes to the depth of the knowledge pool of both the individuals and the…

  6. Organism Encumbrance of Cardiac Surgeon During Surgery

    Science.gov (United States)

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

    2016-01-01

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

  7. Organism Encumbrance of Cardiac Surgeon During Surgery.

    Science.gov (United States)

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

    2016-07-16

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

  8. Burnout and career satisfaction among American surgeons.

    Science.gov (United States)

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

    2009-09-01

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

  9. Robotic versus conventional laparoscopic pyeloplasty: A single surgeon concurrent cohort review

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-01-01

    Conclusions: Robotic assistance helps decrease the operative time for laparoscopic pyeloplasty. It seems ergonomically superior for the surgeon, allowing multiple procedures in the same list. These may be important benefits in busy centers.

  10. Surgeon-Directed Cost Variation in Isolated Rotator Cuff Repair.

    Science.gov (United States)

    Terhune, E Bailey; Cannamela, Peter C; Johnson, Jared S; Saad, Charles D; Barnes, John; Silbernagel, Janette; Faciszewski, Thomas; Shea, Kevin G

    2016-12-01

    As value becomes a larger component of heath care decision making, cost data can be evaluated for regional and physician variation. Value is determined by outcome divided by cost, and reducing cost increases value for patients. "Third-party spend" items are individual selections by surgeons used to perform procedures. Cost data for third-party spend items provide surgeons and hospitals with important information regarding care value, potential cost-saving opportunities, and the total cost of ownership of specific clinical decisions. To perform a cost review of isolated rotator cuff repair within a regional 7-hospital system and to document procedure cost variation among operating surgeons. Economic and decision analysis; Level of evidence, 4. Current Procedural Terminology (CPT) codes were used to retrospectively identify subjects who received an isolated rotator cuff repair within a 7-hospital system. Cost data were collected for clinically sensitive third-party spend items and divided into 4 cost groups: (1) suture anchors, (2) suture-passing devices and needles, (3) sutures used for cuff repair, and (4) disposable tools or instruments. A total of 62 isolated rotator cuff repairs were performed by 17 surgeons over a 13-month period. The total cost per case for clinically sensitive third-party spend items (in 2015 US dollars) ranged from $293 to $3752 (mean, $1826). Four surgeons had a mean procedure cost that was higher than the data set mean procedure cost. The cost of an individual suture anchor ranged from $75 to $1775 (mean, $403). One disposable suture passer was used, which cost $140. The cost of passing needles ranged from $140 to $995 (mean, $468). The cost per repair suture (used to repair cuff tears) varied from $18 to $298 (mean, $61). The mean suture (used to close wounds) cost per case was $81 (range, $0-$454). A total of 316 tools or disposable instruments were used, costing $1 to $1573 per case (mean, $624). This study demonstrates significant cost

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

    Directory of Open Access Journals (Sweden)

    Simwita YW

    2016-10-01

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

  12. Bacterial contamination of surgeons' gloves during shunt insertion; a pilot study

    DEFF Research Database (Denmark)

    Sørensen, Preben; Ejlertsen, Tove; Aaen, Dorte

    2008-01-01

    antibiotics and double gloving, by surgeons experienced in shunt surgery. Surgical incision, dissection and tunnelling were done. Then the surgeon, the scrub-nurse and, in three cases, the assistant made an imprint of their outer gloves on agar plates. Hereafter, they changed the outer pair of gloves before...... cultured from gloves in all 10 operations and coagulase-negative Staphylococci were found in eight operations. These results are preliminary, but nevertheless they are alarming. Despite the use of recommended precautions to avoid infections we found that a substantial numbers of gloves from surgeon, scrub...

  13. Do Orthopaedic Surgeons Acknowledge Uncertainty?

    Science.gov (United States)

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

    2016-06-01

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

  14. What’s in a name? The sense or non-sense of labelling puppets in contemporary Western theatre

    Directory of Open Access Journals (Sweden)

    Marie Kruger

    2014-12-01

    Full Text Available Different terms can be use for puppet theatre: figure theatre, object theatre and animation theatre. Contemporary performances including puppets are nowadays often referred to as multimedia performances, crossover theatre and visual theatre. Some artists avoid the word “puppet” because of negative associations: close association with children and low status amongst the arts. Professional puppetry in many Western countries has evolved into a wide-ranging theatre form. Puppets traditionally used to be seen in isolation in performance and a distinct line could be drawn between puppet theatre and other forms of theatre, but the bonding with other art forms has diminished this segregation. As an artistic label, “puppet theatre” is perhaps not always appropriate as it does not acknowledge the artistic scope and complexity of an art work in which multiple visual and acoustic elements are applied, and this bonding raises questions about genre as a classification system.

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

    Science.gov (United States)

    Awada, T; Liverneaux, P

    2010-05-01

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

  16. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad

    2014-01-01

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

  17. Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

    Directory of Open Access Journals (Sweden)

    Eleanor R Robertson

    Full Text Available BACKGROUND: We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. RESULTS: Mean team Oxford NOTECHS II scores was 73.39 (range 37-92. The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27; 24.22 (IQR 23, 26 and 24.55 (IQR 23, 26. Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5 than those with low compliance (71.1 (p = 0.010. We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15. Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001. CONCLUSIONS: Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  19. IMPACT OF BRECHT ON TURKISH THEATRE / TÜRK TİYATROSUNDA BRECHT ETKİSİ

    Directory of Open Access Journals (Sweden)

    Prof. Dr. Âbide DOĞAN

    2009-01-01

    Full Text Available Epical theatre concept was first proposed by BertoltBrecht who was a German theatre writer as well as atheorist. It was developed as a result of begin influencedby Erwin Piscator’s theatre understanding affected by thepolitical, social and economic strains after the First WorldWar. In Turkish theatre, the first epical plays were writtenin 1960’s by Haldun Taner. He was followed by Vasıf Öngören, Sermet Çağan, Oktay Arayıcı, Đsmet Küntay andTurhan Selçuk.In this article Bertolt Brecht and epical theatre isexplained and its influences to Turkish theatre are clarified.The epical theater plays written by Haldun Taner,Vasıf Öngören and Sermet Çağan are introduced.

  20. Twelfth night of 1917 and the Moscow art theatre Twelfth night of 1917 and the Moscow art theatre

    Directory of Open Access Journals (Sweden)

    Arkady Ostrovsky

    2008-04-01

    Full Text Available On 15 September, 1917, in a letter to Nemirovich-Danchenko, Stanislavsky renounced the stage of the Moscow Art Theatre: I cannot think about any other roles, because I will never be able to do anything, at least in the Moscow Art Theatre. Maybe in some other area or some other place I will be able to rise. Of course I do not mean in other theatres, but in the studios. Othello — free!...1 After the tragedy Stanislavsky had endured with Selo Stepanchikovo, he threw himself into Studio work. He started rehearsing Twelfth Night, a play he had put on at the Society of Art and Literature in 1897. The Studio production of Twelfth Night was played on 25 December 1917, two months to the day after the Revolution. A few months later, Nikolai Efros published a book about the First Studio. It was dedicated to The Cricket on the Hearth but the words Efros used to describe the atmosphere in which Dickens’s production had opened were equally suitable for Twelfth Night: ‘You remember what sort of days those were? On 15 September, 1917, in a letter to Nemirovich-Danchenko, Stanislavsky renounced the stage of the Moscow Art Theatre: I cannot think about any other roles, because I will never be able to do anything, at least in the Moscow Art Theatre. Maybe in some other area or some other place I will be able to rise. Of course I do not mean in other theatres, but in the studios. Othello — free!...1 After the tragedy Stanislavsky had endured with Selo Stepanchikovo, he threw himself into Studio work. He started rehearsing Twelfth Night, a play he had put on at the Society of Art and Literature in 1897. The Studio production of Twelfth Night was played on 25 December 1917, two months to the day after the Revolution. A few months later, Nikolai Efros published a book about the First Studio. It was dedicated to The Cricket on the Hearth but the words Efros used to describe the atmosphere in which Dickens’s production had opened

  1. Eating behavior and nutrition knowledge among musical theatre students.

    Science.gov (United States)

    Vitzthum, Karin; Endres, Eva; Koch, Franziska; Groneberg, David A; Quarcoo, David; Wanke, Eileen; Mache, Stefanie

    2013-03-01

    Eating is a central part in human (social) life. Athletic performance and physical attractiveness are linked to appropriate nutritional behavior, especially for performing artists. Eating behavior and nutrition knowledge have not been examined in musical theatre students so far, which this study aims to analyze. We administered a cross-sectional questionnaire study to 37 musical theatre students. Results for the Eating Disorder Examination-Questionnaire (EDE-Q) showed non-pathological values for 92% of all participants, but 81% of participants answered correctly on only 30-59% of questions on the General Nutrition Knowledge Questionnaire (GNKQ). Our study results reveal the need for specific nutritional knowledge transfer programs for this target group.

  2. The theatre of high-fidelity simulation education.

    Science.gov (United States)

    Roberts, Debbie; Greene, Leah

    2011-10-01

    High-fidelity simulation is a useful mechanism to aid progression, development and skill acquisition in nurse education. However, nurse lecturers are daunted by sophisticated simulation technology. This paper presents a new method of introducing human patient simulation to students and educators, whilst seeking to demystify the roles, responsibilities and underpinning pedagogy. The analogy of simulation as theatre outlines the concepts of the theatre and stage (simulation laboratory); the play itself (Simulated Clinical Experience, SCE); the actors (nursing students); audience (peer review panel); director (session facilitator); and the production team (technical coordinators). Performing in front of people in a safe environment, repeated practice and taking on a new role teaches students to act, think and be like a nurse. This in turn supports student learning and enhances self confidence.

  3. Microbiological safety of glasses dispensed at 3D movie theatres.

    Science.gov (United States)

    De Giusti, Maria; Marinelli, Lucia; Ursillo, Paolo; Del Cimmuto, Angela; Cottarelli, Alessia; Palazzo, Caterina; Marzuillo, Carolina; Solimini, Angelo Giuseppe; Boccia, Antonio

    2015-02-01

    Recent popularity of three-dimensional movies raised some concern about microbiological safety of glasses dispensed into movie theatres. In this study, we analysed the level of microbiological contamination on them before and after use and between theatres adopting manual and automatic sanitation systems. The manual sanitation system was more effective in reducing the total mesophilic count levels compared with the automatic system (P < 0.05), but no differences were found for coagulase-positive staphylococci levels (P = 0.22). No differences were found for mould and yeast between before and after levels (P = 0.21) and between sanitation systems (P = 0.44). We conclude that more evidences are needed to support microbiological risk evaluation. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  4. Theatres of the lie: 'crazy' deception and lying as drama.

    Science.gov (United States)

    Dongen, Els van

    2002-08-01

    In this article, the author argues that lying is drama, theatre, which brings about transition, reflection, reversal and involvement of the participants in the drama. By means of ethnographic data of a psychiatric ward, the author shows that lying of mental patients is not pathological, but a ritual of affliction. By using Turner's theory about rituals and performance and Goffman's theory about presentation of the self it will be showed that lying serves the redefinition of reciprocity and solidarity. With the help of Bakhtin's work on Rabelais, the author discusses the nature of the drama of the lie. It is concluded that a perspective on lying as theatre may be of use outside psychiatric wards and will occur in imbalanced power relationships.

  5. Ritual, Myth and Tragedy: Origins of Theatre in Dionysian Rites

    Directory of Open Access Journals (Sweden)

    Nadja Berberovic

    2015-07-01

    Full Text Available In the deep, dark forests and in the lush green valleys, worshippers of Dionysus celebrated the eternal cycles of death and rebirth, symbolized in the sacred mask of the wild god. Drunk and intoxicated, wearing the mask of Dionysus, the actor is at once the shaman and the priest. Channeling the presence of the fearsome divinity, he drinks the sacred wine and eats the raw flesh of his prey. In this eternal moment, he becomes one with the god and the beast residing inside of him. Within Ancient Greek culture, the sacred rites of Dionysus have been appropriated and transformed to theatre performances. The shaman became the actor, the participants became the audience, the sacred altar became the stage. From myth as a ritual performance emerged the theatre of tragedy, in which the undying spirit of Dionysus, majestic and terrifying, speaks to us even today.

  6. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Scholar Program Resources RAS E-News RAS-JACS Journal Club Medical Students Operation Giving Back Operation Giving ... the ACS Catalog Find a Product Contribute Education Journal of the American College of Surgeons About JACS ...

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2007-10-01

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

  9. National Theatre of Scotland and its sense of place

    OpenAIRE

    Walmsley, BA

    2010-01-01

    This case study focuses on the newly formed National Theatre of Scotland (NTS). It provides a brief introduction into its history and mission before exploring its innovative, non-building based model and the positive and negative implications that this model has on its marketing mix. The case study is centred on the concept of place. It demonstrates how NTS deals with the challenge of creating and delivering a consistent brand image and message when it is constantly a guest in other people's ...

  10. Staff dissatisfaction in the theatre complex of a private hospital

    Directory of Open Access Journals (Sweden)

    E.R. Ackerman

    2007-09-01

    Full Text Available The evident job dissatisfaction of nursing personnel in a theatre complex of a private hospital has seemingly led to an extremely high turnover rate of personnel. Several factors appear to be responsible for the discontent among nursing staff such as low staff levels, the continuous quest for cost-effectiveness in terms of staffing numbers, the flexi-time system, insufficiently experienced staff and inadequate care and maintenance of equipment. As a requirement of the C3-Workbook (which sets requirements for staff appraisal a quantitative, exploratory and descriptive research study was undertaken among all the nursing staff and technicians of a theatre complex in a private hospital. A questionnaire was employed to gather data in this census survey. The aim of the research was to identify the problems in this theatre section in order to take remedial steps in an attempt to re-establish a stable personnel corps which would not only benefit the functioning of the unit but could also contribute to the well being of staff. The findings indicate that dissatisfaction and negative feelings were experienced by the respondents as a result of working conditions, management’s lack of support and understanding, unequal distribution of work, unavailability of stock and supplies, remuneration not in line with actual hours worked, the seemingly unfair flexi-time system and insufficient staff numbers. Recommendations were made relevant to management’s role, the motivation of staff, shortage of personnel and physical environment.

  11. Measuring Coefficients of Friction for Materials Commonly Used in Theatre

    Science.gov (United States)

    Mentzer, Robert; Martell, Eric

    2008-04-01

    While designing a stage setup for a theatrical presentation, designers must consider equipment, materials, cost and manpower, and we can use physics to simplify and enhance the process. Unfortunately, there is a lack of information about the properties of materials commonly used in theatre. The objective of this research was to determine the coefficients of static and kinetic friction for several materials commonly used in theatrical scene construction and the coefficients of rolling friction for a series of commonly used casters. Materials of known coefficients were tested to confirm the accuracy of the experimental process. Data was collected using a sled style apparatus and LabVIEW software. Data was analyzed in mass volumes using Microsoft Excel spreadsheets and macros. This research was performed as a part of the Physics of Theatre project, a joint collaboration between Millikin University and the University of Illinois at Urbana-Champaign, and was supported in part by Millikin, UIUC, and the United States Institute for Theatre Technology.

  12. ISLAMIC ELEMENTS IN TRADITIONAL INDONESIAN AND MALAY THEATRE

    Directory of Open Access Journals (Sweden)

    Ghulam-Sarwar Yousof

    2010-01-01

    Full Text Available From the earliest times, traditional theatre in Southeast Asia has been shaped by a wide range of religious and cultural influences—those deriving from animism, Hinduism, Buddhism, Islam, as well as from Chinese and western traditions. The overwhelming influences, especially of Hinduism, have had the tendency to obscure contributions from the Middle- and Near-East. The view that Islam, with rare exceptions, prohibits performing arts has resulted in a negligence of these arts forms in Muslim societies with the possible exception of Indonesia. This paper highlights significant elements of Islamic culture that have shaped Indonesian and Malay traditional theatre through the adaptation of borrowed genres such as taziya, as well as locally created styles of shadow play (wayang kulit and the doll-puppet theatre (wayang golek; the use of important themes from Islamic literature, in particular thosederived from Hikayat Amir Hamza; as well as esoteric interpretationsof certain episodes originally derived from pre-Islamic sources,including the Mahabharata, in terms of Sufism to make them both highly meaningful and acceptable to Muslim audiences.

  13. The surgeon and human immunodeficiency virus.

    Science.gov (United States)

    Mielke, Jens; Kalangu, Kazadi K N

    2003-08-01

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

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

    Science.gov (United States)

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih

    2015-11-01

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

  15. IMPACT OF BRECHT ON TURKISH THEATRE / TÜRK TİYATROSUNDA BRECHT ETKİSİ

    OpenAIRE

    Prof. Dr. Âbide DOĞAN

    2009-01-01

    Epical theatre concept was first proposed by BertoltBrecht who was a German theatre writer as well as atheorist. It was developed as a result of begin influencedby Erwin Piscator’s theatre understanding affected by thepolitical, social and economic strains after the First WorldWar. In Turkish theatre, the first epical plays were writtenin 1960’s by Haldun Taner. He was followed by Vasıf Öngören, Sermet Çağan, Oktay Arayıcı, Đsmet Küntay andTurhan Selçuk.In this article Bertolt Brecht and epic...

  16. Grafting orchids and ugly: theatre, disability and arts-based health research.

    Science.gov (United States)

    Johnston, Kirsty

    2010-12-01

    Theatre-based health policy research is an emerging field, and this article investigates the work of one of its leaders. In 2005, prominent medical geneticist and playwright Jeff Nisker and his collaborators produced Orchids, his play concerning pre-implantation genetic diagnosis, to research theatre as a tool for engaging citizens in health policy development. Juxtaposing Orchids with a concurrent disability theatre production in Vancouver entitled Ugly, I argue that disability theatre suggests important means for building inclusiveness in this kind of research and complicates Nisker's own call for international guidelines to delimit how journalists, playwrights, filmmakers, physicians and other media authors share genetics-based narratives in public.

  17. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

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

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

  18. [General surgeons and varicose vein surgery].

    Science.gov (United States)

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

    2009-04-01

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

  19. Ibsen in Dutch theatres and the sustainability of Nora

    Directory of Open Access Journals (Sweden)

    Janke Klok

    2015-05-01

    Full Text Available In this article I reflect on Ibsen's laborious road to the Dutch stages to display the reciprocal influence between innovating theatre plays and the process of a modernizing society. In doing this I take into account insights from translation theory and the thinking on cultural mediation, whereby cultural transmission is seen as a way of interacting: the receiving culture’s receptivity towards new ideas and new forms is crucial for the space available for innovative literature from abroad. Tracking Ibsen on the Dutch stages shows a wavelike movement. Research into the reception of Ibsen supports the claim by the Dutch author Ina Boudier-Bakker (1875-1966 who used the late first staging of Ibsen's A Doll's House (1889 to illustrate the Amsterdam and Dutch conservatism with regard to gender roles and avant-garde art. Prior to 1890 the Netherlands lagged behind other European countries. With the Dutch production of A Doll’s House a new era arrives.After a flying start and a growing appreciation for Ibsen as a social reformer, particularly concerning entrenched (gender conventions, Dutch critics in the period 1930-1970, do not seem to be able to place Ibsen’s plays. A qualitative analysis of the revival by way of the jubilee performance Ghosts in 1956, shows that Dutch audiences hold off a contemporary debate by focusing on geographical and ethnographical distance. It indicates that in the fifties this audience was intellectually and artistically conservative. Tracking Ibsen on the stages after 1970 shows us the current multicultural society; it shows us a renewed interest in his female characters, which culminates with Nora. It shows us an increasing number of women directors in Dutch theatres, also in advanced theatre school performances. Present-day Dutch theatres and their audiences seem to be mostly interested in Ibsen’s theatre women, be it his female characters or the relatively new phenomenon of women directing his plays. Their

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

    Directory of Open Access Journals (Sweden)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-01-31

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

  2. Shouldice Herniorrhaphy Technique: Surgeons Need to Remember It

    Directory of Open Access Journals (Sweden)

    Adem Dervişoğlu

    2012-01-01

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

  3. Surgeon-patient communication during awake procedures.

    Science.gov (United States)

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

    2017-06-01

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

  4. Sir Donald Ross, pioneer aortic valve surgeon.

    Science.gov (United States)

    Wheatley, David

    2015-06-01

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

  5. Society of American Gastrointestinal and Endoscopic Surgeons

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... symmetrisation procedures were performed by plastic surgeons. Breast surgeons had sought more specific education, both international observerships and specific courses. In both groups of surgeons, the majority expressed that both tumour removal and reconstruction should be performed by doctors of their own...

  7. Canadian cardiac surgeons' perspectives on biomedical innovation.

    Science.gov (United States)

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

    2012-01-01

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

  8. MICROBIOLOGICAL SURVEILLANCE OF AIR QUALITY IN OPE RATION THEATRES - COMPARISON OF THE CONVENTIONAL SETTLE PL ATE TECHNIQUES VS USE OF AN AIR SAMPLING DEVICE.

    Directory of Open Access Journals (Sweden)

    Prathab

    2012-10-01

    Full Text Available ABSTRACT: BACKGROUND: Air as a means of nosocomial transmission has alw ays remained as a cause of concern for health care providers and especially personnel involved in infection control activities. Although there are no uniform c onsensus on either the standards for surveillance, methodology for monitoring or the lev els of acceptable contamination, it still remains a fact that we need to have some criteria t o monitor air quality in atleast the critical care areas like the operation theatres. METHODOLOGY: Air quality surveillance in the operation theatres was performed simultaneously usin g the settle plate technique and an air sampling device. A total of 9 operation theatres were subjected to 4 surveillance cycles with a minimum of 2 recordings in each theatre following standard protocols and accepted method used to calculate bioburden. RESULTS: A comparison was made between the two methods using the data available with 72 recordings . In th e settle plate technique, the mean cfu /mm3 was found to be 17.11 and 22cfu/mm3 at less than 30 cm and at a point more than 30cms of the operating table where as the corresponding means usi ng the air sampler was137.83 and 164.11cfu/mm3 respectively which showed considerable statistical significance . CONCLUSION : The use of an air sampler would be more appropriate in monitoring the air quality in critical care areas ensuring a more stringent method of qual ity check without compromising on the the standard accepted norms and addressing the issue of patient safety with reference to infection prevention

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

    Science.gov (United States)

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

    2015-02-01

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

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

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-08-01

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

  11. The Ignorant Facilitator: Education, Politics and Theatre in Co-Communities

    Science.gov (United States)

    Lev-Aladgem, Shulamith

    2015-01-01

    This article discusses the book "The Ignorant Schoolmaster: Five Lessons in Intellectual Emancipation" by the French philosopher, Jacques Rancière. Its intention is to study the potential contribution of this text to the discourse of applied theatre (theatre in co-communities) in general, and the role of the facilitator in particular. It…

  12. SMEs, IT, and the Third Space: Colonization and Creativity in the Theatre Industry

    Science.gov (United States)

    Kendall, Julie E.; Kendall, Kenneth E.

    We examine how small and medium-sized, professional, nonprofit performing arts theatres in the US can improve the strategic use of information technology (IT), as well as other aspects of theatre management for large, commercial theatre productions in the West End of London and on Broadway in New York City. In this article we use the epistemology of the third space developed by Bhabha (1994) and extended by Frenkel (2008). Although both authors were discussing knowledge transfer, we use their conceptualizations to characterize and explore more deeply the transfer process of culture (and thereby useful practices and worthwhile lessons) from small and medium-sized professional, nonprofit theaters to large-scale commercial theatres. We include a discussion of Nonaka’s (1991) concept of ba, and how it relates to the third space. We specifically employ the metaphor of the third space developed by Bhabha (1994) to critique and understand the verbal and nonverbal cultural transmissions between small and large theatres. One of our contributions is to use the conceptualization and metaphor of the third space to understand the complex exchanges and relationships between small to medium-sized nonprofit professional theatres and large commercial theatres, and to identify what large commercial productions can learn from nonprofit theatres from these exchanges.

  13. Between the Frames: Youth Spectatorship and Theatre as Curated, "Unruly" Pedagogical Space

    Science.gov (United States)

    Gallagher, Kathleen; Wessels, Anne

    2013-01-01

    In this article, we consider the aesthetic, political and pedagogical strengths of a verbatim theatre performance, "The Middle Place" by Project: Humanity, a play that explores the experiences of shelter youth in Toronto, Canada. This ethnographic study moved from drama classrooms into theatres and charted audience responses to the…

  14. Children's Theatre Review, Volume XXX, Number 2, Spring 1981. Research Edition.

    Science.gov (United States)

    Ritch, Pamela, Ed.

    1981-01-01

    This special journal edition contains research reports on children and the theatre. The seven articles discuss the following subjects: (1) how audiences function in participation plays for young people, (2) creative dramatics and handicapped children, (3) the effect of advance organizers on children's responses to theatre viewing, (4) a Piagetian…

  15. It's Not Always Good For You: Theatre Is Not Supposed To Be Medicine.

    Science.gov (United States)

    Gregg, Stephen

    2002-01-01

    Suggests that theatre's capacity to educate is often overstated. Notes theatre created by and for teenagers is especially guilty of proselytizing. Argues the real danger is that the cumulative, subliminal message is that theater is medicine. Suggests that playwrights, directors, and artistic directors leave the education for the classroom and take…

  16. Theatre Curriculum in the US: A Great Tasting Sandwich on Stale Bread

    Science.gov (United States)

    Duffy, Peter

    2016-01-01

    This essay considers the role that local control, poverty, access and policy play in providing drama/theatre education opportunities to students in the US. It examines how state and federal initiatives shape and determine the curriculum. While there are studies that suggest robust theatre education in the US, these findings are complicated when…

  17. A Search for the Sources of Excellence: Applying Contemporary Management Theory to Theatre Research.

    Science.gov (United States)

    Jones, Tom; White, Donald D.

    A study was conducted to learn about the effective practice of theatre through the application of research methods developed in studies involving other types of organizations. Successful and unsuccessful play directors, as determined by evaluations of their plays in the Southwest Region of the American College Theatre Festival, were surveyed to…

  18. Dramatizing the Content with Curriculum-Based Readers Theatre, Grades 6-12

    Science.gov (United States)

    Flynn, Rosalind M.

    2007-01-01

    Unlike traditional Readers Theatre, which is typically limited to literature-based scripts, Curriculum-Based Readers Theatre (CBRT) allows teachers and students to create scripts based on any topic, any work of literature, any textbook, or almost any collection of facts. It can be easily incorporated into the existing curriculum, and because this…

  19. Shaping the Javanese Play : improvisation of the script in theatre performance

    NARCIS (Netherlands)

    Bosnak, Judith Ernestine

    2006-01-01

    This book focuses on several Javanese theatre companies and more specifically on the way these groups shape and use their play texts. By looking at the different stages and dimensions of Javanese theatre productions various manifestations of the script and ‘script-like phenomena’ are encountered.

  20. Performative Criminology and the “State of Play” for Theatre with Criminalized Women

    Directory of Open Access Journals (Sweden)

    Elise Merrill

    2015-04-01

    Full Text Available This article applies feminist theory with cultural criminology to explore the role of theatre in the lives of criminalized women. Theatre initiatives for criminalized populations are growing worldwide, and so we are seeking to better understand how these two realms intersect. This article is based on a case study which was conducted at the Clean Break Theatre Company in London, England in the summer of 2013. We explore some of the emerging themes, which took shape from a thematic analysis. First we describe how theatre can be used as a lens into the experiences of criminalized women, and then as a tool for growth in their lives. The role of environment at Clean Break, and the role of voice from practicing theatre in a women-only environment are then discussed. Lastly, the roles of transformation and growth overall for the participants are explored in relation to their experiences with theatre practices. This article works to understand how theatre practices can elevate and adapt cultural criminology into a new form of imaginative criminology, and questions how we can embrace this form of engagement between theatre and criminology within a Canadian context.

  1. Mosaic: Re-Imagining the Monolingual Classroom through Theatre-in-Education

    Science.gov (United States)

    Pakkar-Hulla, D.

    2014-01-01

    This article is a study of "Mosaic"--a piece of multilingual theatre-in-education designed to promote linguistically diverse practices in primary schools in Birmingham, United Kingdom. Focusing on the relatively uncharted territory of applied theatre as a means of promoting multilingualism, and challenging a culture of monolingual…

  2. Wishing for a World without "Theatre for Development": Demystifying the Case of Bangladesh.

    Science.gov (United States)

    Ahmed, Syed Jamil

    2002-01-01

    Argues that Theatre for Development in Bangladesh practiced by Non-Governmental Organizations, which is almost entirely funded by international donor organizations, serves globalization in the name of poverty alleviation. Concludes by advocating for the necessity of exploring alternatives by which indigenous theatre performers may access directly…

  3. Staging data: theatre as a tool for analysis and knowledge transfer in health research.

    Science.gov (United States)

    Rossiter, Kate; Kontos, Pia; Colantonio, Angela; Gilbert, Julie; Gray, Julia; Keightley, Michelle

    2008-01-01

    Over the past several decades, researchers have taken an interest in theatre as a unique method of analysing data and translating findings. Because of its ability to communicate research findings in an emotive and embodied manner, theatre holds particular potential for health research, which often engages complex questions of the human condition. In order to evaluate the research potential of theatre, this article critically examines examples of evaluated health research studies that have used theatre for the purposes of data analysis or translation. We examine these studies from two perspectives. First, the literature is divided and categorized into four theatre genres: (1) non-theatrical performances; (2) ethnodramas, which can be interactive or non-interactive; (3) theatrical research-based performances; and (4) fictional theatrical performances. This categorization highlights the importance of these genres of theatre and provides an analysis of the benefits and disadvantages of each, thus providing insight into how theatre may be most effectively utilized in health research. Second, we explore the efficacy of using theatre for the purposes of data analysis and knowledge transfer, and critically examine potential approaches to the evaluation of such endeavours.

  4. "An Impossible Ambition"?: Roy Mitchell's Creative Idealism and the Spiritual Nexus between Theatre and Theosophy

    Science.gov (United States)

    Kivisto, Mikko William

    2009-01-01

    Though a participant of the Little Theatre Movement in North America, Roy Mitchell was largely ignored or--at best--marginalized by theatre practitioners and scholars after his death in 1944 until the late 1980s. Most of the material written about him had labelled him a prophet--a lone voice in the wilderness advocating for a new direction from a…

  5. Theatre Curriculum in the US: A Great Tasting Sandwich on Stale Bread

    Science.gov (United States)

    Duffy, Peter

    2016-01-01

    This essay considers the role that local control, poverty, access and policy play in providing drama/theatre education opportunities to students in the US. It examines how state and federal initiatives shape and determine the curriculum. While there are studies that suggest robust theatre education in the US, these findings are complicated when…

  6. Science Theatre at School: Providing a context to learn about socio-scientific issues

    NARCIS (Netherlands)

    Wieringa, N.F.; Swart, J.A.A.; Maples, T.; Witmondt, L.; Tobi, H.; Windt, v.d. H.J.

    2011-01-01

    Science theatre is recognised as a method for teaching socio-scientific issues (SSI), but is largely under-researched. The essence of science theatre at school is to shape a contextualisation for science and technology and its relationships to individuals and society at large, with the aim to trigge

  7. Shaping the Javanese Play : improvisation of the script in theatre performance

    NARCIS (Netherlands)

    Bosnak, Judith Ernestine

    2006-01-01

    This book focuses on several Javanese theatre companies and more specifically on the way these groups shape and use their play texts. By looking at the different stages and dimensions of Javanese theatre productions various manifestations of the script and ‘script-like phenomena’ are encountered. Al

  8. Low-Achieving Readers, High Expectations: Image Theatre Encourages Critical Literacy

    Science.gov (United States)

    Rozansky, Carol Lloyd; Aagesen, Colleen

    2010-01-01

    Students in an eighth-grade, urban, low-achieving reading class were introduced to critical literacy through engagement in Image Theatre. Developed by liberatory dramatist Augusto Boal, Image Theatre gives participants the opportunity to examine texts in the triple role of interpreter, artist, and sculptor (i.e., image creator). The researchers…

  9. "Playlinks": A Theatre-for-Young Audiences Artist-in-the-Classroom Project

    Science.gov (United States)

    McLauchlan, Debra

    2017-01-01

    "Playlinks," the project documented in this paper, contributed a theatre-based artist-in-the-classroom study to the Community Arts Zone initiative. "Playlinks" involved 248 elementary school classrooms in pre- and post-production workshops connected to live theatre that visited their schools. Data sources included researcher…

  10. Beyond Disability: A Dialogue with Members of the Improbable Theatre Company

    Science.gov (United States)

    Eckard, Bonnie J.; Myers, Wendy

    2009-01-01

    The Improbable Theatre Company (ITC) was created by and for theatre artists with disabilities. Based on interviews of members from the company, we discuss tensions between the disability movement and arts professionals, the correlation between arts and politics within the disabled community, autonomy, advocacy, and control. We examine the…

  11. The Core Competencies for General Orthopaedic Surgeons.

    Science.gov (United States)

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

    2017-01-18

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

  12. The Conference of Theatre Leaders on March 29–30, 1917: Discussion on the Fates of the Russian Theatre in the Age of Revolution

    Directory of Open Access Journals (Sweden)

    GORDEEV P.N.

    2014-09-01

    Full Text Available The article is devoted to the understudied but important event in the history of Russian theatre in the age of revolution – the conference of theatre leaders, held on March 29–30, 1917 in the Winter Palace. The study is aimed at determining the circle of participants, highlighting the discussed issues, evaluating the overall significance of the conference in the history of Russian theatre. In the process of research the author used a number of new archival materials, the most important of which are the recordings of the meeting of March 30 (found by the author in the collections of the St. Petersburg State Museum of Theatre and Music and introduced to the scientific world for the first time. On the basis of these recordings, as well as other archival materials and publicistic articles, the author managed to determine the circle of theatre leaders who participated in the conference. They include such outstanding representatives of the Russian theater as V.E. Meyerhold, M.M. Fokin, A.I. Sumbatov-Yuzhin and L.V. Sobinov. They discussed the responsibilities of self-government, elected by the actors, the rights of the theatre commissars, the pursuit of Moscow scene to achieve the maximum independence from Petrograd as well as the functions of the assistant commissar of the Provisional Government of the former Ministry of the Court. The question about the possible involvement of Soviet Workers and Soldiers in the development of theatrical reforms provoked lively debates (the proposal was not supported by the majority of the participants. The final resolution of the conference stated the demand of the “autonomy” for state theatres. The significance of the conference consists primarily in the fact that it revealed some common intentions of theatre leaders as well as contradictions on a number of issues, many of which were raised for the first time at this conference and were continually discussed throughout the revolution.

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

    Science.gov (United States)

    Koehn, Jacqueline K; Kuchenbecker, Katherine J

    2015-10-01

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

  14. Operational Encirclements: Can the United States Military Decisively Follow Through?

    Science.gov (United States)

    2009-05-21

    friction that trickles down onto the battlefield. The European theatre during World War II was no different. The failure of American, and British...American and their Allied partners would continue to experience the ill-effects of it right up until the end of the war in the European theatre ...on Friday 27 March 2009 about Operation Anaconda. I used some information from our conversation. The following is verbatim from my monograph, "A

  15. Teaching the surgical craft: Surgery residents perception of the operating theater educational environment in a tertiary institution in Nigeria

    Directory of Open Access Journals (Sweden)

    Abdulrasheed Ibrahim

    2013-01-01

    Full Text Available Background: The transformation of a surgical trainee into a surgeon is strongly influenced by the quality of teaching in the operating theater. This study investigates the perceptions of residents about the educational environment of the operating theater and identifies variables that may improve the operating theater education of our trainees. Materials and Methods: Residents in the department of surgery anonymously evaluated teaching in the operating room using the operating theater education environment measure. The residents evaluated 33 variables that might have an impact on their surgical skills within the operating theater. The variables were grouped into four subscales; teaching and training, learning opportunities, operating theater atmosphere and workload/supervision/support. Differences between male and female residents and junior and senior registrars were assessed using Mann-Whitney test. Statistical analysis was completed with the statistics package for the social sciences version 17. Results: A total of 33 residents were participated in this study. Twenty nine (88% males and 4 (12% females. 30 (90% were junior registrars. The mean total score was 67.5%. Operating theater atmosphere subscale had the highest score of 79.2% while workload/supervision/support subscale had the least score of 48.3%. There were significant differences between male and female resident′s perception of workload/supervision/support P 0.05. Conclusion: This study has shown a satisfactory teaching environment based on the existing local realities of means, resources and tools and highlighted the need for improvement in workload/supervision/support in our institution. An acceptable learning environment in the operating theatre will produce surgeons that are technically competent to bridge the gap in the enormous unmet need for surgical care in Nigeria.

  16. Filling the Empty Space: Women and Latin American Theatre

    Directory of Open Access Journals (Sweden)

    Kirsten F. Nigro

    1996-01-01

    Full Text Available In recent years, Latin American women have begun to appropriate and fill a space once empty of their presence. This essay looks at the work of four such women, (Diana Raznovich and Cristina Escofet of Argentina, Raquel Araujo of Mexico and the Peruvian Sara Joffre, to see how they give substance and voice to their particular concerns. In the process, this essay focusses on: 1 the notion of gender as performance; 2 the feminist deconstruction of narrative; 3 the female body in theatrical space; and 4 new, postmodern ways of doing feminist political theatre.

  17. Amazing Acrobatics of Language: The Theatre of Yussef El Guindi

    Directory of Open Access Journals (Sweden)

    Anneka Esch-van Kan

    2008-12-01

    Full Text Available Despite the importance of minority rights movements and literatures of migration within the last century’s history of the humanities, no light has been shed so far on the life and arts of Arab Americans. While there is a tradition of Arab American writers and poets, it is often claimed that ‘Arab American Theatre’ was born on September 11. This article will start from general reflections on the development and forms of Arab American theatre in the United States and will in its main body concentrate on the works of Egyptian-born playwright Yussef El Guindi.

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

    Science.gov (United States)

    Rosenberg, Aaron G

    2006-07-01

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

  19. Project Muskan : Social responsibility of the plastic surgeon

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

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

  20. Evaluation of the contribution of theatre attendance to medical undergraduate neuroscience teaching--a pilot study.

    Science.gov (United States)

    Flannery, Thomas; Gormley, Gerry

    2014-10-01

    Medical students often attend the neurosurgical theatre during their clinical neurosciences attachment. However, few studies have been performed to objectively assess the value of this theatre-based learning experience. The main aim of this study was to explore student perceptions on the contribution of neurosurgical theatre attendance to clinical neuroscience teaching. Third-year medical students undergoing their 2-week clinical neurosciences rotation at the Royal Hospitals Belfast were invited to participate in this study. A multi-method strategy was employed using a survey questionnaire comprising of closed and open-ended questions followed by semi-structured interviews to gain a greater 'in-depth' analysis of the potential contribution of neurosurgical theatre attendance to neuroscience teaching. Based on the completed survey responses of 22 students, the overall experience of neurosurgical theatre-based learning was a positive one. 'In-depth' analysis from semi-structured interviews indicated that students felt that some aspects of their neurosurgical theatre attendance could be improved. Better preparation such as reading up on the case in hand and an introduction to simple theatre etiquette to put the student at ease (in particular, for students who had never attended theatre previously), would improve the learning experience. In addition, having an expectation of what students are expected to learn in theatre making it more learning outcomes-based would probably make it feel a more positive experience by the student. The vast majority of students acknowledged the positive learning outcomes of neurosurgical theatre attendance and felt that it should be made a mandatory component of the curriculum.

  1. Designing a leadership development program for surgeons.

    Science.gov (United States)

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

    2016-01-01

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

  2. History of the Congenital Heart Surgeons' Society.

    Science.gov (United States)

    Mavroudis, Constantine; Williams, William G

    2015-10-01

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

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

    Science.gov (United States)

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

    2017-09-15

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

  4. Ethical Issues in Translational Research: From the Bench to Theatre

    African Journals Online (AJOL)

    ... basic science to research on human participants; a field of research referred to as ... from the “bench to the bed side” is a lengthy, laborious, resource intensive .... professional belief in the surgical research enterprise, surgeon-researchers ...

  5. Medical supply on contingency military operations: experience from Operation GRITROCK.

    Science.gov (United States)

    Robinson, J P; Reeves, P

    2015-01-01

    Medical supply during military operations has the ability to affect the efficacy of the operation being undertaken, either negatively or positively. An appropriately-managed maritime platform with a robust medical supply chain during transit and on arrival in theatre is the main aim. A secure supply chain will reduce any implications that logistics may have with regard to capability, and negate the effects of deficiencies of short shelf life items occurring over time and during use in high tempo operations.

  6. 1004座剧院暖通设计实例分析%Case Analysis of the HVAC Design for a 1004-seat Theatre

    Institute of Scientific and Technical Information of China (English)

    郎卫国

    2014-01-01

    Takes the Shanghai International Dance Center as an example,introduces the design of its air conditioning system,ventilation, smoke control and exhaust system of a 1004-seat Dance Theatre,and makes a design summary combin-ing with the features of dance theatre and past projects’ operation condition.%以上海国际舞蹈中心为例,主要介绍了1004座舞蹈剧院的空调系统设计,通风、防排烟系统,并结合舞蹈剧院特点和过往项目运行情况做了设计小结。

  7. Perioperative dexamethasone administration in tonsillectomy patients: A three-cycle audit showing improvement using printed theatre lists.

    Science.gov (United States)

    Bola, Summy; Bartlett, Annie; Williams, Richard

    2015-01-01

    Dexamethasone administration prior to tonsillectomy has been shown to reduce morbidity and is part of SIGN guideline 117. We conducted a three-cycle audit of 149 patients to ascertain how well guidelines were being met and introduce a sustainable method to improve compliance. A 3-month audit was conducted to ascertain how many tonsillectomy patients didn't receive pre-operative dexamethasone. ENT secretaries were requested to add 'Dex Please' to tonsillectomy theatre lists. A 3-month re-audit was conducted; the intervention was only implemented in half of cases and so a reminding tool for the secretarial staff was administered before a third cycle. Initially, there was 73% compliance to SIGN guidelines, this improved to 87% in the second cycle. After the second intervention, all tonsillectomy theatre lists had the 'Dex Please' note and compliance to SIGN guidelines was 100%. There were five readmissions in the first cycle, three in the second and two in the third cycle. All readmissions were underdosed according to guidelines. Understanding there are regular staff rotations throughout many U.K. hospitals, we implemented a reliable method to increase compliance to guidelines which helped reduce post-operative readmission after tonsillectomy. This can be easily introduced to other institutions and for other perioperative requirements.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  9. Maximizing efficiency on trauma surgeon rounds.

    Science.gov (United States)

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

    2017-01-01

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

  10. Development of a Rapidly Deployable Special Operations Component Command (SOCC) Core Concept for the North Atlantic Treaty Organization (NATO) Special Operations Headquarters (NSHQ)

    Science.gov (United States)

    2011-12-01

    his vast “ renaissance type” knowledge in a wide array of disciplines; and the second, the most important, is his big heart. This is what makes him...operational control (OPCON) of all SOF in a designated theatre of operations. The CJFSOCC normally controls between two and six JSOTFs, SOTGs and /or...must be able to conduct NATO J1-J8 functions, advanced crisis response, time sensitive planning, and theatre - level campaign planning. It must be

  11. Authenticity and commercialization. Cambodian theatre in a postcolonial perspective

    Directory of Open Access Journals (Sweden)

    Maria Delimata

    2010-12-01

    Full Text Available The article discusses the problem of authenticity and commercialization in the context of the postcolonial theatre in Cambodia. It seems that contemporary art in this country depends on foreign funds and at the same time on the special taste of – mainly – Western donors. The author tries to show, that the epithet “pure Cambodian” is very often used to make art more interesting to tourists. A similar situation can be seen in the crucifixions in Cutud (which annually takes place in a Philippine province – Pampanga with a wide touristic audience and in Balinese theatre (another good example of a postcolonial, hybrid identity. Moreover, a discourse of the battle between “traditional” and “touristic” points of view does not have one answer. The search for purity can be a cause of petrifying traditional forms, as well as a sign of neocolonialism and (self-orientalisation. On the other hand, a dialogue between indigenous artists and the others, tourists, may give the art a new profile and new meaning.

  12. The impact of positive and negative intraoperative surgeons' leadership behaviors on surgical team performance.

    Science.gov (United States)

    Barling, Julian; Akers, Amy; Beiko, Darren

    2017-07-18

    The effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance. Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Observers recorded instances of the four leadership behaviors enacted by the surgeon. Postoperatively, team members completed validated questionnaires rating team cohesion and collective efficacy. Multiple regression analyses were computed. Data were analyzed using the complex modeling function in MPlus. Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized B = -0.352, p team performance. Significant effects only surfaced for negative leadership behaviors; transformational leadership did not positively influence team performance. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2006-01-01

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

  14. The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery.

    Science.gov (United States)

    Plerhoples, Timothy A; Hernandez-Boussard, Tina; Wren, Sherry M

    2012-03-01

    There is increasing interest in understanding the toll that operating takes on a surgeon's body. The effect of robotic surgery on surgeon discomfort has not been studied. We sought to document the discomfort of robotic surgery compared with open and laparoscopic surgery and to investigate the factors that affect the risk of physical symptoms. Nineteen-thousand eight-hundred and sixty-eight surgeons from all specialties trained in the use of robots were sent a 26-question online survey and 1,407 responded. One-thousand two-hundred and fifteen surgeons who practiced all three approaches were used in the analysis. Eight-hundred and seventy-one surgeons had physical discomfort or symptoms attributable to operating. Of those with symptoms, 55.4% attributed most of the symptoms to laparoscopic surgery, 36.3% to open surgery, and 8.3% to robotic surgery. A higher case load was predictive of increased symptoms for open and laparoscopic surgery, but not for robotic surgery. Robotic surgery was less likely than open or laparoscopic surgery to lead to neck, back, hip, knee, ankle, foot, and shoulder pain and less likely than laparoscopic surgery to lead to elbow and wrist pain. Robotic surgery was more likely than either open or laparoscopic surgery to lead to eye pain, and more likely than open surgery to lead to finger pain. Nearly a third (30.3%) of surgeons admit to giving consideration to their own discomfort when choosing an operative modality. Robotic surgery has promise in reducing the risk of physical discomfort for the operator. This is important as more surgeons consider their own health when choosing a surgical modality.

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

    Science.gov (United States)

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

    2013-08-01

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

  16. The Unmade City: Subjectivity, Buffalo and the Sad Fate of Studio Arena Theatre

    Directory of Open Access Journals (Sweden)

    Julian Meyrick

    2016-09-01

    Full Text Available This article is a reflection on the disjointed and submerged cultural consciousness of the city of Buffalo, New York. It outlines the concept of subjectivity as put forward by the philosopher Alain Badiou, and maps it onto the history of Studio Arena, Buffalo’s main theatre company. Studio Arena Theatre (1927–2008 was one of the oldest and best known regional theatres in the USA. Its closure is a story fraught with conflict, misunderstanding and loss. That there has been no replacement theatre of comparable size and mandate says something about Buffalo’s diminished civic imaginary. While the link between the Theatre and the City is hard to formularise, it is a historically important relationship, going back to the time of Aristotle when theatre functioned as an informing resource for the lives of citizens. Those interested in urban renewal in Buffalo and other rust-belt US cities can profit not only from an understanding of Studio Arena Theatre’s history, but from a consideration of the kind of emotional engagement that this regional theatre represented.

  17. How helpful is capsule endoscopy to surgeons?

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Bulent Sivri; Yusuf Bayraktar

    2007-01-01

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

  18. Contemporary social media engagement by breast surgeons.

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2005-05-01

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

  20. The Role of Framing in Counterinsurgency/Counterterrorism Operations: The Status of Hearts and Minds

    Science.gov (United States)

    2008-03-01

    terrorist message may yield a more effective response by the U.S. forces in theatre . Key to the terrorist operations is the ability to deny the... theatre of operations against the occupying forces and their sponsored indigenous auxiliaries and security forces. The concept of framing best...with traces of 19th century romanticism : war-like Sheikhs in flowing robes brandishing scimitars and dying for honor. This stereotype feeds the image

  1. Enhancing Hungarian Special Forces through Transformation -- The Shift to Special Operations Forces

    Science.gov (United States)

    2010-06-01

    operational exposure concerns the operational (combat theatre ) experience of the relevant HDF personnel. The assumption is that the more such experience...bureaucratic jungle” or the deployed HUNSF elements’ combat theatre . Moreover, adhocracies are not meant to produce outputs; there is no “product” at the end...infantry brigade as a consequence of the last larger reorganization of the HDF. That reorganization occurred amid the renaissance of the “light

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Claire Jourdan

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

  4. Use of Unsolicited Patient Observations to Identify Surgeons With Increased Risk for Postoperative Complications.

    Science.gov (United States)

    Cooper, William O; Guillamondegui, Oscar; Hines, O Joe; Hultman, C Scott; Kelz, Rachel R; Shen, Perry; Spain, David A; Sweeney, John F; Moore, Ilene N; Hopkins, Joseph; Horowitz, Ira R; Howerton, Russell M; Meredith, J Wayne; Spell, Nathan O; Sullivan, Patricia; Domenico, Henry J; Pichert, James W; Catron, Thomas F; Webb, Lynn E; Dmochowski, Roger R; Karrass, Jan; Hickson, Gerald B

    2017-06-01

    Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations. This retrospective cohort study used data from 7 academic medical centers participating in the National Surgical Quality Improvement Program and the Vanderbilt Patient Advocacy Reporting System from January 1, 2011, to December 31, 2013. Patients older than 18 years included in the National Surgical Quality Improvement Program who underwent inpatient or outpatient operations at 1 of the participating sites during the study period were included. Patients were excluded if the attending surgeon had less than 24 months of data in the Vanderbilt Patient Advocacy Reporting System preceding the date of the operation. Data analysis was conducted from June 1, 2015, to October 20, 2016. Unsolicited patient observations for the patient's surgeon in the 24 months preceding the date of the operation. Postoperative surgical or medical complications as defined by the National Surgical Quality Improvement Program within 30 days of the operation of interest. Among the 32 125 patients in the cohort (13 230 men, 18 895 women; mean [SD] age, 55.8 [15.8] years), 3501 (10.9%) experienced a complication, including 1754 (5.5%) surgical and 2422 (7.5%) medical complications. Prior unsolicited patient observations for a surgeon were significantly associated with the risk of a patient having any complication (odds ratio, 1.0063; 95% CI, 1.0004-1.0123; P = .03), any surgical

  5. The razor's edge: Australian rock music impairs men's performance when pretending to be a surgeon.

    Science.gov (United States)

    Fancourt, Daisy; Burton, Thomas Mw; Williamon, Aaron

    2016-12-12

    Over the past few decades there has been interest in the role of music in the operating theatre. However, despite many reported benefits, a number of potentially harmful effects of music have been identified. This study aimed to explore the effects of rock and classical music on surgical speed, accuracy and perceived distraction when performing multiorgan resection in the board game Operation. Single-blind, three-arm, randomised controlled trial. Imperial Festival, London, May 2016. Members of the public (n = 352) aged ≥ 16 years with no previous formal surgical training or hearing impairments. Participants were randomised to listen through noise-cancelling headphones to either the sound of an operating theatre, rock music or classical music. Participants were then invited to remove three organs from the board game patient, Cavity Sam, using surgical tweezers. Time taken (seconds) to remove three organs from Cavity Sam; the number of mistakes made in performing the surgery; and perceived distraction, rated on a five-point Likert-type scale from 1 (not at all distracting) to 5 (very distracting). Rock music impairs the performance of men but not women when undertaking complex surgical procedures in the board game Operation, increasing the time taken to operate and showing a trend towards more surgical mistakes. In addition, classical music was associated with lower perceived distraction during the game, but this effect was attenuated when factoring in how much people liked the music, with suggestions that only people who particularly liked the music of Mozart found it beneficial. Rock music (specifically Australian rock music) appears to have detrimental effects on surgical performance. Men are advised not to listen to rock music when either operating or playing board games.

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

    Directory of Open Access Journals (Sweden)

    Hashemi Esmat

    2005-04-01

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

  7. Sam Shepard's plays according to Slovenian theatre directors

    Directory of Open Access Journals (Sweden)

    Anina Oblak

    2003-12-01

    Full Text Available The article focuses on the productions of Sam Shepard's plays in Slovenia during 1985-2000 and the author of the paper primarily pays attention to the Slovenian directors' approach to Shepard's works and the problems that have arisen in the process. Five of Shepard's plays have been staged to date in Slovenia, two early works and three works of new realism. In interviews with the directors (Vinko Möderndorfer, Primož Bebler, Boris Kobal, Dušan Jovanovic and Boris Cavazza as well as three actresses and a choreographer (Alenka Vidrih, Barbara Babič, Vesna Jevnikar, Tanja Zgonc it has emerged that the transplantation of typically American issues to Slovenia and their treatment necessitated a different approach from the one normally taken by the Slovenian directors and actors. Shepard's plays being idiosyncratic, the theatre artists had to either accommodate his material or treat it with different methods that were adapted to suit the Slovenian environment.

  8. National Theatre of China's Romeo and Juliet and Its Rituals

    Directory of Open Access Journals (Sweden)

    Benny Lim

    2014-04-01

    Full Text Available This paper explores the “Chinese-ness” of this brand new production of Romeo and Juliet by the National Theatre of China, from a ritual perspective. Three main areas were discussed. Firstly, this play has got several religious connotations. The absence of religion in this play’s setting is relevant to China’s current high percentage of atheists. Despite that, several religions, such as Buddhism, Daoism and Christianity, are mentioned in this play. Secondly, the play has also incorporated several Chinese culture and traditions. The use of bicycles as one of the main props can be linked to the cultural significance of bicycles in China. The play also incorporated other cultural and traditional elements such as wedding customaries in China, Xinjiang dance, as well as the Chinese tongue twisters. Finally, the play has incorporated multiple Brechtian moments. Perhaps the Brechtian moments can lead audience to think about the current religious and cultural developments in modern China.

  9. Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience

    Directory of Open Access Journals (Sweden)

    Praveer K Banerjee

    2016-01-01

    Full Text Available Background and Aims: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. Methods: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone. All of them were medically stable with no need of intensive care or mechanical ventilation in post-operative period. Results: Submandibular intubation in all ten patients of panfacial fractures allowed uninterrupted surgical techniques with a secured airway. All patients were reverted to oro-tracheal tube at the end of surgery as immediate maxillomandibular fixation was not necessary. The patients were extubated after recovery from anaesthesia before they left the operating theatre. One patient in the post-operative period had a superficial infection of incision site that responded well to local treatment. No other complications were encountered in the intra-operative or post-operative period. Conclusion: In complex maxillofacial injuries, when oral or nasal intubation hampers surgeon′s field of view, submandibular intubation offers an effective alternative to short-term tracheostomy along with small risk potential. There is a need to emphasise its regular application in such cases so that technique can be mastered by both surgeons and anaesthesiologist.

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

    Science.gov (United States)

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

    2011-12-01

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

  11. Smart apps for the smart plastic surgeon

    Directory of Open Access Journals (Sweden)

    Aniketh Venkataram

    2015-01-01

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

  12. Professionalism and Commercialism on Cosmetic Surgeons' Websites.

    Science.gov (United States)

    Park, Sung-Yeon; Park, SangHee

    2016-07-15

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

  13. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  14. Ethics and the facial plastic surgeon.

    Science.gov (United States)

    Sethi, Neeraj

    2016-09-01

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

  15. Think small: nanotechnology for plastic surgeons.

    Science.gov (United States)

    Nasir, Amir R; Brenner, Sara A

    2012-11-01

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

  16. Paying surgeons less has cost more.

    Science.gov (United States)

    Bernstein, Joseph; Derman, Peter

    2012-12-01

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

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

    Science.gov (United States)

    Evans, Roger G; Johnston, Colin I

    2017-08-12

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

  18. Plaster of Paris: the orthopaedic surgeon heritage.

    Science.gov (United States)

    Hernigou, Philippe

    2016-08-01

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

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

    Science.gov (United States)

    Mulder, M; De Jong, E

    1997-01-01

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

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

    Science.gov (United States)

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

    2010-02-01

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

  1. Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States.

    Science.gov (United States)

    Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R

    2016-05-01

    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.

  2. Assessment of educational environment of surgical theatre at a teaching hospital of a saudi university: using surgical theatre educational environment measures.

    Science.gov (United States)

    Al-Qahtani, Mona Faisal; Al-Sheikh, Mona

    2012-05-01

    This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD). The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships. The Surgical Theatre Educational Environment Measure (STEEM) was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 17. The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment. The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that equal opportunities for learning and training should be

  3. Improving time to surgery for hip fracture patients. Impact of the introduction of an emergency theatre

    LENUS (Irish Health Repository)

    French-O’Carroll, F

    2017-01-01

    Hip fractures are a major cause of morbidity and mortality1. Surgery performed on the day of or after admission is associated with improved outcome2,3. An audit cycle was performed examining time to surgery for hip fracture patients. Our initial audit identified lack of theatre space as one factor delaying surgery. A dedicated daytime emergency theatre was subsequently opened and a re-audit was performed to assess its impact on time to surgery. Following the opening of the theatre, the proportion of patients with a delay to hip fracture surgery greater than 36 hours was reduced from 49% to 26% with lack of theatre space accounting for 23% (3 of 13) of delayed cases versus 28.6% (9 of 32) previously. 44% of hip fracture surgeries were performed in the emergency theatre during daytime hours, whilst in-hospital mortality rose from 4.6% to 6%. We conclude that access to an emergency theatre during daytime hours reduced inappropriate delays to hip fracture surgery.

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

    Directory of Open Access Journals (Sweden)

    Antoine Duclos

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

  5. Choosing a Breast Reconstruction Surgeon and Questions to Ask

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Science.gov (United States)

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

    2012-04-01

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

  8. Performing Desistance: How Might Theories of Desistance From Crime Help Us Understand the Possibilities of Prison Theatre?

    Science.gov (United States)

    Davey, Linda; Day, Andrew; Balfour, Michael

    2015-07-01

    Despite the ubiquity of theatre projects in prisons there has been little (published) discussion of the application of theatre to the theories of criminology or rehabilitation of offenders, and scant examination of the potential for criminological theories to inform theatre practice in criminal justice settings. This article seeks to address this deficit and argues that positioning prison theatre within the discipline of positive criminology, specifically contemporary theories of desistance from crime, provides a theoretical framework for understanding the contribution that prison theatre might be making in the correctional setting. Through a review of related literature, the article explores how prison theatre may be motivating offenders toward the construction of a more adaptive narrative identity and toward the acquisition of capabilities that might usefully assist them in the process of desisting from crime.

  9. Global plastic surgeons images depicted in motion pictures.

    Science.gov (United States)

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

    2013-03-01

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

  10. Return to theatre in secondary post-tonsillectomy haemorrhage: a comparison of coblation and dissection techniques.

    Science.gov (United States)

    Amir, Ida; Belloso, Antonio; Broomfield, Stephen J; Morar, Pradeep

    2012-02-01

    The aim of this study is to examine the incidence of return to theatre (RTT) for post-operative haemorrhage following coblation and dissection tonsillectomy and to investigate those that required RTT more than 10 days post-surgery. Retrospective review of post-tonsillectomy haemorrhages requiring RTT from April 2005 to March 2009 was conducted. Of 2,541 tonsillectomies performed, 81% were by coblation and 19% by dissection methods. The overall RTT rate was 1.7%. No difference was found in the overall RTT rates for primary and secondary haemorrhage between the two techniques. However, the overall RTT rates for primary and secondary haemorrhage were higher in adults than children (P = 0.0456 and P = 0.0215, respectively). RTT for secondary haemorrhage during the first ten post-operative days occurred in both coblation and dissection tonsillectomy with no significant difference. After the first post-operative week, late secondary bleeding requiring RTT occurred only in the coblation group (P = 0.0676). Four patients required blood transfusion; all were in the coblation group, three of which were required during RTT in the late secondary haemorrhage (after 10 days). The post-operative RTT rates for coblation tonsillectomy did not reveal a change of trend over the 4-year study period. Our RTT rate for secondary haemorrhage is higher than earlier published results. A learning curve could not be identified in RTT for coblation tonsillectomy haemorrhage. Late secondary haemorrhages requiring surgical intervention have only been identified in cases performed by coblation and could potentially be life threatening as 33% (3/9) required blood transfusion. This phenomenon may be explained by a particular physiological healing process associated with coblation.

  11. 21 CFR 878.4470 - Surgeon's gloving cream.

    Science.gov (United States)

    2010-04-01

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

  12. Blood, Monstrosity and Violent Imagery: Grand-Guignol, the French Theatre of Horror as a Form of Violent Entertainment

    OpenAIRE

    Tanja Jurković

    2013-01-01

    During the sixty-year period of its existence, Grand-Guignol, the French theatre of horror, gained a status of a legendary theatre which dealt with horrors and terrors of human mind, successfully connecting faits divers (common, everyday facts) with the erotic and titillating scenes of violence on stage. The performance style, the writing, the special effects, and the directorship over the course of years, made this theatre a legendary place where blood flowed in streams and people fainted du...

  13. Imaging of bone tumors for the musculoskeletal oncologic surgeon

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...

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

    Science.gov (United States)

    2009-12-11

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

  16. Cooling vest for improving surgeons' thermal comfort: a multidisciplinary design project.

    Science.gov (United States)

    Langø, Thomas; Nesbakken, Ragnhild; Faerevik, Hilde; Holbø, Kristine; Reitan, Jarl; Yavuz, Yunus; Mårvik, Ronald

    2009-01-01

    A laparoscopic surgeon sometimes experiences heat-related discomfort even though the temperature situation is moderate. The aim of this project was to design a cooling vest using a phase change material to increase thermal comfort for the surgeon. The project focused on the design process to reveal the most important parameters for the design of a cooling vest that could be demonstrated in a clinical setting. We performed an entire design process, from problem analysis, situation observations, concept for a prototype, temperature measurements, and a final design based on clinical testing. The project was conducted by a multidisciplinary team consisting of product designers, engineers, physiologists, and surgeons. We carried out four physiological demonstrations of one surgeon's skin temperatures and heart rate during different laparoscopic procedures. A commercially available cooling vest for firemen and two proof-of-concept prototypes were tested alongside a reference operation without cooling. To aid the final design, one person went through a climate chamber test with two different set-ups of cooling elements. The final design was found to improve the conditions of our test subject. It was found that whole trunk cooling was more effective than only upper trunk cooling. A final design was proposed based on the design process and the findings in the operating room and in the laboratory. Although the experiences using the vest seemed positive, further studies on several operators and more surgical procedures are needed to determine the true benefits for the operator.

  17. Application of ergonomic guidelines during minimally invasive surgery: a questionnaire survey of 284 surgeons

    NARCIS (Netherlands)

    Wauben, L.; Van Veelen, M.; Gossot, D.; Goossens, R.

    2006-01-01

    Background: This study aimed to obtain an answer for the question: Are ergonomic guidelines applied in the operating room and what are the consequences? Methods: A total of 1,292 questionnaires were sent by email or handed out to surgeons and residents. The subjects worked mainly in Europe, performi

  18. The ERATO project and its contribution to our understanding of the acoustics of ancient Greek and Roman theatres

    DEFF Research Database (Denmark)

    Rindel, Jens Holger; Nielsen, Martin Lisa

    2006-01-01

    the acoustics of the open air theatres and compare to the smaller, originally roofed theatres, also called odea (from Greek: Odeion, a hall for song and declamation with music). The method has been to make computer models of the spaces, first as the exist today, and adjust the acoustical data for surface...... materials by comparison to acoustical measurements from some of the best preserved examples, namely the Aspendos theatre in Turkey and the South theatre in Jerash, Jordan. Next step was to complete the computer models in accordance with archaeological information, to make virtual reconstructions...

  19. Surgeons' exposure to radiation in single- and multi-level minimally invasive transforaminal lumbar interbody fusion; a prospective study.

    Directory of Open Access Journals (Sweden)

    Haruki Funao

    Full Text Available Although minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF has widely been developed in patients with lumbar diseases, surgeons risk exposure to fluoroscopic radiation. However, to date, there is no studies quantifying the effective dose during MIS-TLIF procedure, and the radiation dose distribution is still unclear. In this study, the surgeons' radiation doses at 5 places on the bodies were measured and the effective doses were assessed during 31 consecutive 1- to 3-level MIS-TLIF surgeries. The operating surgeon, assisting surgeon, and radiological technologist wore thermoluminescent dosimeter on the unshielded thyroid, chest, genitals, right middle finger, and on the chest beneath a lead apron. The doses at the lens and the effective doses were also calculated. Mean fluoroscopy times were 38.7, 53.1, and 58.5 seconds for 1, 2, or 3 fusion levels, respectively. The operating surgeon's mean exposures at the lens, thyroid, chest, genitals, finger, and the chest beneath the shield, respectively, were 0.07, 0.07, 0.09, 0.14, 0.32, and 0.05 mSv in 1-level MIS-TLIF; 0.07, 0.08, 0.09, 0.18, 0.34, and 0.05 mSv in 2-level; 0.08, 0.09, 0.14, 0.15, 0.36, and 0.06 mSv in 3-level; and 0.07, 0.08, 0.10, 0.15, 0.33, and 0.05 mSv in all cases. Mean dose at the operating surgeon's right finger was significantly higher than other measurements parts (P<0.001. The operating surgeon's effective doses (0.06, 0.06, and 0.07 mSv for 1, 2, and 3 fusion levels were low, and didn't differ significantly from those of the assisting surgeon or radiological technologist. Revision MIS-TLIF was not associated with higher surgeons' radiation doses compared to primary MIS-TLIF. There were significantly higher surgeons' radiation doses in over-weight than in normal-weight patients. The surgeons' radiation exposure during MIS-TLIF was within the safe level by the International Commission on Radiological Protection's guidelines. The accumulated radiation exposure

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

    Science.gov (United States)

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

    2013-01-01

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

  1. Surgeons' motivation for choice of workplace.

    Science.gov (United States)

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

    2012-09-01

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

  2. American Orthopaedic Surgeons in World War I.

    Science.gov (United States)

    Green, David P; DeLee, Jesse C

    2017-04-05

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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. THE IDENTITY PERSPECTIVE WITHIN THE INTERCULTURAL RELATIONSHIPS ESTABLISHED IN THEATERS OF OPERATIONS

    OpenAIRE

    Adrian LESENCIUC

    2011-01-01

    Identity, a self-defining feature in relation with others, represents one of the standpoints when studying intercultural relationships within the theatres of operations. Military personnel participating in different missions in these theatres are characterized by markers of ascribed identity. The Romanian military personnel participating in international missions cannot be only characterized by their ethnic identity as long as one’s identity is multiple and reflects the relationship(s) establ...

  5. Critical appraisal of the impact of individual surgeon experience on the outcomes of laparoscopic liver resection in the modern era: collective experience of multiple surgeons at a single institution with 324 consecutive cases.

    Science.gov (United States)

    Goh, Brian K P; Teo, Jin-Yao; Lee, Ser-Yee; Kam, Juinn-Huar; Cheow, Peng-Chung; Jeyaraj, Premaraj; Chow, Pierce K H; Ooi, London L P J; Chung, Alexander Y F; Chan, Chung-Yip

    2017-09-15

    Most studies analyzing the learning experience of laparoscopic liver resection (LLR) focused on the experience of one or two expert pioneering surgeons. This study aims to critically analyze the impact of individual surgeon experience on the outcomes of LLR based on the contemporary collective experiences of multiple surgeons at single institution. Retrospective review of 324 consecutive LLR from 2006 to 2016. The cases were performed by 10 surgeons over various time periods. Four surgeons had individual experience with 90 cases. The cohort was divided into two groups: comparing a surgeon's experience between the first 20, 30, 40, and 50 cases with patients treated thereafter. Similarly, we performed subset analyses for anterolateral lesions, posterosuperior lesions, and major hepatectomies. As individual surgeons gained increasing experience, this was significantly associated with older patients being operated, decreased hand-assistance, larger tumor size, increased liver resections, increased major resections, and increased resections of tumors located at the posterosuperior segments. This resulted in significantly longer operation time and increased use of Pringle maneuver but no difference in other outcomes. Analysis of LLR for tumors in the posterosuperior segments demonstrated that there was a significant decrease in conversion rates after a surgeon had experience with 20 LLR. For major hepatectomies, there was a significant decrease in morbidity, mortality, and length of stay after acquiring experience with 20 LLR. LLR can be safely adopted today especially for lesions in the anterolateral segments. LLR for lesions in the difficult posterosuperior segments and major hepatectomies especially in cirrhosis should only be attempted by surgeons who have acquired a minimum experience with 20 LLR.

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

    Science.gov (United States)

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

    2017-07-25

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

  7. Hemi-hepatectomy in pediatric patients using two-surgeon technique and a liver hanging maneuver

    Institute of Scientific and Technical Information of China (English)

    Kyoko Mochizuki; Susumu Eguchi; Ryuichiro Hirose; Taiichiro Kosaka; Mitsuhisa Takatsuki; Takashi Kanematsu

    2011-01-01

    AIM: To evaluate the efficacy of the two-surgeon technique with the liver hanging maneuver (LHM) for hepatectomies in pediatric patients with hepatoblastoma. METHODS: Three pediatric patients with hepatoblastoma were enrolled in this study. Two underwent right hemi-hepatectomies and one underwent a left hemihepatectomy using the two-surgeon technique by means of saline-linked electric cautery (SLC) and the Cavitron Ultrasonic Surgical Aspirator (CUSA; Valleylab, Boulder, CO) and the LHM. RESULTS: The mean operative time during the parenchymal transections was 50 min and the mean blood loss was 235 g. There was no bile leakage from the cut surface after surgery. No macroscopic or microscopic-positive margins were observed in the hepatic transections. CONCLUSION: The two-surgeon technique using SLC and CUSA with the LHM is applicable to even pediatric patients with hepatoblastoma.

  8. Accuracy of navigation in hip resurfacing with different surgeons and varying anatomy.

    Science.gov (United States)

    Schleicher, Iris; Haselbacher, Matthias; Mayr, Eckart; Kaiser, Peter M; Lenze, Florian W; Keiler, Alexander; Nogler, Michael

    2012-01-01

    The accuracy of a commercial imageless navigation system for hip resurfacing and its reproducibility among different surgeons and for varying femoral anatomy was tested by comparing conventional and navigated implantation of the femoral component on different sawbones in a hip simulator. The position of the component was measured on postoperative radiographs. Variance for varus/valgus alignment and anteversion was higher for conventional implantation. Among the three surgeons, operation time, chosen implant size and anteversion were significantly different for conventional implantation but not for the navigated method. Using navigation, no difference was found for normal and abnormal anatomy. Values obtained with the navigation system were consistent with those measured on radiographs. Navigation appeared to be accurate and helped to reduce outliers. This was true for the three different surgeons and in varying anatomical situations.

  9. Does Surgeon Experience Impact the Risk of Complications After Bernese Periacetabular Osteotomy?

    Science.gov (United States)

    Novais, Eduardo N; Carry, Patrick M; Kestel, Lauryn A; Ketterman, Brian; Brusalis, Christopher M; Sankar, Wudbhav N

    2017-04-01

    Bernese periacetabular osteotomy (PAO) is a technically challenging procedure with potential risk for major complications and a previously reported steep learning curve. However, the impact of contemporary hip preservation fellowships on the learning curve of PAO has not been established. (1) What was the frequency of major complications during the PAO learning curve of two surgeons who recently graduated from hip preservation fellowships? (2) Is increasing level of experience associated with the risk of a complication and with operative time, a possible surrogate measure of surgical performance? We retrospectively studied 81 PAOs performed by one of two surgeons who recently graduated from a hip preservation fellowship during their first 4 years of practice in two institutions. One of the surgeons participated as a fellow in 78 PAOs with an increasing level of responsibility during the course of 1 full year. The other surgeon performed 41 PAOs as a fellow during 6 months, also with an increasing level of responsibility during that time. There were 68 (84%) female and 13 (16%) male patients (mean age, 18 years; range, 10-36 years). The frequency of complications was recorded early and at 1 year after surgery and graded according to a validated classification system describing five grades of complications. Complications that required surgical intervention (Grade III) and life-threatening complications (Grade IV) were considered major complications. Persistent pain after surgery, although considered a failure of PAO, was not considered a surgical complication as a result of the multifactorial etiology of pain after hip-preserving surgery. However, early reoperation and revision surgery were counted as complications. To evaluate the association between increasing level of experience and the occurrence of complications, we divided each surgeon's experience into his first 20 procedures (initial interval) and his second 20 (experienced interval) to test whether the

  10. IMPLEMENTING LAPAROSCOPY IN BRAZIL'S NATIONAL PUBLIC HEALTH SYSTEM: THE BARIATRIC SURGEONS' POINT OF VIEW

    Science.gov (United States)

    SUSSENBACH, Samanta; SILVA, Everton N; PUFAL, Milene Amarante; ROSSONI, Carina; CASAGRANDE, Daniela Schaan; PADOIN, Alexandre Vontobel; MOTTIN, Cláudio Corá

    2014-01-01

    Background Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. Aim 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. Methods A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. Results From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. Conclusion 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy. PMID:25409964

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

    Science.gov (United States)

    Neumeister, M W

    2016-04-01

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

  12. Congenital Ulnar Drift in a Surgeon

    Directory of Open Access Journals (Sweden)

    Desirae McKee

    2015-01-01

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

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

    Science.gov (United States)

    Murtha, Yvonne

    2013-10-01

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

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

    Science.gov (United States)

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

    2002-11-01

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

  15. Emergency surgeon-performed hepatobiliary ultrasonography.

    Science.gov (United States)

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

    2002-11-01

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

  16. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

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

  17. Atom Surprise: Using Theatre in Primary Science Education

    Science.gov (United States)

    Peleg, Ran; Baram-Tsabari, Ayelet

    2011-10-01

    Early exposure to science may have a lifelong effect on children's attitudes towards science and their motivation to learn science in later life. Out-of-class environments can play a significant role in creating favourable attitudes, while contributing to conceptual learning. Educational science theatre is one form of an out-of-class environment, which has received little research attention. This study aims to describe affective and cognitive learning outcomes of watching such a play and to point to connections between theatrical elements and specific outcomes. "Atom Surprise" is a play portraying several concepts on the topic of matter. A mixed methods approach was adopted to investigate the knowledge and attitudes of children (grades 1-6) from two different school settings who watched the play. Data were gathered using questionnaires and in-depth interviews. Analysis suggested that in both schools children's knowledge on the topic of matter increased after the play with younger children gaining more conceptual knowledge than their older peers. In the public school girls showed greater gains in conceptual knowledge than boys. No significant changes in students' general attitudes towards science were found, however, students demonstrated positive changes towards science learning. Theatrical elements that seemed to be important in children's recollection of the play were the narrative, props and stage effects, and characters. In the children's memory, science was intertwined with the theatrical elements. Nonetheless, children could distinguish well between scientific facts and the fictive narrative.

  18. Brunch and debate on theatre and quantum physics

    CERN Document Server

    HR Department

    2009-01-01

    The "Comédie de Genève" theatre is organizing a brunch on Sunday 18 January to accompany the play "Kaïros, sisyphes et zombies" which is playing from 15 to 25 January. Michel Cassé, astrophysicist and Director of Research at the Commissariat à l’Energie Atomique (CEA) in Paris, will come to debate with the play’s director, Oskar Gómez Mata, and the entire Kaïros team on the topic of "Théâtre – physique quantique: enquête sur le réel". While the parents take part in the "debate-brunch", the children can have fun with activities organized by "la Bulle d’Air" musical association. Sunday 18 January The brunch starts at 11:30 followed by the debate at 12:30, "la Bulle d’Air" activities will run from 12:30 to 14:00. La Comédie de Genève, 6 bd des Philosophes, 1205 Geneva Entry with brunch: 18 CHF (15 CHF for members). Entry without brunch: 10 CHF Animation for the children: free.

  19. Clinical Core Competency Training for NASA Flight Surgeons

    Science.gov (United States)

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

    2007-01-01

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

  20. Power Dynamics in Applied Theatre: Interrogating the Power of the University-Based TfD Facilitator--the UZ Theatre and CARE Zimbabwe's Zvishavane/Mberengwa NICA Project and SSFP as Case Study

    Science.gov (United States)

    Seda, Owen; Chivandikwa, Nehemiah

    2014-01-01

    One of the central tenets in applied theatre is the ability to confront issues of "power" and "powerlessness." Indeed, success or lack thereof in applied theatre projects is often adjudged against the ability or the extent to which these projects are, or have been able to "empower" the "powerless." In this…