Career outcomes of nondesignated preliminary general surgery residents at an academic surgical program.

Science.gov (United States)

Ahmad, Rima; Mullen, John T

2013-01-01

There remains a debate as to whether nondesignated preliminary (NDP) positions in surgery ultimately translate into successful surgical careers for those who pursue them. We sought to identify the success with which our NDP residents were able to transition to their desired career and what, if any, factors contributed to their success. The records of all NDP residents accepted into the Massachusetts General Hospital General Surgery Residency Program from 1995 to 2010 were examined and long-term follow-up was completed. Thirty-four NDP residents were identified, including 26.5% US graduates and 73.5% international medical graduates. At the end of the initial preliminary year, 30 (88%) got placed in a postgraduate residency program, whereas 4 (12%) pursued other career paths. Of those who got placed, 25 (83%) attained surgical residency positions, including 17 (57%) who continued as preliminary residents at our institution and 8 (27%) who got placed in categorical surgical positions at other programs. After multiple preliminary years, 15 of 17 achieved a categorical position, of which, 93% were in surgical fields. Overall, 64.7% of all entering NDP residents eventually went on to have careers in general surgery (50%) or surgical subspecialties (14.7%), and 24 of 34 (71%) fulfilled their desired career goals. No factor predicted success. From 1995 to 2012 there have been 15 midlevel (11 postgraduate year 4) vacancies in our program, 4 of which were filled by preliminary residents, 2 from our program and 2 from elsewhere. All have gone on to board certifications and careers in surgery. More than 70% of NDP residents in our program successfully transitioned to their desired career paths, many achieving categorical surgical positions and academic surgical careers, thus demonstrating the benefit of this track to both residency programs and trainees. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Abbott Opinions #1-5.

Science.gov (United States)

Education Law Center, Inc., Newark, NJ.

This document contains the following "Abbott Opinions": (1) "Early Childhood Education"; (2) "Adequate School Facilities"; (3) "Supplemental Programs and Whole School Reform in Elementary Schools"; (4) "Supplemental Programs in Middle and High Schools"; and (5) "Planning Programs and Budgets…

National survey of surgeons\\' attitudes to laparoscopic surgical ...

African Journals Online (AJOL)

Aim. Laparoscopic surgery forms an integral component of modern surgical practice. The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical ...

Attitudes and factors contributing to attrition in Canadian surgical specialty residency programs.

Science.gov (United States)

Adams, Simon; Ginther, David Nathan; Neuls, Evan; Hayes, Paul

2017-08-01

We recently studied attrition in Canadian general surgical programs; however, there are no data on whether residents enrolled in other surgical residencies harbour the same intents as their general surgical peers. We sought to determine how many residents in surgical disciplines in Canada consider leaving their programs and why. An anonymous survey was administered to all residents in 9 surgical disciplines in Canada. Significance of association was determined using the Pearson χ2 test. The Canadian Post-MD Education Registry (CAPER) website was used to calculate the response rate. We received 523 responses (27.6% response rate). Of these respondents, 140 (26.8%) were either "somewhat" or "seriously" considering leaving their program. Residents wanting to pursue additional fellowship training and those aspiring to an academic career were significantly less likely to be considering changing specialties ( p = 0.003 and p = 0.005, respectively). Poor work-life balance and fear of unemployment/underemployment were the top reasons why residents would change specialty (55.5% and 40.8%, respectively), although the reasons cited were not significantly different between those considering changing and those who were not ( p = 0.64). Residents who were considering changing programs were significantly less likely to enjoy their work and more likely to cite having already invested too much time to change as a reason for continuing ( p work-life balance and limited employment prospects. Efforts to educate prospective residents about the reality of the surgical lifestyle and to optimize employment prospects may improve completion rates.

Is there still a role for experimental surgery in the surgical sciences?

Science.gov (United States)

Di Cataldo, Antonio

2006-01-01

The firm opposition of public opinion and the reduction in public funding have remarkably curtailed the role of experimental surgery which several years ago was a key aspect of the activity of a surgical department. Experimental surgery in large animals has been virtually banned and experimental research in small animals requires the use of complex microsurgical techniques. In our opinion, experimental surgery is still useful in order to test new surgical devices and new drugs, especially in the field of transplant surgery. Another important function of experimental surgery is to facilitate the training of surgical residents in order to speed up the process of acquiring experience and expertise. Public opinion can be reassured because the legislation is very strict and safeguards the well-being of animals.

Surgical resident perceptions of trauma surgery as a specialty.

Science.gov (United States)

Hadzikadic, Lejla; Burke, Peter A; Esposito, Thomas J; Agarwal, Suresh

2010-05-01

Presenting the opinions of surgical residents about the appeal of trauma surgery as a specialty may influence current reform. Survey study. Academic research. General surgery residents (postgraduate years 1-5 and recent graduates) registered with the American College of Surgeons. A 22-item survey. Career plans and perceptions about trauma surgery as a specialty. Of 6006 mailed surveys, we had a 20.1% response rate. Midlevel residents comprised most of the respondents, and most were undecided about their career choice or planned to enter general surgical private practice. The typical residency programs represented were academic (81.7%), urban (90.6%), and level I trauma centers (78.7%), and included more than 6 months of trauma experience (77.6%). Most respondents (70.6%) thought that trauma surgery was unappealing. The most important deterrents to entering the field were lifestyle, poor reimbursement, and limited operating room exposure, while increased surgical critical care was not seen as a restriction. When questioned about the future of trauma surgery, they believed that trauma surgeons should perform elective (86.8%) and nontrauma emergency (91.5%) cases and would benefit from active association with an outpatient clinic (76.0%). Intellectual challenge and exciting nature of the field were listed as the most appealing aspects, and ideal practice characteristics included guaranteed salary and time away from work. As demand for trauma surgeons increases, resident interest has dwindled. As a specialty, trauma surgery must undergo changes that reflect the needs of the incoming generation. We present a sampling of current surgical resident opinion and offer these data to assist the changing discipline and the evolving field of acute care surgery.

Trainee ophthalmologists' opinions on ways to improve cataract ...

African Journals Online (AJOL)

Objective: To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. Methods: A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. Results: ...

International survey on the management of Chiari 1 malformation and syringomyelia: evolving worldwide opinions.

Science.gov (United States)

Singhal, Ash; Cheong, Alexander; Steinbok, Paul

2018-03-12

In 2003, pediatric neurosurgeons were surveyed under the auspices of the education committee of the International Society for Pediatric Neurosurgery (ISPN) to determine prevailing opinions regarding the management of Chiari I malformation (C1M) with and without associated syringomyelia. In the ensuing years, there has been further information from multiple C1M studies, with regards to indications, success rates of different surgical interventions, and complications. The purpose of this study was to re-evaluate current opinions and practices in pediatric C1M. Pediatric neurosurgeons worldwide were surveyed, using an e-mail list provided by the ISPN communication committee chairperson. Respondents were given scenarios similar to the 2003 C1M survey in order to determine opinions regarding whether to surgically intervene, and if so, with which operations. Of 300 surveys electronically distributed, 122 responses were received (40.6% response rate)-an improvement over the 30.8% response rate in 2003. Pediatric neurosurgeons from 34 different countries responded. There was broad consensus that non-operative management is appropriate in asymptomatic C1M (> 90%) as well as asymptomatic C1M with a small syrinx (> 65%). With a large syrinx, a majority (almost 80%) recommended surgical intervention. Scoliotic patients with CIM were generally offered surgery only when there was a large syrinx. There has been a shift in the surgical management over the past decade, with a bone-only decompression now being offered more commonly. There remains, however, great variability in the operation offered. This survey, with a relatively strong response rate, and with broad geographic representation, summarizes current worldwide expert opinion regarding management of pediatric C1M. Asymptomatic C1M and C1M with a small syrinx are generally managed non-operatively. When an operation is indicated, there has been a shift towards less invasive surgical approaches.

The Opinions of Masters Students about the Learning Program in the Field of Teaching Turkish to Foreigners

Science.gov (United States)

Kilinç, Hasan Huseyin

2015-01-01

The purpose of this study is to determine the opinions of Master students about the learning program in the field of teaching Turkish to foreigners. In the study, case study design which is one of the qualitative research methods was used. The population of the study consists of students studying in the Master program with thesis of Teaching…

Effect of Process Changes in Surgical Training on Quantitative Outcomes From Surgery Residency Programs.

Science.gov (United States)

Dietl, Charles A; Russell, John C

2016-01-01

The purpose of this article is to review the literature on process changes in surgical training programs and to evaluate their effect on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: surgery residency training, surgical education, competency-based surgical education, ACGME core competencies, ABSITE scores, and ABS pass rate. Our initial search list included 990 articles on surgery residency training models, 539 on competency-based surgical education, 78 on ABSITE scores, and 33 on ABS pass rate. Overall, 31 articles met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 5/31, 19/31, and 6/31 articles on process changes in surgical training programs had a positive effect on patient care, medical knowledge, and ABSITE scores, respectively. ABS certification was not analyzed. The other ACGME core competencies were addressed in only 6 studies. Several publications on process changes in surgical training programs have shown a positive effect on patient care, medical knowledge, and ABSITE scores. However, the effect on ABS certification, and other quantitative outcomes from residency programs, have not been addressed. Studies on education strategies showing evidence that residency program objectives are being achieved are still needed. This article addresses the 6 ACGME Core Competencies. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Opinion: Autopsy practice in northern Nigeria | Malami | Nigerian ...

African Journals Online (AJOL)

Nigerian Journal of Surgical Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 3 (2002) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Opinion: Autopsy practice in northern Nigeria.

Reflections in a time of transition: orthopaedic faculty and resident understanding of accreditation schemes and opinions on surgical skills feedback

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Kenneth R. Gundle

2016-04-01

Full Text Available Introduction: Orthopaedic surgery is one of the first seven specialties that began collecting Milestone data as part of the Accreditation Council for Graduate Medical Education's Next Accreditation System (NAS rollout. This transition from process-based advancement to outcome-based education is an opportunity to assess resident and faculty understanding of changing paradigms, and opinions about technical skill evaluation. Methods: In a large academic orthopaedic surgery residency program, residents and faculty were anonymously surveyed. A total of 31/32 (97% residents and 29/53 (55% faculty responded to Likert scale assessments and provided open-ended responses. An internal end-of-rotation audit was conducted to assess timeliness of evaluations. A mixed-method analysis was utilized, with nonparametric statistical testing and a constant-comparative qualitative method. Results: There was greater familiarity with the six core competencies than with Milestones or the NAS (p<0.05. A majority of faculty and residents felt that end-of-rotation evaluations were not adequate for surgical skills feedback. Fifty-eight per cent of residents reported that end-of-rotation evaluations were rarely or never filled out in a timely fashion. An internal audit demonstrated that more than 30% of evaluations were completed over a month after rotation end. Qualitative analysis included themes of resident desire for more face-to-face feedback on technical skills after operative cases, and several barriers to more frequent feedback. Discussion: The NAS and outcome-based education have arrived. Residents and faculty need to be educated on this changing paradigm. This transition period is also a window of opportunity to address methods of evaluation and feedback. In our orthopaedic residency, trainees were significantly less satisfied than faculty with the amount of technical and surgical skills feedback being provided to trainees. The quantitative and qualitative analyses

INVESTIGATING THE OPINIONS OF MoNE STAFF ABOUT INSET PROGRAMS VIA DISTANCE EDUCATION

Directory of Open Access Journals (Sweden)

Rasit OZEN

2009-10-01

Full Text Available The aim of this study is to investigate the opinions of the Ministry of National Education (MoNE staff about in-service training (INSET programs via distance education. The subjects of this study were the staff (n=15 of the Inservice Training Department of MoNE in 2008. During the study, the qualitative data were collected through semi-structured interviews held with the (MoNE staff by the researcher. The results of the interviews revealed the importance of needs assessment, the relationship between INSET program course content and participants’ school curriculum, support mechanism in INSET programs via distance education, the application of what is learned and providing various opportunities to them that lead to their active involvement to the application of these programs, the characteristics of learning environments for these programs, INSET instructors’ teaching competencies and skills to fulfill various roles in online learning environments, of measuring and evaluating the performance of teachers during INSET programs via distance education and of the effectiveness of INSET programs via distance education.

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia.

Science.gov (United States)

Alkhayal, Abdullah; Aldhukair, Shahla; Alselaim, Nahar; Aldekhayel, Salah; Alhabdan, Sultan; Altaweel, Waleed; Magzoub, Mohi Elden; Zamakhshary, Mohammed

2012-01-01

After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors' perspective, and program directors' attitudes toward the available objective tools to assess technical skills. This study was a cross-sectional survey of surgical program directors (PDs). The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs' perspective and the PDs' attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated. Seventy-one (61%) participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative evaluation, whereas 15% perform only formative evaluations of their residents, and the remaining 22% conduct both summative and formative evaluations of their residents' technical skills. Operative portfolios are kept by 53% of programs. The percentage of programs with mechanisms for remediation is 29% (19 of 65). The survey showed that surgical training programs use different tools to assess surgical skills competency. Having a clear remediation mechanism was highly associated with reporting remediation, which reflects the capability to detect struggling residents. Surgical training leadership should invest more in

Public opinion and nuclear power decision-making

International Nuclear Information System (INIS)

Benson, B.

1991-01-01

This document discusses public opinion regarding nuclear power which is particularly difficult to tie down because of five important paradoxes that characterize it: it can be based on sound reason, but also on intense emotion; it is both national and local in perspective; at varying times it has seen nuclear power as both ''clean'' and ''dirty''; it believes nuclear power is both economic, and uneconomic; and nuclear power is perceived as having a fairly safe record, but being potentially unsafe. Equally as complex as the process by which public opinion is formed is the process by which it is converted into public policy. The American political system has numerous checks and balances designed to moderate the power of public opinion. A complex series of legislative, judicial, and executive branch hurdles must be cleared before any idea, however popular, can become day-to-day operating reality in government. As a result, major changes in policy or programs are difficult, and we may expect that nuclear power will be no different; radical change in one direction or the other is unlikely. Nevertheless, carefully focused programs could achieve modest progress, and carefully designed public opinion surveys could support such programs

Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning

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Jeffrey A. Hammoudeh, MD, DDS

2015-02-01

Conclusions: It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.

Teaching methods and surgical training in North American graduate periodontics programs: exploring the landscape.

Science.gov (United States)

Ghiabi, Edmond; Taylor, K Lynn

2010-06-01

This project aimed at documenting the surgical training curricula offered by North American graduate periodontics programs. A survey consisting of questions on teaching methods employed and the content of the surgical training program was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. The chi-square test was used to assess whether the residents' clinical experience was significantly (Pperiodontal plastic procedures, hard tissue grafts, and implants. Furthermore, residents in programs offering a structured preclinical component performed significantly more procedures (P=0.012) using lasers than those in programs not offering a structured preclinical program. Devising new and innovative teaching methods is a clear avenue for future development in North American graduate periodontics programs.

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia

Directory of Open Access Journals (Sweden)

Alkhayal A

2012-10-01

Full Text Available Abdullah Alkhayal,1 Shahla Aldhukair,2 Nahar Alselaim,1 Salah Aldekhayel,1 Sultan Alhabdan,1 Waleed Altaweel,3 Mohi Elden Magzoub,4 Mohammed Zamakhshary1,21Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Public Health Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Urology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 4Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaBackground: After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors’ perspective, and program directors’ attitudes toward the available objective tools to assess technical skills.Methods: This study was a cross-sectional survey of surgical program directors (PDs. The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs’ perspective and the PDs’ attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated.Results: Seventy-one (61% participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative

Surgical treatment for residual or recurrent strabismus

Directory of Open Access Journals (Sweden)

Tao Wang

2014-12-01

Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

OGC Precedent Opinion 2-2010

Data.gov (United States)

Department of Veterans Affairs — Osborn v. Nicholson 21 Vet. App. 223 (2007) - Effect on Existing General Counsel Opinions, Application to other Benefit Programs, and Applicability to Series HH U.S....

Innovative public information programs. 1. Judgment of Opinion Leaders on Nuclear Energy Use

International Nuclear Information System (INIS)

Kim, Jong Seok

2001-01-01

Nuclear energy use requires a delicate balance, which arises between the technological factors involved in generating the power and the socio-psychological factors involved in bringing the power for consumer use. It appears that there are several forces such as media enterprise, civil activists, and political leaders that shape public opinion on nuclear power programs that include the assignment of new sites for nuclear power plants or radioactive waste disposal facilities. These forces often make matters worse or sometimes relieve the public of overstated facts. This paper reviews the structure of public acceptance and examines an extended perception model on nuclear energy among opinion leaders (see Fig. 1). A survey was carried out on 500 opinion leaders in Korean society, including political leaders, professors, seniors in media enterprises, executive members of business, and responsible civil activists in August 2000. The sample included a reasonable mix of opinion leaders. However, males represented 87% of the sample while females represented 13%. Skilled interviewers were joined in visiting the respondents for collecting data. For the data, the structural equation modeling approach was chosen to test the proposed model implied by the hypotheses developed by earlier studies. The model was analyzed using the program AMOS, from SmallWaters Corporation. The model yielded a good fit to the data (GFI = 0.972), which shows general features that indicate a reasonable fit of data to the proposed model. The model gives structural coefficients, and the values in the figure represent standardized estimates. The higher values represent more influence on the affected variables. Opinion leaders believe it should play an important role in providing electricity, and it can be dangerous if it is not controlled properly. Here, risks perceived could be assessed by hazards to health or the environment from radiation and the disaster of a possible accident at a nuclear power

Surgical training, duty-hour restrictions, and implications for meeting the Accreditation Council for Graduate Medical Education core competencies: views of surgical interns compared with program directors.

Science.gov (United States)

Antiel, Ryan M; Van Arendonk, Kyle J; Reed, Darcy A; Terhune, Kyla P; Tarpley, John L; Porterfield, John R; Hall, Daniel E; Joyce, David L; Wightman, Sean C; Horvath, Karen D; Heller, Stephanie F; Farley, David R

2012-06-01

To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training. We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates. Eleven general surgery residency programs. Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors. Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease). Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

Effects of Technological Advances in Surgical Education on Quantitative Outcomes From Residency Programs.

Science.gov (United States)

Dietl, Charles A; Russell, John C

2016-01-01

The purpose of this article is to review the literature on current technology for surgical education and to evaluate the effect of technological advances on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, and Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: technology for surgical education, simulation-based surgical training, simulation-based nontechnical skills (NTS) training, ACGME Core Competencies, ABSITE scores, and ABS pass rate. Our initial search list included the following: 648 on technology for surgical education, 413 on simulation-based surgical training, 51 on simulation-based NTS training, 78 on ABSITE scores, and 33 on ABS pass rate. Further, 42 articles on technological advances for surgical education met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 33 of 42 and 26 of 42 publications on technological advances for surgical education showed objective improvements regarding patient care and medical knowledge, respectively, whereas only 2 of 42 publications showed improved ABSITE scores, but none showed improved ABS pass rates. Improvements in the other ACGME core competencies were documented in 14 studies, 9 of which were on simulation-based NTS training. Most of the studies on technological advances for surgical education have shown a positive effect on patient care and medical knowledge. However, the effect of simulation-based surgical training and simulation-based NTS training on ABSITE scores and ABS certification has not been assessed. Studies on technological advances in surgical education and simulation-based NTS training showing quantitative evidence that surgery residency

Financial "risk-sharing" or refund programs in assisted reproduction: an Ethics Committee opinion.

Science.gov (United States)

2016-10-01

Financial "risk-sharing" fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. This opinion of the ASRM Ethics Committee analyzes the ethical issues raised by these fee structures, including patient selection criteria, conflicts of interest, success rate transparency, and patient informed consent. This document replaces the document of the same name, last published in 2013 (Fertil Steril 2013;100:334-6). Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Implementation of surgical debriefing programs in large health systems: an exploratory qualitative analysis.

Science.gov (United States)

Brindle, Mary E; Henrich, Natalie; Foster, Andrew; Marks, Stanley; Rose, Michael; Welsh, Robert; Berry, William

2018-03-27

The role of the "debrief" to address issues related to patient safety and systematic flaws in care is frequently overlooked. In our study, we interview surgical leaders who have developed successful strategies of debriefing within a comprehensive program of quality improvement. Semi-structured interviews of four implementation leaders were performed. The observations, beliefs and strategies of surgical leaders are compared and contrasted. Common themes are identified related to program success and failure. Quality and safety researchers performed, coded and categorized the interviews and coordinated the analysis and interpretation of the results. The authors from the four institutions aided in interpretation and framing of the results. The debriefing programs evaluated were part of comprehensive quality improvement projects. Seven high-level themes and 24 subthemes were identified from the interviews. Themes related to leadership included early engagement, visible ongoing commitment and enforcement. Success appeared to depend upon meaningful and early debriefing feedback. The culture of safety that promoted success included a commitment to open and fair communication and continuous improvement. There were many challenges to the success of debriefing programs. The loss of institutional commitment of resources and personnel was the instigating factor behind the collapse of the program at Michigan. Other areas of potential failure included communication issues and loss of early and meaningful feedback. Leaders of four surgical systems with strong debriefing programs report success using debriefing to improve system performance. These findings are consistent with previously published studies. Success requires commitment of resources, and leadership engagement. The greatest gains may be best achieved by programs that provide meaningful debriefing feedback in an atmosphere dedicated to open communication.

[Student program, congress grants and their potential influence on surgical career selection].

Science.gov (United States)

Jähne, J; Mittelstädt, A; Götzky, K

2017-11-01

Due to a decreased interest in surgical training the German Society of Surgery (GSS) has provided a specially sponsored student program at its annual clinical congress for many years in order to increase the number of applicants for a career in surgery. It remains unclear if this goal is reached because an evaluation has not yet been performed. At the clinical congress in 2014, 200 medical students participated in a special student program with the aid of a congress grant totaling 100,000 €. By means of a questionnaire it was asked how many of the participants in this special program have started a residency in surgery. Almost 17% of the participants of the student program answered and 13 students (6.5% of all participants) stated that they had started a surgical residency. All of these students claimed an interest in surgery even before participation in the congress. Those students who had not yet decided what kind of residency they should choose did not vote for surgery despite their visit to the congress. The student program and the congress grant at the annual clinical congress of the GSS do not result in an increased number of applicants for a residency in surgery. Both incentives might be not more than a strategic marketing instrument. An increased number of medical students applying for a residency in surgery is only to be expected if social developments (e. g. attention to a work-life balance) and their concomitant challenges are reflected in surgical day to day work.

Nuclear energy and public opinion. Chilean Nuclear Energy Commission (CCHEN) dissemination and extension program

International Nuclear Information System (INIS)

Oviedo, Gonzalo Torres; Quintana, Rosamel Mufioz

2000-01-01

In Chile, demand for electricity will soon exceed water resources. The country will then face severe energy dependence, with very little control over generation costs, and with increasing emission of contaminating gases into the atmosphere. Nuclear energy may be considered an appropriate and stabilizing alternative for the system in the medium term, the benefits of nuclear generation to be thus extended to a country which has a moderate demand for electricity. This new scenario will require an additional technical and regulating effort by CCHEN and by the state, as well as re-orientation of their activities in connection with public opinion. The Public Nuclear Energy Education Program, initiated in 1976 by CCHEN, has been developed for purposes of achieving public acceptance of nuclear energy as a way of facilitating development of various activities which pertain to CCHEN's scope of action, and of creating a climate which is favorable to acceptance of nuclear energy as an alternative source of energy. Thus, the object is that the public draw informed conclusions on the benefits and risks implicit in the use of isotopes, radiation, and nuclear power generation. The Program consists of activities for high school students aimed at vocational orientation of those who stand out in the science area, training and extension activities for teachers, journalists, and professionals, a program of guided tours of the nuclear centers, a publicity campaign conducted in the various media and, since 1980, massive distribution of brochures and magazines. There are no declared anti-nuclear movements in Chile. Nevertheless, there are opinions against nuclear power in different relevant sectors. Lately, the social communication media have preferred CCHEN as their source of information, a fact which makes it possible for the latter to have access to good coverage of its activities

A national survey of program director opinions of core competencies and structure of hand surgery fellowship training.

Science.gov (United States)

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2012-10-01

We assessed hand surgery program directors' opinions of essential components of hand surgery training and potential changes in the structure of hand surgery programs. We recruited all 74 program directors of Accreditation Council of Graduate Medical Education-accredited hand surgery fellowship programs to participate. We designed a web-based survey to assess program directors' support for changes in the structure of training programs and to assess opinions of components that are essential for graduates to be proficient. Respondents were asked to rate 9 general areas of practice, 97 knowledge topics, and 172 procedures. Each component was considered essential if 50% or more of respondents thought that graduates must be fully knowledgeable of the topic and be able to perform the procedure at the end of training. The response rate was 84% (n = 62). A minority of program directors (n = 15; 24%) supported creation of additional pathways for hand surgery training, and nearly three-quarters (n = 46; 74%) preferred a fellowship model to an integrated residency model. Most program directors (n = 40; 65%) thought that a 1-year fellowship was sufficient to train a competent hand surgeon. Wrist, distal radius/ulna, forearm, and peripheral nerve conditions were rated as essential areas of practice. Of the detailed components, 76 of 97 knowledge topics and 98 of 172 procedures were rated as essential. Only 48% respondents (n = 30) rated microsurgery as it relates to free tissue transfer as essential. However, small and large vessel laceration repairs were rated as essential by 92% (n = 57) and 77% (n = 48) of respondents, respectively. This study found resistance to prolonging the length of fellowship training and introduction of an integrated residency pathway. To train all hand surgeons in essential components of hand surgery, programs must individually evaluate exposure provided and find innovative ways to augment training when necessary. Studies of curriculum content in hand

Implementation of a Novel Structured Social and Wellness Committee in a Surgical Residency Program: A Case Study.

Science.gov (United States)

Van Orden, Kathryn E; Talutis, Stephanie D; Ng-Glazier, Joanna H; Richman, Aaron P; Pennington, Elliot C; Janeway, Megan G; Kauffman, Douglas F; Dechert, Tracey A

2017-01-01

This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness.

Examination of Sign Language Education According to the Opinions of Members from a Basic Sign Language Certification Program

Science.gov (United States)

Akmese, Pelin Pistav

2016-01-01

Being hearing impaired limits one's ability to communicate in that it affects all areas of development, particularly speech. One of the methods the hearing impaired use to communicate is sign language. This study, a descriptive study, intends to examine the opinions of individuals who had enrolled in a sign language certification program by using…

Investigation of Pre-Service Teachers' Opinions about Science in Terms of the Basic Elements of the Education Program

Science.gov (United States)

Sengul, Ozge Aydin

2016-01-01

The purpose of the current study is to investigate the pre-service teachers' opinions about science within the context of the basic elements of the education program, such as objectives, content, learning-teaching process and evaluation. The study was designed as a case study, one of the qualitative research methods. The participants of the study…

The effects of the European Working Time Directive on surgical training: the basic surgical trainee's perspective.

LENUS (Irish Health Repository)

Kelly, B D

2012-01-31

BACKGROUND: On the 1 August 2009, the implementation of European Working Time Directive became European law and was implemented in Galway University Hospital (GUH). AIMS: The aim of the study is to ascertain the opinion of the 25 surgical SHOs in GUH on the effect of the implementation of an EWTD compliant roster had on the quality of their training. METHODS: A questionnaire was circulated to all 25 surgical SHOs. RESULTS: Twenty-two (88%) SHOs report a reduction in the quality of their training. 18 (72%) report a reduction in the development of their operative skills. The SHOs believed the EWTD Rotas would encourage Irish graduates to train abroad. CONCLUSIONS: Surgical training faces a challenge with the implementation of EWTD Rotas. Major changes need to be made to the surgical training structure to train surgeons to the highest standard and to retain Irish-trained surgeons in the Irish healthcare system.

OpinionFlow: Visual Analysis of Opinion Diffusion on Social Media.

Science.gov (United States)

Wu, Yingcai; Liu, Shixia; Yan, Kai; Liu, Mengchen; Wu, Fangzhao

2014-12-01

It is important for many different applications such as government and business intelligence to analyze and explore the diffusion of public opinions on social media. However, the rapid propagation and great diversity of public opinions on social media pose great challenges to effective analysis of opinion diffusion. In this paper, we introduce a visual analysis system called OpinionFlow to empower analysts to detect opinion propagation patterns and glean insights. Inspired by the information diffusion model and the theory of selective exposure, we develop an opinion diffusion model to approximate opinion propagation among Twitter users. Accordingly, we design an opinion flow visualization that combines a Sankey graph with a tailored density map in one view to visually convey diffusion of opinions among many users. A stacked tree is used to allow analysts to select topics of interest at different levels. The stacked tree is synchronized with the opinion flow visualization to help users examine and compare diffusion patterns across topics. Experiments and case studies on Twitter data demonstrate the effectiveness and usability of OpinionFlow.

Students' Opinions on Facebook Supported Blended Learning Environment

Science.gov (United States)

Erdem, Mukaddes; Kibar, Pinar Nuhoglu

2014-01-01

The first purpose of this study was to determine students' opinions on blended learning and its implementation. The other purpose was to explore the students' opinions on Facebook integration into blended learning environment. The participants of this study were 40 undergraduate students in their fourth semester of the program.…

Opinions of the Geography Teacher Candidates toward Mind Maps

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Seyihoglu, Aysegul

2013-01-01

The purpose of this study is to reveal the opinions of the teacher candidates about mind mapping technique used in Geography education of undergraduate program. In this study, the qualitative research techniques were used. The study group consists of 55 teacher candidates. The teacher candidates have been asked for their opinions about the process…

A contemporary analysis of Fournier gangrene using the National Surgical Quality Improvement Program.

Science.gov (United States)

Kim, Stanley Y; Dupree, James M; Le, Brian V; Kim, Dae Y; Zhao, Lee C; Kundu, Shilajit D

2015-05-01

To determine a nationwide contemporary description of surgical Fournier gangrene (FG) and necrotizing fasciitis of the genitalia (NFG) outcomes because historically reported mortality rates for FG and NFG are based on small single-institution studies from the 1980s and the 1990s. The National Surgical Quality Improvement Program is a risk-adjusted surgical database used by nearly 400 hospitals nationwide, which tracks preoperative, intraoperative, and 30-day postoperative clinical variables. Data are extracted from patient charts by an independent surgical clinical reviewer at each hospital. Using the National Surgical Quality Improvement Program data from 2005 to 2009, we calculated 30-day mortality rates and identified preoperative factors associated with increased mortality. A total of 650 patients were identified with surgery for FG or NFG. Fourteen patients with do not resuscitate orders placed preoperatively were excluded from analyses. For the remaining 636 patients, the overall 30-day mortality was 10.1% (64 of 636). Fifty-seven percent of patients (360 of 636) were men, 70% (446 of 636) were white, and 13% (81 of 636) were African American. Multivariate logistic regression indicated that increased age (odds ratio [OR], 1.041; P = .004), body mass index (OR, 1.045; P <.001), and preoperative white blood cell count (OR, 1.061; P = .001), and decreased platelet count (OR, 0.993; P <.001) were all associated with increased risk of death. We determined a surgical mortality rate for FG-NFG of 10.1%. This rate is about half of historically published estimates and similar to recent studies. The lower rate may indicate improvements in therapy. Increased age, body mass index, and white blood cell count, and decreased platelet count were all associated with an increased risk of 30-day mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

Science.gov (United States)

Ghiabi, Edmond; Taylor, K Lynn

2010-08-01

This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

Science.gov (United States)

Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

2012-06-01

There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

Patient engagement with surgical site infection prevention: an expert panel perspective

Directory of Open Access Journals (Sweden)

E. Tartari

2017-05-01

Full Text Available Abstract Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers (HCWs and procedure related risk factors. The importance and influence of patient participation is becoming an increasingly important concept and advocated as a means to improve patient safety. Novel interventions supporting an active participative role within SSI prevention programs have not been assessed. Empowering patients with information they require to engage in the process of SSI prevention could play a major role for the implementation of recommendations. Based on available scientific evidence, a panel of experts evaluated options for patient involvement in order to provide pragmatic recommendations for pre-, intra- and postoperative activities for the prevention of SSIs. Recommendations were based on existing guidelines and expert opinion. As a result, 9 recommendations for the surgical patient are presented here, including a practice brief in the form of a patient information leaflet. HCWs can use this information to educate patients and allow patient engagement.

Patient engagement with surgical site infection prevention: an expert panel perspective.

Science.gov (United States)

Tartari, E; Weterings, V; Gastmeier, P; Rodríguez Baño, J; Widmer, A; Kluytmans, J; Voss, A

2017-01-01

Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs) remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved. The current SSI prevention strategies have focused mainly on the role of healthcare workers (HCWs) and procedure related risk factors. The importance and influence of patient participation is becoming an increasingly important concept and advocated as a means to improve patient safety. Novel interventions supporting an active participative role within SSI prevention programs have not been assessed. Empowering patients with information they require to engage in the process of SSI prevention could play a major role for the implementation of recommendations. Based on available scientific evidence, a panel of experts evaluated options for patient involvement in order to provide pragmatic recommendations for pre-, intra- and postoperative activities for the prevention of SSIs. Recommendations were based on existing guidelines and expert opinion. As a result, 9 recommendations for the surgical patient are presented here, including a practice brief in the form of a patient information leaflet. HCWs can use this information to educate patients and allow patient engagement.

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

Science.gov (United States)

Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

2018-01-01

Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

Science.gov (United States)

Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

2018-01-01

Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

Mobile surgical skills education unit: a new concept in surgical training.

Science.gov (United States)

Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

2011-08-01

Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

Balancing Privacy and Professionalism: A Survey of General Surgery Program Directors on Social Media and Surgical Education.

Science.gov (United States)

Langenfeld, Sean J; Vargo, Daniel J; Schenarts, Paul J

Unprofessional behavior is common among surgical residents and faculty surgeons on Facebook. Usage of social media outlets such as Facebook and Twitter is growing at exponential rates, so it is imperative that surgery program directors (PDs) focus on professionalism within social media, and develop guidelines for their trainees and surgical colleagues. Our study focuses on the surgery PDs current approach to online professionalism within surgical education. An online survey of general surgery PDs was conducted in October 2015 through the Association for Program Directors in Surgery listserv. Baseline PD demographics, usage and approach to popular social media outlets, existing institutional policies, and formal curricula were assessed. A total of 110 PDs responded to the survey (110/259, 42.5% response rate). Social media usage was high among PDs (Facebook 68% and Twitter 40%). PDs frequently viewed the social media profiles of students, residents, and faculty. Overall, 11% of PDs reported lowering the rank or completely removing a residency applicant from the rank order list because of online behavior, and 10% reported formal disciplinary action against a surgical resident because of online behavior. Overall, 68% of respondents agreed that online professionalism is important, and that residents should receive instruction on the safe use of social media. However, most programs did not have formal didactics or known institutional policies in place. Use of social media is high among PDs, and they often view the online behavior of residency applicants, surgical residents, and faculty surgeons. Within surgical education, there needs to be an increased focus on institutional policies and standardized curricula to help educate physicians on social media and online professionalism. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Communication Training Program to Encourage Speaking-Up Behavior in Surgical Oncology.

Science.gov (United States)

D'Agostino, Thomas A; Bialer, Philip A; Walters, Chasity B; Killen, Aileen R; Sigurdsson, Hrafn O; Parker, Patricia A

2017-10-01

Patient safety in the OR depends on effective communication. We developed and tested a communication training program for surgical oncology staff members to increase communication about patient safety concerns. In phase one, 34 staff members participated in focus groups to identify and rank factors that affect speaking-up behavior. We compiled ranked items into thematic categories that included role relations and hierarchy, staff rapport, perceived competence, perceived efficacy of speaking up, staff personality, fear of retaliation, institutional regulations, and time pressure. We then developed a communication training program that 42 participants completed during phase two. Participants offered favorable ratings of the usefulness and perceived effect of the training. Participants reported significant improvement in communicating patient safety concerns (t 40  = -2.76, P = .009, d = 0.48). Findings offer insight into communication challenges experienced by surgical oncology staff members and suggest that our training demonstrates the potential to improve team communication. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

Science.gov (United States)

Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

2012-10-01

Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Opinion of gastroenterologists towards quality assurance in endoscopy.

Science.gov (United States)

de Jonge, Vincent; Kuipers, Ernst J; van Leerdam, Monique E

2011-03-01

Quality assurance has become an important issue. Many societies are adopting quality assurance programs in order to monitor and improve quality of care. To assess the opinion of gastroenterologists towards quality assurance on the endoscopy department. A survey was sent to all gastroenterologists (n=319) in the Netherlands. It assessed their opinion on a quality assurance program for endoscopy units, including its design, logistics, and content. 200 gastroenterologists (63%) completed the questionnaire. 95% had a positive opinion towards quality assurance and 67% supposed an increase in quality. 28% assumed a negative impact on the time available for patient contact by introducing a quality assurance program and 35% that the capacity would decrease. A negative attitude towards disclosure of results to insurance companies (23%) and media (53%) was reported. Female gastroenterologists were less positive to share the results with other stakeholders (pquality measurements were assessment of complications (97%), standardised reporting (96%), and adequate patient information (95%). Gastroenterologists have a positive attitude towards quality assurance. However, concerns do exist about time investment and disclosure of results to others. Information provision and procedure characteristics were considered the most important aspects of quality assurance. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

The voice of Holland: Dutch public and patient's opinion favours single-port laparoscopy.

Science.gov (United States)

Fransen, Sofie Af; Broeders, Epm; Stassen, Lps; Bouvy, Nd

2014-07-01

Single-port laparoscopy is prospected as the future of minimal invasive surgery. It is hypothesised to cause less post operative pain, with a shorter hospitalisation period and improved cosmetic results. Population- and patient-based opinion is important for the adaptation of new techniques. This study aimed to assess the opinion and perception of a healthy population and a patient population on single-port laparoscopy compared with conventional laparoscopy. An anonymous 33-item questionnaire, describing conventional and single-port laparoscopy, was given to 101 patients and 104 healthy volunteers. The survey participants (median age 44 years; range 17-82 years) were asked questions about their personal situation and their expectations and perceptions of the two different surgical techniques; conventional multi-port laparoscopy and single-port laparoscopy. A total of 72% of the participants had never heard of single-port laparoscopy before. The most important concern in both groups was the risk of surgical complications. When complication risks remain similar, 80% prefers single-port laparoscopy to conventional laparoscopy. When the risk of complications increases from 1% to 10%, 43% of all participants prefer single-port laparoscopy. A total of 70% of the participants are prepared to receive treatment in another hospital if single-port surgery is not performed in their hometown hospital. The preference for single-port approach was higher in the female population. Although cure and safety remain the main concerns, the population and patients group have a favourable perception of single-port surgery. The impact of public opinion and patient perception towards innovative techniques is undeniable. If the safety of the two different procedures is similar, this study shows a positive attitude of both participant groups in favour of single-port laparoscopy. However, solid scientific proof for the safety and feasibility of this new surgical technique needs to be obtained

Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care

International Nuclear Information System (INIS)

Lakhman, Yulia; Vargas, Hebert Alberto; Sosa, Ramon E.; Hricak, Hedvig; Sala, Evis; D'Anastasi, Melvin; Micco, Maura; Scelzo, Chiara; Nougaret, Stephanie; Chi, Dennis S.; Abu-Rustum, Nadeem R.

2016-01-01

To determine if second-opinion review of gynaecologic oncologic (GynOnc) magnetic resonance imaging (MRI) by sub-specialized radiologists impacts patient care. 469 second-opinion MRI interpretations rendered by GynOnc radiologists were retrospectively compared to the initial outside reports. Two gynaecologic surgeons, blinded to the reports' origins, reviewed all cases with discrepancies between initial and second-opinion MRI reports and recorded whether these discrepancies would have led to a change in patient management defined as a change in treatment approach, counselling, or referral. Histopathology or minimum 6-month imaging follow-up were used to establish the diagnosis. Second-opinion review of GynOnc MRIs would theoretically have affected management in 94/469 (20 %) and 101/469 (21.5 %) patients for surgeons 1 and 2, respectively. Specifically, second-opinion review would have theoretically altered treatment approach in 71/469 (15.1 %) and 60/469 (12.8 %) patients for surgeons 1 and 2, respectively. According to surgeons 1 and 2, these treatment changes would have prevented unnecessary surgery in 35 (7.5 %) and 31 (6.6 %) patients, respectively, and changed surgical procedure type/extent in 19 (4.1 %) and 12 (2.5 %) patients, respectively. Second-opinion interpretations were correct in 103 (83 %) of 124 cases with clinically relevant discrepancies between initial and second-opinion reports. Expert second-opinion review of GynOnc MRI influences patient care. (orig.)

Building a Sustainable Global Surgical Program in an Academic Department of Surgery.

Science.gov (United States)

Zhang, Linda P; Silverberg, Daniel; Divino, Celia M; Marin, Michael

Global surgery and volunteerism in surgery has gained significant interest in recent years for general surgery residents across the country. However, there are few well-established long-term surgical programs affiliated with academic institutions. The present report discusses the implementation process and challenges facing an academic institution in building a long-term sustainable global surgery program. As one of the pioneer programs in global surgery for residents, the Icahn School of Medicine at Mount Sinai global surgery rotation has been successfully running for the last 10 years in a small public hospital in the Dominican Republic. The present report details many key components of implementing a sustainable global surgery program and the evolution of this program over time. Since 2005, 80 general surgery residents have rotated through Juan Pablo Pina Hospital in the Dominican Republic. They have performed a total of 1239 major operations and 740 minor operations. They have also participated in 328 emergency cases. More importantly, this rotation helped shape residents' sense of social responsibility and ownership in their surgical training. Residents have also contributed to the training of local residents in laparoscopic skills and through cultural exchange. As interest in global surgery grows among general surgery residents, it is essential that supporting academic institutions create sustainable and capacity-building rotations for their residents. These programs must address many of the barriers that can hinder maintenance of a sustainable global surgery experience for residents. After 10 years of sending our residents to the Dominican Republic, we have found that it is possible and valuable to incorporate a formal global surgery rotation into a general surgery residency. Copyright © 2016. Published by Elsevier Inc.

Public opinion towards castration without anaesthesia and lack of access to pasture in beef cattle production.

Science.gov (United States)

Lemos Teixeira, Dayane; Larraín, Rafael; Melo, Oscar; Hötzel, María José

2018-01-01

Recent publications have shown that citizens in developing nations are gaining interest in farm animal welfare. The aims of this study were to assess the opinion of Chilean citizens about surgical castration without anaesthesia and lack of access to pasture in beef cattle production, to investigate how involvement in livestock production influences opinions, and to evaluate if different types of information would affect their opinion towards these management practices. The study was carried out in the Metropolitan Region of Santiago, Chile, and consisted of two surveys with 400 participants in each study. The first one used an online, self-administered questionnaire and the second one used a face to face questionnaire. The second questionnaire had four information treatments assigned randomly to survey participants (no information; negative information; negative and positive information; positive information). Most participants were aware that the two management practices are common in beef production systems and were opposed to them. Involvement in animal production was associated with greater acceptance of both management practices and participants that had visited a beef production farm before the study were more likely to support castration without anaesthesia in Survey 1. Belonging to any socioeconomic group and providing negative or positive information had no impact on participants' opinion. The results show a disconnection between the views of participants recruited for this study and beef production systems that do not provide pain control for male cattle surgical castration or provide little or no access to pasture.

Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data.

Science.gov (United States)

Pedron, Sara; Winter, Vera; Oppel, Eva-Maria; Bialas, Enno

2017-08-23

Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical process data in Germany. Panel regression modelling was applied. Results revealed no clear and univocal trend of participation in a benchmarking and reporting program for surgical process data. The largest trend was observed for first-case tardiness. In contrast to expectations, turnover times showed a generally increasing trend during participation. For raw utilization no clear and statistically significant trend could be evidenced. Subgroup analyses revealed differences in effects across different hospital types and department specialties. Participation in a benchmarking and reporting program and thus the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect of OR efficiency in German hospitals and could have meaningful consequences for the medium- and long-run capacity planning in the OR.

A surgical approach in the management of mucormycosis in a trauma patient.

Science.gov (United States)

Zahoor, B A; Piercey, J E; Wall, D R; Tetsworth, K D

2016-11-01

Mucormycosis as a consequence of trauma is a devastating complication; these infections are challenging to control, with a fatality rate approaching 96% in immunocompromised patients. We present a case where a proactive approach was successfully employed to treat mucormycosis following complex polytrauma. Aggressive repeated surgical debridement, in combination with appropriate antifungal therapy, proved successful in this instance. In our opinion, mucormycosis in trauma mandates an aggressive surgical approach. This prevents ascending dissemination of mucormycosis and certainly reduces the risk of patient mortality as a direct result. Anti-fungal therapy should be used secondarily as an adjunct together with surgical debridement, or as an alternative when surgical intervention is not feasible.

Paracentesis as Surgical Intervention in Traumatic Hyphaema: Opinions and Practices of Nigerian Ophthalmologists

Directory of Open Access Journals (Sweden)

Okosa Michael Chuka

2012-01-01

Full Text Available Introduction Various aspects of management of traumatic hyphaema are enmeshed in controversy. Surgery is done to prevent complications: optic atrophy and corneal blood staining occurring if a high risk exists of either or both occurring. Circumstances considered high risk do not enjoy universal consensus. Objectives To determine what Nigerian ophthalmologists consider absolute indications for surgical intervention by means of anterior chamber paracentesis and hyphaema washout in closed globe traumatic hyphaema, evaluate these absolute indications, and attempt to evolve a guideline for surgical intervention based on areas of consensus and disagreement. Method A semi-structured, pre-tested questionnaire with responses analyzed with SPSS 11 software. Result Near universal agreement on indication exist on early corneal blood staining and sickle cell haemoglobinopathy. Differing views concern blackball, volume and duration of hyphaema and secondary hypertension-associated hyphaema. However, it appears surgery is embarked on earlier than other practitioners elsewhere may consider necessary. Conclusion Risk level for non-surgical management against risk and benefit of surgery should be evaluated for each individual before surgery.

Yucca Mountain public tours: Can they impact public opinion?

International Nuclear Information System (INIS)

Reilly, B.; Austin, P.

1991-01-01

The Yucca Mountain site in Nevada was selected by Congress in 1987 as the only site for the US Department of Energy (DOE) to study for suitability as a high-level radioactive waste repository. Several years of site characterization studies are needed to determine if the site is suitable. However, DOE's study of the site is one of the most intensely opposed federal programs today. The fight against DOE's effort to study the repository leads the political agendas of Nevada's governor and Congressional delegation. The politicians and the press have been the primary sources of information for Nevada citizens on the Yucca Mountain site characterization program. However, there is a more direct source of factual information regarding the program - the site itself and the participating scientists. The DOE is offering Nevada citizens the opportunity to form their own opinions by touring the Yucca Mountain site and interacting with DOE scientists and engineers. Feedback from monthly tours conducted from March to June 1991 has indicated substantial support from Nevada citizens for DOE's study of the site. In fact, a surprising number of citizens have indicated that the opportunity to gather information and formulate their own opinions led them to change their opinions

Effective Leadership and Management of an ACS Injury Prevention Program: Current Opinions and Perspectives From Where the Rubber Meets the Road.

Science.gov (United States)

Wolfe, Elizabeth S; Bryant, Elizabeth A

The American College of Surgeons (ACS) mandates that each verified trauma center must have an injury prevention coordinator (IPC); however, Chapter 18 in the Resources for Optimal Care of the Injured Patient (2014) provides minimal information on how to effectively lead or manage an injury prevention (IP) program. This opinion article addresses 3 fundamental components of an effective IP program: (1) construction of an innovative vision of IP programming using current technology; (2) intentional investment and involvement; and (3) stakeholder leadership, engagement, and sustainability. This article also provides leadership and management methods from other professions both within and outside of the health care field that can be translated into sustainable IP program planning, implementation, and longevity.

Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program.

Science.gov (United States)

Pollei, Taylor R; Barrs, David M; Hinni, Michael L; Bansberg, Stephen F; Walter, Logan C

2013-06-01

Describe the procedure length difference between surgeries performed by an attending surgeon alone compared with the resident surgeon supervised by the same attending surgeon. Case series with chart review. Tertiary care center and residency program. Six common otolaryngologic procedures performed between August 1994 and May 2012 were divided into 2 cohorts: attending surgeon alone or resident surgeon. This division coincided with our July 2006 initiation of an otolaryngology-head and neck surgery residency program. Operative duration was compared between cohorts with confounding factors controlled. In addition, the direct result of increased surgical length on operating room cost was calculated and applied to departmental and published resident case log report data. Five of the 6 procedures evaluated showed a statistically significant increase in surgery length with resident involvement. Operative time increased 6.8 minutes for a cricopharyngeal myotomy (P = .0097), 11.3 minutes for a tonsillectomy (P operative time difference. Cost of increased surgical time was calculated per surgery and ranged from $286 (cricopharyngeal myotomy) to $2142 (mastoidectomy). When applied to reported national case log averages for graduating residents, this resulted in a significant increase of direct training-related costs. Resident participation in the operating room results in increased surgical length and additional system cost. Although residency is a necessary part of surgical training, associated costs need to be acknowledged.

Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Joshua Montroy

Full Text Available The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery.A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR and 95% confidence intervals (CI.Eleven articles reporting on 35 health care institutions were included. Nine (82% of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91, deep (pRR 0.82; 95% CI0.64-1.05 and organ space (pRR 1.15; 95% CI 0.96-1.37 infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71. Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program.These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.

Leader's opinion priority bounded confidence model for network opinion evolution

Science.gov (United States)

Zhu, Meixia; Xie, Guangqiang

2017-08-01

Aiming at the weight of trust someone given to participate in the interaction in Hegselmann-Krause's type consensus model is the same and virtual social networks among individuals with different level of education, personal influence, etc. For differences between agents, a novelty bounded confidence model was proposed with leader's opinion considered priority. Interaction neighbors can be divided into two kinds. The first kind is made up of "opinion leaders" group, another kind is made up of ordinary people. For different groups to give different weights of trust. We also analyzed the related characteristics of the new model under the symmetrical bounded confidence parameters and combined with the classical HK model were analyzed. Simulation experiment results show that no matter the network size and initial view is subject to uniform distribution or discrete distribution. We can control the "opinion-leader" good change the number of views and values, and even improve the convergence speed. Experiment also found that the choice of "opinion leaders" is not the more the better, the model well explain how the "opinion leader" in the process of the evolution of the public opinion play the role of the leader.

Results of the 2004 Knowledge and Opinions Surveys for the Baseline Knowledge Assessment of the U.S. Department of Energy Hydrogen Program

Energy Technology Data Exchange (ETDEWEB)

Schmoyer, Richard L [ORNL; Truett, Lorena Faith [ORNL; Cooper, Christy [U.S. Department of Energy

2006-04-01

The U.S. Department of Energy (DOE) Hydrogen Program focuses on overcoming critical barriers to the widespread use of hydrogen fuel cell technology. The transition to a new, hydrogen-based energy economy requires an educated human infrastructure. With this in mind, the DOE Hydrogen Program conducted statistical surveys to measure and establish baselines for understanding and awareness about hydrogen, fuel cells, and a hydrogen economy. The baseline data will serve as a reference in designing an education program, and it will be used in comparisons with future survey results (2008 and 2011) to measure changes in understanding and awareness. Scientific sampling was used to survey four populations: (1) the general public, ages 18 and over; (2) students, ages 12-17; (3) state and local government officials; and (4) potential large-scale hydrogen users. It was decided that the survey design should include about 1,000 individuals in each of the general public and student categories, about 250 state and local officials, and almost 100 large-scale end users. The survey questions were designed to accomplish specific objectives. Technical questions measured technical understanding and awareness of hydrogen technology. Opinion questions measured attitudes about safety, cost, the environment, and convenience, as well as the likelihood of future applications of hydrogen technology. For most of the questions, "I don't know" or "I have no opinion" were acceptable answers. Questions about information sources assessed how energy technology information is received. The General Public and Student Survey samples were selected by random digit dialing. Potential large-scale end users were selected by random sampling. The State and Local Government Survey was of the entire targeted population of government officials (not a random sample). All four surveys were administered by computer-assisted telephone interviewing (CATI). For each population, the length of the survey was less than

Students and Instructors Opinions about Piano Instruction

Science.gov (United States)

Kilic, Deniz Beste Çevik

2016-01-01

This study examined the opinions of the students and piano instructors in the Turkish Education Faculties' Fine Arts Instruction Departments' music instruction programs about piano instruction. The study data were collected using a questionnaire administered to the piano instructors and the students who took lessons from them. The study results…

Implementing Global Fund programs: a survey of opinions and experiences of the Principal Recipients across 69 countries.

Science.gov (United States)

Wafula, Francis; Marwa, Charles; McCoy, David

2014-03-24

Principal Recipients (PRs) receive money from the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) to manage and implement programs. However, little research has gone into understanding their opinions and experiences. This survey set out to describe these, thereby providing a baseline against which changes in PR opinions and experiences can be assessed as the recently introduced new funding model is rolled out. An internet based questionnaire was administered to 315 PRs. A total of 115 responded from 69 countries in Africa, Asia, Eastern Europe and Latin America. The study was conducted between September and December 2012. Three quarters of PRs thought the progress update and disbursement request (PU/DR) system was a useful method of reporting grant progress. However, most felt that the grant negotiation processes were complicated, and that the grant rating system did not reflect performance.While nearly all PRs were happy with the work being done by sub-Recipients (92%) and Fund Portfolio Managers (86%), fewer were happy with the Office of the Inspector General (OIG). Non-government PRs were generally less happy with the OIG's work compared to government PRs.Most PRs thought the Global Fund's Voluntary Pooled Procurement system made procurement easier. However, only 29% said the system should be made compulsory.When asked which aspects of the Global Fund's operations needed improvement, most PRs said that the Fund should re-define and clarify the roles of different actors, minimize staff turnover at its Secretariat, and shorten the grant application and approval processes. All these are currently being addressed, either directly or indirectly, under a new funding model. Vigorous assessments should nonetheless follow the roll-out of the new model to ensure the areas that are most likely to affect PR performance realize sustained improvement. Opinions and experiences with the Global Fund were varied, with PRs having good communication with Fund

[Opinion and Participation in the Regional Early Breast Cancer Detection Program in 2007 on the part of family physicians from a health district in the Autonomous Community of Madrid, Spain].

Science.gov (United States)

Garrido Elustondo, Sofía; Sánchez Padilla, Elisabeth; Ramírez Alesón, Victoria; González Hernández, Ma José; González Navarro, Andrés; López Gómez, Carlos

2008-01-01

Mammogram screening is the most effective method for the early detection of breast cancer. The objective of this study is to evaluate the degree of knowledge, the opinion and the participation in the early breast cancer detection program on the part of the family physicians of the Autonomous Community of Madrid. The population studied was comprised of family physicians from Madrid Health District Seven. An anonymous, self-administered questionnaire comprised of 30 questions grouped into physicians characteristics and opinion concerning the early breast cancer detection programs. A total of 46% of the physicians replied. A total of 94% of the physicians believed that it is their duty to inform their patients concerning preventive activities, including breast cancer screening, and 95% believed their advice to be useful for convincing women to have a mammogram. A total of 72% believed information to be lacking on this program. During the time when mammograms are being taken at their centres, 24% of the physicians surveyed always or almost always ask the women if they have any doubts or would like further information, 43% having set up appointments for them and 95% advising them to have a mammogram taken. The family physicians have a good opinion of the early breast cancer detection program and feel their advice to be effective for improving the participation in the program. They report lack of information and inform women about the program to only a small degree.

Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System.

Science.gov (United States)

Liu, Vincent X; Rosas, Efren; Hwang, Judith; Cain, Eric; Foss-Durant, Anne; Clopp, Molly; Huang, Mengfei; Lee, Derrick C; Mustille, Alex; Kipnis, Patricia; Parodi, Stephen

2017-07-19

Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery). Implementation began in February and March 2014 and concluded by the end of 2014 at 20 medical centers within the Kaiser Permanente Northern California integrated health care delivery system. A multifaceted ERAS program designed with a particular focus on perioperative pain management, mobility, nutrition, and patient engagement. The primary outcome was hospital length of stay. Secondary outcomes included hospital mortality, home discharge, 30-day readmission rates, and complication rates. The study included a total of 3768 patients undergoing elective colorectal resection (mean [SD] age, 62.7 [14.1] years; 1812 [48.1%] male) and 5002 patients undergoing emergency hip fracture repair (mean [SD] age, 79.5 [11.8] years; 1586 [31.7%] male). Comparator surgical patients included 5556 patients undergoing elective gastrointestinal surgery and 1523 patients undergoing emergency orthopedic surgery. Most process metrics had significantly greater changes in the ERAS target populations after implementation compared with comparator surgical populations, including those for ambulation, nutrition, and opioid use. Hospital length of stay and postoperative complication rates were also significantly lower among ERAS target populations after implementation. The rate ratios for postoperative complications were 0.68 (95% CI, 0.46-0.99; P = .04) for patients

American Pediatric Surgical Association

Science.gov (United States)

American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

Science.gov (United States)

Fuchshuber, Pascal R; Greif, William; Tidwell, Chantal R; Klemm, Michael S; Frydel, Cheryl; Wali, Abdul; Rosas, Efren; Clopp, Molly P

2012-01-01

The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

Coding and Billing in Surgical Education: A Systems-Based Practice Education Program.

Science.gov (United States)

Ghaderi, Kimeya F; Schmidt, Scott T; Drolet, Brian C

Despite increased emphasis on systems-based practice through the Accreditation Council for Graduate Medical Education core competencies, few studies have examined what surgical residents know about coding and billing. We sought to create and measure the effectiveness of a multifaceted approach to improving resident knowledge and performance of documenting and coding outpatient encounters. We identified knowledge gaps and barriers to documentation and coding in the outpatient setting. We implemented a series of educational and workflow interventions with a group of 12 residents in a surgical clinic at a tertiary care center. To measure the effect of this program, we compared billing codes for 1 year before intervention (FY2012) to prospectively collected data from the postintervention period (FY2013). All related documentation and coding were verified by study-blinded auditors. Interventions took place at the outpatient surgical clinic at Rhode Island Hospital, a tertiary-care center. A cohort of 12 plastic surgery residents ranging from postgraduate year 2 through postgraduate year 6 participated in the interventional sequence. A total of 1285 patient encounters in the preintervention group were compared with 1170 encounters in the postintervention group. Using evaluation and management codes (E&M) as a measure of documentation and coding, we demonstrated a significant and durable increase in billing with supporting clinical documentation after the intervention. For established patient visits, the monthly average E&M code level increased from 2.14 to 3.05 (p coding and billing of outpatient clinic encounters. Using externally audited coding data, we demonstrate significantly increased rates of higher complexity E&M coding in a stable patient population based on improved documentation and billing awareness by the residents. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Operating Room Efficiency before and after Entrance in a Benchmarking Program for Surgical Process Data

DEFF Research Database (Denmark)

Pedron, Sara; Winter, Vera; Oppel, Eva-Maria

2017-01-01

Operating room (OR) efficiency continues to be a high priority for hospitals. In this context the concept of benchmarking has gained increasing importance as a means to improve OR performance. The aim of this study was to investigate whether and how participation in a benchmarking and reporting...... program for surgical process data was associated with a change in OR efficiency, measured through raw utilization, turnover times, and first-case tardiness. The main analysis is based on panel data from 202 surgical departments in German hospitals, which were derived from the largest database for surgical...... the availability of reliable, timely and detailed analysis tools to support the OR management seemed to be correlated especially with an increase in the timeliness of staff members regarding first-case starts. The increasing trend in turnover time revealed the absence of effective strategies to improve this aspect...

Supernumerary Teeth in the Maxillary Anterior Region: The Dilemma of Early Versus Late Surgical Intervention.

Science.gov (United States)

Sarne, Ofer; Shapira, Yehoshua; Blumer, Sigalit; Finkelstein, Tamar; Schonberger, Shirley; Bechor, Naomi; Shpack, Nir

Supernumerary teeth are the most common developmental dental anomalies in the maxillary anterior region causing interference to the developing permanent incisors resulting in poor dental and facial esthetics. Two different opinions regarding the timing for surgical removal of the supernumerary teeth are presented. In this case report, three brothers with supernumerary teeth in the maxillary anterior region are presented, their surgical and orthodontic management and outcome are discussed.

Opinion and Persuasion

OpenAIRE

Ioan Constantin Dima; Daniela Gîfu

2014-01-01

The research proves that persuasion has two types of objectives. Its main objective is the change of opinion. Its fundamental and foundational objectives are the change in attitude, generic conduct and situational behaviour. The main objective controls the fundamental objectives. The change in attitudes and conduct/behaviour is presided by changes in opinion. Persuasion is thus shown to be primarily and ultimately a matter of opinion. As such, its mechanism to manage and generate ...

Opinion dynamics in activity-driven networks

Science.gov (United States)

Li, Dandan; Han, Dun; Ma, Jing; Sun, Mei; Tian, Lixin; Khouw, Timothy; Stanley, H. Eugene

2017-10-01

Social interaction between individuals constantly affects the development of their personal opinions. Previous models such as the Deffuant model and the Hegselmann-Krause (HK) model have assumed that individuals only update their opinions after interacting with neighbors whose opinions are similar to their own. However, people are capable of communicating widely with all of their neighbors to gather their ideas and opinions, even if they encounter a number of opposing attitudes. We propose a model in which agents listen to the opinions of all their neighbors. Continuous opinion dynamics are investigated in activity-driven networks with a tolerance threshold. We study how the initial opinion distribution, tolerance threshold, opinion-updating speed, and activity rate affect the evolution of opinion. We find that when the initial fraction of positive opinion is small, all opinions become negative by the end of the simulation. As the initial fraction of positive opinions rises above a certain value —about 0.45— the final fraction of positive opinions sharply increases and eventually equals 1. Increased tolerance threshold δ is found to lead to a more varied final opinion distribution. We also find that if the negative opinion has an initial advantage, the final fraction of negative opinion increases and reaches its peak as the updating speed λ approaches 0.5. Finally we show that the lower the activity rate of individuals, the greater the fluctuation range of their opinions.

Encuesta de opinión sobre la cirugía mayor ambulatoria en la formación del residente de especialidades quirúrgicas Opinion survey of the effect of major ambulatory surgery on the training of surgical residents

Directory of Open Access Journals (Sweden)

Carlos Martínez Ramos

2004-12-01

constitute to a large extent the basis of surgical training. The objectives of this study are to assess the opinions of the surgical residents of the likely effects of the advent of MAS on their surgical training, and to record any solutions that they may propose. Material and Methods: A survey of 17 questions (13 closed, 2 open and 1 mixed was administered to 72 residents training in seven of the surgical specialties that participate at the MAS Unit at the Hospital San Carlos, Madrid. Results: The survey was completed by 36.1% of residents. All those that responded considered that: 1 familiarity with, and training in, this type of surgery is important . 2 the surgical techniques performed at the Hospital’s MAS Unit are fundamental for the surgical training of the resident. 3 Major Ambulatory Surgery should be included in the training of surgical residents. 80.8% consider that receiving MAS training will improve their employment prospects on finishing their residence period. Conclusions: Residents consider that their participation in the activity of MAS Units is important and that well-structured, well-coordinated programs are required. All parties involved should participate in the preparation of the programs, which should be adapted to the characteristics of each specialty.

Travel opinion leaders and seekers

DEFF Research Database (Denmark)

Yoo, Kyung-Hyan; Gretzel, Ulrike; Zach, Florian

2011-01-01

While opinion leadership has been recognized as important in tourism, there has been very little empirical research investigating the phenomenon. Given new developments in social media technologies, it is especially important to understand whether travel opinion leadership and seeking are drivers...... of specific social media perceptions and behaviours. Based on an online survey of US online travellers, this paper seeks to identify travel opinion leaders and seekers and their characteristics. Further, the research conducted investigated linkages between travel opinion leadership/seeking and travel social...... media use. The findings suggest that travel opinion leadership and seeking are distinct but connected. Both opinion leaders and seekers are technology savvy, young, educated, involved in travel planning and engaged in social media use for travel. What distinguishes opinion leaders is their greater...

Thoracic surgical resident education: a costly endeavor.

Science.gov (United States)

Calhoon, John H; Baisden, Clint; Holler, Ben; Hicks, George L; Bove, Ed L; Wright, Cameron D; Merrill, Walter H; Fullerton, Dave A

2014-12-01

We sought to define an accurate measure of thoracic surgical education costs. Program directors from six distinct and differently sized and geographically located thoracic surgical training programs used a common template to provide estimates of resident educational costs. These data were reviewed, clarifying questions or discrepancies when noted and using best estimates when exact data were unavailable. Subsequently, a composite of previously published cost-estimation products was used to capture accurate cost data. Data were then compiled and averaged to provide an accurate picture of all costs associated with thoracic surgical education. Before formal accounting was performed, the estimated average for all programs was approximately $250,000 per year per resident. However, when formal evaluations by the six programs were performed, the annual cost of resident education ranged from $330,000 to $667,000 per year per resident. The average cost of $483,000 per year was almost double the initial estimates. Variability was noted by region and size of program. Faculty teaching costs varied from $208,000 to $346,000 per year. Simulation costs ranged from $0 to $80,000 per year. Resident savings to program ranged from $0 to $135,000 per year and averaged $37,000 per year per resident. Thoracic surgical education costs are considerably higher than initial estimates from program directors and probably represent an unappreciated source of financial burden for cardiothoracic surgical educational programs. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Innovating for quality and value: Utilizing national quality improvement programs to identify opportunities for responsible surgical innovation.

Science.gov (United States)

Woo, Russell K; Skarsgard, Erik D

2015-06-01

Innovation in surgical techniques, technology, and care processes are essential for improving the care and outcomes of surgical patients, including children. The time and cost associated with surgical innovation can be significant, and unless it leads to improvements in outcome at equivalent or lower costs, it adds little or no value from the perspective of the patients, and decreases the overall resources available to our already financially constrained healthcare system. The emergence of a safety and quality mandate in surgery, and the development of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) allow needs-based surgical care innovation which leads to value-based improvement in care. In addition to general and procedure-specific clinical outcomes, surgeons should consider the measurement of quality from the patients' perspective. To this end, the integration of validated Patient Reported Outcome Measures (PROMs) into actionable, benchmarked institutional outcomes reporting has the potential to facilitate quality improvement in process, treatment and technology that optimizes value for our patients and health system. Copyright © 2015 Elsevier Inc. All rights reserved.

Quantification of informed opinion

International Nuclear Information System (INIS)

Rasmuson, D.M.

1985-01-01

The objective of this session, Quantification of Informed Opinion, is to provide the statistician with a better understanding of this important area. The NRC uses informed opinion, sometimes called engineering judgment or subjective judgment, in many areas. Sometimes informed opinion is the only source of information that exists, especially in phenomenological areas, such as steam explosions, where experiments are costly and phenomena are very difficult to measure. There are many degrees of informed opinion. These vary from the weatherman who makes predictions concerning relatively high probability events with a large data base to the phenomenological expert who must use his intuition tempered with basic knowledge and little or no measured data to predict the behavior of events with a low probability of occurrence. The first paper in this session provides the reader with an overview of the subject area. The second paper provides some aspects that must be considered in the collection of informed opinion to improve the quality of the information. The final paper contains an example of the use of informed opinion in the area of seismic hazard characterization. These papers should be useful to researchers and statisticians who need to collect and use informed opinion in their work

The pregnant female surgical resident

Directory of Open Access Journals (Sweden)

Shifflette V

2018-05-01

Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

Negative opinions about cancer screening and contraceptive measures by female emergency department patients.

Science.gov (United States)

Merchant, Roland C; Gee, Erin M; Bock, Beth C; Becker, Bruce M; Clark, Melissa A

2008-11-01

We sought to determine the extent to which adult female emergency department participants viewed two women's cancer screening and two contraceptive measures negatively. The study also explored the relationship between having a negative opinion about these measures and participant demography, lack of knowledge, and lack of usage of these measures. Few women expressed negative opinions about these measures. Lack of knowledge about and lack of use of these measures were associated with having negative opinions on these cancer screening and contraceptive measures. Having any negative opinion about one cancer screening or contraceptive measure was associated with a higher risk of having any negative opinion on another measure. The results suggest that influencing opinion and knowledge about these measures might impact the success of emergency department-based cancer screening and contraceptive health programs. Editors' Strategic Implications: Emergency departments (and primary care settings) provide key opportunities for prevention. Replication is needed, but the authors present important data on knowledge, attitudes, and characteristics that might influence women's receptivity to consent to and engage in behaviors consistent with prevention, screening, and health promotion.

Sepsis in general surgery: the 2005-2007 national surgical quality improvement program perspective.

Science.gov (United States)

Moore, Laura J; Moore, Frederick A; Todd, S Rob; Jones, Stephen L; Turner, Krista L; Bass, Barbara L

2010-07-01

To document the incidence, mortality rate, and risk factors for sepsis and septic shock compared with pulmonary embolism and myocardial infarction in the general-surgery population. Retrospective review. American College of Surgeons National Surgical Quality Improvement Program institutions. General-surgery patients in the 2005-2007 National Surgical Quality Improvement Program data set. Incidence, mortality rate, and risk factors for sepsis and septic shock. Of 363 897 general-surgery patients, sepsis occurred in 8350 (2.3%), septic shock in 5977 (1.6%), pulmonary embolism in 1078 (0.3%), and myocardial infarction in 615 (0.2%). Thirty-day mortality rates for each of the groups were as follows: 5.4% for sepsis, 33.7% for septic shock, 9.1% for pulmonary embolism, and 32.0% for myocardial infarction. The septic-shock group had a greater percentage of patients older than 60 years (no sepsis, 40.2%; sepsis, 51.7%; and septic shock, 70.3%; P surgery resulted in more cases of sepsis (4.5%) and septic shock (4.9%) than did elective surgery (sepsis, 2.0%; septic shock, 1.2%) (P surgery, and the presence of any comorbidity. This study emphasizes the need for early recognition of patients at risk via aggressive screening and the rapid implementation of evidence-based guidelines.

Practice management education during surgical residency.

Science.gov (United States)

Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

2008-12-01

Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

(Almost) a slam dunk: Assessing the experiences and opinions of participants in a National Basketball Association (NBA)-funded dropout prevention program.

Science.gov (United States)

Geiger, Tray J; Amrein-Beardsley, Audrey

2017-10-01

Researchers conducted an evaluation of participants' perceptions of a dropout prevention program - the NBA High School program - involving a National Basketball Association (NBA) team, a high school located in downtown [City], and the College of Education (COE) at the local State University (SU). The program targeted "at-risk" high school students while utilizing student-teachers as tutors and mentors. Researchers utilized mixed methods to assess student, student-teacher, and high school teacher participants' experiences with and opinions of the program. Researchers found (1) students enjoyed the program, especially given the involvement of the student-teachers; (2) students believed the program helped improve their grades; (3) student-teachers enjoyed working with their students, although student-teachers found some of the expectations surrounding their positions and roles as tutors/mentors within the high school to be unclear and frustrating; (4) high school teachers felt significantly better about the program than the student-teachers; and (5) overall, all sets of respondents categorically supported the program and its benefits. Findings indicated that the involvement of mentors or role models matters to students, and clear and organized logistics, planning, and communication are integral for program success. Copyright © 2017 Elsevier Ltd. All rights reserved.

Public opinion polls on nuclear energy

International Nuclear Information System (INIS)

Heller, E.D.

1980-07-01

Future developments in the attitude towards nuclear energy can not be predicted on account of this public opinion survey. The survey shows just how many different factors influence the attitude towards issues of public and political interst. For this reason in particular, it would be desirable to include such aspects into future surveys. The survey shows that public opinion polls quite often investigate on the ordering party's opinion rather than the pollees opinion. The attempt at making public opinion polls a means of forming political opinions, implying a certain desired opinion to be the majority opinion has brought those polls into disrepute. If real results are not required and manipulation prevails, results are prevented, which must not be blamed on the principle of public opinion polls as such. (orig.) [de

Opinion Integration and Summarization

Science.gov (United States)

Lu, Yue

2011-01-01

As Web 2.0 applications become increasingly popular, more and more people express their opinions on the Web in various ways in real time. Such wide coverage of topics and abundance of users make the Web an extremely valuable source for mining people's opinions about all kinds of topics. However, since the opinions are usually expressed as…

Coma and Stroke Following Surgical Treatment of Unruptured Intracranial Aneurysm: An American College of Surgeons National Surgical Quality Improvement Program Study.

Science.gov (United States)

McCutcheon, Brandon A; Kerezoudis, Panagiotis; Porter, Amanda L; Rinaldo, Lorenzo; Murphy, Meghan; Maloney, Patrick; Shepherd, Daniel; Hirshman, Brian R; Carter, Bob S; Lanzino, Giuseppe; Bydon, Mohamad; Meyer, Fredric

2016-07-01

A large national surgical registry was used to establish national benchmarks and associated predictors of major neurologic complications (i.e., coma and stroke) after surgical clipping of unruptured intracranial aneurysms. The American College of Surgeons National Surgical Quality Improvement Program data set between 2007 and 2013 was used for this retrospective cohort analysis. Demographic, comorbidity, and operative characteristics associated with the development of a major neurologic complication (i.e., coma or stroke) were elucidated using a backward selection stepwise logistic regression analysis. This model was subsequently used to fit a predictive score for major neurologic complications. Inclusion criteria were met by 662 patients. Of these patients, 57 (8.61%) developed a major neurologic complication (i.e., coma or stroke) within the 30-day postoperative period. On multivariable analysis, operative time (log odds 0.004 per minute; 95% confidence interval [CI], 0.002-0.007), age (log odds 0.05 per year; 95% CI, 0.02-0.08), history of chronic obstructive pulmonary disease (log odds 1.26; 95% CI, 0.43-2.08), and diabetes (log odds 1.15; 95% CI, 0.38-1.91) were associated with an increased odds of major neurologic complications. When patients were categorized according to quartile of a predictive score generated from the multivariable analysis, rates of major neurologic complications were 1.8%, 4.3%, 6.7%, and 21.2%. Using a large, national multi-institutional cohort, this study established representative national benchmarks and a predictive scoring system for major neurologic complications following operative management of unruptured intracranial aneurysms. The model may assist with risk stratification and tailoring of decision making in surgical candidates. Copyright © 2016 Elsevier Inc. All rights reserved.

[Medical students and psychiatry. A survey of students' opinion].

Science.gov (United States)

Giberti, F; Corsini, G; Rovida, S

1994-06-01

In the last years research on the didactics of Psychiatry and opinions of medical students on Psychiatry has gained great interest. The authors think that this research could be useful for the improvement of didactics, for better understanding the meanings of professional choice, the identity of psychiatrist and their relationship with colleagues in other medical field. The goal of this research work was a preliminary survey of Genoese University Medical Student's opinions about psychiatry didactics, and choice of specialization. A questionnaire was submitted to all the students who passed Clinical Psychiatry examination in the period from November 1987 to December 1988. The students were divided in two randomized groups: the first group of students (224) was submitted to the questionnaire immediately after Clinical Psychiatry examination; while to the second group of students (66) the questionnaire was mailed. The aim of the questions was to assess the student's opinions on psychiatry, psychoanalysis, psychotherapy, the career they wanted to take up, and the difficulties of studying psychiatry: 69% of the students of the first group and 42% of the students of the second group answered the questionnaire. Female students answered that they preferred psychiatric specialization more than their male colleagues did, but the difference has no statistical importance. In most cases, the students who answered that they have taken into account psychiatry as a choice of specialisation, are more interested in medical specialties (primary care, etc.) than in surgical specialties. Most of the medical students declare some emotional troubles (anxiety, sleeplessness, problem in social relations).(ABSTRACT TRUNCATED AT 250 WORDS)

Aspect-object alignment with Integer Linear Programming in opinion mining.

Directory of Open Access Journals (Sweden)

Yanyan Zhao

Full Text Available Target extraction is an important task in opinion mining. In this task, a complete target consists of an aspect and its corresponding object. However, previous work has always simply regarded the aspect as the target itself and has ignored the important "object" element. Thus, these studies have addressed incomplete targets, which are of limited use for practical applications. This paper proposes a novel and important sentiment analysis task, termed aspect-object alignment, to solve the "object neglect" problem. The objective of this task is to obtain the correct corresponding object for each aspect. We design a two-step framework for this task. We first provide an aspect-object alignment classifier that incorporates three sets of features, namely, the basic, relational, and special target features. However, the objects that are assigned to aspects in a sentence often contradict each other and possess many complicated features that are difficult to incorporate into a classifier. To resolve these conflicts, we impose two types of constraints in the second step: intra-sentence constraints and inter-sentence constraints. These constraints are encoded as linear formulations, and Integer Linear Programming (ILP is used as an inference procedure to obtain a final global decision that is consistent with the constraints. Experiments on a corpus in the camera domain demonstrate that the three feature sets used in the aspect-object alignment classifier are effective in improving its performance. Moreover, the classifier with ILP inference performs better than the classifier without it, thereby illustrating that the two types of constraints that we impose are beneficial.

Aspect-object alignment with Integer Linear Programming in opinion mining.

Science.gov (United States)

Zhao, Yanyan; Qin, Bing; Liu, Ting; Yang, Wei

2015-01-01

Target extraction is an important task in opinion mining. In this task, a complete target consists of an aspect and its corresponding object. However, previous work has always simply regarded the aspect as the target itself and has ignored the important "object" element. Thus, these studies have addressed incomplete targets, which are of limited use for practical applications. This paper proposes a novel and important sentiment analysis task, termed aspect-object alignment, to solve the "object neglect" problem. The objective of this task is to obtain the correct corresponding object for each aspect. We design a two-step framework for this task. We first provide an aspect-object alignment classifier that incorporates three sets of features, namely, the basic, relational, and special target features. However, the objects that are assigned to aspects in a sentence often contradict each other and possess many complicated features that are difficult to incorporate into a classifier. To resolve these conflicts, we impose two types of constraints in the second step: intra-sentence constraints and inter-sentence constraints. These constraints are encoded as linear formulations, and Integer Linear Programming (ILP) is used as an inference procedure to obtain a final global decision that is consistent with the constraints. Experiments on a corpus in the camera domain demonstrate that the three feature sets used in the aspect-object alignment classifier are effective in improving its performance. Moreover, the classifier with ILP inference performs better than the classifier without it, thereby illustrating that the two types of constraints that we impose are beneficial.

Residency Training in Robotic General Surgery: A Survey of Program Directors.

Science.gov (United States)

George, Lea C; O'Neill, Rebecca; Merchant, Aziz M

2018-01-01

Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. 20 program directors were surveyed, a majority being from medium-sized programs (4-7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

The US Department of Energy hydrogen baseline survey: assessing knowledge and opinions about hydrogen technology

International Nuclear Information System (INIS)

Christy Cooper; Tykey Truett; R L Schmoyer

2006-01-01

To design and maintain its education program, the United States Department of Energy (DOE) Hydrogen Program conducted a statistically-valid national survey to measure knowledge and opinions of hydrogen among key target audiences. The Hydrogen Baseline Knowledge Survey provides a reference for designing the DOE hydrogen education strategy and will be used in comparisons with future surveys to measure changes in knowledge and opinions over time. The survey sampled four U.S. populations: (1) public; (2) students; (3) state and local government officials; and (4) potential large-scale hydrogen end-users in three business categories. Questions measured technical understanding of hydrogen and opinions about hydrogen safety. Other questions assessed visions of the likelihood of future hydrogen applications and sources of energy information. Several important findings were discovered, including a striking lack of technical understanding across all survey groups, as well as a strong correlation between technical knowledge and opinions about safety: those who demonstrated an understanding of hydrogen technologies expressed the least fear of its safe use. (authors)

Staff opinions regarding the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)

NARCIS (Netherlands)

Pal, S.M. van der; Maguire, C.M.; Cessie, S.L.; Veen, S.; Wit, J.M.; Walther, F.J.; Bruil, J.

2007-01-01

This study explored the opinions of (para)medical and nursing staff in two Dutch Neonatal Intensive Care Units (NICU's). A questionnaire was used that measured: a) the perceived impact of NIDCAP on several NICU conditions, b) attitudes, subjective norm, perceived behavioral control, knowledge and

PENGARUH KUALITAS AUDIT, OPINION SHOPPING, DEBTDEFAULT PERTUMBUHAN PERUSAHAAN DAN KONDISI KEUANGAN PERUSAHAAN TERHADAP PENERIMAAN OPINI AUDITGOING CONCERN

Directory of Open Access Journals (Sweden)

Siti Istiana

2016-02-01

Full Text Available This research have a purpose to test the effect of Audit Quality, opinion shopping, debt default, company growth and company financial condition to going concern audit opinion acceptance. The sample which used in this research is Manufacture Company which registered in Indonesia Stock Exchange use of 2006-2008. The sample was taken with purposive sampling method and the result 53 companies were match and fulfill the sample criteria. Hypotheses testing was done whit logistic regression test tool from SPSS application program. The research result show that audit quality does not effect to the possibility of going concern audit opinion acceptance, opinion shopping does not effect to the possibility of going concern audit opinion acceptance, debt default have effect to the possibility of going concern audit opinion acceptance, company growth does not effect to the possibility of going concern audit opinion acceptance, and company financial condition have effect to the possibility of going concern audit opinion acceptance.

Ophthalmology resident surgical competency: a national survey.

Science.gov (United States)

Binenbaum, Gil; Volpe, Nicholas J

2006-07-01

To describe the prevalence, management, and career outcomes of ophthalmology residents who struggle with surgical competency and to explore related educational issues. Fourteen-question written survey. Fifty-eight program directors at Accreditation Council on Graduate Medical Education-accredited, United States ophthalmology residency programs, representing a total of 2179 resident graduates, between 1991 and 2000. Study participants completed a mailed, anonymous survey whose format combined multiple choice and free comment questions. Number of surgically challenged residents, types of problems identified, types of remediation, final departmental decision at the end of residency, known career outcomes, and residency program use of microsurgical skills laboratories and applicant screening tests. One hundred ninety-nine residents (9% overall; 10% mean per program) were labeled as having trouble mastering surgical skills. All of the programs except 2 had encountered such residents. The most frequently cited problems were poor hand-eye coordination (24%) and poor intraoperative judgment (22%). Most programs were supportive and used educational rather than punitive measures, the most common being extra practice-laboratory time (32%), scheduling cases with the best teaching surgeon (23%), and counseling (21%). Nearly one third (31%) of residents were believed to have overcome their difficulties before graduation. Other residents were encouraged to pursue medical ophthalmology (22%) or to obtain further surgical training through a fellowship (21%) or a supervised practice setting (12%); these residents were granted a departmental statement of satisfactory completion of residency for Board eligibility. Twelve percent were asked to leave residency. Of reported career outcomes, 92% of residents were practicing ophthalmology, 65% as surgical and 27% as medical ophthalmologists. Ninety-eight percent of residency programs had microsurgical practice facilities, 64% had a formal

Expert opinion vs. empirical evidence

OpenAIRE

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years sp...

Expert opinion vs. empirical evidence

Science.gov (United States)

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

Opinions regarding neonatal resuscitation training for the obstetric physician: a survey of neonatal and obstetric training program directors.

Science.gov (United States)

Bruno, C J; Johnston, L; Lee, C; Bernstein, P S; Goffman, D

2018-04-01

Our goal was to garner opinions regarding neonatal resuscitation training for obstetric physicians. We sought to evaluate obstacles to neonatal resuscitation training for obstetric physicians and possible solutions for implementation challenges. We distributed a national survey via email to all neonatal-perinatal medicine fellowship directors and obstetrics & gynecology residency program directors in the United States. This survey was designed by a consensus method. Ninety-eight (53%) obstetric and fifty-seven (51%) neonatal program directors responded to our surveys. Eighty-eight percent of neonatologists surveyed believe that obstetricians should be neonatal resuscitation program (NRP) certified. The majority of surveyed obstetricians (>89%) believe that obstetricians should have some neonatal resuscitation training. Eighty-six percent of obstetric residents have completed training in NRP, but only 19% of obstetric attendings are NRP certified. Major barriers to NRP training that were identified include time, lack of national requirement, lack of belief it is helpful, and cost. Most obstetric attendings are not NRP certified, but the majority of respondents believe that obstetric providers should have some neonatal resuscitation training. Our study demonstrates that most respondents support a modified neonatal resuscitation course for obstetric physicians.

TOOL: The Open Opinion Layer

OpenAIRE

Masum, Hassan

2002-01-01

Shared opinions drive society: what we read, how we vote, and where we shop are all heavily influenced by the choices of others. However, the cost in time and money to systematically share opinions remains high, while the actual performance history of opinion generators is often not tracked. This article explores the development of a distributed open opinion layer, which is given the generic name of TOOL. Similar to the evolution of network protocols as an underlying layer for many comput...

Establishing a surgical outreach program in the developing world: pediatric strabismus surgery in Guatemala City, Guatemala.

Science.gov (United States)

Ditta, Lauren C; Pereiras, Lilia Ana; Graves, Emily T; Devould, Chantel; Murchison, Ebony; Figueroa, Ligia; Kerr, Natalie C

2015-12-01

To report our experince in establishing a sustainable pediatric surgical outreach mission to an underserved population in Guatemala for treatment of strabismic disorders. A pediatric ophthalmic surgical outreach mission was established. Children were evaluated for surgical intervention by 3 pediatric ophthalmologists and 2 orthoptists. Surgical care was provided at the Moore Pediatric Surgery Center, Guatemala City, over 4 days. Postoperative care was facilitated by Guatemalan physicians during the second year. In year 1, patients 1-17 years of age were referred by local healthcare providers. In year 2, more than 60% of patients were prescreened by a local pediatric ophthalmologist. We screened 47% more patients in year 2 (132 vs 90). Diagnoses included congenital and acquired esotropia, consecutive and acquired exotropia, congenital nystagmus, Duane syndrome, Brown syndrome, cranial nerve palsy, dissociated vertical deviation, and oblique muscle dysfunction. Overall, 42% of the patients who were screened underwent surgery. We performed 21 more surgeries in our second year (58 vs 37), a 57% increase. There were no significant intra- or postoperative complications. Surgical outreach programs for children with strabismic disorders in the developing world can be established through international cooperation, a multidisciplinary team of healthcare providers, and medical equipment allocations. Coordinating care with local pediatric ophthalmologists and medical directors facilitates best practice management for sustainability. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Surgical nurse: his leadership style with nursing auxiliary personnel

OpenAIRE

Galvão, Cristina Maria; Trevizan, Maria Auxiliadora; Okino Sawada, Namie

2008-01-01

This investigation as carried out in order to promote follow-up in the studies concerning nurse`s leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey na Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in acco...

Surgical competence.

Science.gov (United States)

Patil, Nivritti G; Cheng, Stephen W K; Wong, John

2003-08-01

Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

Directory of Open Access Journals (Sweden)

Ekdahl Charlotte S

2009-09-01

Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

Robotic surgical training.

Science.gov (United States)

Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

2013-01-01

In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

Strategies to improve the dietary quality of Supplemental Nutrition Assistance Program (SNAP) beneficiaries: an assessment of stakeholder opinions.

Science.gov (United States)

Blumenthal, Susan J; Hoffnagle, Elena E; Leung, Cindy W; Lofink, Hayley; Jensen, Helen H; Foerster, Susan B; Cheung, Lilian Wy; Nestle, Marion; Willett, Walter C

2014-12-01

To examine the opinions of stakeholders on strategies to improve dietary quality of Supplemental Nutrition Assistance Program (SNAP) participants. Participants answered a thirty-eight-item web-based survey assessing opinions and perceptions of SNAP and programme policy changes. Survey of 522 individuals with stakeholder interest in SNAP, conducted in October through December 2011. The top three barriers to improving dietary quality identified were: (i) unhealthy foods marketed in low-income communities; (ii) the high cost of healthy foods; and (iii) lifestyle challenges faced by low-income individuals. Many respondents (70 %) also disagreed that current SNAP benefit levels were adequate to maintain a healthy diet. Stakeholders believed that vouchers, coupons or monetary incentives for purchasing healthful foods might have the greatest potential for improving the diets of SNAP participants. Many respondents (78 %) agreed that sodas should not be eligible for purchases with SNAP benefits. More than half (55 %) believed retailers could easily implement such restrictions. A majority of respondents (58 %) agreed that stores should stock a minimum quantity of healthful foods in order to be certified as a SNAP retailer, and most respondents (83 %) believed that the US Department of Agriculture should collect data on the foods purchased with SNAP benefits. Results suggest that there is broad stakeholder support for policies that align SNAP purchase eligibility with national public health goals of reducing food insecurity, improving nutrition and preventing obesity.

Opinion competition dynamics on multiplex networks

Science.gov (United States)

Amato, R.; Kouvaris, N. E.; San Miguel, M.; Díaz-Guilera, A.

2017-12-01

Multilayer and multiplex networks represent a good proxy for the description of social phenomena where social structure is important and can have different origins. Here, we propose a model of opinion competition where individuals are organized according to two different structures in two layers. Agents exchange opinions according to the Abrams-Strogatz model in each layer separately and opinions can be copied across layers by the same individual. In each layer a different opinion is dominant, so each layer has a different absorbing state. Consensus in one opinion is not the only possible stable solution because of the interaction between the two layers. A new mean field solution has been found where both opinions coexist. In a finite system there is a long transient time for the dynamical coexistence of both opinions. However, the system ends in a consensus state due to finite size effects. We analyze sparse topologies in the two layers and the existence of positive correlations between them, which enables the coexistence of inter-layer groups of agents sharing the same opinion.

Competing opinion diffusion on social networks.

Science.gov (United States)

Hu, Haibo

2017-11-01

Opinion competition is a common phenomenon in real life, such as with opinions on controversial issues or political candidates; however, modelling this competition remains largely unexplored. To bridge this gap, we propose a model of competing opinion diffusion on social networks taking into account degree-dependent fitness or persuasiveness. We study the combined influence of social networks, individual fitnesses and attributes, as well as mass media on people's opinions, and find that both social networks and mass media act as amplifiers in opinion diffusion, the amplifying effect of which can be quantitatively characterized. We analytically obtain the probability that each opinion will ultimately pervade the whole society when there are no committed people in networks, and the final proportion of each opinion at the steady state when there are committed people in networks. The results of numerical simulations show good agreement with those obtained through an analytical approach. This study provides insight into the collective influence of individual attributes, local social networks and global media on opinion diffusion, and contributes to a comprehensive understanding of competing diffusion behaviours in the real world.

Non-consensus Opinion Models on Complex Networks

Science.gov (United States)

Li, Qian; Braunstein, Lidia A.; Wang, Huijuan; Shao, Jia; Stanley, H. Eugene; Havlin, Shlomo

2013-04-01

Social dynamic opinion models have been widely studied to understand how interactions among individuals cause opinions to evolve. Most opinion models that utilize spin interaction models usually produce a consensus steady state in which only one opinion exists. Because in reality different opinions usually coexist, we focus on non-consensus opinion models in which above a certain threshold two opinions coexist in a stable relationship. We revisit and extend the non-consensus opinion (NCO) model introduced by Shao et al. (Phys. Rev. Lett. 103:01870, 2009). The NCO model in random networks displays a second order phase transition that belongs to regular mean field percolation and is characterized by the appearance (above a certain threshold) of a large spanning cluster of the minority opinion. We generalize the NCO model by adding a weight factor W to each individual's original opinion when determining their future opinion (NCO W model). We find that as W increases the minority opinion holders tend to form stable clusters with a smaller initial minority fraction than in the NCO model. We also revisit another non-consensus opinion model based on the NCO model, the inflexible contrarian opinion (ICO) model (Li et al. in Phys. Rev. E 84:066101, 2011), which introduces inflexible contrarians to model the competition between two opinions in a steady state. Inflexible contrarians are individuals that never change their original opinion but may influence the opinions of others. To place the inflexible contrarians in the ICO model we use two different strategies, random placement and one in which high-degree nodes are targeted. The inflexible contrarians effectively decrease the size of the largest rival-opinion cluster in both strategies, but the effect is more pronounced under the targeted method. All of the above models have previously been explored in terms of a single network, but human communities are usually interconnected, not isolated. Because opinions propagate not

ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

Science.gov (United States)

Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

2013-01-01

To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (pinterpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.

Science.gov (United States)

Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford

2013-12-01

The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.

Basic surgical training in Ireland: the impact of operative experience, training program allocation and mentorship on trainee satisfaction.

LENUS (Irish Health Repository)

O'Sullivan, K E

2013-12-01

Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs.

Fashion clothing involvement, opinion leadership and opinion seeking amongst black generation Y students / Pulaki Joseph Tshabalala

OpenAIRE

Tshabalala, Pulaki Joseph

2014-01-01

Opinion leadership and opinion seeking are central constructs in academic studies of new product innovations. Fashion opinion leaders as those individuals who accelerate the fashion maturity process by legitimising a fashionable trend and influence other consumers to adopt the new innovative style as a replacement for the current accepted one. Consumers who accept information and adopt new style innovations are called opinion seekers and are important to the diffusion of new fashions because ...

Employee benefits managers' opinions about addiction treatment.

Science.gov (United States)

McFarland, Bentson H; Lierman, Walter K; Penner, Norman R; McCamant, Lynn E; Zani, Brigid G

2003-01-01

Employee benefits managers arrange addictive disease treatment insurance coverage for the majority of people in the United States but little is known about these decision-makers. Managers were surveyed to learn their opinions about addiction treatment. Subjects were 131 people (61 percent female, 94 percent white, average age 46, average of 14 years in the human resources field). Managers were asked to rank health benefits (physical health, dental, alcohol-drug, vision, mental health, employee assistance program, and pharmaceuticals) on 15 dimensions. Managers ranked alcohol-drug abuse treatment worst on fiveitems and second to the worst on another four of the 15 dimensions. On the item considered most important by the managers, respondents noted that employees often (2.8) ask for improved physical health benefits but rarely do so for alcohol and drug (4.1) benefits (p < .001). Education of workers and payers will be needed to change opinions about treatment of addictive disorders.

Plutonium - the ultrapoison? An expert's opinion about an expert opinion

International Nuclear Information System (INIS)

Stoll, W.; Becker, K.

1989-01-01

In an expert opinion written by Professor H. Kuni, Marburg, for the North Rhine-Westphalian state government, plutonium is called by far the most dangerous element in the Periodic Table. The Marburg medical expert holds that even improved legal instruments are unable to warrant effective protection of the workers handling this material, in the light of the present standards of industrial safety, because of radiological conditions and measuring problems with plutonium isotopes. In this article by an internationally renowned expert in the field, the ideas expressed in the expert opinion about the toxicity of plutonium, the cause-and-effect relationship in radiation damage by plutonium, and recent findings about the toxicity are subjected to a critical review. On the basis of results of radiation protection and of case studies, the statements in the expert opinion are contrasted with facts which make them appear in a very different light. (orig./RB) [de

Opinion Dynamics on Networks with Inference of Unobservable States of Others

Science.gov (United States)

Fujie, Ryo

In most opinion formation models which have been proposed, the agents decide their states (i.e. opinions) by referring to the states of others. However, the referred states of others are not necessarily observable and may be inferred. To investigate the effect of an inference of the states of others on opinion dynamics, I propose an extended voter model on networks where observable and referable node sets are different. These sets for a node defined as the nearest to the mo-th neighbors for observable nodes and the nearest to the mr-th neighbors for referable nodes. The state of referable but unobservable node which is the m-th neighbor (mo pagerank'' is conserved. This conserved quantity coincides with the fixation probability. On the other hand, in the case of mo =mr = 1 , the model comes down to the standard voter model on networks and the conserved quantity is a degree-weighted superposition of the states. Thus, the introduction of the inference changes the important opinion spreaders from the high-degree nodes to the high-betweenness pagerank nodes. This work is supported by the Collaboration Research Program of IDEAS, Chubu University IDEAS2016233.

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

Science.gov (United States)

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

Residency Training in Robotic General Surgery: A Survey of Program Directors

Directory of Open Access Journals (Sweden)

Lea C. George

2018-01-01

Full Text Available Objective. Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results. 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year. Most respondents (73.68% had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%, with simulation training prior to console use (84.21%. About two-thirds of the respondents (63.16% believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%. Conclusion. A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

A survey of resident perspectives on surgical case minimums and the impact on milestones, graduation, credentialing, and preparation for practice: AOA critical issues.

Science.gov (United States)

Jeray, Kyle J; Frick, Steven L

2014-12-03

Residency education continues to evolve. Several major changes have occurred in the past several years, including emphasis on core competencies, duty-hour restrictions, and call. The Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS) implemented educational milestones in orthopaedic surgery in July 2013. Additionally, the Residency Review Committee for orthopaedic surgery published suggested surgical case minimums in 2012, which overlap with several of the milestones.We conducted a survey to assess the opinions of orthopaedic residents regarding the ACGME-suggested surgical case minimums and the effects that these may have on resident education and potential future privileges in hospitals. The survey was sent via e-mail to all of the residents participating in the American Orthopaedic Association (AOA) Resident Leadership Forum for both 2011 and 2012. Participants in the Resident Leadership Forum are in either postgraduate year 4 or postgraduate year 5, are selected by the program directors as resident leaders, and represent 80% of the orthopaedic residency programs in the United States. The survey was completed by 157 of the 314 participants. Sixty-nine percent of the participants believed that case logs with minimum numbers of surgical procedures were an effective way to monitor the work but were not necessarily the only way to monitor the educational progress of the residents. Thirty-two percent believed that the minimums should not be required. Overwhelmingly, there was agreement that important cases were missing from the currently proposed sixteen core surgical minimums. Specifically, the residents believed that a minimum number of cases are necessary for distal radial fracture fixation and proximal humeral fracture fixation and possibly have a milestone to reflect the progress of the residents for each fixation.Most residents thought that surgical case minimums are an effective tool in monitoring the progress of

[Quality of surgical continuing education in Germany].

Science.gov (United States)

Ansorg, J; Hassan, I; Fendrich, V; Polonius, M J; Rothmund, M; Langer, P

2005-03-11

One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses. Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.

A survey of contemporary opinions and practices of surgical and intensive care specialists towards peri-operative venous thromboembolism prophylaxis in Asia.

Science.gov (United States)

Lee, L; Liew, N C; Gee, T

2012-12-01

This survey was conducted to determine the opinions and practices of peri-operative venous thromboembolism (VTE) prophylaxis among surgical and intensive care specialists in Asia. A set of questionnaire was distributed to surgeons and intensivists from different countries in Asia. The specialties included were general surgery and its sub-specialties, orthopaedic surgery, gynaecological surgery and intensive care unit. This survey involved teaching institutions, general hospitals and private hospitals. To gauge if the respondents were from hospitals that would likely encounter VTE cases, the hospital's bed-strength, intensive care facility and sub-specialty services were recorded. Over a period of six months, questionnaires and feedbacks were collected and analyzed. One hundred and ninety-one responses were received from 8 countries throughout Asia. Fifty-six percent of these were from large hospitals (800 bedded or more) and 62% of these hospitals have large intensive care facility (20 or more beds). Only half of the respondents practice routine thromboprophylaxis in moderate and high risk surgeries. Thirty six percent of them practices selective thromboprophylaxis and only 3% do not believe in any thromboprophylaxis. A third prescribed thromboprophylaxis for 3 to 5 days; another third extended it until patient is mobile. About 48.6% of the respondents do not have VTE guidelines in their institutions. Majority of the respondents agreed that more evidence is needed in the form of multi-centre randomized controlled trials to influence their decision on thromboprophylaxis. Despite the availability of strong epidemiological data, randomized controlled trials and multicentre case-controlled studies, perioperative VTE prophylactic practices are still suboptimal in Asia.

Perceptions About the Present and Future of Surgical Simulation: A National Study of Mixed Qualitative and Quantitative Methodology.

Science.gov (United States)

Yiasemidou, Marina; Glassman, Daniel; Tomlinson, James; Song, David; Gough, Michael J

Assess expert opinion on the current and future role of simulation in surgical education. Expert opinion was sought through an externally validated questionnaire that was disseminated electronically. Heads of Schools of Surgery (HoS) (and deputies) and Training Program Directors (TPD) (and deputies). Simulation was considered a good training tool (HoS: 15/15, TPD: 21/21). The concept that simulation is useful mostly to novices and for basic skills acquisition was rejected (HoS: 15/15, TPDs: 21/21; HoS: 13/15, TPDs: 18/21). Further, simulation is considered suitable for teaching nontechnical skills (HoS: 13/15, TPDs: 20/21) and re-enacting stressful situations (HoS: 14/15, TPDs: 15/21). Most respondents also felt that education centers should be formally accredited (HoS: 12/15, TPDs: 16/21) and that consultant mentors should be appointed by every trust (HoS: 12/15, TPDs: 19/21). In contrast, there were mixed views on its use for trainee assessment (HoS: 6/15, TPDs: 14/21) and whether it should be compulsory (HoS: 8/15, TPDs: 11/21). The use of simulation for the acquirement of both technical and nontechnical skills is strongly supported while views on other applications (e.g., assessment) are conflicting. Further, the need for center accreditation and supervised, consultant-led teaching is highlighted. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surveyed opinion of American trauma, orthopedic, and thoracic surgeons on rib and sternal fracture repair.

Science.gov (United States)

Mayberry, John C; Ham, L Bruce; Schipper, Paul H; Ellis, Thomas J; Mullins, Richard J

2009-03-01

Rib and sternal fracture repair are controversial. The opinion of surgeons regarding those patients who would benefit from repair is unknown. Members of the Eastern Association for the Surgery of Trauma, the Orthopedic Trauma Association, and thoracic surgeons (THS) affiliated with teaching hospitals in the United States were recruited to complete an electronic survey regarding rib and sternal fracture repair. Two hundred thirty-eight trauma surgeons (TRS), 97 orthopedic trauma surgeons (OTS), and 70 THS completed the survey. Eighty-two percent of TRS, 66% of OTS, and 71% of THS thought that rib fracture repair was indicated in selected patients. A greater proportion of surgeons thought that sternal fracture repair was indicated in selected patients (89% of TRS, 85% of OTS, and 95% of THS). Chest wall defect/pulmonary hernia (58%) and sternal fracture nonunion (>6 weeks) (68%) were the only two indications accepted by a majority of respondents. Twenty-six percent of surgeons reported that they had performed or assisted on a chest wall fracture repair, whereas 22% of surgeons were familiar with published randomized trials of the surgical repair of flail chest. Of surgeons who thought rib fracture or sternal fracture repair was rarely, if ever, indicated, 91% and 95%, respectively, specified that a randomized trial confirming efficacy would be necessary to change their negative opinion. A majority of surveyed surgeons reported that rib and sternal fracture repair is indicated in selected patients; however, a much smaller proportion indicated that they had performed the procedures. The published literature on surgical repair is sparse and unfamiliar to most surgeons. Barriers to surgical repair of rib and sternal fracture include a lack of expertise among TRS, lack of research of optimal techniques, and a dearth of randomized trials.

Using Opinions and Knowledge to Identify Natural Groups of Gambling Employees.

Science.gov (United States)

Gray, Heather M; Tom, Matthew A; LaPlante, Debi A; Shaffer, Howard J

2015-12-01

Gaming industry employees are at higher risk than the general population for health conditions including gambling disorder. Responsible gambling training programs, which train employees about gambling and gambling-related problems, might be a point of intervention. However, such programs tend to use a "one-size-fits-all" approach rather than multiple tiers of instruction. We surveyed employees of one Las Vegas casino (n = 217) and one online gambling operator (n = 178) regarding their gambling-related knowledge and opinions prior to responsible gambling training, to examine the presence of natural knowledge groups among recently hired employees. Using k-means cluster analysis, we observed four natural groups within the Las Vegas casino sample and two natural groups within the online operator sample. We describe these natural groups in terms of opinion/knowledge differences as well as distributions of demographic/occupational characteristics. Gender and language spoken at home were correlates of cluster group membership among the sample of Las Vegas casino employees, but we did not identify demographic or occupational correlates of cluster group membership among the online gambling operator employees. Gambling operators should develop more sophisticated training programs that include instruction that targets different natural knowledge groups.

Choice Shift in Opinion Network Dynamics

Science.gov (United States)

Gabbay, Michael

Choice shift is a phenomenon associated with small group dynamics whereby group discussion causes group members to shift their opinions in a more extreme direction so that the mean post-discussion opinion exceeds the mean pre-discussion opinion. Also known as group polarization, choice shift is a robust experimental phenomenon and has been well-studied within social psychology. In opinion network models, shifts toward extremism are typically produced by the presence of stubborn agents at the extremes of the opinion axis, whose opinions are much more resistant to change than moderate agents. However, we present a model in which choice shift can arise without the assumption of stubborn agents; the model evolves member opinions and uncertainties using coupled nonlinear differential equations. In addition, we briefly describe the results of a recent experiment conducted involving online group discussion concerning the outcome of National Football League games are described. The model predictions concerning the effects of network structure, disagreement level, and team choice (favorite or underdog) are in accord with the experimental results. This research was funded by the Office of Naval Research and the Defense Threat Reduction Agency.

Opinion dynamics with confirmation bias.

Directory of Open Access Journals (Sweden)

Armen E Allahverdyan

Full Text Available Confirmation bias is the tendency to acquire or evaluate new information in a way that is consistent with one's preexisting beliefs. It is omnipresent in psychology, economics, and even scientific practices. Prior theoretical research of this phenomenon has mainly focused on its economic implications possibly missing its potential connections with broader notions of cognitive science.We formulate a (non-Bayesian model for revising subjective probabilistic opinion of a confirmationally-biased agent in the light of a persuasive opinion. The revision rule ensures that the agent does not react to persuasion that is either far from his current opinion or coincides with it. We demonstrate that the model accounts for the basic phenomenology of the social judgment theory, and allows to study various phenomena such as cognitive dissonance and boomerang effect. The model also displays the order of presentation effect-when consecutively exposed to two opinions, the preference is given to the last opinion (recency or the first opinion (primacy -and relates recency to confirmation bias. Finally, we study the model in the case of repeated persuasion and analyze its convergence properties.The standard Bayesian approach to probabilistic opinion revision is inadequate for describing the observed phenomenology of persuasion process. The simple non-Bayesian model proposed here does agree with this phenomenology and is capable of reproducing a spectrum of effects observed in psychology: primacy-recency phenomenon, boomerang effect and cognitive dissonance. We point out several limitations of the model that should motivate its future development.

Trendwatch combining expert opinion

NARCIS (Netherlands)

Hendrix, E.M.T.; Kornelis, M.; Pegge, S.M.; Galen, van M.A.

2006-01-01

In this study, focus is on a systematic way to detect future changes in trends that may effect the dynamics in the agro-food sector, and on the combination of opinions of experts. For the combination of expert opinions, the usefulness of multilevel models is investigated. Bayesian data analysis is

OpinionSeer: interactive visualization of hotel customer feedback.

Science.gov (United States)

Wu, Yingcai; Wei, Furu; Liu, Shixia; Au, Norman; Cui, Weiwei; Zhou, Hong; Qu, Huamin

2010-01-01

The rapid development of Web technology has resulted in an increasing number of hotel customers sharing their opinions on the hotel services. Effective visual analysis of online customer opinions is needed, as it has a significant impact on building a successful business. In this paper, we present OpinionSeer, an interactive visualization system that could visually analyze a large collection of online hotel customer reviews. The system is built on a new visualization-centric opinion mining technique that considers uncertainty for faithfully modeling and analyzing customer opinions. A new visual representation is developed to convey customer opinions by augmenting well-established scatterplots and radial visualization. To provide multiple-level exploration, we introduce subjective logic to handle and organize subjective opinions with degrees of uncertainty. Several case studies illustrate the effectiveness and usefulness of OpinionSeer on analyzing relationships among multiple data dimensions and comparing opinions of different groups. Aside from data on hotel customer feedback, OpinionSeer could also be applied to visually analyze customer opinions on other products or services.

Opinion

African Journals Online (AJOL)

abp

2015-02-10

Feb 10, 2015 ... thrombophilia, an antiphospholipids syndrome, Behçet´s disease and neoplasia. Medical therapy and surgical resection can be mentioned these thrombotic complication. Surgical treatment could be considered because the right atrial thrombus was mobile and it caused a massive pulmonary embolism.

Multimodal strategies to improve surgical outcome

DEFF Research Database (Denmark)

Kehlet, Henrik; Wilmore, Douglas W

2002-01-01

OBJECTIVE: To evaluate the effect of modifying perioperative care in noncardiac surgical patients on morbidity, mortality, and other outcome measures. BACKGROUND: New approaches in pain control, introduction of techniques that reduce the perioperative stress response, and the more frequent use...... anesthesia in elective operations, and pilot studies of fast track surgical procedures using the multimodality approach. RESULTS: The introduction of newer approaches to perioperative care has reduced both morbidity and mortality in surgical patients. In the future, most elective operations will become day...... surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...

Surgical Critical Care Initiative

Data.gov (United States)

Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

Orthopedic surgeons’ and neurologists’ attitudes towards second opinions in the Israeli healthcare system: a qualitative study

Directory of Open Access Journals (Sweden)

Greenfield Geva

2012-07-01

Full Text Available Abstract Background Second opinion is a treatment ratification tool that may critically influence diagnosis, treatment, and prognosis. Second opinions constitute one of the largest expenditures of the supplementary health insurance programs provided by the Israeli health funds. The scarcity of data on physicians’ attitudes toward second opinion motivated this study to explore those attitudes within the Israeli healthcare system. Methods We interviewed 35 orthopedic surgeons and neurologists in Israel and qualitatively analyzed the data using the Grounded Theory approach. Results As a common tool, second opinion reflects the broader context of the Israeli healthcare system, specifically tensions associated with health inequalities. We identified four issues: (1 inequalities between central and peripheral regions of Israel; (2 inequalities between private and public settings; (3 implementation gap between the right to a second opinion and whether it is covered by the National Health Insurance Law; and (4 tension between the authorities of physicians and religious leaders. The physicians mentioned that better mechanisms should be implemented for guiding patients to an appropriate consultant for a second opinion and for making an informed choice between the two opinions. Conclusions While all the physicians agreed on the importance of the second opinion as a tool, they raised concerns about the way it is provided and utilized. To be optimally implemented, second opinion should be institutionalized and regulated. The National Health Insurance Law should strive to provide the mechanisms to access second opinion as stipulated in the Patient’s Rights Law. Further studies are needed to assess the patients' perspectives.

Personal Perceptions and Perceived Public Opinion About Stuttering in the United States: Implications for Anti-Stigma Campaigns.

Science.gov (United States)

Boyle, Michael P

2017-08-15

This exploratory study was the first to obtain quantitative and qualitative data on both personal perceptions and perceived public opinion about stuttering in order to identify topics to include in anti-stigma programs for stuttering. Three-hundred ten adults in the United States completed a web survey that assessed knowledge about stuttering and attitudes toward people who stutter (PWS) with questions addressing personal perceptions (direct questions) and perceived public opinion (indirect questions). Many participants reported favorable personal perceptions of PWS regarding their intelligence, competence, and potential for success. However, most participants did not personally believe PWS were confident, and most believed they were shy. Perceived public opinion was more unfavorable as a majority agreed that the public is uncomfortable talking with PWS and that the public would recommend PWS avoid jobs requiring high speech demands and avoid talking to large audiences. A minority of participants agreed PWS are perceived publicly as capable or mentally healthy. The survey demonstrated misunderstandings and negative perceptions of PWS, especially when measured with perceived public opinion. Results can increase our understanding of content areas that should be included in anti-stigma programs for stuttering and highlight different methods for analyzing public perceptions of stuttering.

Opinion formation models on a gradient.

Directory of Open Access Journals (Sweden)

Michael T Gastner

Full Text Available Statistical physicists have become interested in models of collective social behavior such as opinion formation, where individuals change their inherently preferred opinion if their friends disagree. Real preferences often depend on regional cultural differences, which we model here as a spatial gradient g in the initial opinion. The gradient does not only add reality to the model. It can also reveal that opinion clusters in two dimensions are typically in the standard (i.e., independent percolation universality class, thus settling a recent controversy about a non-consensus model. However, using analytical and numerical tools, we also present a model where the width of the transition between opinions scales proportional g(-1/4, not proportional g(-4/7 as in independent percolation, and the cluster size distribution is consistent with first-order percolation.

Ambulatory Surgical Measures - Facility

Data.gov (United States)

U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

[Medical data security in medico-legal opinioning].

Science.gov (United States)

Susło, Robert; Swiatek, Barbara

2005-01-01

Medical data security can be approached in medico-legal opinioning in three main situations: security of medical data, on which the opinion should be based, opinioning itself and whether the medical data security was properly ensured and ensuring medical data security during medico-legal opinion giving. The importance of medical data security, during collecting, processing and storing, as well in medical as in legal institutions, is of major importance for the possibility of providing a proper medico-legal opinion. Theoretically speeking, it is possible to give a proper medico-legal opinion using incorrect data, but the possibility is low. When the expert is given improper, unreadable, incomplete or even bogus in part or in the whole medical data it is extremely possible, that he fails in giving his opinion. The term "medical data" was defined and subsequently there was a brief review of medical data storing methods made and specific threats bound with them, based on modern literature. The authors also pointed out possible methods of preventing the threats. They listed Polish as well as international regulations and laws concerning the problem, accenting the importance of preserving medical data for the purposes of medico-legal opinioning.

Opinion evolution in different social acquaintance networks

Science.gov (United States)

Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

2017-11-01

Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion ph and variation proportion pv are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve pv+2 ph=2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

Survey Methods, Traditional, Public Opinion Polling

DEFF Research Database (Denmark)

Elmelund-Præstekær, Christian; Hopmann, David Nicolas; Pedersen, Rasmus Tue

2017-01-01

Traditional public opinion polls are surveys in which a random sample of a given population is asked questions about their attitudes, knowledge, or behavior. If conducted properly, the answers from such surveys are approximately representative of the entire population. Traditional public opinion...... polling is typically based on four different methods of data gathering, or combinations hereof: face-to-face, postal surveys, phone surveys, and web surveys. Given that opinion polls are based on a sample, we cannot be sure that the sample reflects public opinion perfectly, however—even if randomness...... is perfect. Moreover, responses may be highly dependent on the contextual information provided with the question. Also, it may be difficult to capture past or complex causes of attitudes or behavior. In short, surveys are a precise way of measuring public opinion, but they do not come without challenges....

Opinion Change: Information or Partisanship?

DEFF Research Database (Denmark)

Justesen, Mogens K.; Klemmensen, Robert; Leavitt, Thomas

Currently two paradigms seek to explain how voters change their opinion when they are confronted with new information. One school argues that voters are bayesian updaters who rationally change their opinion. Another school argues that voters are inherently biased in their evaluation of new...... information. According to this line of thought voters are more likely to accept information that con_rms their opinion compared to information that contradict their point of view. Using a quasi experiment we investigate the extent to which voters rely on bayesian updating or on motivated reasoning when...

Opinion Summarizationof CustomerComments

Science.gov (United States)

Fan, Miao; Wu, Guoshi

Web 2.0 technologies have enabled more and more customers to freely comment on different kinds of entities, such as sellers, products and services. The large scale of information poses the need and challenge of automatic summarization. In many cases, each of the user-generated short comments implies the opinions which rate the target entity. In this paper, we aim to mine and to summarize all the customer comments of a product. The algorithm proposed in this researchis more reliable on opinion identification because it is unsupervised and the accuracy of the result improves as the number of comments increases. Our research is performed in four steps: (1) mining the frequent aspects of a product that have been commented on by customers; (2) mining the infrequent aspects of a product which have been commented by customers (3) identifying opinion words in each comment and deciding whether each opinion word is positive, negative or neutral; (4) summarizing the comments. This paper proposes several novel techniques to perform these tasks. Our experimental results using comments of a number of products sold online demonstrate the effectiveness of the techniques.

Open surgical simulation--a review.

Science.gov (United States)

Davies, Jennifer; Khatib, Manaf; Bello, Fernando

2013-01-01

open surgical procedure. Better quality research is needed into the benefits of open surgical simulation, and this would hopefully stimulate further development of simulators with more accurate and objective assessment tools. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

42 CFR 411.375 - Fees for the cost of advisory opinions.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Fees for the cost of advisory opinions. 411.375... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.375 Fees for the cost... revised the amount of the initial fee in a program issuance, in which case, the requestor must include the...

The surgical dilemma of 'functional inoperability' in oral and oropharyngeal cancer: current consensus on operability with regard to functional results

NARCIS (Netherlands)

Kreeft, A.; Tan, I. B.; van den Brekel, M. W. M.; Hilgers, F. J.; Balm, A. J. M.

2009-01-01

OBJECTIVES: If surgical resection of a tumour results in an unacceptable loss of function, this is defined as 'functional inoperability'. The current survey aims to define the borders of functional inoperability in oral and oropharyngeal carcinoma and evaluate its current use by obtaining opinions

A Self-Categorization Explanation for Opinion Consensus Perceptions

Science.gov (United States)

Zhang, Jinguang; Reid, Scott A.

2013-01-01

The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

Science.gov (United States)

Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

2015-11-01

With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

Incorporating simulation into gynecologic surgical training.

Science.gov (United States)

Wohlrab, Kyle; Jelovsek, J Eric; Myers, Deborah

2017-11-01

Today's educational environment has made it more difficult to rely on the Halstedian model of "see one, do one, teach one" in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted learning from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training. We review high- and low-fidelity surgical simulators, discuss the progression of surgical skills, and provide options for skills competency assessment. Time and money are major hurdles when designing a simulation curriculum, but low-fidelity models, intradepartmental cost sharing, and utilizing local experts for simulation proctoring can aid in developing a simulation program. Copyright © 2017 Elsevier Inc. All rights reserved.

Anisotropic opinion dynamics

Science.gov (United States)

Neirotti, Juan

2016-07-01

We consider the process of opinion formation in a society of interacting agents, where there is a set B of socially accepted rules. In this scenario, we observed that agents, represented by simple feed-forward, adaptive neural networks, may have a conservative attitude (mostly in agreement with B ) or liberal attitude (mostly in agreement with neighboring agents) depending on how much their opinions are influenced by their peers. The topology of the network representing the interaction of the society's members is determined by a graph, where the agents' properties are defined over the vertexes and the interagent interactions are defined over the bonds. The adaptability of the agents allows us to model the formation of opinions as an online learning process, where agents learn continuously as new information becomes available to the whole society (online learning). Through the application of statistical mechanics techniques we deduced a set of differential equations describing the dynamics of the system. We observed that by slowly varying the average peer influence in such a way that the agents attitude changes from conservative to liberal and back, the average social opinion develops a hysteresis cycle. Such hysteretic behavior disappears when the variance of the social influence distribution is large enough. In all the cases studied, the change from conservative to liberal behavior is characterized by the emergence of conservative clusters, i.e., a closed knitted set of society members that follow a leader who agrees with the social status quo when the rule B is challenged.

Opinion evolution in different social acquaintance networks.

Science.gov (United States)

Chen, Xi; Zhang, Xiao; Wu, Zhan; Wang, Hongwei; Wang, Guohua; Li, Wei

2017-11-01

Social acquaintance networks influenced by social culture and social policy have a great impact on public opinion evolution in daily life. Based on the differences between socio-culture and social policy, three different social acquaintance networks (kinship-priority acquaintance network, independence-priority acquaintance network, and hybrid acquaintance network) incorporating heredity proportion p h and variation proportion p v are proposed in this paper. Numerical experiments are conducted to investigate network topology and different phenomena during opinion evolution, using the Deffuant model. We found that in kinship-priority acquaintance networks, similar to the Chinese traditional acquaintance networks, opinions always achieve fragmentation, resulting in the formation of multiple large clusters and many small clusters due to the fact that individuals believe more in their relatives and live in a relatively closed environment. In independence-priority acquaintance networks, similar to Western acquaintance networks, the results are similar to those in the kinship-priority acquaintance network. In hybrid acquaintance networks, similar to the Chinese modern acquaintance networks, only a few clusters are formed indicating that in modern China, opinions are more likely to reach consensus on a large scale. These results are similar to the opinion evolution phenomena in modern society, proving the rationality and applicability of network models combined with social culture and policy. We also found a threshold curve p v +2p h =2.05 in the results for the final opinion clusters and evolution time. Above the threshold curve, opinions could easily reach consensus. Based on the above experimental results, a culture-policy-driven mechanism for the opinion dynamic is worth promoting in this paper, that is, opinion dynamics can be driven by different social cultures and policies through the influence of heredity and variation in interpersonal relationship networks. This

Use of a Surgical Safety Checklist to Improve Team Communication.

Science.gov (United States)

Cabral, Richard A; Eggenberger, Terry; Keller, Kathryn; Gallison, Barry S; Newman, David

2016-09-01

To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = -1.72, P improved surgical teamwork behaviors and an enhanced culture of safety in the OR. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

How Public Opinion is Formed

Science.gov (United States)

Block, Edward M.

1977-01-01

Investigates the evolution of the definition of public relations by examining cultural and personal determinants of public opinion. Outlines functions of communicators and opinionmakers in forming and influencing public opinion. Available from: Public Relations Review, Ray Hiebert, Dean, College of Journalism, University of Maryland, College Park,…

Assessing the Nontechnical Skills of Surgical Trainees: Views of the Theater Team.

Science.gov (United States)

Al-Jundi, Wissam; Wild, Jonathan; Ritchie, Judith; Daniels, Sarah; Robertson, Eleanor; Beard, Jonathan

2016-01-01

This study aims to explore the views of members of theater teams regarding the proposed introduction of a workplace-based assessment of nontechnical skills of surgeons (NOTSS) into the Intercollegiate Surgical Curriculum Programme in the United Kingdom. In addition, the previous training and familiarity of the members of the surgical theater team with the concept and assessment of NOTSS would be evaluated. A regional survey of members of theater teams (consultant surgeons, anesthetists, scrub nurses, and trainees) was performed at 1 teaching and 2 district general hospitals in South Yorkshire. There were 160 respondents corresponding to a response rate of 81%. The majority (77%) were not aware of the NOTSS assessment tool with only 9% of respondents reporting to have previously used the NOTSS tool and just 3% having received training in NOTSS assessment. Overall, 81% stated that assessing NOTSS was as important as assessing technical skills. Trainees attributed less importance to nontechnical skills than the other groups (p ≤ 0.016). Although opinion appears divided as to whether the presence of a consultant surgeon in theater could potentially make it difficult to assess a trainee's leadership skills and decision-making capabilities, overall 60% agree that the routine use of NOTSS assessment would enhance safety in the operating theater and 80% agree that the NOTSS tool should be introduced to assess the nontechnical skills of trainees in theater. However, a significantly lower proportion of trainees (45%) agreed on the latter compared with the other groups (p = 0.001). Our survey demonstrates acceptability among the theater team for the introduction of the NOTSS tool into the surgical curriculum. However, lack of familiarity highlights the importance of faculty training for assessors before such an introduction. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surgical innovation: the ethical agenda: A systematic review.

Science.gov (United States)

Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

2016-06-01

The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation.Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges.To answer the question "What are the main ethical aspects of surgical innovation?", we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers.We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure.We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health care system might

Surgical Residency Training in Developing Countries: West African College of Surgeons as a Case Study.

Science.gov (United States)

Ajao, Oluwole Gbolagunte; Alao, Adekola

2016-01-01

In 1904, William Halsted introduced the present model of surgical residency program which has been adopted worldwide. In some developing countries, where surgical residency training programs are new, some colleges have introduced innovations to the Halsted's original concept of surgical residency training. These include 1) primary examination, 2) rural surgical posting, and 3) submission of dissertation for final certification. Our information was gathered from the publications on West African College of Surgeons' (WACS) curriculum of the medical schools, faculty papers of medical schools, and findings from committees of medical schools. Verbal information was also gathered via interviews from members of the WACS. Additionally, our personal experience as members and examiners of the college are included herein. We then noted the differences between surgical residency training programs in the developed countries and that of developing countries. The innovations introduced into the residency training programs in the developing countries are mainly due to the emphasis placed on paper qualifications and degrees instead of performance. We conclude that the innovations introduced into surgical residency training programs in developing countries are the result of the misconception of what surgical residency training programs entail. Published by Elsevier Inc.

Utility of 3D Reconstruction of 2D Liver Computed Tomography/Magnetic Resonance Images as a Surgical Planning Tool for Residents in Liver Resection Surgery.

Science.gov (United States)

Yeo, Caitlin T; MacDonald, Andrew; Ungi, Tamas; Lasso, Andras; Jalink, Diederick; Zevin, Boris; Fichtinger, Gabor; Nanji, Sulaiman

A fundamental aspect of surgical planning in liver resections is the identification of key vessel tributaries to preserve healthy liver tissue while fully resecting the tumor(s). Current surgical planning relies primarily on the surgeon's ability to mentally reconstruct 2D computed tomography/magnetic resonance (CT/MR) images into 3D and plan resection margins. This creates significant cognitive load, especially for trainees, as it relies on image interpretation, anatomical and surgical knowledge, experience, and spatial sense. The purpose of this study is to determine if 3D reconstruction of preoperative CT/MR images will assist resident-level trainees in making appropriate operative plans for liver resection surgery. Ten preoperative patient CT/MR images were selected. Images were case-matched, 5 to 2D planning and 5 to 3D planning. Images from the 3D group were segmented to create interactive digital models that the resident can manipulate to view the tumor(s) in relation to landmark hepatic structures. Residents were asked to evaluate the images and devise a surgical resection plan for each image. The resident alternated between 2D and 3D planning, in a randomly generated order. The primary outcome was the accuracy of resident's plan compared to expert opinion. Time to devise each surgical plan was the secondary outcome. Residents completed a prestudy and poststudy questionnaire regarding their experience with liver surgery and the 3D planning software. Senior level surgical residents from the Queen's University General Surgery residency program were recruited to participate. A total of 14 residents participated in the study. The median correct response rate was 2 of 5 (40%; range: 0-4) for the 2D group, and 3 of 5 (60%; range: 1-5) for the 3D group (p surgery planning increases accuracy of resident surgical planning and decreases amount of time required. 3D reconstruction would be a useful model for improving trainee understanding of liver anatomy and surgical

The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs.

Science.gov (United States)

Korndorffer, James R; Arora, Sonal; Sevdalis, Nick; Paige, John; McClusky, David A; Stefanidis, Dimitris

2013-07-01

The American College of Surgeons/Association of Program Directors in Surgery (ACS/APDS) National Skills Curriculum is a 3-phase program targeting technical and nontechnical skills development. Few data exist regarding the adoption of this curriculum by surgical residencies. This study attempted to determine the rate of uptake and identify implementation enablers/barriers. A web-based survey was developed by an international expert panel of surgical educators (5 surgeons and 1 psychologist). After piloting, the survey was sent to all general surgery program directors via email link. Descriptive statistics were used to determine the residency program characteristics and perceptions of the curriculum. Implementation rates for each phase and module were calculated. Adoption barriers were identified quantitatively and qualitatively using free text responses. Standardized qualitative methodology of emergent theme analysis was used to identify strategies for success and details of support required for implementation. Of the 238 program directors approached, 117 (49%) responded to the survey. Twenty-one percent (25/117) were unaware of the ACS/APDS curriculum. Implementation rates for were 36% for phase I, 19% for phase II, and 16% for phase III. The most common modules adopted were the suturing, knot-tying, and chest tube modules of phase I. Over 50% of respondents identified lack of faculty protected time, limited personnel, significant costs, and resident work-hour restrictions as major obstacles to implementation. Strategies for effective uptake included faculty incentives, adequate funding, administrative support, and dedicated time and resources. Despite the availability of a comprehensive curriculum, its diffusion into general surgery residency programs remains low. Obstacles related to successful implementation include personnel, learner, and administrative issues. Addressing these issues may improve the adoption rate of the curriculum. Copyright © 2013 Mosby, Inc

28 CFR 80.8 - Attorney General opinion.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Attorney General opinion. 80.8 Section 80.8 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) FOREIGN CORRUPT PRACTICES ACT OPINION PROCEDURE § 80.8 Attorney General opinion. The Attorney General or his designee shall, within 30 days after...

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program.

Science.gov (United States)

Denadai, Rafael; Saad-Hossne, Rogério; Martinhão Souto, Luís Ricardo

2013-05-01

Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

Identifying Opinion Leaders to Promote Behavior Change

Science.gov (United States)

Valente, Thomas W.; Pumpuang, Patchareeya

2007-01-01

This article reviews 10 techniques used to identify opinion leaders to promote behavior change. Opinion leaders can act as gatekeepers for interventions, help change social norms, and accelerate behavior change. Few studies document the manner in which opinion leaders are identified, recruited, and trained to promote health. The authors categorize…

UK Public Opinion Review - Working Paper - An overview of public opinion polls since the Edward Snowden revelations in June 2013

OpenAIRE

Cable, Jonathan

2015-01-01

This document charts public opinion of the Edward Snowden leaks and associated issues\\ud since June 2013. This includes people’s opinions on surveillance, the intelligence services\\ud and personal privacy. Since the Snowden leaks there have been 38 opinion polls on these\\ud topics concerning public opinion in the UK and conducted by large polling organisations,\\ud such as YouGov, ComRes and Ipsos MORI among others.

Opinion survey on energy and climate in 2013

International Nuclear Information System (INIS)

Martin, Jean-Philippe

2013-08-01

This issue comments the results of a survey on the opinion of French people on the reality of climate change (for the whole population and with respect to age), on the opinion of French people on nuclear energy (in relationship with the opinion on climate change, globally in terms of benefit or drawback with evolution of the opinion since 1994), on the feeling of having suffered from the cold during the winter of 2012-2013, on the dwelling temperature in winter, and on the opinion on energy price

Applications of flow-networks to opinion-dynamics

Science.gov (United States)

Tupikina, Liubov; Kurths, Jürgen

2015-04-01

Networks were successfully applied to describe complex systems, such as brain, climate, processes in society. Recently a socio-physical problem of opinion-dynamics was studied using network techniques. We present the toy-model of opinion-formation based on the physical model of advection-diffusion. We consider spreading of the opinion on the fixed subject, assuming that opinion on society is binary: if person has opinion then the state of the node in the society-network equals 1, if the person doesn't have opinion state of the node equals 0. Opinion can be spread from one person to another if they know each other, or in the network-terminology, if the nodes are connected. We include into the system governed by advection-diffusion equation the external field to model such effects as for instance influence from media. The assumptions for our model can be formulated as the following: 1.the node-states are influenced by the network structure in such a way, that opinion can be spread only between adjacent nodes (the advective term of the opinion-dynamics), 2.the network evolution can have two scenarios: -network topology is not changing with time; -additional links can appear or disappear each time-step with fixed probability which requires adaptive networks properties. Considering these assumptions for our system we obtain the system of equations describing our model-dynamics which corresponds well to other socio-physics models, for instance, the model of the social cohesion and the famous voter-model. We investigate the behavior of the suggested model studying "waiting time" of the system, time to get to the stable state, stability of the model regimes for different values of model parameters and network topology.

An online survey of chiropractors' opinions of continuing education

Directory of Open Access Journals (Sweden)

Smith Dean L

2005-10-01

Full Text Available Abstract Background Continuing Education (CE for chiropractors is mandatory for licensure in most North American jurisdictions. Numerous chiropractic colleges have begun collaborating with universities to offer master's degree programs. Distance education master's degree programs may be desirable to allow full-time practicing doctors to further their post-graduate education. The present survey sought to answer three questions. First, what is the level of satisfaction of chiropractors with their continuing education? Second, what is the level of interest of chiropractors in online master's degree programs? Lastly, what is the response rate of chiropractors to an online survey? Methods An online survey consisting of 22 multiple choice questions was e-mailed to 1000 chiropractors randomly selected from the mailing list of an online chiropractic newsletter. Upon completion of the questionnaire, participants' answers were saved on a secure site. Data analysis included evaluation of the demographic characteristics of the respondents, their opinions of and patterns of taking CE including online education, preferred learning formats, and their interest in proposed online master's degree programs. A survey response rate was determined. Results Nearly 86% of respondents felt their previously completed CE courses were either somewhat or extremely satisfactory. Over ninety percent of respondents who had completed online or distance CE coursesfound them to be somewhat or extremelysatisfactory. Almost half the respondents indicated that they most preferred online distance learning, while 34.08% most preferred face-to-face interaction. Fifty-three percent of respondents indicated an interest in starting a master's degree program; however 70.46% of respondents were interested in an online master's degree program that would offer CE credit. A response rate of 35.8% was obtained. Conclusion Satisfaction among chiropractors with CE programs is high. The notion of

Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

Science.gov (United States)

Flache, Andreas; Mäs, Michael

2016-01-01

Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or disliking of the source of influence. There is strong empirical support for the presence of positive social influence (a shift towards the opinion of others), but evidence that large opinion differences or disliking could trigger negative shifts is mixed. We examine positive and negative influence with controlled exposure to opinions of other individuals in one experiment and with opinion exchange in another study. Results confirm that similarities induce attraction, but results do not support that discrepancy or disliking entails negative influence. Instead, our findings suggest a robust positive linear relationship between opinion distance and opinion shifts. PMID:27333160

Effects of CO{sub 2} sanitation program for buildings 2008. Expert opinion; Effekte des CO{sub 2}-Gebaeudesanierungsprogramms 2008. Gutachten

Energy Technology Data Exchange (ETDEWEB)

Clausnitzer, Klaus-Dieter; Gabriel, Juergen; Eilmes, Sabine [Bremer Energie-Institut, Bremen (Germany); Diefenbach, Nikolaus; Loga, Tobias [Institut Wohnen und Umwelt GmbH, Darmstadt (Germany); Wosniok, Werner [Bremen Univ. (Germany). Inst. fuer Statistik

2008-07-01

The climate protection, the securing of the power supply as well as the enabling of payable energy costs belong to the central tasks to the policy. In the year 2006, the working group consisting of the Bremen Energie Institute (Bremen, Federal Republic of Energy), Institute Wohnen und Umwelt GmbH (Darmstadt, Federal Republic of Germany) and the Institute for Statistics of the University of Bremen (Bremen, Federal Republic of Germany) was ordered to develop a model for the estimation of the positive effects of the CO{sub 2} sanitation program for buildings according to the reduction of CO{sub 2}, conservation of final energy, employment, progress in modernization and saving of heating cost. In the expert opinion under consideration, the influences are stated for the case of loan and grant for the year 2008.

The impact of a surgical boot camp on early acquisition of technical and nontechnical skills by novice surgical trainees.

Science.gov (United States)

Heskin, Leonie; Mansour, Ehab; Lane, Brian; Kavanagh, Dara; Dicker, Pat; Ryan, Donncha; Gildea-Byrne, Kate; Pawlikowska, Teresa; Tierney, Sean; Traynor, Oscar

2015-09-01

Acquisition of skills early in surgical training represents a significant challenge at present because of training time constraints. The aim of this study was to investigate if an intensive surgical boot camp was effective in transferring skills at the beginning of a surgical training program. New core surgical trainees (n = 58) took part in a 5-day boot camp. There were pretest and posttest assessments of knowledge, technical skills, and confidence levels. The boot camp used simulation and senior surgical faculty to teach a defined range of technical and nontechnical skills. The scores for knowledge (53.8% vs 68.4%, P technical skills (35.9% to 60.6% vs 50.6% to 78.2%, P Skills improvements were still present a year later. The 5-day surgical boot camp proved to be an effective way to rapidly acquire surgical knowledge and skills while increasing the confidence levels of trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

'Quicksand' of public opinion - trust in nuclear after Fukushima

International Nuclear Information System (INIS)

Gieci, Adam; Maly, Stanislav; Palecek, Milos

2012-01-01

The following public opinion surveys are described: public opinion on nuclear power plants by the end of 2010; first public opinion polls after Fukushima in the US, UK and France; and public opinion and the future of nuclear in Japan. The following issues are discussed: Has nuclear any perspective after Fukushima? Will public opinion change after the Fukushima accident like it did after the TMI event? Will public opinion change after the Fukushima accident like it did after the oil spill accident in the Gulf of Mexico? In conclusion the new approaches to the fight for public confidence after Fukushima are described. (orig.)

Geriatric screening in first opinion practice – results from 45 dogs

Science.gov (United States)

Davies, M

2012-01-01

Objectives To evaluate and report the results of screening geriatric dogs in a first opinion practice. Methods A prospective health screen of dogs over nine-years-old involving history taking, physical examination and urinalysis. Results At least one previously unrecognised problem was identified in 80% of 45 dogs and 353 findings (mean 7·8 per dog) were recorded. Owners often failed to recognise and report serious signs of age-related disease. However, they most often reported increased sleeping (31%), loss of hearing (29%) or sight (20%), stiffness or lameness (22%) and “slowing down” (20%). Increased lens opacity (64%), increased thirst (58%), pain (24%), increased frequency of urination (24%), signs of osteoarthritis (24%) and dental disease (22%) were most frequently identified at the time of consultation. Potentially, life-threatening findings included respiratory distress, palpable abdominal masses and metastatic lung disease. Screening resulted in 29 further diagnostic procedures, including 10 dental procedures, seven medical treatments, two surgical procedures and euthanasia of two dogs. Clinical Significance Screening elderly dogs identified unrecognised and unreported health risk factors resulting in lifestyle modification and ongoing monitoring, as well as signs of age-related diseases resulting in diagnostic investigations, early diagnoses and surgical and medical interventions to improve quality of life. PMID:22835038

Discrete Opinion Dynamics on Online Social Networks

International Nuclear Information System (INIS)

Hu Yan-Li; Bai Liang; Zhang Wei-Ming

2013-01-01

This paper focuses on the dynamics of binary opinions {+1, −1} on online social networks consisting of heterogeneous actors. In our model, actors update their opinions under the interplay of social influence and self- affirmation, which leads to rich dynamical behaviors on online social networks. We find that the opinion leading to the consensus features an advantage of the initially weighted fraction based on actors' strength over the other, instead of the population. For the role of specific actors, the consensus converges towards the opinion that a small fraction of high-strength actors hold, and individual diversity of self-affirmation slows down the ordering process of consensus. These indicate that high-strength actors play an essential role in opinion formation with strong social influence as well as high persistence. Further investigations show that the initial fraction of high-strength actors to dominate the evolution depends on the heterogeneity of the strength distribution, and less high-strength actors are needed in the case of a smaller exponent of power-law distribution of actors' strength. Our study provides deep insights into the role of social influence and self-affirmation on opinion formation on online social networks. (general)

Discrete Opinion Dynamics on Online Social Networks

Science.gov (United States)

Hu, Yan-Li; Bai, Liang; Zhang, Wei-Ming

2013-01-01

This paper focuses on the dynamics of binary opinions {+1, -1} on online social networks consisting of heterogeneous actors. In our model, actors update their opinions under the interplay of social influence and self- affirmation, which leads to rich dynamical behaviors on online social networks. We find that the opinion leading to the consensus features an advantage of the initially weighted fraction based on actors' strength over the other, instead of the population. For the role of specific actors, the consensus converges towards the opinion that a small fraction of high-strength actors hold, and individual diversity of self-affirmation slows down the ordering process of consensus. These indicate that high-strength actors play an essential role in opinion formation with strong social influence as well as high persistence. Further investigations show that the initial fraction of high-strength actors to dominate the evolution depends on the heterogeneity of the strength distribution, and less high-strength actors are needed in the case of a smaller exponent of power-law distribution of actors' strength. Our study provides deep insights into the role of social influence and self-affirmation on opinion formation on online social networks.

Opinion data mining based on DNA method and ORA software

Science.gov (United States)

Tian, Ru-Ya; Wu, Lei; Liang, Xiao-He; Zhang, Xue-Fu

2018-01-01

Public opinion, especially the online public opinion is a critical issue when it comes to mining its characteristics. Because it can be formed directly and intensely in a short time, and may lead to the outbreak of online group events, and the formation of online public opinion crisis. This may become the pushing hand of a public crisis event, or even have negative social impacts, which brings great challenges to the government management. Data from the mass media which reveal implicit, previously unknown, and potentially valuable information, can effectively help us to understand the evolution law of public opinion, and provide a useful reference for rumor intervention. Based on the Dynamic Network Analysis method, this paper uses ORA software to mine characteristics of public opinion information, opinion topics, and public opinion agents through a series of indicators, and quantitatively analyzed the relationships between them. The results show that through the analysis of the 8 indexes associating with opinion data mining, we can have a basic understanding of the public opinion characteristics of an opinion event, such as who is important in the opinion spreading process, the information grasping condition, and the opinion topics release situation.

U.S. aerospace industry opinion of the effect of computer-aided prediction-design technology on future wind-tunnel test requirements for aircraft development programs

Science.gov (United States)

Treon, S. L.

1979-01-01

A survey of the U.S. aerospace industry in late 1977 suggests that there will be an increasing use of computer-aided prediction-design technology (CPD Tech) in the aircraft development process but that, overall, only a modest reduction in wind-tunnel test requirements from the current level is expected in the period through 1995. Opinions were received from key spokesmen in 23 of the 26 solicited major companies or corporate divisions involved in the design and manufacture of nonrotary wing aircraft. Development programs for nine types of aircraft related to test phases and wind-tunnel size and speed range were considered.

Ostomy Home Skills Program

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Full Text Available ... and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

An overview of pre-surgical evaluation

Directory of Open Access Journals (Sweden)

Kurupath Radhakrishnan

2014-01-01

Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

Getting a Second Opinion Before Surgery

Science.gov (United States)

... for a second opinion before surgery. When your doctor says you have a health problem that needs surgery, you have the right to: • Know and understand your treatment choices • Have another doctor look at those choices with you (second opinion) • ...

Psychology Student Opinion of Virtual Reality as a Tool to Educate about Schizophrenia

Science.gov (United States)

Tichon, Jennifer; Loh, Jennifer; King, Robert

2004-01-01

Virtual Reality (VR) techniques are increasingly being used in e-health education, training and in trial clinical programs in the treatment of certain types of mental illness. Undergraduate psychology student opinion of the use of Virtual Reality (VR) to teach them about schizophrenia at the University of Queensland, was determined with reference…

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

Directory of Open Access Journals (Sweden)

Rafael Denadai

2013-01-01

Full Text Available Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

Social opinion dynamics is not chaotic

Science.gov (United States)

Lim, Chjan; Zhang, Weituo

2016-08-01

Motivated by the research on social opinion dynamics over large and dense networks, a general framework for verifying the monotonicity property of multi-agent dynamics is introduced. This allows a derivation of sociologically meaningful sufficient conditions for monotonicity that are tailor-made for social opinion dynamics, which typically have high nonlinearity. A direct consequence of monotonicity is that social opinion dynamics is nonchaotic. A key part of this framework is the definition of a partial order relation that is suitable for a large class of social opinion dynamics such as the generalized naming games. Comparisons are made to previous techniques to verify monotonicity. Using the results obtained, we extend many of the consequences of monotonicity to this class of social dynamics, including several corollaries on their asymptotic behavior, such as global convergence to consensus and tipping points of a minority fraction of zealots or leaders.

Royal College surgical objectives of urologic training: A survey of faculty members from Canadian training programs

Science.gov (United States)

Zakaria, Ahmed S.; Haddad, Richard; Dragomir, Alice; Kassouf, Wassim; Andonian, Sero; Aprikian, Armen G.

2014-01-01

Introduction: According to the Royal College objectives of training in urology, urologic surgical procedures are divided as category A, B and C. We wanted to determine the level of proficiency required and achieved by urology training faculty for Royal College accreditation. Methods: We conducted a survey that was sent electronically to all Canadian urology training faculty. Questions focused on demographics (i.e., years of practice, geographic location, subspecialty, access to robotic surgery), operating room contact with residents, opinion on the level of proficiency required from a list of 54 surgical procedures, and whether their most recent graduates attained category A proficiency in these procedures. Results: The response rate was 43.7% (95/217). Among respondents, 92.6% were full timers, 21.1% practiced urology for less than 5 years and 3.2% for more than 30 years. Responses from Quebec and Ontario formed 69.4% (34.7% each). Of the respondents, 37.9% were uro-oncologists and 75.7% reported having access to robotic surgery. Sixty percent of faculty members operate with R5 residents between 2 to 5 days per month. When respondents were asked which categories should be listed as category A, only 8 procedures received 100% agreement. Also, results varied significantly when analyzed by sub-specialty. For example, almost 50% or more of uro-oncologists believed that radical cystectomy, anterior pelvic exenteration and extended pelvic lymphadenectomy should not be category A. The following procedures had significant disagreement suggesting the need for re-classification: glanular hypospadias repair, boari flap, entero-vesical and vesicovaginal fistulae repair. Overall, more than 80% of faculty reported that their recent graduating residents had achieved category A proficiency, in a subset of procedures. However, more than 50% of all faculty either disagreed or were ambivalent that all of their graduating residents were Category A proficient in several procedures

Are public opinion polls self-fulfilling prophecies?

Directory of Open Access Journals (Sweden)

David Rothschild

2014-08-01

Full Text Available Psychologists have long observed that people conform to majority opinion, a phenomenon sometimes referred to as the ‘bandwagon effect’. In the political domain people learn about prevailing public opinion via ubiquitous polls, which may produce a bandwagon effect. Newer types of information – published probabilities derived from prediction market contract prices and aggregated polling summaries – may have similar effects. Consequently, polls can become self-fulfilling prophecies whereby majorities, whether in support of candidates or policies, grow in a cascading manner. Despite increased attention to whether the measurement of public opinion can itself affect public opinion, the existing empirical literature is surprisingly limited on the bandwagon effects of polls. To address this gap, we conducted an experiment on a diverse national sample in which we randomly assigned people to receive information about different levels of support for three public policies. We find that public opinion as expressed through polls affects individual-level attitudes, although the size of the effect depends on issue characteristics.

Monte Carlo simulations of a model for opinion formation

Science.gov (United States)

Bordogna, C. M.; Albano, E. V.

2007-04-01

A model for opinion formation based on the Theory of Social Impact is presented and studied by means of numerical simulations. Individuals with two states of opinion are impacted due to social interactions with: i) members of the society, ii) a strong leader with a well-defined opinion and iii) the mass media that could either support or compete with the leader. Due to that competition, the average opinion of the social group exhibits phase-transition like behaviour between different states of opinion.

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... ISCR Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

Public opinion on atomic energy after JCO accident

International Nuclear Information System (INIS)

Okamoto, Koichi; Miyamoto, Sosuke; Ishikawa, Masayori; Shimomura, Hideo; Hori, Hiromoto; Suzuki, Yasuko; Kamise, Yumiko

2004-04-01

JCO accident happened on September 30, 1999. This book deals with the public opinion of atomic energy after JCO accident in Japan and comparison with that of USA and France. The analysis of public opinion structure is also shown. The important chapter is the eighth chapter a n opinion survey after the accident , of which sampling areas consisted of three areas such as JCO accident area, the nuclear power plants and the general cities. The analytical results of data showed that the public opinion in Tokai-mura and Naka-machi, the JCO accident area, indicated moderate opinions. It is the interesting results were obtained that the moderate tendency of opinion was in order JCO accident area, the nuclear power plants and the general cities. People's attitude toward nuclear energy related to their social values. Abstract of JCO accident, JCO structure, the effects of accident on the environment and news stories about the accident are reported. (S.Y.)

A Second Opinion is Worth the Cost - 12479

Energy Technology Data Exchange (ETDEWEB)

Madsen, Drew [Project Time and Cost Inc. (United States)

2012-07-01

This paper, 'A Second Opinion is Worth the Cost', shows how a second opinion for a Department of Energy (DOE) Project helped prepare and pass a DOE Order 413.3A 'Program and Project Management for the acquisition of Capital Assets' Office of Engineering and Construction Management (OECM) required External Independent Review (EIR) in support of the approved baseline for Critical Decision (CD) 2. The DOE project personnel were informed that the project's Total Project Cost (TPC) was going to increase from $815 million to $1.1 billion due to unforeseen problems and unexplained reasons. The DOE Project Team determined that a second opinion was needed to review and validate the TPC. Project Time and Cost, Inc. (PT and C) was requested to evaluate the cost estimate, schedule, basis of estimate (BOE), and risk management plan of the Project and to give an independent assessment of the TPC that was presented to DOE. This paper will demonstrate how breaking down a project to the work breakdown structure (WBS) level allows a project to be analyzed for potential cost increases and/or decreases, thus providing a more accurate TPC. The review Team's cost analyses of Projects identified eight primary drivers resulting in cost increases. They included: - Overstatement of the effort required to develop drawings and specifications. - Cost allocation to 'Miscellaneous' without sufficient detail or documentation. - Cost for duplicated efforts. - Vendor estimates or quotations without sufficient detail. - The practice of using the highest price quoted then adding an additional 10% mark-up. - Application of Nuclear Quality Assurance (NQA) highest level quality requirements when not required. - Allocation of operational costs to the Project Costs instead of to the Operating Expenses (OPEX). OPEX costs come from a different funding source. - DOE had not approved the activities. By using a Team approach with professionals from cost, civil

consumer preparedness, knowledge, and opinions about practices and regulations of the funeral industry.

Science.gov (United States)

Garman, E T; Kidd, C A

1983-01-01

This study focuses on consumers' level of knowledge, opinions, and degree of preparedness concerning selected practices and regulations of the funeral industry. Questionnaires were returned by 75 percent of the sample of faculty and staff at a large university. Opinions of respondents rejected the status quo concerning various practices and regulations of the funeral industry, indicating a desire to support newly suggested changes in the industry. Preparedness scores indicated that almost 9 out of 10 of the respondents were quite unprepared for their own funerals. The mean achievement score regarding knowledge as measured by the Consumer Funeral Test, which was developed for this study, was 4.0, representing 57 percent correct. Significant statistical relationships existed between knowledge scores and the age, education, and sex of the respondents; those who were older and had more education scored higher, and men scored higher than women. No relationships existed, however, among knowledge, opinion, and preparedness scores and the demographic variables of age, education, income, sex, and religion, raising the fundamental question of the value of funeral information programs for consumers.

Cost analysis of establishing a relationship between a surgical program in the US and Vietnam.

Science.gov (United States)

Chu, Quyen D; Nguyen, Thu; Nguyen, Phuong; Ho, Hung S

2012-01-01

"Twinning" refers to a constructive partnership between hospitals in developed and developing nations. Such an effort may contribute immensely to capacity building for the developing nation, but one of the reasons given for the lack of sustainability is cost. We share a detailed operating cost analysis of our recent experience with an institution in Vietnam. We were awarded a 1-year $54,000 grant from the Vietnam Education Foundation (VEF) to conduct a live tele-video conferencing course on the "Fundamentals of Clinical Surgery" with Thai Binh Medical University (TBMU). In-country lectures as well as an assessment of the needs at TBMU were performed. Total financial assistance and expenditures were tabulated to assess up-front infrastructure investment and annual cost required to sustain the program. The total amount of direct money ($66,686) and in-kind services ($70,276) was $136,962. The initial infrastructure cost was $41,085, which represented 62% of the direct money received. The annual cost to sustain the program was approximately $11,948. We concluded that the annual cost to maintain a "twinning" program was relatively low, and the efforts to sustain a "twinning" program were financially feasible and worthwhile endeavors. "Twinning" should be a critical part of the surgical humanitarian volunteerism effort.

Retention of fundamental surgical skills learned in robot-assisted surgery.

Science.gov (United States)

Suh, Irene H; Mukherjee, Mukul; Shah, Bhavin C; Oleynikov, Dmitry; Siu, Ka-Chun

2012-12-01

Evaluation of the learning curve for robotic surgery has shown reduced errors and decreased task completion and training times compared with regular laparoscopic surgery. However, most training evaluations of robotic surgery have only addressed short-term retention after the completion of training. Our goal was to investigate the amount of surgical skills retained after 3 months of training with the da Vinci™ Surgical System. Seven medical students without any surgical experience were recruited. Participants were trained with a 4-day training program of robotic surgical skills and underwent a series of retention tests at 1 day, 1 week, 1 month, and 3 months post-training. Data analysis included time to task completion, speed, distance traveled, and movement curvature by the instrument tip. Performance of the participants was graded using the modified Objective Structured Assessment of Technical Skills (OSATS) for robotic surgery. Participants filled out a survey after each training session by answering a set of questions. Time to task completion and the movement curvature was decreased from pre- to post-training and the performance was retained at all the corresponding retention periods: 1 day, 1 week, 1 month, and 3 months. The modified OSATS showed improvement from pre-test to post-test and this improvement was maintained during all the retention periods. Participants increased in self-confidence and mastery in performing robotic surgical tasks after training. Our novel comprehensive training program improved robot-assisted surgical performance and learning. All trainees retained their fundamental surgical skills for 3 months after receiving the training program.

OPINION GIVING SERVICES AS A SOURCE OF CONSUMER INFORMATION

Directory of Open Access Journals (Sweden)

Joanna Wyrwisz

2015-09-01

Full Text Available The goal of the article is to determine the place and role of opinion giving services in consumer behaviours. The discussion is conducted around the thesis saying that in the information society, opinion giving services constitute an important source of information for consumers in the process of selecting and purchasing both products and services. In the article the research approach based on the theoretical and empirical examinations was presented. The discussion starts with presenting a defi nition and types of opinion giving services which constitute the base for the characteristics of activities and usefulness of web portals collecting consumers opinions. The use of opinion giving services provided in the purchase process was evaluated. An essential interest in other consumers opinions, placed in Internet, was observed together with perceiving them as credible. Positive assessment of the functionality of opinion giving services was noticed.

Validation of a virtual reality-based robotic surgical skills curriculum.

Science.gov (United States)

Connolly, Michael; Seligman, Johnathan; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-05-01

The clinical application of robotic-assisted surgery (RAS) is rapidly increasing. The da Vinci Surgical System™ is currently the only commercially available RAS system. The skills necessary to perform robotic surgery are unique from those required for open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (fundamentals of laparoscopic surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool specific for robotic surgery. Based on previously published data and expert opinion, we developed a robotic skills curriculum. We sought to evaluate this curriculum for evidence of construct validity (ability to discriminate between users of different skill levels). Four experienced surgeons (>20 RAS) and 20 novice surgeons (first-year medical students with no surgical or RAS experience) were evaluated. The curriculum comprised five tasks utilizing the da Vinci™ Skills Simulator (Pick and Place, Camera Targeting 2, Peg Board 2, Matchboard 2, and Suture Sponge 3). After an orientation to the robot and a period of acclimation in the simulator, all subjects completed three consecutive repetitions of each task. Computer-derived performance metrics included time, economy of motion, master work space, instrument collisions, excessive force, distance of instruments out of view, drops, missed targets, and overall scores (a composite of all metrics). Experienced surgeons significantly outperformed novice surgeons in most metrics. Statistically significant differences were detected for each task in regards to mean overall scores and mean time (seconds) to completion. The curriculum we propose is a valid method of assessing and distinguishing robotic surgical skill levels on the da Vinci Si™ Surgical System. Further study is needed to establish proficiency levels and to demonstrate that training on the simulator with the proposed curriculum leads to improved robotic

Etiological explanation, treatability and preventability of childhood autism: a survey of Nigerian healthcare workers' opinion

Directory of Open Access Journals (Sweden)

Okonkwo Kevin O

2009-02-01

workers in subscribing to treatability of childhood autism, while working experience of less than 6 years among the healthcare workers significantly influenced the opinion of the healthcare workers in admitting to believing in the preventability of childhood autism. Conclusion In designing policies and programs to change negative opinions or beliefs of healthcare workers about childhood autism, there is a need for baseline information such as this survey. Changing the negative opinions or beliefs of the healthcare workers about childhood autism should encourage appropriate help-seeking behavior among parents of children with ASD who may be seeking advice or information from the healthcare workers. This would encourage early interventions, which are essential to prognosis of childhood autism.

Expanding the Field of Surgical Researchers: The Jahnigen Career Development Award.

Science.gov (United States)

Deiner, Stacie

2017-10-01

Under a long-standing collaboration with the John A. Hartford Foundation (JAHF), the Atlantic Philanthropies (AP), and specialty societies in 10 targeted specialties, the American Geriatrics Society (AGS) has been working to improve quality of care provided to older adults by surgical and related medical specialists. To support and nurture future academic leaders, the Geriatrics-for-Specialists Initiative (GSI) established the Dennis W. Jahnigen Career Development Scholar Award (JCDA) program in 2002, with AP joining JAHF as a core funder of the awards in 2003. Commencing in 2011, the National Institute on Aging (NIA) launched the Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) program, using an RO3 mechanism. Recipients of the JCDA and the GEMSSTAR are provided with 2 years of research support and networking opportunities with other scholars; 79 JCDA and 26 surgical and related medical specialty GEMSSTAR scholars have been funded through these award mechanisms, with AGS, JAHF, and surgical and related medical specialty societies providing matching support for 20 of the GEMSSTAR scholars for leadership development programs. One of the primary criteria for judging the overall success of the program was eventual transition of the award to a federally funded program, which was achieved when NIA launched the GEMSSTAR program in 2011. © 2017, Copyright the Author Journal compilation © 2017, The American Geriatrics Society.

THE LAWYER`S OPINION IN MODERN CIVIL LAW

Directory of Open Access Journals (Sweden)

Elena Evgenyevna Dubovaya

2015-12-01

Full Text Available Purpose to define value of freedom and fight of opinions, views and lawyer’s positions in development of science of civil law.Methodology theoretical analysis, inductive and deductive methods.Results It is established that fight of opinions, collision of various positions allows to understand more deeply the discussed problem, to come nearer to truth. So, free expression of opinions is the engine of development of civil law.Practical implications introduction in educational process on disciplines of civil jurisprudence, further research of fight of opinions in civil law.Tendencies of the present stage of development of legal system are characterized by aspiration to fix in the Russian legal system of the beginning of private law, where at the head of a corner – people as a legal entity. Opinions of lawyers on various legal problems, and the attitudes towards these opinions are subject to considerable dynamics. The centuries-old history of development of the right showed that fight of opinions, collision of various positions allows to understand more deeply the discussed problem, to come nearer to truth. The modern civil law widely uses a method of comparative jurisprudence, studying experience of the civilized countries which promoted in development of the civil legislation.

Continuous Opinion Dynamics Under Bounded Confidence:. a Survey

Science.gov (United States)

Lorenz, Jan

Models of continuous opinion dynamics under bounded confidence have been presented independently by Krause and Hegselmann and by Deffuant et al. in 2000. They have raised a fair amount of attention in the communities of social simulation, sociophysics and complexity science. The researchers working on it come from disciplines such as physics, mathematics, computer science, social psychology and philosophy. In these models agents hold continuous opinions which they can gradually adjust if they hear the opinions of others. The idea of bounded confidence is that agents only interact if they are close in opinion to each other. Usually, the models are analyzed with agent-based simulations in a Monte Carlo style, but they can also be reformulated on the agent's density in the opinion space in a master equation style. The contribution of this survey is fourfold. First, it will present the agent-based and density-based modeling frameworks including the cases of multidimensional opinions and heterogeneous bounds of confidence. Second, it will give the bifurcation diagrams of cluster configuration in the homogeneous model with uniformly distributed initial opinions. Third, it will review the several extensions and the evolving phenomena which have been studied so far, and fourth it will state some open questions.

Opinion Dynamics with Heterogeneous Interactions and Information Assimilation

Science.gov (United States)

Mir Tabatabaei, Seydeh Anahita

2013-01-01

In any modern society, individuals interact to form opinions on various topics, including economic, political, and social aspects. Opinions evolve as the result of the continuous exchange of information among individuals and of the assimilation of information distributed by media. The impact of individuals' opinions on each other forms a network,…

Conciliatory and contradictory dynamics in opinion formation

OpenAIRE

Boudin , Laurent; Mercier , Aurore; Salvarani , Francesco

2012-01-01

International audience; In this article, we study, via a kinetic description, the effect of different psychologies on the evolution of the opinion with respect to a binary choice, in a closed group. We show that the interaction between individuals with different reactions regarding the exchange of opinion induces some phenomena, such as the concentration of opinions or the cyclic-in-time behaviour of the distribution function. We provide an existence and uniqueness result for the model and nu...

Virtual reality technology and surgical training--a survey of general surgeons in Ireland.

Science.gov (United States)

Early, S A; Roche-Nagle, G

2006-01-01

Virtual Reality Technology (VRT) is a validated method of training in industry but only recently has found a place in the postgraduate surgical curriculum. We surveyed 143 Irish consultant surgeons to ascertain their opinions on this topical issue. The survey consisted of 22 questions to which the consultants were asked to respond by choosing from a 5-point Likert scale. Sixty-five per cent responded. A majority of 72% had seen VRT but only 47% had 'hands on' experience. Forty-six per cent believed that they were poorly informed regarding available technologies. As consultants became more informed about VRT significant differences were seen with regard to attitudes regarding the role of VR in skills in surgical training (p<0.05) and in the ability to define teaching objectives (p<0.005). Our survey suggests that the underuse of the current offerings is not due to a perceived lack of interest on the part of the surgical trainers. Suppliers of these programmes have a responsibility to adequately educate and collaborate with all parties involved to improve overall benefit from these simulators.

Quest for professionalism: a biography of the North American Medical and Surgical Journal (1826-31).

Science.gov (United States)

Shultz, S M

2011-08-01

This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.

Preoperative Site Marking: Are We Adhering to Good Surgical Practice?

Science.gov (United States)

Bathla, Sonia; Chadwick, Michael; Nevins, Edward J; Seward, Joanna

2017-06-29

Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general surgery and opinions of the surgeons, to help guide the formulation and implementation of a regional general surgery preoperative marking protocol. A SurveyMonkey questionnaire was designed and distributed to 120 surgeons within the Mersey region, United Kingdom. This included all surgical trainees in Mersey (47 registrars, 56 core trainees), 15 consultants, and 2 surgical care practitioners. This sought to ascertain their routine practice and how they would choose to mark for 12 index procedures in general surgery, if mandated to do so. A total of 72 responses (60%) were obtained to the SurveyMonkey questionnaire. Only 26 (36.1%) said that they routinely marked all of their patients preoperatively. The operating surgeon marked the patient in 69% of responses, with the remainder delegating this task. Markings were visible after draping in only 55.6% of marked cases. Based on our findings, surgeons may not be adhering to "Good Surgical Practice"; practice is widely variable and surgeons are largely opposed and resistant to marking patients unless laterality is involved. We suggest that all surgeons need to be actively engaged in the design of local marking protocols to gain support, change practice, and reduce errors.

Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators.

Science.gov (United States)

Mull, Hillary J; Borzecki, Ann M; Loveland, Susan; Hickson, Kathleen; Chen, Qi; MacDonald, Sally; Shin, Marlena H; Cevasco, Marisa; Itani, Kamal M F; Rosen, Amy K

2014-04-01

The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors. The sensitivity, specificity, and positive predictive value of PSI software version 4.1a were calculated among Veterans Health Administration hospitalizations (2003-2007) reviewed by VASQIP (n = 268,771). Nurses re-reviewed a sample of hospitalizations for which PSI and VASQIP AE detection disagreed. Sensitivities ranged from 31% to 68%, specificities from 99.1% to 99.8%, and positive predictive values from 31% to 72%. Reviewers found that coding errors accounted for some PSI-VASQIP disagreement; some disagreement was also the result of differences in AE definitions. These results suggest that the PSIs have moderate criterion validity; however, some surgical PSIs detect different AEs than VASQIP. Future research should explore using both methods to evaluate surgical quality. Published by Elsevier Inc.

Analysis and application of opinion model with multiple topic interactions.

Science.gov (United States)

Xiong, Fei; Liu, Yun; Wang, Liang; Wang, Ximeng

2017-08-01

To reveal heterogeneous behaviors of opinion evolution in different scenarios, we propose an opinion model with topic interactions. Individual opinions and topic features are represented by a multidimensional vector. We measure an agent's action towards a specific topic by the product of opinion and topic feature. When pairs of agents interact for a topic, their actions are introduced to opinion updates with bounded confidence. Simulation results show that a transition from a disordered state to a consensus state occurs at a critical point of the tolerance threshold, which depends on the opinion dimension. The critical point increases as the dimension of opinions increases. Multiple topics promote opinion interactions and lead to the formation of macroscopic opinion clusters. In addition, more topics accelerate the evolutionary process and weaken the effect of network topology. We use two sets of large-scale real data to evaluate the model, and the results prove its effectiveness in characterizing a real evolutionary process. Our model achieves high performance in individual action prediction and even outperforms state-of-the-art methods. Meanwhile, our model has much smaller computational complexity. This paper provides a demonstration for possible practical applications of theoretical opinion dynamics.

Constructing post-surgical discharge instructions through a Delphi consensus methodology.

Science.gov (United States)

Scott, Aaron R; Sanderson, Cody J; Rush, Augustus J; Alore, Elizabeth A; Naik, Aanand D; Berger, David H; Suliburk, James W

2018-05-01

Patient education materials are a crucial part of physician-patient communication. We hypothesize that available discharge instructions are difficult to read and fail to address necessary topics. Our objective is to evaluate readability and content of surgical discharge instructions using thyroidectomy to develop standardized discharge materials. Thyroidectomy discharge materials were analyzed for readability and assessed for content. Fifteen endocrine surgeons participated in a modified Delphi consensus panel to select necessary topics. Using readability best practices, we created standardized discharge instructions which included all selected topics. The panel evaluated 40 topics, selected 23, deemed 4 inappropriate, consolidated 5, and did not reach consensus on 8 topics after 4 rounds. The evaluated instructions' reading levels ranged from grade 6.5 to 13.2; none contained all consensus topics. Current post surgical thyroidectomy discharge instructions are more difficult to read than recommended by literacy standards and omit consensus warning signs of major complications. Our easy-to-read discharge instructions cover pertinent topics and may enhance patient education. Delphi methodology is useful for developing post-surgical instructions. Patient education materials need appropriate readability levels and content. We recommend the Delphi method to select content using consensus expert opinion whenever higher level data is lacking. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of Surgical Safety Checklist on Mortality of Surgical Patients in the α University Hospitals

Directory of Open Access Journals (Sweden)

R. Mohebbifar

2014-01-01

Full Text Available Background & Aims: Patient safety is one of the indicators of risk management in clinical governance system. Surgical care is one of the most sophisticated medical care in the hospitals. So it is not surprising that nearly half of the adverse events, 66% were related to surgery. Pre-flight aircraft Inspection model is starting point for designing surgical safety checklist that use for audit procedure. The aim of this study is to evaluate the effect of the use of surgical safety checklist on surgical patients mortality and complications. Materials and Methods: This is a prospective descriptive study. This study was conducted in 2012 in the North West of Iran. The population consisted of patients who had undergoing surgery in α university of medical science`s hospital which have surgical department. In this study, 1125 patients underwent surgery within 3 months were studied. Data collection tool was designed based on WHO model and Surgcical Care and Outcomes Assessment Program(SCOAP. Data analysis was performed using the SPSS-20 statistical software and logistic regression analysis was used to calculate P values for each comparison. Results: No significant differences between patients in the two periods (before and after There was. All complications rate reduced from 11 percent to 4 percent after the intervention by checklist (p<0.001. In the all hospitals mortality rate was decreased from 3.44% to 1.3% (p <0.003. Overall rate of surgical site infection and unplanned return to the operating room was reduced (p<0.001 and p<0.046. Conclusion: Many people every year due to lack of safety in hospitals, lose their lives. Despite the risks, such as leaving surgery sets in patient body and wrong surgery is due to lack of proper safety programs during surgery. By using safety checklist in all hospitals mortality rate and complications was reduced but this reduction was extremely in α3 hospital (from 5.2% to 1.48%.

Rise of an alternative majority against opinion leaders

Science.gov (United States)

Tucci, K.; González-Avella, J. C.; Cosenza, M. G.

2016-03-01

We investigate the role of opinion leaders or influentials in the collective behavior of a social system. Opinion leaders are characterized by their unidirectional influence on other agents. We employ a model based on Axelrod's dynamics for cultural interaction among social agents that allows for non-interacting states. We find three collective phases in the space of parameters of the system, given by the fraction of opinion leaders and a quantity representing the number of available states: one ordered phase having the state imposed by the leaders; another nontrivial ordered phase consisting of a majority group in a state orthogonal or alternative to that of the opinion leaders, and a disordered phase, where many small groups coexist. We show that the spontaneous rise of an alternative group in the presence of opinion leaders depends on the existence of a minimum number of long-range connections in the underlying network. This phenomenon challenges the common idea that influentials are fundamental to propagation processes in society, such as the formation of public opinion.

Effects of Groups’ Spatial Segregation on Processes of Opinion Polarization

NARCIS (Netherlands)

Feliciani, Thomas; Flache, Andreas

2015-01-01

We contribute to the literature about processes of opinion formation, investigating theoretically how the spatial segregation of two groups affects opinion polarization as a possible outcome of opinion formation. We focus on two processes of opinion polarization (negative influence and persuasive

A cost-effective approach to establishing a surgical skills laboratory.

Science.gov (United States)

Berg, David A; Milner, Richard E; Fisher, Carol A; Goldberg, Amy J; Dempsey, Daniel T; Grewal, Harsh

2007-11-01

Recent studies comparing inexpensive low-fidelity box trainers to expensive computer-based virtual reality systems demonstrate similar acquisition of surgical skills and transferability to the clinical setting. With new mandates emerging that all surgical residency programs have access to a surgical skills laboratory, we describe our cost-effective approach to teaching basic and advanced open and laparoscopic skills utilizing inexpensive bench models, box trainers, and animate models. Open models (basic skills, bowel anastomosis, vascular anastomosis, trauma skills) and laparoscopic models (basic skills, cholecystectomy, Nissen fundoplication, suturing and knot tying, advanced in vivo skills) are constructed using a combination of materials found in our surgical research laboratories, retail stores, or donated by industry. Expired surgical materials are obtained from our hospital operating room and animal organs from food-processing plants. In vivo models are performed in an approved research facility. Operation, maintenance, and administration of the surgical skills laboratory are coordinated by a salaried manager, and instruction is the responsibility of all surgical faculty from our institution. Overall, the cost analyses of our initial startup costs and operational expenditures over a 3-year period revealed a progressive decrease in yearly cost per resident (2002-2003, $1,151; 2003-2004, $1,049; and 2004-2005, $982). Our approach to surgical skills education can serve as a template for any surgery program with limited financial resources.

2016 CAPS ethics session/Ein debate: 1. Regionalization of pediatric surgical care 2. Ethical introduction of surgical innovation 3. Addressing stress in a surgical practice: resiliency, well-being, and burnout.

Science.gov (United States)

Bagwell, Charles E; Chiu, Priscilla; Fecteau, Annie; Gow, Kenneth W; Mueller, Claudia M; Price, David; Zigman, Andrew F

2017-05-01

The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random. Therefore, the opinions they express within this summary might not reflect their own viewpoints. In the first discussion, arguments for and against the regionalization of pediatric surgical care are discussed, primarily in the context of a case of BA. In the pro argument, the evidence and lessons learned from different European countries are explored as well as different models to provide the best BA care outside of large teaching centers. In the counterargument, the author explains how regionalization of care could be detrimental for the patient, the family, the regional center, and for the health care system in general. In the debate on surgical innovation the authors define surgical innovation. They review the pertinent ethical principles, explore a model for its implementation, and the role of the institution at which the innovation is proposed. In the third section, surgeon well-being is examined, and recent literature on surgeon resiliency and burnout both at the attending and resident level is reviewed. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical education and training in an outer metropolitan hospital: a qualitative study of surgical trainers and trainees.

Science.gov (United States)

Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob

2017-08-01

The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.

Application of the "see one, do one, teach one" concept in surgical training.

Science.gov (United States)

Kotsis, Sandra V; Chung, Kevin C

2013-05-01

The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. The authors reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. The authors provide examples for how these learning techniques can be incorporated into a surgical resident training program. The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as experience, observation, thinking, and action and deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. The authors review the different types of simulators-standardized patients, virtual reality applications, and high-fidelity mannequin simulators-and the advantages and disadvantages of using them. The traditional teaching method of "see one, do one, teach one" in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care.

Patient views on financial relationships between surgeons and surgical device manufacturers.

Science.gov (United States)

Camp, Mark W; Gross, Allan E; McKneally, Martin F

2015-10-01

Over the past decade, revelations of inappropriate financial relationships between surgeons and surgical device manufacturers have challenged the presumption that surgeons can collaborate with surgical device manufacturers without damaging public trust in the surgical profession. We explored postoperative Canadian patients' knowledge and opinions about financial relationships between surgeons and surgical device manufacturers. This complex issue was explored using qualitative methods. We conducted semistructured face-to-face interviews with postoperative patients in follow-up arthroplasty clinics at an academic hospital in Toronto, Canada. Interviews were audiotaped, transcribed and analyzed. Patient-derived concepts and themes were uncovered. We interviewed 33 patients. Five major themes emerged: 1) many patients are unaware of the existence of financial relationships between surgeons and surgical device manufacturers; 2) patients approve of financial relationships that support innovation and research but are opposed to relationships that involve financial incentives that benefit only the surgeon and the manufacturer; 3) patients do not support disclosure of financial relationships during the consent process as it may shift focus away from the more important risks; 4) patients support oversight at the professional level but reject the idea of government involvement in oversight; and 5) patients entrust their surgeons to make appropriate patient-centred choices. This qualitative study deepens our understanding of financial relationships between surgeons and industry. Patients support relationships with industry that provide potential benefit to current or future patients. They trust our ability to self-regulate. Disclosure combined with appropriate oversight will strengthen public trust in professional collaboration with industry.

Strategies to accommodate resident work-hour restrictions: impact on surgical education.

Science.gov (United States)

Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

2011-01-01

The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

More than 30 years of opinion of French people on nuclear risks - Special release of the 2012 IRSN opinion survey

International Nuclear Information System (INIS)

El Jammal, Marie-Helene; Rollinger, Francois; Mur, Emmanuelle; Schuler, Matthieu; Tchernia, Jean-Francois

2013-01-01

Illustrated by many graphs and tables, this report comments and discusses the evolution of opinion surveys performed in France on the perception of nuclear risks through thirty annual IRSN opinion surveys. It appears that the opinion on nuclear is rather steady, and that French people have a rather rational perception of risk hierarchy. The first part outlines that unemployment is the main concern for French people, and that environmental concerns depend on current events. The second part analyses the perception of the nuclear risk with respect to other societal concerns and to other risks, and discusses the evolution of opinion from a quantitative to a qualitative sensitivity. The third part addresses the representations people have of nuclear activities and how they challenge the reality: perception of nuclear plants and of radioactive wastes, fear of a serious accident. The last part deals with issues related to responsibilities, abilities and governance: how actors of nuclear risk management are perceived, and expectations in terms of transparency and opinion plurality

On the opinion formation of mobile agents with memory

Science.gov (United States)

Zhang, Yunhong; Liu, Qipeng; Wang, Zhenling; Zhang, Siying

2018-02-01

This paper studies the opinion formation problem in a group of mobile agents using a multi-agent modeling method. Suppose that all agents move in a two-dimensional space following a certain rule. The interaction range of each agent is determined by its physical location and its opinion similarity with other agents. Moreover, agents have memory of the opinions of their previous interactive neighbors. We investigate the influence of three factors on the formation of group opinion: moving probability, interactive radius, and population density. Using simulations, we find that an opinion consensus can be achieved easily under a small moving probability and a small interactive radius, which is a relatively counterintuitive phenomenon. We also find that a large interactive radius or the model with memory can facilitate the convergence of opinions in a group to either consensus or clusters.

Readmission After Craniotomy for Tumor: A National Surgical Quality Improvement Program Analysis.

Science.gov (United States)

Dasenbrock, Hormuzdiyar H; Yan, Sandra C; Smith, Timothy R; Valdes, Pablo A; Gormley, William B; Claus, Elizabeth B; Dunn, Ian F

2017-04-01

Although readmission has become a common quality indicator, few national studies have examined this metric in patients undergoing cranial surgery. To utilize the prospective National Surgical Quality Improvement Program 2011-2013 registry to evaluate the predictors of unplanned 30-d readmission and postdischarge mortality after cranial tumor resection. Multivariable logistic regression was applied to screen predictors, which included patient age, sex, tumor location and histology, American Society of Anesthesiologists class, functional status, comorbidities, and complications from the index hospitalization. Of the 9565 patients included, 10.7% (n = 1026) had an unplanned readmission. Independent predictors of unplanned readmission were male sex, infratentorial location, American Society of Anesthesiologists class 3 designation, dependent functional status, a bleeding disorder, and morbid obesity (all P ≤ .03). Readmission was not associated with operative time, length of hospitalization, discharge disposition, or complications from the index admission. The most common reasons for readmission were surgical site infections (17.0%), infectious complications (11.0%), venous thromboembolism (10.0%), and seizures (9.4%). The 30-d mortality rate was 3.2% (n = 367), of which the majority (69.7%, n = 223) occurred postdischarge. Independent predictors of postdischarge mortality were greater age, metastatic histology, dependent functional status, hypertension, discharge to institutional care, and postdischarge neurological or cardiopulmonary complications (all P Readmissions were common after cranial tumor resection and often attributable to new postdischarge complications rather than exacerbations of complications from the initial hospitalization. Moreover, the majority of 30-d deaths occurred after discharge from the index hospitalization. The preponderance of postdischarge mortality and complications requiring readmission highlights the importance of posthospitalization

Ostomy Home Skills Program

Medline Plus

Full Text Available ... My OR EHR Incentive Program Global Codes and Data Collection Patient Opioid Use New Medicare Card Project Medicare ... self-care checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS ...

Topological evolution of the internet public opinion

Science.gov (United States)

Lian, Ying; Dong, Xuefan; Liu, Yijun

2017-11-01

The Internet forms a platform featured with high liquidity, accessibility and concealment for the public to express their respective views on certain events, thus leading to a large network graph. Due to such environmental features, the public opinions formed on the Internet are different from those on traditional media. Studies focusing on the former area are relatively fewer. In addition, the majority of existing methods proposed for constructing the Internet public opinion topological structure are based on the classic BA model, thus resulting in drawbacks in the range of simplicity and a lack of strict deduction. Therefore, based on the complex networks theory, a model applied to describe the topology of the Internet public opinion is deduced with rigorous derivation in the present paper. Results show that the proposed expression could well reflect the degree distribution of Internet public opinion which follows an analogous power law distribution, and that the peak value and the degree distribution are not correlative to each other. Moreover, it has been also proved that compared to the classic BA model, the proposed model has better accuracy performance in the description of the degree distribution of the Internet public opinion, which contributes to future studies focusing on this area. Thus, an attempt has been made to give the first theoretical description of the Internet public opinion topology in the present paper. In addition, it is also the first paper focusing on the solution of networks degree distribution with an exponential growth form.

Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time.

Science.gov (United States)

Leraas, Harold J; Cox, Morgan L; Bendersky, Victoria A; Sprinkle, Shanna S; Gilmore, Brian F; Gunasingha, Rathnayaka M; Tracy, Elisabeth T; Sudan, Ranjan

2017-10-04

Surgical skills training varies greatly between institutions and is often left to students to approach independently. Although many studies have examined single interventions of skills training, no data currently exists about the implementation of surgical skills assessment as a component of the medical student surgical curriculum. We created a technical skills competition and evaluated its effect on student surgical skill development. Second-year medical students enrolled in the surgery clerkship voluntarily participated in a surgical skills competition consisting of knot tying, laparoscopic peg transfer, and laparoscopic pattern cut. Winning students were awarded dinner with the chair of surgery and a resident of their choice. Individual event times and combined times were recorded and compared for students who completed without disqualification. Disqualification included compromising cutting pattern, dropping a peg out of the field of vision, and incorrect knot tying technique. Timed performance was compared for 2 subsequent academic years using Mann-Whitney U test. Overall, 175 students competed and 71 students met qualification criteria. When compared by academic year, 2015 to 2016 students (n = 34) performed better than 2014 to 2015 students (n = 37) in pattern cut (133s vs 167s, p = 0.040), peg transfer (66s vs 101s, p skills competition improves student technical performance. Further research is needed regarding long-term benefits of surgical competitions for medical students. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Objectification of injuries and consequences in expert medical opinions

Directory of Open Access Journals (Sweden)

Miran Vrabl

2007-04-01

Full Text Available Background: Only unequivocal evidence confirming the total extent of injury. Biomechanical analysis, objectifications of permanent consequences after injury and objectification, whether such injuries influence life activities of an injured person, should be the basics for preparation of expert medical opinion. To make a necessary distinction from the previous injuries or illnesses that might have influence on current health state of a patient and its treatment, analysis of all medical records of a certain injured person is needed. Therefore this are inevitable steps in preparation of an expert medical opinion. In cases when medical opinion should explain disability of a patient as a consequence of a certain contractual relationship, the contract should be taken into consideration when such opinions is prepared.Methods: 500 opinions have been retrospectively analysed, selected at random out of 3452 opinions, submitted in claims for damages at Zavarovalnica Maribor, d. d., in the period from January 2001 until January 2006. Thirteen typical data have been analysed and evaluated on the basis of objective evidences.Results: On the basis of analyses it has been established that there is a great difference between principles of objectification and the data in analysed opinions. It has been noticed the most obvious deviation in biomechanical analysis (95 %, in records of decreased life activities (90 %, in all medical records of an injured person (65 % and in objectification of permanent consequences after injuries (55 %.Conclusions: As results of analysis demonstrate, there are significant differences in preparations of expert and medical opinions in Slovenia, particularly when basic principles are analysed that need to be considered when writing such opinions. Irrational avoidance of basic principle of objectification, nomination of experts without licence in certain fields of medicine, avoidance of objectification of subjective statements of injured

Investing in a Surgical Outcomes Auditing System

Science.gov (United States)

Bermudez, Luis; Trost, Kristen; Ayala, Ruben

2013-01-01

Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

Perception of risks by opinion leaders 2011

International Nuclear Information System (INIS)

2011-01-01

The authors report a survey made just after the Fukushima accident on a panel of opinion leaders (belonging to political, economical or media sector) in order to compare their perception of risks with that of the public. The questions addressed the perception of risks, the role of scientific experts, the usefulness and breaks on the diffusion of expertise results, the perception of pluralist bodies, and the Fukushima accident. The answers are analysed and discussed with respect to fifteen hazardous situations, to their opinion of expertise, and to their opinion on safety audit and information

Surgical manipulation of mammalian embryos in vitro.

Science.gov (United States)

Naruse, I; Keino, H; Taniguchi, M

1997-04-01

Whole-embryo culture systems are useful in the fields of not only embryology but also teratology, toxicology, pharmacology, and physiology. Of the many advantages of whole-embryo culture, we focus here on the surgical manipulation of mammalian embryos. Whole-embryo culture allows us to manipulate mammalian embryos, similarly to fish, amphibian and avian embryos. Many surgical experiments have been performed in mammalian embryos in vitro. Such surgical manipulation alters the destiny of morphogenesis of the embryos and can answer many questions concerning developmental issues. As an example of surgical manipulation using whole-embryo culture systems, one of our experiments is described. Microsurgical electrocauterization of the deep preaxial mesodermal programmed cell death zone (fpp) in the footplate prevented the manifestation of polydactyly in genetic polydactyly mouse embryos (Pdn/Pdn), in which fpp was abolished.

cultural variations regarding the nature and determinants of opinion ...

African Journals Online (AJOL)

p2333147

Keywords: Opinion leaders, cultural influence, diffusion and determinants of opinion leadership. ABSTRACT. This paper compares the findings from different countries regarding the nature and determinants of opinion leadership. ..... agricultural production among male and female farmers of the Kusenge. Parish in the ...

The assessment of surgical skills as a complement to the training method. Revision.

Science.gov (United States)

Sánchez-Fernández, J; Bachiller-Burgos, J; Serrano-Pascual, Á; Cózar-Olmo, J M; Díaz-Güemes Martín-Portugués, I; Pérez-Duarte, F J; Hernández-Hurtado, L; Álvarez-Ossorio, J L; Sánchez-Margallo, F M

2016-01-01

The acquisition and improvement of surgical skills constitute a fundamental element in the training of any practitioner. At present, however, the assessment of these skills is a scarcely developed area of research. The aim of this study was to analyse the peculiarities of the various assessment systems and establish the minimum criteria that a skills and knowledge assessment system should meet as a method for assessing surgical skills in urological surgery. Scientific literature review aimed at the various currently available assessment systems for skills and competencies (technical and nontechnical), with a special focus on the systematic reviews and prospective studies. After conducting the review, we found that the various assessment systems for surgical competence have, in our opinion, a number of shortcomings. There is a certain degree of subjectivity in the assessment of surgeons by the evaluators. The assessment of nontechnical competencies is not formally recorded. There is no description of a follow-up assessment or any basic parameters associated with healthcare quality. There is no registration of associated competencies associated with the various surgical techniques. There is also no ranking of these competencies and the specific peculiarities for their application. We believe that the development of a new assessment system for surgical competencies (technical and nontechnical) aimed at assessing urologists in the various surgical techniques is necessary. To this end, our team has worked on developing the Evaluation System for Surgical Competencies on Laparoscopy, which is based on the definition, ranking and assessment of competencies demonstrated by surgeons. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Dream Team - A pregraduate surgical talent development project

DEFF Research Database (Denmark)

Jensen, Rune Dall; Seyer-Hansen, Mikkel; Christensen, Mette Krogh

Dream Team is an extracurricular pregraduate surgical talent development project founded in 2009 at Aarhus University Hospital, Denmark. It aims to identify and develop laparoscopic surgical talents during medical school. Dream Team contains two parts: 1) a weeklong boot camp where app. 10 % of 8th...... the mentorship the students will be in operation room at least once a week and participate as much as their skills allow. Dream Team differs from similar pregraduate programs as it selects the most talented students, but does the boot camp select the best and does the mentorship program provide optimal learning......? A PhD project aims to critically analyze and develop Dream Team. The PhD project is based on theories about deliberate practice[1] and social learning[2]. In addition, we compare surgical talent development[3][4] with talent development in elite sport in order to inspire, refine and develop Dream Team...

THE ROMANIAN GEOGRAPHY TEACHERS’ OPINIONS ON CONTINUOUS TRAINING

Directory of Open Access Journals (Sweden)

ANCA LIANA GALE

2017-02-01

Full Text Available In the first part of the paper, we present the legislation from Romania and the methodologies related to the continuous training of teachers. In order to know the teachers’ opinions about their professional development, about the programes, courses and other training activities in which they were involved and about their needs for continuous training as geography teachers, a questionnaire was applied, and was completed by 170 teachers. The results were analysed and interpreted. These views are important because, based on them, decisions can be made concerning the teachers’ continuous training at both ministry level, as well as at the level of various institutions involved in such activities.

Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

Directory of Open Access Journals (Sweden)

Storey Donald F

2012-10-01

Full Text Available Abstract Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010. Physicians implemented recommendation(s from each of 234 (75% audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009, there was a 22% decrease in defined daily doses per 100 admissions (P = .006 and a 16% reduction per 1000 patient-days (P = .013. There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013 and a 25% acquisition cost reduction per patient-day (P = .022. Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital.

Evolution of general surgical problems in patients with left ventricular assist devices.

Science.gov (United States)

McKellar, Stephen H; Morris, David S; Mauermann, William J; Park, Soon J; Zietlow, Scott P

2012-11-01

Left ventricular assist devices (LVADs) are increasingly used to treat patients with end-stage heart failure. These patients may develop acute noncardiac surgical problems around the time of LVAD implantation or, as survival continues to improve, chronic surgical problems as ambulatory patients remote from the LVAD implant. Previous reports of noncardiac surgical problems in LVAD patients included patients with older, first-generation devices and do not address newer, second-generation devices. We describe the frequency and management of noncardiac surgical problems encountered during LVAD support with these newer-generation devices to assist noncardiac surgeons involved in the care of patients with LVADs. We retrospectively reviewed the medical records of consecutive patients receiving LVADs at our institution. We collected data for any consultation by noncardiac surgeons within the scope of general surgery during LVAD support and subsequent treatment. Ninety-nine patients received implantable LVADs between 2003 and 2009 (first-generation, n = 19; second-generation, n = 80). Excluding intestinal hemorrhage, general surgical opinions were rendered for 34 patients with 49 problems, mostly in the acute recovery phase after LVAD implantation. Of those, 27 patients underwent 28 operations. Respiratory failure and intra-abdominal pathologies were the most common problems addressed, and LVAD rarely precluded operation. Patients with second-generation LVADs were more likely to survive hospitalization (P = .04) and develop chronic, rather than emergent, surgical problems. Patients with LVADs frequently require consultation from noncardiac surgeons within the scope of general surgeons and often require operation. Patients with second-generation LVADs are more likely to become outpatients and develop more elective surgical problems. Noncardiac surgeons will be increasingly involved in caring for patients with LVADs and should anticipate the problems unique to this patient

Social influence and the collective dynamics of opinion formation.

Science.gov (United States)

Moussaïd, Mehdi; Kämmer, Juliane E; Analytis, Pantelis P; Neth, Hansjörg

2013-01-01

Social influence is the process by which individuals adapt their opinion, revise their beliefs, or change their behavior as a result of social interactions with other people. In our strongly interconnected society, social influence plays a prominent role in many self-organized phenomena such as herding in cultural markets, the spread of ideas and innovations, and the amplification of fears during epidemics. Yet, the mechanisms of opinion formation remain poorly understood, and existing physics-based models lack systematic empirical validation. Here, we report two controlled experiments showing how participants answering factual questions revise their initial judgments after being exposed to the opinion and confidence level of others. Based on the observation of 59 experimental subjects exposed to peer-opinion for 15 different items, we draw an influence map that describes the strength of peer influence during interactions. A simple process model derived from our observations demonstrates how opinions in a group of interacting people can converge or split over repeated interactions. In particular, we identify two major attractors of opinion: (i) the expert effect, induced by the presence of a highly confident individual in the group, and (ii) the majority effect, caused by the presence of a critical mass of laypeople sharing similar opinions. Additional simulations reveal the existence of a tipping point at which one attractor will dominate over the other, driving collective opinion in a given direction. These findings have implications for understanding the mechanisms of public opinion formation and managing conflicting situations in which self-confident and better informed minorities challenge the views of a large uninformed majority.

Public opinion on water reuse options

International Nuclear Information System (INIS)

Bruvold, W.H.

1988-01-01

Public policy on waste water reuse options must be informed by public opinion because it is the public who must pay the cost of developing the option and who will be served by the option in the future. For public policy on reuse, guidance for innovative reuse is not as simple as first believed. It seems that public opinion regarding actual community reuse options is affected by the linkage of several factors, including water conservation, health protection, treatment and distribution costs, and environmental enhancement. Probability sampling was used in 7 studies to select respondents who were queried regarding their opinions on various reclaimed water uses such as ranging from cooling tower water to full domestic use. These 7 are briefly reviewed

Conformity, Anticonformity and Polarization of Opinions: Insights from a Mathematical Model of Opinion Dynamics

Directory of Open Access Journals (Sweden)

Tyll Krueger

2017-07-01

Full Text Available Understanding and quantifying polarization in social systems is important because of many reasons. It could for instance help to avoid segregation and conflicts in the society or to control polarized debates and predict their outcomes. In this paper, we present a version of the q-voter model of opinion dynamics with two types of responses to social influence: conformity (like in the original q-voter model and anticonformity. We put the model on a social network with the double-clique topology in order to check how the interplay between those responses impacts the opinion dynamics in a population divided into two antagonistic segments. The model is analyzed analytically, numerically and by means of Monte Carlo simulations. Our results show that the system undergoes two bifurcations as the number of cross-links between cliques changes. Below the first critical point, consensus in the entire system is possible. Thus, two antagonistic cliques may share the same opinion only if they are loosely connected. Above that point, the system ends up in a polarized state.

Drivers of going concern audit opinions: empirical evidence from Indonesia

Directory of Open Access Journals (Sweden)

Suroto Lina Rahmawati

2017-08-01

Full Text Available The study of the going concern audit opinions is an important component within the enhancement of firms’ responsibility and stewardship. A going concern audit opinions implies that the independent auditor doubt the future of the firm. This study aimed to examine the drivers of the likelihood of the going-concern audit opinions. Previous studies revealed that there were inconsistent drivers influencing the going-concern audit opinion. This study shows similar results to prior works. The result indicates that firms’ financial condition and profitability significantly affect the likelihood of the going-concern audit opinion, while firms’ size and leverage are not the determinants of the intensity of the going concern audit opinion.

EMOTION BASED ANALYSIS OF TURKISH CUSTOMER OPINIONS

Directory of Open Access Journals (Sweden)

E. Kahya-Ozyirmidokuz

2016-12-01

Full Text Available Firms should manage their customer feedback so they can adapt to rapid changes in the environment. They have to interact with their customers to understand them and to turn their opinions into useful knowledge. Understanding customers' feelings about a product gives firmS competitive advantage through continuous market monitoring. They can thus generate improving strategies about the system to change perceptions that drive the behaviours of the customers. Firms can view their customers' happiness as a key tool for decision-making. This study calculates online product happiness by using the average emotional valence values of customer opinions. We analyse Turkish opinions about a product over a period of 3 months. We find the averages of the online emotional valence values of the product per month. We also determined the increase in happiness over time. According to the opinion valence values, we found the relations between the documents.

Opinion Analysis on Rohingya using Twitter Data

Science.gov (United States)

Rochmawati, N.; Wibawa, S. C.

2018-04-01

Rohingya is an ethnicity in Myanmar. Recently there was a conflict in the area between the Rakhine population and the Myanmar army. Many opinions are pro and contra in addressing this issue. There is a critic, there is a support and there is a neutral. The purpose of this paper is to analyze the world public opinion about the case of Rohingya. The opinion data to be processed is taken from twitter. the reason for using twitter is because twitter has become one of the popular social media and includes the most frequently visited social media. Therefore, it would be a lot of data that can be taken from twitter to be processed in the process of sentiment analysis. The grouping of opinions will be divided into 3 parts of positive, negative and neutral. the method used in grouping is the naïve Bayes method.

Correlation between information diffusion and opinion evolution on social media

Science.gov (United States)

Xiong, Fei; Liu, Yun; Zhang, Zhenjiang

2014-12-01

Information diffusion and opinion evolution are often treated as two independent processes. Opinion models assume the topic reaches each agent and agents initially have their own ideas. In fact, the processes of information diffusion and opinion evolution often intertwine with each other. Whether the influence between these two processes plays a role in the system state is unclear. In this paper, we collected more than one million real data from a well-known social platform, and analysed large-scale user diffusion behaviour and opinion formation. We found that user inter-event time follows a two-scaling power-law distribution with two different power exponents. Public opinion stabilizes quickly and evolves toward the direction of convergence, but the consensus state is prevented by a few opponents. We propose a three-state opinion model accompanied by information diffusion. Agents form and exchange their opinions during information diffusion. Conversely, agents' opinions also influence their diffusion actions. Simulations show that the model with a correlation of the two processes produces similar statistical characteristics as empirical results. A fast epidemic process drives individual opinions to converge more obviously. Unlike previous epidemic models, the number of infected agents does not always increase with the update rate, but has a peak with an intermediate value of the rate.

Correlation between information diffusion and opinion evolution on social media

International Nuclear Information System (INIS)

Xiong, Fei; Liu, Yun; Zhang, Zhenjiang

2014-01-01

Information diffusion and opinion evolution are often treated as two independent processes. Opinion models assume the topic reaches each agent and agents initially have their own ideas. In fact, the processes of information diffusion and opinion evolution often intertwine with each other. Whether the influence between these two processes plays a role in the system state is unclear. In this paper, we collected more than one million real data from a well-known social platform, and analysed large-scale user diffusion behaviour and opinion formation. We found that user inter-event time follows a two-scaling power-law distribution with two different power exponents. Public opinion stabilizes quickly and evolves toward the direction of convergence, but the consensus state is prevented by a few opponents. We propose a three-state opinion model accompanied by information diffusion. Agents form and exchange their opinions during information diffusion. Conversely, agents' opinions also influence their diffusion actions. Simulations show that the model with a correlation of the two processes produces similar statistical characteristics as empirical results. A fast epidemic process drives individual opinions to converge more obviously. Unlike previous epidemic models, the number of infected agents does not always increase with the update rate, but has a peak with an intermediate value of the rate. (paper)

Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

Science.gov (United States)

Hanson, Darlene S.

2013-01-01

The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

Public opinion factors regarding nuclear power

Energy Technology Data Exchange (ETDEWEB)

Benson, B.

1991-12-31

This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry`s practices are aligned with public opinion, a more favorable regulatory climate is possible.

Public opinion factors regarding nuclear power

Energy Technology Data Exchange (ETDEWEB)

Benson, B.

1991-01-01

This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry's practices are aligned with public opinion, a more favorable regulatory climate is possible.

Public opinion factors regarding nuclear power

International Nuclear Information System (INIS)

Benson, B.

1991-01-01

This paper is an effort to identify, as comprehensively as possible, public concerns about nuclear power, and to assess, where possible, the relative importance of these concerns as they relate to government regulation of and policy towards nuclear power. It is based on some two dozen in-depth interviews with key communicators representing the nuclear power industry, the environmental community, and government, as well as on the parallel efforts in our research project: (1) review of federal court case law, (2) a selective examination of the Nuclear Regulatory Commission (NRC) administrative process, and (3) the preceding George Mason University research project in this series. The paper synthesizes our findings about public attitudes towards nuclear power as expressed through federal court case law, NRC administrative law, public opinion surveys, and direct personal interviews. In so doing, we describe the public opinion environment in which the nuclear regulatory process must operate. Our premise is that public opinion ultimately underlies the approaches government agencies take towards regulating nuclear power, and that, to the degree that the nuclear power industry's practices are aligned with public opinion, a more favorable regulatory climate is possible

[The residents of mental health services in 1994. Population characteristics and its opinions about graduation].

Science.gov (United States)

Agrest, M

1995-09-01

Departing from two surveys that took place during a Mental Health Meeting of the Health Residents from Buenos Aires, the main features and their opinions upon their education and work are analyzed. The results are discriminated by profession. Two problems are highlighted: one of them refers to the general insatisfaction of this group with their theoretical learning; the other, shows the exit of prepared human resources from public hospitals. The data suggest that, despite sharing most of their activities, psychologists and psychiatrists have significant different opinions about the clinic education they think are getting. Further research is suggested in order to have a deeper comprehension of what is going on in these training programs.

the nature and determinants of opinion leadership in lesotho

African Journals Online (AJOL)

p2333147

opinion leadership, 39 percent have been nominated and thus qualify ... It obviously cannot be ruled out that with increased consultations more fields of ... 30. 40. 50. 60. 70. 80. 90. 100. %. >3. 3. 2. 1. Opinion leadership (No. of nominations) .... Frequency distribution per gender. Male. Female. Total. Opinion leadership.

Developing a successful robotics program.

Science.gov (United States)

Luthringer, Tyler; Aleksic, Ilija; Caire, Arthur; Albala, David M

2012-01-01

Advancements in the robotic surgical technology have revolutionized the standard of care for many surgical procedures. The purpose of this review is to evaluate the important considerations in developing a new robotics program at a given healthcare institution. Patients' interest in robotic-assisted surgery has and continues to grow because of improved outcomes and decreased periods of hospitalization. Resulting market forces have created a solid foundation for the implementation of robotic surgery into surgical practice. Given proper surgeon experience and an efficient system, robotic-assisted procedures have been cost comparable to open surgical alternatives. Surgeon training and experience is closely linked to the efficiency of a new robotics program. Formally trained robotic surgeons have better patient outcomes and shorter operative times. Training in robotics has shown no negative impact on patient outcomes or mentor learning curves. Individual economic factors of local healthcare settings must be evaluated when planning for a new robotics program. The high cost of the robotic surgical platform is best offset with a large surgical volume. A mature, experienced surgeon is integral to the success of a new robotics program.

Refining Risk Adjustment for the Proposed CMS Surgical Hip and Femur Fracture Treatment Bundled Payment Program.

Science.gov (United States)

Cairns, Mark A; Ostrum, Robert F; Clement, R Carter

2018-02-21

The U.S. Centers for Medicare & Medicaid Services (CMS) has been considering the implementation of a mandatory bundled payment program, the Surgical Hip and Femur Fracture Treatment (SHFFT) model. However, bundled payments without appropriate risk adjustment may be inequitable to providers and may restrict access to care for certain patients. The SHFFT proposal includes adjustment using the Diagnosis-Related Group (DRG) and geographic location. The goal of the current study was to identify and quantify patient factors that could improve risk adjustment for SHFFT bundled payments. We retrospectively reviewed a 5% random sample of Medicare data from 2008 to 2012. A total of 27,898 patients were identified who met SHFFT inclusion criteria (DRG 480, 481, and 482). Reimbursement was determined for each patient over the bundle period (the surgical hospitalization and 90 days of post-discharge care). Multivariable regression was performed to test demographic factors, comorbidities, geographic location, and specific surgical procedures for associations with reimbursement. The average reimbursement was $23,632 ± $17,587. On average, reimbursements for male patients were $1,213 higher than for female patients (p payments; e.g., reimbursement for those ≥85 years of age averaged $2,282 ± $389 less than for those aged 65 to 69 (p reimbursement, but dementia was associated with lower payments, by an average of $2,354 ± $243 (p reimbursement ranging from $22,527 to $24,033. Less common procedures varied by >$20,000 in average reimbursement (p reimbursement (p reimbursed by an average of $10,421 ± $543 more than DRG 482. Payments varied significantly by state (p ≤ 0.01). Risk adjustment incorporating specific comorbidities demonstrated better performance than with use of DRG alone (r = 0.22 versus 0.15). Our results suggest that the proposed SHFFT bundled payment model should use more robust risk-adjustment methods to ensure that providers are reimbursed fairly and that

Current approaches to journal club by general surgery programs within the Southwestern surgical congress.

Science.gov (United States)

Shifflette, Vanessa; Mitchell, Chris; Mangram, Alicia; Dunn, Ernest

2012-01-01

Journal club (JC) is a well-recognized education tool for many postgraduate medical education programs. Journal club helps residents learn critical analytic skills and keep up to date with current medical practices. To our knowledge, there is minimal evidence in the current literature detailing modern JC practices of general surgery training programs. Our study attempts to define how general surgery residency programs are implementing JC in their training process. We distributed by mail a 14-question survey to general surgery program directors within the Southwestern Surgical Congress. These surveys were redistributed 1 month after the initial attempt. The responses were collected and analyzed. Survey questions aimed to define JC practice characteristics, such as where JC is held, when JC is held, who directs JC, what journals are used, the perceived importance of JC, and average attendance. The surveys were sent to 32 program directors (PDs), which included 26 university and 6 community-based programs. We received responses from 26 (81%) PDs. Ninety-two percent of the programs have a consistent journal club (JC). Most JCs meet monthly (64%) or weekly (16%). The meeting places ranged from conference rooms (60%), faculty homes (20%), restaurants (8%), or in the hospital (12%). The meeting times were divided between morning (29%), midday (29%), and evening (42%). Most JCs lasted between 1 and 2 hours (88%), reviewed 1-4 articles (88%), and are attended by more than 60% of residents routinely (75%). Half of the programs (50%) had 3-4 faculty members present during discussion; 29% of the programs had only 1-2 faculty present. The articles were selected from more than 10 different journals. Seventy-five percent of the programs used the American Journal of Surgery and Annals of Surgery to find articles; only 13% of the programs used evidence-based reviews in surgery. PDs believe JC is very beneficial (42%), moderately beneficial (42%), or only fairly beneficial (16

Analysis and Implement of Broadcast Program Monitoring Data

Directory of Open Access Journals (Sweden)

Song Jin Bao

2016-01-01

Full Text Available With the rapid development of the radio and TV industry and the implementation of INT (the integration of telecommunications networks, cable TV networks and the Internet, the contents of programs and advertisements is showing massive, live and interactive trends. In order to meet the security of radio and television, the broadcast of information have to be controlled and administered. In order to master the latest information of public opinion trends through radio and television network, it is necessary research the specific industry applications of broadcast program monitoring. In this paper, the importance of broadcast monitoring in public opinion analysis is firstly analysed. The monitoring radio and television programs broadcast system architecture is proposed combining with the practice, focusing on the technical requirements and implementation process of program broadcast, advertisement broadcast and TV station broadcast monitoring. The more efficient information is generated through statistical analysis, which provides data analysis for radio and television public opinion analysis.

Track leading to decision of 'framework for nuclear energy policy'. Reading the public attitude with public opinions (the first). Contents of a new plan (as of June 2005)

International Nuclear Information System (INIS)

Shimooka, Hiroshi

2006-01-01

The Government decides to respect the 'Framework for Nuclear Energy Policy', which was decided by the Atomic Energy Commission on October 11th, 2005, as a basic principle for the nuclear energy policy and promote research, development and utilization of nuclear science and engineering. The Planning Council asked public opinion and received 758 opinions from 393 citizens. The Council continued the deliberation taking these opinions and compiled a preliminary draft of the 'Framework for Nuclear Energy Policy'. Reading the public attitude with public opinions had been conducted by the author, which showed the necessity for the nation to communicate crucial issues such as the nation's role of nuclear program's implementation, reasons for further promotion of nuclear program and its impacts on environments as well as more preferable introduction of new energy or energy conservation in stead of nuclear power, more to the public. (T. Tanaka)

Discrete opinion dynamics on networks based on social influence

International Nuclear Information System (INIS)

Hu Haibo; Wang Xiaofan

2009-01-01

A model of opinion dynamics based on social influence on networks was studied. The opinion of each agent can have integer values i = 1, 2, ..., I and opinion exchanges are restricted to connected agents. It was found that for any I ≥ 2 and self-confidence parameter 0 ≤ u i ) of the population that hold a given opinion i is a martingale, and the fraction q i of opinion i will gradually converge to (q i ). The tendency can slow down with the increase of degree assortativity of networks. When u is degree dependent, (q i ) does not possess the martingale property, however q i still converges to it. In both cases for a finite network the states of all agents will finally reach consensus. Further if there exist stubborn persons in the population whose opinions do not change over time, it was found that for degree-independent constant u, both q i and (q i ) will converge to fixed proportions which only depend on the distribution of initial obstinate persons, and naturally the final equilibrium state will be the coexistence of diverse opinions held by the stubborn people. The analytical results were verified by numerical simulations on Barabasi-Albert (BA) networks. The model highlights the influence of high-degree agents on the final consensus or coexistence state and captures some realistic features of the diffusion of opinions in social networks

Sentiment Analysis and Opinion Mining

CERN Document Server

Liu, Bing

2012-01-01

Sentiment analysis and opinion mining is the field of study that analyzes people's opinions, sentiments, evaluations, attitudes, and emotions from written language. It is one of the most active research areas in natural language processing and is also widely studied in data mining, Web mining, and text mining. In fact, this research has spread outside of computer science to the management sciences and social sciences due to its importance to business and society as a whole. The growing importance of sentiment analysis coincides with the growth of social media such as reviews, forum discussions

Word of mouth and opinion leadership

Directory of Open Access Journals (Sweden)

Žnideršić-Kovač Ružica

2008-01-01

Full Text Available The new, alternative thinking patterns in marketing highlight the fact that exchanges per se are not the focus of marketing analysis and researches; rather than that, they must surrender this position to relationships between different sides in the marketing setting - the company and consumers, internal relations within companies, and relations between consumers themselves. A new philosophy, relationship marketing, is taking over the position of the old transaction marketing philosophy. The greatest challenge for marketing professionals at the beginning of the 21st century is this third dimension of relationships - relations between consumers, their mutual impact on preferences and purchase decisions, and, most notably, the possibility of involving consumers in companies marketing mix programs. Opinion leaders - their identification, creation, their word-of-mouth communication, its emergence and impact are currently the focus of marketing theory and practice.

Tropospheric ozone. Formation, properties, effects. Expert opinion

International Nuclear Information System (INIS)

Elstner, E.F.

1996-01-01

The formation and dispersion of tropospheric ozone are discussed only marginally in this expert opinion; the key interest is in the effects of ground level ozone on plants, animals, and humans. The expert opinion is based on an analysis of the available scientific publications. (orig./MG) [de

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

Science.gov (United States)

Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P

2015-08-01

The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

Impotent science, omnipotent public opinion

International Nuclear Information System (INIS)

Guillaume, Nathalie

2001-01-01

Full text: Nowadays public opinion has become prominent when political leaders have themselves to vote. Even scientific or economical decisions are often taken more in accordance to these trends than to rational reasons. For a long time it has been widely accepted that a clear and pedagogical explanation was enough to make scientific issues understandable. For nearly 20 years, a true scientific and professional communication has been developed in France towards the general public to make nuclear industry acceptable. Nevertheless today, we notice that the acceptance of the nuclear option has lost many points in public polls. An accident, in the nuclear fields or in another fields, in one point or another of the planet can ruin the work of many years in communication. 1) In order to draw a more precise picture of public opinion, to follow these trends and make them more understandable, the CEA communication direction has built a 'public opinion barometer' dealing with the following fields: - Information on nuclear fields; - The nuclear actors; - The future of nuclear option; - Radioactive waste; - Risks perception; - Nuclear energy and other sources of energy; - Economy and nuclear power; - Image of nuclear. 2) Come and visit our labs to make up your own opinion: As communication methods through the classical media has, up to now, failed in changing public opinion regarding nuclear, the decision was made to offer to people the opportunity to meet searchers at work.400 'Communicating researchers' to day are volunteers to receive the public .They are trained to be able to explain their work to non specialists; they receive documents dealing with current events to help them answer to questions and they are invited to an annual general meeting (last one in January 2001). 85 laboratories are opened (civil and military ones). In 2000, nearly 10,000 visitors have come to us. In 2001, new additional operations will be lead toward young people, teachers, associations. (author)

The interplay of self-reflection, social interaction and random events in the dynamics of opinion flow in two-party democracies

Science.gov (United States)

Lichtenegger, Klaus; Hadzibeganovic, Tarik

2016-01-01

We propose a continuous process opinion formation model to study the dynamics of a multi-level relationship between voters, political parties, and facts in two-party democratic elections. In our model, opinions can take any real value between two extremes and an unaligned, moderate opinion state without a preference. Starting with a random opinion configuration, individual voter opinions evolve and change over time due to self-reflection, inter-personal communication, external media influence, and noise. Parties are influenced by their own ideologies, facts, and voters’ opinions. Elections are held periodically and the party that is closer in opinion to the majority of voters forms the new government. The government policy is then expected to be in proximity to the voter opinions and the policies of the currently ruling political party. We analyze the tension of opinions as a measure of how dramatically opinions can disagree within a given sample of voters and the success of the government and parties as the degree of coincidence between the policies and facts. Our model generates realistic quasi-periodic alternations between incumbents and challengers that are typical for two-party systems. Moreover, our model shows that relative to other voters’ strategies, conscious voting can lead to more successful governments of not only fact-oriented but also pragmatic and balanced political parties, irrespective of the strategies of the competing opposition parties. In addition, our simulations uncover several interesting features including less victories for strictly ideological or fact-oriented parties unless they include some aspects of populism or pragmatism. In this sense, our model can also describe situations where election outcomes are not necessarily based on votes for the current programs of competing parties and their placement on relevant issues, but instead result from voters’ dissatisfaction with the previous government and the votes against it.

The application and interviewing process for surgical house officership.

Science.gov (United States)

Rutkow, I M; Imbembo, A L; Zuidema, G D

1979-02-01

The application and interviewing procedure for surgical house officership is an important process to both the medical student and the clinical department. Up-to-date, informative, and honest appraisals of the training programs under evaluation must be obtained. A survey was undertaken to compare and contrast students' and surgical department members' perceptions of nationwide surgical residency application procedures. It is concluded from this sampling that the majority of medical students applying to university-sponsored surgical training programs and the training institutions themselves generally are satisfied with the present application and interviewing experience. Certain areas in need of reform were elucidated, and the following recommendations are offered to aid in the development of a more effective process: (1) if possible, the descriptive information brochure should be updated on a yearly basis and must be comprehensive in scope; (2) when "en masse" interviewing is conducted, it should be held on a number of dates during the year, not just one, and a limited time for "walk-in" interviews should be allowed; (3) an opportunity should be available for the spouse or fiance'(e) to accompany the applicant; (4) an interviewer should prepare for an interview by having read the applicant's file beforehand; and (5) the interviewing schedule should be arranged so that the applicant is able to meet either the department chairperson and/or program director.

Truth in Reporting: How Data Capture Methods Obfuscate Actual Surgical Site Infection Rates within a Health Care Network System.

Science.gov (United States)

Bordeianou, Liliana; Cauley, Christy E; Antonelli, Donna; Bird, Sarah; Rattner, David; Hutter, Matthew; Mahmood, Sadiqa; Schnipper, Deborah; Rubin, Marc; Bleday, Ronald; Kenney, Pardon; Berger, David

2017-01-01

Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. This study aimed to compare database concordance. This is a multi-institution cohort study of systemwide Colorectal Surgery Collaborative. The National Surgical Quality Improvement Program requires rigorous, standardized data capture techniques; National Healthcare Safety Network allows 5 data capture techniques. Standardized surgical site infection rates were compared between databases. The Cohen κ-coefficient was calculated. This study was conducted at Boston-area hospitals. National Healthcare Safety Network or National Surgical Quality Improvement Program patients undergoing colorectal surgery were included. Standardized surgical site infection rates were the primary outcomes of interest. Thirty-day surgical site infection rates of 3547 (National Surgical Quality Improvement Program) vs 5179 (National Healthcare Safety Network) colorectal procedures (2012-2014). Discrepancies appeared: National Surgical Quality Improvement Program database of hospital 1 (N = 1480 patients) routinely found surgical site infection rates of approximately 10%, routinely deemed rate "exemplary" or "as expected" (100%). National Healthcare Safety Network data from the same hospital and time period (N = 1881) revealed a similar overall surgical site infection rate (10%), but standardized rates were deemed "worse than national average" 80% of the time. Overall, hospitals using less rigorous capture methods had improved surgical site infection rates for National Healthcare Safety Network compared with standardized National Surgical Quality Improvement Program reports. The correlation coefficient

The SEP "robot": a valid virtual reality robotic simulator for the Da Vinci Surgical System?

Science.gov (United States)

van der Meijden, O A J; Broeders, I A M J; Schijven, M P

2010-04-01

The aim of the study was to determine if the concept of face and construct validity may apply to the SurgicalSim Educational Platform (SEP) "robot" simulator. The SEP robot simulator is a virtual reality (VR) simulator aiming to train users on the Da Vinci Surgical System. To determine the SEP's face validity, two questionnaires were constructed. First, a questionnaire was sent to users of the Da Vinci system (reference group) to determine a focused user-group opinion and their recommendations concerning VR-based training applications for robotic surgery. Next, clinical specialists were requested to complete a pre-tested face validity questionnaire after performing a suturing task on the SEP robot simulator. To determine the SEP's construct validity, outcome parameters of the suturing task were compared, for example, relative to participants' endoscopic experience. Correlations between endoscopic experience and outcome parameters of the performed suturing task were tested for significance. On an ordinal five-point, scale the average score for the quality of the simulator software was 3.4; for its hardware, 3.0. Over 80% agreed that it is important to train surgeons and surgical trainees to use the Da Vinci. There was a significant but marginal difference in tool tip trajectory (p = 0.050) and a nonsignificant difference in total procedure time (p = 0.138) in favor of the experienced group. In conclusion, the results of this study reflect a uniform positive opinion using VR training in robotic surgery. Concepts of face and construct validity of the SEP robotic simulator are present; however, these are not strong and need to be improved before implementation of the SEP robotic simulator in its present state for a validated training curriculum to be successful .

Discrete opinion dynamics on networks based on social influence

Energy Technology Data Exchange (ETDEWEB)

Hu Haibo; Wang Xiaofan [Complex Networks and Control Lab, Shanghai Jiao Tong University, Shanghai 200240 (China)

2009-06-05

A model of opinion dynamics based on social influence on networks was studied. The opinion of each agent can have integer values i = 1, 2, ..., I and opinion exchanges are restricted to connected agents. It was found that for any I {>=} 2 and self-confidence parameter 0 {<=} u < 1, when u is a degree-independent constant, the weighted proportion (q{sub i}) of the population that hold a given opinion i is a martingale, and the fraction q{sub i} of opinion i will gradually converge to (q{sub i}). The tendency can slow down with the increase of degree assortativity of networks. When u is degree dependent, (q{sub i}) does not possess the martingale property, however q{sub i} still converges to it. In both cases for a finite network the states of all agents will finally reach consensus. Further if there exist stubborn persons in the population whose opinions do not change over time, it was found that for degree-independent constant u, both q{sub i} and (q{sub i}) will converge to fixed proportions which only depend on the distribution of initial obstinate persons, and naturally the final equilibrium state will be the coexistence of diverse opinions held by the stubborn people. The analytical results were verified by numerical simulations on Barabasi-Albert (BA) networks. The model highlights the influence of high-degree agents on the final consensus or coexistence state and captures some realistic features of the diffusion of opinions in social networks.

Swedish Opinion on Nuclear Power 1986 - 2011

Energy Technology Data Exchange (ETDEWEB)

Holmberg, Soeren

2012-11-01

This report contains the Swedish opinion on Nuclear Power and European Attitudes on Nuclear Power. It also includes European Attitudes Towards the Future of Three Energy Sources; Nuclear Energy, Wind Power and Solar Power - with a focus on the Swedish opinion. Results from measurements done by the SOM Inst. are presented.

French and european opinions about energy questions

International Nuclear Information System (INIS)

1992-03-01

This paper presents a statistical study of french and european opinions in 1989 about energy questions. The main subjects studied are: qualities of different energy sources (coal, petroleum, natural gas, nuclear energy, renewable energies); perception in public opinion of nuclear industry; energy and environmental effects. 6 figs., 1 tab., 4 appendices

Internet Censorship in Turkey: University Students' Opinions

Science.gov (United States)

Ozkan, Hasan; Arikan, Arda

2009-01-01

The aim of this paper is to study university students' opinions toward online censorship with references to their socio-political and economic variables. Considering the upwards trend and the increasing number of online restrictions in Turkey, the opinions of university students (n=138) are thought to give significant findings. The questionnaire…

[The surgical nurse: his/her leadership of auxiliary nursing personnel].

Science.gov (United States)

Galvão, C M; Trevizan, M A; Sawada, N O; Mendes, I A

1997-01-01

This investigation as carried out in order to promote follow-up in the studies concerning nurse's leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey and Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in accordance with the maturity level of an element of the auxiliary personnel based on six categories of activities that were studied. Authors found out that nurses should adopt the styles of participant leadership, such as E3 (participating) and/or E4 (delegating).

Information Filtering Based on Users' Negative Opinions

Science.gov (United States)

Guo, Qiang; Li, Yang; Liu, Jian-Guo

2013-05-01

The process of heat conduction (HC) has recently found application in the information filtering [Zhang et al., Phys. Rev. Lett.99, 154301 (2007)], which is of high diversity but low accuracy. The classical HC model predicts users' potential interested objects based on their interesting objects regardless to the negative opinions. In terms of the users' rating scores, we present an improved user-based HC (UHC) information model by taking into account users' positive and negative opinions. Firstly, the objects rated by users are divided into positive and negative categories, then the predicted interesting and dislike object lists are generated by the UHC model. Finally, the recommendation lists are constructed by filtering out the dislike objects from the interesting lists. By implementing the new model based on nine similarity measures, the experimental results for MovieLens and Netflix datasets show that the new model considering negative opinions could greatly enhance the accuracy, measured by the average ranking score, from 0.049 to 0.036 for Netflix and from 0.1025 to 0.0570 for Movielens dataset, reduced by 26.53% and 44.39%, respectively. Since users prefer to give positive ratings rather than negative ones, the negative opinions contain much more information than the positive ones, the negative opinions, therefore, are very important for understanding users' online collective behaviors and improving the performance of HC model.

Surgical referral coordination from a first-level hospital: a prospective case study from rural Nepal.

Science.gov (United States)

Fleming, Matthew; King, Caroline; Rajeev, Sindhya; Baruwal, Ashma; Schwarz, Dan; Schwarz, Ryan; Khadka, Nirajan; Pande, Sami; Khanal, Sumesh; Acharya, Bibhav; Benton, Adia; Rogers, Selwyn O; Panizales, Maria; Gyorki, David; McGee, Heather; Shaye, David; Maru, Duncan

2017-09-25

Patients in isolated rural communities typically lack access to surgical care. It is not feasible for most rural first-level hospitals to provide a full suite of surgical specialty services. Comprehensive surgical care thus depends on referral systems. There is minimal literature, however, on the functioning of such systems. We undertook a prospective case study of the referral and care coordination process for cardiac, orthopedic, plastic, gynecologic, and general surgical conditions at a district hospital in rural Nepal from 2012 to 2014. We assessed the referral process using the World Health Organization's Health Systems Framework. We followed the initial 292 patients referred for surgical services in the program. 152 patients (52%) received surgery and four (1%) suffered a complication (three deaths and one patient reported complication). The three most common types of surgery performed were: orthopedics (43%), general (32%), and plastics (10%). The average direct and indirect cost per patient referred, including food, transportation, lodging, medications, diagnostic examinations, treatments, and human resources was US$840, which was over 1.5 times the local district's per capita income. We identified and mapped challenges according to the World Health Organization's Health Systems Framework. Given the requirement of intensive human capital, poor quality control of surgical services, and the overall costs of the program, hospital leadership decided to terminate the referral coordination program and continue to build local surgical capacity. The results of our case study provide some context into the challenges of rural surgical referral systems. The high relative costs to the system and challenges in accountability rendered the program untenable for the implementing organization.

A Survey of Key Technology of Network Public Opinion Analysis

Directory of Open Access Journals (Sweden)

Li Su Ying

2016-01-01

Full Text Available The internet has become an important base for internet users to make comments because of its interactivity and fast dissemination. The outbreak of internet public opinion has become a major risk for network information security. Domestic and foreign researchers had carried out extensive and in-depth study on public opinion. Fruitful results have achieved in the basic theory research and emergency handling and other aspects of public opinion. But research on the public opinion in China is still in the initial stage, the key technology of the public opinion analysis is still as a starting point for in-depth study and discussion.

Multi-lingual Opinion Mining on YouTube

NARCIS (Netherlands)

Severyn, Aliaksei; Moschitti, Alessandro; Uryupina, Olga; Plank, Barbara; Filippova, Katja

In order to successfully apply opinion mining (OM) to the large amounts of user-generated content produced every day, we need robust models that can handle the noisy input well yet can easily be adapted to a new domain or language. We here focus on opinion mining for YouTube by (i) modeling

The spreading of opposite opinions on online social networks with authoritative nodes

Science.gov (United States)

Yan, Shu; Tang, Shaoting; Pei, Sen; Jiang, Shijin; Zhang, Xiao; Ding, Wenrui; Zheng, Zhiming

2013-09-01

The study of opinion dynamics, such as spreading and controlling of rumors, has become an important issue on social networks. Numerous models have been devised to describe this process, including epidemic models and spin models, which mainly focus on how opinions spread and interact with each other, respectively. In this paper, we propose a model that combines the spreading stage and the interaction stage for opinions to illustrate the process of dispelling a rumor. Moreover, we set up authoritative nodes, which disseminate positive opinion to counterbalance the negative opinion prevailing on online social networking sites. With analysis of the relationship among positive opinion proportion, opinion strength and the density of authoritative nodes in networks with different topologies, we demonstrate that the positive opinion proportion grows with the density of authoritative nodes until the positive opinion prevails in the entire network. In particular, the relationship is linear in homogeneous topologies. Besides, it is also noteworthy that initial locations of the negative opinion source and authoritative nodes do not influence positive opinion proportion in homogeneous networks but have a significant impact on heterogeneous networks. The results are verified by numerical simulations and are helpful to understand the mechanism of two different opinions interacting with each other on online social networking sites.

Updated clinical indications for transcatheter aortic valve implantation in patients with severe aortic stenosis: expert opinion of the Italian Society of Cardiology and GISE.

Science.gov (United States)

Indolfi, Ciro; Bartorelli, Antonio L; Berti, Sergio; Golino, Paolo; Esposito, Giovanni; Musumeci, Giuseppe; Petronio, Sonia; Tamburino, Corrado; Tarantini, Giuseppe; Ussia, Gianpaolo; Vassanelli, Corrado; Spaccarotella, Carmen; Violini, Roberto; Mercuro, Giuseppe; Romeo, Francesco

2018-05-01

: The introduction of percutaneous treatment of severe aortic stenosis with transcatheter aortic valve implantation (TAVI) remains one of the greatest achievements of interventional cardiology. In fact, TAVI emerged as a better option than either medical therapy or balloon aortic valvuloplasty for patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high surgical risk. Recently, increased operator experience and improved device systems have led to a worldwide trend toward the extension of TAVI to low-risk or intermediate-risk patients. In this expert opinion paper, we first discuss the basic pathophysiology of aortic stenosis in different settings then the key results of recent clinical investigations on TAVI in intermediate-risk aortic stenosis patients are summarized. Particular emphasis is placed on the results of the nordic aortic valve intervention, placement of aortic transcatheter valves (PARTNER) 2 and Surgical Replacement and Transcatheter Aortic Valve Implantation Randomized trials. The PARTNER 2 was the first large randomized trial that evaluated the outcome of TAVI in patients at intermediate risk. The PARTNER 2 data demonstrated that TAVI is a feasible and reasonable alternative to surgery in intermediate-risk patients (Society of Thoracic Surgeons 4-8%), especially if they are elderly or frail. There was a significant interaction between TAVI approach and mortality, with transfemoral TAVI showing superiority over SAVR. Moreover, we examine the complementary results of the recently concluded Surgical Replacement and Transcatheter Aortic Valve Implantation trial. This prospective randomized trial demonstrated that TAVI is comparable with surgery (primary end point 12.6% in the TAVI group vs. 14.0% in the SAVR group) in severe aortic stenosis patients deemed to be at intermediate risk. We review the most relevant clinical evidence deriving from nonrandomized studies and meta-analyses. Altogether, clinical outcome available data

Same-sex marriage and other moral taboos : cultural acceptances, change in American public opinion and the evidence from the opinion polls

OpenAIRE

MORINI, Marco

2017-01-01

Published online: 25 January 2017 Creative Commons Licence This article analyzes the evolution of gay and lesbian rights and same-sex marriage in American public opinion. It describes how Obergefell v. Hodges, state-level decisions and the public opinion trends can be considered as the outcome of a grassroots coordinated campaign which began more than a decade ago and was able to conquer the majority of Americans. It also focuses on the American public opinion trends related to moral is...

Peer-mentoring junior surgical trainees in the United Kingdom: a pilot program.

Science.gov (United States)

Vulliamy, Paul; Junaid, Islam

2012-04-16

Peer-mentoring has attracted substantial interest in various healthcare professions, but has not been formally integrated into postgraduate surgical training. This study aimed to assess the feasibility and acceptability of a peer-mentor scheme among junior surgical trainees in the United Kingdom. Trainees entering the first year of core surgical training (CST) in a single postgraduate school of surgery were allocated a mentor in the second year of CST. Allocation was based on location of the initial clinical placement. An anonymised questionnaire regarding the mentorship scheme was sent to all participants in the third month following its introduction. 18 trainees participated in the scheme, of whom 12 (67%) responded to the questionnaire. All respondents had made contact with their allocated mentor or mentee, and no trainees had opted out of the scheme. Areas in which the mentees received guidance included examinations (83%), CV development (67%), and workplace-based assessments (67%). All respondents felt that the mentor scheme was a good addition to CST. Suggestions for improvement of the scheme included introduction of structured meetings and greater engagement with allocated mentors. A pilot peer-mentoring scheme was well received by junior surgical trainees. Consideration should be given to expansion of this scheme and more rigorous assessment of its value.

20 CFR 416.927 - Evaluating opinion evidence.

Science.gov (United States)

2010-04-01

... the record as a whole, the more weight we will give to that opinion. (5) Specialization. We generally... “disabled” or “unable to work” does not mean that we will determine that you are disabled. (2) Other... opinions from treating sources, nontreating sources, and other nonexamining sources who do not work for us...

Modeling and Simulation of Polarization in Internet Group Opinions Based on Cellular Automata

Directory of Open Access Journals (Sweden)

Yaofeng Zhang

2015-01-01

Full Text Available Hot events on Internet always attract many people who usually form one or several opinion camps through discussion. For the problem of polarization in Internet group opinions, we propose a new model based on Cellular Automata by considering neighbors, opinion leaders, and external influences. Simulation results show the following: (1 It is easy to form the polarization for both continuous opinions and discrete opinions when we only consider neighbors influence, and continuous opinions are more effective in speeding the polarization of group. (2 Coevolution mechanism takes more time to make the system stable, and the global coupling mechanism leads the system to consensus. (3 Opinion leaders play an important role in the development of consensus in Internet group opinions. However, both taking the opinion leaders as zealots and taking some randomly selected individuals as zealots are not conductive to the consensus. (4 Double opinion leaders with consistent opinions will accelerate the formation of group consensus, but the opposite opinions will lead to group polarization. (5 Only small external influences can change the evolutionary direction of Internet group opinions.

Association of General Surgery Resident Remediation and Program Director Attitudes With Resident Attrition.

Science.gov (United States)

Schwed, Alexander C; Lee, Steven L; Salcedo, Edgardo S; Reeves, Mark E; Inaba, Kenji; Sidwell, Richard A; Amersi, Farin; Are, Chandrakanth; Arnell, Tracey D; Damewood, Richard B; Dent, Daniel L; Donahue, Timothy; Gauvin, Jeffrey; Hartranft, Thomas; Jacobsen, Garth R; Jarman, Benjamin T; Melcher, Marc L; Mellinger, John D; Morris, Jon B; Nehler, Mark; Smith, Brian R; Wolfe, Mary; Kaji, Amy H; de Virgilio, Christian

2017-12-01

Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition. Data on total resident complement, demographic information, and annual attrition were collected from the program directors for the study period of July 1, 2010, to June 30, 2015. The general surgery programs were chosen on the basis of their geographic location, previous collaboration with some coauthors, prior work in surgical education and research, or a program director willing to participate. Only categorical surgical residents were included in the study; thus, program directors were specifically instructed to exclude any preliminary residents in their responses. Five-year attrition rates (2010-2011 to 2014-2015 academic years) as well as first-time pass rates on the General Surgery Qualifying Examination and General Surgery Certifying Examination of the American Board of Surgery (ABS) were collected. High- and low-attrition programs were compared. The 21 programs represented different geographic locations and 12 university-based, 3 university-affiliated, and 6 independent program types. Programs had a median (interquartile range [IQR]) number of 30 (20-48) categorical residents, and few of those residents were women (median [IQR], 12 [5-17]). Overall, 85 of 966 residents (8.8%) left training during the study period: 15 (17.6%) left after postgraduate year 1, 34 (40.0%) after postgraduate year 2, and 36 (42.4%) after postgraduate year 3 or later. Forty-four residents (51.8%) left general surgery for another surgical discipline, 21 (24.7%) transferred to a different surgery

Demographic and Social Factors Influencing Public Opinion on ...

African Journals Online (AJOL)

macuser

the pressing need for empirical research into these opinions, to inform and make .... understanding public opinion on the issue of prostitution has critical relevance. For ..... prostitution and presented three options for legal reform in South Africa: ...

PageRank model of opinion formation on Ulam networks

Science.gov (United States)

Chakhmakhchyan, L.; Shepelyansky, D.

2013-12-01

We consider a PageRank model of opinion formation on Ulam networks, generated by the intermittency map and the typical Chirikov map. The Ulam networks generated by these maps have certain similarities with such scale-free networks as the World Wide Web (WWW), showing an algebraic decay of the PageRank probability. We find that the opinion formation process on Ulam networks has certain similarities but also distinct features comparing to the WWW. We attribute these distinctions to internal differences in network structure of the Ulam and WWW networks. We also analyze the process of opinion formation in the frame of generalized Sznajd model which protects opinion of small communities.

Cross-correlation patterns in social opinion formation with sequential data

Science.gov (United States)

Chakrabarti, Anindya S.

2016-11-01

Recent research on large-scale internet data suggests existence of patterns in the collective behavior of billions of people even though each of them may pursue own activities. In this paper, we interpret online rating activity as a process of forming social opinion about individual items, where people sequentially choose a rating based on the current information set comprising all previous ratings and own preferences. We construct an opinion index from the sequence of ratings and we show that (1) movie-specific opinion converges much slower than an independent and identically distributed (i.i.d.) sequence of ratings, (2) rating sequence for individual movies shows lesser variation compared to an i.i.d. sequence of ratings, (3) the probability density function of the asymptotic opinions has more spread than that defined over opinion arising from i.i.d. sequence of ratings, (4) opinion sequences across movies are correlated with significantly higher and lower correlation compared to opinion constructed from i.i.d. sequence of ratings, creating a bimodal cross-correlation structure. By decomposing the temporal correlation structures from panel data of movie ratings, we show that the social effects are very prominent whereas group effects cannot be differentiated from those of surrogate data and individual effects are quite small. The former explains a large part of extreme positive or negative correlations between sequences of opinions. In general, this method can be applied to any rating data to extract social or group-specific effects in correlation structures. We conclude that in this particular case, social effects are important in opinion formation process.

Opinion of women about elective abortion

OpenAIRE

?akmak, B?lent; Metin, Fulya Zeynep; ?zsoy, Asker Zeki; ??t?l, R?za; ?nder, Yal??n; Y?lmaz Do?ru, Hatice

2014-01-01

Objective: The aim of this study was to investigate the opinions of women who presented to the hospital for elective abortion. Materials and Methods: This descriptive study was designed and conducted at our university hospital between March 2013-April 2013 by the method of face-to-face interviews with 500 women who presented to the hospital as patient or relatives of patients. Poll consisted of 6 questions about demographic characteristics and 14 questions evaluating the opinions and attitude...

Modeling opinion dynamics: Theoretical analysis and continuous approximation

International Nuclear Information System (INIS)

Pinasco, Juan Pablo; Semeshenko, Viktoriya; Balenzuela, Pablo

2017-01-01

Highlights: • We study a simple model of persuasion dynamics with long range pairwise interactions. • The continuous limit of the master equation is a nonlinear, nonlocal, first order partial differential equation. • We compute the analytical solutions to this equation, and compare them with the simulations of the dynamics. - Abstract: Frequently we revise our first opinions after talking over with other individuals because we get convinced. Argumentation is a verbal and social process aimed at convincing. It includes conversation and persuasion and the agreement is reached because the new arguments are incorporated. Given the wide range of opinion formation mathematical approaches, there are however no models of opinion dynamics with nonlocal pair interactions analytically solvable. In this paper we present a novel analytical framework developed to solve the master equations with non-local kernels. For this we used a simple model of opinion formation where individuals tend to get more similar after each interactions, no matter their opinion differences, giving rise to nonlinear differential master equation with non-local terms. Simulation results show an excellent agreement with results obtained by the theoretical estimation.

20 CFR 404.1527 - Evaluating opinion evidence.

Science.gov (United States)

2010-04-01

... weight we will give to that opinion. (5) Specialization. We generally give more weight to the opinion of... statement that you are disabled. A statement by a medical source that you are “disabled” or “unable to work... other nonexamining sources who do not work for us. (iii) Administrative law judges may also ask for and...

Personal and Professional Well-Being of Surgical Residents in New England.

Science.gov (United States)

Yoo, Peter S; Tackett, John J; Maxfield, Mark W; Fisher, Rosemarie; Huot, Stephen J; Longo, Walter E

2017-06-01

Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. General surgery residents from the 6 New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training. All surgical residency programs in the New England region were invited to participate. Of these 19 programs, 10 elected to participate in the study. Three hundred and sixty-three total trainees were contacted with requests to participate, and 166 completed responses to the survey, resulting in a response rate of 44.9%. Ninety percent of respondents identified their programs as "university or academic." Substantial cohorts reported that during training they lacked basic healthcare maintenance visits (54%) and had undesired weight gain (44%). Although most found their stipends adequate, three-quarters worried about their finances (75%) and reported substantial educational debt (45%). Most residents enjoyed coming to work; however, the vast majority reported that work-related stress is moderate to extreme (92%). Most also reported that work-related stress negatively affects their overall well-being (72%). The mean Epworth Sleepiness Scale score among respondents was 14, consistent with moderate excessive daytime sleepiness. Surgical trainee well-being is critical to optimal patient care, career development, and burnout reduction. Surgical residents attend to their own preventive health maintenance, finances, sleep, and stress reduction with variable success. Residency programs should make modest programmatic accommodations to allow trainees to tend to various aspects of their personal well-being. Copyright © 2017. Published by Elsevier Inc.

Understanding public opinion regarding transit in southeast Michigan.

Science.gov (United States)

2015-04-01

This report presents findings from a study on public opinion regarding transit in Southeast Michigan. The overall goals of this : study were to assess the nature of public opinion regarding regional transit and to understand its relation to socio-dem...

Management of surgical waiting lists through a Possibilistic Linear Multiobjective Programming problem

OpenAIRE

Pérez Gladish, Blanca María; Arenas Parra, María del Mar; Bilbao Terol, Amelia María; Rodríguez Uria, María Victoria

2005-01-01

This study attempts to apply a management science technique to improve the efficiency of Hospital Administration. We aim to design the performance of the surgical services at a Public Hospital that allows the Decision-Maker to plan surgical scheduling over one year in order to reduce waiting lists. Real decision problems usually involve several objectives that have parameters which are often given by the decision maker in an imprecise way. It is possible to handle these kinds of problems ...

An evidential opinion dynamics model based on heterogeneous social influential power

International Nuclear Information System (INIS)

Lu, Xi; Mo, Hongming; Deng, Yong

2015-01-01

Highlights: •We use Dempster–Shafer evidence theory to handle the uncertainty of the communication. •An ice-breaking uncertainty elimination process in opinion evolution is demonstrated. •The influential power of individuals and the feedback mechanism are considered. •The power-law characteristic of the final influential power distribution is depicted. -- Abstract: This paper introduces an evidential opinion dynamics model combing Dempster–Shafer evidence theory to explore the opinion evolution. Our model is an improvement of the Continuous Opinions and Discrete Actions (CODA) model. The process of people updating their opinions is regarded as a decision making process. The unavoidable uncertainty of the opinion evolution is handled by Dempster–Shafer evidence theory. Thereby, a new opinion group, i.e.the neutrals, is introduced into the system. Simulations show the neutral group plays a significant part in the opinion evolution. An opinion ice-breaking process at the early stage of the opinion evolution is observed. It is found that the consensus is not always reached then clusters emerge instead, which depends on the proportions of supporters, neutrals and opponents. The individual’s influential power is taken into account. With the positive feedback mechanism of people’s influential power, the obtained results are in accordance with people’s daily cognition such as the Authority Effect and the Matthew Effect. The final influential power distribution of all individuals in our model presents power-law characteristic

[Simulation-based robot-assisted surgical training].

Science.gov (United States)

Kolontarev, K B; Govorov, A V; Rasner, P I; Sheptunov, S A; Prilepskaya, E A; Maltsev, E G; Pushkar, D Yu

2015-12-01

Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: "robotics", "robotic surgery", "computer assisted surgery", "simulation", "computer simulation", "virtual reality", "surgical training", and "surgical education". There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists training.

[Opinions and attitudes regarding sexuality: Brazilian national research, 2005].

Science.gov (United States)

Paiva, Vera; Aranha, Francisco; Bastos, Francisco I

2008-06-01

To describe opinions and attitudes concerning sexuality of the Brazilian urban population. A population survey was carried out in 2005 on a representative sample of 5,040 interviewees. An analysis of the attitudes regarding sexual initiation and sexual education of teenagers, considering gender, age, schooling, income, marital status, color, geographic region and opinion on fidelity, homosexuality, and masturbation. The results were contrasted with a similar survey carried out in 1998, when possible. Most interviewees selected the "sex is evidence of love" option when describing the meaning of sex. As in 1998, the majority was in favor of sexual initiation after marriage (63.9% for women vs. 52.4% for men initiation); results differed among religions. School teenage education on the use of condoms was supported by 97% of the interviewees across all social groups. The proportion of Brazilians who agreed with having access to condoms in health services (95%) and at school (83.6%) was high. Fidelity remained an almost unanimous value and there was an increase, in 2005, in the proportion of those in favor of sexual initiation after marriage, and in the rate of acceptance of masturbation and homosexuality compared to the 1998 survey. The younger generations tend to be more tolerant and egalitarian. As observed in other countries, this study confirms the difficulty in establishing a single dimension that guides sexual life ("liberal" vs "conservative"). The study suggests that the normativity concerning sexual activity should be understood in the light of the local culture and social organization of sexuality, considered by the STD/Aids programs. Opinions in favor of free access to preservatives at school clash with the slower results obtained in fighting the stigma and discriminating against homosexual minorities. The design of laical policies on sexuality allow for the dialog across different perspectives.

Developing Surgical Antimicrobial Prophylaxis Interventions Using Theoretical Domains Framework

OpenAIRE

Bonnar, Paul E; Senthinathan, Arrani; Nakamachi, Yoshiko; Backstein, David J; Steinberg, Marilyn; Morris, Andrew M

2017-01-01

Abstract Background Surgical site infections are common causes of healthcare-associated infections. Using surgical antimicrobial prophylaxis (SAP) is a complex process that can reduce these rates if performed correctly. While antimicrobial stewardship programs have developed guidelines for SAP, there has been less focus on understanding and modifying the behavioral and contextual factors required to optimize prophylaxis use. We performed chart reviews and workflow analyses to develop interven...

STEM field courses that increase interest, opinions and confidence in conservation- related fields

Science.gov (United States)

Christensen, B. A.; Freeman, A. S.; Donovan, C.; Cooperstein, D.; Foellmer, M.; Ward, A.

2016-12-01

Students in the Environmental Studies and Biology programs at Adelphi University, situated in the NYC metropolitan area, have had little exposure to the outdoors or nature and are often reluctant to engage in field activities. We developed three courses to provide outdoor experiences at different levels of intensity, financial and travel/ time commitments. Adelphi in Australia is a three-week field course taught mostly at a marine station that includes day and night hikes, snorkeling on the Great Barrier Reef (GBR) and independent research. Adelphi in the U.S. Virgin Islands is a one-week field `starter course' focusing on snorkeling and hiking. Observing Nature is an on-campus, once a week course with nature-based readings, weekend hikes and camping. It was developed after Hurricane Sandy revealed a lack of experience and confidence living without some modern infrastructure. We evaluated student opinions, interests and career goals in a survey administered at the start and at the end of the course that focused on knowledge, skills, opinion, and interest in STEM. Opinion questions addressed confidence, awareness of conservation issues, and interest in outdoor activities. The survey confirmed most of our students have a limited relationship with the outdoors when they start our field classes. More than half had never camped. Most had learned about nature through school trips and family. When asked to rank hiking against other activities, the majority regularly placed hiking below `going to the beach' and 'watching a movie'. The post-survey asked how students would apply what they had learned (interest in the environment; staying in the sciences). The generally positive results indicate the courses play an important role in connecting our students with the outdoors, and may have a lasting impact if they in turn connect others or get involved with local conservation programs.

Stimulating energy conservation: the use of the opinion-leadership process

Energy Technology Data Exchange (ETDEWEB)

Yavas, U [Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia; Riecken, G

1981-09-01

While the US federal government, public utilities and oil companies, among others, have instigated programs to educate the general public on energy conservation and to stimulate an energy-conservation ethic, results of a number of surveys indicate that such efforts in promoting energy conservation have had only limited success. This may be particularly attributable to the low credibility ascribed by the public to energy-information-disseminating sources. This article investigates the feasibility of utilizing opinion leadership, an untried approach, to overcome the credibility problem in disseminating energy information to the general public. 23 references, 4 tables.

Do gender and personality traits (BFI-10) influence self-perceived opinion leadership?

DEFF Research Database (Denmark)

Sudzina, Frantisek

2016-01-01

. This approach would require to identify opinion leaders. This paper investigates whether gender and personality traits can predict opinion leadership. Methodology/methods: The paper can be perceived as a replication in a loose sense of the term, since it replicates only a part of a previously published model...... and in one's own opinion (two variables). Generalized linear models (GLM) and Pearson product-moment correlation coefficient are used to analyze data. Scientific aim: The aim of the paper is to estimate impact of gender and personality traits on opinion leadership. Findings: Extraversion is the personality...... trait closest related to opinion leadership regardless whether it is self-perceived in the eyes of others or in one's own opinion. Opinion leadership in one's own opinion can be predicted even using neuroticism, and conscientiousness. The three traits are consistent with previous findings. Unlike...

The Surgical Site Infection Risk Score (SSIRS: A Model to Predict the Risk of Surgical Site Infections.

Directory of Open Access Journals (Sweden)

Carl van Walraven

Full Text Available Surgical site infections (SSI are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions to decrease the risk of SSI.We randomly divided all surgeries recorded in the National Surgical Quality Improvement Program from 2010 into a derivation and validation population. We used multivariate logistic regression to determine the independent association of patient and surgical covariates with the risk of any SSI (including superficial, deep, and organ space SSI within 30 days of surgery. To capture factors particular to specific surgeries, we developed a surgical risk score specific to all surgeries having a common first 3 numbers of their CPT code.Derivation (n = 181 894 and validation (n = 181 146 patients were similar for all demographics, past medical history, and surgical factors. Overall SSI risk was 3.9%. The SSI Risk Score (SSIRS found that risk increased with patient factors (smoking, increased body mass index, certain comorbidities (peripheral vascular disease, metastatic cancer, chronic steroid use, recent sepsis, and operative characteristics (surgical urgency; increased ASA class; longer operation duration; infected wounds; general anaesthesia; performance of more than one procedure; and CPT score. In the validation population, the SSIRS had good discrimination (c-statistic 0.800, 95% CI 0.795-0.805 and calibration.SSIRS can be calculated using patient and surgery information to estimate individual risk of SSI for a broad range of surgery types.

42 CFR 411.382 - CMS's right to rescind advisory opinions.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false CMS's right to rescind advisory opinions. 411.382... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.382 CMS's right to rescind advisory opinions. Any advice CMS gives in an opinion does not prejudice its right to reconsider...

Does the weather influence public opinion about climate change?

Science.gov (United States)

Donner, S. D.; McDaniel, J.

2010-12-01

Public opinion in North America about the science of anthropogenic climate change and the motivation for policy action has been variable over the past twenty years. The trends in public opinion over time have been attributed the general lack of pressing public concern about climate change to a range of political, economic and psychological factors. One driving force behind the variability in polling data from year to year may be the weather itself. The difference between what we “expect” - the climate - and what we “get” - the weather - can be a major source of confusion and obfuscation in the public discourse about climate change. For example, reaction to moderate global temperatures in 2007 and 2008 may have helped prompt the spread of a “global cooling” meme in the public and the news media. At the same time, a decrease in the belief in the science of climate change and the need for action has been noted in opinion polls. This study analyzes the relationship between public opinion about climate change and the weather in the U.S. since the mid-1980s using historical polling data from several major organizations (e.g. Gallup, Pew, Harris Interactive, ABC News), historical monthly air temperature (NCDC) and a survey of opinion articles from major U.S. newspapers (Washington Post, New York Times, Wall Street Journal, Houston Chronicle, USA Today). Seasonal and annual monthly temperature anomalies for the northeastern U.S and the continental U.S are compared with available national opinion data for three general categories of questions: i) Is the climate warming?, ii) Is the observed warming due to human activity?, and iii) Are you concerned about climate change? The variability in temperature and public opinion over time is also compared with the variability in the fraction of opinion articles in the newspapers (n ~ 7000) which express general agreement or disagreement with IPCC Summary for Policymakers consensus statements on climate change (“most of

Peer-to-peer and mass communication effect on opinion shifts

Science.gov (United States)

Kindler, A.; Solomon, S.; Stauffer, D.

2013-02-01

Opinion dynamics is studied through a minimal Ising model with three main influences (fields): personal conservatism (power-law distributed), inter-personal and group pressure, and a global field incorporating peer-to-peer and mass communications, which is generated bottom-up from the faction supporting the new opinion. A rich phase diagram appears separating possible terminal stages of the opinion diffusion, characterizing failure phases by the features of the individuals who had changed their opinion. An exhaustive solution of the model is produced, allowing predictions to be made on the opinion’s assimilation in the society.

Opinion formation driven by PageRank node influence on directed networks

Science.gov (United States)

Eom, Young-Ho; Shepelyansky, Dima L.

2015-10-01

We study a two states opinion formation model driven by PageRank node influence and report an extensive numerical study on how PageRank affects collective opinion formations in large-scale empirical directed networks. In our model the opinion of a node can be updated by the sum of its neighbor nodes' opinions weighted by the node influence of the neighbor nodes at each step. We consider PageRank probability and its sublinear power as node influence measures and investigate evolution of opinion under various conditions. First, we observe that all networks reach steady state opinion after a certain relaxation time. This time scale is decreasing with the heterogeneity of node influence in the networks. Second, we find that our model shows consensus and non-consensus behavior in steady state depending on types of networks: Web graph, citation network of physics articles, and LiveJournal social network show non-consensus behavior while Wikipedia article network shows consensus behavior. Third, we find that a more heterogeneous influence distribution leads to a more uniform opinion state in the cases of Web graph, Wikipedia, and Livejournal. However, the opposite behavior is observed in the citation network. Finally we identify that a small number of influential nodes can impose their own opinion on significant fraction of other nodes in all considered networks. Our study shows that the effects of heterogeneity of node influence on opinion formation can be significant and suggests further investigations on the interplay between node influence and collective opinion in networks.

(Miscommunication across the Borders: Politics, Media and Public Opinion in Turkey

Directory of Open Access Journals (Sweden)

Banu Baybars-Hawks

2015-08-01

Full Text Available The American sociologist Charles Horton Cooley defined public opinion "as a process of interaction and mutual influence rather than a state of broad agreement" in 1918. On the other hand, according to the American political scientist V.O. Key, public opinion was "opinions held by private persons which governments find it prudent to heed," in 1961. During the 1990s, advances in statistical and demographic analysis helped the development of an understanding of public opinion as the collective view of a defined population, such as a particular demographic or ethnic group. In this view, the influence of public opinion is not restricted to politics and elections. Public opinion is considered a powerful force in many other spheres, such as culture, fashion, literature and the arts, consumer spending, and marketing and public relations.1 Attitudes and values play a crucial role in the development of public opinion. Different variables embedded in the political, social and media structure of the country also have potential to make an impact on public opinion. These dynamics vary from the economics to the judicial system and democratic principles functioning in that country. On the other hand, public opinion has a power to shape politics and media's priorities in reporting. The interaction among politics, public opinion and media of one country can be better analyzed with the findings of public opinion research administered regularly. In Turkey, the research on and analysis of public opinion are most frequent during the election times. Therefore, it seems necessary to measure the public opinion more regularly to test the relationships among political, public and media agendas. Accordingly, the current study seeks to fill this gap. It is argued that in the absence of timely feedback from public surveys, decisions and policies for improving different services and institutions functioning in the country might not achieve their expected goal. The findings of

Opinion formation on multiplex scale-free networks

Science.gov (United States)

Nguyen, Vu Xuan; Xiao, Gaoxi; Xu, Xin-Jian; Li, Guoqi; Wang, Zhen

2018-01-01

Most individuals, if not all, live in various social networks. The formation of opinion systems is an outcome of social interactions and information propagation occurring in such networks. We study the opinion formation with a new rule of pairwise interactions in the novel version of the well-known Deffuant model on multiplex networks composed of two layers, each of which is a scale-free network. It is found that in a duplex network composed of two identical layers, the presence of the multiplexity helps either diminish or enhance opinion diversity depending on the relative magnitudes of tolerance ranges characterizing the degree of openness/tolerance on both layers: there is a steady separation between different regions of tolerance range values on two network layers where multiplexity plays two different roles, respectively. Additionally, the two critical tolerance ranges follow a one-sum rule; that is, each of the layers reaches a complete consensus only if the sum of the tolerance ranges on the two layers is greater than a constant approximately equaling 1, the double of the critical bound on a corresponding isolated network. A further investigation of the coupling between constituent layers quantified by a link overlap parameter reveals that as the layers are loosely coupled, the two opinion systems co-evolve independently, but when the inter-layer coupling is sufficiently strong, a monotonic behavior is observed: an increase in the tolerance range of a layer causes a decline in the opinion diversity on the other layer regardless of the magnitudes of tolerance ranges associated with the layers in question.

OPINION

African Journals Online (AJOL)

decrease trainee exposure to rare and complex as well as and to common paediatric surgical pathologies.1 ... nurses, anaesthetists and intensivists), and overall shortage of health care workers and resources pose ... order to gain the skills, knowledge and maturity necessary to practice independently as professionals.

WTO Compliance Status of the Conservation Security Program (CSP) and the Conservation Reserve Program (CRP)

National Research Council Canada - National Science Library

Schnepf, Randy

2007-01-01

.... This report is not a legal opinion, but describes both the CSP and CRP programs, the WTO Annex II provisions that govern compliance, and the potential issues involved in evaluating the compliance status of the two programs. This report will be updated as events warrant.

Early Surgical Site Infection Following Tissue Expander Breast Reconstruction with or without Acellular Dermal Matrix: National Benchmarking Using National Surgical Quality Improvement Program

Directory of Open Access Journals (Sweden)

Sebastian Winocour

2015-03-01

Full Text Available BackgroundSurgical site infections (SSIs result in significant patient morbidity following immediate tissue expander breast reconstruction (ITEBR. This study determined a single institution's 30-day SSI rate and benchmarked it against that among national institutions participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP.MethodsWomen who underwent ITEBR with/without acellular dermal matrix (ADM were identified using the ACS-NSQIP database between 2005 and 2011. Patient characteristics associated with the 30-day SSI rate were determined, and differences in rates between our institution and the national database were assessed.Results12,163 patients underwent ITEBR, including 263 at our institution. SSIs occurred in 416 (3.4% patients nationwide excluding our institution, with lower rates observed at our institution (1.9%. Nationwide, SSIs were significantly more common in ITEBR patients with ADM (4.5% compared to non-ADM patients (3.2%, P=0.005, and this trend was observed at our institution (2.1% vs. 1.6%, P=1.00. A multivariable analysis of all institutions identified age ≥50 years (odds ratio [OR], 1.4; confidence interval [CI], 1.1-1.7, body mass index ≥30 kg/m2 vs. 4.25 hours (OR, 1.9; CI, 1.5-2.4 as risk factors for SSIs. Our institutional SSI rate was lower than the nationwide rate (OR, 0.4; CI, 0.2-1.1, although this difference was not statistically significant (P=0.07.ConclusionsThe 30-day SSI rate at our institution in patients who underwent ITEBR was lower than the nation. SSIs occurred more frequently in procedures involving ADM both nationally and at our institution.

Effect of users' opinion evolution on information diffusion in online social networks

Science.gov (United States)

Zhu, Hengmin; Kong, Yuehan; Wei, Jing; Ma, Jing

2018-02-01

The process of topic propagation always interweaves information diffusion and opinion evolution, but most previous works studied the models of information diffusion and opinion evolution separately, and seldom focused on their interaction of each other. To shed light on the effect of users' opinion evolution on information diffusion in online social networks, we proposed a model which incorporates opinion evolution into the process of topic propagation. Several real topics propagating on Sina Microblog were collected to analyze individuals' propagation intentions, and different propagation intentions were considered in the model. The topic propagation was simulated to explore the impact of different opinion distributions and intervention with opposite opinion on information diffusion. Results show that the topic with one-sided opinions can spread faster and more widely, and intervention with opposite opinion is an effective measure to guide the topic propagation. The earlier to intervene, the more effectively the topic propagation would be guided.

Abortion - surgical

Science.gov (United States)

Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

A young surgeon's perspective on alternate surgical training pathways.

Science.gov (United States)

Sutherland, Michael J

2007-02-01

Most residents in training today are in focused on their training, and the thoughts of changing the structure of residencies and fellowships is something that they are ambivalent about or have never heard anything about. The small minority who are vocal on these issues represent an activist group supporting change. This group is very vocal and raises many of the excellent questions we have examined. In discussion with residents, some feel that shortened training will help with the financial issues facing residents. However, many people today add additional years to their training with research years or "super" fellowships. The residents demonstrate that they want to get the skill sets that they desire despite the added length of training. This is unlikely to change even if the minimum number of years of training changes with the evolution of tracked training programs. Medical students, in the Resident and Associate Society of the American College of Surgeons survey, did not indicate that shortened training would have an affect on decision to pursue or not pursue a surgical career. If the focus of these changes is to encourage medical students to pursue a residency in surgical specialties, we may need to look at other options to increase medical student interest. Medical students indicated that lifestyle issues, types of clinical problems, stress-related concerns, and interactions with the surgical faculty were far more important in their decision to enter a surgical specialty than work hours or duration of training. If we are to make a difference in the quality and quantity of applicants for surgical residencies, then changes in the structure of residencies do not seem to be the most effective way to accomplish this. We should possibly focus more on faculty and medical student interaction and the development of positive role models for medical students to see surgeons with attractive practices that minimize some of the traditionally perceived negative stereotypes

The Distribution of Climate Change Public Opinion in Canada.

Directory of Open Access Journals (Sweden)

Matto Mildenberger

Full Text Available While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change's causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels.

The Distribution of Climate Change Public Opinion in Canada.

Science.gov (United States)

Mildenberger, Matto; Howe, Peter; Lachapelle, Erick; Stokes, Leah; Marlon, Jennifer; Gravelle, Timothy

2016-01-01

While climate scientists have developed high resolution data sets on the distribution of climate risks, we still lack comparable data on the local distribution of public climate change opinions. This paper provides the first effort to estimate local climate and energy opinion variability outside the United States. Using a multi-level regression and post-stratification (MRP) approach, we estimate opinion in federal electoral districts and provinces. We demonstrate that a majority of the Canadian public consistently believes that climate change is happening. Belief in climate change's causes varies geographically, with more people attributing it to human activity in urban as opposed to rural areas. Most prominently, we find majority support for carbon cap and trade policy in every province and district. By contrast, support for carbon taxation is more heterogeneous. Compared to the distribution of US climate opinions, Canadians believe climate change is happening at higher levels. This new opinion data set will support climate policy analysis and climate policy decision making at national, provincial and local levels.

Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

Science.gov (United States)

Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models.

Science.gov (United States)

Van Esbroeck, Alexander; Rubinfeld, Ilan; Hall, Bruce; Syed, Zeeshan

2014-11-01

To investigate the use of machine learning to empirically determine the risk of individual surgical procedures and to improve surgical models with this information. American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 2005 to 2009 were used to train support vector machine (SVM) classifiers to learn the relationship between textual constructs in current procedural terminology (CPT) descriptions and mortality, morbidity, Clavien 4 complications, and surgical-site infections (SSI) within 30 days of surgery. The procedural risk scores produced by the SVM classifiers were validated on data from 2010 in univariate and multivariate analyses. The procedural risk scores produced by the SVM classifiers achieved moderate-to-high levels of discrimination in univariate analyses (area under receiver operating characteristic curve: 0.871 for mortality, 0.789 for morbidity, 0.791 for SSI, 0.845 for Clavien 4 complications). Addition of these scores also substantially improved multivariate models comprising patient factors and previously proposed correlates of procedural risk (net reclassification improvement and integrated discrimination improvement: 0.54 and 0.001 for mortality, 0.46 and 0.011 for morbidity, 0.68 and 0.022 for SSI, 0.44 and 0.001 for Clavien 4 complications; P risk for individual procedures. This information can be measured in an entirely data-driven manner and substantially improves multifactorial models to predict postoperative complications. Copyright © 2014 Elsevier Inc. All rights reserved.

Forming of political opinion and decision

International Nuclear Information System (INIS)

Urban, K.

1980-01-01

Taking the SNR-300 reactor in Kalkar as an example, the process of forming of political opinion and decision is reconstructed in order to get a picture of typical consensus- and conflict patterns in the discussion of safety problems. On this basis, it should be possible to derive a freedom of action for the political and administrative managing of safety matters by means of feed back with social groups. As a crucial point the aspects concerning the steps of the forming of political opinion and decision are examined. (DG) [de

Impact of the Antibiotic Stewardship Program on Prevention and Control of Surgical Site Infection during Peri-Operative Clean Surgery.

Science.gov (United States)

Liu, Juyuan; Li, Na; Hao, Jinjuan; Li, Yanming; Liu, Anlei; Wu, Yinghong; Cai, Meng

2018-04-01

Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention. During the pre-intervention stage (January 1, 2010 through December 31, 2011), comprehensive surveillance was performed to determine the SSI baseline data. In the second stage (January 1, 2012 through December 31, 2016), an infectious diseases physician and an infection control practitioner identified the surgical patients daily and followed up on the duration of antimicrobial prophylaxis. From January 1, 2010 to December 31, 2016, 41,426 patients underwent clean surgeries in a grade III, class A hospital. The rate of prophylactic antibiotic use in the 41,426 clean surgeries was reduced from 82.9% to 28.0% after the interventions. The rate of antibiotic agents administered within 120 minutes of the first incision increased from 20.8% to 85.1%. The rate at which prophylactic antimicrobial agents were discontinued in the first 24 hours after surgery increased from 22.1% to 60.4%. Appropriate antibiotic selection increased from 37.0% to 93.6%. Prophylactic antibiotic re-dosing increased from 3.8% to 64.8%. The SSI rate decreased from 0.7% to 0.5% (p < 0.05). The pathogen detection rate increased from 16.7% up to 41.8% after intervention. The intensity of antibiotic consumption reduced from 74.9 defined daily doses (DDDs) per 100 bed-days to 34.2 DDDs per 100 bed-days after the interventions. Long-term and continuous antibiotic stewardship programs have important effects on the prevention and control of SSI during clean surgery.

Post surgical complications from students' large animal surgical ...

African Journals Online (AJOL)

A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

Do Others’ Opinion Matter?

DEFF Research Database (Denmark)

Liu, Fei; Xiao, Bo Sophia; Lim, Eric T. K.

2016-01-01

when experiencing dissonance in e-WOM, male consumers value opinionated review over numerical rating and vice versa for their female counterparts. The results of our field survey on a custom developed website with 115 college students empirically validated our hypothesized relationships and also...

MindDigger: Feature Identification and Opinion Association for Chinese Movie Reviews

Science.gov (United States)

Zhao, Lili; Li, Chunping

In this paper, we present a prototype system called MindDigger, which can be used to analyze the opinions in Chinese movie reviews. Different from previous research that employed techniques on product reviews, we focus on Chinese movie reviews, in which opinions are expressed in subtle and varied ways. The system designed in this work aims to extract the opinion expressions and assign them to the corresponding features. The core tasks include feature and opinion extraction, and feature-opinion association. To deal with Chinese effectively, several novel approaches based on syntactic analysis are proposed in this paper. Running results show the performance is satisfactory.

Discrepant perceptions of communication, teamwork and situation awareness among surgical team members.

Science.gov (United States)

Wauben, L S G L; Dekker-van Doorn, C M; van Wijngaarden, J D H; Goossens, R H M; Huijsman, R; Klein, J; Lange, J F

2011-04-01

To assess surgical team members' differences in perception of non-technical skills. Questionnaire design. Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands. Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists. All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT. Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

Formal mentorship in a surgical residency training program: a prospective interventional study.

Science.gov (United States)

Zhang, Han; Isaac, Andre; Wright, Erin D; Alrajhi, Yaser; Seikaly, Hadi

2017-02-13

Otolaryngology-Head and Neck surgery resident physicians (OHNSR) have a high prevalence of burnout, job dissatisfaction and stress as shown within the literature. Formal mentorship programs (FMP) have a proven track record of enhancing professional development and academic success. More importantly FMP have an overall positive impact on residents and assist in improving job satisfaction. The purpose of the study is to determine the effects of a FMP on the well-being of OHNSR. A FMP was established and all OHNSR participation was voluntary. Eight OHNSR participated in the program. Perceived Stress Survey (PSS) and the Maslach Burnout Inventory (MBI) were administered at baseline and then at 3, 6, 9, and 12 month intervals. World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline and at 12 months. Baseline statistics found a significant burden of stress and burnout with an average PSS of 18.5 with a high MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. Quality of life was also found to be low with a WH-QOL score of 71.9. After implementation of the FMP, PSS was reduced to 14.5 at 3 months (p = 0.174) and a statistically significant lower value of 7.9 at 12 months (p = 0.001). Participants were also found to have lower emotional scores (14.9, p values using the WH-QOL was also found to be significantly improved (37.5, P = 0.003) with statistically significant lower scores for the physical health (33.9, p = 0.003), psychological (41.1, p = 0.001), social relationship (46.9, p = 0.019), and environment (53.5, p = 0.012) domains. This is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.

The surgical experience of general surgery residents: an analysis of the applicability of the specialty program in General and Digestive Surgery.

Science.gov (United States)

Targarona Soler, Eduardo Ma; Jover Navalon, Jose Ma; Gutierrez Saiz, Javier; Turrado Rodríguez, Víctor; Parrilla Paricio, Pascual

2015-03-01

Residents in our country have achieved a homogenous surgical training by following a structured residency program. This is due to the existence of specific training programs for each specialty. The current program, approved in 2007, has a detailed list of procedures that a surgeon should have performed in order to complete training. The aim of this study is to analyze the applicability of the program with regard to the number of procedures performed during the residency period. A data collection form was designed that included the list of procedures from the program of the specialty; it was sent in April 2014 to all hospitals with accredited residency programs. In September 2014 the forms were analysed, and a general descriptive study was performed; a subanalysis according to the resident's sex and Autonomous region was also performed. The number of procedures performed according to the number of residents in the different centers was also analyzed. The survey was sent to 117 hospitals with accredited programs, which included 190 resident places. A total of 91 hospitals responded (53%). The training offered adapts in general to the specialty program. The total number of procedures performed in the different sub-areas, in laparoscopic and emergency surgery is correct or above the number recommended by the program, with the exception of esophageal-gastric and hepatobiliary surgery. The sub-analysis according to Autonomous region did not show any significant differences in the total number of procedures, however, there were significant differences in endocrine surgery (P=.001) and breast surgery (P=.042). A total of 55% of residents are female, with no significant differences in distribution in Autonomous regions. However, female surgeons operate more than their male counterparts during the residency period (512±226 vs. 625±244; P<.01). The number of residents in the hospital correlates with the number of procedures performed; the residents with more procedures

Opinion Spreading with Mobility on Scale-Free Networks

International Nuclear Information System (INIS)

Qiang, Guo; Xing-Wen, Chen; Jian-Guo, Liu; Bing-Hong, Wang; Tao, Zhou; Yu-Hua, Yao

2008-01-01

A continuum opinion dynamic model is presented based on two rules. The first one considers the mobilities of the individuals, the second one supposes that the individuals update their opinions independently. The results of the model indicate that the bounded confidence in c , separating consensus and incoherent states, of a scale-free network is much smaller than the one of a lattice. If the system can reach the consensus state, the sum of all individuals' opinion change O c (t) quickly decreases in an exponential form, while if it reaches the incoherent state finally O c (t) decreases slowly and has the punctuated equilibrium characteristic

Zealotry effects on opinion dynamics in the adaptive voter model

Science.gov (United States)

Klamser, Pascal P.; Wiedermann, Marc; Donges, Jonathan F.; Donner, Reik V.

2017-11-01

The adaptive voter model has been widely studied as a conceptual model for opinion formation processes on time-evolving social networks. Past studies on the effect of zealots, i.e., nodes aiming to spread their fixed opinion throughout the system, only considered the voter model on a static network. Here we extend the study of zealotry to the case of an adaptive network topology co-evolving with the state of the nodes and investigate opinion spreading induced by zealots depending on their initial density and connectedness. Numerical simulations reveal that below the fragmentation threshold a low density of zealots is sufficient to spread their opinion to the whole network. Beyond the transition point, zealots must exhibit an increased degree as compared to ordinary nodes for an efficient spreading of their opinion. We verify the numerical findings using a mean-field approximation of the model yielding a low-dimensional set of coupled ordinary differential equations. Our results imply that the spreading of the zealots' opinion in the adaptive voter model is strongly dependent on the link rewiring probability and the average degree of normal nodes in comparison with that of the zealots. In order to avoid a complete dominance of the zealots' opinion, there are two possible strategies for the remaining nodes: adjusting the probability of rewiring and/or the number of connections with other nodes, respectively.

Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs – Clinical and surgical skills

Directory of Open Access Journals (Sweden)

Parikshit Gogate

2017-01-01

Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates

Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients.

Science.gov (United States)

Atay, Selma; Vurur, Sevda; Erdugan, Necla

Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large. This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals. This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses. It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes. The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel. The training of nurses and caregivers helps to prevent the falls of inpatients.

The Fernald Envoy Program: How face-to-face public involvement is working

Energy Technology Data Exchange (ETDEWEB)

Hoopes, J. [Fernald Environmental Restoration Management Corp., Cincinnati, OH (United States). Fernald Environmental Management Project; Hundertmark, C.A. [Jacobs Engineering Group, Inc., Albuquerque, NM (United States); Jordan, J. [Univ. of Cincinnati, OH (United States). Center for Environmental Communication Studies

1995-12-31

In March 1994, the Fernald Environmental Management Project (FEMP), initiated the Fernald Envoy Program as a tool for strengthening public involvement in the restoration of the Fernald site, a former US Department of Energy uranium processing facility which ceased operation in 1989 and became an environmental restoration site. Based on the concept that opinion leaders play a key role in the flow of information, the Envoy Program was developed to link Fernald with opinion leaders in community groups. In February and March 1995, the University of Cincinnati Center for Environmental Communication Studies, under contract with the Fernald Environmental Restoration Management Corporation, conducted an evaluation to determine how the Envoy Program was functioning in relation to the original Envoy Plan. A quasi-experimental design was applied using telephone surveys of opinion leaders in groups with envoy representation and in groups without representation. Findings validated the effectiveness of the program and also identified areas for program improvement.

The Fernald Envoy Program: How face-to-face public involvement is working

International Nuclear Information System (INIS)

Hoopes, J.; Jordan, J.

1995-01-01

In March 1994, the Fernald Environmental Management Project (FEMP), initiated the Fernald Envoy Program as a tool for strengthening public involvement in the restoration of the Fernald site, a former US Department of Energy uranium processing facility which ceased operation in 1989 and became an environmental restoration site. Based on the concept that opinion leaders play a key role in the flow of information, the Envoy Program was developed to link Fernald with opinion leaders in community groups. In February and March 1995, the University of Cincinnati Center for Environmental Communication Studies, under contract with the Fernald Environmental Restoration Management Corporation, conducted an evaluation to determine how the Envoy Program was functioning in relation to the original Envoy Plan. A quasi-experimental design was applied using telephone surveys of opinion leaders in groups with envoy representation and in groups without representation. Findings validated the effectiveness of the program and also identified areas for program improvement

Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training.

Science.gov (United States)

Gallagher, Anthony G; Ritter, E Matt; Champion, Howard; Higgins, Gerald; Fried, Marvin P; Moses, Gerald; Smith, C Daniel; Satava, Richard M

2005-02-01

To inform surgeons about the practical issues to be considered for successful integration of virtual reality simulation into a surgical training program. The learning and practice of minimally invasive surgery (MIS) makes unique demands on surgical training programs. A decade ago Satava proposed virtual reality (VR) surgical simulation as a solution for this problem. Only recently have robust scientific studies supported that vision A review of the surgical education, human-factor, and psychology literature to identify important factors which will impinge on the successful integration of VR training into a surgical training program. VR is more likely to be successful if it is systematically integrated into a well-thought-out education and training program which objectively assesses technical skills improvement proximate to the learning experience. Validated performance metrics should be relevant to the surgical task being trained but in general will require trainees to reach an objectively determined proficiency criterion, based on tightly defined metrics and perform at this level consistently. VR training is more likely to be successful if the training schedule takes place on an interval basis rather than massed into a short period of extensive practice. High-fidelity VR simulations will confer the greatest skills transfer to the in vivo surgical situation, but less expensive VR trainers will also lead to considerably improved skills generalizations. VR for improved performance of MIS is now a reality. However, VR is only a training tool that must be thoughtfully introduced into a surgical training curriculum for it to successfully improve surgical technical skills.

Consistency of performance of robot-assisted surgical tasks in virtual reality.

Science.gov (United States)

Suh, I H; Siu, K-C; Mukherjee, M; Monk, E; Oleynikov, D; Stergiou, N

2009-01-01

The purpose of this study was to investigate consistency of performance of robot-assisted surgical tasks in a virtual reality environment. Eight subjects performed two surgical tasks, bimanual carrying and needle passing, with both the da Vinci surgical robot and a virtual reality equivalent environment. Nonlinear analysis was utilized to evaluate consistency of performance by calculating the regularity and the amount of divergence in the movement trajectories of the surgical instrument tips. Our results revealed that movement patterns for both training tasks were statistically similar between the two environments. Consistency of performance as measured by nonlinear analysis could be an appropriate methodology to evaluate the complexity of the training tasks between actual and virtual environments and assist in developing better surgical training programs.

The role of inter-institutional cooperation in surgical training and ...

African Journals Online (AJOL)

Methods: Contact was first initiated between the heads of department at the two institutions and communications was almost entirely through e-mail. A Memorandum of Understanding ... taking part in the exchange programs. Keywords: Surgical training, North-South divide, academic exchange programs, Tanzania, Germany ...

Can a teaching assistant experience in a surgical anatomy course influence the learning curve for nontechnical skill development for surgical residents?

Science.gov (United States)

Heidenreich, Mark J; Musonza, Tashinga; Pawlina, Wojciech; Lachman, Nirusha

2016-01-01

The foundation upon which surgical residents are trained to work comprises more than just critical cognitive, clinical, and technical skill. In an environment where the synchronous application of expertise is vital to patient outcomes, the expectation for optimal functioning within a multidisciplinary team is extremely high. Studies have shown that for most residents, one of the most difficult milestones in the path to achieving professional expertise in a surgical career is overcoming the learning curve. This view point commentary provides a reflection from the two senior medical students who have participated in the Student-as-Teacher program developed by the Department of Anatomy at Mayo Clinic, designed to prepare students for their teaching assistant (TA) role in anatomy courses. Both students participated as TAs in a six week surgical anatomy course for surgical first assistant students offered by the School of Health Sciences at Mayo Clinic. Development of teaching skills, nontechnical leadership, communication, and assessment skills, are discussed in relation to their benefits in preparing senior medical students for surgical residency. © 2015 American Association of Anatomists.

Impact of gender and personality traits (BFI-10) on opinion leadership

DEFF Research Database (Denmark)

Sudzina, Frantisek; Pavlicek, Antonin

2017-01-01

The paper studies the influence of gender and personality traits on opinion leadership. It tries to partially replicate the study about effect of Big Five Inventory (BFI) personality traits on domain-specific opinion leadership mediated through objective knowledge and generalized opinion leadership...

42 CFR 1008.31 - OIG fees for the cost of advisory opinions.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false OIG fees for the cost of advisory opinions. 1008.31... SERVICES OIG AUTHORITIES ADVISORY OPINIONS BY THE OIG Advisory Opinion Fees § 1008.31 OIG fees for the cost of advisory opinions. (a) Responsibility for fees. The requestor is responsible for paying a fee...

Program Director Perceptions of Surgical Resident Training and Patient Care under Flexible Duty Hour Requirements.

Science.gov (United States)

Saadat, Lily V; Dahlke, Allison R; Rajaram, Ravi; Kreutzer, Lindsey; Love, Remi; Odell, David D; Bilimoria, Karl Y; Yang, Anthony D

2016-06-01

The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial was a national, cluster-randomized, pragmatic, noninferiority trial of 117 general surgery programs, comparing standard ACGME resident duty hour requirements ("Standard Policy") to flexible, less-restrictive policies ("Flexible Policy"). Participating program directors (PDs) were surveyed to assess their perceptions of patient care, resident education, and resident well-being during the study period. A survey was sent to all PDs of the general surgery residency programs participating in the FIRST trial (N = 117 [100% response rate]) in June and July 2015. The survey compared PDs' perceptions of the duty hour requirements in their arm of the FIRST trial during the study period from July 1, 2014 to June 30, 2015. One hundred percent of PDs in the Flexible Policy arm indicated that residents used their additional flexibility in duty hours to complete operations they started or to stabilize a critically ill patient. Compared with the Standard Policy arm, PDs in the Flexible Policy arm perceived a more positive effect of duty hours on the safety of patient care (68.9% vs 0%; p care (98.3% vs 0%; p care (71.8%), continuity of care (94.0%), quality of resident education (83.8%), and resident well-being (55.6%) would be improved with a hypothetical permanent adoption of more flexible duty hours. Program directors involved in the FIRST trial perceived improvements in patient safety, continuity of care, and multiple aspects of resident education and well-being with flexible duty hours. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Current status of endoscopic simulation in gastroenterology fellowship training programs.

Science.gov (United States)

Jirapinyo, Pichamol; Thompson, Christopher C

2015-07-01

Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to

PENGARUH MODIFIED AUDIT OPINION TERHADAP BORROWING CASH FLOW DAN INVESTMENT CASH FLOW

Directory of Open Access Journals (Sweden)

Puspita Hardina Cahyaningrum

2013-06-01

Full Text Available This study examines and analyzes the economic consequences of modified audit opinion on borrowing cash flow and investment cash flow. Panel data model was used to observe the research. The sample of this study was 247 companies listed in Indonesia Stock Exchange for the years 2008-2010. The results show that modified audit opinion, except unqualified opinion with explanatory paragraph about going concern, did not affect borrowing cash flow because audit opinion was not the only consideration for granting credit by creditors. Companies receiving modified audit opinion were proven using more operating cash flow for investing shown in investment cash flow, especially companies receiving unqualified opinion with explanatory paragraph about going concern.

An opinion formation based binary optimization approach for feature selection

Science.gov (United States)

Hamedmoghadam, Homayoun; Jalili, Mahdi; Yu, Xinghuo

2018-02-01

This paper proposed a novel optimization method based on opinion formation in complex network systems. The proposed optimization technique mimics human-human interaction mechanism based on a mathematical model derived from social sciences. Our method encodes a subset of selected features to the opinion of an artificial agent and simulates the opinion formation process among a population of agents to solve the feature selection problem. The agents interact using an underlying interaction network structure and get into consensus in their opinions, while finding better solutions to the problem. A number of mechanisms are employed to avoid getting trapped in local minima. We compare the performance of the proposed method with a number of classical population-based optimization methods and a state-of-the-art opinion formation based method. Our experiments on a number of high dimensional datasets reveal outperformance of the proposed algorithm over others.

The effects of information and social conformity on opinion change.

Science.gov (United States)

Mallinson, Daniel J; Hatemi, Peter K

2018-01-01

Extant research shows that social pressures influence acts of political participation, such as turning out to vote. However, we know less about how conformity pressures affect one's deeply held political values and opinions. Using a discussion-based experiment, we untangle the unique and combined effects of information and social pressure on a political opinion that is highly salient, politically charged, and part of one's identity. We find that while information plays a role in changing a person's opinion, the social delivery of that information has the greatest effect. Thirty three percent of individuals in our treatment condition change their opinion due to the social delivery of information, while ten percent respond only to social pressure and ten percent respond only to information. Participants that change their opinion due to social pressure in our experiment are more conservative politically, conscientious, and neurotic than those that did not.

The effects of information and social conformity on opinion change

Science.gov (United States)

Hatemi, Peter K.

2018-01-01

Extant research shows that social pressures influence acts of political participation, such as turning out to vote. However, we know less about how conformity pressures affect one’s deeply held political values and opinions. Using a discussion-based experiment, we untangle the unique and combined effects of information and social pressure on a political opinion that is highly salient, politically charged, and part of one’s identity. We find that while information plays a role in changing a person’s opinion, the social delivery of that information has the greatest effect. Thirty three percent of individuals in our treatment condition change their opinion due to the social delivery of information, while ten percent respond only to social pressure and ten percent respond only to information. Participants that change their opinion due to social pressure in our experiment are more conservative politically, conscientious, and neurotic than those that did not. PMID:29718958

Joint Degree Program: the Perspective of Employers

Directory of Open Access Journals (Sweden)

Tatjana Bilevičienė

2013-08-01

Full Text Available Purpose — the purpose of this article is to extend discussion towards the need and importance of joint degree programs in modern universities, introducing the perspective of the employers toward this question. Design/methodology/approach — the research was conducted to analyze the demand of joint degree programs from the perspective of employers, identify weak and strong aspects, opinion and demand for graduates of such programs. To achieve this purpose, a combination of theoretical and empirical methods was chosen: document analysis (previous studies, statistics was conducted and an online qualitative survey was organized. Findings — The analysis of articles, studies and statistics points out the challenges and threats faced by universities nowadays, forcing higher education institutions to find new ways to raise the quality of studies and raise the interest of employers to choose graduates from MRU, as well as the satisfaction of employers with their choice of employees. Theoretical analysis pointed out these challenges and requirements for the modern employee, summarised the challenges in preparation of IT field specialists. The conducted research results showed that the diploma of joint degree programs would not be treated as an advantage of possible employee from the perspective of employers in case some important aspects will not be taken into consideration by program creators. On the other hand, undeniably there are strong sides, such as knowledge in the fields of foreign language, international experience, innovativeness and creativeness of employees that would be treated as an advantage in the process of selection for positions of any technical support related positions. Research limitations/implications — employers, whose business activities are closely related to information technology, have been invited as experts. In addition, these experts have a good understanding of the specifics of joint degree programs. The received

Why are junior doctors deterred from choosing a surgical career?

Science.gov (United States)

Rogers, Mary E; Creed, Peter A; Searle, Judy

2012-05-01

To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

Prevention of Surgical Fires: A Certification Course for Healthcare Providers.

Science.gov (United States)

Fisher, Marquessa

2015-08-01

An estimated 550 to 650 surgical fires occur annually in the United States. Surgical fires may have severe consequences, including burns, disfigurement, long-term medical care, or death. This article introduces a potential certification program for the prevention of surgical fires. A pilot study was conducted with a convenience sample of 10 anesthesia providers who participated in the education module. The overall objective was to educate surgical team members and to prepare them to become certified in surgical fire prevention. On completion of the education module, participants completed the 50-question certification examination. The mean pretest score was 66%; none of the participants had enough correct responses (85%) to be considered competent in surgical fire prevention. The mean post- test score was 92.80%, with all participants answering at least 85% of questions correct. A paired-samples t test showed a statistically significant increase in knowledge: t (df = 9) = 11.40; P = .001. Results of the pilot study indicate that this course can remediate gaps in knowledge of surgical fire prevention for providers. Their poor performance on the pretest suggests that many providers may not receive sufficient instruction in surgical fire prevention.

Blood transfusion knowledge of surgical residents: is an educational intervention effective?

Science.gov (United States)

Champion, Caitlin; Saidenberg, Elianna; Lampron, Jacinthe; Pugh, Debra

2017-04-01

Evidence-based transfusion education for surgical residents is crucial to improving practice. A pilot study was undertaken to assess the effectiveness of an education module for improving transfusion knowledge among surgical residents. Modules were developed and delivered by experts in surgery and transfusion medicine. They were delivered to residents in their first 2 years of training (Surgical Foundations), and to General Surgery residents across all years of training. Premodule and postmodule and retention knowledge assessments were used to assess efficacy. Median assessment scores for each group were compared using a two-sample Wilcoxon rank-sum analysis. Chi-square tests were used to compare each group's correct response rates for each question across the three tests. Median assessment scores of residents in the Surgical Foundations program improved from a mean of 60% premodule to 80% postmodule and remained at 80% in the retention assessment (p transfusion dose, preoperative blood management, management of reactions, and informed consent (p Transfusion knowledge of surgical residents was improved by a collaborative educational initiative. This could serve as a model for other training programs to improve resident knowledge of evidence-based transfusion practices. The efficacy of such interventions in changing practice remains untested. © 2017 AABB.

Surgical inpatient satisfaction: what are the real drivers?

Science.gov (United States)

Danforth, Rachel M; Pitt, Henry A; Flanagan, Mindy E; Brewster, Benjamin D; Brand, Elizabeth W; Frankel, Richard M

2014-08-01

Inpatient satisfaction is a key element of hospital pay-for-performance programs. Communication and pain management are known to influence results, but additional factors may affect satisfaction scores. We tested the hypothesis that patient factors and outcome parameters not considered previously are clinically important drivers of inpatient satisfaction. Medical records were reviewed for 1,340 surgical patients who returned nationally standardized inpatient satisfaction questionnaires. These patients were managed by 41 surgeons in seven specialties at two academic medical centers. Thirty-two parameters based on the patient, surgeon, outcomes, and survey were measured. Univariate and multivariable analyses were performed. Inpatients rated their overall experience favorably 75.7% of the time. Less-satisfied patients were more likely to be female, younger, less ill, taking outpatient narcotics, and admitted via the emergency department (all P expectations of patients with cancer, and postoperative complications are important and clinically relevant drivers of surgical inpatient satisfaction. Programs to manage expectations of cancer patient expectations and decrease postoperative morbidity should improve surgical inpatient satisfaction. Further efforts to risk-adjust patient satisfaction scores should be undertaken. Copyright © 2014 Mosby, Inc. All rights reserved.

Training surgical residents for a career in academic global surgery: a novel training model.

Science.gov (United States)

Swain, JaBaris D; Matousek, Alexi C; Scott, John W; Cooper, Zara; Smink, Douglas S; Bolman, Ralph Morton; Finlayson, Samuel R G; Zinner, Michael J; Riviello, Robert

2015-01-01

Academic global surgery is a nascent field focused on improving surgical care in resource-poor settings through a broad-based scholarship agenda. Although there is increasing momentum to expand training opportunities in low-resource settings among academic surgical programs, most focus solely on establishing short-term elective rotations rather than fostering research or career development. Given the complex nature of surgical care delivery and programmatic capacity building in the resource-poor settings, many challenges remain before global surgery is accepted as an academic discipline and an established career path. Brigham and Women's Hospital has established a specialized global surgery track within the general surgery residency program to develop academic leaders in this growing area of need and opportunity. Here we describe our experience with the design and development of the program followed by practical applications and lessons learned from our early experiences. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Characteristics associated with requests by pathologists for second opinions on breast biopsies.

Science.gov (United States)

Geller, Berta M; Nelson, Heidi D; Weaver, Donald L; Frederick, Paul D; Allison, Kimberly H; Onega, Tracy; Carney, Patricia A; Tosteson, Anna N A; Elmore, Joann G

2017-11-01

Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Tailoring the operative approach for appendicitis to the patient: a prediction model from national surgical quality improvement program data.

Science.gov (United States)

Senekjian, Lara; Nirula, Raminder

2013-01-01

Laparoscopic appendectomy (LA) is increasingly being performed in the United States, despite controversy about differences in infectious complication rates compared with open appendectomy (OA). Subpopulations exist in which infectious complication rates, both surgical site and organ space, differ with respect to LA compared with OA. All appendectomies in the National Surgical Quality Improvement Program database were analyzed with respect to surgical site infection (SSI) and organ space infection (OSI). Multivariate logistic regression analysis identified independent predictors of SSI or OSI. Probabilities of SSI or OSI were determined for subpopulations to identify when LA was superior to OA. From 2005 to 2009, there were 61,830 appendectomies performed (77.5% LA), of which 9,998 (16.2%) were complicated (58.7% LA). The risk of SSI was considerably lower for LA in both noncomplicated and complicated appendicitis. Across all ages, body mass index, renal function, and WBCs, LA was associated with a lower probability of SSI. The risk of OSI was considerably greater for LA in both noncomplicated and complicated appendicitis. In complicated appendicitis, OA was associated with a lower probability of OSI in patients with WBC >12 cells × 10(3)/μL. In noncomplicated appendicitis, OA was associated with a lower probability of OSI in patients with a body mass index OSI, however, SSI is consistently lower in LA patients. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Differing professional views or opinions: 1994 Special Review Panel

International Nuclear Information System (INIS)

1996-09-01

In July 1994, the Executive Director for Operations of the US Nuclear Regulatory Commission (NRC) appointed a Special Review Panel to assess the Differing Professional View or Opinion (DPV/DPO) process, including its effectiveness, how well it is understood by employees, and the organizational climate for having such views aired and properly decided. An additional area within this review was to address the effectiveness of the DPO procedures as they pertain to public access and confidentiality. Further, the Panel was charged with the review of the submittals completed since the last review to identify employees who made significant contributions to the agency or to the public health and safety but had not been adequately recognized for this contribution. The report presents the Special Review Panel's evaluation of the NRC's current process for dealing with Differing Professional Views or Opinions. Provided in this report are the results of an employee opinion survey on the process; highlights and suggestions from interviews with individuals who had submitted a Differing Professional View or Opinion, as well as with agency managers directly involved with the Differing Professional Views or Opinions process; and the Special Review Panel's recommendations for improving the DPV/DPO process

Nuclear power engineering: Public understanding and public opinion

International Nuclear Information System (INIS)

Kryshev, A.I.; Sazykina, T.G.

1998-01-01

Subjective and objective reasons for the formation of public opinion about nuclear power engineering of Russia were analyzed. Some methodological errors in work with the Russian public on the problems of nuclear energy and possible methods of their correction were discussed. The social groups of the general public, which are of greatest importance in forming the attitude towards nuclear power engineering were indicated. The conclusion was reached that opinion of the ordinary population is often indicative of real drawbacks in the work of specialists in the nuclear fuel cycle. Consequently, careful surveys of public opinion about the problems of the nuclear industry should be very useful in organizing research work properly and improving the radiation safety. (author)

[State school children's opinions regarding violence in the media].

Science.gov (United States)

Piedrahita S, Laura E

2009-01-01

To describe the opinion of schoolage children, from a public school, regarding the violence they perceive in the media. Descriptive-exploratory research with a sample, selected according to the child's age in a public school. Quantitative data were collected. There were found common issues related to the child's opinion about the violence present in the media such as frequent exposure to the media violence and lack of parental supervision. Social context and constant exposure to the media violence affect the children's opinion about the violence phenomenon and their predisposition to it.

Nurses Opinion on the Attributes of Polypharmacy in Patient Safety

Directory of Open Access Journals (Sweden)

Fathi Mohamed Mohamed

2012-07-01

Full Text Available Nurses play a functional role in preventing drug related problems. They need to be aware of the dangers of polypharmacy while reviewing patient medications. We studied the nurses' opinion on the diverse effects of polypharmacy in the hospital setting. Nurses working in a tertiary care teaching hospital participated in this cross-sectional study, conducted over 3 months, by responding to a self-administered questionnaire. Chi-square test was used to analyze association between socio-demographic characteristics and items in the study. A value of P<0.05 was considered statistically significant. Increased drug interactions scored the highest (98.1%, followed by increased adverse drug effects (81.9%, and increase in financial burden (69.5% among the negative effects of polypharmacy. 61% of the respondents felt that polypharmacy increased therapeutic effect in polypathology. No difference was observed in the opinion between male and female nurses or among varying nursing experience. Nurses with 5-10 years of experience opined increase in non-compliance to prescribed medication regimen and increase in financial burden also as negative attributes. Nurses pointed out both positive and negative implications of polypharmacy. Training programs such as continuing nursing education and workshops can be planned to translate this knowledge into practice in their routine nursing practice.

European dental students' opinions on their local anaesthesia education

NARCIS (Netherlands)

Brand, H.S.; Tan, L.L.S.; van der Spek, S.J.; Baart, J.A.

2011-01-01

Objective: To investigate students’ opinion about theoretical and clinical training in local anaesthesia at different European dental schools. Materials and Methods: A questionnaire was designed to collect information about local anaesthesia teaching. Students’ opinion was quantified with five-point

The importance of opinion leaders in agricultural production among ...

African Journals Online (AJOL)

The importance of opinion leaders in agricultural production among male and ... farmers do not have adequate access to extension services due to, amongst others, the ... In view of these problems, the role of opinion leaders is important and ...

Readmissions to Different Hospitals After Common Surgical Procedures and Consequences for Implementation of Perioperative Surgical Home Programs.

Science.gov (United States)

Dexter, Franklin; Epstein, Richard H; Sun, Eric C; Lubarsky, David A; Dexter, Elisabeth U

2017-09-01

We consider whether there should be greater priority of information sharing about postacute surgical resources used: (1) at skilled nursing facilities or inpatient rehabilitation hospitals to which patients are transferred upon discharge (when applicable) versus (2) at different hospitals where readmissions occur. Obtaining and storing data electronically from these 2 sources for Perioperative Surgical Home initiatives are dissimilar; both can be challenging depending on the country and health system. Using the 2013 US Nationwide Readmissions Database, we studied discharges of surgical diagnosis-related group (DRG) with US national median length of stay (LOS) ≥ 3 days and ≥ 10 hospitals each with ≥ 100 discharges for the Medicare Severity DRG. Nationwide, 16.15% (95% confidence interval [CI], 15.14%-17.22%) of discharges were with a disposition of "not to home" (ie, transfer to a skilled nursing facility or an inpatient rehabilitation hospital). Within 30 days, 0.88% of discharges (0.82%-0.95%) were followed by readmission and to a different hospital than the original hospital where the surgery was performed. Among all discharges, disposition "not to home" versus "to home" was associated with greater odds that the patient would have readmission within 30 days and to a different hospital than where the surgery was performed (2.11, 95% CI, 1.96-2.27; P < .0001). In part, this was because disposition "not to home" was associated with greater odds of readmission to any hospital (1.90, 95% CI, 1.82-1.98; P < .0001). In addition, among the subset of discharges with readmission within 30 days, disposition "not to home" versus "to home" was associated with greater odds that the readmission was to a different hospital than where the surgery was performed (1.20, 95% CI, 1.11-1.31; P < .0001). There was no association between the hospitals' median LOS for the DRG and the odds that readmission was to a different hospital (P = .82). The odds ratio per each 1 day decrease

Scientific Opinion on Risk Assessment of Synthetic Biology.

Science.gov (United States)

Epstein, Michelle M; Vermeire, Theo

2016-08-01

In 2013, three Scientific Committees of the European Commission (EC) drafted Scientific Opinions on synthetic biology that provide an operational definition and address risk assessment methodology, safety aspects, environmental risks, knowledge gaps, and research priorities. These Opinions contribute to the international discussions on the risk governance for synthetic biology developments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Results of the 2008/2009 Knowledge and Opinions Surveys Conducted for the U.S. Department of Energy Hydrogen Program

Energy Technology Data Exchange (ETDEWEB)

Schmoyer, Richard L [ORNL; Truett, Lorena Faith [ORNL; Cooper, Christy [U.S. Department of Energy; Chew, Andrea [U.S. Department of Energy

2010-04-01

The U.S. Department of Energy (DOE) Fuel Cell Technologies Program (FCT) conducts comprehensive efforts to enable the widespread commercialization of fuel cells in diverse sectors of the economy - with emphasis on applications that will most effectively strengthen our nation's energy security and improve our stewardship of the environment. Expanding the use of fuel cells requires a sustained education effort to lay the foundation for future commercial market introduction. The FCT education subprogram seeks to facilitate fuel cell demonstrations and support future commercialization by providing technically accurate and objective information to key target audiences both directly and indirectly involved in the use of fuel cells today. These key target audiences include a public that is familiar and comfortable with using a new fuel, state and local government officials who understand the near-term realities and long-term potential of the technology, an educated business and industry component, and trained safety and codes officials. With this in mind, the DOE FCT program established an education key activity to address the training and informational needs of target audiences that have a role in the near-term transition and the long-term development of a hydrogen economy. Whether or not changes can be attributed to the program, designing and maintaining an effective education program entails measuring baseline awareness and periodically measuring what has been learned. The purpose of this report is to document the data and results of statistical surveys undertaken in 2008 and 2009 to measure and establish changes in understanding and awareness about hydrogen and fuel cell technologies since a baseline survey was conducted in 2004. This report is essentially a data book, a digest of the survey data and an exposition of changes in knowledge of and opinions about hydrogen and fuel cell technology since 2004. Many conclusions can be made from the survey data. However

Comparison between the public opinion and the image of public opinion on nuclear power generation. From the viewpoint of risk communication

International Nuclear Information System (INIS)

Matsuda, Toshihiro

2003-01-01

One objective for risk communication is to improve the understanding of public values and concerns. This paper examined the perceptions of nuclear power plant engineers of an electric power company, about public values and concerns regarding nuclear power generation (image of public opinion), and compared them with actual public opinion. The image of public opinion was surveyed by questionnaire method. In the questionnaire, the subjects were asked to estimate the most preferred answer given to questions posed to the Japanese public. For some questions, subjects were asked to estimate the percentage of Japanese who selected a certain answer for a question or the distribution of the answers. The results showed: (1) Nuclear power plant engineers correctly recognized the existence of high anxiety in the public's mind concerning nuclear power generation. (2) Engineers were apt to underestimate the percentage of Japanese who think nuclear power generation is useful in our society. (3) The majority of Japanese assume that when nuclear power plant accidents occur radioactive leakage is so severe that it affects the health of inhabitants. However, the engineers were apt to estimate that the majority of Japanese think radioactive leakage is not so severe. (4) Engineers correctly recognized that the majority of Japanese think it is a realistic option to use the nuclear power generation. However, they incorrectly estimated that only 40% of Japanese think it is a realistic option to use the nuclear power generation when in fact 67% think so. These gaps between public opinion and the image of public opinion by the engineers were classified into two groups, one that stems from the cognitive bias when people estimate public opinion and one that is inherent in the engineers of nuclear power plants. (author)

Surgical Nondestructive Evaluation (SuNDE)

Science.gov (United States)

2011-07-01

on a moveable pedestal) demonstrated during the program visit to CMU.......................................................45 APPENDIX LIST OF... bridge inspection, and tank inspection. The CMU research group has constructed a variety of highly articulated snake robots, which can exploit their...visit to CMU. The locomoting or free crawling snake (on the left) is observed climbing a pole. The surgical type snake on a moveable pedestal (on the

On the empirical relevance of the transient in opinion models

International Nuclear Information System (INIS)

Banisch, Sven; Araujo, Tanya

2010-01-01

While the number and variety of models to explain opinion exchange dynamics is huge, attempts to justify the model results using empirical data are relatively rare. As linking to real data is essential for establishing model credibility, this Letter develops an empirical confirmation experiment by which an opinion model is related to real election data. The model is based on a representation of opinions as a vector of k bits. Individuals interact according to the principle that similarity leads to interaction and interaction leads to still more similarity. In the comparison to real data we concentrate on the transient opinion profiles that form during the dynamic process. An artificial election procedure is introduced which allows to relate transient opinion configurations to the electoral performance of candidates for which data are available. The election procedure based on the well-established principle of proximity voting is repeatedly performed during the transient period and remarkable statistical agreement with the empirical data is observed.

On the empirical relevance of the transient in opinion models

Energy Technology Data Exchange (ETDEWEB)

Banisch, Sven, E-mail: sven.banisch@universecity.d [Mathematical Physics, Physics Department, Bielefeld University, 33501 Bielefeld (Germany); Institute for Complexity Science (ICC), 1249-078 Lisbon (Portugal); Araujo, Tanya, E-mail: tanya@iseg.utl.p [Research Unit on Complexity in Economics (UECE), ISEG, TULisbon, 1249-078 Lisbon (Portugal); Institute for Complexity Science (ICC), 1249-078 Lisbon (Portugal)

2010-07-12

While the number and variety of models to explain opinion exchange dynamics is huge, attempts to justify the model results using empirical data are relatively rare. As linking to real data is essential for establishing model credibility, this Letter develops an empirical confirmation experiment by which an opinion model is related to real election data. The model is based on a representation of opinions as a vector of k bits. Individuals interact according to the principle that similarity leads to interaction and interaction leads to still more similarity. In the comparison to real data we concentrate on the transient opinion profiles that form during the dynamic process. An artificial election procedure is introduced which allows to relate transient opinion configurations to the electoral performance of candidates for which data are available. The election procedure based on the well-established principle of proximity voting is repeatedly performed during the transient period and remarkable statistical agreement with the empirical data is observed.

Chaotic Modes in Scale Free Opinion Networks

Science.gov (United States)

Kusmartsev, Feo V.; Kürten, Karl E.

2010-12-01

In this paper, we investigate processes associated with formation of public opinion in varies directed random, scale free and small-world social networks. The important factor of the opinion formation is the existence of contrarians which were discovered by Granovetter in various social psychology experiments1,2,3 long ago and later introduced in sociophysics by Galam.4 When the density of contrarians increases the system behavior drastically changes at some critical value. At high density of contrarians the system can never arrive to a consensus state and periodically oscillates with different periods depending on specific structure of the network. At small density of the contrarians the behavior is manifold. It depends primary on the initial state of the system. If initially the majority of the population agrees with each other a state of stable majority may be easily reached. However when originally the population is divided in nearly equal parts consensus can never be reached. We model the emergence of collective decision making by considering N interacting agents, whose opinions are described by two state Ising spin variable associated with YES and NO. We show that the dynamical behaviors are very sensitive not only to the density of the contrarians but also to the network topology. We find that a phase of social chaos may arise in various dynamical processes of opinion formation in many realistic models. We compare the prediction of the theory with data describing the dynamics of the average opinion of the USA population collected on a day-by-day basis by varies media sources during the last six month before the final Obama-McCain election. The qualitative ouctome is in reasonable agreement with the prediction of our theory. In fact, the analyses of these data made within the paradigm of our theory indicates that even in this campaign there were chaotic elements where the public opinion migrated in an unpredictable chaotic way. The existence of such a phase

Surgical lighting

NARCIS (Netherlands)

Knulst, A.J.

2017-01-01

The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

Surgical smoke.

Science.gov (United States)

Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

2009-10-01

Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

The relevance of security analyst opinions for investment decisions

NARCIS (Netherlands)

Gerritsen, D.F.

2014-01-01

Security analysts analyze information regarding publicly traded companies after which they publish their opinion regarding these companies’ stocks. In this dissertation the published opinions of two different types of analysts are analyzed. Technical analysts derive a recommendation to buy, hold, or

Changes in alcohol policies and public opinions in Finland 2003-2013.

Science.gov (United States)

Österberg, Esa; Lindeman, Mikaela; Karlsson, Thomas

2014-05-01

There is a constant and ongoing interplay between public opinions and public policies, alcohol policies being no exception. This article describes the development of public opinions regarding alcohol policy in Finland during a 10-year period between 2003 and 2013. Fluctuations in the alcohol policy opinion climate are put in context by looking at concurrent changes in alcohol policies and in total alcohol consumption. The study is based on data from opinion surveys on alcohol policies commissioned by the National Institute for Health and Welfare and the Finnish Social and Health Association. The opinion polls include questions about the general acceptance of prevailing alcohol policies, appropriate sales channels of different alcoholic beverage categories and opinions about the legal age limits and prices of alcoholic beverages. In the study, changes in alcohol policy during 2003-2013 are surveyed, and their relationship with changes in alcohol policy opinion is examined. There seem to be a strong positive correlation during the study period between the level of alcohol consumption and the share of those wanting a more restrictive alcohol policy in Finland. It seems that an increased level of awareness of alcohol-related issues among the general public created a more restrictive opinion climate on alcohol policy issues after the big alcohol excise duty decrease in 2004. The reverse seems to happen but in a lesser degree when alcohol excise duties has been increased after the year 2007. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone.

Science.gov (United States)

Kushner, Adam L; Kamara, Thaim B; Groen, Reinou S; Fadlu-Deen, Betsy D; Doah, Kisito S; Kingham, T Peter

2010-01-01

Although surgery is increasingly recognized as an essential component of primary health care, there has been little documentation of surgical programs in low- and middle-income countries. Surgeons OverSeas (SOS) is a New York-based organization with a mission to save lives in developing countries by improving surgical care. This article highlights the surgical program in Sierra Leone as a possible model to improve access to surgery. An SOS team conducted a needs assessment of surgical capacity in Sierra Leone in February 2008. Interventions were then developed and programs were implemented. A follow-up assessment was conducted in December 2009, which included interviews of key Sierra Leone hospital personnel and a review of operating room log books. Based on an initial needs assessment, a program was developed that included training, salary support, and the provision of surgical supplies and equipment. Two 3-day workshops were conducted for a total of 44 health workers, salary support given to over 100 staff, and 2 containers of supplies and equipment were donated. Access to surgery, as measured by the number of major operations at Connaught Hospital, increased from 460 cases in 2007 to 768 cases in 2009. The SOS program in Sierra Leone highlights a method for improving access to surgery that incorporates an initial needs assessment with minimal external support and local staff collaboration. The program functions as a catalyst by providing training, salary support, and supplies. The beneficial results of the program can then be used to advocate for additional resources for surgery from policy makers. This model could be beneficial in other resource-poor countries in which improved access to surgery is desired. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation.

Science.gov (United States)

Berry, Meredith S; Nickerson, Norma P; Metcalf, Elizabeth Covelli

2016-09-01

Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf ( Canis lupus ), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [ Cervus canadensis ]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as

Using Spatial, Economic, and Ecological Opinion Data to Inform Gray Wolf Conservation

Science.gov (United States)

Berry, Meredith S.; Nickerson, Norma P.; Metcalf, Elizabeth Covelli

2018-01-01

Public opinion can be an influential factor in wildlife management decisions. Evaluating public opinions can help legitimize, or delegitimize, management and facilitate long-term conservation goals. This is especially true for the controversial issues surrounding the management of predators. We surveyed Montana, USA, residents during summer of 2013 to measure public opinion regarding economic and ecological impacts of the gray wolf (Canis lupus), and current management of this species. Although opinions were polarized in some areas, a greater percentage of Montanans think that wolves negatively affect the economy, but impact tourism (which contributes to the economy) positively. These differences may reflect the belief that rancher economic losses from wolf predation of cattle is greater than overall tourism gains related to wolves (e.g., wolf-watching), in addition to the perception of wolves negatively affecting big game (e.g., elk [Cervus canadensis]). Results also show that a slightly greater percentage of Montanans feel that wolves positively rather than negatively affect the ecosystem. Regarding specific practices, more Montanans than not have a positive opinion of maintaining wolves on the landscape and also support hunting of wolves. More Montanans hold negative rather than positive opinions, however, regarding wolf trapping. This result was most evident in western Montana as assessed by a spatial distribution of opinions by county and has implications for current wolf management and nontarget species. Results of ordinal regression analyses revealed that big game hunters, males, and those who held negative opinions of the effect of wolves on the Montana ecosystem and economy were significantly more likely to support both hunting and trapping practices. Living in western Montana predicted positive opinions of hunting, but alternatively, negative opinions of trapping. These results provide an understanding of public opinion of wolf management by county as

Virtual vitreoretinal surgery: construction of a training programme on the Eyesi Surgical Simulator

DEFF Research Database (Denmark)

Vergmann, Anna Stage; Vestergaard, Anders Højslet; Grauslund, Jakob

Purpose: The purpose of this study was to test the construct validity of a full virtual reality vitreoretinal training program at the Eyesi Surgical simulator. Design and methods: A virtual vitreoretinal training program was composed on the Eyesi Surgical simulator, software version 2.9.2 (VRmagic...... GmbH, Manheim, Germany). It was completed twice by three groups: Group 1: Twenty medical students Group 2: Ten ophthalmology residents Group 3: Five vitreoretinal surgeons The program consisted of six training modules (Figure 1): Navigation level 2 (Nav2) Forceps Training level 5 (ForT5) Bimanual...... developed a training program in virtual vitreoretinal surgery with construct validity for four out of six modules and for overall score. This makes the program a useful tool in the training of future vitreoretinal surgeons....

Pregnancy and Motherhood During Surgical Training.

Science.gov (United States)

Rangel, Erika L; Smink, Douglas S; Castillo-Angeles, Manuel; Kwakye, Gifty; Changala, Marguerite; Haider, Adil H; Doherty, Gerard M

2018-03-21

Although family priorities influence specialty selection and resident attrition, few studies describe resident perspectives on pregnancy during surgical training. To directly assess the resident experience of childbearing during training. A self-administered 74-question survey was electronically distributed in January 2017 to members of the Association of Women Surgeons, to members of the Association of Program Directors in Surgery listserv, and through targeted social media platforms. Surgeons who had 1 or more pregnancies during an Accreditation Council for Graduate Medical Education-accredited US general surgery residency program and completed training in 2007 or later were included. Important themes were identified using focus groups of surgeons who had undergone pregnancy during training in the past 7 years. Additional topics were identified through MEDLINE searches performed from January 2000 to July 2016 combining the keywords pregnancy, resident, attrition, and parenting in any specialty. Descriptive data on perceptions of work schedule during pregnancy, maternity leave policies, lactation and childcare support, and career satisfaction after childbirth. This study included 347 female surgeons (mean [SD] age, 30.5 [2.7] years) with 452 pregnancies. A total of 297 women (85.6%) worked an unmodified schedule until birth, and 220 (63.6%) were concerned that their work schedule adversely affected their health or the health of their unborn child. Residency program maternity leave policies were reported by 121 participants (34.9%). A total of 251 women (78.4%) received maternity leave of 6 weeks or less, and 250 (72.0%) perceived the duration of leave to be inadequate. The American Board of Surgery leave policy was cited as a major barrier to the desired length of leave by 268 of 326 respondents (82.2%). Breastfeeding was important to 329 (95.6%), but 200 (58.1%) stopped earlier than they wished because of poor access to lactation facilities and challenges leaving

Mentoring console improves collaboration and teaching in surgical robotics.

Science.gov (United States)

Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

2006-10-01

One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P nudge mode was particularly useful for guiding a resident's hands during crucially precise steps of an operation (such as proper placement of stitches). The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

Financial and Non Financial Factors on Going-Concern Opinion

Directory of Open Access Journals (Sweden)

Junaidi Junaidi

2012-09-01

Full Text Available Company's ability to survive is a fundamental uncertainty faced in the preparation and auditing financial statements. Provision of going-concern opinion on these financial statements the company is still being debated. Public Accountant Professional Standards in section 341 states that the auditor is responsible for evaluating whether there is a major doubt on the ability of entities in the continued survival of the appropriate period of time, not more than one year from the date of the financial statements being audited. This research analyzed the financial and non financial factors that affected the provision of going-concern opinion. This research used samples of 63 companies with 315 observations, taken from years 2005-2009. The logistic regression analysis showed that the company's financial condition variables, mitigating evidence, and disclosure significantly influence the acceptance of going-concern opinion. Enterprise risk was not significant at propensity of going-concern opinion.

42 CFR 411.380 - When CMS issues a formal advisory opinion.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false When CMS issues a formal advisory opinion. 411.380... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.380 When CMS issues a formal advisory opinion. (a) CMS considers an advisory opinion to be issued once it has received payment...

Dynamics of bounded confidence opinion in heterogeneous social networks: Concord against partial antagonism

Science.gov (United States)

Kurmyshev, Evguenii; Juárez, Héctor A.; González-Silva, Ricardo A.

2011-08-01

Bounded confidence models of opinion dynamics in social networks have been actively studied in recent years, in particular, opinion formation and extremism propagation along with other aspects of social dynamics. In this work, after an analysis of limitations of the Deffuant-Weisbuch (DW) bounded confidence, relative agreement model, we propose the mixed model that takes into account two psychological types of individuals. Concord agents (C-agents) are friendly people; they interact in a way that their opinions always get closer. Agents of the other psychological type show partial antagonism in their interaction (PA-agents). Opinion dynamics in heterogeneous social groups, consisting of agents of the two types, was studied on different social networks: Erdös-Rényi random graphs, small-world networks and complete graphs. Limit cases of the mixed model, pure C- and PA-societies, were also studied. We found that group opinion formation is, qualitatively, almost independent of the topology of networks used in this work. Opinion fragmentation, polarization and consensus are observed in the mixed model at different proportions of PA- and C-agents, depending on the value of initial opinion tolerance of agents. As for the opinion formation and arising of “dissidents”, the opinion dynamics of the C-agents society was found to be similar to that of the DW model, except for the rate of opinion convergence. Nevertheless, mixed societies showed dynamics and bifurcation patterns notably different to those of the DW model. The influence of biased initial conditions over opinion formation in heterogeneous social groups was also studied versus the initial value of opinion uncertainty, varying the proportion of the PA- to C-agents. Bifurcation diagrams showed an impressive evolution of collective opinion, in particular, radical changes of left to right consensus or vice versa at an opinion uncertainty value equal to 0.7 in the model with the PA/C mixture of population near 50/50.

Discrepancy and Disliking Do Not Induce Negative Opinion Shifts

NARCIS (Netherlands)

Takács, Károly; Flache, Andreas; Maes, Michael

2016-01-01

Both classical social psychological theories and recent formal models of opinion differentiation and bi-polarization assign a prominent role to negative social influence. Negative influence is defined as shifts away from the opinion of others and hypothesized to be induced by discrepancy with or

22 CFR 126.9 - Advisory opinions and related authorizations.

Science.gov (United States)

2010-04-01

.... 126.9 Section 126.9 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS GENERAL POLICIES AND PROVISIONS § 126.9 Advisory opinions and related authorizations. (a) Advisory opinion. Any person desiring information as to whether the Directorate of Defense Trade Controls would be...

49 CFR 604.21 - Special considerations for advisory opinions.

Science.gov (United States)

2010-10-01

... Desist Orders § 604.21 Special considerations for advisory opinions. Based on new facts involving significant financial considerations, the Chief Counsel may take appropriate enforcement action contrary to an... 49 Transportation 7 2010-10-01 2010-10-01 false Special considerations for advisory opinions. 604...

Interplay between media and social influence in the collective behavior of opinion dynamics

Science.gov (United States)

Colaiori, Francesca; Castellano, Claudio

2015-10-01

Messages conveyed by media act as a major drive in shaping attitudes and inducing opinion shift. On the other hand, individuals are strongly affected by peer pressure while forming their own judgment. We solve a general model of opinion dynamics where individuals either hold one of two alternative opinions or are undecided and interact pairwise while exposed to an external influence. As media pressure increases, the system moves from pluralism to global consensus; four distinct classes of collective behavior emerge, crucially depending on the outcome of direct interactions among individuals holding opposite opinions. Observed nontrivial behaviors include hysteretic phenomena and resilience of minority opinions. Notably, consensus could be unachievable even when media and microscopic interactions are biased in favor of the same opinion: The unfavored opinion might even gain the support of the majority.

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Resources Educational Resources E-Learning Entering Resident Readiness Assessment Evidence-Based Decisions in Surgery Medical Student Resources ... checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS Ostomy Home ...

Sifting Through Chaos: Extracting Information from Unstructured Legal Opinions.

Science.gov (United States)

Oliveira, Bruno Miguel; Guimarães, Rui Vasconcellos; Antunes, Luís; Rodrigues, Pedro Pereira

2018-01-01

Abiding to the law is, in some cases, a delicate balance between the rights of different players. Re-using health records is such a case. While the law grants reuse rights to public administration documents, in which health records produced in public health institutions are included, it also grants privacy to personal records. To safeguard a correct usage of data, public hospitals in Portugal employ jurists that are responsible for allowing or withholding access rights to health records. To help decision making, these jurists can consult the legal opinions issued by the national committee on public administration documents usage. While these legal opinions are of undeniable value, due to their doctrine contribution, they are only available in a format best suited from printing, forcing individual consultation of each document, with no option, whatsoever of clustered search, filtering or indexing, which are standard operations nowadays in a document management system. When having to decide on tens of data requests a day, it becomes unfeasible to consult the hundreds of legal opinions already available. With the objective to create a modern document management system, we devised an open, platform agnostic system that extracts and compiles the legal opinions, ex-tracts its contents and produces metadata, allowing for a fast searching and filtering of said legal opinions.

Surgical Assisting

Science.gov (United States)

... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

Paediatric Abdominal Surgical Emergencies in a General Surgical ...

African Journals Online (AJOL)

... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

Risk Factors and Predictive Model Development of Thirty-Day Post-Operative Surgical Site Infection in the Veterans Administration Surgical Population.

Science.gov (United States)

Li, Xinli; Nylander, William; Smith, Tracy; Han, Soonhee; Gunnar, William

2018-04-01

Surgical site infection (SSI) complicates approximately 2% of surgeries in the Veterans Affairs (VA) hospitals. Surgical site infections are responsible for increased morbidity, length of hospital stay, cost, and mortality. Surgical site infection can be minimized by modifying risk factors. In this study, we identified risk factors and developed accurate predictive surgical specialty-specific SSI risk prediction models for the Veterans Health Administration (VHA) surgery population. In a retrospective observation study, surgical patients who underwent surgery from October 2013 to September 2016 from 136 VA hospitals were included. The Veteran Affairs Surgical Quality Improvement Program (VASQIP) database was used for the pre-operative demographic and clinical characteristics, intra-operative characteristics, and 30-day post-operative outcomes. The study population represents 11 surgical specialties: neurosurgery, urology, podiatry, otolaryngology, general, orthopedic, plastic, thoracic, vascular, cardiac coronary artery bypass graft (CABG), and cardiac valve/other surgery. Multivariable logistic regression models were developed for the 30-day post-operative SSIs. Among 354,528 surgical procedures, 6,538 (1.8%) had SSIs within 30 days. Surgical site infection rates varied among surgical specialty (0.7%-3.0%). Surgical site infection rates were higher in emergency procedures, procedures with long operative duration, greater complexity, and higher relative value units. Other factors associated with increased SSI risk were high level of American Society of Anesthesiologists (ASA) classification (level 4 and 5), dyspnea, open wound/infection, wound classification, ascites, bleeding disorder, chemotherapy, smoking, history of severe chronic obstructive pulmonary disease (COPD), radiotherapy, steroid use for chronic conditions, and weight loss. Each surgical specialty had a distinct combination of risk factors. Accurate SSI risk-predictive surgery specialty

Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

Science.gov (United States)

Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

2018-02-05

To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior

Extracting product features and opinion words using pattern knowledge in customer reviews.

Science.gov (United States)

Htay, Su Su; Lynn, Khin Thidar

2013-01-01

Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product.

Extracting Product Features and Opinion Words Using Pattern Knowledge in Customer Reviews

Directory of Open Access Journals (Sweden)

Su Su Htay

2013-01-01

Full Text Available Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product.

Extracting Product Features and Opinion Words Using Pattern Knowledge in Customer Reviews

Science.gov (United States)

Lynn, Khin Thidar

2013-01-01

Due to the development of e-commerce and web technology, most of online Merchant sites are able to write comments about purchasing products for customer. Customer reviews expressed opinion about products or services which are collectively referred to as customer feedback data. Opinion extraction about products from customer reviews is becoming an interesting area of research and it is motivated to develop an automatic opinion mining application for users. Therefore, efficient method and techniques are needed to extract opinions from reviews. In this paper, we proposed a novel idea to find opinion words or phrases for each feature from customer reviews in an efficient way. Our focus in this paper is to get the patterns of opinion words/phrases about the feature of product from the review text through adjective, adverb, verb, and noun. The extracted features and opinions are useful for generating a meaningful summary that can provide significant informative resource to help the user as well as merchants to track the most suitable choice of product. PMID:24459430

What drives people's opinions of electricity infrastructure? Empirical evidence from Ireland

International Nuclear Information System (INIS)

Bertsch, Valentin; Hyland, Marie; Mahony, Michael

2017-01-01

Across the EU, significant infrastructure investment is needed in both generation from renewable energy sources (RES) and the electricity grid to meet the European targets on emission reduction and RES expansion. Experiences show, however, that citizens may object to new energy infrastructure in their localities which may cause delays in achieving the targets. To avoid delays, it is crucial to understand what drives people's opinions. To explore people's opinions of different electricity generation and transmission technologies in Ireland, we conducted a nationally-representative survey. Concerning the drivers, we distinguish between socio-demographics, technology-specific perceptions, and energy policy preferences. Our results show that people generally have positive views of RES technologies. While this indicates that Irish citizens agree to move towards cleaner electricity sources, we find reluctance amongst people to have these technologies located close to their places of residence. We find that, across most technologies, the tradeoff people make between economic and environmental policy objectives drives their opinions of, and their tendencies to oppose, technology developments. The significance of most socio-demographic variables, however, is largely technology-dependent. This highlights that policy makers need to understand how people make tradeoffs between policy objectives and how these tradeoffs relate to their opinions of different technologies. - Highlights: • Conducted a survey to understand drivers of opinions of electricity infrastructure. • Considered socio-demographic, policy-related and technology-specific drivers. • Irish citizens generally have positive opinions of renewable technologies. • Positive opinions don't rule out local opposition. • Tradeoffs on policy objectives shape opinions most consistently across technologies.

Entropy based classifier for cross-domain opinion mining

Directory of Open Access Journals (Sweden)

Jyoti S. Deshmukh

2018-01-01

Full Text Available In recent years, the growth of social network has increased the interest of people in analyzing reviews and opinions for products before they buy them. Consequently, this has given rise to the domain adaptation as a prominent area of research in sentiment analysis. A classifier trained from one domain often gives poor results on data from another domain. Expression of sentiment is different in every domain. The labeling cost of each domain separately is very high as well as time consuming. Therefore, this study has proposed an approach that extracts and classifies opinion words from one domain called source domain and predicts opinion words of another domain called target domain using a semi-supervised approach, which combines modified maximum entropy and bipartite graph clustering. A comparison of opinion classification on reviews on four different product domains is presented. The results demonstrate that the proposed method performs relatively well in comparison to the other methods. Comparison of SentiWordNet of domain-specific and domain-independent words reveals that on an average 72.6% and 88.4% words, respectively, are correctly classified.

A comparative study of teacher's opinions relating to inclusive classrooms in Indonesia and Thailand

Directory of Open Access Journals (Sweden)

Pennee Kantavong

2017-09-01

Full Text Available This research compared the work and opinions of regular school teachers teaching in inclusive classrooms in Indonesia and Thailand. These teachers were drawn from schools participating in an in-service training program to enhance the capacity of students with special needs in regular classrooms. A sample of 172 teachers in primary schools in Thailand and 165 from Indonesia answered a questionnaire based on Friedmen's concept of teacher burnout. Eighty percent of the Thai teachers had bachelor's degrees, but only 1 percent were in special education, whereas 77 percent of the Indonesian teachers had bachelor's degrees and 13 percent were in special education. Teachers' opinions on four areas were investigated: inclusion, support from various parties, work environment, and exhaustion. There was no correlation between background variables and teachers' exhaustion and fulfillment. There was a correlation between the number of students in a class and a teacher's de-personalization at the .01 level. When considering social dimensions and exhaustion, there was a correlation at the .01 level. There was a correlation between self-fulfillment and exhaustion at the .01 level. There was no correlation between the organizational, psychological, structural and support dimensions, and exhaustion. In general, teachers reported that they received support from various parties. Most of them expressed positive opinions of students with special needs.

The learning effect of intraoperative video-enhanced surgical procedure training.

Science.gov (United States)

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

2011-07-01

The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

Quantifying the Effect of Open-Mindedness on Opinion Dynamics and Advertising Optimization

OpenAIRE

Innes, Clinton R

2014-01-01

Group opinion dynamics shape our world in innumerable ways. Societal aspects ranging from the political parties we support to the economic decisions we make in our daily lives are all directly af- fected in some way by group opinion dynamics. This makes understanding and potentially being able to predict the complex inter-relationships between individuals’ opinions and group opinion dynam- ics invaluable both scientifically and economically. We propose an aggregation model incorporating ingro...

The influence of persuasion in opinion formation and polarization

Science.gov (United States)

La Rocca, C. E.; Braunstein, L. A.; Vazquez, F.

2014-05-01

We present a model that explores the influence of persuasion in a population of agents with positive and negative opinion orientations. The opinion of each agent is represented by an integer number k that expresses its level of agreement on a given issue, from totally against k=-M to totally in favor k = M. Same-orientation agents persuade each other with probability p, becoming more extreme, while opposite-orientation agents become more moderate as they reach a compromise with probability q. The population initially evolves to (a) a polarized state for r=p/q\\gt 1 , where opinions' distribution is peaked at the extreme values k=+/- M , or (b) a centralized state for r < 1, with most opinions around k=+/- 1 . When r \\gg 1 , polarization lasts for a time that diverges as r^M \\ln N , where N is the population's size. Finally, an extremist consensus (k = M or -M ) is reached in a time that scales as r^{-1} for r \\ll 1 .

A Retrospective Analysis of Pre-surgical Incisor Decompensation Attained in an Orthognathic Surgery Population

Science.gov (United States)

2016-07-01

incisors were more proclined. One of the goals of pre - surgical orthodontic treatment is decompensation of the occlusion and movement of teeth into...purpose of this study is to analyze pre - surgical orthodontic incisor decompensation attained in a group of orthognathic surgery patients treated in...the Tri-Service Orthodontic Residency Program. B. Specific Hypothesis Pre - surgical orthodontic treatment does not achieve full decompensation of

Opinions and Knowledge About Climate Change Science in High School Students

DEFF Research Database (Denmark)

Harker-Schuch, Inez; Henriksen, Christian Bugge

2013-01-01

in national and international schools before and after a lecture in climate change science. The results show that knowledge about climate change science significantly affects opinions about climate change. Students with a higher number of correct answers are more likely to have the opinion that humans......This study investigates the influence of knowledge on opinions about climate change in the emerging adults' age group (16-17 years). Furthermore, the effects of a lecture in climate change science on knowledge and opinions were assessed. A survey was conducted in Austria and Denmark on 188 students...... are causing climate change and that both individuals and governments are responsible for addressing climate change. The lecture in climate change science significantly improved knowledge development but did not affect opinions. Knowledge was improved by 11 % after the lecture. However, the percentage...

The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

Science.gov (United States)

Dydykin, Sergey; Kapitonova, Marina

2015-01-01

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

Opinion leadership and willingness to pay for residential photovoltaic systems

International Nuclear Information System (INIS)

Yamamoto, Yoshihiro

2015-01-01

According to diffusion theory, opinion leaders play an important role in the diffusion of new technologies through interpersonal communication with potential adopters. This study investigates the role and utility of opinion leadership in photovoltaic (PV) system diffusion. Specifically, the study proposes, examines, and considers the implications of the hypothesis that there is a positive relationship between willingness to pay (WTP) for a PV system and opinion leadership on PV-system adoption. The investigation employed an internet-based questionnaire to assess the use of interpersonal communication in decision-making on adoption, to identify opinion leaders on adoption, and to characterize their WTP. The response pool consisted of 488 individuals who lived in a detached house, owned a residential PV system, and were responsible for making the decision to adopt the system. The results support the hypothesis. Considering that subsidization preferentially incentivizes households with greater WTP to adopt PV systems, this suggests that subsidization is more effective than purchases of PV power under feed-in tariffs in promoting the diffusion of residential PV systems through interpersonal communication. -- Highlights: •Interpersonal communication about the adoption of PV systems is analyzed. •A questionnaire survey is conducted. •Opinion leaders on PV-system adoption are identified. •A relationship is confirmed between willingness to pay and opinion leadership. •Subsidization is more essential than feed-in tariffs from this point of view

Sudden transitions in coupled opinion and epidemic dynamics with vaccination

Science.gov (United States)

Pires, Marcelo A.; Oestereich, André L.; Crokidakis, Nuno

2018-05-01

This work consists of an epidemic model with vaccination coupled with an opinion dynamics. Our objective was to study how disease risk perception can influence opinions about vaccination and therefore the spreading of the disease. Differently from previous works we have considered continuous opinions. The epidemic spreading is governed by an SIS-like model with an extra vaccinated state. In our model individuals vaccinate with a probability proportional to their opinions. The opinions change due to peer influence in pairwise interactions. The epidemic feedback to the opinion dynamics acts as an external field increasing the vaccination probability. We performed Monte Carlo simulations in fully-connected populations. Interestingly we observed the emergence of a first-order phase transition, besides the usual active-absorbing phase transition presented in the SIS model. Our simulations also show that with a certain combination of parameters, an increment in the initial fraction of the population that is pro-vaccine has a twofold effect: it can lead to smaller epidemic outbreaks in the short term, but it also contributes to the survival of the chain of infections in the long term. Our results also suggest that it is possible that more effective vaccines can decrease the long-term vaccine coverage. This is a counterintuitive outcome, but it is in line with empirical observations that vaccines can become a victim of their own success.

Opinion-enhanced collaborative filtering for recommender systems through sentiment analysis

Science.gov (United States)

Wang, Wei; Wang, Hongwei

2015-10-01

The motivation of collaborative filtering (CF) comes from the idea that people often get the best recommendations from someone with similar tastes. With the growing popularity of opinion-rich resources such as online reviews, new opportunities arise as we can identify the preferences from user opinions. The main idea of our approach is to elicit user opinions from online reviews, and map such opinions into preferences that can be understood by CF-based recommender systems. We divide recommender systems into two types depending on the number of product category recommended: the multiple-category recommendation and the single-category recommendation. For the former, sentiment polarity in coarse-grained manner is identified while for the latter fine-grained sentiment analysis is conducted for each product aspect. If the evaluation frequency for an aspect by a user is greater than the average frequency by all users, it indicates that the user is more concerned with that aspect. If a user's rating for an aspect is lower than the average rating by all users, he or she is much pickier than others on that aspect. Through sentiment analysis, we then build an opinion-enhanced user preference model, where the higher the similarity between user opinions the more consistent preferences between users are. Experiment results show that the proposed CF algorithm outperforms baseline methods for product recommendation in terms of accuracy and recall.

[Virtual surgical education: experience with medicine and surgery students].

Science.gov (United States)

Bonavina, Luigi; Mozzi, Enrico; Peracchia, Alberto

2003-01-01

The use of virtual reality simulation is currently being proposed within programs of postgraduate surgical education. The simple tasks that make up an operative procedure can be repeatedly performed until satisfactory execution is achieved, and the errors can be corrected by means of objective assessment. The aim of this study was to evaluate the applicability and the results of structured practice with the LapSim laparoscopic simulator used by undergraduate medical students. A significant reduction in operative time and errors was noted in several tasks (navigation, clipping, etc.). Although the transfer of technical skills to the operating room environment remains to be demonstrated, our research shows that this type of teaching is applicable to undergraduate medical students and in future may become a useful tool for selecting individuals for surgical residency programs.

Motives for seeking a second opinion in orthopaedic surgery.

NARCIS (Netherlands)

Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van

2001-01-01

The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

Nursing opinion leadership: a preliminary model derived from philosophic theories of rational belief.

Science.gov (United States)

Anderson, Christine A; Whall, Ann L

2013-10-01

Opinion leaders are informal leaders who have the ability to influence others' decisions about adopting new products, practices or ideas. In the healthcare setting, the importance of translating new research evidence into practice has led to interest in understanding how opinion leaders could be used to speed this process. Despite continued interest, gaps in understanding opinion leadership remain. Agent-based models are computer models that have proven to be useful for representing dynamic and contextual phenomena such as opinion leadership. The purpose of this paper is to describe the work conducted in preparation for the development of an agent-based model of nursing opinion leadership. The aim of this phase of the model development project was to clarify basic assumptions about opinions, the individual attributes of opinion leaders and characteristics of the context in which they are effective. The process used to clarify these assumptions was the construction of a preliminary nursing opinion leader model, derived from philosophical theories about belief formation. © 2013 John Wiley & Sons Ltd.

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review.

Science.gov (United States)

Forgione, Antonello; Guraya, Salman Y

2017-01-01

Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. This research aimed to explore the value of currently available modern surgical tools that can be used outside the OR and also elaborates the existing laparoscopic surgical training programs in world-class centers across the globe with a view to formulate a blended and unified structured surgical training program. Several data sources were searched using MeSH terms "Laparoscopic surgery" and "Surgical training" and "Surgical curriculum" and "fundamentals of endoscopic surgery" and "fundamentals of laparoscopic surgery" and "Telementoring" and "Box trainer." The eligibility criteria used in data extraction searched for original and review articles and by excluding the editorial articles, short communications, conference proceedings, personal view, and commentaries. Data synthesis and data analysis were done by reviewing the initially retrieved 211 articles. Irrelevant and duplicate and redundant articles were excluded from the study. Finally, 12 articles were selected for this systematic review. Data results showed that a myriad of cutting-edge technical innovations have provided modern surgical training tools such as the simulation-based mechanical and virtual reality simulators, animal and cadaveric labs, telementoring, telerobotic-assisted surgery, and video games. Surgical simulators allow the trainees to acquire surgical skills in a tension-free environment without supervision or time constraints. The existing world-renowned surgical training centers employ various clusters of training

The brazilian nuclear policy with respect to the public opinion

International Nuclear Information System (INIS)

Freitas Brandao Bittencourt, C.

1988-01-01

Four decades of the Brazilian nuclear history have been analysed with special emphasis placed on government policy and its repercussion on public opinion. The implications of the new constitutional regulations which rule the issue are discussed. it is also studied the change in the nuclear program structure, enforced in August 1988. At different times, the government decisions on nuclear energy could be classified as miser, extravagant, dissimulated and frank, successively. Their aftermaths, which show little consistency with the expectations laid on them, have led to discredit by part of the society, which is controlled by a scientific - intellectual elite. However, recent successes are likely to reverse this trend, if the government explores them properly. (author) [pt

Public opinion survey 'Nuclear energy - the present and the future'

International Nuclear Information System (INIS)

Matani, R.; Lebegner, J.; Jurkovi, I.-A.; Prah, M.

2000-01-01

As a part of Croatian Nuclear Society Young Generation Network efforts in improving relations with the general public, a survey on nuclear energy issues among a student population (18-22 years old) has been planned. The survey, although somewhat modified, is based on a similar one that has been conducted at high schools as a part of organized educational program by the Museum of Technical Sciences and Hrvatska Elektroprivreda. Preliminary results show a positive altitude among the student population when it comes to nuclear power plants. As it can be seen from the obtained data (preliminary analysis), this opinion is mostly built on student awareness of nuclear power plants as a clean energy source. (authors)

Expert opinion vs. empirical evidence: the precautionary principle applied to GM crops.

Science.gov (United States)

Herman, Rod A; Raybould, Alan

2014-01-01

Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops.

Surgical simulators in urological training--views of UK Training Programme Directors.

Science.gov (United States)

Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

2012-09-01

What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Ostomy Home Skills Program

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A projective surgical navigation system for cancer resection

Science.gov (United States)

Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald

2016-03-01

Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

Islamic Work Ethics and Audit Opinions: Audit Professionalism and Dysfunctional

Directory of Open Access Journals (Sweden)

Tulus Suryanto

2016-02-01

Full Text Available This study examines the relationship between Islamic work ethics and auditors' opinion, focusing on the aspects of audit professionalism and dysfunctional behavior  as intervening  variables. The research involved in Internal Auditors working of Islamic Banking industry in Sumatra Island. A questionnaire was used for data collection. The study represents the empirical test employing census sampling. The data collected were analysed using Amos.  The results of the study confirmed the three hypotheses examined: there is a positive corelation between Islamic work ethics and auditors' opinions; auditors’ professionalism is an intervening variable of the correlation between Islamic work ethics and auditors’ opinions and dysfunctional behavior is a negative intervening variable of the correlation between Islamic Work Ethics and auditors' opinionsDOI: 10.15408/aiq.v8i1.1864

Phase Transitions in a Social Impact Model for Opinion Formation

Science.gov (United States)

Bordogna, Clelia M.; Albano, Ezequiel V.

A model for opinion formation in a social group, based on the Theory of Social Impact developed by Latané, is studied by means of numerical simulations. Interactions among the members of the group, as well as with a strong leader competing with the mass media, are considered. The model exhibits first-order transitions between two different states of opinion, which are supported by the leader and the mass media, respectively. The social inertia of the group becomes evident when the opinion of the leader changes periodically. In this case two dynamic states are identified: for long periods of time, the group follows the changes of the leader but, decreasing the period, the opinion of the group remains unchanged. This scenery is suitable for the ocurrence of dynamic phase transitions.

Democracy, the media stage and opinions evaluation. The particular case of nuclear

International Nuclear Information System (INIS)

Ansel, Ph.; Pages, J.P.

1997-01-01

The intention is pointed at the public opinion. The public debate, linked to the political system, is described in the frame where the opinions are expressed in interaction with the media. This debate has a fundamental role in the opinions structuration. Then it is shown how it is possible to introduce it in the way of measuring the opinions. Then, we arrive to the structures of public opinion. The analysis of facts registered during twenty years on nuclear energy allows to illustrate the interest of this global approach: considered from a controversy point of view, it is also a technical object and then it can be considered as a differentiation theme among others ones. (N.C.)

Ostomy Home Skills Program

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Full Text Available ... Membership Excelsior Surgical Society Officer Nominations ACS Clinical Congress Fitts Oration Contact MHSSPACS Society of Surgical Chairs ... Publications Resources Education Program Videos Contact Us Clinical Congress Clinical Congress 2018 Clinical Congress 2018 Postgraduate Courses ...

Indicators of opinion leadership in customer networks : self-reports and degree centrality

NARCIS (Netherlands)

Risselada, Hans; Verhoef, Pieter; Bijmolt, Tammo

In this paper, we assess two alternative indicators of opinion leadership, self-reported opinion leadership and degree centrality, on the same dataset. We also investigate the interaction effect of these two indicators and the social network environment on opinion leadership. We use social network

The nature and determinants of opinion leadership in Lesotho ...

African Journals Online (AJOL)

This research investigates the nature, the occurrence and the factors influencing opinion leadership in Lesotho. The focus is on a typical rural district where 200 maize farmers were randomly selected and their opinion leaders identified by means of sociometric methods with the number of nominations as the major indicator ...

7 CFR Appendix H to Subpart E of... - Suggested Format for the Opinion of the Lender's Legal Counsel

Science.gov (United States)

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Suggested Format for the Opinion of the Lender's Legal Counsel H Appendix H to Subpart E of Part 1980 Agriculture Regulations of the Department of Agriculture... Industrial Loan Program Pt. 1980, Subpt. E, App. H Appendix H to Subpart E of Part 1980—Suggested Format for...

Surgical stress response: does endoscopic surgery confer an advantage?

DEFF Research Database (Denmark)

Kehlet, H

1999-01-01

of postoperative pulmonary function and less hypoxemia with endoscopic operation. The slight modification of surgical stress responses by endoscopic surgery is in contrast to the common, though not universal, demonstration of less pain, shorter hospital stay, and less morbidity after endoscopic surgery...... operations where differences are more likely to be found. The clinical consequences of these findings in relation to all over surgical outcome remain to be defined, but effective pain treatment, stress reduction by other techniques, and provision of an active rehabilitation program with early mobilization...

Analysing Customer Opinions with Text Mining Algorithms

Science.gov (United States)

Consoli, Domenico

2009-08-01

Knowing what the customer thinks of a particular product/service helps top management to introduce improvements in processes and products, thus differentiating the company from their competitors and gain competitive advantages. The customers, with their preferences, determine the success or failure of a company. In order to know opinions of the customers we can use technologies available from the web 2.0 (blog, wiki, forums, chat, social networking, social commerce). From these web sites, useful information must be extracted, for strategic purposes, using techniques of sentiment analysis or opinion mining.

The Hidden Story of Innovation: Charity Hospital, Angola Prison, and the Challenging of Surgical Dogma.

Science.gov (United States)

Greiffenstein, Patrick; Hastings, Paul R

2017-02-01

The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.

Surgical case volume in Canadian urology residency: a comparison of trends in open and minimally invasive surgical experience.

Science.gov (United States)

Mamut, Adiel E; Afshar, Kourosh; Mickelson, Jennifer J; Macneily, Andrew E

2011-06-01

The application of minimally invasive surgery (MIS) has become increasingly common in urology training programs and clinical practice. Our objective was to review surgical case data from all 12 Canadian residency programs to identify trends in resident exposure to MIS and open procedures. Every year, beginning in 2003, an average of 41 postgraduate year 3 to 5 residents reported surgical case data to a secure internet relational database. Data were anonymized and extracted for the period 2003 to 2009 by measuring a set of 11 predefined index cases that could be performed in both an open and MIS fashion. 16,687 index cases were recorded by a total of 198 residents. As a proportion, there was a significant increase in MIS from 12% in 2003 to 2004 to 32% in 2008 to 2009 (P=0.01). A significant decrease in the proportion of index cases performed with an open approach was also observed from 88% in 2003 to 2004 to 68% in 2008 to 2009 (P=0.01). The majority of these shifts were secondary to the increased application of MIS for nephrectomies of all type (29%-45%), nephroureterectomy (27%-76%), adrenalectomy (15%-71%), and pyeloplasty (17%-54%) (Pfashion during the study period. MIS constitutes an increasingly significant component of surgical volume in Canadian urology residencies with a reciprocal decrease in exposure to open surgery. These trends necessitate ongoing evaluation to maintain the integrity of postgraduate urologic training.

42 CFR 411.386 - CMS's advisory opinions as exclusive.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false CMS's advisory opinions as exclusive. 411.386... Relationships Between Physicians and Entities Furnishing Designated Health Services § 411.386 CMS's advisory... described in § 411.370. CMS has not and does not issue a binding advisory opinion on the subject matter in...

Analysis of Primary School Teachers' Opinions on Family Diversity

Science.gov (United States)

Bosch, Alvaro Capano; Massonnier, Natalie; González Tornaría, Maria del L.

2016-01-01

This article aims to do an analysis based on the opinion of primary school teachers on family models that are different from the traditional nuclear family. We worked with 60 teachers from Montevideo and the metropolitan area. They answered the Questionnaire: Teachers' Opinion on Family Diversity (CIDF for its Spanish acronym) (Morgado,…

29 CFR 18.701 - Opinion testimony by lay witnesses.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Opinion testimony by lay witnesses. 18.701 Section 18.701 Labor Office of the Secretary of Labor RULES OF PRACTICE AND PROCEDURE FOR ADMINISTRATIVE HEARINGS... Opinion testimony by lay witnesses. If the witness is not testifying as an expert, the witness' testimony...

Modern, multi-media, advances in surgical information.

Science.gov (United States)

Ponsky, Todd A; Rothenberg, Steven S

2015-06-01

The need for education does not end with residency. Practicing surgeons must find ways to stay current. The boom in new technologic developments may significantly enhance our methods of teaching through the use of new mutli-media. Here we will explore some of the muti-media innovations that have or may have the greatest impact on surgical education. Live, interactive, and online forums have proven to be effective new methods of bringing people together to discuss and learn new concepts in medicine. These forums allow physicians to interact with key opinion leaders and flatten knowledge sharing, so that everyone may have a voice. The dynamic, fast paced, and interactive format allows for screen-based learning to be engaging and interactive. Information is now available online in multiple formats that are continuously updated, so that information is no longer outdated by the time it is published in a textbook. Multi-media is now being used to disseminate content through, archived video, live video, as well as audiocasts. All of these are creating more modern ways for physicians to stay up-to-date either at home, in the office, or when mobile. Lastly, new advanced, interactive, technology can allow experts to assist less-experienced surgeons as "virtual partners" through telementoring. With telementoring, an expert can be virtually present while another surgeon is performing a complex, new, operation, and the expert can help with voice suggestions and on-screen telestration. Pediatric surgical education has made a giant leap thanks to new developments in multi-media technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Wearable Technology for Global Surgical Teleproctoring.

Science.gov (United States)

Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

2015-01-01

In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery

Ostomy Home Skills Program

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[Psychiatric expert opinions on asylum seekers in Germany].

Science.gov (United States)

Sieberer, Marcel; Ziegenbein, Marc; Eckhardt, Gudrun; Machleidt, Wielant; Calliess, Iris T

2011-01-01

To investigate the frequency of traumatisation, suicidality and given diagnoses in expert opinions on asylum seekers and to describe the sociodemographic characteristics of this population. The psychiatric expert opinions on asylum seekers, furnished in an 8-year-period at Hannover Medical School, were analysed retrospectively for qualitative and quantitative characteristics. 62 psychiatric expert opinions on asylum seekers were included in this study. The asylum seekers originated from 18 different countries, mainly from Turkey and former Yugoslavia. Most expert opinions were given in secondary asylum procedures, i. e. after the initial asylum request had been rejected. The asylum seekers reported on traumatisation in 82.3 %. The most frequently reported forms of traumatisation were rape in female, and torture in male persons. According to ICD-10 or DSM-IV-R criteria posttraumatic stress disorder (PTSD) was the most frequent diagnosis (74.1 %) in this study. The second most common diagnoses were depressive disorders (ICD-10: F32.x in 33.9 % and ICD-10: F33.x in 25.9 %). Suicidal tendency was found in 56.5 % of the asylum seekers. Cultural differences, language barriers, a heavy burden by psychological symptoms, and clinical severity are difficulties in the process of psychiatric assessment of refugees in legal asylum procedures. © Georg Thieme Verlag KG Stuttgart · New York.

Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

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Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

2015-08-01

Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per

Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time.

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Dunn, John C; Belmont, Philip J; Lanzi, Joseph; Martin, Kevin; Bader, Julia; Owens, Brett; Waterman, Brian R

2015-01-01

Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and

Your opinion on climate change might not be as common as you think

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Leviston, Z.; Walker, I.; Morwinski, S.

2013-04-01

Political and media debate on the existence and causes of climate change has become increasingly factious in several western countries, often resting on claims and counter-claims about what most citizens really think. There are several well-established phenomena in psychology about how people perceive the prevalence of opinions, including the false consensus effect (a tendency to overestimate how common one's `own' opinion is) and pluralistic ignorance (where most people privately reject an opinion, but assume incorrectly that most others accept it). We investigated these biases in people's opinions about the existence and causes of climate change. In two surveys conducted 12 months apart in Australia (n=5,036 n=5,030), respondents were asked their own opinion about the nature of climate change, and then asked to estimate levels of opinion among the general population. We demonstrate that opinions about climate change are subject to strong false consensus effects, that people grossly overestimate the numbers of people who reject the existence of climate change in the broader community, and that people with high false consensus bias are less likely to change their opinions.

Contradictions and Consensus--Clusters of Opinions on E-Books

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Shrimplin, Aaron K.; Revelle, Andy; Hurst, Susan; Messner, Kevin

2011-01-01

Q methodology was used to determine attitudes and opinions about e-books among a group of faculty, graduate students, and undergraduates at Miami University of Ohio. Oral interviews formed the basis for a collection of opinion statements concerning e-books versus print. These statements were then ranked by a second group of research participants.…

Attitudes of Serbian food technology students towards surgical and immunocastration of boars and their sensitivity to androstenone and skatole

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Tomasevic, I.; Đekić, I.; Font-i-Furnols, M.; Aluwé, M.; Čandek-Potokar, M.; Bonneau, M.; Weiler, U.

2017-09-01

Various European Union pork chain actors and stakeholders agreed in 2010 on a road map to voluntarily abandon piglet castration by 1 January 2018. Because currently in Serbia, male piglets are surgically castrated and consumers are not used to the boar taint odour and flavour, the introduction of boar meat may modify the acceptability of pork. The objective of the study was to investigate the attitudes, awareness and opinions of future Serbian food technologist towards surgical castration of boars and its alternatives, and to test their sensitivity to androstenone and skatole. We found that they were concerned about the animal welfare issues and that they were willing to pay a little more for meat from animals treated with dignity. This was more so if they were females and less so if they had had a rural upbringing. They strongly believed that surgical castration is painful for the animals, but at the same time agreed that meat from castrated pigs is of better quality. Their ambiguous attitudes regarding efficacy and quality of alternatives to surgical castration clearly indicated the knowledge gap that must be filled by appropriate modifications of the curriculum. Students demonstrated average sensitivity to both androstenone and skatole. Females exhibited higher intensities of difference in both cases.

Opinions and knowledge about climate change science in high school students.

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Harker-Schuch, Inez; Bugge-Henriksen, Christian

2013-10-01

This study investigates the influence of knowledge on opinions about climate change in the emerging adults' age group (16-17 years). Furthermore, the effects of a lecture in climate change science on knowledge and opinions were assessed. A survey was conducted in Austria and Denmark on 188 students in national and international schools before and after a lecture in climate change science. The results show that knowledge about climate change science significantly affects opinions about climate change. Students with a higher number of correct answers are more likely to have the opinion that humans are causing climate change and that both individuals and governments are responsible for addressing climate change. The lecture in climate change science significantly improved knowledge development but did not affect opinions. Knowledge was improved by 11 % after the lecture. However, the percentage of correct answers was still below 60 % indicating an urgent need for improving climate change science education.

Domain Adaptation for Opinion Classification: A Self-Training Approach

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Yu, Ning

2013-03-01

Full Text Available Domain transfer is a widely recognized problem for machine learning algorithms because models built upon one data domain generally do not perform well in another data domain. This is especially a challenge for tasks such as opinion classification, which often has to deal with insufficient quantities of labeled data. This study investigates the feasibility of self-training in dealing with the domain transfer problem in opinion classification via leveraging labeled data in non-target data domain(s and unlabeled data in the target-domain. Specifically, self-training is evaluated for effectiveness in sparse data situations and feasibility for domain adaptation in opinion classification. Three types of Web content are tested: edited news articles, semi-structured movie reviews, and the informal and unstructured content of the blogosphere. Findings of this study suggest that, when there are limited labeled data, self-training is a promising approach for opinion classification, although the contributions vary across data domains. Significant improvement was demonstrated for the most challenging data domain-the blogosphere-when a domain transfer-based self-training strategy was implemented.