Sample records for surgical royal colleges

  1. Royal College surgical objectives of urologic training: A survey of faculty members from Canadian training programs (United States)

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


    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

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

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


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

  3. Digital curation and online resources: digital scanning of surgical tools at the royal college of physicians and surgeons of Glasgow for an open university learning resource. (United States)

    Earley, Kirsty; Livingstone, Daniel; Rea, Paul M


    Collection preservation is essential for the cultural status of any city. However, presenting a collection publicly risks damage. Recently this drawback has been overcome by digital curation. Described here is a method of digitisation using photogrammetry and virtual reality software. Items were selected from the Royal College of Physicians and Surgeons of Glasgow archives, and implemented into an online learning module for the Open University. Images were processed via Agisoft Photoscan, Autodesk Memento, and Garden Gnome Object 2VR. Although problems arose due to specularity, 2VR digital models were developed for online viewing. Future research must minimise the difficulty of digitising specular objects.

  4. Nuclear training facilities at the Royal Naval College, Greenwich

    International Nuclear Information System (INIS)

    Head, J.L.; Lowther, C.A.; Marsh, J.R.W.


    The paper describes some of the nuclear training facilities at the Royal Naval College and the way the facilities are used in the training of personnel for the Naval nuclear propulsion programme. (author)

  5. The Royal College of Psychiatrists and the death penalty. (United States)

    Gunn, John


    The Royal College of Psychiatrists recently issued a revised statement on its position concerning capital punishment. The College proposes to support psychiatrists who refuse to be involved in the capital process, but accepts that some may take up limited involvement in the manner set out in the document. The Royal College is the professional body for psychiatric practitioners in the United Kingdom and Ireland. Almost no public statements are issued from the College without first being deliberated on within at least two of its three major committees. The new document on capital punishment remains in the spirit of the previous ones. The topic of capital punishment is noncontroversial within the British medical profession. In all European countries, capital punishment is against the law, because there is an overarching directive from the Council of Europe (a wide group of nations, wider than the European Union) insisting that it be abolished.

  6. The Royal College of Radiologists Breast Group breast imaging classification

    International Nuclear Information System (INIS)

    Maxwell, A.J.; Ridley, N.T.; Rubin, G.; Wallis, M.G.; Gilbert, F.J.; Michell, M.J.


    Standardisation of the classification of breast imaging reports will improve communication between the referrer and the radiologist and avoid ambiguity, which may otherwise lead to mismanagement of patients. Following wide consultation, Royal College of Radiologists Breast Group has produced a scoring system for the classification of breast imaging. This will facilitate audit and the development of nationally agreed standards for the investigation of women with breast disease. This five-point system is as follows: 1, normal; 2, benign findings; 3, indeterminate/probably benign findings; 4, findings suspicious of malignancy; 5, findings highly suspicious of malignancy. It is recommended that this be used in the reporting of all breast imaging examinations in the UK.

  7. 'Any style but gothic': Building a home for the Royal College of Physicians of Ireland. (United States)

    Wheelock, H


    On 15 July 1864 the Royal College of Physicians of Ireland held its first business meeting in its newly built home at 6 Kildare Street, Dublin. Although the Royal College of Physicians of Ireland had been in existence for over 200 years this was the first occasion that a College meeting had been held in a building owned by the College. This paper looks at the history behind the construction of a home for the Royal College of Physicians of Ireland. It will examine why it took over 200 years for the Physicians to find a permanent home, how they ended up with the building they did, and what they borrowed from the Royal College of Physicians in Edinburgh in the process.

  8. The ICT-Integrated Pedagogy in the Colleges of Royal University of Bhutan

    DEFF Research Database (Denmark)

    Choeda, Par-Ola Zander; Penjor, Tandin; Dukpa, Dorji


    This paper reports a research study on the integration of ICT and pedagogy in the colleges of the Royal University of Bhutan. It investigates whether ICT is integrated into the pedagogy, and if so, in what way. The samples (Faculty members) of the study were picked up randomly from ten colleges u...

  9. The quality of operative note taking: an audit using the Royal College of Surgeons Guidelines as the gold standard. (United States)

    Shayah, A; Agada, F O; Gunasekaran, S; Jassar, P; England, R J A


    To assess the quality of operative note keeping and compare the results with the Royal College of Surgeons (RCS) of England guidelines 'Good Surgical Practice' as the gold standard. ENT Department at Hull Royal Infirmary, University Hospital. A hundred consecutive operative notes were selected between November 2005 and January 2006. The documentation of the operative notes in each case was compared with the RCS of England guidelines. All surgeons were made aware of the results of the first cycle and the guidelines were made available in all ENT theatres in the form of a printed aide-memoir. A second audit cycle was then carried out prospectively between April and June 2006. The results demonstrated a change in practice in key areas. The 1st cycle results showed the documentation of patient identification (94%), name of surgeon (98%) and clearly written postoperative instructions (94%). However, surgeons performed suboptimally at recording the name of assistant (82%), operative diagnosis (46%), the incision type (87%) and the type of wound closure (83%). After introducing the aide-memoir, the second cycle demonstrated a change in practice with 100% documentation in most of the assessed parameters except that the time of surgery and the type of surgery (emergency or elective) were not adequately recorded. We recommend that all surgical departments should have the RCS guidelines as an aide-memoir in theatres to enhance the quality and standardise operative note recording.

  10. The William Houston Medal of the Royal College of Surgeons of Edinburgh 2002. (United States)

    Teague, A M


    The William Houston medal is a prestigious prize awarded to the individual achieving the most outstanding examination performance at the Membership in Orthodontics examination for the Royal College of Surgeons of Edinburgh. Five clinical cases treated by the candidate are presented as part of the final examination; two of these cases are described below. The first a Class III malocclusion, and the second a Class II division 1 malocclusion, were both treated by orthodontic camouflage.

  11. [Residency in plastic surgery: comparison between the French and the Canadian Royal College programs]. (United States)

    Sinna, R; Harris, P G; Danino, A M


    Learning plastic surgery in Montreal is different from learning plastic surgery in a French university. In Canada, all residency programs are accredited by a national structure: the Royal College of Physicians and Surgeons. We tried to highlight the differences that exist between the French and a North American academic system. With the different rules and law that governs academic education in both countries, we analyzed the following elements: the residency selection, the program of plastic surgery (content and organisation), the system of evaluation and the diplomas. The training of a Canadian plastic surgeon is very controlled. The recommendations of the Royal College guarantee to the resident who enters a program to have the means to acquire a complete training in quantity and in quality. On the four studied items, none is completely similar between both countries. Each having advantages and inconveniences as, for example, the selection of residency by interview or by the classifying national exam. Actually, few French plastic surgery programs could satisfy the requirements of the Royal College on several points, however without failing the training of French plastic surgeons. Nevertheless, we could be inspired by several elements (rotation in private practice,grouping together several academic hospitals. . .) to improve our system of training.

  12. The JASON reactor at the Royal Naval College: Silver Jubilee 6th November 1987

    International Nuclear Information System (INIS)

    Lakey, J.R.A.; Roust, C.B.


    The 10 kW Research and Training Reactor Jason has been used at the Royal Naval College for 25 years in support of the Naval Nuclear Submarine Propulsion Programme. The principal features of Jason, relevant to its training role are given, along with the specifications of Jason, instrumentation, maintenance and operational experience. The educational role of the reactor is described with respect to the Nuclear Reactor Course, Nuclear Advanced Course, and the Nuclear Radiation Protection Course. Future developments in operator training, advantages of the low power reactor, quality control of education and training, and research and development, are also discussed. (U.K.)

  13. Royal Military College of Canada SLOWPOKE-2 facility. Integrated regulating and instrumentation system (SIRCIS) upgrade project

    International Nuclear Information System (INIS)

    Corcoran, W.P.; Nielsen, K.S.; Kelly, D.G.; Weir, R.D.


    The SLOWPOKE-2 Facility at the Royal Military College of Canada has operated the only digitally controlled SLOWPOKE reactor since 2001 (Version 1.0). The present work describes ongoing project development to provide a robust digital reactor control system that is consistent with Aging Management as summarized in the Facility's Life Cycle Management and Maintenance Plan. The project has transitioned from a post-graduate research activity to a comprehensively managed project supported by a team of RMCC professional and technical staff who have delivered an update of the V1.1 system software and hardware implementation that is consistent with best Canadian nuclear industry practice. The challenges associated with the implementation of Version 2.0 in February 2012, the lessons learned from this implementation, and the applications of these lessons to a redesign and rewrite of the RMCC SLOWPOKE-2 digital instrumentation and regulating system (Version 3) are discussed. (author)

  14. Radiographic facilities and their utilization at the Royal Military College of Science

    International Nuclear Information System (INIS)

    Carter, A.C.; Wilson, C.G.


    Non-destructive testing is playing an ever-increasing role in the design and production of weapons and material for the Ministry of Defence and the modern Army staff officer or officer in a technical corps must have the scientific and technological background to appreciate this importance. Some Army staff officers will be required to discuss the design of projects with civilian engineers and research staff and give judgement decisions involving NDT tests of weapons and equipment during and after manufacture and also after field use, etc. Radiography plays a key role in this work. The range of equipment utilised in x and γ-radiography, and experiments using these, described here are used at the Royal Military College of Science, UK for the education of such personnel. (U.K.)

  15. Malignant mast cell tumor of the thymus in an Royal College of Surgeons (RCS) rat. (United States)

    Terayama, Yui; Matsuura, Tetsuro; Ozaki, Kiyokazu


    A 152-week-old male Royal College of Surgeons (RCS) rat kept as a non-treated animal in a long-term animal study presented with a soft mass in the anterior mediastinum, which adhered to the pleura of the lung. Histopathologically, the mass mainly consisted of round to short spindle-shaped tumor cells that had infiltrated through the hyperplastic thymic tissue. The tumor cells were arranged in loose to dense sheets. Nuclei were moderate in size and round to spindle-shaped, with small nucleoli. Almost all tumor cells exhibited abundant eosinophilic cytoplasm, including eosinophilic granules of a range of sizes. The granules of tumor cells exhibited metachromasia with toluidine blue stain and were positive for c-kit and mast cell protease II. These findings indicate that the tumor described here represents a rare case of spontaneous malignant mast cell tumor with thymic epithelial hyperplasia.

  16. Concussion knowledge among Sport Chiropractic Fellows from the Royal College of Chiropractic Sports Sciences (Canada). (United States)

    Kazemi, Mohsen; Bogumil, Mary Emma; Vora, Khushboo


    The objective of this study was to investigate the degree of knowledge that sports chiropractors have in regard to concussion diagnosis and management. A concussion knowledge survey was administered to Sport Chiropractic Fellows of the Royal College of Chiropractic Sports Sciences - Canada (RCCSS(C)) (n=44) via Sports chiropractors scored statistically higher on the survey when compared to chiropractic residents (mean =5.57 vs. 5.25; t=2.12; p=0.04) and to fourth year chiropractic interns (mean = 5.57 vs 5.2; t=2.45; p=0.02). Additionally, with our modified scoring, the sports chiropractors scored 85.3%. A few knowledge gaps were identified in the sample population. Sports chiropractors demonstrated the skills and knowledge to diagnose concussion and excel at identifying the definition and mechanism of concussion, but knowledge gaps regarding diagnosis and management of concussion were found in the sample population.

  17. Surgical Competence: Assessing, Acquiring, Maintaining, and ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    Emeritus Professor of Paediatric Surgery, Royal Aberdeen Children s ... Formerly Vice President of the Royal College of Surgeons of Edinburgh ... where a highly critical if not toxic climate of low tolerance of surgical failure, with judicial,.

  18. Introduction of clerking pro forma for surgical spinal patients at the Royal National Orthopaedic Hospital NHS Trust (London): an audit cycle. (United States)

    Pace, Valerio; Farooqi, Omar; Kennedy, James; Park, Chang; Cowan, Joseph


    As a tertiary referral centre of spinal surgery, the Royal National Orthopaedic Hospital (RNOH) handles hundreds of spinal cases a year, often with complex pathology and complex care needs. Despite this, issues were raised at the RNOH following lack of sufficient documentation of preoperative and postoperative clinical findings in spinal patients undergoing major surgery. This is not in keeping with guidelines provided by the Royal College of Surgeons. The authors believe that a standardised clerking pro forma for surgical spinal patients admitted to RNOH would improve the quality of care provided. Therefore, the use of a standard clerking pro forma for all surgical spinal patients could be a useful tool enabling improvements in patients care and safety in keeping with General Medical Council/National Institute for Health and Care Excellence guidelines. An audit (with closure of loop) looking into the quality of the preoperative and postoperative clinical documentation for surgical spinal patients was carried out at the RNOH in 2016 (retrospective case note audit comparing preintervention and postintervention documentation standards). Our standardised pro forma allows clinicians to best utilise their time and standardises examination to be compared in a temporal manner during the patients admission and care. It is the authors understanding that this work is a unique study looking at the quality of the admission clerking for surgical spinal patients. Evidently, there remains work to be done for the widespread utilisation of the pro forma. Early results suggest that such a pro forma can significantly improve the documentation in admission clerking with improvements in the quality of care for patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. (United States)

    Malhi, Gin S; Bassett, Darryl; Boyce, Philip; Bryant, Richard; Fitzgerald, Paul B; Fritz, Kristina; Hopwood, Malcolm; Lyndon, Bill; Mulder, Roger; Murray, Greg; Porter, Richard; Singh, Ajeet B


    To provide guidance for the management of mood disorders, based on scientific evidence supplemented by expert clinical consensus and formulate recommendations to maximise clinical salience and utility. Articles and information sourced from search engines including PubMed and EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (MDC) (e.g., books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Information was reviewed and discussed by members of the MDC and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous successive consultation and external review involving: expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest in mood disorders. The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Mood Disorders CPG) provide up-to-date guidance and advice regarding the management of mood disorders that is informed by evidence and clinical experience. The Mood Disorders CPG is intended for clinical use by psychiatrists, psychologists, physicians and others with an interest in mental health care. The Mood Disorder CPG is the first Clinical Practice Guideline to address both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Professor Gin Malhi (Chair), Professor Darryl Bassett, Professor Philip Boyce, Professor Richard Bryant, Professor Paul Fitzgerald, Dr Kristina Fritz, Professor Malcolm Hopwood, Dr Bill Lyndon, Professor Roger Mulder, Professor Greg Murray, Professor Richard Porter and Associate Professor Ajeet Singh. Professor Carlo Altamura, Dr Francesco Colom, Professor Mark George, Professor Guy Goodwin, Professor Roger McIntyre, Dr Roger Ng

  20. The nuclear engineering programmes at the Royal Military College of Canada. Part I

    Energy Technology Data Exchange (ETDEWEB)

    Bonin, H.W. [Royal Military College of Canada, Dept. of Chemistry and Chemical Engineering, Kingston, Ontario (Canada)


    The last years have been eventful for the staff and students in the nuclear engineering programmes at the Royal Military College of Canada (RMC) in Kingston, Ontario. Among the several changes is the accessibility of the graduate programmes to civilian (Canadian citizens) students, a fact that is little known outside RMC since, in the past, these graduate programmes were intended only for military personnel. Another major event is the accreditation of the graduate programmes offered by the Department of Chemistry and Chemical Engineering(chemical, nuclear and environmental science and engineering) by the Ontario Council of Graduate Studies. The teaching and research staff share the following research areas: radiochemistry and neutron activation analysis, radiation effects on materials, radiation processing of polymers, neutron radiography, nuclear reactor simulation, analysis and design, CANDU fuel bundle optimal design, nuclear fuel cycles and management, nuclear fuel engineering and behaviour, including fission product release modelling, artificial intelligence applications to nuclear systems, nuclear accident response, nuclear radiation detection and measurement, health physics, dosimetry and radiation protection and nuclear reactor control.

  1. Enhancements to the SLOWPOKE-2 nuclear research reactor at the Royal Military College of Canada

    Energy Technology Data Exchange (ETDEWEB)

    Hungler, P.C.; Andrews, M.T.; Weir, R.D.; Nielson, K.S.; Chan, P.K.; Bennett, L.G.I., E-mail: [Royal Military College of Canada, Kingston, Ontario (Canada)


    In 1985 a Safe Low Power C(K)ritical Experiment (SLOWPOKE) nuclear research reactor was installed at the Royal Military College of Canada (RMCC). The reactor at nominally 20 kW thermal was named SLOWPOKE-2 and the core was designed to have a total of 198 fuel pins with Low Enriched Uranium (LEU) fuel (19.89% U-235). Installation of the reactor was intended to provide an education tool for members of the Canadian Armed Forces (CAF) and an affordable neutron source for the application of neutron activation analysis (NAA) and radioisotope production. Today, the SLOWPOKE-2 at RMCC continues to be a key education tool for undergraduate and post-graduate students and successfully conducts NAA and isotope production as per its original design intent. RMCC has significantly upgraded the facility and instruments to develop capabilities such as delayed neutron and gamma counting (DNGC) and neutron imaging, including 2D thermal neutron radiography and 3D thermal neutron tomography. These unique nuclear capabilities have been applied to relevant issues in the CAF. The analog control system originally installed in 1985 has been removed and replaced in 2001 by the SLOWPOKE Integrated Reactor Control and Instrumentation System (SIRCIS) which is a digital controller. This control system continues to evolve with SIRCIS V2 currently in operation. The continual enhancement of the facility, instruments and systems at the SLOWPOKE-2 at RMCC will be discussed, including an update on RMCC's refueling plan. (author)

  2. The nuclear engineering programmes at the Royal Military College of Canada. Part I

    International Nuclear Information System (INIS)

    Bonin, H.W.


    The last years have been eventful for the staff and students in the nuclear engineering programmes at the Royal Military College of Canada (RMC) in Kingston, Ontario. Among the several changes is the accessibility of the graduate programmes to civilian (Canadian citizens) students, a fact that is little known outside RMC since, in the past, these graduate programmes were intended only for military personnel. Another major event is the accreditation of the graduate programmes offered by the Department of Chemistry and Chemical Engineering(chemical, nuclear and environmental science and engineering) by the Ontario Council of Graduate Studies. The teaching and research staff share the following research areas: radiochemistry and neutron activation analysis, radiation effects on materials, radiation processing of polymers, neutron radiography, nuclear reactor simulation, analysis and design, CANDU fuel bundle optimal design, nuclear fuel cycles and management, nuclear fuel engineering and behaviour, including fission product release modelling, artificial intelligence applications to nuclear systems, nuclear accident response, nuclear radiation detection and measurement, health physics, dosimetry and radiation protection and nuclear reactor control

  3. Enhancements to the SLOWPOKE-2 nuclear research reactor at the Royal Military College of Canada

    International Nuclear Information System (INIS)

    Hungler, P.C.; Andrews, M.T.; Weir, R.D.; Nielson, K.S.; Chan, P.K.; Bennett, L.G.I.


    In 1985 a Safe Low Power C(K)ritical Experiment (SLOWPOKE) nuclear research reactor was installed at the Royal Military College of Canada (RMCC). The reactor at nominally 20 kW thermal was named SLOWPOKE-2 and the core was designed to have a total of 198 fuel pins with Low Enriched Uranium (LEU) fuel (19.89% U-235). Installation of the reactor was intended to provide an education tool for members of the Canadian Armed Forces (CAF) and an affordable neutron source for the application of neutron activation analysis (NAA) and radioisotope production. Today, the SLOWPOKE-2 at RMCC continues to be a key education tool for undergraduate and post-graduate students and successfully conducts NAA and isotope production as per its original design intent. RMCC has significantly upgraded the facility and instruments to develop capabilities such as delayed neutron and gamma counting (DNGC) and neutron imaging, including 2D thermal neutron radiography and 3D thermal neutron tomography. These unique nuclear capabilities have been applied to relevant issues in the CAF. The analog control system originally installed in 1985 has been removed and replaced in 2001 by the SLOWPOKE Integrated Reactor Control and Instrumentation System (SIRCIS) which is a digital controller. This control system continues to evolve with SIRCIS V2 currently in operation. The continual enhancement of the facility, instruments and systems at the SLOWPOKE-2 at RMCC will be discussed, including an update on RMCC's refueling plan. (author)

  4. Improving the beam quality of the neutron radiography facility using the SLOWPOKE-2 at the Royal Military College of Canada

    International Nuclear Information System (INIS)

    Lewis, W.J.; Bennett, L.G.I.; Teshima, P.


    At the SLOWPOKE-2 Facility at the Royal Military College of Canada, a neutron radiography facility has been designed and installed, and the beam quality has been improved by performing a series of radiographs using American standard for testing and materials (ASTM) E 545 indicators. Other means of determining the progress such as bubble detectors and activation foils were used. Modifications to the nosepiece of the beam tube including shielding and linings for fast neutron and gamma radiation were made. (orig.)

  5. The multi-role nature of the SLOWPOKE-2 facility at the Royal Military College of Canada

    International Nuclear Information System (INIS)

    Bennett, L.G.I.; Beeley, P.A.


    After up to a decade of successful operation of seven SLOWPOKE-2 reactors within Canada and in Jamaica, an eighth SLOWPOKE-2 research reactor was installed at the Royal Military College of Canada in 1985. Its open pool was one factor that allowed the authors to develop a variety of research capabilities beyond those being established for NAA. A description of the research projects to date will serve to indicate the diversity of this facility. (author) 14 refs.; 4 figs.; 1 tab

  6. An exploration of the use of social media by surgical colleges. (United States)

    Ralston, Maximilian R; O'Neill, Stephen; Wigmore, Stephen J; Harrison, Ewen M


    Social media use has become common for organisations in surgery, however the nature and reach of these communications is unknown. This study aimed to characterise and compare the use of "Twitter" by five prominent organisations in surgery. Data were collected from Twitter and the scale, reach, nature and sentiment of messages analysed. Message influence was determined and content analysed by frequency and association using hierarchical clustering and network analysis. Poisson regression was used to compare institutional message and "re-tweet" counts. 7712 messages were analysed from a four-year period up to 13th April 2013. The American College of Surgeons (ACS) had tweeted most and posted the greatest number of messages per day (3.3/day). The number of followers reflects social reach and the Royal College of Surgeons of England (RCSEng) had the greatest number (11,600) followed by the ACS (7320). The number of "retweets" a message receives is a measure of influence with the RCSEng (2.0) demonstrating a significantly greater count than the Royal College of Surgeons of Ireland (RCSI; 0.8, p social media. UK colleges frequently communicate about education/training opportunities while the ACS focuses on patient-related matters. Only one organisation was found to have an explicit social media policy, which would be considered best practice and can focus on-line activity. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Radiology standards for primary dental care: report by the Royal College of Radiologists and the National Radiological Protection Board

    International Nuclear Information System (INIS)

    Hudson, Tony


    In 1992 a joint venture between the Royal College of Radiologists (RCR) and the National Radiological Protection Board (NRPB) resulted in the formation of a Working Party (WP) to consider dental radiology. Although individual doses to patients are low, WP identified considerable scope for reducing the collective dose to patients and for improving the diagnostic quality of radiographs. The report published in the Documents of the NRPB series presents the WP conclusions in the form of guidelines that deal with all aspects of dental radiology in primary dental care. (Author)

  8. The Royal College of Pathologists of Australasia Quality Assurance Program: Immunohistochemistry Breast Marker Audit Overview 2005-2015. (United States)

    Haffajee, Zenobia Ayesha Mohamed; Kumar, Beena; Francis, Glenn; Peck, Martyn; Badrick, Tony


    The Royal College of Pathologists of Australasia Quality Assurance Program (RCPAQAP) Anatomical Pathology provides a comprehensive External Quality Assurance (EQA) exercise to review the reporting of immunohistochemistry (IHC) and in-situ hybridization (ISH) breast markers through an audit of clinical results. The aim of this exercise was to provide information regarding the quality of breast marker testing within clinical laboratories from 2005 to 2015. This comprehensive audit included estrogen, progesterone, and HER2 marker reporting. This was an important quality assurance activity established in response to ongoing difficulties experienced in laboratories in this area of testing.

  9. Three Licentiates of the Royal College of Surgeons of Edinburgh who were decorated with the Victoria Cross. (United States)

    Kaufman, M H


    Since the Victoria Cross was introduced in January 1856 by Queen Victoria to reward acts of valour in the face of the enemy, initially during the Crimean War, over 1350 medals have been awarded. Of these, three were awarded to medical officers who had previously gained the Licentiate Diploma of the Royal College of Surgeons of Edinburgh (LRCS Edin) - Valentine Munbee McMaster on 25 September 1857, Henry Thomas Sylvester on 20 November 1857 (although the acts of valour for which he was awarded his VC occurred on two occasions in September 1855) and Campbell Mellis (or Millis) Douglas on 7 May 1867.

  10. Provision of services for the diagnosis and treatment of heart disease. Fourth report of a Joint Cardiology Committee of the Royal College of Physicians of London and the Royal College of Surgeons of England. (United States)


    -regional funding for infant cardiac surgery and transplantation has been successful and should be continued. 10 Despite advances in non-invasive diagnosis of congenital heart disease the amount of cardiac catheterisation of children has risen due to the increase in number of interventional procedures. Vacant consultant posts in paediatric cardiology and the need for an increase in the number of such posts cannot be filled from existing senior registrar posts. All paediatric cardiac units should have a senior registrar and in the meantime it may be necessary to make proleptic appointments to consultant posts with arrangements for the appointees to complete their training. 11 Provision of care for the increasing number of adolescent and adult survivors of complex congenital heart disease is urgently required. The management of these patients is specialised, and the committee recommends that it should ultimately be undertaken by either adult or pediatric cardiologists with appropriate additional training working in supra-regionally funded centers alongside specially trained surgeons. 12 Cardiac rehabilitation should be available to all patients in the United Kingdom. 13 New recommendations for training in cardiology are for a total of at least five years in the specialty after general professional training, plus a year as senior registrar in general medicine. An additional year may be required for those wishing to work in interventional cardiology and adequate provision must be made for those with an academic interest. 14 It is essential that both basic and clinical research is carried out in cardiac centres but these activities are becoming increasingly limited by the lack of properly funded posts in the basic sciences and restriction in the number of honorary posts for clinical research workers. 15 A joint audit committee of the Royal College of Physicians and the British Cardiac Society has been established to coordinate audit in the specialty. All district and regional cardiac

  11. Looking back at the John Mitchell Crouch Fellowship: the most prestigious research award of the Royal Australasian College of Surgeons. (United States)

    Boult, Margaret; Babidge, Wendy; Pleass, Susan; Scott, David


    The John Mitchell Crouch Fellowship is a generous endowment made to the Royal Australasian College of Surgeons (RACS) by the young neurosurgeon's family, following his death from a brain tumour. In this article, we examine the significance and legacy of the grant since its inception in 1979. This is the highest level of research fellowship awarded by the RACS recognizing early career excellence, as part of its significant research funding programme (over $1.7 million in 2015). John Mitchell Crouch recipients have been pioneers in various areas of medicine where they have developed new technologies, established research centres, improved patient safety and military surgery and embraced evidence-based medicine. The funds they received have directly contributed to research published in numerous highly respected peer-reviewed journals such as The New England Journal of Medicine; established new laboratories, helped fund clinical trials and allowed new directions of research to be pursued. Recipients of the John Mitchell Crouch Fellowship have been recognized with many awards including 11 Australian and New Zealand Honours to date. Many other significant research funds have been subsequently bestowed, including over 120 National Health Medical Research Council (NHMRC) grants to Australian and New Zealand recipients subsequent to their Fellowship. This article also shows the range of disciplines in which the award has supported cutting-edge research leading to benefits for patients and health care. © 2015 Royal Australasian College of Surgeons.

  12. Myocardial perfusion scintigraphy: the evidence. A consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society, endorsed by the Royal College of Physicians of London and the Royal College of Radiologists

    International Nuclear Information System (INIS)

    Underwood, S.R.; Anagnostopoulos, C.; Cerqueira, M.; Ell, P.J.; Flint, E.J.; Harbinson, M.; Kelion, A.D.; Al-Mohammad, A.; Prvulovich, E.M.; Shaw, L.J.; Tweddel, A.C.


    This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by

  13. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. (United States)

    Hay, Phillipa; Chinn, David; Forbes, David; Madden, Sloane; Newton, Richard; Sugenor, Lois; Touyz, Stephen; Ward, Warren


    This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to

  14. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. (United States)

    Galletly, Cherrie; Castle, David; Dark, Frances; Humberstone, Verity; Jablensky, Assen; Killackey, Eóin; Kulkarni, Jayashri; McGorry, Patrick; Nielssen, Olav; Tran, Nga


    This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. The

  15. The nuclear engineering programmes at the Royal Military College of Canada. Part II

    Energy Technology Data Exchange (ETDEWEB)

    Bonin, H.W. [Royal Military College of Canada, Dept. of Chemistry and Chemical Engineering, Kingston, Ontario (Canada)


    The coverage of the activities within the nuclear science and engineering programmes at RMC reveals the dynamism of the College which is still growing at a fast rate. Being the only completely bilingual university in Canada and a true national institution gathering students and staff from all parts of the country. RMC continues in its mission to support the Canadian Forces, the Department of National Defence, the people of Canada and Canadian Industry that includes the nuclear sector. It is in this spirit that the staff has been actively involved with organizations such as the Canadian Nuclear Society and the Canadian Nuclear Association, having hosted four of the Student conferences and three major topical conferences of the CNS.

  16. The nuclear engineering programmes at the Royal Military College of Canada. Part II

    International Nuclear Information System (INIS)

    Bonin, H.W.


    The coverage of the activities within the nuclear science and engineering programmes at RMC reveals the dynamism of the College which is still growing at a fast rate. Being the only completely bilingual university in Canada and a true national institution gathering students and staff from all parts of the country. RMC continues in its mission to support the Canadian Forces, the Department of National Defence, the people of Canada and Canadian Industry that includes the nuclear sector. It is in this spirit that the staff has been actively involved with organizations such as the Canadian Nuclear Society and the Canadian Nuclear Association, having hosted four of the Student conferences and three major topical conferences of the CNS

  17. The Service Review Committee: Royal College of Radiologists. Philosophy, role, and lessons to be learned

    International Nuclear Information System (INIS)

    Thind, R.; Barter, S.


    The Service Review Committee (SRC) was established by the Board of the Faculty of Clinical Radiology in 2000. At the time, the RCR identified a clear need to respond appropriately and swiftly to requests for review of service provision in clinical radiology departments where trusts were concerned about standards or performance issues. It was recognized by the College that the poorly performing radiologist is often part of a department that is itself dysfunctional, and that sub-optimal performance may often reflect inadequate management, lack of support, overwhelming workload, or inadequate facilities. Following the completion of a range of service reviews during its first 6 years, the SRC recognized that among the reviews there were recurring themes and causes for poorly functioning departments. The committee felt it appropriate to share these with the wider radiological community. In doing so, it is hoped that other departments may recognize their own problems at an early stage and take appropriate steps to prevent any escalation of difficulties

  18. The Royal Australian College of Radiologists (RACR) survey of reactions to intravenous ionic and non-ionic contrast media

    International Nuclear Information System (INIS)

    Palmer, J.F.


    The Royal Australian College of Radiologists (RACR) expressed concern as to medico-legal implications of the continued use of conventional ionic contrast media in view of the availability of the new low-osmolar media. The new agents had demonstrated significant advantages and it was anticipated that their use would be associated with a lower incidence of undesirable reactions and deaths. However, these new media are significantly more expensive than conventional ionic media and complete changes to these agents has considerable implications for health budgets. Since it was the view of the RACR that there was insufficient information available of the incidence of reactions in clinical use to justify a complete change, a prospective survey of reations to intravenous contrast media injections was initiated. Particpants were issued a simple form, which required for each patient a record of the presence or absence of risk factors, wether ionic or non-ionic contrast media were used, and of the severity of eventual reactions. The results of about 170.000 patients were reported. The survey demonstrated the relative safety of non-ionic media for intravenous use. Despite the relative high cost of these media the continued use of conventional ionic media will become increasingly difficult to justify. (H.W.). 9 refs.; 4 tabs

  19. Optical Coherence Tomography of Retinal Degeneration in Royal College of Surgeons Rats and Its Correlation with Morphology and Electroretinography (United States)

    Yamauchi, Kodai; Mounai, Natsuki; Tanabu, Reiko; Nakazawa, Mitsuru


    Purpose To evaluate the correlation between optical coherence tomography (OCT) and the histological, ultrastructural and electroretinography (ERG) findings of retinal degeneration in Royal College of Surgeons (RCS-/-) rats. Materials and Methods Using OCT, we qualitatively and quantitatively observed the continual retinal degeneration in RCS-/- rats, from postnatal (PN) day 17 until PN day 111. These findings were compared with the corresponding histological, electron microscopic, and ERG findings. We also compared them to OCT findings in wild type RCS+/+ rats, which were used as controls. Results After PN day 17, the hyperreflective band at the apical side of the photoreceptor layer became blurred. The inner segment (IS) ellipsoid zone then became obscured, and the photoreceptor IS and outer segment (OS) layers became diffusely hyperreflective after PN day 21. These changes correlated with histological and electron microscopic findings showing extracellular lamellar material that accumulated in the photoreceptor OS layer. After PN day 26, the outer nuclear layer became significantly thinner (P RCS-/- and RCS+/+ rats. Conclusion Our results suggest that OCT demonstrates histologically validated photoreceptor degeneration in RCS rats, and that OCT findings partly correlate with ERG findings. We propose that OCT is a less invasive and useful method for evaluating photoreceptor degeneration in animal models of retinitis pigmentosa. PMID:27644042

  20. Going the distance: early results of a distributed medical education initiative for Royal College residencies in Canada. (United States)

    Myhre, Douglas L; Hohman, Stacey


    There is a shortage of specialty physicians practising in rural Canada: only 2.4% of Canadian specialist physicians practise rurally. Numerous strategies have been proposed and attempted that aim to increase the number of rural physicians. These include undergraduate and postgraduate distributed medical education opportunities. The Distributed Royal College Initiative at the University of Calgary is increasing the exposure of specialty residents to rural medicine through regional rotations and electives. An assessment of the initial impacts of this programme was made. Specialty residents were sent a voluntary survey following their regional rotation in academic year 2010-2011. The survey measured each resident's satisfaction with the experience, interest in undertaking another rotation and the impact of the rotation on potential rural practice location. The survey asked for written comments on the rotation. Data were analysed using descriptive statistics. A total of 73% (29) of the 40 eligible residents completed the survey that was distributed upon completion of the rotation. In the survey, 45% of respondents indicated they would have been likely to practise in a regional community prior to the experience. This changed to 76% following the rotation. Analysis of the comments revealed strong positive characteristics of the experience across all disciplines. Specialty-based, rural distributed programmes were perceived by the residents as educationally valuable and may be crucial in helping shift attitudes towards rural practice. Specific successful characteristics of the rotations provide direction to increase their quality further. These findings need to be verified in a larger sample.

  1. Executive Summary of the American College of Surgeons/Surgical Infection Society Surgical Site Infection Guidelines-2016 Update. (United States)

    Ban, Kristen A; Minei, Joseph P; Laronga, Christine; Harbrecht, Brian G; Jensen, Eric H; Fry, Donald E; Itani, Kamal M F; Dellinger, E Patchen; Ko, Clifford Y; Duane, Therese M

    Guidelines regarding the prevention, detection, and management of surgical site infections (SSIs) have been published previously by a variety of organizations. The American College of Surgeons (ACS)/Surgical Infection Society (SIS) Surgical Site Infection (SSI) Guidelines 2016 Update is intended to update these guidelines based on the current literature and to provide a concise summary of relevant topics.

  2. Introduction to the corporate governance model of a Portuguese organization of the Ancient Regime, with particular reference to its accounting: the Royal College of Nobles (1766

    Directory of Open Access Journals (Sweden)

    Miguel Ângelo Caçoilo Gonçalves


    Full Text Available This article explores, in an introductory approach, a former Portuguese educational institution: the Royal College of Nobles. This institution, founded in Lisbon in 1761 and opened in 1766, was an entity that made part of the public education reform undertaken by the Marquis of Pombal in the reign of D. José. The work expands the traditional boundaries of the definition of non-profits organizations in order to extend it to an old Portuguese educational entity. Our main objective is to present the main features of the organization, management and school administration of the Royal College of Nobles, in the light of the modern discourse applied to the understanding of phenomena assigned to the areas of education and management of non-profit entities. We also seek to present insights on the interrelation between accounting and this institution. We used a qualitative methodology and, to collect information, the method of analysis of texts and documents, especially primary sources. The main conclusion is that this entity, the Royal College of Nobles, used double entry bookkeeping in its system of accounting and, despite having corporate governance models, both executive and financial, absolutely innovative for the time, has failed in aspects of pedagogy, such as the inadequacy of curricula and the ineffective control of students’ disruptive behavior.

  3. The Royal Book by Haly Abbas from the 10th century: one of the earliest illustrations of the surgical approach to skull fractures. (United States)

    Aciduman, Ahmet; Arda, Berna; Kahya, Esin; Belen, Deniz


    Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author's name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas' work include unique management strategies for his period with essential quotations from Paul of Aegina's work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe.

  4. Optical Coherence Tomography of Retinal Degeneration in Royal College of Surgeons Rats and Its Correlation with Morphology and Electroretinography.

    Directory of Open Access Journals (Sweden)

    Kobu Adachi

    Full Text Available To evaluate the correlation between optical coherence tomography (OCT and the histological, ultrastructural and electroretinography (ERG findings of retinal degeneration in Royal College of Surgeons (RCS-/- rats.Using OCT, we qualitatively and quantitatively observed the continual retinal degeneration in RCS-/- rats, from postnatal (PN day 17 until PN day 111. These findings were compared with the corresponding histological, electron microscopic, and ERG findings. We also compared them to OCT findings in wild type RCS+/+ rats, which were used as controls.After PN day 17, the hyperreflective band at the apical side of the photoreceptor layer became blurred. The inner segment (IS ellipsoid zone then became obscured, and the photoreceptor IS and outer segment (OS layers became diffusely hyperreflective after PN day 21. These changes correlated with histological and electron microscopic findings showing extracellular lamellar material that accumulated in the photoreceptor OS layer. After PN day 26, the outer nuclear layer became significantly thinner (P < 0.01 and hyperreflective compared with that in the controls; conversely, the photoreceptor IS and OS layers, as well as the inner retinal layers, became significantly thicker (P < 0.001 and P = 0.05, respectively. The apical hyperreflective band, as well as the IS ellipsoid zone, gradually disappeared between PN day 20 and PN day 30; concurrently, the ERG a- and b-wave amplitudes deteriorated. In contrast, the thicknesses of the combined retinal pigment epithelium and choroid did not differ significantly between RCS-/- and RCS+/+ rats.Our results suggest that OCT demonstrates histologically validated photoreceptor degeneration in RCS rats, and that OCT findings partly correlate with ERG findings. We propose that OCT is a less invasive and useful method for evaluating photoreceptor degeneration in animal models of retinitis pigmentosa.

  5. Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. (United States)

    Cook, T M; Counsell, D; Wildsmith, J A W


    Serious complications of central neuraxial block (CNB) are rare. Limited information on their incidence and impact impedes clinical decision-making and patient consent. The Royal College of Anaesthetists Third National Audit Project was designed to inform this situation. A 2 week national census estimated the number of CNB procedures performed annually in the UK National Health Service. All major complications of CNBs performed over 1 yr (vertebral canal abscess or haematoma, meningitis, nerve injury, spinal cord ischaemia, fatal cardiovascular collapse, and wrong route errors) were reported. Each case was reviewed by an expert panel to assess causation, severity, and outcome. 'Permanent' injury was defined as symptoms persisting for more than 6 months. Efforts were made to validate denominator (procedures performed) and numerator (complications) data through national databases. The census phase produced a denominator of 707,455 CNB. Eighty-four major complications were reported, of which 52 met the inclusion criteria at the time they were reported. Data were interpreted 'pessimistically' and 'optimistically'. 'Pessimistically' there were 30 permanent injuries and 'optimistically' 14. The incidence of permanent injury due to CNB (expressed per 100,000 cases) was 'pessimistically' 4.2 (95% confidence interval 2.9-6.1) and 'optimistically' 2.0 (1.1-3.3). 'Pessimistically' there were 13 deaths or paraplegias, 'optimistically' five. The incidence of paraplegia or death was 'pessimistically' 1.8 per 100,000 (1.0-3.1) and 'optimistically' 0.7 (0-1.6). Two-thirds of initially disabling injuries resolved fully. The data are reassuring and suggest that CNB has a low incidence of major complications, many of which resolve within 6 months.

  6. Specialist perioperative allergy clinic services in the UK 2016: Results from the Royal College of Anaesthetists Sixth National Audit Project. (United States)

    Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K


    Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6 th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait specialist nurses and 18/44 (41%) an anaesthetist] and provision of information [18/44 (41%) gave immediate information in clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.

  7. An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender (United States)

    Bowhay, Andrew R; Watmough, Simon D


    Background There has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ) section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. Methods Data from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender. Results There were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7), p < 0.001; pharmacology, mean difference = 1.7% (95% CI 1.0, 2.3), p < 0.001; physics with clinical measurement, mean difference = 3.5% (95% CI 2.8, 4.1), p < 0.001; overall mark, mean difference = 2.7% (95% CI 2.1, 3.3), p < 0.001; and standardised overall mark minus the pass mark, mean difference = 2.5% (95% CI 1.9, 3.1), p < 0.001. Graduates from three medical schools that have undergone the change from Traditional to Problem Based Learning curricula did not show any change in performance in any aspects of the MCQ pre and post curriculum change. Conclusion Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males. PMID:19563655

  8. Basal membrane complex architecture is disrupted during posterior subcapsular cataract formation in Royal College of Surgeons rats (United States)

    Joy, Anita


    Purpose Previous studies detailing the development of posterior subcapsular cataracts (PSC) in Royal College of Surgeons (RCS) rats have shown that aberrant fiber-end migration underlies the structural compromise. This investigation was conducted to examine the distribution of select basal membrane complex (BMC) components and to assess the intravitreal levels of specific cytokines during PSC formation. Methods Lenses from 52 RCS dystrophic rats (RCS/Lav) and 28 genetically matched control animals (RCS-rdy+/Lav) from 2 to 8 weeks old were used. After enucleation, vitreous was collected for eventual cytokine level analyses; lenses were then removed and processed for immunocytochemical localization of actin, cadherin, β integrin, vinculin, and cell nuclei. Results At 2–3 weeks postnatal, dystrophic lenses showed normal BMC distribution of actin, cadherin, and vinculin; however β integrin distribution was altered as compared to controls. By 4–6 weeks of age, F-actin was visible as bright foci arranged in a “rosette” pattern around fiber-end profiles. Concurrently, vinculin was rearranged into a diffuse pattern within the BMC. Cadherin delineated the fiber ends in dystrophic lenses until 5 weeks postnatal, after which it displayed diffuse cytoplasmic staining with more definitive labeling at the BMC periphery. β integrin was initially distributed as punctuate spots at 2–3 weeks postnatal; however, by 4–6 weeks it was co-localized with F-actin around the periphery of fiber ends. The distribution of F-actin, cadherin, and β integrin components did not undergo further changes after 6 weeks of age; however, vinculin was present predominantly at the periphery of the BMC in 7–8-week-old dystrophic lenses. Intravitreal cytokine levels were assessed for interleukin (IL)-1α, IL-4, IL-6, IL-8, tumor necrosis factor (TNF), and interferon (IFN)-γ. Levels of IL-1α, IL-4, TNF, and IFN-γ demonstrated a similar pattern, with concentrations increasing from 2 to 6

  9. [Carl Gustav Carus, the first director of the newly established maternity institute of the Dresden Royal Surgical-Medical Academy 1814-1827]. (United States)

    Sarembe, B


    Carl Gustav Carus was born in 1789 in Leipzig. He studied at the University of Leipzig. His specialization in Gynecology and Obstetrics took place at the Triersches Maternity Hospital. In 1814 he was named Professor for Obstetrics in Dresden at the Royal-Surgical-Medical-Academy. He was the head of the Maternity Hospital till 1827. Under his direction many midwives, students and physicians were educated. He published numerous articles and books on medical and philosophical-psychological topics. He was a talented artist of the Romantic especially in painting landscapes. He was a friend of Caspar David Friedrich and Johann Wolfgang von Goethe. After 1827 he was the physician in ordinary to 3 saxonian kings. He died in 1869. The Medical Academy in Dresden bears his name "Carl Gustav Carus" since its foundation.

  10. Content analysis of the professional journal of the Royal College of Speech and Language Therapists, III: 1966-2015-into the 21st century. (United States)

    Armstrong, Linda; Stansfield, Jois; Bloch, Steven


    Following content analyses of the first 30 years of the UK speech and language therapy professional body's journal, this study was conducted to survey the published work of the speech (and language) therapy profession over the last 50 years and trace key changes and themes. To understand better the development of the UK speech and language therapy profession over the last 50 years. All volumes of the professional journal of the Royal College of Speech and Language Therapists published between 1966 and 2015 (British Journal of Communication Disorders, European Journal of Communication Disorders and International Journal of Language and Communication Disorders) were examined using content analysis. The content was compared with that of the same journal as it appeared from 1935 to 1965. The journal has shown a trend towards more multi-authored and international papers, and a formalization of research methodologies. The volume of papers has increased considerably. Topic areas have expanded, but retain many of the areas of study found in earlier issues of the journal. The journal and its articles reflect the growing complexity of conditions being researched by speech and language therapists and their professional colleagues and give an indication of the developing evidence base for intervention and the diverse routes which speech and language therapy practice has taken over the last 50 years. © 2017 Royal College of Speech and Language Therapists.

  11. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders. (United States)


    The Royal Australian and New Zealand College of Psychiatrists is co-ordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority. This paper presents CPGs for schizophrenia and related disorders. Over the past decade schizophrenia has become more treatable than ever before. A new generation of drug therapies, a renaissance of psychological and psychosocial interventions and a first generation of reform within the specialist mental health system have combined to create an evidence-based climate of realistic optimism. Progressive neuroscientific advances hold out the strong possibility of more definitive biological treatments in the near future. However, this improved potential for better outcomes and quality of life for people with schizophrenia has not been translated into reality in Australia. The efficacy-effectiveness gap is wider for schizophrenia than any other serious medical disorder. Therapeutic nihilism, under-resourcing of services and a stalling of the service reform process, poor morale within specialist mental health services, a lack of broad-based recovery and life support programs, and a climate of tenacious stigma and consequent lack of concern for people with schizophrenia are the contributory causes for this failure to effectively treat. These guidelines therefore tackle only one element in the endeavour to reduce the impact of schizophrenia. They distil the current evidence-base and make recommendations based on the best available knowledge. A comprehensive literature review (1990-2003) was conducted, including all Cochrane schizophrenia reviews and all relevant meta-analyses, and a number of recent international clinical practice guidelines were consulted. A series of drafts were refined by the expert committee and enhanced through a bi-national consultation process. This guideline provides evidence-based recommendations

  12. CME and the role of the Journal of the Royal College of Physicians of London. Results of a survey of consultant and trainee physicians. (United States)

    Kerr, D; Toghill, P; Klär, B


    To assess (a) the views of Members and Fellows of the College on the role of reading general medical journals in continuing medical education (CME); (b) the place of the Journal of the Royal College of Physicians of London (JRCPL) in relation to seven other general medical journals; (c) the possible need for change in the content of the JRCPL and the demand for a systematic series of articles designed specifically for CME; (d) the extent of home ownership and use of computers and of readers' readiness for interactive teaching and electronic books and journals. Distribution of a questionnaire to all Fellows and Collegiate members of the College, mailed with the JRCPL in May 1995. Responses were received from 2,600 (26.4% home recipients and 8.4% overseas recipients). Journal reading was rated the most important form of CME. All eight journals listed play a part in CME, the three weekly journals playing the most prominent role. There was strong support for the introduction of a series of articles covering topics systematically as part of CME. Seventy-six per cent of respondents own a home computer and 40% of these have either a CD-ROM drive or full multimedia facilities. Most use their computers mainly as word-processors and few have access to the Internet or E-mail.

  13. An examination of the time-dependent background counts of the delayed neutron counting system at the Royal Military College of Canada

    International Nuclear Information System (INIS)

    Sellers, M.T.; Corcoran, E.C.; Kelly, D.G.


    A delayed neutron counting (DNC) system for the analysis of special nuclear materials (SNM) has been constructed and calibrated at the Royal Military College of Canada. The polyethylene vials used to transport SNM samples have been found to contribute a time-dependent count rate, B(t), far above the system background. B(t) has been found to be independent of polyethylene mass and shows a dependence on irradiation position in the SLOWPOKE-2 reactor and irradiation time. A comparison of B(t) and the theoretical delayed neutron production from the fission of small amounts of 235 U has indicated that trace amounts of uranium may be present in the DNC system tubing. (author)

  14. Surgical Residency Training in Developing Countries: West African College of Surgeons as a Case Study. (United States)

    Ajao, Oluwole Gbolagunte; Alao, Adekola


    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.

  15. Shared learning for chronic conditions: a methodology for developing the Royal College of Paediatrics and Child Health (RCPCH) care pathways for children with allergies. (United States)

    Warner, John O; Lloyd, Kate


    The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies. The pathways focus on defining the competences to deliver the highest standard of care for such children. By defining competences rather than criteria for onward referral, the authors have sought to create flexibility in delivery of care which will be responsive to regional variations in knowledge, skills and service. All pathways were developed by multidisciplinary working groups, based on a comprehensive review of evidence. The pathways were reviewed by a broad group of stakeholders and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. The results for all pathways are presented in two sections: a pathway algorithm and the competences. The entry points for each pathway are defined at the point where symptoms first occur and the ideal management is described from self-care through complete diagnosis to monitoring of progress. From the evidence review the working groups were able to make research recommendations. The authors present eight national care pathways for allergic conditions based on evidence review, expert consensus and stakeholder input. They provide a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible. The authors recommend that these pathways are implemented locally by a multidisciplinary team with a focus on creating networks between primary, secondary and tertiary care to improve services for children with allergic conditions.

  16. Nutrition education in the medical school curriculum: a review of the course content at the Royal College of Surgeons in Ireland-Bahrain. (United States)

    Schreiber, K R; Cunningham, F O


    Only 14 % of American physicians report that they feel adequately trained to provide nutritional counselling. The average number of nutrition teaching hours in American medical schools is falling below recommendations by the National Academy of Sciences and nutritional education in the medical school curriculum is currently an important discussion topic. This study aimed to review the teaching hours delivered during a 6-year medical programme at The Royal College of Surgeons in Ireland-Bahrain (RCSI-B) and define the importance of nutritional education for medical students. Lecture time regarding the topic of nutrition was quantified by studying the contents of the 6-year course materials on the Moodle ® platform virtual learning environment used by RCSI-B. Students are exposed to approximately 15 h of education in nutrition during their medical studies at RCSI-B. The 15 h spent educating RCSI-B medical students on nutrition is inadequate according to international recommendations. However, RCSI-B is one of many medical schools that do not reach the minimum required hours (25-44) as set by the National Academy of Sciences and the American Society for Nutrition. We recommend that more teaching hours on nutrition be introduced into the curriculum. These extra teaching hours may greatly benefit RCSI-B students, patients and public health in Bahrain.

  17. An investigation of roof runoff during rain events at the Royal Military College of Canada and potential discharge to Lake Ontario. (United States)

    Kelly, David G; Weir, Ron D; White, Steven D


    The Royal Military College of Canada, located on the north eastern shore of Lake Ontario, possesses an abundance of copper roofs and lacks surface water treatment prior to discharge into Lake Ontario. Rainwater, roof runoff and soil samples were collected and analyzed for copper and other parameters. Copper was consistently detected in runoff samples with average concentrations of 3200 +/- 2100 microg/L. Multivariable linear regression analysis for a dependant copper runoff concentration yielded an adjusted R2 value of 0.611, based on an independent variable model using minimum temperature, maximum temperature, total precipitation, and wind speed. Lake water samples taken in the vicinity of storm water outfalls draining areas with copper roofs ranged from 2.0 to 40 microg/L copper. Such data exceed the 2.0 microg/L Canadian Water Quality Guidelines for the Protection of Aquatic Life as outlined by the Canadian Council of Ministers of the Environment (CCME). Analysis of raw, filtered and digested forms suggested that the majority of copper present in runoff and lake water samples was in a dissolved form. The majority of soils taken in this study displayed copper concentrations below the 63 microg/g CCME residential/parkland land use limits. These findings suggested that ion exchange processes between runoff water and soil do not occur to a sufficient extent to elevate copper levels in soil. It may therefore be concluded that the eventual fate of copper, which is not discharged via storm water outfalls, is lost to the water table and Lake Ontario through the sub-soil.

  18. Cognizance and utilization about breast cancer screening among the health professional female students and staffs of University Kuala Lumpur, Royal College of Medicine Perak, Malaysia. (United States)

    Haque, A T M Emdadul; Mohd Hisham, Muhammad Afif Bin; Ahmad Adzman, Noor Azwa Laili Binti; Azudin, Nur Atiqah Binti; Shafri, Nursakinah Binti; Haque, Mainul


    Breast cancer (BC) is a major life-threatening problem and a global concern including Malaysia. BC is an equal threat for both developing and developed countries. The aim of this study was to determine the relationship between sociodemographic factors with knowledge, attitude, and perception on BC screening among the females of University Kuala Lumpur, Royal College of Medicine Perak (UniKL RCMP). This cross-sectional study was conducted from 2015 to 2016. The populations included were the students and staff of UniKL RCMP. The simple sampling method was used and a set of questionnaire was prepared and distributed to the participants who were willing to participate. The data were analyzed by using the SPSS version 17. Of the 220 only 203 questionnaires were returned. Nearly 87.7% of participants indicated genetic factors as the cause of BC, followed by exposure to carcinogenic and X-ray. Excessive smoking (54.2%) and sedentary lifestyle (52.2%) were the risk factors of the BC. 100% of participants thought that breast self-examination (BSE) is important to detect a breast lump and most of them (76.8%) knew what a mammogram is but only 2.0% went for a mammogram. Chemotherapy (71.9%) and surgery (71.9%) were treatments options according to study participants. Nearly 91.1% agreed that regular mammogram could help to detect BC at an early stage. Nearly 88.2% thought BC is not easily curable. Finally, for the attitude on BC screening, most of them knew how to perform BSE (69.0%) with the frequency of 36.0% doing it once a year. The majority of the participants found the good knowledge on BC and on how to perform BSE. Although most of them knew what a mammogram is, only a few have gone for it since perhaps it is recommended for those who are above 50-year-old. Therefore, researchers believe and trust that there is an urgent need of state-funded multicenter study to prevent and early diagnosis of BC in Malaysia.

  19. Human Adipose-Derived Stem Cells Delay Retinal Degeneration in Royal College of Surgeons Rats Through Anti-Apoptotic and VEGF-Mediated Neuroprotective Effects. (United States)

    Li, Z; Wang, J; Gao, F; Zhang, J; Tian, H; Shi, X; Lian, C; Sun, Y; Li, W; Xu, J-Y; Li, P; Zhang, J; Gao, Z; Xu, J; Wang, F; Lu, L; Xu, G-T


    Stem cell therapy is a promising therapeutic approach for retinal degeneration (RD). Our study investigated the effects of human adipose derived stem cell (hADSCs) on Royal College of Surgeons (RCS) rats. Green fluorescent protein (GFP)-labeled hADSCs were transplanted subretinally into RCS rats at postnatal (PN) 21 days to explore potential therapeutic effects, while adeno-associated viral vector (AAV2)-vascular endothelial growth factor (VEGF) and siVEGF-hADSCs were used to aid the mechanistic dissections. Visual function was evaluated by Electroretinogram (ERG) recording. Potential transdifferentiations were examined by Immunofluorescence (IF) and gene expressions were analyzed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Apoptotic retinal cells were detected by Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) assay and the cytokines secreted by hADSCs were measured by Enzyme-linked Immunosorbent Assay (ELISA). The visual function of RCS rats began to decrease one week after their eyes opened at PN week 3 and almost lost in PN 5 weeks, accompanied by the loss of retinal outer nuclear layer (ONL). Subretinal transplantation of hADSCs significantly improved the visual function 2 weeks after the transplantation and such therapeutic effect persisted up to 8 weeks after the treatment (PN 11 weeks), with 3-4 rows of photoreceptors remained in the ONL and reduced apoptosis. Consistent with these phenotypic changes, the gene expression of rod photoreceptor markers Rhodopsin (Rho), Crx and Opsin (Opn1) in RCS rats showed obvious decreasing trends over time after PN 3 weeks, but were elevated with hADSC treatment. hADSC transplantation also repressed the expressions of Bax, Bak and Caspase 3, but not the expression of anti-apoptotic genes, including Bcl-2 and Bcl-XL. Finally, substantial VEGF, hepatocyte growth factor (HGF) and pigment epithelium-derived factor (PEDF) secretions from hADSCs were detected, while endogenous

  20. Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) Investigation of Perioperative Anaphylaxis. (United States)

    Egner, W; Cook, T M; Garcez, T; Marinho, S; Kemp, H; Lucas, D N; Floss, K; Farooque, S; Torevell, H; Thomas, M; Ferguson, K; Nasser, S; Karanam, S; Kong, K-L; McGuire, N; Bellamy, M; Warner, A; Hitchman, J; Farmer, L; Harper, N J N


    The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey. 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. 192/266 (72%) had anaphylaxis with a trigger identified, of which 140/192(75%) met NAP6 criteria for IgE-mediated allergic anaphylaxis, 13% lacking evidence of positive IgE tests were labelled "non-allergic anaphylaxis". 3% were non-IgE mediated anaphylaxis. Adherence to guidance was similar to the baseline survey for waiting time for clinic assessment. However, lack of testing for chlorhexidine and latex, non-harmonised testing practices and poor coverage of all possible culprits was confirmed. Challenge testing may be under-used and many have unacceptably delayed assessments, even in urgent cases. Communication or information provision for patients was insufficient, especially for avoidance advice and communication of test results. Insufficient detail regarding skin test methods was available to draw conclusions regarding techniques. Current clinical assessment in the UK is effective but harmonisation of approach to testing, access to services and MHRA reporting is needed. Expert anaesthetist involvement should increase to optimise diagnostic yield and advice for future anaesthesia. Dynamic tryptase evaluation improves detection of tryptase release where peak tryptase is <14mcg/L and should be adopted. Standardised clinic reports containing appropriate details of tests

  1. The internalization of posterior subcapsular cataracts (PSCs) in Royal College of Surgeons (RCS) rats. II. The inter-relationship of optical quality and structure as a function of age. (United States)

    Kuszak, J R; Al-Ghoul, K J; Novak, L A; Peterson, K L; Herbert, K L; Sivak, J G


    The Royal College of Surgeons (RCS) rat is an animal model for human retinal degenerative disease and posterior subcapsular cataracts (PSCs). The purpose of this study was to correlate the structure and optical quality of RCS lenses with PSCs as a function of their internalization, with normal, non-cataractous, age-matched control lenses. Correlative light (LM), scanning electron microscopic (SEM), three-dimensional computer assisted drawings (3D-CADs) and low power helium-neon laser scan analysis were used to examine the structure and function of lenses. The optical properties (average focal length variability; sharpness of focus) of RCS rat lenses are quantitatively compromised by PSCs. Correlative LM and SEM analysis of RCS lenses at various stages of PSC internalization (1.5, 3, 6, 9, 12 and 15 months of age), revealed that the sutures formed by additional fiber growth were progressively more abnormal. During PSC internalization, two to nine small suture branches were formed and arranged in modified line to multiple y configurations rather than the normal three branch y sutures. These temporal changes were also chronicled in animated 3D-CAD videos derived from lens reconstructions based on LM and SEM micrographs from the selected time points stated above. However, laser scan analysis also revealed that as the PSCs of RCS rat lenses were progressively internalized, there was a steady improvement in total sharpness of focus that reached normal levels by 12 months of age. The correlation of laser scan and structural data from specific regions of lenses revealed the following: 1. The abnormal posterior sutures of RCS rats with internalized PSCs effect a greater reduction in optical quality than normal posterior sutures of age-matched controls; 2. However, the resulting abnormal suture plane area was cumulatively similar to that of age-matched controls; 3. Thus, total optical quality was similar between RCS lenses with internalized PSCs and age-matched controls by

  2. Power struggles for control of the University and its financing seen rising from the students of Quito’s Royal College and Seminary Maximum of Saint Louis at 1725

    Directory of Open Access Journals (Sweden)

    Emiliano GIL BLANCO


    Full Text Available In this study we establish the origin, the economy, the confrontations and the corruption in the Quito’s Royal Maximum College and Seminary of Saint Luis. We are going to do this through the study of an incident in 1725 between different ecclesiastical and civil authorities for the control of the seminary and its finances. It is only a part of the confrontation between creoles and «peninsulares» by the control of the porters and of the important incomes that provided Real Estate to finance.

  3. Management of waste associated with the decommissioning of the JASON research reactor and the nuclear laboratories at the Royal Naval College Greenwich

    International Nuclear Information System (INIS)

    Beeley, P.A.; Lockwood, R.J.S.; Hoult, D.; Major, R.


    In 1996 the UK Government announced that the Royal Naval College, Greenwich would pass to non-defence use by the millennium. As a consequence of this decision, the decommissioning of the JASON 10 kW Argonaut research reactor and the relocation of the Department of Nuclear Science and Technology (DNST) were approved by the Ministry of Defence. The decommissioning of the reactor commenced in November 1997 while DNST remained operational until October 1998. The DNST was responsible for education and training in support of the UK Naval Nuclear Propulsion Programme and operated academic laboratories for atomic and nuclear physics, health physics, instrument calibration and radiochemistry. Therefore, besides the nuclear reactor, open and sealed sources (alpha, beta and gamma), intense x-ray (sealed tube) and gamma-ray ( 60 CO and 137 Cs) sources and small 241 Am/Be neutron sources had been used in the Department for over 35 years. Decommissioning of all facilities was therefore a relatively complex task and the management of waste streams was challenging. All facilities were successfully decommissioned for unrestricted site release by December 1999 and this paper will describe the methodology used for preparation, storage, characterisation and disposal of all waste streams. The most significant waste management task during this decommissioning programme was that associated with the JASON reactor. It should be noted that the JASON reactor fuel was not designated as nuclear waste, the fuel removal and storage were covered under separate contracts and therefore no high level waste was generated. With respect to other waste streams, a combination of Monte Carlo modelling and selective sampling and analysis of the reactor materials was used to estimate the quantities of waste as follows: LLW - 76 tonnes packed in 4 half height ISO containers; LLW - 6 Tonnes packed in 200litre drums in 1 full height ISO container; ILW - 60 kg packed in approved shielded containers; FRW -121

  4. Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions. (United States)

    Volmar, Keith E; Idowu, Michael O; Hunt, Jennifer L; Souers, Rhona J; Meier, Frederick A; Nakhleh, Raouf E


    The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P benchmarking data on report defects and defect fractions using standardized taxonomy.

  5. Mobile surgical skills education unit: a new concept in surgical training. (United States)

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


    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.

  6. Sir John Struthers (1823-1899), Professor of Anatomy in the University of Aberdeen (1863-1889), President of the Royal College of Surgeons of Edinburgh (1895-1897). (United States)

    Kaufman, M H


    Between 1841 and 1845 John Struthers attended both the University of Edinburgh and some of the various Extra-mural Schools of Medicine associated with Surgeons' Hall. While a medical student he became a Member of the Hunterian Medical Society of Edinburgh and later was elected one of their Annual Presidents. He graduated with the MD Edin and obtained both the LRCS Edin and the FRCS Edin diplomas in 1845. Shortly afterwards he was invited to teach Anatomy in Dr Handyside's Extra-mural School in Edinburgh. The College of Surgeons certified him to teach Anatomy in October 1847. He had two brothers, and all three read Medicine in Edinburgh. His younger brother, Alexander, died of cholera in the Crimea in 1855 while his older brother James, who had been a bachelor all his life, practised as a Consultant Physician in Leith Hospital, Edinburgh, until his death.When associated with Dr Handyside's Extra-mural School in Edinburgh, John taught Anatomy there until he was elected to the Chair of Anatomy in Aberdeen in 1863. Much of his time was spent in Aberdeen teaching Anatomy and in upgrading the administrative facilities there. He resigned from this Chair in 1889 and subsequently was elected President of Leith Hospital from 1891 to 1897. This was in succession to his older brother, James, who had died in 1891. Later, he was elected President of the Royal College of Surgeons of Edinburgh from 1895 to 1897 and acted as its Vice-President from 1897 until his death in 1899. In 1898, Queen Victoria knighted him. His youngest son, John William Struthers, was the only one of his clinically qualified sons to survive him and subsequently was elected President of the Edinburgh College of Surgeons from 1941 to 1943. © The Author(s) 2014.

  7. American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment. (United States)

    Glass, Charity C; Acton, Robert D; Blair, Patrice G; Campbell, Andre R; Deutsch, Ellen S; Jones, Daniel B; Liscum, Kathleen R; Sachdeva, Ajit K; Scott, Daniel J; Yang, Stephen C


    Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners. A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests. Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors. Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Outcomes of Concurrent Operations: Results From the American College of Surgeons' National Surgical Quality Improvement Program. (United States)

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


    To determine whether concurrently performed operations are associated with an increased risk for adverse events. Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety. Propensity-score-matched cohorts were constructed to compare death or serious morbidity (DSM), unplanned reoperation, and unplanned readmission in concurrent versus non-concurrent operations. Multilevel hierarchical regression was used to account for the clustered nature of the data while controlling for procedure and case mix. There were 1430 (32.3%) surgeons from 390 (77.7%) hospitals who performed 12,010 (2.3%) concurrent operations. Plastic surgery (n = 393 [13.7%]), otolaryngology (n = 470 [11.2%]), and neurosurgery (n = 2067 [8.4%]) were specialties with the highest proportion of concurrent operations. Spine procedures were the most frequent concurrent procedures overall (n = 2059/12,010 [17.1%]). Unadjusted rates of DSM (9.0% vs 7.1%; P < 0.001), reoperation (3.6% vs 2.7%; P < 0.001), and readmission (6.9% vs 5.1%; P < 0.001) were greater in the concurrent operation cohort versus the non-concurrent. After propensity score matching and risk-adjustment, there was no significant association of concurrence with DSM (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.96-1.21), reoperation (OR 1.16; 95% CI 0.96-1.40), or readmission (OR 1.14; 95% CI 0.99-1.29). In these analyses, concurrent operations were not detected to increase the risk for adverse outcomes. These results do not lessen the need for further studies, continuous self-regulation and proactive disclosure to patients.

  9. Leaving surgical training: some of the reasons are in surgery. (United States)

    Forel, Deanne; Vandepeer, Meegan; Duncan, Joanna; Tivey, David R; Tobin, Stephen A


    In 2014, the Royal Australasian College of Surgeons identified, through internal analysis, a considerable attrition rate within its Surgical Education and Training programme. Within the attrition cohort, choosing to leave accounted for the majority. Women were significantly over-represented. It was considered important to study these 'leavers' if possible. An external group with medical education expertise were engaged to do this, a report that is now published and titled 'A study exploring the reasons for and experiences of leaving surgical training'. During this time, the Royal Australasian College of Surgeons came under serious external review, leading to the development of the Action Plan on Discrimination, Bullying and Sexual Harassment in the Practice of Surgery, known as the Building Respect, Improving Patient Safety (BRIPS) action plan. The 'Leaving Training Report', which involved nearly one-half of all voluntary 'leavers', identified three major themes that were pertinent to leaving surgical training. Of these, one was about surgery itself: the complexity, the technical, decision-making and lifestyle demands, the emotional aspects of dealing with seriously sick patients and the personal toll of all of this. This narrative literature review investigates these aspects of surgical education from the trainees' perspective. © 2018 Royal Australasian College of Surgeons.

  10. Update of guidelines for surgical endodontics - the position after ten years. (United States)

    Evans, G E; Bishop, K; Renton, T


    This is the first of a series of articles, which will summarise new or updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). Important developments for the dental profession from a number of clinical guidelines will be presented, commencing with the Guidelines for surgical endodontics. The impact of recent evidence relating to the outcome of surgical endodontics and techniques such as cone beam computed tomography and microsurgical techniques are considered.

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


    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.

  12. Evaluation matters: lessons learned on the evaluation of surgical teaching. (United States)

    Woods, Nicole N


    The traditional system of academic promotion and tenure can make it difficult to reward those who excel at surgical teaching. A successful faculty evaluation process can provide the objective measures of teaching performance needed for performance appraisals and promotion decisions. Over the course of two decades, an extensive faculty evaluation process has been developed in the Department of Surgery at the University of Toronto. This paper presents some of the non-psychometric characteristics of that system. Faculty awareness of the evaluation process, the consistency of its application, trainee anonymity and the materiality of the results are described key factors of a faculty evaluation system that meets the assessment needs of individual teachers and raises the profile of teaching in surgical departments. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  13. A royal visit

    CERN Multimedia


    King Harald V and Queen Sonja of Norway made a trip to CERN on Tuesday 4 April, taking a tour of part of the LHC and greeting the Norwegian students and scientists at the Laboratory. Norway's King Harald V and Queen Sonja take a tour of the ATLAS detector with CERN Director-General Robert Aymar.King Harald V and Queen Sonja are greeted warmly by members of the Norwegian community at the CERN Globe. CERN Director-General Robert Aymar welcomed the royal party, which included the Norwegian Minister of Foreign Affairs, Jonas Gahr Støre, and provided an overview of CERN's history and current and future research. ATLAS deputy spokesperson Steinar Stapnes then quickly explained the concept and inner workings of the LHC, some LHC physics goals and ATLAS, which is one of the main experiments receiving Norwegian contributions. 'I don't think I've ever had so many distinguished students before,' Stapnes said jokingly to the crowd.The royal delegation was then escorted underground for a look at the LHC tunnel and the...

  14. Wound healing in plastic surgery: does age matter? An American College of Surgeons National Surgical Quality Improvement Program study. (United States)

    Karamanos, Efstathios; Osgood, Geoff; Siddiqui, Aamir; Rubinfeld, Ilan


    Increasing age has traditionally been associated with impairment in wound healing after operative interventions. This is based mostly on hearsay and anecdotal information. This idea fits with the authors’ understanding of biology in older organisms. This dictum has not been rigorously tested in clinical practice. The American College of Surgeons National Surgical Quality Improvement Program database was retrospectively queried for all patients undergoing plastic surgery from 2005 to 2010. Variables extracted included basic demographics, comorbidities, previous steroid and tobacco use, wound classification at the end of the surgery, and development of postoperative surgical-site infections. Multivariate analyses were used to investigate the impact of aging in wound dehiscence. A total of 25,967 patients were identified. Overall, the incidence of wound dehiscence was 0.75 percent (n = 196). When patients younger than 30 years were compared to older patient groups, no difference in the probability of developing wound dehiscence was noted. Specifically, the groups of patients aged 61 to 70 years and older than 70 years did not have statistically significant wound healing deficiencies [adjusted OR, 0.63 (95 percent CI, 0.11 to 3.63), adjusted p = 0.609; 2.79 (0.55 to 14.18), adjusted p = 0.217, for 61 to 70 years and older than 70 years, respectively]. Factors independently associated with wound dehiscence included postoperative abscess development, paraplegia, quadriplegia, steroid and tobacco use, deep surgical-site infection development, increasing body mass index, and wound classification at the end of surgery. In patients undergoing plastic surgery, wound dehiscence is a rare complication (0.75 percent). Aging is not associated with an increased incidence of wound dehiscence. Risk, III.

  15. What Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences. (United States)

    Zhang, Jacques X; Song, Diana; Bedford, Julie; Bucevska, Marija; Courtemanche, Douglas J; Arneja, Jugpal S


    Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality. ACS NSQIP-P and morbidity and mortality data were extracted for 2012 and 2013 at a quaternary care institution. Overall complication rates were compared statistically, segregated by type and severity, followed by a subset comparison of ACS NSQIP-P-eligible cases only. Concordance and discordance rates between the two methodologies were determined. One thousand two hundred sixty-one operations were performed in the study period. Only 51.4 percent of cases were ACS NSQIP-P eligible. The overall complication rates of ACS NSQIP-P (6.62 percent) and morbidity and mortality conferences (6.11 percent) were similar (p = 0.662). Comparing for only ACS NSQIP-P-eligible cases also yielded a similar rate (6.62 percent versus 5.71 percent; p = 0.503). Although different complications are tracked, the concordance rate for morbidity and mortality and ACS NSQIP-P was 35.1 percent and 32.5 percent, respectively. The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.

  16. UK Royal Navy WWII Logbooks (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — In 2006, the UK and NOAA's Climate Database Modernization Program (CDMP) funded the imaging of approximately 8,000 Royal Navy logbooks in the UK National Archives...

  17. Improving surgical site infection prevention practices through a multifaceted educational intervention.

    LENUS (Irish Health Repository)

    Owens, P


    As part of the National Clinical Programme on healthcare-associated infection prevention, a Royal College of Surgeons in Ireland (RCSI) and Royal College of Physicians of Ireland (RCPI) working group developed a quality improvement tool for prevention of surgical site infection (SS). We aimed to validate the effectiveness of an educational campaign, which utilises this quality improvement tool to prevent SSI in a tertiary hospital. Prior to the SSI educational campaign, surgical patients were prospectively audited and details of antibiotic administration recorded. Prophylactic antibiotic administration recommendations were delivered via poster and educational presentations. Post-intervention, the audit was repeated. 50 patients were audited pre-intervention, 45 post-intervention. Post-intervention, prophylaxis within 60 minutes prior to incision increased from 54% to 68% (p = 0.266). Appropriate postoperative prescribing improved from 71% to 92% (p = 0.075). A multifaceted educational program may be effective in changing SSI prevention practices.

  18. Predictors of readmission in nonagenarians: analysis of the American College of Surgeons National Surgical Quality Improvement Project dataset. (United States)

    Hothem, Zachary; Baker, Dustin; Jenkins, Christina S; Douglas, Jason; Callahan, Rose E; Shuell, Catherine C; Long, Graham W; Welsh, Robert J


    Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files. This population was randomly divided into a 70% derivation cohort for model development and 30% validation cohort. Using multivariate step-down regression, predictive models were developed for 30-d readmission. Of 7092 nonagenarians undergoing elective surgery, 798 (11.3%) were readmitted within 30 d. Factors significant in univariate analysis were used to develop predictive models for 30-d readmissions. Diabetes (odds ratio [OR]: 1.51, 95% confidence interval [CI]: 1.24-1.84), dialysis dependence (OR: 2.97, CI: 1.77-4.99), functional status (OR: 1.52, CI: 1.29-1.79), American Society of Anesthesiologists class II or higher (American Society of Anesthesiologist physical status classification system; OR: 1.80, CI: 1.42-2.28), operative time (OR: 1.05, CI: 1.02-1.08), myocardial infarction (OR: 5.17, CI: 3.38-7.90), organ space surgical site infection (OR: 8.63, CI: 4.04-18.4), wound disruption (OR: 14.3, CI: 4.80-42.9), pneumonia (OR: 8.59, CI: 6.17-12.0), urinary tract infection (OR: 3.88, CI: 3.02-4.99), stroke (OR: 6.37, CI: 3.47-11.7), deep venous thrombosis (OR: 5.96, CI: 3.70-9.60), pulmonary embolism (OR: 20.3, CI: 9.7-42.5), and sepsis (OR: 13.1, CI: 8.57-20.1), septic shock (OR: 43.8, CI: 18.2-105.0), were included in the final model. This model had a c-statistic of 0.73, indicating a fair association of predicted probabilities with observed outcomes. However, when applied to the validation

  19. Developing an indigenous surgical workforce for Australasia. (United States)

    Aramoana, Jaclyn; Alley, Patrick; Koea, Jonathan B


    Progress has been made in Australia and New Zealand to increase the numbers of indigenous students (Aboriginal, Torres Strait Islander and Maori) entering primary medical qualification courses. In New Zealand, up to 20 Maori are graduating annually, with similar numbers possible in Australia, creating a potential opportunity to develop an indigenous surgical workforce. A literature review identified factors utilized by medical schools to attract indigenous students into medical careers and the interventions necessary to ensure successful graduation. A further search identified those factors important in encouraging indigenous medical graduates to enter specialist training programmes and achieve faculty appointments. All medical schools have utilized elements of a 'pipeline approach' encompassing contact with students at secondary school level to encourage aspirational goals and assist with suitable subject selection. Bridging courses can ensure students leaving school have appropriate skill sets before entering medical degree courses. Extensive practical help is available during primary medical qualification study. The elements necessary for primary medical qualification success - dedicated and focused study, developing appropriate skill sets, mentoring, support, and an institutional and collegial commitment to success - are also the elements required for postgraduate achievement. The Royal Australasian College of Surgeons (RACS) is primarily involved in training rather than service provision. The increasing numbers of indigenous medical graduates in both Australia and New Zealand represent an opportunity for the College to contribute to improving indigenous health status by implementing specific measures to increase numbers of indigenous surgeons. © 2013 Royal Australasian College of Surgeons.

  20. Surgical outcome and clinical profile of emergency versus elective cases of colorectal cancer in College of Medical Sciences, Nepal

    Directory of Open Access Journals (Sweden)

    Sujit Kumar


    Full Text Available Background: Patients who undergo emergency colorectal cancer surgery has poor outcome compared to elective surgery, both in terms of morbidity and mortality. Approximately 15 to 30% of colorectal cancers present as an emergency, most often as obstruction or perforation. Objective: To compare surgical outcome and clinical profiles of emergency and elective cases for colorectal cancer. Methods: Retrospective analysis of 34 cases who underwent surgery for colorectal cancer between December 2011 to January 2013was carried out and their surgical outcomes, clinical presentation, demographic profile were analyzed. Results: The total numbers of patients included in this study were 34. Out of which 52.94 %( n=18 were emergency cases and 47.05 %( n=16 were elective. Male female ratio was 3:1 in emergency cases and 2.6:1 in elective cases. Per rectal bleeding (56% and altered bowel habit (31.25% was predominant clinical presentation in elective cases whereas intestinal obstruction (55.55% and peritonitis (22.22% were predominant clinical presentation in emergency cases. In emergency cases most of the tumors were located in left side (77.77% and in elective cases rectum was common site (37.5%. Left hemicolectomy was the commonest surgery performed (72.22% in emergency set up. In elective cases, right hemicolectomy, left hemicolectomy, APR and LAR was done in 31.25%, 31.25%, 25% and 25% cases respectively. In the emergency group 11.11% (n=2 developed enterocutaneous fistula and early mortality within 30 days was observed in 5% (n=1 of emergency cases only. Conclusion: In emergency conditions, colorectal cancer presented with intestinal obstruction where as elective cases presented with per rectal bleeding and altered bowel habits. Compared with the elective patients, the emergency patients had higher rate of morbidity and mortality. Because of higher incidence of colorectal cancer in our institution, in all emergency cases who presents with features of

  1. The role of multimedia in surgical skills training and assessment. (United States)

    Shariff, Umar; Seretis, Charalampos; Lee, Doreen; Balasubramanian, Saba P


    Multimedia is an educational resource that can be used to supplement surgical skills training. The aim of this review was to determine the role of multimedia in surgical training and assessment by performing a systematic review of the literature. A systematic review for published articles was conducted on the following databases: PubMed/MEDLINE (1992 to November 2014), SCOPUS (1992 to November 2014) and EMBASE (1992 to November 2014). For each study the educational content, study design, surgical skill assessed and outcomes were recorded. A standard data extraction form was created to ensure systematic retrieval of relevant information. 21 studies were included; 14 randomized controlled trials (RCTs) and 7 non-randomized controlled trials (Non-RCTs). Technical skills were assessed in 7 RCTs and 3 non-RCTs; cognitive skills were assessed in 9 RCTs and 4 non-RCTs. In controlled studies, multimedia was associated with significant improvement in technical skills (4 studies; 4 RCTs) and cognitive skills (7 studies; 6 RCTs). In two studies multimedia was inferior in comparison to conventional teaching. Evaluation of multimedia (9 studies) demonstrated strongly favourable results. This review suggests that multimedia effectively facilitates both technical and cognitive skills acquisition and is well accepted as an educational resource. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  2. Simulation-based surgical education. (United States)

    Evgeniou, Evgenios; Loizou, Peter


    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  3. Part-time general surgical training in South Australia: its success and future implications (or: pinnacles, pitfalls and lessons for the future). (United States)

    Neuhaus, Susan; Igras, Emma; Fosh, Beverley; Benson, Sarah


    Flexible training options are sought by an increasing number of Australasian surgical trainees. Reasons include increased participation of women in the surgical workforce, postgraduate training and changing attitudes to family responsibilities. Despite endorsement of flexible training by the Royal Australasian College of Surgeons and Board in General Surgery, part-time (PT) training in General Surgery in Australia and New Zealand is not well established. A permanent 'stand-alone' PT training position was established at the Royal Adelaide Hospital in 2007 under the Surgical Education and Training Program. This position offered 12 months of General Surgical training on a 0.5 full-time (FT) equivalent basis with pro rata emergency and on-call commitments and was accredited for 6 months of General Surgical training. This paper reviews the PT training experience in South Australia. De-identified logbook data were obtained from the South Australian Regional Subcommittee of the Board in General Surgery with consent of each of the trainees. Totals of operative cases were compared against matched FT trainees working on the same unit. Overall, PT trainees achieved comparable operative caseloads compared with their FT colleagues. All trainees included in this review have subsequently passed the Royal Australasian College of Surgeons Fellowship Examination in General Surgery and returned to FT workforce positions. This paper presents two validated models of PT training. Training, resource and regulatory requirements and individual and institutional barriers to flexible training are substantial. Successful PT models offer positive and beneficial training alternatives for General Surgical trainees and contribute to workforce flexibility. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  4. Acquiring surgical skills: the history of surgical teaching at the University of Sydney 1883-2014. (United States)

    Brown, Kilian G M; Storey, Catherine E


    There have been at least 10 major revisions of the medical curriculum since the inauguration of the Faculty of Medicine at the University of Sydney in 1883. This study traced the evolution of the teaching of surgery at our institution by examination of the set curriculum of each period; the expectations of student knowledge in the final examination as well as examining some of the insights provided by past students of their surgical experience through their writings. In the early years, medical graduates were qualified to perform operative surgery without any further training, whereas the modern postgraduate medical curriculum provides students with the basis for further surgical training. © 2016 Royal Australasian College of Surgeons.

  5. In the time of significant generational diversity - surgical leadership must step up! (United States)

    Money, Samuel R; O'Donnell, Mark E; Gray, Richard J


    The diverse attitudes and motivations of surgeons and surgical trainees within different age groups present an important challenge for surgical leaders and educators. These challenges to surgical leadership are not unique, and other industries have likewise needed to grapple with how best to manage these various age groups. The authors will herein explore management and leadership for surgeons in a time of age diversity, define generational variations within "Baby-Boomer", "Generation X" and "Generation Y" populations, and identify work ethos concepts amongst these three groups. The surgical community must understand and embrace these concepts in order to continue to attract a stellar pool of applicants from medical school. By not accepting the changing attitudes and motivations of young trainees and medical students, we may disenfranchise a high percentage of potential future surgeons. Surgical training programs will fill, but will they contain the highest quality trainees? Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  6. Cognitive training: How can it be adapted for surgical education? (United States)

    Wallace, Lauren; Raison, Nicholas; Ghumman, Faisal; Moran, Aidan; Dasgupta, Prokar; Ahmed, Kamran


    There is a need for new approaches to surgical training in order to cope with the increasing time pressures, ethical constraints, and legal limitations being placed on trainees. One of the most interesting of these new approaches is "cognitive training" or the use of psychological processes to enhance performance of skilled behaviour. Its ability to effectively improve motor skills in sport has raised the question as to whether it could also be used to improve surgical performance. The aim of this review is to provide an overview of the current evidence on the use of cognitive training within surgery, and evaluate the potential role it can play in surgical education. Scientific database searches were conducted to identify studies that investigated the use of cognitive training in surgery. The key studies were selected and grouped according to the type of cognitive training they examined. Available research demonstrated that cognitive training interventions resulted in greater performance benefits when compared to control training. In particular, cognitive training was found to improve surgical motor skills, as well as a number of non-technical outcomes. Unfortunately, key limitations restricting the generalizability of these findings include small sample size and conceptual issues arising from differing definitions of the term 'cognitive training'. When used appropriately, cognitive training can be a highly effective supplementary training tool in the development of technical skills in surgery. Although further studies are needed to refine our understanding, cognitive training should certainly play an important role in future surgical education. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  7. Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria. (United States)

    Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D


    Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

  8. National surgical mortality audit may be associated with reduced mortality after emergency admission. (United States)

    Kiermeier, Andreas; Babidge, Wendy J; McCulloch, Glenn A J; Maddern, Guy J; Watters, David A; Aitken, R James


    The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

  9. Getting lost in translation? Workplace based assessments in surgical training. (United States)

    Ali, Jason M


    Workplace based assessments (WBA) are integral to the competence-based surgical training curriculum that currently exists in the UK. The GMC emphasise the value of WBA's as assessments for learning (formative), rather than as assessments of learning (summative). Current implementation of WBA's in the workplace though, is at odds with their intended use, with the formative functions often being overlooked in favour of the summative, as exemplified by the recent announcement that trainees are required to complete a minimum of 40 WBA's a year, an increase from 24. Even before this increase, trainees viewed WBA's as tick-box exercises that negatively impact upon training opportunities. As a result, the tools are commonly misused, often because both trainees and trainers lack understanding of the benefits of full engagement with the formative learning opportunities afforded by WBA's. To aid the transition in mind-set of trainees and trainers to the purpose of assessment in the workplace, the GMC propose the introduction of 'supervised learning events' and 'assessments of performance' to supersede 'WBA's'. The impact of this change and how these will be integrated into surgical training is yet to be seen, but is likely to be a step in the right direction. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. Basic airway skills acquisition using the American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum: Initial results. (United States)

    Muratore, Sydne; Kim, Michael; Olasky, Jaisa; Campbell, Andre; Acton, Robert


    The ACS/ASE Medical Student Simulation-Based Skills Curriculum was developed to standardize medical student training. This study aims to evaluate the feasibility and validity of implementing the basic airway curriculum. This single-center, prospective study of medical students participating in the basic airway module from 12/2014-3/2016 consisted of didactics, small-group practice, and testing in a simulated clinical scenario. Proficiency was determined by a checklist of skills (1-15), global score (1-5), and letter grade (NR-needs review, PS-proficient in simulation scenario, CP-proficient in clinical scenario). A proportion of students completed pre/post-test surveys regarding experience, satisfaction, comfort, and self-perceived proficiency. Over 16 months, 240 students were enrolled with 98% deemed proficient in a simulated or clinical scenario. Pre/post-test surveys (n = 126) indicated improvement in self-perceived proficiency by 99% of learners. All students felt moderately to very comfortable performing basic airway skills and 94% had moderate to considerable satisfaction after completing the module. The ACS/ASE Surgical Skills Curriculum is a feasible and effective way to teach medical students basic airway skills using simulation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Preliminary results of a prospective study of inter- and intra-user variability of the Royal Veterinary College corneal clarity score (RVC-CCS) for use in veterinary practice. (United States)

    Sanchez, Rick F; Dawson, Charlotte; Matas Riera, Màrian; Escanilla, Natàlia


    To introduce a new corneal clarity score for use in small animals and describe its inter- and intra-user variability. Twelve dogs and two cats with corneal abnormalities and five dogs with healthy corneas. Four examiners scored every patient twice and never consecutively, focusing on the central cornea. The peripheral cornea was scored separately. The following scoring system was used to describe corneal clarity: G0: no fundus reflection is visible on retroillumination (RI) using a head-mounted indirect ophthalmoscope. G1: a fundus reflection is visible with RI. G2: a 0.1-mm diameter light beam is visible on the anterior surface of the iris and/or lens. G3: gross fundic features are visible when viewed with indirect ophthalmoscopy (IO) using a head-mounted indirect ophthalmoscope and a hand-held 30D lens, although fine details are not clear. G4: fine details of the fundic features are clearly visible with IO. The minimum grades given were analyzed for inter- and intra-user variability with kappa analysis. Intra- and interuser variability of the central corneal clarity ranged from 0.78 to 0.96, showing substantial to almost perfect reproducibility, and from 0.66 to 0.91, showing substantial to almost perfect reliability, respectively. Intra- and interuser variability of the peripheral cornea ranged from 0.83 to 0.95, showing almost perfect agreement, and from 0.53 to 0.91, showing moderate to almost perfect agreement. The RVC-CCS is well suited to assess and monitor central corneal clarity in small animals and to compare outcomes between studies and different surgeons. © 2015 American College of Veterinary Ophthalmologists.

  12. Does Royal jelly affect tumor cells?

    Directory of Open Access Journals (Sweden)

    Shirzad Maryam


    Full Text Available Introduction: Royal jelly is a substance that appears to be effective on immune system and it appears to be effective on both prevention and growth of cancer cells. In this study, we aimed to carry out a research to investigate the effect of royal jelly on the growth of WEHI-164 fibrosarcoma cell in syngenic Balb/c mice. Methods: In an experimental study, 28 male Balb/c mice were designated into four equal groups. The mice were subcutaneously injected with 5x105 WEHI-164 tumor cells on the day zero in the chest area of the animal. Animals in groups 1 to 4 were orally given 100, 200, 300 mg/kg of royal jelly or vehicle, respectively. In every individual mouse, the tumour size was measured every 2 days from day 5 (days 5, 7, 9, 11, 13, 15 and 17. Data were statistically analyzed using Kruskal-Wallis and Mann Whitney-U tests. Result: Our results showed that the mean size of tumor in case group was significantly smaller than the control group in days 11, 13, 15 and 17 (P<0.05. No metastasis was seen in test and control groups. Conclusion: With emphasize on antitumor effect of royal jelly, it seems that royal jelly has important role in control and regression of fibrosarcoma cells. Since royal jelly showed a delayed effect in control of fibrosarcoma, we suggest that royal jelly be used at least 10 days before tumor inoculation.

  13. Barriers for students pursuing a surgical career and where the Surgical Interest Association can intervene. (United States)

    Dolan-Evans, Elliot; Rogers, Gary D


    There are some concerns that medical student interest in surgery is suffering. The aims of this project were to investigate the proportion of medical students interested in surgery from years 1 to 4, explore influential attitudinal and demographic factors, and establish baseline data to study the future effects of the Surgical Interest Association. Students were surveyed through an audience response system in year orientation sessions. For a majority of the analyses, respondents were dichotomized based on expressing an interest in surgery or not. There were no significant differences in the interest students had for a surgical career between medical student year levels in a cross-sectional analysis. However, available longitudinal data demonstrated a significant decrease in surgical interest from first years in 2012 to second years in 2013. Lifestyle, working hours and training length concerns had minimal effects as career influences on students interested in surgery, whereas academic interest and career opportunities were motivating factors in choosing this career. The results suggested no difference between levels of interest from first to final year students in surgery as a career, though only 22% of final year students were interested in surgery. This study also suggested that promoting the academic and scientific side of surgery, along with career opportunities available, may be an important avenue to encourage students into surgery. Future research will investigate the changing interests of students in surgery longitudinally throughout the medical school and to analyse the effects of the Surgical Interest Association. © 2014 Royal Australasian College of Surgeons.

  14. Evolving a common surgical curriculum for ASEAN nations with a public health approach. (United States)

    Lum, Siew Kheong


    The Association of Southeast Asian Nations (ASEAN) Mutual Recognition Arrangement (MRA) on medical practitioners' agreement will become a reality in the year 2015. Doctors registered in one ASEAN country will be given reciprocal recognition in another country under this agreement. Rapid and excessive movement of human resources between countries in a short span of time is undesirable and can be destabilizing. The surgical fraternity in the ASEAN countries should plan for a common surgical curriculum, a common examination and an ASEAN Board of Surgery so that standards of future trainees in different countries are comparable. The curriculum should take into consideration the diversity of the countries in socio-economic development. Ideally, it should be based on a public health approach to bring affordable quality surgical care to the masses in an efficient and effective manner. © 2013 The Author. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  15. Key Royale bridge five year evaluation. (United States)


    This report describes the design, construction, instrumentation, and five-year evaluation of the Key Royale Bridge substructure. The primary focus was the evaluation of the implementation of highly reactive supplementary cementitious materials (SCM) ...

  16. Biological Activities of Royal Jelly - Review

    Directory of Open Access Journals (Sweden)

    Crenguţa I. Pavel


    Full Text Available Royal jelly is a secretion product of the cephalic glands of nurse bees that has been used for centuries for itsextraordinary properties and health effects. This bibliographic study aims to review many of the scientific findingsand research that prove many of the remarkable various actions, effects and some uses of royal jelly. There are takeninto consideration numerous biological properties and effects of royal jelly: antioxidant, neurotrophic, hipoglicemiant, hipocholesterolemiant and hepatoprotective, hypotensive and blood pressure regulatory, antitumor, antibiotic, anti-inflammatory, immunomodulatory and anti-allergic, general tonic and antiaging. Royal jelly is one ofthe most studied bee products, but there still remains much to reveal about its biochemistry and biological activity infuture research for our health and life benefit.

  17. Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

    Directory of Open Access Journals (Sweden)

    Tashmin Afroz Binte Islam


    Full Text Available Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections. Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics. Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests – oxidase test and reaction in MIU (motility indole urease and Simmon’s citrate and TSI (triple sugar iron media. ESBL producers were detected by double-disk synergy test (DDST. Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71% followed by Pseudomonas aeruginosa 6 (17.14%, Klebsiella pneumoniae 3 (8.57%, Acinetobacter baumannii 2 (5.72% and Proteus vulgaris 1 (2.86% respectively. Among the isolates, 10 (28.57% ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85% followed by Klebsiella pneumoniae 1 (2.86% and Pseudomonas aeruginosa 1 (2.86%. The isolates were resistant to most of the commonly used antimicrobial agents. Conclusion: The emergence of multi-drug resistant (MDR bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

  18. Surgeons' and surgical trainees' acute stress in real operations or simulation: A systematic review. (United States)

    Georgiou, Konstantinos; Larentzakis, Andreas; Papavassiliou, Athanasios G


    Acute stress in surgery is ubiquitous and has an immediate impact on surgical performance and patient safety. Surgeons react with several coping strategies; however, they recognise the necessity of formal stress management training. Thus, stress assessment is a direct need. Surgical simulation is a validated standardised training milieu designed to replicate real-life situations. It replicates stress, prevents biases, and provides objective metrics. The complexity of stress mechanisms makes stress measurement difficult to quantify and interpret. This systematic review aims to identify studies that have used acute stress estimation measurements in surgeons or surgical trainees during real operations or surgical simulation, and to collectively present the rationale of these tools, with special emphasis in salivary markers. A search strategy was implemented to retrieve relevant articles from MEDLINE and SCOPUS databases. The 738 articles retrieved were reviewed for further evaluation according to the predetermined inclusion/exclusion criteria. Thirty-three studies were included in this systematic review. The methods for acute stress assessment varied greatly among studies with the non-invasive techniques being the most commonly used. Subjective and objective tests for surgeons' acute stress assessment are being presented. There is a broad spectrum of acute mental stress assessment tools in the surgical field and simulation and salivary biomarkers have recently gained popularity. There is a need to maintain a consistent methodology in future research, towards a deeper understanding of acute stress in the surgical field. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  19. Surgical and procedural skills training at medical school - a national review. (United States)

    Davis, Christopher R; Toll, Edward C; Bates, Anthony S; Cole, Matthew D; Smith, Frank C T


    This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Teaching Simulation and Modelling at Royal Military College. (United States)

    Bonin, Hugues W.; Weir, Ronald D.


    Describes a course designed to assist students in writing differential equations to represent chemical processes and to solve these problems on digital computers. Course outline and discussion of computer projects and the simulation and optimization of a continuously stirred tank reactor process are included. (JN)

  1. Virtual Learning Spaces at the Royal Danish Defence College

    DEFF Research Database (Denmark)

    Frølund, Gro

    A growing proportion of today’s educational activity, civilian as well as military, takes place in virtual learning environments. A corollary of this growth is the emerging concern that the educational value of information and communication technology (ICT) is under-used by educators....... There are also professional concerns that ICT may even undermine the effectiveness of teaching in some instances. A recent report notes that our educational institutions are ill-prepared pedagogically for making the most of technology. It asserts that simply adding twenty first century technologies to twentieth...... century teaching practices will “dilute the effectiveness of teaching”. Since our military institutions are currently adopting new technologies extensively, this issue is a pressing one. We need a deeper understanding of how e-learning affects learners in a military context. For this reason, the present...


    African Journals Online (AJOL)

    Obstetricians and Gynaecologists to inaugurate the new South. African Regional .... steady advance in' scientific knowledge and clinical treatment. Note that of the three great discoveries I mentioned two, viz. anaes- thesia and antisepsis ...

  3. Surgical wisdom and Genghis Khan's Pax Mongolica. (United States)

    Köstenbauer, Jakob


    The unrivalled conquests of Genghis Khan (CE c.1162-1227) led to the establishment of the Greater Mongolian Empire. By 1279, the Mongol dynasty controlled a vast Empire which, for the first time in history, unified Europe and China via the famous Silk Road. The ensuing century of peace and stability is referred to by historians as the Pax Mongolica, which facilitated Europe's renaissance and remarkably contributed to the rise of modern medicine and surgery. Secondary sources from published literature, primary sources from manuscripts and illustrations courtesy of universities, museum libraries and archives. There is ample evidence detailing the Mongol Empire's power during the thirteenth century and the Silk Road's role as a vehicle of commercial, cultural and scientific exchange. Advances in medical knowledge and surgical skills were made in all parts of the Empire and exchanged from China to Constantinople and back. Prominent medical figures traversed these centres, and no doubt contributed to the spread of surgical science, including Rashid al-Din and Mansur Ibn Ilyas. Their works, it is argued, enriched the practice of surgery and may have indirectly ushered-in the rise of modern surgery in the early medical schools at Salerno, Bologna, Pavia, Oxford, Montpellier and Constantinople to name but a few. The blossoming and diversification of medical and surgical knowledge was an integral part of the great cultural exchange facilitated by the Pax Mongolica. This enhanced surgical practice in China, Persia and Arabia, while coinciding with the renaissance of surgical teaching in Europe. © 2017 Royal Australasian College of Surgeons.

  4. 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. (United States)

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


    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

  5. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan


    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  6. Whither surgical quality assurance of breast cancer surgery (surgical margins and local recurrence) after paterson. (United States)

    Bundred, N J; Thomas, J; Dixon, J M J


    The Kennedy report into the actions of the disgraced Breast Surgeon, Paterson focussed on issues of informed consent for mastectomy, management of surgical margins and raised concerns about local recurrence rates and the increasing emphasis on cosmesis after mastectomy for breast cancer. This article assesses whether Kennedy's recommendations apply to the UK as a whole and how to address these issues. New GMC advice on consent and newer nonevidenced innovations in immediate reconstruction have altered the level of informed consent required. Patients deserve a better understanding of the issues of oncological versus cosmetic outcomes on which to base their decisions. Involvement of the whole multidisciplinary team including Oncologists is necessary in surgical planning. Failure to obtain clear microscopic margins at mastectomy leads to an increased local recurrence, yet has received little attention in the UK. Whereas, other countries have used surgical quality assurance audits to reduce local recurrence; local recurrence rates are not available and the extent of variation across the UK in margin involvement after surgery, its management and relationship to local recurrence needs auditing prospectively to reduce unnecessary morbidity. To reassure public, patients and the NHS management, an accreditation system with more rigour than NHSBSP QA and peer review is now required. Resource and efforts to support its introduction will be necessary from the Royal College of Surgeons and the Association of Breast Surgeons. New innovations require careful evaluation before their backdoor introduction to the NHS. Private Hospitals need to have the same standards imposed.

  7. Quality Parameters for Commercial Royal Jelly

    Directory of Open Access Journals (Sweden)

    Carmen Ioana Muresan


    Full Text Available Royal jelly has become a high-value commercial product and the standardization of this product is required to guarantee its quality on the market. The objective of the research activity was to pursue the chemical composition of commercial samples of Royal Jelly in Romania in order to propose standardization for this product. The physico-chemical composition of commercial Royal Jelly samples was analysed by determining quality parameters like: carbohydrates, lipids, proteins, 10-hydroxy-2-decenoic acid (10-HDA and mineral elements. Carbohydrates analysis showed values between 3.4 % and 5.87 % for fructose, 4.12 % and 7.05 % for glucose, while for sucrose the values ranged between 0.95 % and 2.56 % (determined by HPLC-RI. The lipids content ranged between 1.85 % and 6.32 % (determined by the Soxhlet method. The protein values extended from 13.10 % (RJ2 to 17.04 % (RJ10 (the total protein content was determined by the Kjeldahl method. The values for the major fatty acid in Royal Jelly, 10-HDA, ranged between 1.35 % (RJ8 and 2.03 % (RJ10 (determined by high-performance liquid chromatography. The concentration of minerals varied between 3188.70 mg/kg and 4023.39 mg/kg (the concentration of minerals was measured using flame atomic absorption spectrometry. Potassium, followed by magnesium, sodium and calcium, occurs in the highest concentrations. The commercial Royal Jelly samples analysed presented variable physico-chemical characteristics that correspond with the values given by international quality standard proposals for Royal Jelly.

  8. Royal Dutch Petroleum Company annual report 1992

    International Nuclear Information System (INIS)



    The Royal Dutch Petroleum Company has no operations of its own and virtually the whole of its income derives from its 60% interest in the companies known collectively as the Royal Dutch/Shell Group of Companies; the other 40% is owned by the Shell Transport and Trading Company, p.l.c. The company is engaged in the oil, natural gas, chemicals, coal and metals businesses throughout the world. The annual report summarises the year's results and analyses earnings in each industry segment. Financial statements for the year ended 31 December 1992 are presented. The Group companies' estimated net quantities of crude oil, natural gas and coal are given

  9. 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 ...

  10. Royal Ahold: A Failure Of Corporate Governance

    NARCIS (Netherlands)

    A. de Jong (Abe); D.V. DeJong; G.M.H. Mertens (Gerard); P.G.J. Roosenboom (Peter)


    textabstractRoyal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures in corporate governance, suffering a complete meltdown in 2003. This clinical study analyzes Ahold’s growth strategy through acquisitions and isolates the cause of the

  11. Isaac Newton and the Royal Mint

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 12. Isaac Newton and the Royal Mint. Biman Nath. Article-in-a-Box Volume 11 Issue 12 December 2006 pp 6-7. Fulltext. Click here to view fulltext PDF. Permanent link: ...

  12. Royal Naval nursing: 'testing but worth it'. (United States)

    Moore, Alison


    Inga Kennedy is the most senior nurse in the Royal Navy. She enjoys the commitment and discipline required by a career in the armed forces and says the work offers great opportunities for nurses. Her career highlights have included checking that injured personnel in Afghanistan were receiving the best care possible.

  13. A historical vignette (20). A royal otitis. (United States)

    Tainmont, J


    A royal otitis. The young king of France, Francis II, the eldest son of Henry II and Catherine de Medici, died in Orleans from the effects of the complications of a chronic otitis on 6 December 1560. Based on texts of the time, the paper discusses the nature of the illness, the treatment, and the medical and political entourage of the king.

  14. Sociomateriality at the Royal Court of IS

    DEFF Research Database (Denmark)

    Kautz, Karlheinz; Jensen, Tina Blegind


    understanding of the notion of sociomateriality and its use in the IS discipline. We invite the reader to attend a prolonged monologue – characterized by honesty, frank observations and wit – at the royal court of IS. The monologue is delivered by the court jester and directed to the two sovereigns who, based...

  15. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program (United States)

    Sherrod, Brandon A.; Johnston, James M.; Rocque, Brandon G.


    Objective Readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and risk factors for readmission after pediatric neurosurgical procedures. Methods The American College of Surgeons National Surgical Quality Improvement Program–Pediatric database was queried for pediatric patients treated by a neurosurgeon from 2012 to 2013. Procedures were categorized by current procedural terminology code. Patient demographics, comorbidities, preoperative laboratory values, operative variables, and postoperative complications were analyzed via univariate and multivariate techniques to find associations with unplanned readmission within 30 days of the primary procedure. Results A total of 9799 cases met the inclusion criteria, 1098 (11.2%) of which had an unplanned readmission within 30 days. Readmission occurred 14.0 ± 7.7 days postoperatively (mean ± standard deviation). The 4 procedures with the highest unplanned readmission rates were CSF shunt revision (17.3%), repair of myelomeningocele > 5 cm in diameter (15.4%), CSF shunt creation (14.1%), and craniectomy for infratentorial tumor excision (13.9%). Spine (6.5%), craniotomy for craniosynostosis (2.1%), and skin lesion (1.0%) procedures had the lowest unplanned readmission rates. On multivariate regression analysis, the odds of readmission were greatest in patients experiencing postoperative surgical site infection (SSI; deep, organ/space, superficial SSI and wound disruption: OR > 12 and p readmission risk. Independent patient risk factors for unplanned readmission included Native American race (OR 2.363, p = 0.019), steroid use > 10 days (OR 1.411, p = 0.010), oxygen supplementation (OR 1.645, p = 0.010), nutritional support (OR 1.403, p = 0.009), seizure disorder (OR 1.250, p = 0.021), and longer operative time (per hour increase, OR 1.059, p = 0.014). Conclusions This study may aid in

  16. Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program. (United States)

    Sherrod, Brandon A; Johnston, James M; Rocque, Brandon G


    OBJECTIVE Hospital readmission rate is increasingly used as a quality outcome measure after surgery. The purpose of this study was to establish, using a national database, the baseline readmission rates and risk factors for patient readmission after pediatric neurosurgical procedures. METHODS The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database was queried for pediatric patients treated by a neurosurgeon between 2012 and 2013. Procedures were categorized by current procedural terminology (CPT) code. Patient demographics, comorbidities, preoperative laboratory values, operative variables, and postoperative complications were analyzed via univariate and multivariate techniques to find associations with unplanned readmissions within 30 days of the primary procedure. RESULTS A total of 9799 cases met the inclusion criteria, 1098 (11.2%) of which had an unplanned readmission within 30 days. Readmission occurred 14.0 ± 7.7 days postoperatively (mean ± standard deviation). The 4 procedures with the highest unplanned readmission rates were CSF shunt revision (17.3%; CPT codes 62225 and 62230), repair of myelomeningocele > 5 cm in diameter (15.4%), CSF shunt creation (14.1%), and craniectomy for infratentorial tumor excision (13.9%). The lowest unplanned readmission rates were for spine (6.5%), craniotomy for craniosynostosis (2.1%), and skin lesion (1.0%) procedures. On multivariate regression analysis, the odds of readmission were greatest in patients experiencing postoperative surgical site infection (SSI; deep, organ/space, superficial SSI, and wound disruption: OR > 12 and p 10 days (OR 1.411, p = 0.010), oxygen supplementation (OR 1.645, p = 0.010), nutritional support (OR 1.403, p = 0.009), seizure disorder (OR 1.250, p = 0.021), and longer operative time (per hour increase, OR 1.059, p = 0.029). CONCLUSIONS This study may aid in identifying patients at risk for unplanned readmission following pediatric neurosurgery

  17. Audit of referrals for concern regarding labial appearance at the Royal Children's Hospital: 2000-2012. (United States)

    McQuillan, Sarah K; Jayasinghe, Yasmin; Grover, Sonia R


    To audit the clinical features and outcomes for all patients referred to our centre with concerns regarding labial appearance. Young females referred to a paediatric/adolescent gynaecology tertiary centre between 2000 and 2012 with concerns regarding their labial appearance were retrospectively identified. Adolescents presenting with anomalies were excluded. Retrospective chart review was undertaken to identify reasons for referral, patient characteristics, outcome of referral and concurrent health problems. In total, 46 females presenting with concerns about labial appearance were identified. Five were excluded. Median age of the study population was 14.5 years (range 5-21 years). Only four (9.8%) underwent surgery after a minimum of five consultations each, with mental health review in three of four cases prior to surgery. None of the 41 patients had documented abnormal labia; however, 6 patients had asymmetry, and 3 had a labial width of >5 cm. Of mothers, 24% (n = 10) raised the initial concern regarding labial appearance to a physician, of whom, 50% of patients had a comorbid condition. In total, 70.7% initially reported interference with daily activities, and 87.8% were reassured following discussion. With appropriate education and counselling, the majority of girls with concerns regarding labial appearance can be managed without surgery. Overall, our data support current international policy that female cosmetic genital surgery not be performed in mature minors unless there are specific indications. More research about characteristics of patients referred with labial concerns, definition of labial size and long-term satisfaction of conservative versus surgical methods is necessary to determine the best approach. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  18. Mental training in surgical education: a systematic review. (United States)

    Davison, Sara; Raison, Nicholas; Khan, Muhammad S; Dasgupta, Prokar; Ahmed, Kamran


    Pressures on surgical education from restricted working hours and increasing scrutiny of outcomes have been compounded by the development of highly technical surgical procedures requiring additional specialist training. Mental training (MT), the act of performing motor tasks in the 'mind's eye', offers the potential for training outside the operating room. However, the technique is yet to be formally incorporated in surgical curricula. This study aims to review the available literature to determine the role of MT in surgical education. EMBASE and Medline databases were searched. The primary outcome measure was surgical proficiency following training. Secondary analyses examined training duration, forms of MT and trainees level of experience. Study quality was assessed using Consolidated Standards of Reporting Trials scores or Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. Fourteen trials with 618 participants met the inclusion criteria, of which 11 were randomized and three longitudinal. Ten studies found MT to be beneficial. Mental rehearsal was the most commonly used form of training. No significant correlation was found between the length of MT and outcomes. MT benefitted expert surgeons more than medical students or novice surgeons. The majority studies demonstrate MT to be beneficial in surgical education especially amongst more experienced surgeons within a well-structured MT programme. However, overall studies were low quality, lacked sufficient methodology and suffered from small sample sizes. For these reasons, further research is required to determine optimal role of MT as a supplementary educational tool within the surgical curriculum. © 2017 Royal Australasian College of Surgeons.

  19. Cost-effective framework for basic surgical skills training. (United States)

    Jiang, Deng-Jin; Wen, Chan; Yang, Ai-Jun; Zhu, Zhi-Li; Lei, Yan; Lan, Yang-Jun; Huang, Qing-Yuan; Hou, Xiao-Yu


    The importance of basic surgical skills is entirely agreed among surgical educators. However, restricted by ethical issues, finance etc, the basic surgical skills training is increasingly challenged. Increasing cost gives an impetus to the development of cost-effective training models to meet the trainees' acquisition of basic surgical skills. In this situation, a cost-effective training framework was formed in our department and introduced here. Each five students were assigned to a 'training unit'. The training was implemented weekly for 18 weeks. The framework consisted of an early, a transitional, an integrative stage and a surgical skills competition. Corresponding training modules were selected and assembled scientifically at each stage. The modules comprised campus intranet databases, sponge benchtop, nonliving animal tissue, local dissection specimens and simulating reality operations. The training outcomes used direct observation of procedural skills as an assessment tool. The training data of 50 trainees who were randomly selected in each year from 2006 to 2011 year, were retrospectively analysed. An excellent and good rate of the surgical skills is from 82 to 88%, but there is no significant difference among 6 years (P > 0.05). The skills scores of the contestants are markedly higher than those of non-contestants (P < 0.05). The average training cost per trainee is about $21.85-34.08. The present training framework is reliable, feasible, repeatable and cost-effective. The skills competition can promote to improve the surgical skills level of trainees. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.


    Directory of Open Access Journals (Sweden)

    Zinka Maksimović


    Full Text Available Antibacterial effects of the fresh royal jelly, royal jelly stored at 4 °C and -40 °C for a period of 12 months against reference and isolated bacterial strains from the different clinical samples, were tested and compared by the diffusion test. Royal jelly shows antibacterial effects against both tested gram-positive and gram-negative bacteria. Fresh royal jelly has the most effective antibacterial activity. Storage temperature at -40 oC slightly affects antibacterial activity of royal jelly, while storage temperature at 4 oC decreases its antibacterial activity.Key words: royal jelly, antibacterial effects, storage temperature, storage duration

  1. A pilot comparison of standardized online surgical curricula for use in low- and middle-income countries. (United States)

    Goldstein, Seth D; Papandria, Dominic; Linden, Allison; Azzie, Georges; Borgstein, Eric; Calland, James Forrest; Finlayson, Samuel R G; Jani, Pankaj; Klingensmith, Mary; Labib, Mohamed; Lewis, Frank; Malangoni, Mark A; O'Flynn, Eric; Ogendo, Stephen; Riviello, Robert; Abdullah, Fizan


    Surgical conditions are an important component of global disease burden, due in part to critical shortages of adequately trained surgical providers in low- and middle-income countries. To assess the use of Internet-based educational platforms as a feasible approach to augmenting the education and training of surgical providers in these settings. Access to two online curricula was offered to 75 surgical faculty and trainees from 12 low- and middle-income countries for 60 days. The Surgical Council on Resident Education web portal was designed for general surgery trainees in the United States, and the School for Surgeons website was built by the Royal College of Surgeons in Ireland specifically for the College of Surgeons of East, Central and Southern Africa. Participants completed an anonymous online survey detailing their experiences with both platforms. Voluntary respondents were daily Internet users and endorsed frequent use of both print and online textbooks as references. Likert scale survey questionnaire responses indicating overall and content-specific experiences with the Surgical Council on Resident Education and School for Surgeons curricula. Survey responses were received from 27 participants. Both online curricula were rated favorably, with no statistically significant differences in stated willingness to use and recommend either platform to colleagues. Despite regional variations in practice context, there were few perceived hurdles to future curriculum adoption. Both the Surgical Council on Resident Education and School for Surgeons educational curricula were well received by respondents in low- and middle-income countries. Although one was designed for US surgical postgraduates and the other for sub-Saharan African surgical providers, there were no significant differences detected in participant responses between the two platforms. Online educational resources have promise as an effective means to enhance the education of surgical providers in low

  2. Surgical training and the European Working Time Directive: The role of informal workplace learning. (United States)

    Giles, James A


    The introduction of European Working Time Directive, limiting doctors' working hours to 48 per week, has caused recent controversy within the profession. The Royal College of Surgeons of England in particular has been one of the loudest critics of the legislation. One of the main concerns is regarding the negative impact on training hours for those embarking on surgical careers. Simulation technology has been suggested as a method to overcome this reduction in hospital training hours, and research suggests that this is a good substitute for operative training in a theatre. However, modern educational theory emphasises the power of informal workplace learning in postgraduate education, and the essential role of experience in training future surgeons. Copyright 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  3. A cross sectional study of surgical training among United Kingdom general practitioners with specialist interests in surgery. (United States)

    Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J


    Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Prospective, questionnaire-based cross-sectional study. A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Respondents performed a mean of 38 (range 5-150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care surgical training in the UK undergoes. The Royal Colleges of

  4. An evaluation of stereoacuity (3D vision) in practising surgeons across a range of surgical specialities. (United States)

    Biddle, Mairiosa; Hamid, Sana; Ali, Nadeem


    Judging depth is important in surgery. Although there are several cues that permit depth perception, stereoacuity has been singled out as a possible predictor of surgical ability. However, it is not clear whether high-grade stereoacuity is necessary for a career in surgery. To help answer this, we aimed to evaluate stereoacuities in practising surgeons across a range of surgical specialities. We recorded stereoacuity values on 66 surgeons working at a London teaching hospital using three standard stereotests: Titmus, TNO and Frisby. There were 36 Trainees and 30 Consultants, covering 12 surgical specialities. Median stereoacuities (with range) for the whole group were: 40 s arc on Titmus (40-800), 30 s arc on TNO (15-480) and 20 s arc on Frisby (20-600). Four surgeons had no recordable stereoacuity on TNO, and one was also unrecordable on Titmus. Three of these four were Consultants. Depending on the test used, high-grade stereopsis was found in 74%-83% of surgeons while reduced stereopsis was found in 2%-14% of surgeons. While we found that most surgeons in current NHS practice have high-grade stereoacuity, there are also surgeons with reduced stereopsis and some with no stereopsis. The findings do not therefore support the assertion that high-grade stereopsis is a universal requirement for a career in surgery. It would be difficult to justify setting a stereoacuity criterion for entrance into a surgical training programme. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  5. Inca Royal Estates in the Sacred Valley (United States)

    McKim Malville, J.

    The royal estates lying between Cusco and Machu Picchu illustrate the remarkable variety by which the sun was honored and worshipped in the Inca Empire. The terraced basins of Moray combine the sun at both solstices and, perhaps, the zenith sun, with flowing water and offerings to Pachamama. The complex astronomy at Urubamba involves the palace of Quespiwanka, horizon pillars, solstices, and mountain worship. Ollantaytambo contains horizontal shadow-casting gnomons with a major water shrine.

  6. Creating the Royal Society's Sylvester Medal


    Cantor, G.


    Following the death of James Joseph Sylvester in 1897, contributions were collected in order to mark his life and work by a suitable memorial. This initiative resulted in the Sylvester Medal, which is awarded triennially by the Royal Society for the encouragement of research into pure mathematics. Ironically the main advocate for initiating this medal was not a fellow mathematician but the chemist and naturalist Raphael Meldola. Religion, not mathematics, provided the link between Meldola and...

  7. Surgical Assisting (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 ...

  8. Abortion - surgical (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. ...

  9. Chemical Composition and Antimicrobial Activity of Royal Jelly - Review

    Directory of Open Access Journals (Sweden)

    Lavinia Ioana Bărnuţiu


    Full Text Available The present paper presents the literature data regarding the chemical composition and antimicrobial activity of RoyalJelly. Royal Jelly is a secretion from the hypofaringeal glands of worker bees which serves as a food for queen beeand to the growing up larvae. Having biological properties already proven, Royal Jelly has considerable commercialappeal and is today used in many sectors (pharmaceutical, food industries and cosmetic products. Thephysicochemical composition of pure royal jelly are analyzed by determining moisture, ash, lipids, proteins,vitamins,aminoacids, carbohydrates, 10-HDA; RJ is the key substance in the antimicrobial function of the system Apismellifera. The intact Royal Jelly exhibited the highest antibacterial activity.

  10. Cognitive skills training in digital era: A paradigm shift in surgical education using the TaTME model. (United States)

    Knol, Joep; Keller, Deborah S


    Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient. The introduction and implementation of the transanal total mesorectal excision (TaTME) into practice may be the best demonstration of this new model of teaching and training, including pre-training, course attendance, and post-course guidance on technical and cognitive skills. To date, the TaTME framework has been the ideal model for structured training to ensure safe implementation. Further development of metrics to grade successful learning and assessment of long term outcomes with the new pathway will confirm the success of this training model. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.

  11. Rare royal families in honeybees, Apis mellifera (United States)

    Moritz, Robin F. A.; Lattorff, H. Michael G.; Neumann, Peter; Kraus, F. Bernhard; Radloff, Sarah E.; Hepburn, H. Randall


    The queen is the dominant female in the honeybee colony, Apis mellifera, and controls reproduction. Queen larvae are selected by the workers and are fed a special diet (royal jelly), which determines caste. Because queens mate with many males a large number of subfamilies coexist in the colony. As a consequence, there is a considerable potential for conflict among the subfamilies over queen rearing. Here we show that honeybee queens are not reared at random but are preferentially reared from rare “royal” subfamilies, which have extremely low frequencies in the colony's worker force but a high frequency in the queens reared.

  12. Impact of workflow on the use of the Surgical Safety Checklist: a qualitative study. (United States)

    Gillespie, Brigid M; Marshall, Andrea P; Gardiner, Therese; Lavin, Joanne; Withers, Teresa K


    Regardless of the benefits associated of the Surgical Safety Checklist, adherence across its three phases remains inconsistent. The aim of this study was to systematically identify issues around workflow that impact on surgical teams' ability to use the Surgical Safety Checklist in a large tertiary facility in Queensland, Australia. Observational audit of 10 surgical teams and 33 semi-structured interviews with 70 participants from nursing, medicine and the community were conducted. Data were collected during 2014-2015. Inductive and deductive approaches were used to analyse field observations and interview transcripts. The domain, impact of workflow on checklist utilization, was identified. Within this domain, seven categories illustrated the causal conditions which determined the ways in which workflow influenced checklist use. These categories included: 'busy doing the task'; 'clashing task priorities'; 'being pressured, running out of time'; 'adapting processes to work patterns'; 'doubling up on work'; 'a domino effect, leading to delays' and 'reality of the workflow'. One of the greatest systemic challenges to checklist use in surgery is workflow. Process changes in the way that surgical safety checklists are used need to incorporate the temporal demands of the workflow. Any changes made must ensure the process is reliable, is easily embedded into existing work routines and is not disruptive. © 2016 Royal Australasian College of Surgeons.

  13. From ancient to avant-garde: a review of traditional and modern multimodal approaches to surgical anatomy education. (United States)

    Hu, Minhao; Wattchow, David; de Fontgalland, Dayan


    The landscape of surgical anatomy education is progressively changing. Traditional methods, such as cadaveric dissection and didacticism are being increasingly phased out in undergraduate courses for multimodal approaches incorporating problem-based learning, radiology and computer-based simulations. Although effective at clinically contextualizing and integrating anatomical information, these approaches may be a poor substitute for fostering a grasp of foundational 'pure' anatomy. Dissection is ideal for this purpose and hence remains the cornerstone of anatomical education. However, novel methods and technological advancements continually give way to adjuncts such as cadaveric surgery, three-dimensional printing, virtual simulation and live surgical streaming, which have demonstrated significant efficacy alone or alongside dissection. Therefore, although divergent paradigms of 'new versus old' approaches have engulfed and divided the community, educators should seek to integrate the ancient and avant-garde to comprehensively satisfy all of the modern anatomy learner's educational needs. © 2017 Royal Australasian College of Surgeons.

  14. Surgical outcomes of trabeculectomy and glaucoma drainage implant for uveitic glaucoma and relationship with uveitis activity. (United States)

    Kwon, Hye Jin; Kong, Yu Xiang George; Tao, Lingwei William; Lim, Lyndell L; Martin, Keith R; Green, Catherine; Ruddle, Jonathan; Crowston, Jonathan G


    This study provides ophthalmologists who manage uveitic glaucoma with important information on factors that can affect the success of surgical management of this challenging disease. This study examines surgical outcomes of trabeculectomy and glaucoma device implant (GDI) surgery for uveitic glaucoma, in particular the effect of uveitis activity on surgical outcomes. Retrospective chart review at a tertiary institution. Eighty-two cases with uveitic glaucoma (54 trabeculectomies and 28 (GDI) surgeries) performed between 1 December 2006 and 30 November 2014. Associations of factors with surgical outcomes were examined using univariate and multivariate analysis. Surgical outcomes as defined in Guidelines from World Glaucoma Association. Average follow up was 26.4 ± 21.5 months. Overall qualified success rate of the trabeculectomies was not statistically different from GDI, being 67% and 75%, respectively (P = 0.60). Primary and secondary GDI operations showed similar success rates. The most common postoperative complication was hypotony (~30%). Active uveitis at the time of operation was higher in trabeculectomy compared with GDI group (35% vs. 14%). Active uveitis at the time of surgery did not significantly increase risk of failure for trabeculectomies. Recurrence of uveitis was significantly associated with surgical failure in trabeculectomy group (odds ratio 4.8, P = 0.02) but not in GDI group. Surgical success rate of GDI was not significantly different from trabeculectomy for uveitic glaucoma in this study. Regular monitoring, early and prolonged intensive treatment of ocular inflammation is important for surgical success particularly following trabeculectomy. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  15. Voice work at the Royal Shakespeare Company


    Wade, Andrew


    En tant que responsable du département de la voix de la Royal Shakespeare Company, je me dois de démystifier la façon dont nous travaillons avec les acteurs. Il me semble également essentiel de mettre en lumière l’histoire et les objectifs du travail de la RSC sur la voix. Ceci devrait encore clarifier ce que nous entendons par « la voix de Shakespeare ». Depuis de nombreuses années les besoins d’un travail spécifique sur la voix n’ont cessé de grandir avec la compagnie. Cette pratique fait m...

  16. Oral Allergy Syndrome in a Child Provoked by Royal Jelly

    Directory of Open Access Journals (Sweden)

    Fantini Paola


    Full Text Available Royal jelly has been demonstrated to have several physiological activities. However, in the literature, different reactions induced by royal jelly are reported. We describe a case of seven-year-old child that was referred to our observation for two episodes of oral allergy syndrome (OAS that appeared ten minutes after ingestion of royal jelly. Skin prick test with standard panel of inhalant and food allergens, a prick-to-prick test using the royal jelly’s extract responsible for patient’s reactions, and royal jelly patch test with extemporaneous preparation were performed. The specific IgE by ImmunoCAP System method versus Hymenoptera venom, inhalant allergens, food allergens, and lipid transfer proteins was dosed. According to the positive reactions to royal jelly both by prick-by-prick test and by a first reading patch test, royal jelly immediate hypersensitivity was diagnosed. According to the positive response for almond in both in vivo and in vitro tests we can think of the royal jelly contamination with almond pollen as possible cause of patient’s reaction. Moreover, from the results of specific IgE titers versus Compositae pollens, we have argued the possibility that this case of royal jelly allergy could be explained also by the mechanism of cross-reaction with Compositae pollens.

  17. The Royal pilgrimage of the Goddess Nanda

    Directory of Open Access Journals (Sweden)

    William S. Sax


    Full Text Available Once every twelve years, when it is thought that some calamity has taken place because of the curse of the goddess Nanda Devi, a four-horned ram is born in the fields of the former king of Garhwal, an erstwhile Central Himalayan kingdom in north India (see map of Garhwal. This four-horned ram leads a procession of priests and pilgrims on the most dangerous and spectacular pilgrimage in all of India: a three-week, barefoot journey of one-hundred and sixty-four miles, during some of the worst weather of the year, at the end of the rainy season. The procession reaches Rupkund, a small pond located at an altitude of more than 5,000 metres, which is surrounded by human­ skeletons, and from there it goes yet further, to Homkund, the ‘Lake of the Fire Sacrifice’. According to the faithful, the four-horned ram leaves the procession at that point and finds its way, unaided, to the summit of Mount Trishul. As its name suggests, the Royal Procession is closely associated with the ruler of this erstwhile Himalayan kingdom: he attends its inaugural rituals, the bones that litter the shores of Rupkund are believed to be those of one of his ancestors, and the chief sponsor of the event is a local ‘Prince’ who is thought to be descended from the first kings of Garhwal. This Prince traverses the domain of his ancestors and thereby lays claim to it in the name of the goddess Nanda, who is not only his lineage goddess but was also the royal goddess of the neighbouring kingdom of Kumaon, in pre-colonial times. Although the Royal Procession ideally fosters social integration, it was disrupted in 1987 by a quarrel between two factions of priests. The goddess’s itinerary, the culminating date of the pilgrimage, the type of sacrifice to be performed, the order of procession, the participation of previously excluded persons, and the competency of certain ritual specialists—all were subjects of heated dispute between the rival groups. What was the reason for

  18. Evaluating the value and impact of the Victorian Audit of Surgical Mortality. (United States)

    Retegan, Claudia; Russell, Colin; Harris, Darren; Andrianopoulos, Nick; Beiles, C Barry


    Since the Victorian Audit of Surgical Mortality (VASM) commenced in 2007, 95% of Victorian Fellows have agreed to participate and have provided data on the deaths of patients receiving surgical care. All public, and the majority of private, hospitals involved in the delivery of surgical services in Victoria have been submitting data on deaths associated with surgery. De-identified reports on this data are distributed in regular annual reports and case note review booklets. Although informal feedback on the perceived value of the audit was encouraging, a formal review of all aspects of the audit was felt necessary. An independent formal review of VASM governance, documentation, datasets and data analysis was performed, in addition to a survey of 257 individuals (surgeons and other stakeholders) on the perceived impact of VASM. The review confirmed increasing participation and acceptance by surgeons since the inception of the project. Governance mechanisms were found to be effective and acknowledged by stakeholders and collaborators. Robust participation rates have been achieved, and stakeholders were generally satisfied with the quality of feedback. Suggestions for improvement were provided by some surgeons and hospitals. External review of VASM processes and procedures confirmed that the audit was operating effectively, with robust quality control and achieving the trust of stakeholders. The educational value of the audit to the surgical community was acknowledged and areas for future improvement have been identified. © 2013 Royal Australasian College of Surgeons.

  19. Supply and demand mismatch for flexible (part-time) surgical training in Australasia. (United States)

    McDonald, Rachel E; Jeeves, Amy E; Vasey, Carolyn E; Wright, Deborah M; O'Grady, Gregory


    To define current patterns of flexible (part-time) surgical training in Australasia, determine supply and demand for part-time positions, and identify work-related factors motivating interest in flexible training. All Royal Australasian College of Surgeons trainees (n = 1191) were surveyed in 2010. Questions assessed demographic characteristics and working patterns, interest in flexible training, work-related fatigue and work-life balance preferences. Interest in part-time training, and work-related factors motivating this interest. Of the 1191 trainees, 659 responded (response rate, 55.3%). Respondents were representative of all trainees in terms of specialty and sex. The median age of respondents was 32 2013s, and 187 (28.4%) were female. Most of the 659 respondents (627, 95.1%) were in full-time clinical training; only two (0.3%) were in part-time clinical training, and 30 (4.6%) were not in active clinical training. An interest in part-time training was reported by 208 respondents (31.6%; 54.3% of women v 25.9% of men; P work and limited their social or family life, and that they had insufficient time in life for things outside surgical training, including study or research (P flexible surgical training and the number of trainees currently in part-time training positions in Australia and New Zealand. Efforts are needed to facilitate part-time surgical training.

  20. Comparison of appendicectomy outcomes: acute surgical versus traditional pathway. (United States)

    Pillai, Sandhya; Hsee, Li; Pun, Andy; Mathur, Sachin; Civil, Ian


    The acute surgical unit (ASU) is an evolving novel concept introduced to address the challenge of maintaining key performance indicators (KPIs) in the face of an increasing acute workload. The aim of this retrospective study was to compare the performance of the ASU (from June 2008 to December 2010) at Auckland City Hospital with the traditional model (from January 2006 to May 2008) and benchmark the results against other similar published studies. The analysis was on the basis of KPIs for 1857 appendicectomies, which form a large volume of acute surgical presentations. Our results show significant improvement in length of stay (2.8 days, 2.6 days, P = 0.0001) and proportion of daytime operations (59.4%, 65.8%, P = 0.004), in keeping with other studies on benchmarking. The introduction of ASU has led to significant improvements in some KPIs for appendicectomy outcomes in the face of an increasing workload. © 2013 Royal Australasian College of Surgeons.

  1. Fresh frozen cadaver workshops for advanced vascular surgical training. (United States)

    Jansen, Shirley; Cowie, Margaret; Linehan, John; Hamdorf, Jeffery M


    Reduction in working hours, streamlined training schemes and increasing use of endovascular techniques has meant a reduction in operative experience for newer vascular surgical trainees, especially those exposures which are not routinely performed such as thoracoabdominal, thoracotomy and retroperitoneal aortic, for example. This paper describes an Advanced Anatomy of Exposure course which was designed and convened at the Clinical Training & Evaluation Centre in Western Australia and uses fresh frozen cadavers. Feedback was obtained from the participants who attended over three courses by questionnaire. Feedback was strongly positive for the course meeting both its learning outcomes and personal learning objectives, and in addition, making a significant contribution to specialty skills. Most participants thought the fresh frozen cadaveric model significantly improved the learning objectives for training. The fresh frozen cadaver is an excellent teaching model highly representative of the living open surgical scenario where advanced trainees and newly qualified consultants can improve their operative confidence and consequently patient safety in vascular surgery. An efficient fresh frozen cadaver teaching programme can benefit many health professionals simultaneously maximizing the use of donated human tissue. © 2013 Royal Australasian College of Surgeons.

  2. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.


    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,

  3. Workplace-based assessment in surgical training: experiences from the Intercollegiate Surgical Curriculum Programme. (United States)

    Eardley, Ian; Bussey, Maria; Woodthorpe, Adrian; Munsch, Chris; Beard, Jonathan


    The Intercollegiate Surgical Curriculum Programme was launched in the United Kingdom in 2007. At its heart was the reliance upon clear, defined curricula, competence-based training and the use of workplace-based assessments to assess the competence. The principle assessments used were Case-based Discussion, Procedure-based Assessments (PBA), Direct Observation of Procedural Skills, and Clinical Evaluation Exercise and a Multisource Feedback tool. We report the initial experience with that system, and most importantly, the experience with workplace-based assessment. Themes include issues around faculty development, misuse of assessments, inappropriate timing of assessments, concerns about validity and reliability of the assessments and concerns about the actual process of workplace-based assessments. Of the assessments, the PBA performed best. As a consequence, there has been an increased focus upon faculty development, while some of the assessments have been redesigned in line with the PBA. A global rating scale has been introduced that uses clinical anchors. The rating scales have also been altered with a reduction in the number of ratings while an enhanced description of the complexity of the case has been introduced within the Case-based Discussion and the Clinical Evaluation Exercise. A re-evaluation will take place in the near future. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  4. The first royal appendix abscess drainage. (United States)

    Ellis, Harold


    On January 22nd 1901, at Osborne House on the Isle of Wight, Queen Victoria, nearing her 82nd birthday and having ruled for 64 years, drew her last breath. Edward Prince of Wales, 59 years of age, was now King Edward VII. A year of mourning was proclaimed and his coronation scheduled for June 26th. It was unexpectedly delayed by an attack of royal appendicitis. On Saturday June 14th 1902, less than two weeks before the coronation, Edward travelled to Aldershot to attend a military review. It was a cold, rainy day and the King did not feel well. That night, his abdominal discomfort was getting worse and by five next morning the King's personal physician, Sir Francis Laking, was called to see him. Laking asked Sir Thomas Barlow, Physician-Extraordinary to the King, for a second opinion. By now there was fever, rigor and distinct tenderness in the right iliac fossa of the very obese abdomen. Under heavy sedation, the King was transferred to Windsor Castle, leaving his Queen, Alexandra, to review the parade of 30,000 soldiers gathered at Aldershot.

  5. Extremity dosimetry trial: Devonport royal dockyard

    International Nuclear Information System (INIS)

    Kenyon, R.; Collison, R.


    This trial was undertaken to assess extremity dosemeters, which were made available to Devonport Royal Dockyard and determine the most suitable to the site. The trial included operational and laboratory-based exposures. Operational exposures were within a submarine reactor compartment and a waste storage area. Laboratory exposures were undertaken using 241 Am, 137 Cs and 60 Co sources to compare and contrast the dosemeters energy response. In addition, the low dose response and the response if placed in the incorrect orientation were also assessed. Ten passive and two active dosemeters were tested, with three highlighted as the most technically suitable, DSTL Harshaw DXT-RAD, HPA Harshaw EXT-RAD and the AMEC Panasonic UD-807A. The most technically suitable dosemeter was the DSTL Harshaw DXT-RAD, due to good responses within all aspects of the trial and the user's preference for the ring type design. The John Caunt ED2 electronic dosemeter 2 (ED2) also performed well, but suffered radio frequency interference. (authors)

  6. Royal Wine Corporation d/b/a/ Royal Kedem (Herzog Wine Cellars), Oxnard, CA; Consent Agreement and Final Order (United States)

    Consent Agreement and Final Order (Proposed CA/FO), between the U.S. Environmental Protection Agency, Region 9 (EPA or Complainant), and Royal Wine Corporation, d/b/a Royal Kedem (Herzog Wine Cellars or Respondent). Docket Number CWA-09-2018-0004.

  7. Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery.

    LENUS (Irish Health Repository)

    Carroll, Sean M


    OBJECTIVE: The objective of this study was to develop and validate a transparent, fair and objective assessment programme for the selection of surgical trainees into higher surgical training (HST) in plastic surgery in the Republic of Ireland. METHODS: Thirty-four individuals applied for HST in plastic surgery at the Royal College of Surgeons in Ireland (RCSI) in the academic years 2005-2006 and 2006-2007. Eighteen were short-listed for interview and further assessment. All applicants were required to report on their undergraduate educational performance and their postgraduate professional development. Short-listed applicants completed validated objective assessment simulations of surgical skills, an interview and assessment of their suitability for a career in surgery. RESULTS: When applicants\\' short-listing scores were combined with their interview scores and assessment of their suitability for a career in surgery, individuals who were selected for HST in plastic surgery performed significantly better than those who were not (P<0.002). However, when the assessment of technical skills scores were added the significance level of this difference increased further (P<0.0001) as did the statistical power of the difference to 99.9%, thus increasing the robustness of the selection package. CONCLUSION: The results from this study suggest that the assessment protocol we used to select individuals for HST in plastic surgery reliably and statistically significantly discriminated between the performances of candidates.

  8. Women's royal holiness as the church-historical phenomenon

    Directory of Open Access Journals (Sweden)

    Efimov Vladimir Fedorovich


    Full Text Available The article under the topic of the Royal Holiness examines its specific subtype, the righteousness of the Royal women. Among the saint queens, empresses and princesses the authors distinguish the independent rulers, the widows, and wives of monarchs. The Holy Byzantine Empress and canonized European Queen, the Queen of the Georgian and the Russian Princess defended the Christian statehood brightened by feats of patience, mercy, by building the temples. In the conclusion of the article briefly tells about the Royal martyrs and Confessors of the 20th century.

  9. Surgical smoke. (United States)

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


    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.

  10. Physicochemical composition of pure and adulterated royal jelly

    Directory of Open Access Journals (Sweden)

    Luis Henrique Garcia-Amoedo


    Full Text Available The physicochemical composition of pure royal jelly as well as of some adulterated samples was analyzed by determining moisture, ash, lipids, nitrogen/proteins, carbohydrates, starch and 10- HDA (10-hydroxy-2-decenoic acid. The solubility in alkaline medium was used to detect the main frauds for adulterating royal jelly which comprise addition of yogurt, water, egg white, sweet condensed milk mixed with propolis, unripe banana and corn starch slurry.

  11. Kesejahteraan Karyawan PT. Royal Coconut Kabupaten Minahasa Utara


    Londa, Very Y; Kaunang, Markus; Karim, Dian Fitriani


    Employee welfare is a form of welfare services provided by the company to the employees who have given power, mind and their services. Company Parties have an obligation to make efforts to motivate employees to provide benefits that can improve employee productivity. Welfare programs provided by the company to employees of PT. Royal Coconut North Minahasa yet either. Using qualitative methodology, research results show that the well-being of employees is not a good idea due to the PT. Royal C...

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

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


    In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  13. Appropriate working hours for surgical training according to Australasian trainees. (United States)

    O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew


    The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  14. Victorian Audit of Surgical Mortality is associated with improved clinical outcomes. (United States)

    Beiles, C Barry; Retegan, Claudia; Maddern, Guy J


    Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in mortality over the duration of the audit process. This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010-2013. A 20% reduction in surgical mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented. The benefits of VASM are reflected in the association with a reduction of mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS. © 2014 Royal Australasian College of Surgeons.

  15. Elective Stoma Reversal Has a Higher Incidence of Postoperative Clostridium Difficile Infection Compared With Elective Colectomy: An Analysis Using the American College of Surgeons National Surgical Quality Improvement Program and Targeted Colectomy Databases. (United States)

    Skancke, Matthew; Vaziri, Khashayar; Umapathi, Bindu; Amdur, Richard; Radomski, Michal; Obias, Vincent


    Clostridium difficile infection is caused by the proliferation of a gram-positive anaerobic bacteria after medical or surgical intervention and can result in toxic complications, emergent surgery, and death. This analysis evaluates the incidence of C difficile infection in elective restoration of intestinal continuity compared with elective colon resection. This was a retrospective database review of the 2015 American College of Surgeons National Surgical Quality Improvement Project and targeted colectomy database. The intervention cohort was defined as the primary Current Procedural Terminology codes for ileostomy/colostomy reversal (44227, 44620, 44625, and 44626) and International Classification of Diseases codes for ileostomy/colostomy status (VV44.2, VV44.3, VV55.2, VV55.3, Z93.2, Z93.3, Z43.3, and Z43.2). A total of 2235 patients underwent elective stoma reversal compared with 10403 patients who underwent elective colon resection. Multivariate regression modeling of the impact of stoma reversal on postoperative C difficile infection risk was used as the study intervention. The incidence of C difficile infection in the 30 days after surgery was measured. The incidence of C difficile infection in the 30-day postoperative period was significantly higher (3.04% vs 1.25%; p difficile infection incidence in the 30-day postoperative period. The study was limited because it was a retrospective database review with observational bias. Patients who undergo elective stoma reversal have a higher incidence of postoperative C difficile infection compared with patients who undergo an elective colectomy. Given the impact of postoperative C difficile infection, a heightened sense of suspicion should be given to symptomatic patients after stoma reversal. See at Video Abstract at

  16. Recovering the royal cuisine in Chosun Dynasty and its esthetics

    Directory of Open Access Journals (Sweden)

    Hae-Kyung Chung


    Full Text Available We believe that researching the cuisine consumed by the royal family, in particular the king, during the 500-year long Chosun Dynasty is an interesting and meaningful endeavor. This task is an important part of unraveling the cultural significance of Korean cuisine in the 21st century, a new age of gastronomy. Until now, research has largely focused on recreating Chosun royal cuisine based on oral statements from staff in the last royal kitchen or the Uikwe (儀軌, the Royal Protocols which recorded food consumed at banquets. However, little research has been conducted on ordinary royal cuisine consumed by the king, mainly because of a lack of materials to study. This article aims to shed light on this topic and recreate what every day royal cuisine looked like in the late stages of the Chosun Dynasty by examining joseoksangsikbalgi (朝夕上食撥記, memos of morning and evening ancestral rites table and judaryebalgi (晝茶禮撥記, memos of daytime tea ceremonies. The memos are similar to the chanpumdanja (饌品單子, literally meaning “a list of dishes served on the table” that recorded national banquets and therefore do not contain records of ordinary royal cuisine. However, the memos of morning and evening ancestral rites table still remain. These documents describe food offered to the deceased, which was the same as the meals they regularly ate while alive. Accordingly, we attempted to reproduce the traditional table setting for ordinary royal cuisine served to King Kojong (高宗 by analyzing these memos. King Kojong (1852–1919 was the 26th king of the Chosun Dynasty, and a detailed description of the sangsik (上食, ancestral rites table prepared following his death in January 1919 is present in the morning and evening sangsik memos and daytime tea ceremony memos from October 11, 1919. After analyzing the memos from after King Kojong's death in 1919, we were able to determine that the cuisine consisted of rice as bap (a

  17. Effect of different levels of royal jelly on biochemical parameters of ...

    African Journals Online (AJOL)



    Sep 12, 2011 ... treatment of cancer, atherosclerosis, hypertension, infertility, asthma, depression and ... and body composition was determined by Tanita BC 418 MA. Royal jelly. Royal jelly used in the study was ... acids content of royal jelly. The composition of the royal jelly used in the study was determined. Saritaş et al.

  18. Open cholecystectomy: Exposure and confidence of surgical trainees and new fellows. (United States)

    Campbell, Beth M; Lambrianides, Andreas L; Dulhunty, Joel M


    The laparoscopic approach to cholecystectomy has overtaken open procedures in terms of frequency, despite open procedures playing an important role in certain clinical situations. This study explored exposure and confidence of Australasian surgical trainees and new fellows in performing an open versus laparoscopic cholecystectomy. An online survey was disseminated via the Royal Australasian College of Surgeons to senior general surgery trainees (years 3-5 of surgical training) and new fellows (fellowship within the previous 5 years). The survey included questions regarding level of experience and confidence in performing an open cholecystectomy and converting from a laparoscopic to an open approach. A total of 135 participants responded; 58 (43%) were surgical trainees, 58 (43%) were fellows and 19 (14%) did not specify their level of training. Respondents who were involved in more than 20 open cholecystectomy procedures as an assistant or independent operator compared with those less exposed were more likely to feel confident to independently perform an elective open cholecystectomy (87.8% vs. 57.3%, P = 0.001), independently convert from a laparoscopic to open cholecystectomy (87.8% vs. 58.7%, P = 0.001) and independently perform an open cholecystectomy as a surgical consultant based on their level of exposure as a trainee (73.2% vs. 45.3%, P = 0.004). This study suggests the need to ensure surgical trainees are exposed to sufficient open cholecystectomies to enable confidence and skill with performing these procedures when indicated. Greater recognition of the need for exposure during training, including meaningful simulation, may assist. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  19. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. (United States)

    Lucci, Anthony; McCall, Linda Mackie; Beitsch, Peter D; Whitworth, Patrick W; Reintgen, Douglas S; Blumencranz, Peter W; Leitch, A Marilyn; Saha, Sukumal; Hunt, Kelly K; Giuliano, Armando E


    The American College of Surgeons Oncology Group trial Z0011 was a prospective, randomized, multicenter trial comparing overall survival between patients with positive sentinel lymph nodes (SLNs) who did and did not undergo axillary lymph node dissection (ALND). The current study compares complications associated with SLN dissection (SLND) plus ALND, versus SLND alone. From May 1999 to December 2004, 891 patients were randomly assigned to SLND + ALND (n = 445) or SLND alone (n = 446). Information on wound infection, axillary seroma, paresthesia, brachial plexus injury (BPI), and lymphedema was available for 821 patients. Adverse surgical effects were reported in 70% (278 of 399) of patients after SLND + ALND and 25% (103 of 411) after SLND alone (P alone group. At 1 year, lymphedema was reported subjectively by 13% (37 of 288) of patients after SLND + ALND and 2% (six of 268) after SLND alone (P alone. Lymphedema was more common after SLND + ALND but was significantly different only by subjective report. The use of SLND alone resulted in fewer complications.

  20. Royal Wine Corporation d/b/a/ Royal Kedem (Herzog Wine Cellars), Oxnard, CA; Proposed Settlement of Clean Water Act Class II Administrative Penalty and Opportunity to Comment (United States)

    Public Notice of Proposed Settlement of Clean Water Act Class II Administrative Penalty and Opportunity to Comment In the Matter of Royal Wine Corporation d/b/a/ Royal Kedem (Herzog Wine Cellars), Oxnard, California.

  1. Private sector surgical training: feasibility through the lens of appendicectomy. (United States)

    Yap, Raymond; Cullinan, Mark


    Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

  2. Accuracy of surgical wound drainage measurements: an analysis and comparison. (United States)

    Yue, Brian; Nizzero, Danielle; Zhang, Chunxiao; van Zyl, Natasha; Ting, Jeannette


    Surgical drain tube readings can influence the clinical management of the post-operative patient. The accuracy of these readings has not been documented in the current literature and this experimental study aims to address this paucity. Aliquots (10, 25, 40 and 90 mL) of black tea solution prepared to mimic haemoserous fluid were injected into UnoVac, RedoVac and Jackson-Pratt drain tubes. Nursing and medical staff from a tertiary hospital were asked to estimate drain volumes by direct observation; analysis of variance was performed on the results and significance level was set at 0.05. Doctors and nurses are equally accurate in estimating drain tube volumes. Jackson-Pratt systems were found to be the most accurate for intermediate volumes of 25 and 40 mL. For extreme of volumes (both high and low), all drainage systems were inaccurate. This study suggests that for intermediate volumes (25 and 40 mL), Jackson-Pratt is the drainage system of choice. The accuracy of volume measurement is diminished at the extremes of drain volumes; emptying of drainage systems is recommended to avoid overfilling of drainage systems. © 2014 Royal Australasian College of Surgeons.

  3. The Accounting Register of a Royal Secretary in Aragonese Naples

    Directory of Open Access Journals (Sweden)

    Enza Russo


    Full Text Available In the crucial years of the succession war that involved the Kingdom of Naples after Alfonso the Magnanimous’death (1459-1464, a secretary of the new king Ferrante I of Aragon, Antonello Petrucci, was entrusted with royal financial charges. He therefore compiled an account book, where receipts and payments of the royal finances were carefully recorded. It has been recently discovered: this paper aims at examining its actual framework as well as the relative volume of the state budget. Because of its new and comprehensive body of evidence, Petrucci’s account book is a very useful source, which may provide additional informations not only on the bulk of the state funds and expenditure but also on the structure of the king’s household and on the system of the royal financial administration, which appears now as characterized by a more complex organization than it was supposed to be in the past.

  4. Octanoic acid confers to royal jelly varroa-repellent properties (United States)

    Nazzi, Francesco; Bortolomeazzi, Renzo; Della Vedova, Giorgio; Del Piccolo, Fabio; Annoscia, Desiderato; Milani, Norberto


    The mite Varroa destructor Anderson & Trueman is a parasite of the honeybee Apis mellifera L. and represents a major threat for apiculture in the Western world. Reproduction takes place only inside bee brood cells that are invaded just before sealing; drone cells are preferred over worker cells, whereas queen cells are not normally invaded. Lower incidence of mites in queen cells is at least partly due to the deterrent activity of royal jelly. In this study, the repellent properties of royal jelly were investigated using a lab bioassay. Chemical analysis showed that octanoic acid is a major volatile component of royal jelly; by contrast, the concentration is much lower in drone and worker larval food. Bioassays, carried out under lab conditions, demonstrated that octanoic acid is repellent to the mite. Field studies in bee colonies confirmed that the compound may interfere with the process of cell invasion by the mite.

  5. Outcome of pregnancy following induced abortion. Report from the joint study of the Royal College of General Practitioners and the Royal College of Obstetricians and Gynaecologists. (United States)

    Frank, P I; Kay, C R; Lewis, T L; Parish, S


    A total of 1590 general practitioners and 795 gynaecologists in England, Scotland and Wales are participating in a long-term, prospective study concerning the sequelae of induced abortion. In the present report a comparison is made between the outcome of the first post-index pregnancy in 745 women whose index pregnancy ended in an induced abortion (cases) and that in 1339 women who had an unplanned index pregnancy but were not referred for induced abortion (controls). There were no statistically significant differences between cases and controls. The increased relative risk which was found amongst the induced abortion group of non-viable outcome, low birthweight and shortened gestation, could have arisen by chance. Further analysis of a larger number of pregnancies is required to permit confident interpretation of these observations. The present data provide no reason for alterations in the current management of induced abortion, or the subsequent pregnancy.

  6. Royal Order of 5 December 1975 amending the Royal Order of 11 May 1971 embodying the general Military Regulations for Protection Against the Hazards of Ionizing Radiations

    International Nuclear Information System (INIS)


    This Royal Order amends the Royal Order on general Military Regulations for Protection against the Hazards of Ionizing Radiations to bring it into line with the Royal Order of 23 December 1970, amending the general Regulations for Protection of the Population and Workers against the Hazards of Ionizing Radiations of 28 February 1963, subject to certain adaptations specific to military activities. (NEA) [fr

  7. Benchmarking of surgical complications in gynaecological oncology: prospective multicentre study. (United States)

    Burnell, M; Iyer, R; Gentry-Maharaj, A; Nordin, A; Liston, R; Manchanda, R; Das, N; Gornall, R; Beardmore-Gray, A; Hillaby, K; Leeson, S; Linder, A; Lopes, A; Meechan, D; Mould, T; Nevin, J; Olaitan, A; Rufford, B; Shanbhag, S; Thackeray, A; Wood, N; Reynolds, K; Ryan, A; Menon, U


    To explore the impact of risk-adjustment on surgical complication rates (CRs) for benchmarking gynaecological oncology centres. Prospective cohort study. Ten UK accredited gynaecological oncology centres. Women undergoing major surgery on a gynaecological oncology operating list. Patient co-morbidity, surgical procedures and intra-operative (IntraOp) complications were recorded contemporaneously by surgeons for 2948 major surgical procedures. Postoperative (PostOp) complications were collected from hospitals and patients. Risk-prediction models for IntraOp and PostOp complications were created using penalised (lasso) logistic regression using over 30 potential patient/surgical risk factors. Observed and risk-adjusted IntraOp and PostOp CRs for individual hospitals were calculated. Benchmarking using colour-coded funnel plots and observed-to-expected ratios was undertaken. Overall, IntraOp CR was 4.7% (95% CI 4.0-5.6) and PostOp CR was 25.7% (95% CI 23.7-28.2). The observed CRs for all hospitals were under the upper 95% control limit for both IntraOp and PostOp funnel plots. Risk-adjustment and use of observed-to-expected ratio resulted in one hospital moving to the >95-98% CI (red) band for IntraOp CRs. Use of only hospital-reported data for PostOp CRs would have resulted in one hospital being unfairly allocated to the red band. There was little concordance between IntraOp and PostOp CRs. The funnel plots and overall IntraOp (≈5%) and PostOp (≈26%) CRs could be used for benchmarking gynaecological oncology centres. Hospital benchmarking using risk-adjusted CRs allows fairer institutional comparison. IntraOp and PostOp CRs are best assessed separately. As hospital under-reporting is common for postoperative complications, use of patient-reported outcomes is important. Risk-adjusted benchmarking of surgical complications for ten UK gynaecological oncology centres allows fairer comparison. © 2016 Royal College of Obstetricians and Gynaecologists.

  8. Basic surgical skills course - Why is it so costly? (United States)

    Waduud, Mohammed Abdul; Ahmed, Nadeem


    •Courses can be expensive and are often criticised for the transparency of associated costs.•It is important to appreciate the organisational costs of running high quality courses.•The three Royal Colleges in the UK do not use courses as profit making vehicles.

  9. Surgical orthodontics. (United States)

    Strohl, Alexis M; Vitkus, Lauren


    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  10. Lost opportunity cost of surgical training in the Australian private sector. (United States)

    Aitken, R James


    To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  11. Development of the Australasian vascular surgical audit. (United States)

    Bourke, Bernie M; Beiles, Charles Barry; Thomson, Ian A; Grigg, Michael J; Fitridge, Rob


    The purpose of this study was to describe the development of the Australasian Vascular Audit that was created to unify audit activities under the umbrella of the Australian and New Zealand Society for Vascular Surgery as a Web-based application. Constitutional change in late 2008 deemed participation in this audit compulsory for Society members. The Web-based application was developed and tested during 2009. Data for all open vascular surgery and for all endovascular procedures are collected at two points in the admission episode: at the time of operation and at discharge, and entered into the application. Data are analyzed to produce risk-adjusted outcomes. An algorithm has been developed to deal with outliers according to natural justice and to comply with the requirements of regulatory bodies. The Audit is protected by legislated privilege and is officially endorsed and indemnified by the Royal Australasian College of Surgeons. Confidentiality of surgeons and patients alike is ensured by a legally protected coding system and computer encryption system. Validation is by a verification process of 5% of members per year who are randomly selected. The application is completely funded by the Society. Data entry commenced on January 1, 2010. Over 40,000 vascular procedures were entered in the first year. The Audit application allows instantaneous on-line access to individual data and to deidentified group data and specific reports. It also allows real-time instantaneous production of log books for vascular trainees. The Audit has already gained recognition in the Australasian public arena during its first year of operation as an important benchmark of correct professional surgical behavior. Compliance has been extremely high in public hospitals but less so in private hospitals such that only 60% of members received a certificate of complete participation at the end of its first year of operation. An Internet-based compulsory audit of complete surgical practice is

  12. Single-centre experience of radiation exposure in acute surgical patients: assessment of therapeutic impact and future recommendations. (United States)

    Fitzmaurice, Gerard J; Brown, Robin; Cranley, Brian; Conlon, Enda F; Todd, R Alan J; O'Donnell, Mark E


    Radiological investigations have become a key adjunct in patient management and consequently radiation exposure to patients is increasing. The study objectives were to examine the use of radiological investigations in the management of acute surgical patients and to assess whether a guideline-based radiation exposure risk/benefit analysis can aid in the choice of radiological investigation used. A prospective observational study was completed over a 12-week period from April to July 2008 for all acute surgical admissions. Data recorded included demographics, clinical presentation, differential diagnosis, investigations, surgical interventions, and final clinical outcome. The use of radiological investigative modalities as an adjunct to clinical assessment was then evaluated against The Royal College of Radiologists (RCR) guidelines. A total of 380 acute surgical admissions (M = 174, F = 185, children = 21) were assessed during the study period. Seven hundred thirty-four radiological investigations were performed with a mean of 1.93 investigations per patient. Based on the RCR guidelines, 680 (92.6%) radiological investigations were warranted and included 142 CT scans (19.3%), 129 chest X-rays (17.6%), and 85 abdominal X-rays (11.6%). Clinically, radiological imaging complemented surgical management in 326 patients (85.8%) and the management plan remained unchanged for the remaining 54 patients (14.2%). This accounted for an average radiation dose of 4.18 millisievert (mSv) per patient or 626 days of background radiation exposure. CT imaging was responsible for the majority of the radiation exposure, with a total of 1310 mSv (82.6%) of the total radiation exposure being attributed to CT imaging in 20.8% of acute admissions. Subgroup analysis demonstrated that 92.8% of the CT scans performed were appropriate. Radiation exposure was generally low for the majority of acute surgical admissions. However, it is recommended that CT imaging requests be evaluated carefully

  13. The British Royal Family’s Circumcision Tradition

    Directory of Open Access Journals (Sweden)

    Robert Darby


    Full Text Available The birth of Prince William’s son in July 2013 was the occasion for an outpouring of media speculation about the fate of the royal baby’s foreskin. The possibility that he might be circumcised was connected to a purported tradition of circumcision within the British royal family, said to be have been initiated either by Queen Victoria or by George I. In this article, we trace the origins and evolution of these stories and assess their validity. Our conclusion is that belief in a royal circumcision tradition derives from the reported circumcision of Prince Charles by the mohel Jacob Snowman in 1948, and the efforts of the British Israelite movement to concoct a “lost tribes of Israel” origin for the British race. These elements merged into a fully developed narrative that was widely disseminated from the late 1990s. The initially separate claim that the tradition was imported from Hanover by George I can be sourced precisely to 2012. We further show that these stories are inventions, and that the royal family circumcision tradition should be regarded as a classic instance of a contemporary legend or urban myth.

  14. Re-engineering production systems: the Royal Netherlands Naval Dockyard

    NARCIS (Netherlands)

    Zijm, Willem H.M.


    Reengineering production systems in an attempt to meet tight cost, quality and leadtime standards has received considerable attention in the last decade. In this paper, we discuss the reengineering process at the Royal Netherlands Naval Dockyard. The process starts with a characterisation and a

  15. Royal Numico N.V. : Resurrecting shareholder value

    NARCIS (Netherlands)

    Lachotzki, F.; Olson, M.A.


    This case presents the extraordinary turn-around engineered at Royal Numico (a specialized nutrition company, previously covered in another Nyenrode case under its old name Nutricia) by a team of managers formed and led by Jan Bennink. Company fortunes were at a low ebb by the beginning of 2002, as

  16. Efficacy of royal jelly on methotrexate-induced systemic oxidative ...

    African Journals Online (AJOL)

    The aim of this present study is to investigate the mucositis caused by methotrexate (MTX), as well as whether the application of royal jelly (RJ) has a protective effect on oxidative stress. This present study included six groups each consisted of 12 Wistar rats. Distilled water (po: peroral) was given to the 1st group as placebo ...

  17. Evaluation of the antioxidant potential of royal jelly during storage

    Directory of Open Access Journals (Sweden)

    Renata Galhardo Borguini


    Full Text Available Royal jelly is a creamy substance produced by young nurse worker bees, which has a color that ranges from white to slightly yellow, and is secreted by the hypopharingeal and mandibular glands of the bees. The objective of this work was to assess the in vitro antioxidant potential of royal jelly while in storage. The physical-chemical parameters analyzed were moisture, ascorbic acid and total phenolic content. Alcohol extracts were made and used to evaluate the 1.1-diphenyl-2-picrylhydrazyl (DPPH radical scavenging activity. The ascorbic acid (to 0.75 from 1.31mg.100g-1wet base and total phenolic content (to 14.26 from 28.30mg GAE.100g-1 wet base of the royal jelly were low. The percentages of DPPH discoloration of the samples were above 50%, except for the samples stored for 90 days. Considering the reduced ascorbic acid and total phenolic content, and the low alcohol DPPH scavenging activity of the samples, it can be concluded that royal jelly presents relatively low antioxidant potential. The storage time did not determine the changes found.

  18. Effectiveness of core biopsy for screen-detected breast lesions under 10 mm: implications for surgical management. (United States)

    Farshid, Gelareh; Downey, Peter; Pieterse, Steve; Gill, P Grantley


    Technical advances have improved the detection of small mammographic lesions. In the context of mammographic screening, accurate sampling of these lesions by percutaneous biopsy is crucial in limiting diagnostic surgical biopsies, many of which show benign results. Women undergoing core biopsy between January 1997 and December 2007 for core histology, 345 women (43.0%) were immediately cleared of malignancy and 300 (37.4%) were referred for definitive cancer treatment. A further 157 women (19.6%) required diagnostic surgical biopsy because of indefinite or inadequate core results or radiological-pathological discordance, and one woman (0.1%) needed further imaging in 12 months. The open biopsies were malignant in 46 (29.3%) cases. The positive predictive value of malignant core biopsy was 100%. The negative predictive value for benign core results was 97.7%, and the false-negative rate was 2.6%. The lesion could not be visualized after core biopsy in 5.1% of women and in 4.0% of women with malignant core biopsies excision specimens did not contain residual malignancy. Excessive delays in surgery because of complications of core biopsy were not reported. Even at this small size range, core biopsy evaluation of screen-detected breast lesions is highly effective and accurate. A lesion miss rate of 3.1% and under-representation of lesions on core samples highlight the continued need for multidisciplinary collaboration and selective use of diagnostic surgical biopsy. © 2015 Royal Australasian College of Surgeons.

  19. Royal Order of 23 November 1977 amending the Royal order of 12 December 1975 setting up a National Energy Committee

    International Nuclear Information System (INIS)


    Royal Order of 23 November 1977 modified the composition of the National Energy Committee. Members of delegations are appointed by the Minister for Economic Affairs for a 5-year period which is renewable. The Secretariat includes members recognised for their technical, economic or social competence in the energy field. (NEA) [fr

  20. A portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital in Sydney by Dr Rex Money. (United States)

    White, Richard T; McGee-Collett, Martin


    The objective of this article is to provide a portrait of prefrontal lobotomy performed at the Royal Prince Alfred Hospital, Sydney by the Head of Neurosurgery Dr Rex Money and to describe Dr Money's role in the promotion of psychosurgery in Sydney. We draw attention to an oral presentation by Dr Rex Money in 1951, a journal article written by Money, archival information held at the Royal Prince Alfred Hospital, including Dr Money's accounts of his travels and his reports regarding neurosurgery - both internationally and in Australia. Dr Rex Money performed a series of 13 prefrontal lobotomies between 1945 and 1951, and presented the theoretical basis for his series, his operative procedures and the outcomes at the annual meeting of its medical officers' association. Notwithstanding various deficiencies in his clinical research, Money's descriptions give a relatively comprehensive account of one of the first series of prefrontal lobotomies performed in Australia. The current article also describes Dr Money's contributions to the promotion of psychosurgery in Sydney, and illustrates the participation of a senior neurosurgeon and of a major Sydney teaching hospital during the psychosurgery saga. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  1. Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction. (United States)

    Musiienko, Anton M; Shakerian, Rose; Gorelik, Alexandra; Thomson, Benjamin N J; Skandarajah, Anita R


    The acute surgical unit (ASU) is a recently established model of care in Australasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of ASU at a major tertiary referral centre. We hypothesized that introduction of ASU would correlate with improved patient outcomes. A retrospective review of prospectively maintained databases was performed over two separate 2-year periods, before and after the introduction of ASU. Data collected included demographics, co-morbidity status, use of water-soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30-day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality. Total emergency admissions to the ASU increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of ASU). Mortality decreased from 5.8% to 2.0% (P = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08-0.73, P = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, P = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, P = 0.02). Fewer patients received water-soluble contrast agent (27.1% versus 18.4%, P = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, P = 0.02). The ASU model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change. © 2015 Royal Australasian College of Surgeons.

  2. Surgical competence. (United States)

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


    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.

  3. [In the era of the Royal Society of Medicine]. (United States)

    Gramain, Pascale


    In the May 2013 issue of medecine/sciences, the Rob Laffecteur complained about the constraints imposed by the Société Royale de Médecine in 1779, bearing on the labelling of remedies. Though, he did take advantage of the evaluation from an advertising point of view; though in this prospect he diverted his evaluation's report, in order to present it in a flattering manner. The Société Royale de Médecine was founded in 1778; its mission was to cover everything that had to do with public healthcare. Active, age-old and competent, it was submitted to many of contemporary issues that we are facing nowadays in the matter of medicines' evaluation, which is based on a rigorous scientific evaluation, itself based on knowledge's state-of-the-art. © 2013 médecine/sciences – Inserm.

  4. The Magnetic Observatory Buildings at the Royal Observatory, Cape (United States)

    Glass, I. S.


    During the 1830s there arose a strong international movement, promoted by Carl Friedrich Gauss and Alexander von Humboldt, to characterise the earth's magnetic field. By 1839 the Royal Society in London, driven by Edward Sabine, had organised a "Magnetic Crusade" - the establishment of a series of magnetic and meteorological observatories around the British Empire, including New Zealand, Australia, St Helena and the Cape. This article outlines the history of the latter installation, its buildings and what became of them.

  5. The Ursula Faince Dinnerware Series by Royal Copenhagen

    DEFF Research Database (Denmark)

    Moeran, Brian

    This working paper is a case study about the development of a faience product line in Royal Copenhagen and illustrates several aspects of how, at what stages of development, and by whom, cultural products in general are evaluated. Three theoretical issues emerge. One concerns the constraints impo...... of a particular cultural product had to be negotiated within a particular organizational world embracing both management and workers, with differentiated skills. These issues lead to a more general discussion of craftsmanship and storytelling....

  6. Je Maintiendrai: The Royal Netherlands Army Within the Alliance (United States)


    CHAPTER I Combat History of the Dutch Army The Kir.ngdom of the Netherlands has tended to favor neutrality or abstentionism over involvement in...a small power and the Dutch increasingly favored abstentionism from European conflicts. Subsequently, the wartime organization of the Royal Army was...Netherlands abandoned its traditional policy of abstentionism and became a founding member of the Brussels Treaty (1948) and the North Atlantic

  7. Gambling in revolutionary Paris - The Palais Royal: 1789-1838. (United States)

    Barnhart, R T


    By the revolution of 1789, the four-story, quadrangular Palais Royal in Paris had become the most glittering tourist center of Europe, with 180 shops and cafes in its ground floor arcades. By 1791, its basement and secondary story contained over 100 separate, illicit gambling operations featuring the most popular dice and card games. The mania for gambling had been transferred from defunct, monarchical Versailles to the thriving, bourgeois Palais Royal, where the five main gaming clubs throbbed from noon till midnight. During the Revolution, Prince Talleyrand won 30,000 francs at one club, and after Waterloo in 1815, Marshal Blucher lost 1,500,000 francs in one night at another. To bring the situation under control and raise taxes for the state, in 1806 Napoleon legalized the main clubs, which from 1819 to 1837 grossed an enormous 137 million francs. When the anti-gambling forces triumphed in 1837 and the clubs were closed down, the National Guard had to be called out to evict the mobs of gamblers who refused to leave the tables. Dramatic reports from Revolutionary police raids, and quotations from the memoirs of humorous French gamblers and shocked foreign visitors, provide anecdotal illustrations of the 49 years during which the Palais Royal was the most intriguing and picturesque gambling mecca of Europe-and probably of the world.

  8. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan


    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  9. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.


    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  10. Supplemental Colleges (United States)

    Department of Homeland Security — The Supplemental Colleges layer attempts to capture additional Post Secondary Education campuses of colleges and universities associated with a single campus listed...

  11. Surgical travellers: tapestry to Bayeux. (United States)

    Hedley-Whyte, John; Milamed, Debra R


    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  12. The geologic story of Isle Royale National Park (United States)

    Huber, N. King


    Isle Royale is an outstanding example of relatively undisturbed northwoods lake wilderness. But more than simple preservation of such an environment is involved in its inclusion in our National Park System. Its isolation from the mainland provides an almost untouched laboratory for research in the natural sciences, especially those studies whose very nature depends upon such isolation. One excellent example of such research is the intensive study of the predator-prey relationship of the timber wolf and moose, long sponsored by the National Park Service and Purdue University. In probably no other place in North America are the necessary ecological conditions for such a study so admirably fulfilled as on Isle Royale. The development of a natural laboratory with such conditions is ultimately dependent upon geologic processes and events that although not unique in themselves, produced in their interplay a unique result, the island archipelago as we know it today, with its hills and valleys, swamps and bogs the ecological framework of the plant and animal world. Even the most casual visitor can hardly fail to be struck by the fiordlike nature of many of the bays, the chains of fringing islands, the ridge-and-valley topography, and the linear nature of all these features. The distinctive topography of the archipelago is, of course, only the latest manifestation of geologic processes in operation since time immemorial. Fragments of geologic history going back over a billion years can be read from the rocks of the island, and with additional data from other parts of the Lake Superior region, we can fill in some of the story of Isle Royale. After more than a hundred years of study by man, the story is still incomplete. But then, geologic stories are seldom complete, and what we do know allows a deeper appreciation of one of our most naturally preserved parks and whets our curiosity about the missing fragments.

  13. The impact of reduced working hours on surgical training in Australia and New Zealand. (United States)

    Gough, Ian R


    There is a worldwide trend for reduced working hours for doctors, particularly in the developed western countries. This has been led by the introduction of the European Working Time Directive (EWTD) that has had a significant impact on work patterns and training. Australia currently has a more flexible working environment but this is changing. In New Zealand there is a contract for resident doctors defining a maximum 72 h of rostered work per week. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Visit of Her Royal Highness Princess Maha Chakri Sirindhorn, Thailand

    CERN Multimedia

    Patrice Loïez


    Her Royal Highness Princess Maha Chakri Sirindhorn of Thailand (left) visiting DELPHI with Spokesman, Tiziano Camporesi, and Prapol Assavavirulhakarn, Pattaratorn Chirapravati, Claude Détraz, CERN Director for Fixed Target andFuture Programmes and Richard Breedon, University of California. No. 05: Princess Maha Chakri Sirindhorn and Daniel Treille, former spokesman of Delphi. No. 31: in Delphi experiment. No. 35: H.E. Mr. Virasakdi Futrakul, Ambassador, Permanent Representative ofThailand, Geneva with H.E. Dr. Ronarong Nopakun, Ambassador of the Thai Embassy in Bern

  15. Mycelium characterization of the Amauroderma sp collected from Royal Belum

    International Nuclear Information System (INIS)

    Hassan Hamdani Mutaat; Mat Rasol Awang; Fauzi Daud; Rosnani Rashid; Meswan Maskom; Arfah Sumeri


    Etnobotanical study carried on the native community in the Royal Belum Forest areas had identified many potentially valuable spices that could be further explored for its medicinal and health purposes. The mushrooms, Amauroderma sp. was one of the resources that had been screened and collected for further investigation. In this works, the mycelium characterization of the mushroom was carried out in order to develop suitable seed or spawn for cultivation. The Amauroderma sp. mycelium, cultured from the fruit body tissue was found to grow well on the PDA plate. While on the potato extract liquid medium the mushroom could grow and produce stalk like fruit body. (author)

  16. Background submission to the Royal Commission on Nuclear Power Generation

    International Nuclear Information System (INIS)


    The Royal Commission on Nuclear Power Generation in New Zealand is required to inquire into and report upon the likely consequences of a nuclear power programme. The New Zealand Electricity Department would have prime responsibilty for implementing the construction, operation and maintenance of nuclear power plants should the need be established and should this be acceptable to the Government. In this submission the Department has attempted to present the issues raised by the introduction of nuclear power in relatively simple terms on the assumption that elaboration can be provided later if necessary

  17. Royal Ageing: The Queen Mother and Queen Victoria


    Mike Hepworth


    This paper is a reflection on the contribution of the image of the Queen Mother to the cultural construction of role models of positive ageing. The interest lies in the Queen Mother's performance in public of her roles as woman and royal personage particularly as she grew older. It is suggested that cultural analysis of the icon of the Queen Mother as a blend of gender and power suggests certain significant parallels with the imagery cultivated around the career of Queen Victoria in the later...

  18. Out-of-office hours' elective surgical intensive care admissions and their associated complications. (United States)

    Morgan, David J R; Ho, Kwok Ming; Ong, Yang Jian; Kolybaba, Marlene L


    The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08.00-18.00 hours) or 'out-of-office hours' (all other times). The main outcomes were surgical complications using the Dindo-Clavien classification and length-of-stay data. Of the total 4363 ICU admissions, 3584 ICU admissions were planned following elective surgery resulting in 2515 (70.2%) in-office hours and 1069 (29.8%) out-of-office hours elective ICU surgical admissions. Out-of-office hours ICU admissions following elective surgery were associated with an increased risk of infection (P = 0.029), blood transfusion (P = 0.020), total parental nutrition (P office hours ICU admissions were also associated with an increased hospital length-of-stay, with (1.74 days longer, P office hours ICU admissions following elective surgery is common and associated with serious post-operative complications culminating in significantly longer hospital length-of-stays and greater transfers with important patient and health economic implications. © 2017 Royal Australasian College of Surgeons.

  19. Poor Employment Conditions Adversely Affect Mental Health Outcomes Among Surgical Trainees. (United States)

    Kevric, Jasmina; Papa, Nathan; Perera, Marlon; Rashid, Prem; Toshniwal, Sumeet

    Poor mental health in junior clinicians is prevalent and may lead to poor productivity and significant medical errors. We aimed to provide contemporary data on the mental health of surgical trainees and identify risk factors relating to poorer mental health outcomes. A detailed questionnaire was developed comprising questions based on the 36-item short-form health survey (SF-36) and Physical Activity Questionnaire. Each of the questionnaires has proven validity and reliability in the clinical context. Ethics approval was obtained from the Royal Australasian College of Surgeons. The questionnaire was aimed at surgical registrars. We used Physical Activity Questionnaire, SF-36 scores and linear regression to evaluate the effect of putative predictors on mental health. A total of 83 responses were collected during the study period, of which 49 (59%) were from men and 34 (41%) were from women. The mean Mental Component Summary (MCS) score for both sexes was significantly lower than the population mean at ages 25-34 (p work culture and a feeling of a lack of support at work were extremely strong predictors of a lower MCS score (p Hours of overtime worked, particularly unpaid overtime, were also strong predictors of a poorer score. Australian surgical trainees reported lower MCS scores from the SF-36 questionnaire compared to the general population. Increasing working hours, unpaid overtime, poor job security, and job satisfaction were associated with poorer scores among trainees. Interventions providing improved working conditions need to be considered by professional training bodies and employers. Copyright © 2018 Association of Program Directors in Surgery. All rights reserved.

  20. Occupational stress and strain in the Royal Navy 2007. (United States)

    Bridger, R S; Brasher, K; Dew, A; Kilminster, S


    Previous surveys of psychological strain in the Naval Service (NS) have shown higher than expected levels of strain when compared to the general population. To repeat the survey last carried out in 2004 and to obtain further information on the nature of the occupational stressors associated with strain. General Health Questionnaire-12 strain rates and job/life stressors were measured using a Work and Well-Being Questionnaire. Models of strain were developed for male and female personnel in the Royal Navy (RN) and males in the Royal Marines (RM). The response rate was 57%. The psychological strain rate was 31.5% overall. Personnel suffering from strain tended to be 'overcommitted' to work, had low levels of commitment to the NS and had suffered stressful life events (SLEs) in the previous 12 months. Strain rates declined with age and rank in males, but not in females. Strain was significantly positively correlated with levels of overcommitment, effort-reward imbalance (ERI), role conflict, work-family conflict, organizational commitment and exposure to SLEs. Models of strain in the males and females in the RN and in the RM accounted for between 37 and 44% of the variance in strain. The survey provides evidence for both the demand control and ERI models-components of these models contribute independently to strain. High levels of commitment to the organization were associated with lower strain and exposure to SLEs to higher strain.

  1. Royal Society Scientific Meeting: Extracellular vesicles in the tumour microenvironment. (United States)

    Pink, Ryan Charles; Elmusrati, Areeg A; Lambert, Daniel; Carter, David Raul Francisco


    Cancer cells do not grow as an isolated homogeneous mass; tumours are, in fact, complex and heterogeneous collections of cancer and surrounding stromal cells, collectively termed the tumour microenvironment. The interaction between cancer cells and stromal cells in the tumour microenvironment has emerged as a key concept in the regulation of cancer progression. Understanding the intercellular dialogue in the tumour microenvironment is therefore an important goal. One aspect of this dialogue that has not been appreciated until recently is the role of extracellular vesicles (EVs). EVs are small vesicles released by cells under both normal and pathological conditions; they can transfer biological molecules between cells leading to changes in phenotype. EVs have emerged as important regulators of biological processes and can be dysregulated in diseases such as cancer; rapidly growing interest in their biology and therapeutic potential led to the Royal Society hosting a Scientific Meeting to explore the roles of EVs in the tumour microenvironment. This cross-disciplinary meeting explored examples of how aberrant crosstalk between tumour and stromal cells can promote cancer progression, and how such signalling can be targeted for diagnostic, prognostic and therapeutic benefit. In this review, and the special edition of Philosophical Transactions of the Royal Society B that follows, we will provide an overview of the content and outcomes of this exciting meeting.This article is part of the discussion meeting issue 'Extracellular vesicles and the tumour microenvironment'. © 2017 The Author(s).

  2. Are older women more likely to receive surgical treatment for stress urinary incontinence since the introduction of the mid-urethral sling? An examination of Hospital Episode Statistics data. (United States)

    Gibson, W; Wagg, A


    To examine the trends in surgical treatment of stress urinary incontinence (SUI) in older women since the introduction of the mid-urethral sling. Analysis of data from Hospital Episode Statistics (HES) between 2000 and 2012. All surgical procedures for SUI in the National Health Service (NHS) in England. Retrospective cohort analysis of Hospital Episode Statistics for England from 2000 to 2012. Number of invasive, less invasive, and urethral bulking procedures performed in women in three age groups. There was a 90% fall in the number of invasive surgical treatments for SUI and a four-fold increase in the number of mid-urethral slings over this time. The total number of surgical procedures for SUI increased from 8458 to 13 219. However, the rise in the number of procedures in women aged over 75 was more modest-a three-fold increase from a low start of 187-and these women now make up a smaller proportion of all women receiving a mid-urethral sling (MUS). Despite the development and wide availability of a less invasive, safe and effective operation for stress urinary incontinence in older women, they do not appear to have benefitted. The reasons for this require prospective investigation. © 2015 Royal College of Obstetricians and Gynaecologists.

  3. Educational and health impact of the Baume Report: 'A Cutting Edge: Australia's Surgical Workforce'. (United States)

    Hillis, David J; Gorton, Michael W; Barraclough, Bruce H; Beckett, David


    The Baume Report (1994) on Australia's surgical workforce had the potential to impact upon the health and educational sectors. This paper analyses the recommendations of this report and their impact at the time and 15 years later (2009). A questionnaire-based study was performed with the 18 senior Fellows and the Royal Australasian College of Surgeons (RACS) solicitor who had been instrumental in facilitating responses to the review. The 19 respondents were asked to evaluate 22 areas from the Baume Report. The most highly ranked areas identified as being reasonable in 1994 were: additional funding being made available for more training positions, identifying workforce deficits, moving towards compulsory continuing professional development and having evidence of competence before introducing new technology. In 2009, the most highly ranked areas were: funding for more training positions; compulsory continuing professional development, involving the profession in improvements and broadening the training environment beyond public hospitals. Areas considered to be substantially addressed were: the selection process and encouragement of diversity, workforce numbers and deficits, confirming the educational merit of the training program and the role of professional colleges. The Baume Report highlighted many issues including workforce planning, the role of professional organisations in society and the complex interface between health and education. Issues of ongoing standards through a surgical career, access for patients to surgical services, funding for more training posts to provide the appropriate workforce level and distribution, and the assessment and introduction of technology remain priorities. Time has not diminished the relevance of these issues. WHAT IS KNOWN ABOUT THIS TOPIC?: The impact of key government reviews can always be substantial. The Baume Report was directed to postgraduate specialist medical training, particularly surgical training. There have been

  4. Suction Cup Induced Palatal Fistula: Surgical Closure by Palatal ...

    African Journals Online (AJOL)

    1Department of Pediatrics, Pragna Children's Hospital, Hyderabad, ... Eluru, 4Department of Conservative Dentistry and Endodontics, KIMS Dental College and ... The surgical closure of palatal fistula planned under general anesthesia.

  5. College Explorer. (United States)

    Ahl, David H.


    The "College Explorer" is a software package (for the 64K Apple II, IBM PC, TRS-80 model III and 4 microcomputers) which aids in choosing a college. The major features of this package (manufactured by The College Board) are described and evaluated. Sample input/output is included. (JN)

  6. Hearing loss in the Royal Norwegian Navy: A longitudinal study. (United States)

    Irgens-Hansen, Kaja; Baste, Valborg; Bråtveit, Magne; Lind, Ola; Koefoed, Vilhelm F; Moen, Bente E


    The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy's (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

  7. Hearing loss in the Royal Norwegian Navy: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Kaja Irgens-Hansen


    Full Text Available The aims of this longitudinal study were to investigate a significant threshold shift (STS among personnel working on board the Royal Norwegian Navy′s (RNoN vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226. STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports. This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

  8. Royal dynasties as human inbreeding laboratories: the Habsburgs. (United States)

    Ceballos, F C; Alvarez, G


    The European royal dynasties of the Early Modern Age provide a useful framework for human inbreeding research. In this article, consanguineous marriage, inbreeding depression and the purging of deleterious alleles within a consanguineous population are investigated in the Habsburgs, a royal dynasty with a long history of consanguinity over generations. Genealogical information from a number of historical sources was used to compute kinship and inbreeding coefficients for the Habsburgs. The marriages contracted by the Habsburgs from 1450 to 1750 presented an extremely high mean kinship (0.0628±0.009), which was the result of the matrimonial policy conducted by the dynasty to establish political alliances through marriage. A strong inbreeding depression for both infant and child survival was detected in the progeny of 71 Habsburg marriages in the period 1450-1800. The inbreeding load for child survival experienced a pronounced decrease from 3.98±0.87 in the period 1450-1600 to 0.93±0.62 in the period 1600-1800, but temporal changes in the inbreeding depression for infant survival were not detected. Such a reduction of inbreeding depression for child survival in a relatively small number of generations could be caused by elimination of deleterious alleles of a large effect according with predictions from purging models. The differential purging of the infant and child inbreeding loads suggest that the genetic basis of inbreeding depression was probably very different for infant and child survival in the Habsburg lineage. Our findings provide empirical support that human inbreeding depression for some fitness components might be purged by selection within consanguineous populations.

  9. Fibrous osteodystrophy in two Northern Royal albatross chicks (Diomedea sanfordi). (United States)

    Morgan, K J; Alley, M R; Gartrell, B D; Thompson, K G; Perriman, L


    In February 2004, two Northern Royal albatross chicks aged 20 and 25 days old were presented for necropsy. Both chicks had been hand-fed in situ at a breeding colony, from 2-3 days post-hatch. The hand-rearing diet consisted of boneless hoki fillets (Macraronus novaezelandiae), electrolytes, and sooty shearwater (Puffinus griseus) proventricular oil obtained as a by-product of cultural harvest. Routine necropsies on the affected chicks revealed many bones were soft and easily bent. Radiography and histopathology revealed decreased bone density, pathological fractures, and extensive remodelling suggestive of fibrous osteodystrophy. Nutritional secondary hyperparathyroidism, resulting from an imbalance in the dietary Ca:P ratio. The imbalance in the dietary Ca:P ratio was a result of feeding deboned and eviscerated fish. This investigation also highlighted potential health risks associated with the practice of feeding stored rancid proventricular oil, including the destruction of fat-soluble vitamins. It is therefore possible that oxidative degradation of vitamin D may have contributed to the development of nutritional secondary hyperparathyroidism. Subsequently, dietary recommendations for supplementary feeding of orphaned Northern Royal albatross chicks include the feeding of whole human-grade fish with an appropriate Ca:P ratio, and the exclusion of proventricular oil. These cases highlight the need for scientific input into wildlife conservation projects, as lack of appropriate nutritional advice resulted in the feeding of a nutritionally inadequate diet. Following the recommended changes in diet, no further cases of osteodystrophy have been diagnosed in hand-raised chicks in the albatross colony.

  10. Mobile task management tool that improves workflow of an acute general surgical service. (United States)

    Foo, Elizabeth; McDonald, Rod; Savage, Earle; Floyd, Richard; Butler, Anthony; Rumball-Smith, Alistair; Connor, Saxon


    Understanding and being able to measure constraints within a health system is crucial if outcomes are to be improved. Current systems lack the ability to capture decision making with regard to tasks performed within a patient journey. The aim of this study was to assess the impact of a mobile task management tool on clinical workflow within an acute general surgical service by analysing data capture and usability of the application tool. The Cortex iOS application was developed to digitize patient flow and provide real-time visibility over clinical decision making and task performance. Study outcomes measured were workflow data capture for patient and staff events. Usability was assessed using an electronic survey. There were 449 unique patient journeys tracked with a total of 3072 patient events recorded. The results repository was accessed 7792 times. The participants reported that the application sped up decision making, reduced redundancy of work and improved team communication. The mode of the estimated time the application saved participants was 5-9 min/h of work. Of the 14 respondents, nine discarded their analogue methods of tracking tasks by the end of the study period. The introduction of a mobile task management system improved the working efficiency of junior clinical staff. The application allowed capture of data not previously available to hospital systems. In the future, such data will contribute to the accurate mapping of patient journeys through the health system. © 2015 Royal Australasian College of Surgeons.

  11. Outlier experienced surgeon's performances impact on benchmark for technical surgical skills training. (United States)

    Gallagher, Anthony G; Henn, Patrick J; Neary, Paul C; Senagore, Anthony J; Marcello, Peter W; Bunting, Brendan P; Seymour, Neal E; Satava, Richard M


    Training in medicine must move to an outcome-based approach. A proficiency-based progression outcome approach to training relies on a quantitative estimation of experienced operator performance. We aimed to develop a method for dealing with atypical expert performances in the quantitative definition of surgical proficiency. In study one, 100 experienced laparoscopic surgeons' performances on virtual reality and box-trainer simulators were assessed for two similar laparoscopic tasks. In study two, 15 experienced surgeons and 16 trainee colorectal surgeons performed one simulated hand-assisted laparoscopic colorectal procedure. Performance scores of experienced surgeons in both studies were standardized (i.e. Z-scores) using the mean and standard deviations (SDs). Performances >1.96 SDs from the mean were excluded in proficiency definitions. In study one, 1-5% of surgeons' performances were excluded having performed significantly below their colleagues. Excluded surgeons made significantly fewer correct incisions (mean = 7 (SD = 2) versus 19.42 (SD = 4.6), P 4 SDs for time to complete the procedure and >6 SDs for path length. After their exclusions, experienced surgeons' performances were significantly better than trainees for path length: P = 0.031 and for time: P = 0.002. Objectively assessed atypical expert performances were few. Z-score standardization identified them and produced a more robust quantitative definition of proficiency. © 2018 Royal Australasian College of Surgeons.

  12. Developing antiviral surgical gown using nonwoven fabrics for ...

    African Journals Online (AJOL)


    Developing antiviral surgical gown using nonwoven fabrics for health care sector. *Parthasarathi V, Thilagavathi G. Department of Fashion Technology, PSG college of Technology, Peelamedu, Coimbatore – 641 004,. India. Abstract. Background: Healthcare workers' uniforms including surgical gowns are used as barriers ...

  13. Establishing pediatric surgical services in emerging countries: What the first world can learn from Vanuatu. (United States)

    Leodoro, Basil M; Beasley, Spencer W; Maoate, Kiki


    Conventional surgical aid to emerging countries often does little to build capacity or infrastructure. An evolving model in the South Pacific has been designed to promote local expertise by training local surgeons to a high standard and helping establish sustainable pediatric surgical services in those regions. This review identifies the key elements required to improve and expand local specialist pediatric surgical capacity in Vanuatu. It highlights some of the challenges that face external agencies in helping to create sufficient local infrastructure to achieve these goals and describes how the impediments can be overcome. We conducted a review of the program that provides a sustainable pediatric surgical service to the small and poor Pacific nation of Vanuatu through the involvement and support of the Pacific Island Project administered by the Royal Australasian College of Surgeons. A needs assessment must be done from the recipient's perspective and can be achieved by collaboration between an external agency and existing local surgeons. The key to a sustainable service is identifying and training high quality young indigenous doctors early and providing mentorship and support, including after their return. A sustainable and viable service requires an adequately resourced position for the new surgeons(s) within a framework of a long term strategic plan for the specialty and adequate infrastructure in place on their return. Development of rapport with government and influencing strategic health priorities is a prerequisite of a new national specialty service. (1) Establishing long term viable pediatric surgical capability can only be achieved through the local health system with local leadership and ownership. (2) Internal capability includes governance, alignment with ministry of health priorities and policies, and effective clinical leadership. (3) Selection of person(s) to be trained is best done early, and he/she must be supported throughout training and

  14. An audit of the quality of surgical operation notes in a Nigerian ...

    African Journals Online (AJOL)

    Methods: Operation notes completed by doctors in the Surgery Department over a 2-month period were audited for completeness, legibility and conformity to the standards of the Royal College of Surgeons of England. Results: There were 100 operation notes reviewed, two-thirds of these were written by Senior Registrars, ...

  15. Is Western Australia's rural surgical workforce going to sustain the future? A quantitative and qualitative analysis. (United States)

    Shanmugakumar, Sharanyaa; Playford, Denese; Burkitt, Tessa; Tennant, Marc; Bowles, Tom


    Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia's rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the

  16. The Relationship Between Soils and Foliar Nutrition For Planted Royal Paulownia (United States)

    James E. Johnson; David O. Mitchem; Richard E. Kreh


    Royal paulownia is becoming an important hardwood plantation species in the southern U.S. A study was done to investigate two novel site preparation techniques for aiding the establishment of royal paulownia seedlings in the Virginia Piedmont. The effects of these treatments on the foliar nutrition of first year seedlings was determined, as was the relationship...

  17. Evaluation of royal jelly as an alternative to fetal bovine serum in cell ...

    African Journals Online (AJOL)

    Background: Royal jelly is a nutritious substance produced by the young nurse bees and contains significant amounts of proteins which are important for cell growth ... In the Alamar Blue assay, 0.156 and 0.078 mg/ml of royal jelly produced greater percentage of reduction at day 3 even though no significant difference was ...

  18. 78 FR 77772 - Culturally Significant Objects Imported for Exhibition Determinations: “A Royal Passion: Queen... (United States)


    ... DEPARTMENT OF STATE [Public Notice 8570] Culturally Significant Objects Imported for Exhibition Determinations: ``A Royal Passion: Queen Victoria and Photography'' SUMMARY: Notice is hereby given of the... that the objects to be included in the exhibition ``A Royal Passion: Queen Victoria and Photography...

  19. 78 FR 42512 - Application to Export Electric Energy; Royal Bank of Canada (United States)


    ... DEPARTMENT OF ENERGY [OE Docket No. EA-342-A] Application to Export Electric Energy; Royal Bank of.... SUMMARY: Royal Bank of Canada (RBC) has applied to renew its authority to transmit electric energy from..., 2008, DOE issued Order No. EA-342, which authorized RBC to transmit electric energy from the United...

  20. 77 FR 62311 - Culturally Significant Objects Imported for Exhibition Determinations: “Royal Treasures From the... (United States)


    ... DEPARTMENT OF STATE [Public Notice 8061] Culturally Significant Objects Imported for Exhibition Determinations: ``Royal Treasures From the Louvre: Louis XIV to Marie- Antoinette'' SUMMARY: Notice is hereby... objects to be included in the exhibition ``Royal Treasures from the Louvre: Louis XIV to Marie-Antoinette...

  1. 76 FR 33019 - Waiver of Restriction on Assistance to the Royal Government of Cambodia (United States)


    ... DEPARTMENT OF STATE [Public Notice: 7491] Waiver of Restriction on Assistance to the Royal Government of Cambodia Pursuant to Section 7086(c)(2) of the Department of State, Foreign Operations, and... waive the requirements of Section 7086(c)(1) of the Act with respect to the Royal Government of Cambodia...

  2. Improved ovulation rate and implantation in rats treated with royal jelly

    African Journals Online (AJOL)

    The ovaries and uteris of 12 mature female rats (Rattus norvegicus) were examined to determine the effect of commercial royal jelly on ovulation, ovarian weight and implantation rates. Rats were split in two groups of 6 each. Group one served as the treatment and group two the control. A daily dose of 25mg of royal jelly ...


    Directory of Open Access Journals (Sweden)



    Full Text Available This paper contents a summery about physicochemical composition of frash and lyophilized royal jelly. Royal jelly (RJ is a yellowish and creamy secretion from hypo pharyngeal and mandibular glands of young worker bees (Apis mellifera L. to feed all larvae for the first three days of their life and the queen bee for both her larval life and adulthood.. Royal jelly is a honey bee secretion that is used in the nutrition of the larvae. Queen bees are made, not born, and their feeding with royal jelly is the key to that process. The geographical authenticity of royal jelly can be determined also by pollen analysis (Ricciardelli d'Albore et al., 1978; Ricciardelli d'Albore, 1986. The physicochemical composition of pure royal jelly are analyzed by determining moisture, ash, lipids, proteins, carbohydrates, 10-HDA; and for lyophilized royal jelly are analyzed by determining ash, lipids, protein, carbohydrates, 10-HDA, sugars. 10-HDA content is the criteria of royal jelly quality analysis and it is a freshness parameter(Antinelli J.F., Sarah Zeggane, Renee Davico, Catherine Rognone, Jean Paul Faucon, Louisette Lizzani.

  4. Working hours and roster structures of surgical trainees in Australia and New Zealand. (United States)

    O'Grady, Gregory; Loveday, Benjamin; Harper, Simon; Adams, Brandon; Civil, Ian D; Peters, Matthew


    The working hours of surgical trainees are a subject of international debate. Excessive working hours are fatiguing, and compromise performance, learning and work-life balance. However, reducing hours can impact on continuity of care, training experience and service provision. This study defines the current working hours of Australasian trainees, to inform the working hours debate in our regions. An online survey was conducted of all current Australasian trainees. Questions determined hours spent at work (AW) and off-site on-call (OC) per week, and roster structures were evaluated by training year, specialty and location. The response rate was 55.3%. Trainees averaged 61.4 ± 11.7 h/week AW, with 5% working ≥80 h. OC shifts were worked by 73.5%, for an average of 27.8 ± 14.3 h/week. Trainees of all levels worked similar hours (P= 0.10); however, neurosurgical trainees worked longer hours than most other specialties (P hours (P= 0.01) and rural rotations more OC (P Long days (>12 h) were worked by 86%; median frequency 1:4.4 days; median duration 15 h. OC shifts of 24-h duration were worked by 75%; median frequency 1:4.2 days; median sleep: 5-7 h/shift; median uninterrupted sleep: 3-5 h/shift. This study has quantified the working hours and roster structures of Australasian surgical trainees. By international standards, Australasian trainee working hours are around average. However, some rosters demand long hours and/or induce chronic sleep loss, placing some trainees at risk of fatigue. Ongoing efforts are needed to promote safe rostering practices. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

  5. Quality of royal jelly produced by Africanized honeybees fed a supplemented diet

    Directory of Open Access Journals (Sweden)

    Maria Josiane Sereia


    Full Text Available This study was carried out to evaluate the effect of artificial supplements prepared with soybean protein isolate, brewer's yeast, mixture of soybean protein isolate with brewer's yeast, linseed oil, palm oil, and a mixture of linseed oil with palm oil on the physicochemical and microbiological composition of royal jelly produced by Africanized honey bee colonies. Considering these results, providing supplements for Africanized honeybee colonies subjected to royal jelly production can help and strengthen the technological development of the Brazilian beekeeping industry increasing its consumption in the national market. This research presents values of royal jelly a little different from those established by the Brazilian legislation. This fact shows that is important to discuss or change the official method for royal jelly analysis. The characterization of physicochemical and microbiological parameters is important in order to standardize fresh, frozen, and lyophilized royal jelly produced by Africanized honeybees.

  6. BOOK REVIEW: Robert Hooke and the Royal Society (United States)

    Brown, Neil


    Many physics students only come across Hooke when they learn his law of stretching springs, which is a pity because it is just one of his contributions to progress in science, and a minor one at that. His, Micrographia, the first great book of microscopical observations, arouses admiration to this day. He was also active in horology, astronomy, geology and surveying, and he took part in biological experiments, transfusing blood between animals. Much of his work was done while he was curator of experiments for the Royal Society, in which he was involved almost from its foundation. This was by no means a full-time occupation, however. After the Great Fire of London, Hooke was appointed one of the three surveyors for the rebuilding of the city. One of the others was Christopher Wren, a lifelong friend. In this role Hooke was responsible for the design of several buildings, including the Monument. Nichols writes about all these activities, as well as Hooke's childhood, his education at Westminster School, the University of Oxford when Hooke was an undergraduate, and the founding of the Royal Society. The book draws on research for a master's degree. Turning a dissertation into a popular book is risky. The author has avoided the pitfall of making it too academic, but the result is not satisfying. Nichols seems overawed by Hooke and his work, frequently seeming to credit Hooke with a far-reaching influence that he did not necessarily have. There may be a case for lauding Hooke as the father of English microscopy, the father of English meteorology, and the founder of English geology and earth sciences, but it needs to be made much more critically, even in a popular work. Hooke was full of good ideas, but he rarely continued long enough to put them into practice. There is no doubt that Hooke proposed using a balance wheel and spring to improve the timekeeping of a watch, for example, but he did not have a watch made to his design until after Christiaan Huygens had

  7. Conventual Writing and Context: The Case of Port-Royal

    Directory of Open Access Journals (Sweden)

    John J. Conley


    Full Text Available Many of the spiritual texts produced in the early modern period were written by nuns. To teach these texts adequately, it is not sufficient to study the work itself or the biography of the author. Effective exegesis of the texts requires detailed attention to the conventual culture in which these works were written, since this culture is foreign to the vast majority of contemporary students and readers. This contextual analysis operates on three levels. The first level introduces the students to the general nature of the convent and the life of a nun: the evangelical vows, the rule/constitution of the order, and the different types of religious orders. The second level focuses on the specific culture of the convent where the texts were composed. This involves analysis of the convent’s particular spirituality, apostolate, literary genres of communication, and relationship to broader ecclesiastical and political movements of the times. The third level studies the gendered nature of the nuns’ writings. This contextualist-cultural method of teaching écriture couventuelle is illustrated through analysis of the writings of the prolific Port-Royal abbess, Angélique de Saint-Jean Arnauld d’Andilly.

  8. Domingos Vandelli and the deficit in royal Portuguese treasury

    Directory of Open Access Journals (Sweden)

    Ricardo Dalla Costa


    Full Text Available This work aims to discuss the economic situation and policy recommendations of Vandelli to solve the difficulties in economic situation in Portugal at the end of seven hundred. Starting with a prior proposal for Vandelli on institutionalization of knowledge in Sciencia of Finance to further expose the difficulties in maintaining the Kingdom in not justifiable times as costly ordered and even military expenditures, investments in manufacturing, arts and science without there being at that time a real war economy. As a result, it failed to materialize the idea of a Portuguese Economic Society since it was transmuted into a Science Academy. With regard to the deficit in the Royal Treasury, there was an increase of Portuguese State spending concurrently with the drop in revenue from overseas, and finally opportunism behind the financial difficulties of the metropolis led Vandelli to do harsh criticism to financial managers and usurers who took advantage of an emblematic situation and suggest economic policies to balance public finances

  9. Rama in the royal title of the Hungarian kings

    Directory of Open Access Journals (Sweden)

    Živković Tibor D.


    Full Text Available The region (župa of Rama was enlisted in the official title of the Hungarian kings around 1138, as it is known from an official document. The exact answer to the question under which circumstances it happened has never been reached. It is most probable that Rama was not just other name for Bosnia as it was proposed in historiography, neither was a part of Bosnia conquered by military action of the Hungarian king around 1135. Having in mind that Rama was a part of the principality of Raška during the Early Middle Ages, it is quite possible that Rama became part of the official title of the Hungarian kings through some direct connections between ruling families of Hungary and Raška. The most probable answer could be reached through the examination of these relations. Namely, a daughter of Raška's župan, Uroš I, Helena, was married to the Hungarian crown prince Bela in 1129, when Rama was, most probably, part of Helena's dowry. When the crown prince became king of Hungary in 1131, Rama was included in his royal title. Later on during the Middle Ages Rama became part of Bosnia giving ground to the Hungarian kings to claim whole Bosnia as their heritage. .

  10. The BINA collaboration: science at the Royal Observatory of Belgium (United States)

    De Cat, Peter; Cuypers, Jan; Blomme, Ronny; Frémat, Yves; Groenewegen, Martin; Lampens, Patricia; Lobel, Alex; Pauwels, Thierry; Van de Steene, Griet; van Hoof, Peter


    The Belgo-Indian Network for Astronomy and Astrophysics (BINA) is a collaboration between Indian and Belgian astronomical institutes with the main aim to optimize the scientific output of the Indo-Belgian telescopes, being the 4.0-m International Liquid Mirror Telescope and the 3.6-m Devasthal Optical Telescope. These new facilities are both located at the Devasthal Observatory near Nainital, India. In this contribution, we introduce projects that are of scientific interest for colleagues of the department "Astronomy and Astrophysics" of the Royal Observatory of Belgium (ROB). It serves as an invitation for Indian astronomers to participate. We highlight how these projects could benefit from observations with the Indo-Belgian telescopes by using instruments from the first-generation (currently offered) and/or the next-generation (development or design phase). We show that, from an ROB point-of-view, the BINA would be the most successful if the 3.6-m DOT would be equipped with an efficient optical high-resolution spectrograph.

  11. Spectral domain optical coherence tomography imaging of spectacular ecdysis in the royal python (Python regius). (United States)

    Tusler, Charlotte A; Maggs, David J; Kass, Philip H; Paul-Murphy, Joanne R; Schwab, Ivan R; Murphy, Christopher J


    To describe using spectral domain optical coherence tomography (SD-OCT), digital slit-lamp biomicroscopy, and external photography, changes in the ophidian cuticle, spectacle, and cornea during ecdysis. Four normal royal pythons (Python regius). Snakes were assessed once daily throughout a complete shed cycle using nasal, axial, and temporal SD-OCT images, digital slit-lamp biomicroscopy, and external photography. Spectral domain optical coherence tomography (SD-OCT) images reliably showed the spectacular cuticle and stroma, subcuticular space (SCS), cornea, anterior chamber, iris, and Schlemm's canal. When visible, the subspectacular space (SSS) was more distended peripherally than axially. Ocular surface changes throughout ecdysis were relatively conserved among snakes at all three regions imaged. From baseline (7 days following completion of a full cycle), the spectacle gradually thickened before separating into superficial cuticular and deep, hyper-reflective stromal components, thereby creating the SCS. During spectacular separation, the stroma regained original reflectivity, and multiple hyper-reflective foci (likely fragments from the cuticular-stromal interface) were noted within the SCS. The cornea was relatively unchanged in character or thickness throughout all stages of ecdysis. Slit-lamp images did not permit observation of these changes. Spectral domain optical coherence tomography (SD-OCT) provided excellent high-resolution images of the snake anterior segment, and especially the cuticle, spectacle, and cornea of manually restrained normal snakes at all stages of ecdysis and warrants investigation in snakes with anterior segment disease. The peripheral spectacle may be the preferred entry point for diagnostic or therapeutic injections into the SSS and for initiating spectacular surgery. © 2014 American College of Veterinary Ophthalmologists.

  12. Violence toward health workers in Bahrain Defense Force Royal Medical Services’ emergency department

    Directory of Open Access Journals (Sweden)

    Rafeea F


    Full Text Available Faisal Rafeea,1 Ahmed Al Ansari,2–4 Ehab M Abbas,1 Khalifa Elmusharaf,5 Mohamed S Abu Zeid1 1Emergency Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 2Training and Education Department, Bahrain Defense Force Hospital, Riffa, Bahrain; 3Department of General Surgery, College of Medicine and Medical Science, Arabian Gulf University, Manama, Bahrain; 4Medical Education Department, Royal College of Surgeons in Ireland - Medical University of Bahrain, Busaiteen, Bahrain; 5Graduate Entry Medical School, University of Limerick, Ireland Background: Employees working in emergency departments (EDs in hospital settings are disproportionately affected by workplace violence as compared to those working in other departments. Such violence results in minor or major injury to these workers. In other cases, it leads to physical disability, reduced job performance, and eventually a nonconducive working environment for these workers. Materials and methods: A cross-sectional exploratory questionnaire was used to collect data used for the examination of the incidents of violence in the workplace. This study was carried out at the ED of the Bahrain Defense Force (BDF Hospital. Participants for the study were drawn from nurses, support staff, and emergency physicians. Both male and female workers were surveyed.Results: The study included responses from 100 staff in the ED of the BDF Hospital in Bahrain (doctors, nurses, and support personnel. The most experienced type of violence in the workers in the past 12 months in this study was verbal abuse, which was experienced by 78% of the participants, which was followed by physical abuse (11% and then sexual abuse (3%. Many cases of violence against ED workers occurred during night shifts (53%, while physical abuse was reported to occur during all the shifts; 40% of the staff in the ED of the hospital were not aware of the policies against workplace violence, and 26% of the staff considered leaving their jobs

  13. Concours annuels Academie Royale des Sciences d'Outre-mer

    Directory of Open Access Journals (Sweden)

    Royal Academy for Overseas Sciences


    Full Text Available Yearly competitions Royal Academy for Overseas Sciences. L'Organisation des Nations Unies, face aux inégalités croissantes a initié le processus des Objectifs du Millénaire pour le Développement (OMD qui doivent être réalisés d'ici 2015. L'atteinte des huit OMD devrait permettre de réduire la pauvreté et d'améliorer les conditions de vie des populations. L'élevage est pratiqué par une grande partie de la population mondiale surtout les plus pauvres. Il est pourvoyeur d'emplois et contribue à l'émancipation des femmes grâce aux revenus générés par la vente des produits animaux. Les animaux d'élevage sont également utilisés pour le transport et la culture attelée. La forte densité en nutriments des produits animaux en fait des aliments de choix pour améliorer l'état nutritionnel des enfants. La domestication des espèces animales sauvages et le développement de l'aquaculture contribuent à réduire les prélèvements dans la nature et à protéger la biodiversité. Le développement d'un élevage durable et raisonné peut donc positivement impacter plusieurs secteurs et doper la croissance économique des pays. Ce qui peut aider les pays en développement à se rapprocher des OMD d'ici 2015. La note présente également les pré-requis pour rendre effective la contribution de l'élevage aux.

  14. The Sigiriya Royal Gardens. Analysis of the Landscape Architectonic Composition

    Directory of Open Access Journals (Sweden)

    Jude Nilan Cooray


    Full Text Available Besides the efforts that are of descriptive and celebrative nature, studies related to Sri Lanka’s historical built heritage are largely to view material remains in historical, sociological, socio-historical and semiological perspectives. But there is hardly any serious attempt to view such material remains from a technical-analytical approach to understand the compositional aspects of their designs. The 5th century AC royal complex at Sigiriya is no exception in this regard. The enormous wealth of information and the unearthed material remains during more than hundred years of field-based research by several generations of archaeologists at Sigiriya provide ideal opportunity for such an analysis. The present study is, therefore, to fill the gap in research related to Sri Lanka’s historical built heritage in general and to Sigiriya in particular. Therefore the present research attempts to read Sigiriya as a landscape architectonic design to expose its architectonic composition and design instruments. The study which is approached from a technical-analytical point of view follows a methodological framework that is developed at the Landscape Design Department of the Faculty of Architecture at Delft University of Technology. The study reveals that the architectonic design of Sigiriya constitutes multiple design layers and multiple layers of significance with material-spatial-metaphorical-functional coherence, and that it has both general and unique landscape architectonic elements, aspects, characteristics and qualities. The richness of its composition also enables to identify the landscape architectural value of the Sigiriya, which will help re-shape the policies related to conservation and presentation of Sigiriya as a heritage site as well as the protection and management as a green monument. The positive results of the study also underline that the methodology adapted in this research has devised a framework for the study of other examples

  15. Royal Jelly Inhibits Pseudomonas aeruginosa Adherence and Reduces Excessive Inflammatory Responses in Human Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Heni Susilowati


    Full Text Available Pseudomonas aeruginosa is a Gram-negative bacterium and causes respiratory infection especially in elderly patients. Royal jelly has been used worldwide as a traditional remedy and as a nutrient; however, the effect against P. aeruginosa is unclear. The aim of this study was to analyze antibacterial, antiadherent, and anti-inflammatory effects of royal jelly against P. aeruginosa. Wild-type strain PAO1 and clinical isolates of P. aeruginosa were used for antibacterial assay and antiadherent assay to abiotic surface and epithelial cells, which are pharynx (Detroit 562 and lung (NCI-H292 epithelial cells. In anti-inflammatory assay, epithelial cells were pretreated with royal jelly before bacterial exposure to investigate its inhibitory effect on interleukin (IL-8 and macrophage inflammatory protein-3α/CCL20 overproduction. Although royal jelly did not have antibacterial activity at concentration of 50% w/v, antiadherent activity was confirmed on the abiotic surface and epithelial cells under concentration of 25%. Pretreatment with royal jelly significantly inhibited overproduction of IL-8 and CCL20 from both cells. These results demonstrated that royal jelly inhibits P. aeruginosa adherence and protects epithelial cells from excessive inflammatory responses against P. aeruginosa infection. Our findings suggested that royal jelly may be a useful supplement as complementary and alternative medicine for preventing respiratory infection caused by P. aeruginosa.

  16. Body-enlarging effect of royal jelly in a non-holometabolous insect species, Gryllus bimaculatus

    Directory of Open Access Journals (Sweden)

    Atsushi Miyashita


    Full Text Available Honeybee royal jelly is reported to have body-enlarging effects in holometabolous insects such as the honeybee, fly and silkmoth, but its effect in non-holometabolous insect species has not yet been examined. The present study confirmed the body-enlarging effect in silkmoths fed an artificial diet instead of mulberry leaves used in the previous literature. Administration of honeybee royal jelly to silkmoth from early larval stage increased the size of female pupae and adult moths, but not larvae (at the late larval stage or male pupae. We further examined the body-enlarging effect of royal jelly in a non-holometabolous species, the two-spotted cricket Gryllus bimaculatus, which belongs to the evolutionarily primitive group Polyneoptera. Administration of royal jelly to G. bimaculatus from its early nymph stage enlarged both males and females at the mid-nymph and adult stages. In the cricket, the body parts were uniformly enlarged in both males and females; whereas the enlarged female silkmoths had swollen abdomens. Administration of royal jelly increased the number, but not the size, of eggs loaded in the abdomen of silkmoth females. In addition, fat body cells were enlarged by royal jelly in the silkmoth, but not in the cricket. These findings suggest that the body-enlarging effect of royal jelly is common in non-holometabolous species, G. bimaculatus, but it acts in a different manner than in holometabolous species.

  17. Micro-surgical endodontics. (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I


    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  18. The Madrid Royal Schools of St. Elisabeth and Loreto according Constitutions of 1715 and 1718

    Directory of Open Access Journals (Sweden)



    Full Text Available The Madrid Royal Schools of Saint Elizabeth and Loreto were founded by Philip II at the end of 16th Century. Both institutions provided education for orphan girls. They still exist as Catholic coeducational schools granted by the Education Department. These two Schools were Royal Sponsorship belonging to Palace ecclesiastical jurisdiction. The Schools Constitutions sanctioned by Philip V have been preserved until now. Although these Schools have a parallel history, the mentioned Constitutions are completely different for each School. According to these Norms, the Madrid Royal Schools of Saint Elizabeth and Loreto have many differences between them.

  19. Pouvoir et religion à la chapelle royale de Versailles sous Louis XIV Power and religion at the royal chapel of Versailles under Louis XIV

    Directory of Open Access Journals (Sweden)

    Alexandre Maral


    Full Text Available D’une manière peut‑être plus sensible que partout ailleurs, les objets et les insignes du pouvoir prennent une importance particulière dans le contexte du cérémonial liturgique de la religion catholique. À la chapelle royale de Versailles, la présence régulière du monarque et de sa cour complique encore la situation, d’autant que la desserte est assurée par deux corps distincts d’ecclésiastiques. Dépassant le simple cadre des préséances, Louis XIV a défini autour de sa personne royale un système rituel susceptible d’en manifester le caractère épiscopal dérivé du sacre. De même, l’enjeu juridictionnel représenté par la Chapelle royale se traduit par un jeu subtil d’attitudes, de gestes et de rites, chorégraphie sacrée qui accompagne et exprime les revendications des partisans et des adversaires de l’exemption du lieu de culte royal au regard du diocèse de Paris. Ce discours trouve un écho partiel dans le programme décoratif de la chapelle définitive du palais, achevée en 1710.Objects and symbols of power take on a particular importance in the liturgical ceremony of the Catholic Church, perhaps more so than in any other context. At the royal chapel of Versailles, the regular presence of the king and his court complicated the situation further, all the more so in that religious ceremony was administered by two distinct ecclesiastic bodies. Beyond the rules of precedence, Louis XIV had introduced around his royal persona a system of ritual that would manifest the episcopal identity conferred upon him by his coronation. Similarly, the jurisdictional authority represented by the royal chapel was conveyed in a subtle play of attitudes, gestures and rites, a symbolic choreography that accompanied and expressed the claims of the partisans and adversaries of the exemption of the royal place of worship with regard to the diocese of Paris. This stance was reflected in the decorative scheme of the palace

  20. Royal-Dutch Shell in Russia and Western Sanctions

    Directory of Open Access Journals (Sweden)

    Konstantin Kurilev


    Full Text Available This article reports on research based on three crucial aspects of the current global economic situation. First is the role of transnational corporations (TNCs in establishing and constructing international cooperation at the supranational level. Second is the policy of sanctions against Russia in connection with the situation in Ukraine. And third is the cooperation of Royal Dutch Shell with Russia’s Gazprom despite the political, economic and technological sanctions imposed on Russian companies and economic sectors.Analyzing Shell’s policy on the Russian energy market should reveal some kind of the managing principle that not only Shell but most TNCs follow in taking the political atmosphere into consideration, while striving to avoid any related restrictions. The research methodology uses analytical, ultimate analysis and functional methods. The analytical method helped to lay the theoretical foundation of the research. Modern TNCs are deeply engaged in the process of economic globalization. To expand their influence, such companies create economic conditions for organizing international production with local markets and for international markets for capital, labour, and scientific and consulting services. The ultimate analysis method revealed the following pattern: in struggling for the global market, TNCs raise the level of competition, which creates a permanent need for technical innovations and scientific progress. The functional analysis method demonstrated a casual relationship in modern economic development: by assisting capital turnover and labour and transport mobility, TNCs contribute significantly to economic growth and development. The first part of the article focuses on the history and methodology of the genesis and development of TNCs as actors in global economic relations. It also reviews the current role of TNCs in the global economy. The second part of the article examines the cooperation between Shell and Gazprom

  1. Royal Service on Eesti mainekaim üritusturundusfirma / Eda-Liis Kann

    Index Scriptorium Estoniae

    Kann, Eda-Liis, 1979-


    Turu-uuringute AS-i korraldatud üritusturunduse ettevõtete maineuuringust selgus, et kõige mainekamad Eestis on Royal Service, Event Masters, Broadline ja Sinine Elevant. Kõige madalama mainega on Tequila

  2. Presence of women in Royal Economic Society of Friends of the Country (1775-1808

    Directory of Open Access Journals (Sweden)

    María Consolación Calderón España


    Full Text Available In this work we present the performance of women in the work of the Royal Economic Society of Friends of the Country, institutions of the eighteenth century who sought to lift the economy of Spain in that century. Women’s participation in the Royal Economic So- ciety was carried out by the Boards of Damas and supervisory work of the Schools «patriotism» and the first letters. The first schools to be named, according to Campomanes conceived of yarn and fabric and should be established in major cities throughout the kingdom. Participation in the Royal Economic Society from all social classes and genders with equal rights, was a fact. There is no comprehensive study on all of the Royal Economic Society of Friends of the Country, therefore there is no one on women in one way or another took part in them. With this work we present the work done by some.

  3. Development of an Information Security Awareness Training Program for the Royal Saudi Naval Forces (RSNF)

    National Research Council Canada - National Science Library

    Alageel, Sami


    The Royal Saudi Naval Forces (RSNF) are vulnerable to the same kinds of threats to its information infrastructure as the rest of the industrialized nations, As an officer in the RSNF, I am familiar with the special information...

  4. Doctor William Gunn (1804-1890): From the South Pacific Islands to Chatham Royal Dockyard. (United States)

    Biddle, Richard


    Doctor William Gunn had a long and varied career in the Royal Navy. After spending time on anti-slavery patrols along the west coast of Africa, he was posted to the south Pacific. At Pitcairn Island, he treated the inhabitants during an influenza epidemic, proving himself to be a determined and dedicated practitioner. Subsequently, he was appointed head of the medical department at Chatham Royal Dockyard (1859-1865), an appointment that coincided with the final stages of the Royal Navy's transition from sail and wood to steam and iron. The impact of these changes on the health of dockworkers was quickly felt at Chatham, and Gunn found himself in charge during the building of the first iron warship in a royal dockyard. His story thus offers a window through which to observe a practitioner confronting the health issues and medical uncertainties thrown up by technological change in the Victorian era. © The Author(s) 2016.

  5. Royal london hospital set P28 plans 30th anniversary reunion. (United States)

    Sibthorpe, Fran


    Members of Set P28 at the Royal London Hospital who began their training in February 1980 are planning a reunion on July 27 in London. The venue will be announced later. Email for details.

  6. The surgical personality: does it exist? (United States)

    Whitaker, Matthew


    Introduction This study aims to answer the question of whether surgeons have different personalities to non-surgeons. Methods Members of the Royal College of Surgeons of England were sent an email survey containing 50 standard questions from the Five Factor personality assessment, which scores each respondent in five key personality traits (conscientiousness, agreeableness, neuroticism, openness, extroversion). Results were analysed and compared with a population-level data set from a survey conducted by the BBC. Results Five hundred and ninety-nine surgeons completed the survey. Analysis showed that surgeons scored significantly higher for conscientiousness, agreeableness, openness and neuroticism than non-surgeons (P personality, as well as indicating that female surgeons have significantly different personality profiles from male surgeons, and that age affects surgeons' personalities in different ways to non-surgeons.

  7. Nephroprotective effect of bee honey and royal jelly against subchronic cisplatin toxicity in rats


    Ibrahim, Abdelazim; Eldaim, Mabrouk A. Abd; Abdel-Daim, Mohamed M.


    Cisplatin is one of the most potent and effective chemotherapeutic agents. However, its antineoplastic use is limited due to its cumulative nephrotoxic side effects. Therefore, the present study was undertaken to examine the nephroprotective potential of dietary bee honey and royal jelly against subchronic cisplatin toxicity in rats. Male Wistar rats were randomly divided into controls, cisplatin-treated, bee honey-pretreated cisplatin-treated and royal jelly-pretreated cisplatin-treated grou...

  8. Marketingová strategie jazykové školy Royal School


    Pazderská, Lucie


    The aim of this thesis is to analyse the marketing strategy of the language school Royal School and to suggest its improvement on the basis of observed data. The thesis is divided into two main parts -- theoretical and practical part. The theoretical part focuses on marketing of services and its differences especially in terms of marketing mix. In the practical part, Royal School is first briefly introduced, then there are the main features of Callan method and an evaluation of current market...

  9. The Code of Ethics and Editorial Code of Practice of the Royal Astronomical Society (United States)

    Murdin, Paul


    Whilst the Royal Astronomical Society has got by for more than 100 years without a written code of ethics, modern standards of governance suggested that such a code could be useful in the resolution of disputes. In 2005, the RAS adopted the Universal Code of Ethics for Science that had been formulated by the Royal Society of London. At the same time and for similar reasons the RAS adopted an Editorial Code of Practice.

  10. The Queens' estates: fiscal properties and royal policy ( 9th -10th centuries

    Directory of Open Access Journals (Sweden)

    Tiziana Lazzari (a cura di


    Full Text Available The special condition of the queens of italic Kingdom during the 9th and 10th centuries is exemplified by the title of consors regni and by the exceptionally copious dowers bestowed to them when compared to those entrusted to other European queens. Through the accurate reconstruction of these dowries, composed of royal fiscal assets, this anomaly is explained within the context of specific royal governmental strategies.

  11. The functional property of royal jelly 10-hydroxy-2-decenoic acid as a melanogenesis inhibitor


    Peng, Chi-Chung; Sun, Hui-Tzu; Lin, I-Ping; Kuo, Ping-Chung; Li, Jen-Chieh


    Background It has been reported that royal jelly would reduce melanin synthesis and inhibit the expression of melanogensis related proteins and genes. In this study, we evaluate the anti-melanogenic and depigmenting activity of 10-hydroxy-2-decenoic acid (10-HDA) from royal jelly of Apis mellifera. Methods In this study, we assesses the 10-HDA whitening activity in comparison with the changes in the intracellular tyrosinase activity, melanin content and melanin production related protein levl...

  12. Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia. (United States)

    Teshome, Million; Wolde, Zenebe; Gedefaw, Abel; Tariku, Mequanent; Asefa, Anteneh


    Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures. Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the

  13. Effect of Honey and Royal Jelly against Cisplatin-Induced Nephrotoxicity in Patients with Cancer. (United States)

    Osama, Hasnaa; Abdullah, Aya; Gamal, Bassma; Emad, Dina; Sayed, Doha; Hussein, Eman; Mahfouz, Eman; Tharwat, Joy; Sayed, Sally; Medhat, Shrouk; Bahaa, Treza; Abdelrahim, Mohamed E A


    Cisplatin constitutes one of the most potent antineoplastic drugs; however, nephrotoxicity limited its eligibility for optimal clinical use. This study was designed to evaluate the role of honey and royal jelly with antioxidant properties in the protection of cisplatin-induced acute kidney injury in patients with cancer. Patients with cancer assigned for cisplatin chemotherapy were randomly divided into bee honey and royal jelly groups pretreated before the initiation and during cisplatin chemotherapeutic regimen and control group on cisplatin only. Serum creatinine and urea levels were measured before and after the chemotherapeutic cycle and over 2 cycles. Patients on crude bee honey and royal jelly capsules showed lower serum levels of renal injury products (creatinine and urea) compared to those in the control group. The changes in kidney parameters were significantly (p honey group before and after cisplatin treatment. Royal jelly was found to be effective; however, the difference in creatinine and urea levels before and after chemotherapy was not statistically significant. The use of bee honey and royal jelly as natural compounds is effective in reducing cisplatin nephrotoxicity and may offer a promising chance for clinically meaningful prevention. This study has potentially important implications for the treatment of cisplatin kidney side effects and is considered to be the first to investigate this effect of honey and royal jelly in human subjects. However, due to its small sample size, we recommend further investigation using a larger sample size.

  14. The Acoustics of the Double Elliptical Vault of the Royal Palace of Caserta (Italy

    Directory of Open Access Journals (Sweden)

    Umberto Berardi


    Full Text Available This work investigates the acoustic characteristics of the double elliptical vault, which overlooks the Grand Staircase of the Royal Palace of Caserta (Italy. The Royal Palace was built by the architect Luigi Vanvitelli in the Seventeenth Century and it is the largest royal building in Italy. The double elliptical vault presents a great scenography effect. Inside the vault, on the planking level, musicians used to play for the king and his guests when the royal procession, going up the grand staircase, entered the royal apartments, creating astonishment among the guests who heard the music without understanding from where it was coming. Since the musicians were inside the vault, the long reverberation made the listeners perceive the vault to be enveloped by the music. To investigate this effect, the acoustic characteristics of the double vault were measured, putting the sound source on the planking level of the vault, while the microphones were put along the staircase and in the vestibule towards the royal apartments. Finally, the spatial distribution of several acoustic parameters is evaluated also using architectural acoustic simulations.

  15. American Pediatric Surgical Association (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 / ...

  16. Abortion - surgical - aftercare (United States)

    ... this page: // Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  17. Urogynecologic Surgical Mesh Implants (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  18. Improving patient safety in cardiothoracic surgery: an audit of surgical handover in a tertiary center

    Directory of Open Access Journals (Sweden)

    Bauer NJ


    Full Text Available Natasha Johan Bauer Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, UK Background: Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of ­England and the British Medical Association. Methods: A 16-item questionnaire prospectively audited the nature, time and duration of handover, patient details, operative history and current clinical status, interruptions during handover, and difficulties cross-covering specialties over a month. Results: Just over half (52% of the time, no handover took place. The majority of handovers (64% occurred over the phone; two-thirds of these were uninterrupted. All handovers were less than 10 minutes in duration. About half of the time, the senior house officer had previously met the registrar involved in the handover, but the overwhelming majority felt it would facilitate the handover process if they had prior contact. Patient details handed over 100% of the time included name, ward, and current clinical diagnosis. A third of the time, the patient’s age, responsible consultant, and recent operations or procedures were not handed over, potentially compromising future management due to delays and lack of relevant information. Perhaps the most revealing result was that the overall safety of handover was perceived to be five out of ten, with ten being very safe with no aspects felt to impact negatively on optimal patient care. Conclusion: These findings were presented to the department, and a handover proforma

  19. College education (United States)

    Criswell, David R.


    Space Grant Colleges and Universities must build the space curriculum of the future on the firm basis of deep knowledge of an involvement with the present operating programs of the nation and an on-going and extensive program of leading edge research in the aerospace sciences and engineering, management, law, finance, and the other arts that are integral to our planetary society. The Space Grant College and Fellowship Program must create new academic fields of enquiry, which is a long and difficult process that will require deeper and broader interaction between NASA and academia than has previously existed.

  20. College algebra

    CERN Document Server

    Kolman, Bernard


    College Algebra, Second Edition is a comprehensive presentation of the fundamental concepts and techniques of algebra. The book incorporates some improvements from the previous edition to provide a better learning experience. It provides sufficient materials for use in the study of college algebra. It contains chapters that are devoted to various mathematical concepts, such as the real number system, the theory of polynomial equations, exponential and logarithmic functions, and the geometric definition of each conic section. Progress checks, warnings, and features are inserted. Every chapter c

  1. Technical considerations for surgical intervention of Jones fractures. (United States)

    Mendicino, Robert W; Hentges, Matthew J; Mendicino, Michael R; Catanzariti, Alan R


    Jones fractures are a common injury treated by foot and ankle surgeons. Surgical intervention is recommended because of the high rate of delayed union, nonunion, and repeat fracture, when treated conservatively. Percutaneous intramedullary screw fixation is commonly used in the treatment of these fractures. We present techniques that can increase the surgical efficiency and decrease the complications associated with percutaneous delivery of internal fixation. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

    Directory of Open Access Journals (Sweden)

    Visweswara Rao Pasupuleti


    Full Text Available Background. There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food. Scope and Approach. In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding. Key Findings and Conclusions. An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.

  3. The absolute configurations of hydroxy fatty acids from the royal jelly of honeybees (Apis mellifera). (United States)

    Kodai, Tetsuya; Nakatani, Takafumi; Noda, Naoki


    9-Hydroxy-2E-decenoic acid (9-HDA) is a precursor of the queen-produced substance, 9-oxo-2E-decenoic acid (9-ODA), which has various important functions and roles for caste maintenance in honeybee colonies (Apis mellifera). 9-HDA in royal jelly is considered to be a metabolite of 9-ODA produced by worker bees, and it is fed back to the queen who then transforms it into 9-ODA. Recently we found that 9-HDA is present in royal jelly as a mixture of optical isomers (R:S, 2:1). The finding leads us to suspect that chiral fatty acids in royal jelly are precursors of semiochemicals. Rather than looking for semiochemicals in the mandibular glands of the queen bee, this study involves the search for precursors of pheromones from large quantities of royal jelly. Seven chiral hydroxy fatty acids, 9,10-dihydroxy-2E-decenoic, 4,10-dihydroxy-2E-decenoic, 4,9-dihydroxy-2E-decenoic, 3-hydroxydecanoic, 3,9-dihydroxydecanoic, 3,11-dihydroxydodecanoic, and 3,10-dihydroxydecanoic acids were isolated. The absolute configurations of these acids were determined using the modified Mosher's method, and it was revealed that, similar to 9-HDA, five acids are present in royal jelly as mixtures of optical isomers.

  4. Cardiothoracic surgical experience in Ghana. (United States)

    Tettey, Mark; Tamatey, Martin; Edwin, Frank


    Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level. As a result, the medical landscape of what is achievable locally in both pediatric and adult patients has changed substantially: outbound medical travel that used to be common among Ghanaian cardiovascular patients has been reduced drastically. Ghana's National Cardiothoracic Center (NCTC), the only tertiary center in the country for cardiothoracic surgical pathology manages all such patients that were previously referred abroad. The NCTC has become a medical/surgical hub in the West African sub-region providing service, training, and research opportunities to neighboring countries. The Centre is accredited by the West African College of Surgeons as a center of excellence for training specialists in cardiothoracic surgery. Expectedly, practicing cardiothoracic surgery in such a resource-poor setting has peculiar challenges. This review focuses on the history, practice, successes, and challenges of cardiovascular and thoracic surgery in Ghana.

  5. Improving patient safety in cardiothoracic surgery: an audit of surgical handover in a tertiary center. (United States)

    Bauer, Natasha Johan


    Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of England and the British Medical Association. A 16-item questionnaire prospectively audited the nature, time and duration of handover, patient details, operative history and current clinical status, interruptions during handover, and difficulties cross-covering specialties over a month. Just over half (52%) of the time, no handover took place. The majority of handovers (64%) occurred over the phone; two-thirds of these were uninterrupted. All handovers were less than 10 minutes in duration. About half of the time, the senior house officer had previously met the registrar involved in the handover, but the overwhelming majority felt it would facilitate the handover process if they had prior contact. Patient details handed over 100% of the time included name, ward, and current clinical diagnosis. A third of the time, the patient's age, responsible consultant, and recent operations or procedures were not handed over, potentially compromising future management due to delays and lack of relevant information. Perhaps the most revealing result was that the overall safety of handover was perceived to be five out of ten, with ten being very safe with no aspects felt to impact negatively on optimal patient care. These findings were presented to the department, and a handover proforma was implemented. Recommendations included the need for a new face-to-face handover. A reaudit will evaluate the effects of these changes.

  6. Impact of sex on prognostic host factors in surgical patients with lung cancer. (United States)

    Wainer, Zoe; Wright, Gavin M; Gough, Karla; Daniels, Marissa G; Choong, Peter; Conron, Matthew; Russell, Prudence A; Alam, Naveed Z; Ball, David; Solomon, Benjamin


    Lung cancer has markedly poorer survival in men. Recognized important prognostic factors are divided into host, tumour and environmental factors. Traditional staging systems that use only tumour factors to predict prognosis are of limited accuracy. By examining sex-based patterns of disease-specific survival in non-small cell lung cancer patients, we determined the effect of sex on the prognostic value of additional host factors. Two cohorts of patients treated surgically with curative intent between 2000 and 2009 were utilized. The primary cohort was from Melbourne, Australia, with an independent validation set from the American Surveillance, Epidemiology and End Results (SEER) database. Univariate and multivariate analyses of validated host-related prognostic factors were performed in both cohorts to investigate the differences in survival between men and women. The Melbourne cohort had 605 patients (61% men) and SEER cohort comprised 55 681 patients (51% men). Disease-specific 5-year survival showed men had statistically significant poorer survival in both cohorts (P < 0.001); Melbourne men at 53.2% compared with women at 68.3%, and SEER 53.3% men and 62.0% women were alive at 5 years. Being male was independently prognostic for disease-specific mortality in the Melbourne cohort after adjustment for ethnicity, smoking history, performance status, age, pathological stage and histology (hazard ratio = 1.54, 95% confidence interval: 1.10-2.16, P = 0.012). Sex differences in non-small cell lung cancer are important irrespective of age, ethnicity, smoking, performance status and tumour, node and metastasis stage. Epidemiological findings such as these should be translated into research and clinical paradigms to determine the factors that influence the survival disadvantage experienced by men. © 2016 Royal Australasian College of Surgeons.

  7. Obituary: R(oyal) Glenn Hall, 1921-2004 (United States)

    McCarthy, Dennis Dean


    R. Glenn Hall died on 25 June 2004 following a battle with prostate cancer. His contributions to the determination of the frequency corresponding to an energy level transition in the Cesium atom led to the definition of the length of the second and formed the basis for precise modern timekeeping. Glenn was born on 23 June 1921 in Koloa, Hawaii, and together with a brother and three sisters, grew up in Albion, Michigan. His father was a professor of political science at Albion College. He graduated from Park College in Parkville, Missouri with a degree in mathematics in 1941. He served as a corpsman in the U. S. Navy during World War II, and went on to earn a PhD at the University of Chicago in 1949. Glenn joined the faculty at the University of Chicago as an instructor from 1949 through 1952 and became a research associate there in 1953. While at the U. of Chicago he worked extensively on mass ratios of binary stars, binary star orbits and the determination of stellar parallaxes. In 1953 Glenn came to the U. S. Naval Observatory (USNO) where he became the Assistant Director of the Time Service Division. His early work at the Naval Observatory was related to the determination of Ephemeris Time (ET) from photographic observations of the Moon with respect to background stars. This work provided a time scale more uniform than that based on the Earth's rotation, which was the internationally accepted time scale at the time. As a result, the International Astronomical Union in 1955 redefined the second to be the second as determined from Ephemeris Time. In June 1955, L. Essen and J.V.L. Parry placed in operation a Cesium beam atomic standard at the National Physical Laboratory in Teddington, England. William Markowitz (1907-1998), the director of the Time Service, and Hall together with Essen and Parry then began the work leading to the determination of the frequency of the Cesium atom in terms of the second of the seasonally corrected time scale determined from the

  8. Varroa destructor mite in Africanized honeybee colonies Apis mellifera L. under royal jelly or honey production

    Directory of Open Access Journals (Sweden)

    Pedro da Rosa Santos


    Full Text Available This study evaluated the level of invasion of Varroa mite into worker brood cells, the infestation rate on adult worker honeybees, total and effective reproduction rates of the mite in Africanized honeybee colonies under royal jelly or honey production. Invasion and infestation rates were not statistically different between honeybee colonies producing honey or royal jelly and the averages for these parameters were 5.79 and 8.54%, respectively. Colonies producing honey presented a higher (p < 0.05 total and effective reproduction of Varroa than colonies producing royal jelly. There was a negative correlation between levels of invasion and infestation with minimum external temperature, relative humidity and rainfall. The variables month and season influenced the development of the mite, but rates were low and within the range normally found in Brazil for Africanized honeybee colonies, which confirm the greater resistance of these honeybees to Varroa destructor than European honeybees.

  9. Dimitrie Gusti and the Royal Cultural Foundations (1922-1948. Archive Documents

    Directory of Open Access Journals (Sweden)

    PhD Student Laura-Rodica Hîmpa


    Full Text Available This research aims to emphasize the activity of The "Prince Carol" Royal Cultural Foundation created in 1921 in order to lead to the emancipation especially of villages, but also the Romanian culture in a more general perspective. Overall, we may say that the period between the two world wars was marked, also due to the help of the Royal Cultural Foundation, by substantial progress in various fields of education, science and culture in general and thus contributed to changing Romania into a state with a high level of culture and the creation of an image and prestige that commanded worldwide respect. The research was done on the basis of the documents studied at the Service of the National Central Historical Archives, the Stock of the "Prince Carol" Royal Cultural Foundation and at the Library of the Romanian Academy.

  10. ‘All Touched my Hand’: Queenly Sentiment and Royal Prerogative

    Directory of Open Access Journals (Sweden)

    Rachel Bates


    Full Text Available The Crimean War occurred during a formative period of ‘civic publicness’, a term used by John Plunkett to describe the press-mediated public duties undertaken by Victoria and Albert to affirm the monarchy’s popular constitution. The war triggered significant royal intervention into the condition of the army, one of the few sites of royal prerogative. At a time when aristocratic governance was being attacked and the privations of soldiers exposed to an unprecedented extent, the monarchy was keen both to legitimize its role as head of the army and to demonstrate its sensitivity to popular concern for the suffering of ordinary soldiers. This manifested in a highly publicized leaked letter from the Queen expressing her regard for ‘her troops’, the royal family’s visits to wounded soldiers, and the distribution of the Crimean Medal at a special ceremony, which portrayed the accessibility of the Queen through the use of touch. This article explores the symbolism and impetus of these occurrences and assesses the reception of royal intervention in the press. The few assessments of royal influence during the Crimean War have focused largely on Victoria’s personal fascination with the progress of the war and her soldiers. This article explores instead the wider, political significance of the army as extension of the royal family. The Liberal press and artists responded favourably to demonstrations of the Queen’s maternal sympathy for the troops, but my article will point to a hidden struggle to assert the Crown’s authority. Normal 0 false false false EN-GB X-NONE X-NONE

  11. The Case of the Royal School of Library and Information Science

    DEFF Research Database (Denmark)

    Borlund, Pia


    The present paper forms the basis of the invited talk to be given by the author at the International Symposium on the Transformation and Innovation of Library and Information Science, November 16-17, 2010, Taipei, Taiwan. The paper introduces the Royal School of Library and Information Science......, Denmark, as a European School of Library and Information Science and a member of iSchool Caucus. The paper outlines some of the current challenges of the Royal School of Library and Information Science and how these challenges are met, including how the membership of the iSchool movement is considered...

  12. Presidential addresses of the Royal Society of Tropical Medicine and Hygiene: 1907–2013 (United States)

    Hay, Simon I.; McHugh, Gerri M.


    Presidents have been required to give an inaugural address on commencing office at the Royal Society of Tropical Medicine and Hygiene (RSTMH) since its foundation in 1907. All presidential addresses were identified, sourced and assembled into an annotated bibliography. The majority of presidential addresses have been published in Transactions of the Royal Society of Tropical Medicine and Hygiene. Unpublished and in some cases ‘lost’ contributions have now been sourced where possible and archived at the RSTMH. This unique, rich and rewarding archive provides a vista into the development of the RSTMH and the discipline of tropical medicine. The archive is freely available to all. PMID:24026462

  13. The Role of the Royal Navy in Counter-Insurgency Campaigns since 1945


    Guoth, Maroš


    The aim of this work is to prove that a navy can play an important role during a counter-insurgency campaign and be involved in many different tasks both at sea and from sea, particularly due to its flexibility, mobility and versatility. The main research question of the thesis is: what role can a navy play in a counter-insurgency campaign? The decision to focus on the role of the Royal Navy is based on the fact, that the Royal Navy is probably the most experienced navy in the world in the fi...

  14. Alternative sources of supplements for Africanized honeybees submitted to royal jelly production


    Sereia, Maria Josiane; Toledo, Vagner de Alencar Arnaut de; Furlan, Antonio Claudio; Faquinello, Patrícia; Maia, Fabiana Martins Costa; Wielewski, Priscila


    This study was carried out to evaluate the effect of supplements with isolated soy protein, brewer's yeast, a mixture of isolated soy protein with brewer's yeast, linseed oil, palm oil and mixture of linseed oil with palm oil in the production of royal jelly by Africanized honeybee colonies. Total royal jelly production was higher (p < 0.05) in colonies fed with isolated soy protein and brewer's yeast (11.68 g colony-1), followed by linseed oil and palm oil (11.30 g colony-1) and palm oil (9....

  15. The Royal Treasury of the Kingdom of Majorca during the War of the Spanish Succession (1701-1715

    Directory of Open Access Journals (Sweden)



    Full Text Available The royal treasury of the kingdom of Majorca during the War of the Spanish Succession suffered an economic downturn caused mainly by its logistical contribution to the war. This article shows the evolution of the taxation carried out by the Royal Treasury of Majorca during the war, and is divided into three parts. The first one is a description of the Royal Treasury as an institution. The second one analyses revenues and expenses and shows the evolution of the institution’s finances during the conflict. The third part is a general inventory of the royal accounts during the war.

  16. Assessment of surgeon fatigue by surgical simulators

    Directory of Open Access Journals (Sweden)

    Tuwairqi K


    Full Text Available Khaled Tuwairqi,1 Jessica H Selter,2 Shameema Sikder3 1College of Medicine, University of Utah, Salt Lake City, UT, 2Johns Hopkins School of Medicine, 3Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Background: The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms “simulator”, “surgery”, and “fatigue”. In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical

  17. Guidelines for the use of radioiodine in the management of hyperthyroidism: a summary. Prepared by the Radioiodine Audit Subcommittee of the Royal College of Physicians Committee on Diabetes and Endocrinology, and the Research Unit of the Royal College of Physicians. (United States)

    Lazarus, J H


    Radioiodine (131I) therapy is indicated in patients with nearly all causes of hyperthyroidism. It may safely be given to patients of all age groups but is less often given to children under 10 years old. It is completely contraindicated in pregnancy and while breast feeding, but there is no increased risk of thyroid cancer, leukaemia or solid tumours. Administration of radioiodine must conform to regulations and definitions laid down by ARSAC And POPUMET. Medical staff authorising therapy must hold an ARSAC licence. The recommended strategy is to give an activity sufficient to render the patient rapidly euthyroid and maintain that state or achieve no more than a low rate of hypothyroidism in subsequent years. A range of activity (300-800 MBq) is suggested depending on the clinical state. Antithyroid drugs may be given before or after (or both) radioiodine if necessary. Full written information should be given to the patient and written consent obtained. A structured follow-up should be used ensuring regular measurement of TSH or FT4. Close cooperation with the patient's general practitioner is recommended throughout the assessment, treatment and follow-up. Shared care with a computer based follow-up system is recommended.

  18. Deriving DICOM surgical extensions from surgical workflows (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.


    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  19. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.


    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  20. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.


    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  1. The Patterns Of Surgical Thyroid Diseases And Operative Treatment ...

    African Journals Online (AJOL)

    The Patterns Of Surgical Thyroid Diseases And Operative Treatment. In Gondar College of Medical sciences, North-western Ethiopia. Abebe B. M.D. Lecturer and General practitioner,. Girmaye T. M.D. Assistant professor of surgery,. Mensur 0. M.D. Assistant professor of surgery,. Sentayehu T. M.D. General practitioner,.

  2. Total body irradiation and marrow transplantation for acute leukaemia. The Royal Marsden Hospital experience

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, A; Barrett, A J; Powles, R L [Institute of Cancer Research, Sutton (UK). Surrey Branch; Royal Marsden Hospital, London (UK))


    The experience with total body irradiation at the Royal Marsden Hospital is described for an elective program of transplantation in patients with acute myeloid leukaemia (AML) in first remission. Dose rate appears to be a critical factor in the reduction of radiation-associated damage and careful monitoring of the actual dose distribution and dose received is mandatory.

  3. Royal Ahold : A Failure of Corporate Governance and an Accounting Scandal

    NARCIS (Netherlands)

    de Jong, A.; DeJong, D.V.; Mertens, G.M.H.; Roosenboom, P.G.J.


    Royal Ahold (Koninklijke Ahold NV) was one of the major success stories in the 1990s and is one of the major failures, suffering a complete meltdown, in 2003.We investigate the strategy, accounting transparency and corporate governance of Ahold; elements which jointly drive the firm s performance

  4. Dr. Steve Thompson, Chief Executive, The Royal Society of New Zealand

    CERN Multimedia

    Maximilien Brice


    L. to r.: Dr Austin Ball, Deputy Technical Coordinator, CMS experiment; Dr Roland Horisberger, Paul Scherrer Institute and CERN, CMS experiment; Dr Steve Thompson, Chief Executive, The Royal Society of New Zealand; Dr Michel Della Negra, Spokesman, CMS experiment and Dr Alick Macpherson, Paul Scherrer Institute and CERN, CMS experiment, in the CMS Silicon Tracker assembly hall.

  5. Delegation from the Royal Government and the Permanent Mission of Bhutan

    CERN Multimedia

    Patrice Loïez


    Photoa 01,02: Mr Yeshey Dorji, Chargé d'affaires, a. i., Permanent Mission of Bhutan in New York (3rd from left), visiting the ATLAS underground cavern with Dr Diether Blechschmidt, CERN Non-Member States Relations (4th from left) and Representatives of the Bhutan Royal Government and Permanent Mission in Geneva.

  6. Royal Service tegutseb üheksas riigis / Paavo Pilv ; interv. Eda-Liis Kann

    Index Scriptorium Estoniae

    Pilv, Paavo


    Äripäeva üritusturundusfirmade TOP-is I koha saavutanud Royal Service-i juht ettevõtte edukuse põhjustest, olulisematest töödest 2003. aastal, üritusturunduse tulevikutrendidest ja EL-iga liitumise mõjust valdkonna arengule

  7. Field Philosophy: Environmental Learning and Moral Development in Isle Royale National Park (United States)

    Goralnik, Lissy; Nelson, Michael Paul


    We conducted a qualitative analysis of 5 years of student writing data to understand learning and moral development on a field philosophy course in Isle Royale National Park. We were interested in the connection between physical experiences in the natural world and the way students care about or value nonhuman beings, natural systems, and place.…

  8. Amateur Hour: Culture, Capital, and the Royal Shakespeare Company's Open Stages Initiative (United States)

    Flynn, Molly


    In 2011, the Royal Shakespeare Company (RSC) began a series of collaborations with established amateur theatre groups from across the UK. The initiative now known as Open Stages became one of the most ambitious educational outreach programmes ever run by the RSC, engaging hundreds of amateur theatre practitioners in a process of skills sharing and…

  9. The Royal Entries of Henry VI in a London Civic Manuscript

    DEFF Research Database (Denmark)

    Bourassa, Kristin


    London Metropolitan Archives, MS Letter Book K, contains descriptions of Henry VI’s royal entries into both Paris (1431) and London (1432). Their placement one after the other in a London Letter Book was likely the work of the city’s common clerk, John Carpenter, who was the author of the descrip...

  10. Assessment of a number of compasses which contain radioactive paint, available from the Royal Airforce

    International Nuclear Information System (INIS)

    Aten, T.B.Th.


    There was a degree of uncertainty about the radiation safety of a number of compasses in use by the Dutch Royal Airforce and this has been investigated by the Medical Biological Laboratory of TNO. Four compasses have been examined and advice for their use, maintenance and repair is presented. (C.F.)

  11. Integrating Social Sustainability in Engineering Education at the KTH Royal Institute of Technology (United States)

    Björnberg, Karin Edvardsson; Skogh, Inga-Britt; Strömberg, Emma


    Purpose: The purpose of this paper is to investigate what are perceived to be the main challenges associated with the integration of social sustainability into engineering education at the KTH Royal Institute of Technology, Stockholm. Design/methodology/approach: Semi-structured interviews were conducted with programme leaders and teachers from…

  12. Network Centric Warfare Concepts in the Royal Netherlands Army C2 Architecture

    NARCIS (Netherlands)

    Meijden, M.G. van der


    The Royal Netherlands Army (RNLA) has been working on its second generation C2 Information System since 2000. Its first generation Integrated Staff Information System (ISIS) that is currently deployed is based on ATCCIS specifications and uses the ATCCIS Replication Mechanism for database to


    85Kr activities were determined in 264 domestic and municipal wells from 2002-2004 in the Royal watershed (361 km2), Maine. Gas extraction for 85Kr from wells was effected directly via a well-head methodology permitting efficient widespread analys...

  14. Description of Etrocorema belumensis sp.n. from Royal Belum State Park, Perak, Malaysia:


    Asiah, Wan Nur; Salmah, Che M. R.; Sivec, Ignac


    Only one variable Etrocorema species, E. nigrogeniculatum (Enderlein), is currently recognized from Peninsular Malaysia. During limnological study in Royal Belum State Park, Malaysia, specimens of a new species of Etrocorema, E.belumensis n. sp., were discovered. Illustrations of male and female genitalia, eggs, and larvae of this new taxon are provided.

  15. Reflections on a Degree Initiative: The UK's Birmingham Royal Ballet Dancers Enter the University of Birmingham (United States)

    Benn, Tansin


    This paper provides an opportunity to share experiences and perceptions of the first 5 years of a degree programme for professional dancers. A partnership developed in the mid-1990s between the UK's Birmingham Royal Ballet and the University of Birmingham, Westhill (now School of Education), to provide a part-time, post-experience, flexible study…

  16. A Member of Complementary Medicinal Food: Anatolian Royal Jellies, Their Chemical Compositions, and Antioxidant Properties. (United States)

    Kolayli, Sevgi; Sahin, Huseyin; Can, Zehra; Yildiz, Oktay; Malkoc, Meltem; Asadov, Alsever


    This study investigated various chemical and antioxidant properties of Anatolian royal jelly samples. Moisture, pH, total protein, 10-hydroxy-2-decenoic acid (10-HDA) and sugars were analyzed from 18 samples. Total phenolic contents, ferric reducing antioxidant capacity and 2,2-diphenyl-1-picryhydrazyl (DPPH) free radical scavenging activity were measured as antioxidant determinants. 10-HDA contents and total protein content of fresh weight ranged between 1.0% and 3.9%, and 11.4% and 15.8%, respectively. The main sugars detected were glucose and fructose. Maltose, trehalose, and melibiose were detected at less than 1.0% in all samples. Lactose, a milk sugar, was detected in only 3 samples, at values between 0.8% and 1.4%. Total henolic content ranged from 91.0 to 301.0 mg gallic acid equivalents/kg fresh weight. Antioxidant activity is due to both to the total phenolic content, proteins and fatty acids of royal jelly. Anatolian royal jelly samples were not different from other royal jelly samples from across the world. © The Author(s) 2015.

  17. Depression riots and the calling of the 1897 West India Royal Commission

    Directory of Open Access Journals (Sweden)

    Bonham C. Richardson


    Full Text Available Questions why the West India Royal Commission of 1897 was considered necessary when serious distress already existed in the 1880s. Author argues that riots caught the government's attention much more readily than statistical data. Even minor disturbances could have distracted London from its preoccupation with the newer, more important parts of the Empire.

  18. Use of the Slowpoke-2 nuclear reactor at the Royal Military College of Canada for book conservation

    Energy Technology Data Exchange (ETDEWEB)

    Shaheen, K.; Welland, M.; Allen, F.; Corcoran, E.; Deschenes, M.; Bonin, H. [Royal Military College of Canada, Kingston, Ontario (Canada)


    The present project investigated the use of the mixed radiation field produced by the SLOWPOKE-2 reactor to prolong the life of biodeteriorated books. Research into past studies of radiation treatment indicated that the primary biodeteriorating agents, insects and moulds, can be reduced enough to return books to the 'natural' level of infestation with a dose of 2-3kGy where they will age in a manner consistent with a 'normal' book. Based on research of the potential negative effects of irradiation on paper, including depolymerization, loss of paper strength and durability, discoloration, and harm to ink, it was found that at doses below 8kGy, at a dose rate of 2.4kGy, there is no serious harm to the paper. Based on a desired dose range of 2 to 8kGy, and the dimensions and flux mapping of the radiation field in the reactor pool, a 60cm x 58cm x 43.5cm vacuum-sealed box, with a Cadmium foil neutron shield, is proposed. A preliminary feasibility study suggests that the capital and operating costs of this irradiation procedure would be approximately C$15000 and C$600, respectively. (author)

  19. Communication through music : The education system and the environment at the Royal College of Music in London


    近藤, 綾子; Ayako, KONDO; 鈴鹿国際大学短期大学部


    Music is art that can expresses one's feelings through each and every note. That is the same compositions, or those of the great composers, such as Bach's Partitas and Mozart's Sonatas. If performers do not feel and truly enjoy the music they play, then it is natural that the experience for the listener will also be empty. This is because music through the medium of sounds is one way that humans interact and ultimately communicate. In this article, I examine, "The education system and the env...

  20. Exodus? The training paths and plans of postgraduate medical trainees, under the Royal College of Physicians of Ireland.

    LENUS (Irish Health Repository)

    Bennett, D


    In 2006, the Buttimer report highlighted the paucity of demographic data on those applying for and entering postgraduate medical education and training (PGMET) in Ireland. Today, concerns that there is an "exodus" of graduates of Irish medical schools are at the forefront of national discussion, however, published data on PGMET remains inadequate.

  1. Allergy. Conventional and alternative concepts. A report of the Royal College of Physicians Committee on Clinical Immunology and Allergy. (United States)

    Kay, A B; Lessof, M H


    Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are due entirely to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may have either a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time. The most common allergens (substances causing allergy) are grass and tree pollens, the house dust mite, products from pets and other animals, agents encountered in industry, wasp and bee venom, drugs, and certain foods. Food allergy presents a particularly difficult problem. Some individuals who react to food suffer from food allergy in its strict sense but in others there is no evidence of an alteration in the immune system. Here the term 'food intolerance' is preferable. Conventional doctors treat allergy by allergen avoidance--where this is possible--and drugs that relieve symptoms. In a few selected cases, in which other methods have failed, immunotherapy (desensitisation or hyposensitisation) is recommended. Although patients who consult practitioners of alternative allergy may do so by preference, it is often also because they are dissatisfied with the conventional approach to diagnosis and treatment, or because they have conditions which conventional doctors do not accept as having an allergic basis. There is a very wide range of alternative approaches to allergy, including the methods used by clinical ecologists and other treatments such as acupuncture and homoeopathy. Hypnosis may have a small role to play in helping the asthmatic and similar effects have been suggested for acupuncture. Furthermore, it is likely that there are still many active ingredients in medicinal plants used by herbalists but these need to be clearly identified and purified before their usefulness can be evaluated properly. Apart from these situations, we have yet to be convinced by substantial evidence that any of the other alternative methods of diagnosing or treating allergic disease are of proven value. There have, however, been many false and misleading claims and serious harm may be caused by misdiagnosis or delays in appropriate treatment. The public should be warned against costly methods of diagnosis and treatment which have not been validated.(ABSTRACT TRUNCATED AT 400 WORDS)

  2. Call for consistent coding in diabetes mellitus using the Royal College of General Practitioners and NHS pragmatic classification of diabetes

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan


    Full Text Available Background The prevalence of diabetes is increasing with growing levels of obesity and an aging population. New practical guidelines for diabetes provide an applicable classification. Inconsistent coding of diabetes hampers the use of computerised disease registers for quality improvement, and limits the monitoring of disease trends.Objective To develop a consensus set of codes that should be used when recording diabetes diagnostic data.Methods The consensus approach was hierarchical, with a preference for diagnostic/disorder codes, to define each type of diabetes and non-diabetic hyperglycaemia, which were listed as being completely, partially or not readily mapped to available codes. The practical classification divides diabetes into type 1 (T1DM, type 2 (T2DM, genetic, other, unclassified and non-diabetic fasting hyperglycaemia. We mapped the classification to Read version 2, Clinical Terms version 3 and SNOMED CT.Results T1DMand T2DM were completely mapped to appropriate codes. However, in other areas only partial mapping is possible. Genetics is a fast-moving field and there were considerable gaps in the available labels for genetic conditions; what the classification calls ‘other’ the coding system labels ‘secondary’ diabetes. The biggest gap was the lack of a code for diabetes where the type of diabetes was uncertain. Notwithstanding these limitations we were able to develop a consensus list.Conclusions It is a challenge to develop codes that readily map to contemporary clinical concepts. However, clinicians should adopt the standard recommended codes; and audit the quality of their existing records.

  3. Casemix and process indicators of outcome in stroke. The Royal College of Physicians minimum data set for stroke. (United States)

    Irwin, P; Rudd, A


    The emphasis on outcomes measurement requires that casemix is considered in any comparative studies. In 1996 the Intercollegiate Working Party for Stroke agreed a minimum data set to measure the severity of casemix in stroke. The reasons for its development, the evidence base supporting the items included and the possible uses of the data set are described. It is currently being evaluated in national outcome and process audits to be reported at a later date.

  4. Relativism, regulation and the dangers of indifferent science: the Sir Roy Cameron lecture of the Royal College of Pathologists. (United States)

    Berry, Colin L


    The evaluation of data obtained from scientific investigations is not easy and the process often seems counterintuitive to the uninformed. Some commentators hold the conviction that ideological motives colour all deliberations-this makes it easy to suggest that in any scientific debate an opponent's reason for holding a particular viewpoint or belief depends on his or her motives, rather than their knowledge base. This position may be useful in providing the grounds on which to mount a polemic against any perceived threat (drugs in modern medicine, pesticides in intensive agriculture or genetically modified organisms). However, its existence is not a reason to ignore the fact that the data obtained by use of the scientific method may be of a different kind from that which depends on opinions, honed by prejudices. Here I use prejudice to mean a bias that may be favourable or unfavourable to a particular viewpoint, rather than to a willful disregard of fact or an unreasoning predilection to arrive at a particular answer--the Precautionary Principle is a good example of only considering results that fit a preconceived viewpoint. The conviction that opinions cannot be based on independent thought has led to a disregard of professionalism and the development of the view that who pays you determines your opinion--not your science. This is relativism, which embodies the assertion that knowledge is relative and that ethical truths depend on the individuals and groups holding them-there are no absolutes. This compounds the problems of regulatory toxicology which is always beset by unavoidable uncertainties and suffers from being based on the use of the results of testing procedures many decades old which have themselves failed to incorporate new knowledge about the processes we investigate (see Hartung, 2009). A more vigorous assertion of the particular values of the scientific viewpoint and a willingness to incorporate new knowledge into regulatory decision making is necessary. 2009 Elsevier Ireland Ltd. All rights reserved.

  5. Condensation system with seawater in the Royal Solaris Hotel of Cancun; Sistema de condensacion con agua salada en el hotel Royal Solaris de Cancun

    Energy Technology Data Exchange (ETDEWEB)

    Herrero, Juan F.; Hernandez A, David [Celsol, S.A. de C.V., Nuevo Leon (Mexico)


    After performing a technical study, during the month of September of 1998, in the facilities of Villas Solaris, S.A. de C.V., specifically in the Royal Solaris Hotel, towers Royal and Caribe, important opportunities of saving were found, which were evaluated technical and economically to be able to present to Villa Solaris, S.A. of C.V., an energy saving project highly profitable that allows to obtain great economic benefits, a better service for the hosts and an important step to the reduction of the operative expenses (energy), that guaranteed the future competitiveness of the hotel in the zone. The base of the energy saving opportunities is the substitution of the air conditioning equipment, since the installed ones in the Hotel, are very deficient equipment (piston in Caribbean Tower) or because of by International ecological Norms they will be obsolete in short time (centrifugal R-11 Torre Royal). In addition the service machine area of the Hotel was centralized in a single site. The substitution measure of the air conditioning systems, contemplated the installation of centrifugal equipment of high efficiency (0.65kW/Ton at full load) cooled with brackish water, that is a very abundant resource in the zone and does not represent any cost for the Hotel. The waste heat of the refrigeration machines is contemplated to be used to preheat the service water and the swimming pool water by means of heat exchange equipment. In order to arrive to the desired optimal temperatures the advantage of the installation of the already existing in the Hotel thermo solar systems was taken into consideration. When implementing this global system, the use of cooling towers was eliminated, that was the equipment that cools the condensation water of the air conditioning equipment. In addition the use of the steam boilers was eliminated that made the function of warming up the service water, reason why an important saving of fuel was generated. [Spanish] Despues de haber realizado un

  6. Anti-inflammatory effects of royal jelly on ethylene glycol induced renal inflammation in rats

    Directory of Open Access Journals (Sweden)

    Zeyneb Aslan


    Full Text Available ABSTRACT Objective: In this study, anti-inflammatory effects of Royal Jelly were investigated by inducing renal inflammation in rats with the use of ethylene glycol. For this purpose, the calcium oxalate urolithiasis model was obtained by feeding rats with ethylene glycol in drinking water. Materials and Methods: The rats were divided in five study groups. The 1st group was determined as the control group. The rats in the 2nd group received ethylene glycol (1% in drinking water. The rats in the 3rd group were daily fed with Royal Jelly by using oral gavage. The 4th group was determined as the preventive group and the rats were fed with ethylene glycol (1% in drinking water while receiving Royal Jelly via oral gavage. The 5th group was determined as the therapeutic group and received ethylene glycol in drinking water during the first 2 weeks of the study and Royal Jelly via oral gavage during the last 2 weeks of the study. Results: At the end of the study, proinflammatory/anti-inflammatory cytokines, TNF-α, IL-1β and IL-18 levels in blood and renal tissue samples from the rats used in the application were measured. Conclusion: The results have shown that ethylene glycol does induce inflammation and renal damage. This can cause the formation of reactive oxygen species. Royal Jelly is also considered to have anti-inflammatory effects due to its possible antiradical and antioxidative effects. It can have positive effects on both the prevention of urolithiasis and possible inflammation during the existing urolithiasis and support the medical treatment.

  7. The Community College Option (United States)

    Rosenbaum, James E.; Ahearn, Caitlin; Rosenbaum, Janet


    Efforts to promote college for all for all has opened college doors to a broad range of students. But college--and career success after college--doesn't have to mean a bachelor's degree. Community college credentials, such as associate's degrees and one-year certificates, can lead to further degrees or jobs that offer more benefits than students…

  8. The Effects of Royal Jelly on In-Vitro Cytotoxicity of K562 Cells and Peripheral Blood Mononuclear Cells

    Directory of Open Access Journals (Sweden)

    SE Hosseini


    Full Text Available Abstract Background & aim: Royal jelly, secreted by worker bees, has different biological activities on cells and tissues. The aim of this study was to evaluate the effects of royal jelly on peripheral blood mononuclear cells and on the tumor category of K562 cell line. Methods: In the present experimental study, three subjects were selected separately with three repetitions. K562 (104 cells and PBMC (105 cells with different concentrations of royal jelly (5, 10, 25, 50 and 100 mg/ml were cultured under standard conditions for 48 and 72 h separately. The fatality rate on PBMC cells and K562 cancer cells was evaluated by using MTT (Tetrazolium Dye-Reduction Assay. The number of viable cells in PBMC that were exposed for 48 hours with Royal Jelly was evaluated by trypan blue staining. Data were analyzed by ANOVA. Results: The royal jelly had no cytotoxicity effect on PBMC cells but at concentration of 50 and 100 mg/mL the cytotoxicity effect were observed on k562 cells whereas, at 10 and 25 mg/ml the number of PBMC viable cells increased. Conclusion: Due to the lack of lethality of royal jelly on PBMC cells and PBMC cell viability and an increase in the fatality rate of cancer cells in the future, royal jelly can be used as a potential candidate for treatment of leukemia. Keywords: Royal jelly, K562, peripheral blood mononuclear cell

  9. Determination of (2E-10-hydroxydec-2-enoic acid in Croatian royal jelly by high-performance liquid chromatography

    Directory of Open Access Journals (Sweden)

    Ivana Flanjak


    Full Text Available Although health-promoting properties of royal jelly are known for many years, the absence of quality standards and methods prescribed for their determination leads to royal jelly adulteration. Royal jelly is a source of unique unsaturated fatty acid, (2E-10-hydroxydec-2-enoic acid (10-HDA, and its content is considered as one of the freshness and authenticity parameter. In this study, high performance liquid chromatographic method (HPLC with UV detection was validated and 10-HDA content in fresh royal jelly samples produced in Eastern Croatia was determined. The data about Croatian royal jelly are not available, therefore the results presented in this study could be considered as pioneer results for Croatian royal jelly characterization in respect of the 10-HDA. Method performance characteristics showed that the used method is fit for purpose. The content of 10-HDA in analysed samples varied from 1.56% up to 3.78%. According to the international recommendations for royal jelly quality, samples were fresh and authentic regarding 10-HDA content. Furthermore, the effect of packaging material on 10-HDA content was observed. Based on the obtained results, the conclusion was reached that if the samples were collected at the same time and frozen after collection, collection and storage of fresh royal jelly in glass and plastic containers had no effect on 10-HDA content.

  10. Surgical ethics: surgical virtue and more. (United States)

    Vercler, Christian J


    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  11. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  12. Surgical Critical Care Initiative (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....

  13. Ambulatory Surgical Measures - Facility (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...

  14. Surgical Management of Hemorrhoids (United States)

    Agbo, S. P.


    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  15. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  16. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  17. [Simulation in surgical training]. (United States)

    Nabavi, A; Schipper, J


    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  18. College mechanics

    CERN Document Server

    Şengül, Caner


    College Mechanics QueBank has been designed to be different, enthusiastic, interesting and helpful to you. Therefore, it is not just a test bank about mechanics but also it is like a compass in order to find your way in mechanics Each chapter in this book is put in an order to follow a hierarchy of the mechanics topics; from vectors to simple harmonic motion. Throughout the book there are many multiple choice and long answer questions for you to solve. They have been created for YGS, LYS, SAT, IB or other standardized exams in the world because mechanics has no boundaries and so Physics has no country. Learn the main principle of each chapter and explore the daily life applications. Then you can start to solve the questions by planning a problem solving method carefully. Finally, enjoy solving the questions and discover the meachanics of the universe once more.

  19. 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 ...

  20. Sir William Burnett (1779-1861), professional head of the Royal Naval Medical Department and entrepreneur. (United States)

    Penn, Christopher


    Sir William Burnett (1779-1861) had an active career as a Royal Navy surgeon in the French Revolutionary and Napoleonic Wars, including service at the battles of St Vincent, the Nile and Trafalgar. From 1822 to 1855 he was professional head of the Royal Naval Medical Department, when he provided effective leadership in a time of great change. Although his official work earned him the reputation of a "hard-working, unimaginative, somewhat harsh man", his correspondence shows a very humane centre under the official carapace. His official performance and reputation were both eroded towards the end of his career by his determined promotion of zinc chloride, for which he held lucrative patents.

  1. The zoonotic implications of pentastomiasis in the royal python (python regius). (United States)

    Ayinmode, Ab; Adedokun, Ao; Aina, A; Taiwo, V


    Pentastomes are worm-like endoparasites of the phylum Pentastomida found principally in the respiratory tract of reptiles, birds, and mammals. They cause a zoonotic disease known as pentastomiasis in humans and other mammals. The autopsy of a Nigerian royal python (Python regius) revealed two yellowish-white parasites in the lungs, tissue necrosis and inflammatory lesions. The parasite was confirmed to be Armillifer spp (Pentastomid); this is the first recorded case of pentastomiasis in the royal python (Python regius) in Nigeria. This report may be an alert of the possibility of on-going zoonotic transmission of pentastomiasis from snake to man, especially in the sub-urban/rural areas of Nigeria and other West African countries where people consume snake meat.

  2. Action Stations! 100 years of trauma care on maritime and amphibious operations in the Royal Navy. (United States)

    Osborne, M; Smith, J E


    Over the past century trauma care within the Royal Navy (RN) has evolved; wartime experiences and military medical research have combined to allow significant improvement in the care of casualties. This article describes the key maritime and amphibious operations that have seen the Royal Navy Medical Service (RNMS) deliver high levels of support to wherever the Naval Service has deployed in the last 100 years. Key advancements in which progress has led to improved outcomes for injured personnel are highlighted--the control and treatment of blood loss, wound care, and the prevention and management of organ failure with optimal resuscitation. Historians often point out how slowly military medicine progressed for the first few thousand years of its recorded history, and how quickly it has progressed in the last century. This reflective article will show how the RNMS has been an integral part of that story, and how the lessons learnt by our predecessors have shaped our modern day doctrine surrounding trauma care.


    Directory of Open Access Journals (Sweden)

    J. Cardenal


    Full Text Available At present, cultural heritage documentation projects use a variety of spatial data acquisition techniques such as conventional surveying, photogrammetry and terrestrial laser scanning. This paper deals with a full documentation project based on all those techniques in the Royal Chapel located in the Cathedral-Mosque of Cordoba in Spain, declared World Heritage Site by UNESCO. At present, the Royal Chapel is under study for a detailed diagnostic analysis in order to evaluate the actual state of the chapel, pathologies, construction phases, previous restoration works, material analysis, etc. So in order to assist the evaluation, a documentation project with photogrammetric and laser scanner techniques (TLS has been carried out. With this purpose, accurate cartographic and 3D products, by means of the integration of both image and laser based techniques, were needed to register all data collected during the diagnostic analysis.

  4. Observing the skies of Lisbon. Isaac de Sequeira Samuda, an estrangeirado in the Royal Society. (United States)

    Vieira, Carla Costa


    Elected in 1723, Isaac de Sequeira Samuda (1681-1729) was the first Jewish Fellow of the Royal Society. He had arrived in London just a few years earlier, escaping from the Portuguese Inquisition. Despite his past, he had no difficulty in establishing links with his country's diplomatic representatives in London. A physician and adviser on scientific subjects, he became a conduit between the emerging world of Portuguese astronomy and the British scientific community. He reported to the Royal Society on astronomical observations made in the new observatories in Lisbon and helped with the acquisition of scientific instruments and books destined for Portugal. These activities were facets of Samuda's unusual career and the diverse though often converging associations that he established until his death. As the member of a network active in the diffusion of new ideas and in the modernization of Portuguese science, Samuda can be regarded as an estrangeirado, as this term has come to be used in the modern literature.

  5. Structural diagnosis of historic timber structures: the Diplomatic Room of the of Royal Palace of Naples

    Directory of Open Access Journals (Sweden)

    Donato Calicchio


    Full Text Available The aim of this article is to describe the diagnosis process made on the timber structure that holds up the vault of the Diplomatic Room of the Royal Palace in Naples (Italy. After a brief historical description of the Royal Palace and the Diplomatic Room, it discusses the methodology according to Italian regulations and the speci­fic problems that arose during the works. To complete the diagnosis, a dendrochronological analysis of the wooden elements was performed. The results show the residual mechanical properties of each structural element and the main problems to be resolved by the restorers. The dendrochronological conclusions yield that the dating of the elements is compatible with that of the frescoes on the vault and therefore demonstrate that the elements have not been replaced.

  6. Identification of genes related to high royal jelly production in the honey bee (Apis mellifera) using microarray analysis. (United States)

    Nie, Hongyi; Liu, Xiaoyan; Pan, Jiao; Li, Wenfeng; Li, Zhiguo; Zhang, Shaowu; Chen, Shenglu; Miao, Xiaoqing; Zheng, Nenggan; Su, Songkun


    China is the largest royal jelly producer and exporter in the world, and high royal jelly-yielding strains have been bred in the country for approximately three decades. However, information on the molecular mechanism underlying high royal jelly production is scarce. Here, a cDNA microarray was used to screen and identify differentially expressed genes (DEGs) to obtain an overview on the changes in gene expression levels between high and low royal jelly producing bees. We developed a honey bee gene chip that covered 11,689 genes, and this chip was hybridised with cDNA generated from RNA isolated from heads of nursing bees. A total of 369 DEGs were identified between high and low royal jelly producing bees. Amongst these DEGs, 201 (54.47%) genes were up-regulated, whereas 168 (45.53%) were down-regulated in high royal jelly-yielding bees. Gene ontology (GO) analyses showed that they are mainly involved in four key biological processes, and pathway analyses revealed that they belong to a total of 46 biological pathways. These results provide a genetic basis for further studies on the molecular mechanisms involved in high royal jelly production.

  7. Identification of genes related to high royal jelly production in the honey bee (Apis mellifera using microarray analysis

    Directory of Open Access Journals (Sweden)

    Hongyi Nie


    Full Text Available Abstract China is the largest royal jelly producer and exporter in the world, and high royal jelly-yielding strains have been bred in the country for approximately three decades. However, information on the molecular mechanism underlying high royal jelly production is scarce. Here, a cDNA microarray was used to screen and identify differentially expressed genes (DEGs to obtain an overview on the changes in gene expression levels between high and low royal jelly producing bees. We developed a honey bee gene chip that covered 11,689 genes, and this chip was hybridised with cDNA generated from RNA isolated from heads of nursing bees. A total of 369 DEGs were identified between high and low royal jelly producing bees. Amongst these DEGs, 201 (54.47% genes were up-regulated, whereas 168 (45.53% were down-regulated in high royal jelly-yielding bees. Gene ontology (GO analyses showed that they are mainly involved in four key biological processes, and pathway analyses revealed that they belong to a total of 46 biological pathways. These results provide a genetic basis for further studies on the molecular mechanisms involved in high royal jelly production.

  8. The Avaldsnes Royal Manor Project’s Research Plan and Excavation Objectives


    Skre, Dagfinn


    This chapter provides an outline of the scholarly problems that the Avaldsnes Royal Manor Project was designed to address, the central theme explored being the political institutions and processes in the first millennium AD. The research plan was developed during the 2007–9 pilot project phase, and was adjusted and supplemented during the 2011–12 excavations and the research and publication phase in the subsequent years. The first of the research plan’s two sections, the results of which are ...

  9. Early examples of art in Scottish hospitals, 2: Crichton Royal Hospital, Dumfries. (United States)

    Park, Maureen


    Fine art has been used in hospitals for centuries. However, Crichton Royal Hospital in Dumfries pioneered the use of art activity in the treatment of its patients. This article is the second of two which look at examples of art created for, and in, Scottish hospitals in the 19th century. It is suggested that the importance of Scotland's contribution to this movement is unrecognized by many of its modern-day practitioners.

  10. The Phenotypic Effects of Royal Jelly on Wild-Type D. melanogaster Are Strain-Specific


    Morgan, Stefanie L.; Seggio, Joseph A.; Nascimento, Nara F.; Huh, Dana D.; Hicks, Jasmin A.; Sharp, Katherine A.; Axelrod, Jeffrey D.; Wang, Kevin C.


    The role for royal jelly (RJ) in promoting caste differentiation of honeybee larvae into queens rather than workers is well characterized. A recent study demonstrated that this poorly understood complex nutrition drives strikingly similar phenotypic effects in Drosophila melanogaster, such as increased body size and reduced developmental time, making possible the use of D. melanogaster as a model system for the genetic analysis of the cellular mechanisms underlying RJ and caste differentiatio...

  11. Serving the medicinal chemistry community with Royal Society of Chemistry cheminformatics platforms


    Williams, Antony


    The Royal Society of Chemistry (RSC) is a major participant in providing access to chemistry related data via the web. As an internationally renowned society for the chemical sciences, a scientific publisher and the host of the ChemSpider database for the community, RSC continues to make dramatic strides in providing online access to data. ChemSpider provides access to over 30 million chemicals sourced from over 500 data suppliers and linked out to related information on the web. The platform...

  12. The Zoonotic Implications of Pentastomiasis in the Royal Python (Python Regius)


    Ayinmode, AB; Adedokun, AO; Aina, A; Taiwo, V


    Pentastomes are worm-like endoparasites of the phylum Pentastomida found principally in the respiratory tract of reptiles, birds, and mammals. They cause a zoonotic disease known as pentastomiasis in humans and other mammals. The autopsy of a Nigerian royal python (Python regius) revealed two yellowish-white parasites in the lungs, tissue necrosis and inflammatory lesions. The parasite was confirmed to be Armillifer spp (Pentastomid); this is the first recorded case of pentastomiasis in the r...

  13. Royal Observatory extension will teach the wonder of the night sky

    CERN Multimedia

    Jury, L


    "The Royal Observatory in Greenwich is gearing up for a massive pounds 15m extension next year, to capitalise on growing interest in outer space. A Victorian building which has been used for administration for decades is to be renovated, with new galleries and a 120-seat planetarium to treble the space for visitors to gaze at the stars. The Observatory hopes to complete the extension by 2007" (1 page).

  14. Royal Order of 28 March 1969 listing occupational diseases giving rise to compensation

    International Nuclear Information System (INIS)


    This Royal Order, made in implementation of the Act of 24 December 1963 on compensation for damage resulting from occupational diseases and prevention thereof, as amended by an Act fo 24 December 1968, lists the occupational diseases giving rise to compensation and includes those caused by ionizing radiations. The Order came into force on 1 July 1969 and repealed a previous Order of 18 January 1964 which laid down a first list of such diseases giving rise to compensation. (NEA) [fr

  15. Resource recovery. A report for the Royal Commission of Environmental Pollution

    Energy Technology Data Exchange (ETDEWEB)


    A report for the Royal Commission on Environmental Pollution describes the key factors influencing the level of resource recovery in the UK and compares the level in other European countries and the US. Aspects covered include waste paper, oils and batteries, cost allocation, waste disposal cost and charges, separation of waste streams and energy from waste. Finally the report identifies a number of specific areas where action might be taken to increase resource recovery. (UK).

  16. Making public ahead of print: Meetings and publications at the Royal Society, 1752?1892


    Fyfe, Aileen; Moxham, Noah


    This essay examines the interplay between the meetings and publications of learned scientific societies during the eighteenth and nineteenth centuries, when journals were an established but not yet dominant form of scholarly communication. The practice of ‘making public’ research at meetings, long before actual ‘publication’ in society periodicals, enabled a complex of more-or-less formal sites of communication and discussion ahead of print. Using two case studies from the Royal Society of Lo...

  17. Ground water for public water supply at Windigo, Isle Royale National Park, Michigan (United States)

    Grannemann, N.G.; Twenter, F.R.


    Three test holes drilled at Windigo in Isle Royale National Park in 1981 indicate that the ophitic basaltic lava flows underlying the area contain little water and cannot be considered a source for public water supply. The holes were 135, 175, and 71 feet deep. One hole yielded about 1 gallon of water perminute; the other two yielded less. Glacial deposits seem to offer the best opportunity for developing a ground-water supply of 5 to 10 gallons per minute.

  18. Informing Royal Navy People Strategy: Understanding Career Aspirations and Behaviours of Naval Personnel


    Bewley, Elizabeth Emma; Royal Navy (Great Britain); Ministry of Defence (Great Britain)


    Following a series of imposed redundancies in the Royal Navy (RN) there was a need to understand the career desires of remaining personnel and how these interact with important organisational behaviours and turnover. Taking a social psychology perspective, this thesis addresses criticisms over the high use of non-working populations in research and provides the first empirical evidence for the utility, applicability and relevance of specific psychological theories to the RN. Chapter 2 explore...

  19. Readability and the Production of Instructional Text in the Royal Navy, (United States)


    images became blurred. A finding of particular irrpor- tance for the Royal Navy was by Brand et al [6]. They found that the actual movemnt or rotion of a...Organisation 3. Headings 4. Typography 5. Clarity of words 6. Questions 7. Clarity of structure 8. Complex material 9. Illustrations 10. Colour 11...Illustrations, Tables, Graphs and Charts. (Hartley 1978) - 6B - 4. Typography Legibility is the most important factor in the printed page. Before any significance

  20. Effect of Royal Jelly on Improving Passive Avoidance Learning and Spatial Learning and Memory in Rats

    Directory of Open Access Journals (Sweden)

    H Alaei


    Full Text Available Introduction: Studies have proposed that royal jelly(RJ has various biological activities in different cells and tissues. Since it has been demonstrated that RJ contains compounds having desirable effects on central neurons system and neural functions, the present study aimed to investigate the effect of royal jelly on learning and memory in rats. Methods: Male wistar rats were divided into two groups, the royal jelly and the control. In the RJ group, the rats received a food that contained 3% RJ instead of regular food for 10 days. Then learning and memory were investigated in these animals through both passive avoidance learning test(1 day and 1 week after receiving electrical shock and Morris water maze test(1 day and 1 week after a 4-day learning period. Results: The study results indicated that the food containing RJ in the RJ group significantly increased the time of the first entrance to the dark room one week after the electrical shock in passive avoidance learning test. In other words, the findings suggest an improvement of learning and memory in RJ group. In the acquisition phase of Morris water maze test, rats receiving RJ found the underwater escape plate during less time and distance comparing with the control group. Furthermore, one week after the acquisition phase, in the retention phase, rats spent more time in the quadrant in which the escape plate was previously located. Conclusion: The present study findings propose that Royal Jelly can improve cognitive processes through positive effects on neural functions and probably has a significant influence on prevention and therapy of some neuronal disorders.

  1. Incidence of Boxing Injuries in the Royal Air Force in the United Kingdom 1953—66 (United States)

    Brennan, T. N. N.; O'Connor, P. J.


    Statistics of injuries arising in amateur boxing in the Royal Air Force in the 14 years 1953-66 are given. There were 240 injuries including two deaths in the 14 years. During the seven years 1960-66, four men out of every thousand entering the ring received injuries to the head or neck which kept them off work for 48 hours or more. No case of the punch-drunk syndrome was seen. PMID:5723355

  2. The factors that influence job satisfaction among royal Malaysian customs department employee (United States)

    Ammar Shafi, Muhammad; Saifullah Rusiman, Mohd; Nor, Maria Elena; Khamis, Azme; Nabilah Syuhada Abdullah, Siti; Syafiq Azmi, Mohd; Sakinah Zainal Abidin, Munirah; Ali, Maselan


    This research aims to spot the factors that influence job satisfaction among Royal Malaysian Customs Department employees. Primary data was used in this research and it was collected from the employees who work in five different departments at Royal Malaysian Customs Department Tower Johor. Those departments were customs department, Internal Taxes, Technical Services, Management and Prevention. The research used stratified random sampling to collect the sample and Structural Equation Modelling (SEM) to measure the relationship between variables using AMOS software. About 127 employees are selected as the respondents from five departments to represent the sample. The result showed that ‘Organizational Commitment’ (p-value = 0.001) has significant and direct effect toward job satisfaction compared to the ‘Stress Condition’ (p-value = 0.819) and ‘Motivation’ factor (p-value = 0.978). It was also concluded that ‘Organizational Commitment’ was the most influential factor toward job satisfaction among Royal Malaysian Customs Department employees at Tower Custom Johor, Johor Bahru.

  3. Evaluation and review of the safety management system implementation in the Royal Thai Air Force (United States)

    Chaiwan, Sakkarin

    This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.


    Directory of Open Access Journals (Sweden)

    Asep Rijwan


      Abstrak - Masalah yang di teliti adalah bagaimana pendelegasian tugas kepadatraineedi main kitchen, bagaimana standar operasional prosedur pendelegasian tugas kepada trainee di main kitchen, serta bagaimana kesempatan dan peluang dari pendelegasian tugas kepada trainee di main kitchen.  Dalam hal pengolahan data, penulis menggunakan analisis deskriptif, yaitu metode yang berusaha mengumpulkan data dan sesuai dengan keadaan yang sebenarnya, menyajikan serta menganalisanya sehigga dapat memberikan gambaran yang cukup jelas atas objek yang diteliti dan kemudian di ambil kesimpulannya. Berdasarkan hasil observasi ini dapat disimpulkan bahwa pendelegasian tugas kepada trainee di Main Kitchen Grand Royal Panghegar Hotel sudah dilaksanakan dengan sangat baik, hal ini dapat dilihat dengan di selesaikannya delegasi tugas dengan baik pula oleh trainee. Standar operasional prosedur pendelegasian kepada trainee di Main Kitchen Grand Royal Panghegar Hotel sudah baik, hal ini dapat dilihat bahwa trainee dapat melaksanakan kegiatan- kegiatan yang ada di main kitchen dengan baik pula. Peluang dari pendelegasian tugas kepada trainee di Main Kitchen Grand Royal Panghegar Hotel menjadikan trainee lebih percaya diri, memiliki pengalaman baru dalam mengolah makanan, lebih meningkatnya skill trainee, dan memiliki pengetahuan yang lebih dari sebelumnya, dan staff pun tidak akan mendapat terlalu banyak beban pekerjaan, karena sebagian dapat dikerjakan oleh trainee dengan baik. Berdasarkan dari hasil observasi dan pembahasan tersebut, penulis menyimpulkan bahwa apabila standar operasional prosedur pendelegasian kepada Trainee dijalankan dengan baik, maka selain berdampak baik kepada trainee akan berdampak baik pula kepada staff atau hotel itu sendiri.

  5. The Australian Royal Commission into Institutional Responses to Child Sexual Abuse: Dreaming of Child Safe Organisations?

    Directory of Open Access Journals (Sweden)

    William Budiselik


    Full Text Available On 12 November 2012 the then Australian Prime Minister Julia Gillard announced she was recommending to the Governor General the establishment of a Royal Commission into Institutional Responses to Child Sexual Abuse. Following inquiries in Australia and elsewhere much is already known about institutional and inter-institutional child protection failures and what is required to address them. That Australia’s national government has pursued another abuse inquiry with terms of reference limited to institution-based (excluding the family sexual abuse is of interest given the lack of political will to enact previous findings and recommendations. This article examines the background to the Government’s announcement, the Commission’s terms of reference and some of its settings, and literature on the nature of royal commissions across time and place. After the lack of success in implementing the recommendations of previous inquiries into how to better protect Australia’s children, the question is: how will this Royal Commission contribute to Australian child protection and safety? Will the overwhelming public support generated by “truth speaking to power” in calling for this inquiry translate into action?

  6. The Australian Royal Commission into Institutional Responses to Child Sexual Abuse. (United States)

    Wright, Katie; Swain, Shurlee; McPhillips, Kathleen


    The Royal Commission into Institutional Responses to Child Sexual Abuse is the largest royal commission in Australia's history and one of the largest public inquiries into institutional child abuse internationally. With an investment from the Australian government of half a billion dollars, it examined how institutions with a responsibility for children, both historically and in the present, have responded to allegations of child sexual abuse. Announced in the wake of previous Australian and international inquiries, public scandals and lobbying by survivor groups, its establishment reflected increasing recognition of the often lifelong and intergenerational damage caused by childhood sexual abuse and a strong political commitment to improving child safety and wellbeing in Australia. This article outlines the background, key features and innovations of this landmark public inquiry, focusing in particular on its extensive research program. It considers its international significance and also serves as an introduction to this special edition on the Australian Royal Commission, exploring its implications for better understanding institutional child sexual abuse and its impacts, and for making institutions safer places for children in the future. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. The efficacy of topical Royal Jelly on diabetic foot ulcers healing: A case series

    Directory of Open Access Journals (Sweden)

    Mansour Siavash


    Full Text Available Background: Foot ulcers and infections are the major sources of morbidity in individuals with diabetes mellitus. This study aimed to evaluate the efficacy of topical Royal Jelly (a worker honey bee product on healing diabetic foot ulcers. Methods: Diabetic patients with foot ulcers that were referred to our clinic at Khorshid Hospital, Isfahan, Iran; were evaluated three times a week and treated according to standard treatments consisted of offloading, infection control, vascular improvement and debridement if required. In addition, all ulcers were measured and then topical sterile 5% Royal Jelly was applied on the total surface area of the wounds. Eventually, they were covered with sterile dressings. Each patient was followed for a period of three months or until the complete healing. Results: A total of eight patients were enrolled in this study. Of these, two had two ulcers and, therefore, ten ulcers were evaluated. Two ulcers were excluded. Seven of the remained eight ulcers healed. Mean duration of complete healing was 41 days. One ulcer did not completely heal but improved to 40% smaller in length, 32% in width and 28% in depth. The mean length, width and depth reduction rates were 0.35 mm/day, 0.28 mm/day and 0.11 mm/day, respectively. Conclusions: Royal Jelly dressing may be an effective method for treating diabetic foot ulcers besides standard treatments.

  8. 3D Surgical Simulation (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael


    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  9. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff


    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  10. In the Service of the King. Concerning Royal Diplomatic Letters in the Crown of Aragon (1336-1458

    Directory of Open Access Journals (Sweden)

    María Luz Mandingorra Llavata


    Full Text Available The aim of this paper is to reconstruct the morphological evolution of the royal diplomatic letter in the Crown of Aragon between the reigns of Peter the Ceremonious and Alfonso the Magnanimous. During this period, the form taken by this document was adapted to its contents and those in receipt of it, according to the principles of the Ars dictaminis, without relinquishing its material and textual simplicity in the process. With its adaptation to the communicative requirements of the monarchy, the royal diplomatic letter became an instrument of governance that helped to strengthen royal power and anticipated mechanisms that would be fully developed during the Early Modern Period.

  11. College Student Migration. (United States)

    Fenske, Robert H.; And Others

    This study examines the background characteristics of two large national samples of first-time enrolled freshmen who (a) attended college within their state of residence but away from their home community, (b) migrated to a college in an adjacent state, (c) migrated to a college in a distant state, and (d) attended college in their home community.…

  12. College Student Suicide (United States)

    Taub, Deborah J.; Thompson, Jalonda


    Suicide is the second-leading cause of death among college students, and it is estimated that 1,088 college students die by suicide each year (National Mental Health Association and the Jed Foundation, 2002). This chapter presents the context of college student mental health within which the problem of college student suicide is situated. Because…

  13. Surviving Math, Surviving College (United States)

    Schaffhauser, Dian


    According to a 2000 community college study by Miami Dade College (FL) President Emeritus Robert McCabe, 41 percent of students entering community colleges are underprepared in at least one basic skill area. A three-year study of community college students, published in 2009 by the National Center for Education Statistics, reported that 41 percent…


    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai


    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  15. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.


    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  16. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S


    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  17. [Surgical therapy of gynecomastia]. (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A


    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  18. Surgical manifestations of filariasis

    Directory of Open Access Journals (Sweden)

    Subrahmanyam M


    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  19. Improving surgical weekend handover. (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine


    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  20. [Surgical complications of colostomies]. (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam


    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  1. Canine Supply for Physical Security: An Analysis of the Royal Australian Air Force Military Working Dog Program (United States)


    PHYSICAL SECURITY: AN ANALYSIS OF THE ROYAL AUSTRALIAN AIR FORCE MILITARY WORKING DOG PROGRAM by Mark W. Powell March 2016 Thesis...AN ANALYSIS OF THE ROYAL AUSTRALIAN AIR FORCE MILITARY WORKING DOG PROGRAM 5. FUNDING NUMBERS 6. AUTHOR(S) Mark W. Powell 7. PERFORMING...increased demand on its physical security elements. Its military working dog (MWD) workforce is required to meet an inventory of 204 by end of year 2023 as

  2. Personal Qualities and College Admissions. (United States)

    Willingham, Warren W.; Breland, Hunter M.

    The extent to which personal and academic factors are important in college admission decisions was studied in 1978, based on data on 25,000 applicants to 9 colleges (Colgate University, Williams College, Ohio Wesleyan University, Kenyon College, Kalamazoo College, Occidental College, Hartwick College, University of Richmond, and Bucknell…

  3. [da Vinci surgical system]. (United States)

    Watanabe, Gou; Ishikawa, Norihiro


    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  4. An Overview of Ecological Footprinting and Other Tools and Their Application to the Development of Sustainability Process: Audit and Methodology at Holme Lacy College, UK (United States)

    Dawe, Gerald F. M.; Vetter, Arnie; Martin, Stephen


    A sustainability audit of Holme Lacy College is described. The approach adopted a "triple bottom line" assessment, comprising a number of key steps: a scoping review utilising a revised Royal Institution of Chartered Surveyors project appraisal tool; an environmental impact assessment based on ecological footprinting and a social and…

  5. Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models. (United States)

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


    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.

  6. [Nahabed Roussignan, the first professor of deontology at the Royal School of Medicine]. (United States)

    Yildirim, N


    This study based on researches utilizing the American and Ottoman sources, deals with the claim upon the lectures given by Roussignan (Rusinyan Efendi), especially at the Royal School of Medicine and describes his medical career as follows. Nahabed Roussignan who graduated from Paris School of Medicine in 1849, returned to Istanbul in 1851 and was appointed as the private physician to Fuad Pasha, upon the request of Dr. Serviçen. In the meantime he worked at the Bab-i Seraskeri Hastanesi (the Hospital of the Military Ministry) until 1860 and also started to work at the Military High School as a doctor of medicine. As to the Royal School of Medicine, he taught pathological anatomy between 1864-1872. There are not any records to prove his being a faculty member during this year. He was probably in financial shortage because of unemployment during that year, as stated by Artin Mezbour. The following year he was employed at in the School of Medicine again, through his friends' support. this time he taught logic and French composition between 1874-1876 and instructed deontology for a little while in 1876. He collected his lectures on logic as a Textbook of Philosophy. He passed away in the same week, so this book was published posthumously (Istanbul 1879). Since he died on November 29th 1876, at the end of the year, his name was included in the State Yearbook of 1877, but was misspelled as "Rüsteban". To sum up, deontology as an independant discipline at the Royal School of Medicine began to be lectured for the first time by N. Roussignan in 1876, and succeeding his death these lectures were taken over by Dr. Hovsep Nouridjan (Nurican Efendi). Istepan Arslanian, who was claimed to be the lecturer of these courses after Roussignan, was in Rumelie during 1875-1876 and employed in Austria in 1877; therefore he could never have taught deontology during this period.

  7. CLEP college mathematics

    CERN Document Server

    Friedman, Mel


    Earn College Credit with REA's Test Prep for CLEP* College Mathematics Everything you need to pass the exam and get the college credit you deserve.CLEP* is the most popular credit-by-examination program in the country, accepted by more than 2,900 colleges and universities. For over 15 years, REA has helped students pass the CLEP* exam and earn college credit while reducing their tuition costs. Our test prep for CLEP* College Mathematics and the free online tools that come with it, allow you to create a personalized CLEP* study plan that can be customized to fit you: your schedule, your lea

  8. Effect of royal jelly ingestion for six months on healthy volunteers

    Directory of Open Access Journals (Sweden)

    Morita Hiroyuki


    Full Text Available Abstract Background Royal jelly is a widely ingested supplement for health, but its effects on humans are not well known. The objective was to evaluate the effects of long-term royal jelly ingestion on humans. Methods We conducted a randomized placebo-controlled, double-blind trial. A total of 61 healthy volunteers aged 42-83 years were enrolled and were randomly divided into a royal jelly group (n = 31 and a control group (n = 30. Three thousand mg of royal jelly (RJ or a placebo in 100 ml liquid/day were ingested for 6 months. The primary outcomes were changes in anthropometric measurements and biochemical indexes from baseline to 6 months after intervention. Results Thirty subjects in the RJ group and 26 in the control group were included in the analysis of endpoints. In an adjusted mean change of the variables from the baseline, significant differences between the two groups could be found in red blood cell counts (+0.16x106 /μL for the RJ group vs. -0.01x106 /μL for the control group, P = 0.0134, hematocrit (+0.9% vs. -0.8%, P = 0.0251, log (fasting plasma glucose (+0.01 ± 0.01 log mg/dL vs. +0.05 ± 0.01 log mg/dL, P = 0.0297, log (insulinogenic index (+0.25 vs. -0.13, P = 0.0319, log dehydroepiandrosterone sulfate (DHEA-S (+0.08 log μg/dL vs. +0.20 log μg/dL, P = 0.0483, log testosterone (T (+0.12 ± 0.04 log ng/mL vs. -0.02 ± 0.05 log ng/mL, P = 0.0416, log T/DHEA-S ratio (+0.05 ± 0.05 vs. -0.23 ± 0.59, P = 0.0015, and in one of the SF-36 subscale scores, mental health (MH (+4 vs. -7, P = 0.0276. Conclusions Six-month ingestion of RJ in humans improved erythropoiesis, glucose tolerance and mental health. Acceleration of conversion from DHEA-S to T by RJ may have been observed among these favorable effects.

  9. Royal Order of 12 December 1975 setting up a National Energy Committee

    International Nuclear Information System (INIS)


    The National Energy Committee was set up by Royal Order of 12 December 1975. Its duties are to advise on the general objectives of energy policy and its implementation. It supervises execution of the policy and makes recommendations on matters within its competence. The Committee is chaired by the Minister for Economic Affairs and Energy and is composed of representatives of the Government, trade unions, undertakings, consumers, gas and electricity committees, oil and coal industries and a delegate of the Planning Department. This Order repeals the Order of 17 July 1957 creating an Energy Advisory Council. (NEA) [fr

  10. A short history of the Royal Odonto Chirurgical Society of Scotland. (United States)

    Geissler, Paul R


    In the mid-19th Century, the practice of dentistry in Britain was unregulated and chaotic. Organised training was non-existent, and the public was unable to be assured of satisfactory, ethical treatment. A group of Scottish practitioners, led by John Smith, an Edinburgh surgeon, established the Odonto Chirurgical Society of Scotland in 1867 as an ethical dental society promoting education and regulation of the emerging profession. The Society has prospered over the years. It was granted the title "Royal" on the occasion of its centenary in 1967, and approaches its 150th year with confidence.

  11. Longevity extension of worker honey bees (Apis mellifera) by royal jelly: optimal dose and active ingredient


    Yang, Wenchao; Tian, Yuanyuan; Han, Mingfeng; Miao, Xiaoqing


    In the Western honey bee, Apis mellifera, queens and workers have different longevity although they share the same genome. Queens consume royal jelly (RJ) as the main food throughout their life, including as adults, but workers only eat worker jelly when they are larvae less than 3 days old. In order to explore the effect of RJ and the components affecting longevity of worker honey bees, we first determined the optimal dose for prolonging longevity of workers as 4% RJ in 50% sucrose solution,...

  12. The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning. (United States)

    Faye, M


    This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

  13. Royal Decree-Law 1302/1986 of 28 June 1986 on environmental impact studies

    International Nuclear Information System (INIS)


    This Royal Decree-Law (No 1302/1986) of 28th June 1986 was published in the Official Gazette of 30th June 1986. The purpose of this Decree-Law is to provide for assessments of the environmental impact of certain projected installations and activities. The installations and activities requiring environmental impact studies are listed in the Annex to the Decree-Law and include nuclear power plants and other nuclear reactors (excluding those whose thermal power does not exceed 1 kW) as well as installations for the disposal and final storage of radioactive waste (NEA) [fr

  14. Un siècle de chimie à l'Académie royale des sciences


    Coorebyter, Vincent de; Decaix, Véronique; Franckowiak, Rémi; Francobandiera, Daria; Ierna, Carlo; Jolly, Edouard; Joly, Bernard; Joly, Bernard; Joly, Bernard; Joly, Bernard; Lehman, Christine; Masselot, Nathanaël; Mazet, Edmond; Parmentier, Marc; Parmentier, Marc


    Le laboratoire alchimique, lieu privilégié de l’élaboration de la chimie ancienne, symbolisait à la fois le caractère privé, si ce n’est secret, de cette science et sa nécessaire articulation avec une pratique qui lui donnait son sens : il ne s’agissait pas seulement de trouver la pierre philosophale, mais aussi de fabriquer médicaments et substances chimiques répondant à des demandes sociales. L’introduction de la chimie parmi les « classes » de l’Académie royale des sciences va transformer ...

  15. Slim 198gold-grain implanter loaded with standard royal marsden 14-grain magazines

    International Nuclear Information System (INIS)

    Delclos, L.; Moore, E.B.


    We designed a slim gold-grain implanter with adaptable lengths to implant areas accessible only through long, narrow, examining instruments, such as a suspension laryngoscope. The implanter is loaded with the same 14-grain magazine designed for and supplied with the Royal Marsden gun. The simplicity of the loading mechanism with a minimum of moving parts makes the instrument practically trouble free. Although it is designed to be used along narrow examining instruments, it can also be used in any situation in which a permanent implant is required, for instance, prostatic cancer and pelvic recurrences in cancer of the uterine cervix previously treated by external and intracavitary irradiation

  16. Factors impacting on employee performance: A case study of the royal Swaziland police service

    Directory of Open Access Journals (Sweden)

    Nirmala Dorasamy


    Full Text Available The principal challenge for most organisations is to ensure that the performance of employees will result in the effectiveness and success of any organisation. The Royal Swaziland Police Service (RSPS, in order to differentiate itself from other organisations and ensure survival effectiveness and competitiveness, must render services of high quality. The key findings of the RSPS study suggest that the most positive factors of job satisfaction are receiving respect from the community and relations with colleagues, while the negative aspects are that salaries are not equal to effort put into the job and fear of victimization after voicing a personal opinion.

  17. RICH – A new AMS facility at the Royal Institute for Cultural Heritage, Brussels, Belgium

    Energy Technology Data Exchange (ETDEWEB)

    Boudin, Mathieu; Van Strydonck, Mark; Brande, Tess van den [Royal Institute for Cultural Heritage, Jubelpark 1, 1000 Brussels (Belgium); Synal, Hans-Arno; Wacker, Luckas [Laboratory of Ion Beam Physics, ETH Zurich, 8093 Zurich (Switzerland)


    Since 1989 the radiocarbon dating lab has their own graphitization system for {sup 14}C AMS dating but RICH (Royal Institute for Cultural Heritage) did not possess their own AMS and measurements were carried out in collaboration with other AMS facilities. In April 2013 the Micadas (Mini Carbon Dating System) AMS was installed at RICH in Brussels and after 1.5 year operation the high stability and performance of the Micadas can be demonstrated by repeated analyses of primary standard OXA II and secondary standards. Results of unknown samples measured on the RICH–Micadas and on other AMS systems are in good agreement.

  18. Viva Voce in Postgraduate Surgical Examinations in Anglophone West Africa


    Bode, CO; UGWU, BT; DONKOR, P


    The Viva Voce is a form of assessment dating back to antiquity. It is widely used by the English-speaking West African Postgraduate Medical Colleges for intermediate and exit level examinations. Although it is still popular till the present day, there is a growing awareness of its limitation as an examination method. This paper explores the origin, format, advantages and limitations of oral examinations in postgraduate surgical assessment and proffers practical guidelines on its usage.

  19. Viva voce in postgraduate surgical examinations in anglophone west Africa. (United States)

    Bode, Co; Ugwu, Bt; Donkor, P


    The Viva Voce is a form of assessment dating back to antiquity. It is widely used by the English-speaking West African Postgraduate Medical Colleges for intermediate and exit level examinations. Although it is still popular till the present day, there is a growing awareness of its limitation as an examination method. This paper explores the origin, format, advantages and limitations of oral examinations in postgraduate surgical assessment and proffers practical guidelines on its usage.

  20. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

  1. Improving surgical weekend handover


    Culwick, Caroline; Devine, Chris; Coombs, Catherine


    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  2. Acquiring minimally invasive surgical skills


    Hiemstra, Ellen


    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  3. Robotic surgical training. (United States)

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


    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.

  4. Surgical experts: born or made? (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger


    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel


    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  6. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  7. American College Health Association (United States)

    ... a robust series of courses leading to a brand new certification – the College Health and Wellness Professional ( ... future college health and wellness professionals, and strengthen awareness of the profession and association. Each month we' ...

  8. Depression and College Students (United States)

    ... depression and other mental health issues? Reference Share Depression and College Students Download PDF Download ePub Order ... Answers to college students’ frequently asked questions about depression Feeling moody, sad, or grouchy? Who doesn’t ...

  9. College Information Needs. (United States)

    Cibik, Margaret A.


    A survey of a sampling of college-bound high school seniors in Arizona was undertaken to determine students' information needs for college choice. Items, including institutional, student, and program characteristics, are ranked in order of perceived importance. (MSE)

  10. College Women's Health (United States)

    ... Health - Learn the facts about HPV, HIV, and birth control. College Women's Social Media Toolkit - Share health tips with your campus community. College Women's Campaign - Find out how your school can join. Sign up for email alerts. Order ...

  11. The library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library. (United States)

    Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E


    The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that "medical" libraries, if they survive, in due course become primarily "medical history" libraries. Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials-and personal experience with the collection-to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. The story told here is of how a particular nineteenth-century library became a twenty-first-century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.

  12. Making Kew Observatory: the Royal Society, the British Association and the politics of early Victorian science. (United States)

    Macdonald, Lee T


    Built in 1769 as a private observatory for King George III, Kew Observatory was taken over in 1842 by the British Association for the Advancement of Science (BAAS). It was then quickly transformed into what some claimed to be a 'physical observatory' of the sort proposed by John Herschel - an observatory that gathered data in a wide range of physical sciences, including geomagnetism and meteorology, rather than just astronomy. Yet this article argues that the institution which emerged in the 1840s was different in many ways from that envisaged by Herschel. It uses a chronological framework to show how, at every stage, the geophysicist and Royal Artillery officer Edward Sabine manipulated the project towards his own agenda: an independent observatory through which he could control the geomagnetic and meteorological research, including the ongoing 'Magnetic Crusade'. The political machinations surrounding Kew Observatory, within the Royal Society and the BAAS, may help to illuminate the complex politics of science in early Victorian Britain, particularly the role of 'scientific servicemen' such as Sabine. Both the diversity of activities at Kew and the complexity of the observatory's origins make its study important in the context of the growing field of the 'observatory sciences'.

  13. The 'royal disease'--haemophilia A or B? A haematological mystery is finally solved. (United States)

    Lannoy, N; Hermans, C


      'History can change blood. And blood can change the course of history'. Haemophilia is an illustration of this, as this congenital hereditary coagulation disorder, passed through the majority of royal European families at the beginning of the 20th century by Queen Victoria of England and Empress of the Indies, had indisputable political consequences, which led to one of the most defining moments of contemporary history: the Bolshevik Revolution. Today, none of Queen Victoria's living descendents carry haemophilia. Because of this, the characterization of haemophilia (deficit of either factor VIII or XI) and the identification of the causal mutation are rendered impossible. In 1991, a tomb containing the remains of Czar Nicolas II's entire family was discovered. A second tomb was discovered in 2007, allowing Russian and American scientists to fill in this gap in medical history. Following a scientific approach combining current genetic experimentation tools and the development of biological information technology, researchers were able to identify each body, allowing them to obtain precious genetic material from the young Czar Alexis, who was stricken by the disease, which revealed a causal substitution in the splice acceptor site of exon 4 in the F9 gene. This mutation that is responsible for haemophilia B had traumatized European royal families throughout the 20th century! © 2010 Blackwell Publishing Ltd.

  14. [Tuberculosis in the Royal Norwegian Navy at the time of the Second World War]. (United States)

    Ongre, Aksel; Sommerfelt-Pettersen, Jan


    Tuberculosis became a great problem in the Royal Norwegian Navy during the first years of the Second World War (when it operated in allied services mainly from the UK); with the highest incidence (9.6 per 1 000) during the first half of 1943. Main reasons were insufficient medical examination of recruits, crowded living conditions on board (favoured the contagion) and the physical and psychological pressure during sea operations, which may have reduced the immune defence. Prophylactic measures in terms of tuberculin testing of all personnel, chest X-rays of the positives, vaccination of the negatives, environment investigation when disease was discovered, and isolation of those infected, gave control from the second half of 1943 and onwards. The article also mentions treatment, repatriation and the incidence of tuberculosis in the Norwegian Navy before and after the war as well as in the Royal Canadian Naval Services (where the incidence was low) during the war. Today, the tuberculosis situation in Norway is so favourable that routine chest X-ray of the recruits is no longer performed in the armed forces.

  15. Molecular genetic analysis on the remains of the Dark Countess: Revisiting the French Royal family. (United States)

    Parson, Walther; Berger, Cordula; Sänger, Timo; Lutz-Bonengel, Sabine


    The "Dark Counts" were a mysterious couple that appeared in the Thuringian village Eishausen in 1807. After living in self imposed solitude for 30 years the woman died and was buried under the name Sophia Botta. Her companion, who presented himself as Vavel de Versay, died in 1845 and was later identified as Leonardus Cornelius van der Valck, secretary of the Dutch embassy in Paris. Their lifestyle led to speculations that she was the true princess Marie Thérèse Charlotte of France, daughter of Louis XVI and Marie Antoinette. According to these speculations she was substituted by another young woman on a voyage from Paris to Vienna. Molecular genetic analyses were set out to test the remains attributed to the Dark Countess. Mitochondrial DNA testing brought concordant results determined in two forensic laboratories (Innsbruck, Austria and Freiburg, Germany) on parallel samples of the remains. The results were in exclusion to both, the mitochondrial lineage earlier reported for the French Royal family and the mitochondrial haplotype observed in a living descendant of the Royal family. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Introducing Union Representation and Its Complexities – A Case Study of the Royal Thai Civil Service

    Directory of Open Access Journals (Sweden)

    Maarten Pontier


    Full Text Available This paper deals with the result of the recognition under the ILO Conventions 87 and 98 of the freedom of association and subsequent introduction of union representation in the Royal Thai civil service. As a consequence, the Royal Thai Government has changed the Constitution to allow for union representation in its civil service. A decree has been drafted and focus groups have been interviewed to establish the views of a cross-section of civil servants on their expectations and desires in being allowed to form and join a union. The paper discusses the approach taken to union representation in terms of collective bargaining versus joint consultation and centralization versus decentralization and the discourse that has surfaced as a result of the interviews between the policy makers and civil servants, particularly with regard to its context of a high power distance culture. The analysis provides the best practice and effective approach to the introduction of union representation within the Thai Civil Service.

  17. College Access Marketing (United States)

    Tremblay, Christopher W.


    College Access Marketing (CAM) is a relatively new phenomenon that seeks to positively influence the college-going rate. This report defines CAM, describes CAM examples, and discusses how CAM seeks to counter barriers to college. It explores four main elements of CAM: information, marketing, advocacy, and social mobilization. Further, it…

  18. American Indian Community Colleges. (United States)

    One Feather, Gerald

    With the emergence of reservation based community colleges (th Navajo Community College and the Dakota Community Colleges), the American Indian people, as decision makers in these institutions, are providing Indians with the technical skills and cultural knowledge necessary for self-determination. Confronted with limited numbers of accredited…

  19. Cash for College. (United States)

    National Association of Student Financial Aid Administrators, Washington, DC.

    This booklet contains answers to questions that students may ask about financial aid for college. The booklet describes the usual costs of college, and suggests ways students can pay for a college education. The types of financial aid available are described, and the application process is outlined. The booklet offers tips for comparing different…

  20. Early College High Schools (United States)

    Dessoff, Alan


    For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

  1. Planning for College Success (United States)

    PEPNet, 2009


    "Planning for College Success" (PCS) is a curriculum model designed by Sharon Downs, M.S., for a course intended to assist deaf and hard of hearing students during their initial introduction to college life. This program allows students to work one-on-one with a counselor to plan for their college success. The program includes short-term goals and…

  2. Cyberbullying in College


    Carlos P. Zalaquett; SeriaShia J. Chatters


    Cyberbullying is commonly presented as affecting K-12 populations. Current research suggests cyberbullying continues in college. A diverse sample of 613 university students was surveyed to study their cyberbullying experiences in high school and college. Nineteen percent of the sample reported being a victim of cyberbullying in college and 35% of this subsample reported being cyberbullied in high school. Additional fin...

  3. Surgical management of hyperthyroidism. (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M


    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  4. [Duane vertical surgical treatment]. (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G


    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  5. Ethylene inhibitor aminoethoxyvinilglycine on glomerella leaf spot in apple cultivar 'Royal Gala' Inibidor de etileno aminoetoxivinilglicina sobre a mancha foliar de 'Glomerella' na cultivar de macieira 'Royal Gala'

    Directory of Open Access Journals (Sweden)

    Amauri Bogo


    Full Text Available Aqueous solution of Aminoethoxyvinylglycine (AVG has been commercialized in Brazil as ReTainTM C, 15% mainly as a potent inhibitor of ethylene biosynthesis by prevention of pre-harvest abscission and ripening of apple fruits. The effect of the product was evaluated during the 2007-08 and 2008-09 crop seasons in edafoclimatic conditions of Santa Catarina upland. Plants of 'Royal Gala' cultivar were sprayed with ReTainTM C, four weeks before the first commercial harvest at doses of 0; 62,5; 125, and 250mg a.i L-1. The incidence and severity were quantified weekly in 100 leaves distributed in four branches with 12 replications and assessed the area under the incidence -I and severity -S disease progress curve (AUIDPC and AUSDPC of Glomerella leaf spot (GLS. The AUIDPC and AUSDPC were significantly higher after AVG application and although there was no significant difference between 125 and 250mg a.i L-1 doses in both 2007-08 and 2008-09 crop seasons. In general, the symptoms of GLS (e.g. chlorosis, necrosis increased between the fourth and eighth week after application.Solução aquosa de Aminoetoxivinilglicina (AVG tem sido comercializada no Brasil como ReTainTM C, 15%, principalmente como um potente inibidor da biossíntese do etileno na prevenção da abscisão e maturação de frutos em macieira. O efeito do produto foi avaliado durante as safras 2007-08 e 2008-09 nas condições edafo-climáticas do planalto Catarinense. Plantas de maçãs 'Royal Gala' foram pulverizadas com o ReTainTM C, quatro semanas antes da primeira colheita comercial, nas concentrações de 0;62,5; 125 e 250mg i.a L-1. A incidência e a severidade foram quantificadas semanalmente em 100 folhas, distribuídas em quatro ramos por plantas, com 12 repetições e calculado a área abaixo da curva do progresso da incidência -I e severidade -S da doença (AACPID e AACPSD. A AACPID e AACPSD foram significativamente maiores após a aplicação do AVG e não houve diferen

  6. Royal Order of 24 May 1977 amending the Royal Order of 28 February 1963 on General Regulations for Protection of the Population and Workers against the Hazards of Ionizing Radiations

    International Nuclear Information System (INIS)


    This Royal Order amends the Royal Order of 28 February 1963, as revised, embodying the General Regulations for the Protection of the Population and Workers against the Hazards of Ionizing Radiations. The amendment refers in particular to the conditions for the direct supply by manufacturers or importers of unsealed radioactive substances, radioisotopes or preparations containing them, to duly authorized physicians, veterinary surgeons and chemists. It also refers to the conditions of use of devices and substances emitting ionizing radiations, as well as to the licensing conditions for holders of isotopes and the qualifications of users. (NEA) [fr

  7. The Royal Society, natural history and the peoples of the 'New World(s)', 1660-1800. (United States)

    Gascoigne, John


    This paper focuses on the response of the Royal Society to the increasing contact with parts of the globe beyond Europe. Such contact was in accord with the programme of Baconian natural history that the early Royal Society espoused, but it also raised basic questions about the extent and nature of the pursuit of natural history. In particular, the paper is concerned with the attention paid to one particular branch of natural history, the study of other peoples and their customs. Such scrutiny of other peoples in distant lands raised basic questions about what methods natural history should employ and the extent to which it could serve as a foundation for more general and theoretical claims. By taking a wide sweep from the beginnings of the Royal Society until the end of the eighteenth century it is hoped light will be shed on the changing understanding of natural history over this period.

  8. From the Activity of ‘Prince Carol’Royal Cultural Foundation 1922-1948 Archive Documents (II

    Directory of Open Access Journals (Sweden)

    Laura Rodica Hîmpă


    Full Text Available This research aims to emphasize the activity of the ‘Prince Carol’ Royal Cultural Foundation created in 1921 in order to lead to the emancipation of villages in particular and of the Romanian culture in a more general perspective. Overall, we may say that the period between the two world wars was marked, also due to the help of the Royal Cultural Foundation, by substantial progress in various fields of education, science and culture in general, and thus contributed to changing Romania into a state with a high level of culture and to creating an image and a prestige of the country that commanded worldwide respect. The research was done on the basis of the documents studied at the Service of the Central National Historical Archives (SANIC, the Stock of the ‘Prince Carol’ Royal Cultural Foundation and at the Library of the Romanian Academy.

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

    Ghanem, Omar M; Heitmiller, Richard F


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

  10. [Surgical treatment of gynecomastia]. (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina


    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  11. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams. (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  12. Sperm abnormality toxicity due to cyclosporine A and the ameliorative effect of royal jelly in male rats

    Directory of Open Access Journals (Sweden)

    Azza M. Gawish


    Full Text Available The immunosuppressive drug, utilized widely in Egypt, cyclosporine A was studied to evaluate its toxicity in male rats. Animals were divided into a control (untreated, 3 groups treated intraperitoneally with 20, 40 and 60 m/kg cyclosporine A for 5, 10 and 15 days, respectively and 3 groups treated intraperitoneally with 20, 40 and 60 mg/kg of cyclosporine A plus 100 mg/kg royal jelly administrated orally. Toxicity evaluation was carried out using two main endpoints: reproductive study (sperm morphology and count abnormalities and biochemical changes in liver and testis (DNA amounts. The aim of this work is to study the protective role of royal jelly against sperm abnormalities in shape and count, and changes in DNA contents in liver and testis tissue induced in rats when treated by cyclosporine A with different doses (20–40–60 mg/kg/day for 5, 10, and 15 days in male rats and how the royal jelly can repair this changes. Our results showed that sperm abnormalities induced by cyclosporine A included deviation from normal shape in head and tail. Abnormal heads contained amorphous head and banana-shaped head, whereas the abnormal tails included divided and coiled tails. It also induced an insignificant effect on the total sperm counts after 5 days of injection with the drug combined with royal jelly. DNA contents were determined in rat liver and testis cells to illustrate the mutagenic effect of cyclosporine A and how the royal jelly can modulate this effect. From these results we concluded that cyclosporine A toxicity was dose and time dependent and should be administrated under special precautions and medical supervision. Using of royal jelly in combination with cyclosporine A drug decreased its toxic effect, so it's considered as protector.

  13. Deposition and cycling of sulfur controls mercury accumulation in Isle Royale fish

    Energy Technology Data Exchange (ETDEWEB)

    Paul E. Drevnick; Donald E. Canfield; Patrick R. Gorski (and others) [Miami University, Oxford, OH (United States). Department of Zoology


    Mercury contamination of fish is a global problem. Consumption of contaminated fish is the primary route of methylmercury exposure in humans and is detrimental to health. Newly mandated reductions in anthropogenic mercury emissions aim to reduce atmospheric mercury deposition and thus mercury concentrations in fish. However, factors other than mercury deposition are important for mercury bioaccumulation in fish. In the lakes of Isle Royale, U.S.A., reduced rates of sulfate deposition since the Clean Air Act of 1970 have caused mercury concentrations in fish to decline to levels that are safe for human consumption, even without a discernible decrease in mercury deposition. Therefore, reductions in anthropogenic sulfur emissions may provide a synergistic solution to the mercury problem in sulfate-limited freshwaters. 71 refs., 3 figs., 1 tab.

  14. The Phenotypic Effects of Royal Jelly on Wild-Type D. melanogaster Are Strain-Specific.

    Directory of Open Access Journals (Sweden)

    Stefanie L Morgan

    Full Text Available The role for royal jelly (RJ in promoting caste differentiation of honeybee larvae into queens rather than workers is well characterized. A recent study demonstrated that this poorly understood complex nutrition drives strikingly similar phenotypic effects in Drosophila melanogaster, such as increased body size and reduced developmental time, making possible the use of D. melanogaster as a model system for the genetic analysis of the cellular mechanisms underlying RJ and caste differentiation. We demonstrate here that RJ increases the body size of some wild-type strains of D. melanogaster but not others, and report significant delays in developmental time in all flies reared on RJ. These findings suggest that cryptic genetic variation may be a factor in the D. melanogaster response to RJ, and should be considered when attempting to elucidate response mechanisms to environmental changes in non-honeybee species.

  15. The report of the Royal Commission into British nuclear tests in Australia

    International Nuclear Information System (INIS)



    The conclusions and recommendations of the Royal commission into British nuclear tests conducted in Australia between 1952 and 1963 are presented. The recommendations include that action should be commenced immediately to effect a clean-up of Maralinga and Emu so that they are fit for unrestricted habitation by the traditional Aboriginal owners as soon as practicable; all costs of any future clean-ups at Maralinga, Emu and the Monte Bello Islands should be borne by the United Kingdom Government; a Maralinga Commission should be established to determine the clean-up criteria, oversee the clean-up and co-ordinate all future Range management; the Australian government should make compensation to those persons and descendants of those persons who have a traditional interest in sites at the former Maralinga Prohibited Area for loss of use and enjoyment of their lands since the beginning, and as a result of the atomic tests program

  16. MANAGEMENT ART - The Royal Danish Opera's Artistic Director Kasper Bech Holten as case

    DEFF Research Database (Denmark)

    Nørreklit, Hanne

    successful Artistic Director of the Royal Danish Opera, Kasper Bech Holten. The analysis shows that conventional management models primarily use the symbolic forms of science and myth, while Kasper integrates the symbolic forms of art and science. In what Kasper has to say on management, features...... and structures for a new management discourse practice emerge which is more suited to postmodern society than more conventional management models.......This article investigates whether it would be expedient for our management models to be inspired by art as a form of consciousness. With this in mind, the article analyses the symbolic forms embedded in the management discourse practice of art in the way that the concept is unfolded by the highly...

  17. Compromises in orchestra pit design: A ten-year trench war in The Royal Theatre, Copenhagen

    DEFF Research Database (Denmark)

    Gade, Anders Christian; Mortensen, Bo


    of opera finally opened the way for a new renovation of the pit, which solved most of the problems. The paper describes the many lessons learned during the ten-year period in which the authors were involved with the case as acoustic consultants. Questions of how pit configuration influences mutual hearing......The ``old stage'' of The Royal Theatre in Copenhagen-a classical horseshoe theatre with an almost flat audience floor and four balcony levels—is the primary opera and ballet theatre in Denmark. In the early 1980s the orchestra pit was enlarged and its size made flexible. However, in the following...... years this new flexibility caused a formal battle between the orchestra, the singers, and management, because each group had different interests as to how the pit should be configured for each new production. In the 1990s, increased concern about the musicians' hearing and the increase in the popularity...

  18. The last Viking King: a royal maternity case solved by ancient DNA analysis

    DEFF Research Database (Denmark)

    Dissing, Jørgen; Binladen, Jonas; Hansen, Anders


    Estridsen to haplogroup H; Estrid's sequence differed from that of Sven at two positions in HVR-1, 16093T-->C and 16304T-->C, indicating that she belongs to subgroup H5a. Given the maternal inheritance of mtDNA, offspring will have the same mtDNA sequence as their mother with the exception of rare cases...... doubts among historians whether the woman entombed was indeed Estrid. To shed light on this problem, we have extracted and analysed mitochondrial DNA (mtDNA) from pulp of teeth from each of the two royals. Four overlapping DNA-fragments covering about 400bp of hypervariable region 1 (HVR-1) of the D...

  19. Comparative Study on Quality Parameters of Royal Jelly, Apilarnil and Queen Bee Larvae Triturate

    Directory of Open Access Journals (Sweden)

    Rodica MARGAOAN


    Full Text Available Given their beneficial effects in terms of health, the natural products, especially beehive products, have drawn the attention of consumers since long time ago. In order to guarantee the quality of these products on the market, their chemical composition needs to be analyzed. Thus, this current research had as objective the establishment of quality parameters for beehive brood food derived products: apilarnil and queen bee larvae triturate. These two products were compared with royal jelly which is the basis of brood food in the first 3 days of larval stage. The carbohydrates were determined by HPLC-IR and allowed the identification of seven carbohydrate compounds, predominantly glucose, fructose and sucrose. The lipid profile was analyzed by the Soxhlet method. The total protein content was determined by the Kjeldahl method. Free amino acids were analyzed by LC-MS. A total of 31 amino acids were identified of which nine are essential amino acids for humans.Â

  20. Key Enablers of Effective Implementation of TQM in Royal Jet Airways

    Directory of Open Access Journals (Sweden)

    Moza Tahnoon Al Nahyan


    Full Text Available Total quality management (TQM is a unified management approach that concentrates on the consecutive improvement of processes, products, and methods to surpass client expectations. This paper aims to highlight the advantages of implementing TQM in the airline industry by examining the key enablers of TQM. This study was based on a research model including six factors that were found to have a profound influence in implementing TQM. The data needed for the study was collected with the aid of questionnaires and secondary sources. The study discovered that procedures, policies, and a culture of knowledge transfer were the most significant enablers of successful TQM initiatives in Royal Jet Airways. In order to effectively implement TQM, the study suggests that management should offer appropriate recognition and rewards to employees. This will motivate them to adopt and practice TQM initiatives. Apart from that, management should also arrange seminars or workshops to accustom the employees to the basic procedures and objectives of effective TQM.

  1. The discovery of microorganisms by Robert Hooke and Antoni Van Leeuwenhoek, fellows of the Royal Society. (United States)

    Gest, Howard


    The existence of microscopic organisms was discovered during the period 1665-83 by two Fellows of The Royal Society, Robert Hooke and Antoni van Leeuwenhoek. In Micrographia (1665), Hooke presented the first published depiction of a microganism, the microfungus Mucor. Later, Leeuwenhoek observed and described microscopic protozoa and bacteria. These important revelations were made possible by the ingenuity of Hooke and Leeuwenhoek in fabricating and using simple microscopes that magnified objects from about 25-fold to 250-fold. After a lapse of more than 150 years, microscopy became the backbone of our understanding of the roles of microbes in the causation of infectious diseases and the recycling of chemical elements in the biosphere.

  2. Seventeenth-century 'treasure' found in Royal Society archives: the Ludus helmontii and the stone disease. (United States)

    Alfonso-Goldfarb, Ana Maria; Ferraz, Márcia Helena Mendes; Rattansi, Piyo M


    Our archival researches at the Royal Society reveal that a small envelope attached to a 1675 letter from an Antwerp apothecary, A. Boutens, contained a sample of the 'Ludus' prepared as a remedy for the 'stone disease' then sweeping through Europe, which was first announced in J. B. van Helmont's De lithiasi (1644). After examining the fascination with the medical use of the Ludus (which required the 'alkahest' for its preparation) and the tenacious efforts to procure it, we trace the fortunae of two other ludi in England, brought to and offered by Francis Mercurius van Helmont during his English sojourn. Both eventually found their way to the geologist John Woodward, one of them through Sir Isaac Newton. Finally we show how the allure of the Ludus helmontii vanished, with transformations in mineral analysis and reclassifications from Woodward to John Hill.


    Riggs, Christina


    In 1821 Augustus Bozzi Granville FRS unwrapped and dissected an ancient Egyptian mummy, presenting the results of his examination to the Royal Society in 1825. He commissioned artist Henry Perry to draw the process in stages; these drawings were subsequently engraved by James Basire for publication in Philosophical Transactions. This article presents the original drawings for the first time, allowing comparison with their engravings. Taken together with Granville's accounts of the unwrapping of the mummy, the drawings demonstrate the significant role of illustration and other visual practices in anatomical argumentation in the early nineteenth century, as well as the prestige that commissioned illustrations lent to the performance and dissemination of scientific expertise. Moreover, the drawings include one of the key visual tropes of race science--a skull in left-facing profile, mapped with a facial angle--and thus indicate the early incorporation of Egyptian mummies into typologies of race.

  4. An autopsic art: drawings of ‘Dr Granville's mummy’ in the Royal Society archives (United States)

    Riggs, Christina


    In 1821 Augustus Bozzi Granville FRS unwrapped and dissected an ancient Egyptian mummy, presenting the results of his examination to the Royal Society in 1825. He commissioned artist Henry Perry to draw the process in stages; these drawings were subsequently engraved by James Basire for publication in Philosophical Transactions. This article presents the original drawings for the first time, allowing comparison with their engravings. Taken together with Granville's accounts of the unwrapping of the mummy, the drawings demonstrate the significant role of illustration and other visual practices in anatomical argumentation in the early nineteenth century, as well as the prestige that commissioned illustrations lent to the performance and dissemination of scientific expertise. Moreover, the drawings include one of the key visual tropes of race science—a skull in left-facing profile, mapped with a facial angle—and thus indicate the early incorporation of Egyptian mummies into typologies of race. PMID:27386713

  5. The logic of scientific unity? Medawar, the Royal Society and the Rothschild controversy 1971–72 (United States)

    Calver, Neil; Parker, Miles


    In 1971 Lord (Victor) Rothschild published his report for the government, The organisation and management of government R&D, and Sir Peter Medawar launched a campaign for the election of Sir Karl Popper to Fellowship of the Royal Society. We explore these two developments in the contexts of the then current views of the role and purpose of science, and their underpinning philosophy. Although the political battle was won by Rothschild, resulting in major changes to the funding and management of applied R&D, we argue that, despite this, Medawar's campaign for Popper provided an embattled science community with a philosophical basis for defending pure research and the unity of basic and applied science. PMID:27017681


    Calver, Neil; Parker, Miles


    In 1971 Lord (Victor) Rothschild published his report for the government, The organisation and management of government R&D, and Sir Peter Medawar launched a campaign for the election of Sir Karl Popper to Fellowship of the Royal Society. We explore these two developments in the contexts of the then current views of the role and purpose of science, and their underpinning philosophy. Although the political battle was won by Rothschild, resulting in major changes to the funding and management of applied R&D, we argue that, despite this, Medawar's campaign for Popper provided an embattled science community with a philosophical basis for defending pure research and the unity of basic and applied science.

  7. Adaptogenic potential of royal jelly in liver of rats exposed to chronic stress.

    Directory of Open Access Journals (Sweden)

    Douglas Carvalho Caixeta

    Full Text Available Restraint and cold stress increase both corticosterone and glycemia, which lead to oxidative damages in hepatic tissue. This study assessed the effect of royal jelly (RJ supplementation on the corticosterone level, glycemia, plasma enzymes and hepatic antioxidant system in restraint and cold stressed rats. Wistar rats were allocated into no-stress, stress, no-stress supplemented with RJ and stress supplemented with RJ groups. Initially, RJ (200mg/Kg was administered for fourteen days and stressed groups were submitted to chronic stress from the seventh day. The results showed that RJ supplementation decreases corticosterone levels and improves glycemia control after stress induction. RJ supplementation also decreased the body weight, AST, ALP and GGT. Moreover, RJ improved total antioxidant capacity, SOD activity and reduced GSH, GR and lipoperoxidation in the liver. Thus, RJ supplementation reestablished the corticosterone levels and the hepatic antioxidant system in stressed rats, indicating an adaptogenic and hepatoprotective potential of RJ.

  8. Radiofrequency radiation: safe working practices in the Royal Australian Air Force

    International Nuclear Information System (INIS)

    Joyner, K.H.; Stone, K.R.


    The Royal Australian Air Force (RAAF) has long recognised the value of its work force and the need to preserve their health and wellbeing to achieve operational objectives. The Directorate of Air Force Safety (DAFS) is required by the Chief of the Air Staff to take all measures possible to prevent accidents and incidents in the RAAF, under the provisions of the Defence Instruction, 'Air Force Safety and Occupational Health Policy'. Consequently, the RAAF has exercised a pragmatic approach to radiofrequency radiation (RFR) and has always adopted and implemented strict exposure standards. DAFS receives technical advice on RFR from the Directorate of Telecommunications Engineering (DTELENG) and on occupational health from the Directorate General of Air Force Health Services (DGAFHS)

  9. The Royal Philanthropic Expedition of the Vaccine: a landmark in the history of public health. (United States)

    Soto-Pérez-de-Celis, E


    In 1979, smallpox officially became the first disease ever to be eradicated by mankind. The global efforts to defeat this dreadful pandemic, however, started almost two centuries before. One of the most important, and sometimes forgotten, events in the fight against smallpox was the Royal Philanthropic Expedition of the Vaccine, commissioned by Charles IV of Spain to physicians Francisco Xavier Balmis y Berenguer and Jose Salvany in 1804. The aim of this expedition was to take the smallpox vaccine, discovered by Jenner, to Spain's territories in the Americas and in the Far East. After several years of vaccination in modern day Puerto Rico, Cuba, Venezuela, Ecuador, Peru, Bolivia, Chile, Mexico and the Philippines, the expedition returned to Europe. To this day, the Balmis and Salvany expedition remains a great example of international cooperation, and a landmark in the history of public health.

  10. Radiotherapy alone for early stage Hodgkin's disease: a 16 year experience at the Royal Adelaide Hospital

    International Nuclear Information System (INIS)

    O'Brein, P.


    The records of all patients with stage I and II Hodgkin's disease treated with radiotherapy alone at the Royal Adelaide Hospital between 1970 and 1986 were reviewed. The aim was to ensure the results were equivalent to the best reported series, particularly as treating such patients with chemotherapy alone has been shown to produce equivalent overall survival figures with improved relapse-free survival. There were 104 patients of whom 67 and undergone staging laparotomy. Fifty-seven patients were stage I and 47 stage II. Nine patients had B symptoms. Overall survival at 10 years was 83% with disease-specific survival being 86% and relapse-free survival 68%. These results compare favourably with those in the world literature. Multivariate analysis only revealed stage as an independent predictor of improved relapse-free survival. 30 refs., 3 figs., 3 tabs

  11. Energy - the changing climate. Summary of the Royal Commission on Environmental Pollution's report

    Energy Technology Data Exchange (ETDEWEB)



    In August 1997 the Royal Commission announced that it intended to review energy prospects for the 21st century and their environmental implications. In September 1998 it said its main focus would be the implications of considerably reducing the use of fossil fuels as an energy source in the UK by 2050, or even phasing them out completely. Evidence was invited on 23 specific issues. This document begins with a brief summary of the twenty-second report, Energy - The Changing Climate. This is followed by a short description of four UK energy scenarios for 2050. The key recommendations are given followed by a list of all the recommendations on which the government could act now. 8 figs., 15 photos.


    Directory of Open Access Journals (Sweden)



    Full Text Available ABSTRACT ‘Gala’ apple trees have low fruit set in restrictive pollination situations, being an obstacle to the achievement of high production rates in orchards in southern Brazil, which can be minimized by the use of growth regulators. The aim of this study was to evaluate the effect of thidiazuron concentrations in ‘Royal Gala’ apple fruiting and production, grown in mild winter conditions. The experiment was conducted during the 2011/2012, 2012/2013 and 2013/2014 crop years in Fraiburgo, SC, on ‘Royal Gala’ apple trees in Marubakaido rootstock M9 with filter. In all evaluation cycles, the experimental design was a randomized block with factorial arrangement (6x2 with six TDZ concentrations and two application forms, with six replicates, and the experimental unit consisting of one plant. The TDZ concentrations of each treatment were applied split into two seasons. The first application was performed on pink bud stage (E2 and the second application was in full bloom stage (F2. The variables evaluated were: fruit set (%, return bloom (%, number and weight of fruits per plant, mean fruit weight (g and average number of seeds per fruit. Data were submitted to analysis of variance, in which for significant variables by the F test, analysis of contrast and polynomial regression were performed in order to evaluate the response of variables with increasing TDZ concentration. TDZ is effective even at low concentrations, increasing the production and fruit set of ‘Gala’ apples in the climatic conditions of southern Brazil.

  13. Antioxidant and protective effects of Royal jelly on histopathological changes in testis of diabetic rats

    Directory of Open Access Journals (Sweden)

    Elham Ghanbari


    Full Text Available Background: Diabetes is the most common endocrine disease. It has adverse effects on male reproductive function. Royal Jelly (RJ has antioxidant and anti-diabetic effects and show protective effects against diabetes. Objective: This study was conducted to evaluate the effect of RJ on histopathological alterations of the testicular tissue in streptozotocin (STZ-induced diabetic rats. Materials and Methods: In this experimental study, 28 adult Wistar rats were randomly divided into control (C, royal jelly (R, diabetic (D and RJ-treated diabetic (D+R groups. Diabetes was induced by a single intraperitoneal injection of STZ at 50 mg/kg body weight (BW. The rats from the R and D+R groups received daily RJ (100 mg/kg BW for 6 wks orally. Hematoxylin-Eosin staining was used to analyze histopathological changes including: tunica albuginea thickness (TAT, seminiferous tubules diameter (STsD, Johnsen’s score, tubular differentiation index (TDI, spermiogenesis index (SPI, Sertoli cell index (SCI, meiotic index (MI, and mononuclear immune cells (MICs in testes. The antioxidant status was examined by evaluating testicular levels of ferric reducing antioxidant power (FRAP and catalase (CAT activity. Results: Histological results of the testis from diabetic rats showed significant decrease in STsD, Johnsen’s score, TDI, SPI, SCI and MI, and significant increase in TAT and MICs, while administration of RJ significantly reverted these changes (p<0.05. RJ treatment markedly increased activity of CAT and FRAP. There were significant differences in FRAP levels among C (13.0±0.5, RJ (13.4±0.3, D (7.8±0.6 and D+R (12.4±0.7 groups (p<0.05. Conclusion: RJ improved diabetes-induced impairment in testis, probably through its antioxidant property.

  14. Effect of Royal Jelly on Sterile Wound Healing in Balb/C Mice

    Directory of Open Access Journals (Sweden)

    H Shirzad


    Full Text Available Introduction & Objective: Wound healing is the process of repairing following injury to the skin and other soft tissues. Following injury, inflammatory response occurs and the cells below the dermis begin to increase collagen production, later on, the epithelial tissue is regenerated. Royal jelly (RJ is a bee product. There are many reports on pharmacological activity of RJ on experimented animals. The purpose of this study was to investigate the effect of RJ on the induction of wound healing of sterile incision in Balb/C mice. Materials & Methods: In this experimental study which was conducted at Shahr-e-kord University of Medical Sciences in 60 female Balb/C mice (8 weeks old were selected. The mice were anesthetized with ether. The dorsal fur of the animals was shaved and sterilized with alcohol, and then a longitudinal para vertebral full thickness incision of 10mm long was made. The animals were then divided into six equal groups. In group one (negative control, nothing was applied to the wound. Group 2 (positive control was treated with nitrofurazon ointment, group 3 was treated with RJ 200 mg/kg daily, group 4 was treated with RJ 200 mg/kg every two days, group 5 was treated with RJ 300 mg/kg daily, group 6 treated with RJ 300 mg/kg every two days. Royal jelly was topically used on the wounds. The wound length was measured with vernier capilar every two days until the complete healing was occurred. The data were analyzed with SPSS version 11.5 using Kruscal Walis tests. Results: There was a significant difference between groups 1, 2 with the other groups (p0.015. Conclusion: The results of this study indicated that daily application of RJ possesses betters wound healing effects than nitrofurazon.

  15. The functional property of royal jelly 10-hydroxy-2-decenoic acid as a melanogenesis inhibitor. (United States)

    Peng, Chi-Chung; Sun, Hui-Tzu; Lin, I-Ping; Kuo, Ping-Chung; Li, Jen-Chieh


    It has been reported that royal jelly would reduce melanin synthesis and inhibit the expression of melanogensis related proteins and genes. In this study, we evaluate the anti-melanogenic and depigmenting activity of 10-hydroxy-2-decenoic acid (10-HDA) from royal jelly of Apis mellifera. In this study, we assesses the 10-HDA whitening activity in comparison with the changes in the intracellular tyrosinase activity, melanin content and melanin production related protein levles in B16F1 melanoma cells after treating with 10-HDA. Furthermore, the skin whitening effect was evaluated by applying a cream product containing with 0.5%, 1% and 2% of 10-HDA onto the skin of mice (C57BL/6 J) for 3 week to observe the effect of DL*-values. The results showed that 10-HDA inhibited the MITF protein expression (IC50 0.86 mM) in B16F1 melanoma cells. Western blot analysis revealed that 10-HDA inhibited the activity of tyrosinase and the expression of tyrosinase-related protein 1 (TRP-1), TRP-2, and microphthalmia-associated transcription factor (MITF) in B16F1 melanoma cells. In addition, the 10-HDA was applied on the skin of mice show significantly increased the average skin-whitening index (L value). The validation data indicated the potential of 10-HDA for use in suppressing skin pigmentation. The 10-HDA is proposed as a candidate to inhibit melanogenesis, thus it could be developed as cosmetics skin care products.

  16. Global curriculum in surgical oncology. (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A


    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  17. VEIL Surgical Steps. (United States)

    Raghunath, S K; Nagaraja, H; Srivatsa, N


    Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes. Inguinal node dissection is a morbid procedure with operative morbidity noted in almost two third of the patients. Video endoscopic inguinal lymphadenectomy (VEIL) was described and currently practiced with proven equivalent oncological outcomes. We describe our technique of VEIL using laparoscopic and robotic access as well as various new surgical strategies.

  18. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh


    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  19. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.


    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  20. Public versus Private Colleges: Political Participation of College Graduates (United States)

    Lott, Joe L., II.; Hernandez, Jose; King, Joe P.; Brown, Tiffany; Fajardo, Ismael


    Using data from the Baccalaureate and Beyond Longitudinal Study (B&B:93/03) of College Graduates, we use structural equation modeling to model the relationships between college major, values held in college, collegiate community service participation, and the post-college political participation of college graduates by public versus private…

  1. Cyberbullying in College

    Directory of Open Access Journals (Sweden)

    Carlos P. Zalaquett


    Full Text Available Cyberbullying is commonly presented as affecting K-12 populations. Current research suggests cyberbullying continues in college. A diverse sample of 613 university students was surveyed to study their cyberbullying experiences in high school and college. Nineteen percent of the sample reported being a victim of cyberbullying in college and 35% of this subsample reported being cyberbullied in high school. Additional findings and practical implications are presented.

  2. Simultaneous high performance liquid chromatographic analysis of vitamins B1, B2 and B6 in royal jelly

    Directory of Open Access Journals (Sweden)

    Presoto Ana Elisa F


    Full Text Available Royal jelly is used as a food supplement, popularly known as rich in B vitamins. The present work has two objectives: firstly, to apply simultaneous quantitative determination by High Performance Liquid Chromatography of thiamin (vitamin B1, riboflavin (vitamin B2 and pyridoxine (vitamin B6 and secondly to compare the obtained data with the Dietary Reference Intake (DRI values. The values obtained showed no thiamin, a range from 20 to 171 ng g-1 of riboflavin and from 408 to 2 188 ng g-1 of pyridoxine in royal jelly. According to the Food and Nutrition Board (2000, the DRI of these vitamins varies from 0.2-1.4 mg for thiamin; 0.3-1.6 mg for riboflavin and 0.1-2.0 mg for pyridoxine, depending on age and sex. According to these recommendations, royal jelly is not a good source of vitamins B1, B2 or B6 as these vitamins appear only on order of ng g-1. The proposed method can be used in routine analysis for royal jelly, having the advantage of being simple, fast and reliable.

  3. Royal Decree-Law 12/1982 of 27 August regulating State intervention in the Lemoniz nuclear power plant

    International Nuclear Information System (INIS)


    This Royal Decree-Law sets out the conditions of intervention by the State in the achievement of the Lemoniz nuclear power plant with a view to accelerating the work. It sets up an Intervention Council responsible for directing the work which is empowered to take the necessary measures for discharging its duties. (NEA) [fr

  4. 78 FR 23316 - The Royal Bank of Scotland plc, et al.; Notice of Application and Temporary Order (United States)


    ... plc, et al.; Notice of Application and Temporary Order April 12, 2013. AGENCY: Securities and Exchange Commission (``Commission''). ACTION: Temporary order and notice of application for a permanent order under... application for a permanent order. Applicants have also applied for a permanent order. APPLICANTS: The Royal...

  5. Comparative study on the antifungal activity of hydroalcoholic extract of Iranian Propolis and Royal jelly against Rhizopus oryzae

    Directory of Open Access Journals (Sweden)

    Moghim Hassan


    Full Text Available Introduction: Mucormycosis is an opportunistic fungal infection. Rhizopus oryzae is major cause of mucormycosis in humans. This disease is the most common form of the acute fungal infection with rapid progress. Iranian Propolis extract and Royal jelly are honey bee products which have been used by human over the past centuries in traditional medicine. In this study the effects of Iranian Propolis and Royal jelly were investigated against Rhizopus oryzae and Candida albicans. Methods: The used method in this study was microdilution. To perform it, the prepared dilutions of Royal jelly and alcoholic extract of Iranian Propolis were added to tubes containing Sabouraud dextrose broth culture media except to control group and then Rhizopus oryzae suspension was added to all microtubes. In the next stage, microtubes were maintained in incubator at 25oC for 48 hours and then 10 ml of the content of each microtube was transferred to Sabouraud dextrose agar media. The minimum inhibitory concentration (MIC and minimum fungicidal concentration (MFC of the agents were calculated. Results: In this study, the MIC and MFC of Iranian Propolis alcoholic extract on Rhizopus oryzae were respectively 0.1 and 0.25 mg/ml and the MFC of Royal jelly on Rhizopus oryzae were respectively 100 ± 34 and 133 ± 46 mg/ml. Conclusion: The results indicate that Propolis might be used as an ideal combination for the treatment of fungal infections like Rhizopus oryzae. However, clinical studies are needed to confirm the effects of these drugs.

  6. [Terhi Kiiskinen. Library of the Finnish nobleman, royal secretary and trustee Henrik Matsson (ca 1540-1617)] / Liivi Aarma

    Index Scriptorium Estoniae

    Aarma, Liivi, 1948-


    Arvustus: Kiiskinen, Terhi. Library of the Finnish nobleman, royal secretary and trustee Henrik Matsson (ca 1540-1617). Helsinki, 2004. Terhi Kiiskinen valgustab Forsiuse lugemust temaga seotud ajaloolise isiku Henrik Matsson Hugguti raamatukogu kataloogi abil, mis on säilinud Tallinna Linnaarhiivis

  7. Muusikamaailm : Festivalid Prahas ja Westfalias. Populaarne saksa uusooper. Royal Festival Hall ئ 50. Kaks preemiat Soome. Austusavaldus Mahlerile / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-


    Festivalist "Praha kevad" Tšehhis, festivalist Westfälische Musikfest Saksamaal. M. Trojahni ooperist "Enrico". Londoni Royal Festival Hall tähistab avamise 50. aastapäeva. 34. Chicago filmi- ja videofestivalil võitis peapreemia soome dokumentaalfilm "Jean Sibelius ئ naturally". H. Wallen võitis Stuttgardi kammerduode konkursi. Jihlava konservatooriumile Moraavias anti G. Mahleri nimi

  8. Two Years on: Koha 3.0 in Use at the CAMLIS Library, Royal London Homoeopathic Hospital (United States)

    Bissels, Gerhard; Chandler, Andrea


    Purpose: The purpose of this paper is to describe the further development of the Koha 3.0 library management system (LMS) and the involvement of external software consultants at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper takes the…

  9. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY. January 2016 Volume 13 Issue 1 1. EDITORIAL. Access to Specialized Surgical Care. Saidi H. University of Nairobi. Correspondence to: Prof Hassan Saidi, P.O Box 30196-00100, Nairobi. Email: Ann Afr Surg. 2016;13(1):1-2. The narrative of surgical disease in ...

  10. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  11. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  12. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen


    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  13. Impact of reduced working time on surgical training in the United Kingdom and Ireland. (United States)

    Canter, Richard


    The European Working Time Directive (EWTD) 48 h working week has been law in European countries since 1998. A phased approach to implementation was agreed for doctors in training, which steadily brought down working hours to 58 in 2004, 56 in 2007 and 48 in 2009. Medical trainees can "opt out" to a 54 h working week but this has to be voluntary and rotas cannot be constructed that assume an opt out is taking place. A key component of the working week arrangements is that the maximum period of work for a resident doctor without rest is 13 h. Shorter sessions of work have led to complex rotas, frequent handovers with difficulties maintaining continuity of care with implications for patient safety. Although there has been over 10 years notice of the changes to the working week and progress has up to now been reasonable (helped, in part by a steady increase in consultant numbers) this latest reduction from 56 h to 48 h seems to have been the most difficult to manage. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Using Appreciative Inquiry to Discover and Deliver Change for Surgical Technology Students (United States)

    Cabai, Katherine A.


    The purpose of this study was to examine efficacious teaching-learning strategies that community college stakeholders employ that enhance surgical technology student outcomes. Knowles's adult learning theory, constructivist theory, and appreciative inquiry served as the theoretical foundation for this study. Discovering effective aspects and…

  15. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.


    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  16. Beyond College Eligibility: A New Framework for Promoting College Readiness. College Readiness Indicator Systems Resource Series (United States)

    Annenberg Institute for School Reform at Brown University, 2014


    The College Readiness Indicator Systems (CRIS) initiative was developed in response to a troubling pattern: More students than ever are enrolling in college after high school, but many of them are not college ready, as evidenced by persistently low rates of college completion. The sense of urgency to close the gap between college eligibility and…

  17. Output control of da Vinci surgical system's surgical graspers. (United States)

    Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar


    The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Impact of royal jelly to improve reproductive performance of male rabbits under hot summer conditions

    Directory of Open Access Journals (Sweden)

    A. M. El-Hanoun


    Full Text Available To alleviate the deleterious effect of heat stress during summer conditions on male rabbits’ reproduction, 40 V Line adult rabbit bucks (on av. 8 mo old were divided into 4 experimental groups and exposed to temperatures ranging from 23 to 36°C. Bucks in the 1st, 2nd, 3rd, and 4th group were supplemented with 0, 50, 100 or 150 mg of Chinese royal jelly (RJ/kg twice per week, respectively, over a 20-wk period. Semen quality and blood biochemical constituents were evaluated. RJ at any dose exhibited a significant increase (P<0.05 in rabbits’ sperm concentration, total sperm output, sperm motility, live sperm and normal sperm compared to the untreated controls. Plasma total protein, albumin, globulin, glucose and high density lipids (HDL concentrations were significantly (P<0.05 boosted in the RJ groups compared to the controls. In contrast, RJ treatment resulted in a significant (P<0.05 reduction in plasma total lipids, triglycerides, cholesterol and low density lipids (LDL concentrations. Treatment with RJ significantly boosted (P<0.05 testosterone concentration in the RJ groups to reach 110, 120 and 128%, respectively, of the control group. Improved kidney and liver functions were observed in the RJ bucks groups where plasma creatinine, urea concentrations, aspartate aminotransferase and alanine aminotransferase enzyme activities were significantly (P<0.05 decreased by RJ treatments. Treating bucks subjected to heat stress by different RJ doses increased (P<0.05 total antioxidant capacity to 106, 111 and 115% of basal, but significantly reduced (P<0.05 malondialdehyde and thiobarbituric acid reactive substances compared to the untreated. It was concluded that Chinese royal jelly supplementation for heat-stressed male rabbits can counteract summer infertility and improve their physiological status.

  19. Retrospective Analysis of Patient Presentations at the Sydney (Australia) Royal Easter Show from 2012 to 2014. (United States)

    Crabtree, Nathan; Mo, Shirley; Ong, Leon; Jegathees, Thuvarahan; Wei, Daniel; Fahey, David; Liu, Jia Jenny


    Introduction Comprehensive studies on the relationship between patient demographics and subsequent treatment and disposition at a single mass-gathering event are lacking. The Sydney Royal Easter Show (SRES; Sydney Olympic Park, New South Wales, Australia) is an annual, 14-day, agricultural mass-gathering event occurring around the Easter weekend, attracting more than 800,000 patrons per year. In this study, patient records from the SRES were analyzed to examine relationships between weather, crowd size, day of week, and demographics on treatment and disposition. This information would help to predict factors affecting patient treatment and disposition to guide ongoing training of first responders and to evaluate the appropriateness of staffing skills mix at future events. Hypothesis Patient demographics, environmental factors, and attendance would influence the nature and severity of presentations at the SRES, which would influence staffing requirements. A retrospective analysis of 4,141 patient record forms was performed for patients who presented to St John Ambulance (Australian Capital Territory, Australia) at the SRES between 2012 and 2014 inclusive. Presentation type was classified using a previously published minimum data set. Data on weather and crowd size were obtained from the Australian Bureau of Meteorology (Melbourne, Victoria, Australia) and the SRES, respectively. Statistical analyses were performed using SPSS v22 (IBM; Armonk, New York USA). Between 2012 to 2014, over 2.5 million people attended the SRES with 4,141 patients treated onsite. As expected, the majority of presentations were injuries (49%) and illnesses (46%). Although patient demographics and presentation types did not change over time, the duration of treatment increased. A higher proportion of patients were discharged to hospital or home compared to the proportion of patients discharged back to the event. Patients from rural/regional locations (accounting for 15% of all patients) were

  20. College Drinking - Changing the Culture (United States)

    ... about college alcohol policies College Drinking - Changing the Culture This is your one-stop resource for comprehensive ... More about special features College Drinking - Changing the Culture This is your one-stop resource for comprehensive ...

  1. 78 FR 76711 - Royal City Charter Coach Lines Ltd.-Acquisition of Control-Quick Coach Lines Ltd. d/b/a Quick... (United States)


    ... current ownership of Quick, and its wholly owned subsidiary Quick Coach Lines USA Inc. (Quick USA... Charter Coach Lines Ltd.--Acquisition of Control-- Quick Coach Lines Ltd. d/b/a Quick Shuttle Service.... SUMMARY: On November 18, 2013, Royal City Charter Coach Lines Ltd. (Royal, or Applicant) filed an...

  2. Alternative sources of supplements in Africanized honeybees submitted to royal jelly production - doi: 10.4025/actascianimsci.v35i2.16976

    Directory of Open Access Journals (Sweden)

    Fabiana Martins Costa-Maia


    Full Text Available This study was carried out to evaluate the effect of supplements with isolated soy protein, brewer’s yeast, a mixture of isolated soy protein with brewer’s yeast, linseed oil, palm oil and mixture of linseed oil with palm oil in the royal jelly production of Africanized honey bee colonies. Total royal jelly produced was superior (P

  3. What Is College for? (United States)

    Wise, Phyllis M.; Martin, Carolyn A.; Kinbrough, Walter M.; Hitt, John C.; Urgo, Joseph R.; Lief, Charles G.; Drake, Michael V.; Hellyer, Brenda; Pepicello, William


    Lately there has been a great deal of discussion about the importance of measuring a college's "return on investment." Is the point of a college education quantifiable results or personal and intellectual growth? In pursuit of answers, "The Chronicle" asked a selection of higher-education leaders. Phyllis M. Wise, Chancellor of…

  4. Latino College Completion: Hawaii (United States)

    Excelencia in Education (NJ1), 2012


    In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. An executive summary of Latino College Completion in 50 states synthesizes information on 50 state factsheets and builds on the national benchmarking guide. Each…

  5. Faculty Handbook. Regis College. (United States)

    Regis Coll., Weston, MA.

    Regis College policies and procedures are described in this 1976 faculty handbook. Chapter 1 covers college organization and governance, including roles of academic officers and committees. Specific faculty data are presented in Chapter 2, such as definition of academic ranks and titles, recruitment and appointment, promotion, tenure, review,…

  6. Who Takes College Algebra? (United States)

    Herriott, Scott R.; Dunbar, Steven R.


    The common understanding within the mathematics community is that the role of the college algebra course is to prepare students for calculus. Though exceptions are emerging, the curriculum of most college algebra courses and the content of most textbooks on the market both reflect that assumption. This article calls that assumption into question…

  7. Community Colleges Today (United States)

    Crawford, Corinne; Jervis, Angela


    Dr. Jill Biden, Vice President Joe Biden's wife, has been teaching in community colleges for the past 18 years. Dr. Biden believes that community colleges are "…uniquely American institutions where anyone who walks through the door is one step closer to realizing the American dream." This is an inspiring sentiment. However, of all the…

  8. Latino College Completion: Pennsylvania (United States)

    Excelencia in Education (NJ1), 2012


    In 2009, Excelencia in Education launched the Ensuring America's Future initiative to inform, organize, and engage leaders in a tactical plan to increase Latino college completion. An executive summary of Latino College Completion in 50 states synthesizes information on 50 state factsheets and builds on the national benchmarking guide. Each…

  9. Examining Latina College Experiences (United States)

    Romero, Amanda R.


    The purposes of this qualitative narrative study were to explore the potential areas of conflict Latina college students experience between their educational goals and traditional cultural gender roles and expectations. Participants were selected utilizing purposeful sampling methods. All participants were first-generation college students.…

  10. College Rankings. ERIC Digest. (United States)

    Holub, Tamara

    The popularity of college ranking surveys published by "U.S. News and World Report" and other magazines is indisputable, but the methodologies used to measure the quality of higher education institutions have come under fire by scholars and college officials. Criticisms have focused on methodological flaws, such as failure to consider…

  11. Protective effect of royal jelly on the sperm parameters and testosterone level and lipid peroxidation in adult mice treated with oxymetholone

    Directory of Open Access Journals (Sweden)

    Ensieh Zahmatkesh


    Full Text Available Objectives: The aim of the present study was to evaluate protective effect of royal jelly on sperm parameters, testosterone level, and malondialdehyde (MDA production in mice. Materials and Methods: Thirty-two adult male NMRI mice weighing 30±2 g were used. All the animals were divided into 4 groups. Control group: received saline 0.1 ml/mouse/day orally for 30 days. Royal Jelly group (RJ: received royal jelly at dose of 100 mg/kg daily for 30 days orally. Oxymetholone group: the received Oxymetholone (OX at dose of 5 mg/kg daily for 30 days orally. Royal Jelly+Oxymetholone group: received royal jelly at dose of 100 mg/kg/day orally concomitant with OX administration. Sperm count, sperm motility, viability, maturity, and DNA integrity were analyzed. Furthermore, serum testosterone and MDA concentrations were determined. Results: In Oxymetholone group, sperm count, motility as well as testosterone concentration reduced significantly (p

  12. Estrogenic Activities of Fatty Acids and a Sterol Isolated from Royal Jelly (United States)

    Isohama, Yoichiro; Maruyama, Hiroe; Yamada, Yayoi; Narita, Yukio; Ohta, Shozo; Araki, Yoko; Miyata, Takeshi; Mishima, Satoshi


    We have previously reported that royal jelly (RJ) from honeybees (Apis mellifera) has weak estrogenic activity mediated by interaction with estrogen receptors that leads to changes in gene expression and cell proliferation. In this study, we isolated four compounds from RJ that exhibit estrogenic activity as evaluated by a ligand-binding assay for the estrogen receptor (ER) β. These compounds were identified as 10-hydroxy-trans-2-decenoic acid, 10-hydroxydecanoic acid, trans-2-decenoic acid and 24-methylenecholesterol. All these compounds inhibited binding of 17β-estradiol to ERβ, although more weakly than diethylstilbestrol or phytoestrogens. However, these compounds had little or no effect on the binding of 17β-estradiol to ERα. Expression assays suggested that these compounds activated ER, as evidenced by enhanced transcription of a reporter gene containing an estrogen-responsive element. Treatment of MCF-7 cells with these compounds enhanced their proliferation, but concomitant treatment with tamoxifen blocked this effect. Exposure of immature rats to these compounds by subcutaneous injection induced mild hypertrophy of the luminal epithelium of the uterus, but was not associated with an increase in uterine weight. These findings provide evidence that these compounds contribute to the estrogenic effect of RJ. PMID:18830443

  13. Estrogenic Activities of Fatty Acids and a Sterol Isolated from Royal Jelly

    Directory of Open Access Journals (Sweden)

    Kazu-Michi Suzuki


    Full Text Available We have previously reported that royal jelly (RJ from honeybees (Apis mellifera has weak estrogenic activity mediated by interaction with estrogen receptors that leads to changes in gene expression and cell proliferation. In this study, we isolated four compounds from RJ that exhibit estrogenic activity as evaluated by a ligand-binding assay for the estrogen receptor (ER β. These compounds were identified as 10-hydroxy-trans-2-decenoic acid, 10-hydroxydecanoic acid, trans-2-decenoic acid and 24-methylenecholesterol. All these compounds inhibited binding of 17β-estradiol to ERβ, although more weakly than diethylstilbestrol or phytoestrogens. However, these compounds had little or no effect on the binding of 17β-estradiol to ERα. Expression assays suggested that these compounds activated ER, as evidenced by enhanced transcription of a reporter gene containing an estrogen-responsive element. Treatment of MCF-7 cells with these compounds enhanced their proliferation, but concomitant treatment with tamoxifen blocked this effect. Exposure of immature rats to these compounds by subcutaneous injection induced mild hypertrophy of the luminal epithelium of the uterus, but was not associated with an increase in uterine weight. These findings provide evidence that these compounds contribute to the estrogenic effect of RJ.

  14. Radiosurgery for brain metastases at the Royal Adelaide Hospital: are we treating the right patients?

    International Nuclear Information System (INIS)

    Roos, D.E.; Brophy, B.P.; Zavgorodni, S.F.; Katsilis, E.S.


    Although non-randomized data strongly suggest improved outcome from radiosurgery (RS) for brain metastases relative to whole brain radiotherapy (WBRT) alone, selection factors account for much of the observed differences. This retrospective review of the 16 brain metastases patients treated so far with RS at the Royal Adelaide Hospital confirms a median survival of 10.1 months, consistent with recent multi-institutional pooled results and significantly longer than the median survival of 3-6 months typically reported for WBRT alone. The emerging randomized trials comparing surgery, RS and WBRT for brain metastases are reviewed in the context of the Radiation Therapy Oncology Group Recursive Partitioning Analysis prognostic Class concept in order to assess whether we are using this resource intensive technique to treat the 'right' patients. We conclude that it is reasonable to continue our current policy of considering RS primarily for patients of good performance status with solitary brain metastases. VVe have a flexible approach to adjuvant WBRT which appears to decrease brain relapse, but not improve survival. Copyright (2002) Blackwell Science Pty Ltd

  15. The Royal Society of Chemistry and the delivery of chemistry data repositories for the community (United States)

    Williams, Antony; Tkachenko, Valery


    Since 2009 the Royal Society of Chemistry (RSC) has been delivering access to chemistry data and cheminformatics tools via the ChemSpider database and has garnered a significant community following in terms of usage and contribution to the platform. ChemSpider has focused only on those chemical entities that can be represented as molecular connection tables or, to be more specific, the ability to generate an InChI from the input structure. As a structure centric hub ChemSpider is built around the molecular structure with other data and links being associated with this structure. As a result the platform has been limited in terms of the types of data that can be managed, and the flexibility of its searches, and it is constrained by the data model. New technologies and approaches, specifically taking into account a shift from relational to NoSQL databases, and the growing importance of the semantic web, has motivated RSC to rearchitect and create a more generic data repository utilizing these new technologies. This article will provide an overview of our activities in delivering data sharing platforms for the chemistry community including the development of the new data repository expanding into more extensive domains of chemistry data.

  16. Apparent 85Kr ages of groundwater within the Royal watershed, Maine, USA. (United States)

    Sidle, W C


    Specific 85Kr activity is mapped from 264 domestic and municipal wells sampled during 2002-2004 in the Royal watershed (361 km2), Maine. Gas samples are collected at 20 m, 40 m, and > 50 m interval depths within the unconfined aquifers. Gas extraction for 85Kr from wells is obtained directly via a wellhead methodology avoiding conventional collection of large sample volumes. Atmospheric 85Kr input to the recharge environment is estimated at 1.27 Bq m(-3) by time-series analyses of weighted monthly precipitation (2001-2004). Numerical simulation of Kr gas transport through the variable unsaturated zones to the water table suggests up to 12-year time lags locally, thus biasing the 85Kr groundwater ages. Apparent 85Kr ages suggest that approximately 70% of groundwater near 20 m depth was recharged less than 30 years BP (2004). Mass-age transport modeling suggests that post mid-1950s recharge penetrates to part of the basin's floor and that older groundwater seeps from the underlying fractured bedrock may occur.

  17. Tracheostomy decannulation at the Royal Hospital for Sick Children in Glasgow: Predictors of success and failure. (United States)

    Beaton, Fiona; Baird, Tracy-Anne; Clement, W Andrew; Kubba, Haytham


    Tracheostomy techniques, indications and care are extensively covered in the literature. However, little is written about the process of removing the tracheostomy tube. At the Royal Hospital for Sick Children in Glasgow we use a stepwise ward-based protocol for safe tracheostomy decannulation. Our aim therefore was to review all the paediatric tracheostomy decannulations that we attempted over the last 3 years to evaluate our protocol, to determine our success rate and to see whether any modifications to the protocol are required. We reviewed all patients who had undergone ward decannulation between January 2012 and May 2015. We extracted data from clinical records including patient characteristics, indications for tracheostomy, timing of decannulation and success or failure of the process. The 45 children in the study underwent 57 attempts at decannulation during the study period. 25 were male (56%) and 20 were female (44%), and they were aged between 1 day and 16 years 6 months at the time of the original tracheostomy operation. 33 attempts were successful (58%). 10 children had more than one attempt at decannulation. Children were found to fail at every stage of the protocol, with the commonest point of failure being day 2 when the tracheostomy tube was capped. We have demonstrated that our current protocol for ward decannulation is effective and safe, and that all five days of the protocol are required. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Conservation of Stone Cladding on the FAÇADE of Royal Palace in Caserta (United States)

    Titomanlio, I.


    The beauty of cultural heritage and monumental architecture, is often linked to their non-structural elements and decorative stones façades cladding. The collapse of these elements causes significant consequences that interest the social, the economic, the historical and the technical fields. Several regulatory documents and literature studies contain methods to address the question of relief and of the risk analysis and due to the non - structural stones security. Among the references are widespread international regulatory documents prepared by the Federal Emergency Management Agency of the United States by Applied Technology Council and California. In Italy there are some indications contained in the Norme Tecniche per le Costruzioni and the Direttiva del Presidente del Consiglio dei Ministri in 2007, finalize to the reduction of seismic risk assessment of cultural heritage. The paper, using normative references and scientific researches, allows to analyze on Royal Palace of Caserta the safety and the preservation of cultural heritage and the vulnerability of non-structural stones façade cladding. Using sophisticated equipments of Laboratory ARS of the Second University of Naples, it was possible to analyze the collapse of stone elements due to degradation caused by natural phenomena of deterioration (age of the building, type of materials, geometries , mode of fixing of the elements themselves). The paper explains the collapse mechanisms of stones façade cladding of Luigi Vanvitelli Palace.

  19. Reel Royal Diversity? The Glass Ceiling in Disney’s Mulan and Princess and the Frog

    Directory of Open Access Journals (Sweden)

    Lauren Dundes


    Full Text Available Both in Mulan and Princess and the Frog, Disney eschews a traditional fairytale ending involving palatial opulence by substituting an alternative narrative for women of color. Mulan disguises herself as a male soldier in order to serve in her father’s place. After sharing victory with male companions, she willingly returns home to domesticity and the confines imposed by her gender. Tiana spends two thirds of the movie as a frog, substantially limiting her on-screen time as an African American female. Like Mulan, she is driven to please her father. She fulfills his dream of owning a high-end restaurant, ironically named Tiana’s Palace, the closest she comes to a royal lifestyle. Although protagonists with more realistic lives could potentially enhance viewers’ connection with them and model a work ethic or commitment to home life, the standard and more financially successful Disney narrative immerses viewers in a fantasy world of endless prospects including a life of royalty. These nonwhite heroines instead display a willingness to settle for more modest aspirations in stories replete with stereotypical gender and race-bound tropes. This divergent narrative suggests that protagonists of color are not entitled to a life of leisure and privilege that white Disney princesses enjoy.

  20. Royal Policy and the Transfer ot the Consulado under the Old Regime

    Directory of Open Access Journals (Sweden)

    Allan J. KUETHE


    Full Text Available The abrupt transfer of the Casa de la Contratación and the Consulado de Cargadores a Indias from Seville to Cádiz in 1717 opened a political struggle between the two cities that would not be completely resolved until the enlightened absolutism of the Marqués de la Ensenada imposed its will. This struggle witnessed old regime politics at both their best and their worst. The present work seeks to analyze the several manifestations of this competition as well as the broader settings in which they occurred. While the new absolutism first appeared through the abad Alberoni in the original transfer and again through its affirmation by the duque de Ripperdá, with the hand of Queen Isabel not far beneath the surface, the traditional culture of consultation and compromise would eventually emerge and permit Seville to retain important powers until much later. Then, in a new era with much different priorities, which were heavily influenced by the coming of the War of the Asiento, royal absolutism as personified by Ensenada and his immediate predecessors would strip Sevilla of its remaining rights and at long last complete the transfer that had begun over twenty-six years before. 

  1. Longevity extension of worker honey bees (Apis mellifera by royal jelly: optimal dose and active ingredient

    Directory of Open Access Journals (Sweden)

    Wenchao Yang


    Full Text Available In the Western honey bee, Apis mellifera, queens and workers have different longevity although they share the same genome. Queens consume royal jelly (RJ as the main food throughout their life, including as adults, but workers only eat worker jelly when they are larvae less than 3 days old. In order to explore the effect of RJ and the components affecting longevity of worker honey bees, we first determined the optimal dose for prolonging longevity of workers as 4% RJ in 50% sucrose solution, and developed a method of obtaining long lived workers. We then compared the effects of longevity extension by RJ 4% with bee-collected pollen from rapeseed (Brassica napus. Lastly, we determined that a water soluble RJ protein obtained by precipitation with 60% ammonium sulfate (RJP60 contained the main component for longevity extension after comparing the effects of RJ crude protein extract (RJCP, RJP30 (obtained by precipitation with 30% ammonium sulfate, and RJ ethanol extract (RJEE. Understanding what regulates worker longevity has potential to help increase colony productivity and improve crop pollination efficiency.

  2. Longevity extension of worker honey bees (Apis mellifera) by royal jelly: optimal dose and active ingredient. (United States)

    Yang, Wenchao; Tian, Yuanyuan; Han, Mingfeng; Miao, Xiaoqing


    In the Western honey bee, Apis mellifera , queens and workers have different longevity although they share the same genome. Queens consume royal jelly (RJ) as the main food throughout their life, including as adults, but workers only eat worker jelly when they are larvae less than 3 days old. In order to explore the effect of RJ and the components affecting longevity of worker honey bees, we first determined the optimal dose for prolonging longevity of workers as 4% RJ in 50% sucrose solution, and developed a method of obtaining long lived workers. We then compared the effects of longevity extension by RJ 4% with bee-collected pollen from rapeseed ( Brassica napus ). Lastly, we determined that a water soluble RJ protein obtained by precipitation with 60% ammonium sulfate (RJP 60 ) contained the main component for longevity extension after comparing the effects of RJ crude protein extract (RJCP), RJP 30 (obtained by precipitation with 30% ammonium sulfate), and RJ ethanol extract (RJEE). Understanding what regulates worker longevity has potential to help increase colony productivity and improve crop pollination efficiency.

  3. Royal Society of Canada expert panel report : environmental and health impacts of Canada's oil sands industry

    International Nuclear Information System (INIS)

    Gosselin, P.; Hrudey, S.E.; Naeth, M.A.; Plourde, A.; Therrien, R.; Laval Univ., Quebec City, PQ; Van Der Kraak, G.; Guelph Univ., ON; Xu, Z.


    This expert panel report was commissioned by the Royal Society of Canada to provide a comprehensive evidence-based assessment of the environmental and health impacts of Canada's oil sands industry. The report evaluated the feasibility of land reclamation and the impacts of oil sands contaminants on downstream residents. Health impacts on residents living in the Regional Municipality of Wood Buffalo were assessed, and the impacts on regional water supplies were evaluated. Regional water and ground water quantities were examined, and issues related to tailing pond operations and reclamation were examined. Ambient air quality impacts were assessed, as well as potential impacts of the oil sands industry on greenhouse gas (GHG) emissions. The environmental regulatory performance of operators in the industry was also evaluated. A summary of economic and policy issues related to the industry was also provided. The study identified major gaps in the process of assessment, prevention, and mitigation of the health impacts of oil sands exploitation, as as major indirect health impacts linked to past exploitation activities. 672 refs., 11 tabs., 11 figs. 10 appendices.

  4. Protective Role of Royal Jelly in Oxymetholone-induced Oxidative Injury in Mouse Testis

    Directory of Open Access Journals (Sweden)

    Gholamreza Najafi


    Full Text Available Background: An adverse effect of oxymetholone (OXM, an anabolic-androgenic steroid used as energetic medicine, is reproductive toxicity. Royal jelly (RJ is an efficient antioxidant that has been used to treat reproductive problems. In this study, we investigated the effects of RJ on OXM-induced oxidative injuries in mouse testes. Methods: Male mice were divided into four groups. Two groups of mice were administered OXM (5 mg/kg/day, p.o. for 28 days. One of these groups received RJ (100 mg/kg/day, p.o. concurrently. A vehicle-treated control group and a RJ control group were also included. Results: The OXM-treated group showed a significant decrease in the serum testosterone concentration and spermatogenic activities, along with many histological alterations. OXM treatment also caused a significant decrease in catalase activity with an increase in lipid peroxidation in the mouse testes. The above-noted parameters were restored to near normal levels by RJ co-administration. Conclusion: The results demonstrate that RJ protects against OXM-induced reproductive toxicities.

  5. Noise exposure and cognitive performance: A study on personnel on board Royal Norwegian Navy vessels

    Directory of Open Access Journals (Sweden)

    Kaja Irgens-Hansen


    Full Text Available Prior research shows that work on board vessels of the Royal Norwegian Navy (RNoN is associated with noise exposure levels above recommended standards. Further, noise exposure has been found to impair cognitive performance in environmental, occupational, and experimental settings, although prior research in naval and maritime settings is sparse. The aim of this study was to evaluate cognitive performance after exposure to noise among personnel working on board vessels in the RNoN. Altogether 87 Navy personnel (80 men, 7 women; 31 ± 9 years from 24 RNoN vessels were included. Noise exposure was recorded by personal noise dosimeters at a minimum of 4 h prior to testing, and categorized into 4 groups for the analysis: 85.2 dB(A. The participants performed a visual attention test based on the Posner cue-target paradigm. Multivariable general linear model (GLM analyses were performed to analyze whether noise exposure was associated with response time (RT when adjusting for the covariates age, alertness, workload, noise exposure in test location, sleep the night before testing, use of hearing protection device (HPD, and percentage of errors. When adjusting for covariates, RT was significantly increased among personnel exposed to >85.2 dB(A and 77.1-85.2 dB(A compared to personnel exposed to <72.6 dB(A.

  6. The Lyophilization Process Maintains the Chemical and Biological Characteristics of Royal Jelly

    Directory of Open Access Journals (Sweden)

    Andresa Piacezzi Nascimento


    Full Text Available The alternative use of natural products, like royal jelly (RJ, may be an important tool for the treatment of infections caused by antibiotic-resistant bacteria. RJ presents a large number of bioactive substances, including antimicrobial compounds. In this study, we carried out the chemical characterization of fresh and lyophilized RJ and investigated their antibacterial effects with the purpose of evaluating if the lyophilization process maintains the chemical and antibacterial properties of RJ. Furthermore, we evaluated the antibacterial efficacy of the main fatty acid found in RJ, the 10-hydroxy-2-decenoic acid (10H2DA. Chromatographic profile of the RJ samples showed similar fingerprints and the presence of 10H2DA in both samples. Furthermore, fresh and lyophilized RJ were effective against all bacteria evaluated; that is, the lyophilization process maintains the antibacterial activity of RJ and the chemical field of 10H2DA. The fatty acid 10H2DA exhibited a good antibacterial activity against Streptococcus pneumoniae. Therefore, it may be used as an alternative and complementary treatment for infections caused by antibiotic-resistant S. pneumoniae.

  7. Hearing loss in the royal Norwegian Navy: a cross-sectional study. (United States)

    Irgens-Hansen, Kaja; Sunde, Erlend; Bråtveit, Magne; Baste, Valborg; Oftedal, Gunnhild; Koefoed, Vilhelm; Lind, Ola; Moen, Bente Elisabeth


    Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing.

  8. Noise exposure and cognitive performance: A study on personnel on board Royal Norwegian Navy vessels. (United States)

    Irgens-Hansen, Kaja; Gundersen, Hilde; Sunde, Erlend; Baste, Valborg; Harris, Anette; Bråtveit, Magne; Moen, Bente E


    Prior research shows that work on board vessels of the Royal Norwegian Navy (RNoN) is associated with noise exposure levels above recommended standards. Further, noise exposure has been found to impair cognitive performance in environmental, occupational, and experimental settings, although prior research in naval and maritime settings is sparse. The aim of this study was to evaluate cognitive performance after exposure to noise among personnel working on board vessels in the RNoN. Altogether 87 Navy personnel (80 men, 7 women; 31 ± 9 years) from 24 RNoN vessels were included. Noise exposure was recorded by personal noise dosimeters at a minimum of 4 h prior to testing, and categorized into 4 groups for the analysis: 85.2 dB(A). The participants performed a visual attention test based on the Posner cue-target paradigm. Multivariable general linear model (GLM) analyses were performed to analyze whether noise exposure was associated with response time (RT) when adjusting for the covariates age, alertness, workload, noise exposure in test location, sleep the night before testing, use of hearing protection device (HPD), and percentage of errors. When adjusting for covariates, RT was significantly increased among personnel exposed to >85.2 dB(A) and 77.1-85.2 dB(A) compared to personnel exposed to <72.6 dB(A).

  9. "Inhumanly brought back to life and misery": Mary Wollstonecraft, Frankenstein, and the Royal Humane Society. (United States)

    Williams, C


    While thorough investigation of many aspects of contemporary scientific developments and Mary Shelley's personal history have provided illuminating contexts for the study of Frankenstein, the activities of the Royal Humane Society, and other bodies and individuals who pioneered and publicized resuscitation techniques, have been comparatively neglected. Here we find a richly documented, highly conspicuous area of scientific endeavour, which generated much excitement in life and literature from the last quarter of the eighteenth century onwards. There are three major points of contact with Frankenstein: Victor Frankenstein's revival of dead tissue to make his creature; the frequent occurrences of unconsciousness and asphyxia, both in the novel and in Mary Shelley's family during the period leading up to its composition, and the widely differing degrees of competence and success with which they are treated; and the possibility that resuscitative techniques were used to revive Mary Shelley's mother, Mary Wollstonecraft, after a suicide attempt. The impact on Frankenstein of Mary Shelley's lifelong distress at the role she played in bringing about her mother's death in childbirth has been thoroughly canvassed by other critics, notably Anne Mellor, but the thought that Mary Shelley, who was herself conceived after her mother's second suicide attempt, might be, in a sense, a child of the dead adds a further turn to the Gothic screw. This study traces a hitherto unexplored intersection between Mary Shelley's first novel and her family history, as well as showing how it launches a formidable attack on the shady ethics and inconsiderate arrogance of some early resuscitators.

  10. Changes in Alternative Splicing in Apis Mellifera Bees Fed Apis Cerana Royal Jelly

    Directory of Open Access Journals (Sweden)

    Shi Yuan Yuan


    Full Text Available The Western honey bee (Apis mellifera is a social insect characterized by caste differentiation in which the queen bee and worker bees display marked differences in morphology, behavior, reproduction, and longevity despite their identical genomes. The main causative factor in caste differentiation is the food fed to queen larvae, termed royal jelly (RJ. Alternative splicing (AS is an important RNA-mediated post-transcriptional process in eukaryotes. Here we report AS changes in A. mellifera after being fed either A. mellifera RJ or A. cerana RJ. The results demonstrated that the RJ type affected 4 types of AS in adult A. mellifera: exon skipping, intron retention, alternative 5’ splice sites, and alternative 3’splice sites. After feeding with A. cerana RJ, AS occurred in many genes in adult A. mellifera that encode proteins involved in development, growth, the tricarboxylic acid cycle, and substance metabolism. This study provides the first evidence that heterospecific RJ can influence the AS of many genes related to honey bee development and growth.

  11. Protective Effect of Royal Jelly against Renal Damage in Streptozotocin Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Elham Ghanbari


    Full Text Available Background: Royal jelly has been shown to have antioxidant and antidiabetic effects. The objective of this study was to evaluate the protective effect of RJ against kidney damage in streptozotocin induced diabetic rats. Methods: Thirty two male Wistar rats were divided randomly into four groups (n=8 per group. Normal control and diabetic control groups received 1cc/day distilled water, normal RJ-treated and diabetic RJ-treated groups received 100mg RJ/kg body weight daily. Diabetes was induced by intraperitoneal injection of streptozotocin. At the end of the experiment, urine and kidney samples were collected for biochemical and histopathological analysis. Results: The results showed that diabetes could increase levels of urine urea, total protein and albumin significantly, and could decrease the levels of creatinine and uric acid in urine. In the kidney tissue homogenates, catalase activity and antioxidant power were significantly lower, whereas malondialdehyde levels were significantly higher in diabetic group when compared with control group. Diabetic rats showed severe histological changes in kidney tissues. Treatment of diabetic rats with RJ improved significantly all of these parameters. Conclusion: The present study revealed that treatment with RJ resulted in significant improvement in histopathological alterations in kidney tissue and urine parameters of diabetic rats. This could be due to its antioxidant activity and the ability of RJ for scavenging the free radicals released in diabetes. These findings suggest that RJ has protective effects on kidneys affected by diabetes mellitus.

  12. The protective effect of Royal Jelly against the hemopoiesis dysfunction in X-irradiated mice

    Energy Technology Data Exchange (ETDEWEB)

    Emori, Yutaka; Oka, Hideki; Ohya, Osamu; Tamaki, Hajime; Hayashi, Yoshiro [Zeria Pharmaceutical Co., Ltd., Konan, Saitama (Japan). Central Research Laboratories; Nomoto, Kikuo


    The protective effect of Royal Jelly (RJ) against the hemopoietic dysfunction in whole body X-irradiated C57BL/6 mice was investigated. When RJ (1.0 g/kg, po or 0.5 g/kg, ip) was administered every day beginning two weeks before X-irradiation (10 Gy), a significant increase in the number of leukocytes and erythrocytes was observed in mice treated with RJ, as compared with X-irradiated control. In addition, the number of colony forming units in culture (CFU-C) of bone marrow cells or splenocytes was significantly increased in mice treated with RJ. Therefore, when granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-3 (IL-3) in peripheral blood was measured by ELISA kit, a significant increase in the amount of GM-CSF and IL-3 was observed. These results suggest that the protective effect of RJ against hemopoietic dysfunction could be expressed through an increase in the number of hemopoietic stem cells by the induction of hemopoietic factor such as GM-CSF and IL-3. (author)

  13. In Vitro Anti-Inflammatory Effects of Three Fatty Acids from Royal Jelly

    Directory of Open Access Journals (Sweden)

    Yi-Fan Chen


    Full Text Available Trans-10-hydroxy-2-decenoic acid (10-H2DA, 10-hydroxydecanoic acid (10-HDAA, and sebacic acid (SEA are the three major fatty acids in royal jelly (RJ. Previous studies have revealed several pharmacological activities of 10-H2DA and 10-HDAA, although the anti-inflammatory effects and underlying mechanisms by which SEA acts are poorly understood. In the present study, we evaluated and compared the in vitro anti-inflammatory effects of these RJ fatty acids in lipopolysaccharide-stimulated RAW 264.7 macrophages. The results showed that 10-H2DA, 10-HDAA, and SEA had potent, dose-dependent inhibitory effects on the release of the major inflammatory-mediators, nitric oxide, and interleukin-10, and only SEA decreased TNF-α production. Several key inflammatory genes have also been modulated by these RJ fatty acids, with 10-H2DA showing distinct modulating effects as compared to the other two FAs. Furthermore, we found that these three FAs regulated several proteins involved in MAPK and NF-κB signaling pathways. Taken together, these findings provide additional references for using RJ against inflammatory diseases.

  14. The Effects of Royal Jelly on Fitness Traits and Gene Expression in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    John R Shorter

    Full Text Available Royal Jelly (RJ is a product made by honey bee workers and is required for queen differentiation and accompanying changes in queen body size, development time, lifespan and reproductive output relative to workers. Previous studies have reported similar changes in Drosophila melanogaster in response to RJ. Here, we quantified viability, development time, body size, productivity, lifespan and genome wide transcript abundance of D. melanogaster reared on standard culture medium supplemented with increasing concentrations of RJ. We found that lower concentrations of RJ do induce significant differences in body size in both sexes; higher concentrations reduce size, increase mortality, shorten lifespan and reduce productivity. Increased concentrations of RJ also consistently lengthened development time in both sexes. RJ is associated with changes in expression of 1,581 probe sets assessed using Affymetrix Drosophila 2.0 microarrays, which were enriched for genes associated with metabolism and amino acid degradation. The transcriptional changes are consistent with alterations in cellular processes to cope with excess nutrients provided by RJ, including biosynthesis and detoxification, which might contribute to accelerated senescence and reduced lifespan.

  15. Determination of amino acids and protein content in fresh and commercial royal jelly from Bulgaria

    Directory of Open Access Journals (Sweden)

    R. Balkanska


    Full Text Available Royal jelly (RJ is popular among consumers around the world due to its perceived health benefits. The purpose of this study was to assess the levels of free and total amino acid profile as well as protein content in order to characterize Bulgarian RJ samples. A total of 17 fresh and commercial RJ samples from different regions of Bulgaria were analyzed. The results obtained show that proline (Pro, lysine (Lys, methionine (Met, aspartic acid (Asp, cysteine (Cys, histidine (His were major free amino acids (FAAs in RJ. The average content of Pro was 2.3 mg/g. The FAA content ranged from 5.5 to 6.2 mg/g of RJ. The most abundant total amino acids (TAAs were aspartic acid (Asp, glutamic acid (Glu, lysine (Lys, leucine (Leu, serine (Ser and proline (Pro. The average TAA content in fresh and commercial RJ were 129±10 and 114±8 mg/g, respectively. The results obtained for TAA content were used to establish a range for amino acid composition of Bulgarian RJ. The content of proteins was higher in fresh RJ than in commercial samples and this difference was significant (p<0.05. The following ranges were observed for fresh and commercial samples 14.7–17.3 and 12.5–14.9 mg/g, respectively. DOI:

  16. Private finance initiative hospital architecture: towards a political economy of the Royal Liverpool University Hospital. (United States)

    Jones, Paul


    Sociological analysis has done much to illuminate the architectural contexts in which social life takes place. Research on care environments suggests that the built environment should not be understood as a passive backdrop to healthcare, but rather that care is conditioned by the architecture in which it happens. This article argues for the importance of going beyond the hospital walls to include the politics that underwrite the design and construction of hospital buildings. The article assesses the case of the yet-to-be-realised Liverpool Royal University Hospital, and the private finance initiative (PFI) funding that underpins the scheme, which is suggested as a salient 'external' context for understanding architecture's role in the provision of healthcare of many kinds for many years to come. PFI has major implications for democratic accountability and local economy, as well as for the architecture of the hospital as a site of care. Critical studies can illuminate these paradoxically visible-but-opaque hospital spaces by going beyond that which is immediately empirically evident, so as to reveal the ways in which hospital architecture is conditioned by political and economic forces. © 2018 Foundation for the Sociology of Health & Illness.

  17. The dreams of a cancer patient: a "royal road" to understanding the somatic illness. (United States)

    Calogeras, R C; Alston, T M


    In this paper we have presented the principal dreams of a 39-year-old female patient in order to demonstrate how closely the dreams were linked with the understanding of her cancerous condition. The analysis, lasting over a period of eight years, ended with the remission of the patient's cancerous condition to the point where she was without pain and symptom-free. The findings suggested that her dreams played a special role in her analysis by providing important landmarks regarding her treatment's progress and state of her cancerous condition. In a general sense, it was concluded that the patient's dreams did provide a "royal road" to understanding her somatic illness. Specifically, it was concluded that, first, the patient's dreams were able to represent quite reliably, in symbolic form, the state of her cancerous condition; second, that the cancer condition and transference-countertransference reactions were closely entwined; and third, that each of the patient's dreams seemed to be introduced by a crisis situation connected with a traumatic early memory.

  18. Heritage Landmark of the Royal Town of Klang: Balai Bomba Klang Selatan (United States)

    Sulaiman, Normah; Powell, Robert


    The arrival of the British colony in Kuala Lumpur sparked a radical change in the town in terms of infrastructure and town planning. Due to the British Empire’s reign over Malaya in the advent of 20th century, the colonial architectural style has influenced a lot of important building in the royal town of Selangor. Some of the building is abandoned disrespect, disregard and it’s frightening. Many deemed historic buildings and structures disappears in exchange for modernity, which is a threat to the townscape and history. The local council of Klang aims to preserve clusters of colonial sights, place of worships, schools, and remnants of a fort that has shaped the town enabling people to be more appreciative towards it. Located in the heart of Klang town, the fire station sits next to another heritage trail icon, Raja Abdullah Warehouse. Without proper documentation and curation, the building significant will remain unknown and eventually disappear. The core of this paper will showcase the building design quality and its importance, as the first attempt to document the Balai Bomba Klang Selatan to assist in conserving its tangible and intangible qualities. The study aims to collate and document the tangible qualities of the fire station to complement the measured drawing exercise.

  19. Surgical therapy in chronic pancreatitis. (United States)

    Neal, C P; Dennison, A R; Garcea, G


    Chronic pancreatitis (CP) is an inflammatory disease of the pancreas which causes chronic pain, as well as exocrine and endocrine failure in the majority of patients, together producing social and domestic upheaval and a very poor quality of life. At least half of patients will require surgical intervention at some stage in their disease, primarily for the treatment of persistent pain. Available data have now confirmed that surgical intervention may produce superior results to conservative and endoscopic treatment. Comprehensive individual patient assessment is crucial to optimal surgical management, however, in order to determine which morphological disease variant (large duct disease, distal stricture with focal disease, expanded head or small duct/minimal change disease) is present in the individual patient, as a wide and differing range of surgical approaches are possible depending upon the specific abnormality within the gland. This review comprehensively assesses the evidence for these differing approaches to surgical intervention in chronic pancreatitis. Surgical drainage procedures should be limited to a small number of patients with a dilated duct and no pancreatic head mass. Similarly, a small population presenting with a focal stricture and tail only disease may be successfully treated by distal pancreatectomy. Long-term results of both of these procedure types are poor, however. More impressive results have been yielded for the surgical treatment of the expanded head, for which a range of surgical options now exist. Evidence from level I studies and a recent meta-analysis suggests that duodenum-preserving resections offer benefits compared to pancreaticoduodenectomy, though the results of the ongoing, multicentre ChroPac trial are awaited to confirm this. Further data are also needed to determine which of the duodenum-preserving procedures provides optimal results. In relation to small duct/minimal change disease total pancreatectomy represents the only

  20. Surgical Skills Beyond Scientific Management. (United States)

    Whitfield, Nicholas


    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.